Showing posts with label WHO. Show all posts
Showing posts with label WHO. Show all posts

Thursday, May 19, 2016

MALAWI: USAID-Funded Program Kidnapping Children for Circumcision - Boy Loses Penis


As if it weren't already bad that circumcision advocates were using questionable "research" to push "mass circumcision campaigns" in Africa under the supposed guise of "HIV prevention," apparently US-funded organizations are now simply taking the liberty of kidnapping children off the streets and circumcising them without their parents' approval.

According to this report, SSDI, a component of the Malawi Ministry of Health, has been simply picking up children off the street, coaxing them with candy, cookies and drinks, forcibly circumcising them without their parents' awareness, and dumping them near their homes, much to their parents' dismay upon discovery.

SSDI apparently receives support from USAID to promote and perform male circumcisions through a campaign known as the "Sankhani HIV Prevention Project."

In one particular case in Chipakuza Village, T/A Lundu in Chikhwawa, a 9-yo boy has lost his entire penis, and his angry father is seeking to sue the Malawi Ministry of Health for damages.

The lawsuit documents served to the Attorney General and Chikhwawa District Hospital, stressed the need for authorities to take this matter seriously, chiefly citing the fundamental right of the minor, which had been violated, and the fact that the parents' wishes were not disregarded.

Furthermore, the father has complained that the people involved forcefully circumcised his son against the values and customs of the Sena culture, his culture of origin.

Given that circumcision is elective, non-medical surgery with dubious "benefits" that are already afforded by less invasive, more effective means, given that it was forcibly performed on a healthy, non-consenting child, given that his fundamental rights were violated, and given that his parents were completely disregarded, the fact that this child has lost his penis is a disastrous tragedy in more ways than one.

This needs to be brought to the attention of the WHO and UNICEF; what has happened here is anything but "voluntary."

Related Posts:
MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

Where Circumcision Doesn't Prevent HIV

Where Circumcision Doesn't Prevent HIV II

INTACTIVISTS: Why We Concern Ourselves

JAMA: Lead Article is a "Study" on Bribing Men to Get Circumcised

AFRICA: Creating Circumcision "Volunteers"

Thursday, August 21, 2014

JAMA: Lead Article is a "Study" on Bribing Men to Get Circumcised


So a friend contacts me about a recent "study" published in the current issue of the Journal of the American Medical Association (JAMA).

"You've got to blast it on your blog!" he says.

So I skim through the article and my first thought is "meh."

I mean, so what. Yet another junk "study" that adds nothing of any actual value to science or medical literature, and serves as nothing more than another chance to repeat the same dubious claim, as always, that "circumcision prevents HIV transmission by 60%," and tries to pretend as if it were bygone conclusion. (Researchers can't actually prove that circumcision prevents HIV transmission AT ALL, let alone by 60%.)

What can I say about one more trash "study" that I haven't already said about all the rest? Only just two or three posts ago I posted about promoters using football to coerce teenagers into getting circumcised. They were using bribery as far back as 2011. So what's new to be seen here?

And then he points to the fact that this so-called "study" was actually the lead article in the latest edition of JAMA.

I look again and think "Holy smokes, he's right!" So I decide to take a closer look. (Readers can read the abstract here.)

The "study" is titled:

"Effect of Providing Conditional Economic Compensation on Uptake of Voluntary Medical Male Circumcision in Kenya: A Randomized Clinical Trial"

The title tries very little to hide the fact that the article is only extremely remotely related to medicine. The long and the short of it is, they're trying to see if bribing men will get them to go get circumcised. I've already said this, but the only reason this can be is because "circumcision prevents HIV by 60%" simply isn't selling. African men aren't stupid.


"Gee, if I still have to wear condoms, what's the whole point? NO THANKS!"

More from the abstract:

Objective  To determine whether small economic incentives could increase circumcision prevalence by addressing reported economic barriers to VMMC and behavioral factors such as present-biased decision making.

Translation: Let's see how many men we can bribe into getting circumcised.

It should be noted here that the "researchers," if they can even be called that, are not actually interested in any behavioral factors that matter. They're not interested in seeing if the men are diligently using condoms, for example. (Or if they are not, and hope not to following their circumcisions.) They're not interested in how many sexual partners they have on a weekly or monthly basis, or if they are faithful to one partner or their spouse. Maybe the men feel that since they are faithful, and/or use condoms consistently, they don't feel they ought to be circumcised. And, they would be right.

