Saturday, 6 March 2010

Circumcision and human rights

This is a fascinating article from UNAIDS, entitled "Safe, Voluntary, Informed Male Circumcision and Comprehensive HIV Prevention Programming: Guidance for decision-makers on human rights, ethical and legal considerations".

I think this quote captures its essence:

Given that it reduces a man’s risk of acquisition of HIV through penile–vaginal intercourse, male circumcision provides an opportunity to reinforce HIV prevention efforts and thereby promote human rights. A human rights-based approach to introducing or expanding male circumcision services requires measures to ensure that the procedure can be carried out safely, under conditions of informed consent, and without discrimination. From a public health and human rights perspective, it also requires that governments implement male-circumcision programmes in the context of a comprehensive HIV prevention framework. This will ensure that “risk compensation” (i.e. increases in risky behaviour sparked by decreases in perceived risk) (Cassell et al., 2006) does not undermine the partially protective effects of male circumcision for men.


(Emph. added)

I'll also add the following quote re infant circumcision:

Studies have shown that the circumcision of infants is simpler and carries fewer medical risks than circumcision of older people. Parents considering circumcision of an infant boy should be provided with all the facts so they can determine the best interest of the child. In these cases, determining the best interests of the child should include diverse factors—the positive and negative health, religious, cultural and social benefits. Because the HIV-related benefits of circumcision only arise in the context of sexual activity, and because male circumcision is an irreversible procedure, parents may consider that the child should be given the option to decide for himself when he has the capacity to do so.


It's an excellent document, worth reading in full.

5 comments:

James said...

"Studies have shown that the circumcision of infants is simpler and carries fewer medical risks than circumcision of older people."

Which studies are these? With around 3.4% of circumcised boys being referred to pediatric urologists for circumcision complications, you make adult circumcisions seem a very risky prospect, although Dr Reid < www.gccircumcisions.com.au/circumcision.html > suggests adult circumcisions are pretty straightforward. Who to believe...?

"Circumcision does not interfere with work/study. You need the day of your circumcision off, but some of my patients return to work the next day even though a day or two of rest is ideal."

Jake said...

I'm not sure how you're getting this 3.4% figure, but it is much, much higher than the 0.2-0.6% figure quoted by the AAP.

Vikinggirl said...

Typically Jake you missed the most important statement in the whole document: "Mandatory or coerced male circumcision is a violation of a range of human rights,
including rights to dignity, bodily integrity and personal autonomy."

You had a choice in your circumcision and since then have been absurdly determined to deny this choice to others. Infant circumcision is forced circumcision, let's be in no doubt. The man who has to live with the consequences throughout his sex life gets no choice, and if he grows up gay he gets no benefit (it remains unproven in fact whether anyone gets a long term benefit).

The bit about infant genital surgery being safer is unreferenced. And guess why? Because the evidence shows the opposite.

http://www.cirp.org/library/complications/machmouchi2007/

Jake said...

Hello Vikinggirl,

I don't consider infant circumcision to be forced or mandatory, as long as the decision is made at the parents' discretion. And, given the paragraph about infant circumcision that I quoted, I don't think your interpretation was intended by the authors.

To respond to a couple of specific points:

and if he grows up gay he gets no benefit

What on earth makes you say that? The evidence regarding HIV among homosexual males is less certain than that for heterosexuals, but most other benefits apply equally regardless of sexual orientation.

The bit about infant genital surgery being safer is unreferenced. And guess why? Because the evidence shows the opposite.

Well, Horowitz and Gershbein immediately springs to mind...

Jake said...

I'm rejecting an anonymous comment, because it quoted an article in its entirety. Allowing it would have placed the blog at risk due to copyright violation.

Anon, you're welcome to re-post if you wish, but please quote only the key sentence(s).