Should Boys be Circumcised?

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Morris cites numerous alleged and exaggerated benefits for circumcision. Circumcised doctors often promote “benefits” of circumcision because they have an emotional or cultural need to justify their own condition, their cultural bias, or their medical training. They misuse their professional status and the medical literature to promote alleged benefits and to assert their own pro-circumcision agenda. Physicians are not cultural brokers.

To address Morris’ claims:

1.    Phimosis is a vague term, which applies to normal physiological phimosis as well as pathological phimosis, which may be problematic. Physiological phimosis resolves itself without intervention. Promoting surgery for a normal developmental stage is unethical. The incidence of post-circumcision phimosis exceeds the incidence of phimosis in intact males.

2.    The natural moisture under the foreskin contains essential oils, which keep the mucosa of the glans penis and pathogen-fighting substances in good health.  Inflammation and infection rarely are a problem in normal males and, should they occur, are easily treated with antibiotics.

3.    Studies that show an increase in urinary tract infection (UTI) in intact males have so many methodological flaws that they cannot be seriously considered. The incidence of circumcision in Australia and Canada has plummeted without an increase in UTI. To the contrary, as circumcised declined, Australia has reported an increase in child heath. It is much more ethical to treat UTIs with antibiotics.

4.    Penile cancer is a rare disease of the elderly, not infants or children. It makes no sense to circumcise an infant to prevent penile cancer in old age. The infant is likely to die of other causes before he is old enough to have penile cancer. The incidence of penile cancer is lower in Denmark, where circumcision is rare, than in the U.S. where circumcision has been the norm. The incidence of penile cancer is 1:100,000 men. To put this argument in perspective, 1:9 males will get breast cancer. According to Gairdner, there will be 15 deaths with every 100,000 circumcisions. So, to save on elderly male from penile cancer, 15 babies will die. Furthermore, and sadly ironic, when penile cancer does occur, the circumcision scar is often the location.

5.    Studies that show circumcision prevents HIV infection are gravely flawed. In any event, Australian and American medical authorities have refused to recommend circumcision in those nations.

6.    With regard to sexually transmitted diseases (STDs), the National Health and Social Life Survey (NHSLS) found more STDs in circumcised men.

7.    With regard to chlamydia, the NHSLS found no chlamydia in non-circumcised intact males, so there is to reason to believe that an intact male puts a woman at risk. With regard to HPV, the major risk factors are sexual behavior (sexual activity at an early age and multiple partners), and smoking.

8.    Contrary to Morris’ assertions, women are more likely to climax with an intact partner.

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Don't believe the NOCIRC lies of Milos


Scientific facts obliterate Milos' unsubstantiated opinions. What she says is pure fiction. Doctors have no interest in promoting anything but evidence-based facts. The only hidden agendas lie with the one or two doctors who belong to a minority organization with the grandiose title of 'Doctors Opposing Circumcision', used to fool the general public into thinking a lot of doctors are opposed to circumcision. There are, of course bad doctors. One, an outspoken anti-circ advocate, Fleiss, is a convicted criminal who escaped jail by testifying against his daughter, and served a suspended sentence for money laundering. Various tragic outcomes of his particular medical abilities have been recorded. Even Milos seems to admit that in the USA most doctors are in favour of circumcison. Then presents fantasies of her own as to why this might be so.

To debunk her various points:
 
1. All boys are born with a foreskin attached to the underlying head of the pe.nis and in 90% it detaches with time. But in 10% it doesn't. These older children and men have physiological phimosis, most effectively cured by circumcision. Some have a pathological phimosis. There is little point trying to preserve the foreskin when removing it also has so many other lifetime benefits (see www.circinfo.net).

2. The moisture under the foreskin is sweat and other secretions that serve as a breeding ground for bacteria, so that this 'smegma' has a foul odor. Inflammation and infection are much more common in uncircumcised males (10-20%). The bacteria cause urinary tract infections and in half of boys permanent kidney disease before treatment with antibiotics can be instituted. And antibiotics have no effect against viruses, such as HIV (that causes AIDS and infects via the foreskin), HPV (that is much higher in uncircumcised men, and causes penile cancer and, in the female partners, cervical cancer), and herpes simplex type 2 (genital herpes, that is twice as high in women who have had uncircumcised partners). Women also  So Milos' claims are more myths.

3. Every one of the numerous research studies on urinary tract infections have shown a greater incidence of these in uncircumcised males. The evidence is so strong that a randomized controlled trial (the gold standard of epidemiology) would probably not get ethical approval, as it would deny infant males the early benefit of this health-conferring procedure. The other statements by Milos here are ridiculous - we all know that health has improved over time - but rising rates of UTIs have accompanied the slight reductions in circumcision rates in the 70s and 80s. Fortunately, circumcision rate is now rising again.

4. Penile cancer affects 1 in 600 males over their lifetime, and like most cancers is more common in older age groups, but can affect the young. Milos uses deception by citing the annual incidence rates. Compare fatal heart attack, which has an annual incidence of 200 in 100,000, but as we all know 1 in 4 people die of a heart attack as the event that ends their life. The other arguments Milos uses here are nonsensical and show she has no concept of epidemiology or a scientific study design. The rubbish about deaths from circumcision is pure fiction. Perhaps she is referring to circumcision performed by witch-doctors in remote tribal settings. There are no deaths from circumcision in Western settings. And as for the rubbish about where penile cancer occurs - it is over 20 times more common in uncircumcised men and can affect the head of the pe.nis lying under the foreskin that is the cause.

5. The evidence that circumcision prevents HIV infection is rock solid. This is now an established facts, supported by 3 large randomized controlled trials and 40 observational studies. Circumcision for HIV prevention is now endorsed by the World Health Organization and is being rolled out first in populations with high HIV prevalence as a cost-effective means of lowering AIDS. Mischievous attempts by anti-circ activists to dispute the evidence have been demolished by a 46-author article that includes scientists and doctors from around the world, as well as from WHO, UNAIDS and the World Bank.

6. As for STDs (now termed STIs), it is well known and established by randomized  controleld trials, that uncircumcised men are more susceptible to HIV, genital ulcer disease, herpes, HPV and trichomosas. There is no difference in gonorrhoea or chalamydia. The National Health and Lifestyle Survey found circumcised men were more sexually active, so any increase in the latter two STIs was due to more exposure. This survey may also reflect the preferences by women and the sexual problems of uncircumcised men.

7. A large multinational research study published in the prestigious Am J Epidemiol by Castellsague et al. in 2005 showed up to 5.6 times higher chlamydia in women who had ever had sex with an uncircumcised man, this upper level being for men who had had 6 or more other sexual partners in their lifetime (which is common).

8. Women's sexual response and satisfaction are greater when the man is circumcised. Milos is probably referring to NOCIRC's own internal propaganda, rather than credible research published in good peer-reviewed journals. Milos' off-the-cuff statements have no credence.