Also not important to the "researchers," and this would actually be relevant from a "how many men can we dupe into getting circumcised" standpoint; what background were the men from? Did they come from Muslim or tribal backgrounds where circumcision is a social norm, if not expectation? How many were from tribes where NOT being circumcised is important? This is a very important factor; it's not "news" if men who would be circumcised at an initiation school anyway agreed to get circumcised for money in a clinical setting. How many men were actually convinced to get circumcised by financial incentive? How many were already going to get circumcised, but joined the program for the cash?

Only one behavioral factor seems to be important here: What will get the men to comply with having part of their penis cut off?

Design, Setting, and Participants  Randomized clinical trial conducted between June 22, 2013, and February 4, 2014, among 1504 uncircumcised men aged 25 to 49 years in Nyanza region, Kenya. VMMC services were provided free of charge and participants were randomized to 1 of 3 intervention groups or a control group.

"Randomized clinical trial" for what, exactly? What drug or form of medical treatment was being tested for efficacy? It seems the only thing "clinical" about this so-called "trial" was the fact that it was conducted by doctors at clinics, and the only thing "random" about it was what group the men would land in. All of them were offered circumcision.

Interventions  Participants in the 3 intervention groups received varying amounts of compensation conditional on undergoing circumcision at 1 of 9 study clinics within 2 months of enrollment. Compensation took the form of food vouchers worth 200 Kenya shillings (≈US $2.50), 700 Kenya shillings (≈US $8.75), or 1200 Kenya shillings (≈US $15.00), which reflected a portion of transportation costs and lost wages associated with getting circumcised. The control group received no compensation.

In short, groups were offered different amounts of money in increasing increments; the control group was there to see how many men could be conned into needless surgery for nothing.

Main Outcomes and Measures  VMMC uptake within 2 months.

That men would submit for circumcision was an expected outcome; the study was not conducted to measure "whether or not" financial incentive worked in convincing men to get circumcised, but "how well."

Results  Analysis of data for 1502 participants with complete data showed that VMMC uptake within 2 months was higher in the US $8.75 group (6.6%; 95% CI, 4.3%-9.5% [25 of 381]) and the US $15.00 group (9.0%; 95% CI, 6.3%-12.4% [34 of 377]) than in the US $2.50 group (1.9%; 95% CI, 0.8%-3.8% [7 of 374]) and the control group (1.6%; 95% CI, 0.6%-3.5% [6 of 370]). In logistic regression analysis, the US $8.75 group had significantly higher VMMC uptake than the control group (adjusted odds ratio [AOR] 4.3; 95% CI, 1.7-10.7), as did the US $15.00 group (AOR 6.2; 95% CI, 2.6-15.0). Effect sizes for the US $8.75 and US $15.00 groups did not differ significantly (P = .20).
Conclusions and Relevance  Among uncircumcised men in Kenya, compensation in the form of food vouchers worth approximately US $8.75 or US $15.00, compared with lesser or no compensation, resulted in a modest increase in the prevalence of circumcision after 2 months. The effects of more intense promotion or longer implementation require further investigation.

Or, in short, the more money you shell out, the more men are likely to agree to having part of their penis cut off. (Surprise, surprise...)

Conclusion
There are so many things wrong with this "study," I don't even know where to start.

How can this even be called "research" or a "study?" It's not looking to contribute anything of actual value to science or medicine. This "study" is about nothing, on a topic that isn't even remotely related to medicine, yet it gets the lead spot in JAMA. It proves nothing more than that, the more money you offer men, the more likely they'll be to do what you ask them to, in this case, submit to non-therapeutic surgery.

Is it even ethical to conduct this kind of "study" on financial incentive in a setting where food, water and other supplies are scarce? Wouldn't most men say yes to money in situations where it is scarce, regardless of how they feel about HIV prevention and the proper use of condoms? How ethical is it to exploit the financial situations of people who are already in dire poverty, to offer them a dubious form of "protection" from HIV, which is already far superseded by less expensive, less invasive, more effective means?

They call it "VMMC" which stands for "VOLUNTARY Male Medical Circumcision." How is it "voluntary" if you're continuously looking for ways to put men between a rock and a hard place?

As I've told my friend, what more can I say?

This is just one more in a long line of other "studies" that look for the same thing; "Acceptance. Feasibility. Demand creation."

And it will not stop here.

Circumcision "researchers" are desperately looking for every which way they can to get the men to go circumcise themselves on a supposed "voluntary" basis, I will not be surprised to see "studies" on the "effect" of celebrity endorsement. Sex appeal. Sports. Money. Emasculation. Outright insults. Whatever works.

Because "circumcise to prevent HIV" isn't working.

Be on the lookout for an upcoming onslaught of  circumcision "research."

Watch as the message of "prevent HIV" is slowly replaced with "get yourself circumcised."

The way progress in the fight against HIV should be measured is how many cases of HIV/AIDS have been avoided, but this is slowly being replaced by how many men have been circumcised, and it ought to concern those interested in reducing HIV transmission in Africa.




"Most studies on male circumcision, including the Kenya Aids Indicator Survey 2013 (KAIS), have so far concentrated on the quantity of procedures but none has shown it is achieving its primary objective of reducing HIV infections. Started almost seven years ago, on the promise that it could reduce the risk of infection by 60 per cent, the KAIS report showed a spike in prevalence in places like Nyanza where the circumcision programme is most intense."~Standard Digital
There is something wrong when progress on the HIV front is measured, not by how much HIV infection has decreased in time, but by how prolific the practice of circumcision has become. It is simply mistaken to assume that a mostly circumcised population automatically translates to a lowered HIV transmission rate, as real-world data indicates.

The way so-called "researchers" are trying to pass their brainwashing strategies as legitimate "science" and "research" is a complete disgrace.

It is outrageous, despicable and disgraceful that no one at JAMA sees a problem with this.

How was this "study" approved to go on? Who agreed to fund it? Why hasn't there been any kind of public outcry from respected medical communities around the world deploring this horrendous conduct? Who at the IRB approved this unethical "study?" What was the editor of JAMA thinking when he decided to make this the "lead study?" Is the AMA going to voice any complaint?

Lies are being spread. Garbage is being passed off as "research" and being used to shape public health policy. This is not the first "study" of this kind. They have been going on since the WHO endorsed circumcision as "HIV prevention." Why does it seem respected medical organizations are not concerned that this is going on?

Why isn't the WHO concerned that their endorsement of circumcision as "HIV prevention" is resulting in horrendous misconduct on the part of "researchers," circumcision promoters and even amongst African tribes themselves?

It ought to concern respected medical organizations around the world that "research" on what is essentially the financial coercion of men living in poverty to comply with non-therapeutic surgery was published as the leading article in a medical journal of a respected medical organization.

Readers are encouraged to write to representatives at medical organizations in their respective countries, as this is an issue that needs to be addressed. American readers, you are encouraged to write to the AMA and the editors of their JAMA journal. Other medical organizations need to be concerned that this is what passes today as legitimate "research."

I repeat, the WHO must be made aware of this, and respected medical organizations and influential doctors and researchers ought to call for the WHO to withdraw their endorsement of male genital mutilation as HIV prevention.

Human experimentation in Africa must end, and the rights of non-consenting individuals ought to be respected.

How about we give Africans food and water, and not make genital mutilation a condition for not dying of hunger or thirst?

Readers, please express your outrage to the AMA, JAMA and other respected medical organizations about this so-called "research" happening in Africa today. Let them know that this is NOT acceptable conduct for people that call themselves "researchers" and/or medical professionals.

Related Posts:
MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

AFRICA: Creating Circumcision "Volunteers"

AFRICA: When Propaganda Fails, Try Bribery

 CIRCUMCISION "RESEARCH": Rehashed Findings and Misleading Headlines

Where Circumcision Doesn't Prevent HIV


Where Circumcision Doesn't Prevent HIV II


Sunday, May 18, 2014

MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

Photo taken from ploscollections.com

It seems organizations intent on seeing the whole of Africa circumcised are growing ever desperate that their "mass circumcision campaigns" aren't working out as they had wished.

The pretext for promoting male circumcision for all is "HIV prevention," and sprinkled here and there, on various HIV organizations, one can read slogans along the lines of "an AIDS-free world." Or "an AIDS-free generation." "We can achieve it!," spokespeople say. "And the solution is circumcision!"

To begin with, "circumcision prevents HIV" is already a dubious, wishy-washy premise. Promoters of circumcision-as-HIV-prevention are careful in the way they present circumcision. They can't verily say "Circumcision prevents HIV," because it doesn't. They can't also say "Circumcision fails to prevent HIV, so circumcised men still have to wear condoms" either, because that would drive HIV charity donors, not to mention the men they're trying to convince, away.

No. They have to say "circumcision reduces HIV transmission by as much as 60%," that "circumcision is not foolproof" and that it has to be "part of a comprehensive package." They have to gloss over the fact that they've yet to establish a scientifically demonstrable causal link between the presence of the foreskin and increased HIV transmission, and/or between circumcision and decreased HIV transmission. They have to be careful to not bring any attention to the reality that a reduction in HIV transmission has not been observed in other populations where the majority of men are already circumcised, including other parts of Africa, South East Asia (e.g. Malaysia and The Philippines), and the United States.

The dubiousness of circumcision as an HIV prevention method goes further back. Promoters of circumcision would like to pretend as if circumcision were this "brand new innovative technology" that they've only "just found" yesterday, when history tells us that circumcision advocates have been trying to make circumcision relevant to medicine for at least 150 years. The idea that circumcision might do anything to prevent HIV is itself close to 30 years old.

Not to mention the fact that the practice itself has been under fire as far back as Greco-Roman rule; there are other, deep-running convictions to defend circumcision which have absolutely nothing to do with a genuine concern for disease prevention and public health. Circumcision may be an important rite of passage for members of certain tribes, for example. It is considered divine commandment by Jews, Muslims and certain Christian sects (although circumcision is not once mentioned in the Qur'an, and the New Testament says circumcision profits the Christian nothing.)


 Jews have defended the practice of infant circumcision for centuries

With circumcision already being part of the culture in most, if not all, African countries, it's not too hard to find a captive audience that can be wooed by slogans to the effect that circumcision is medically advantageous, and that everyone ought to be circumcised.

Circumcision is already a rite of passage for many tribes and peoples in Africa

I personally suspect that that has been the plan all along; that circumcision promoters aren't the least bit interested in preventing disease, but in reinforcing pre-existing partiality to circumcision, and using it to their advantage in proliferating the practice of circumcision and ensure its continuance, both in Africa and elsewhere.

A Hard Sell
It seems despite their best efforts, circumcision promoters are failing to meet their quotas. "Those foreskins are flying," assures Robert Bailey in the New York Times, but, if reports from Africa are to be believed, not fast enough. Circumcision promoters have tried everything in the book, from celebrity endorsement, to songs on the radio, to art exhibitions, to patriarchal endorsement, to legislative proposition of compulsory circumcision for all (there goes the "voluntary" part of the program...), to bribery.

There was an initial surge of men lining up to get circumcised at medical facilities, but that has pretty much died down, and now circumcision promoters are at their wit's end trying to encourage more men to get circumcised.

In Swaziland, the "Soka Uncobe" (or "Circumcise and Conquer") campaign was launched with the intention of circumcising 80% of the male Swazi population (that's 200,000 men), but the program ended in failure, as after four years, the program was able to convince only 20% (roughly 34,000 men) of the population to undergo circumcision.

Programs in other countries are also facing the same failure to circumcise the number of men they want, such as in Zimbabwe Botswana, Zambia and Kenya.

My suspicion is that the men who did go in to get circumcised, were men who belonged to tribes and cultures where circumcision is already a rite of passage, and who were going to be circumcised anyway. Perhaps there were a few gullible men here and there who actually bought into the circumcision/HIV propaganda, but on the whole, those who went in were probably only men who couldn't care less about the potential HIV reduction, who said whatever they had to in order to cash in on a free and "safe" circumcision. All of the men who were going to get circumcised have gotten circumcised, so there's no one left, until new tribe or Muslim initiates come of age.

And now, it seems, circumcision promoters are asking themselves, "What could be the problem? What has gone wrong? Why aren't men breaking down the doors to have part of their penis cut off?"

"Circumcise or bust!" seems to be the motto.

"We need to do whatever it takes to get as many men and boys circumcised."

And this, I believe, is what's wrong with HIV programs in Africa today. There is something wrong when progress on the HIV front is measured, not by how much HIV infection has decreased in time, but by how prolific the practice of circumcision has become. It is simply mistaken to assume that a mostly circumcised population automatically translates to a lowered HIV transmission rate, as real-world data indicates.

Latest Ploy: Sex Appeal
Circumcision advocates have been trying to use the influence of women to try and see if they could coerce men to go get circumcised. For a while now, programs like PEPFAR have been trying to sell circumcision as "beneficial to women," rather farfetched, as, even if the so-called "research" is correct, circumcision would only reduce HIV transmission from women to men. Actually, research shows that women are 50% more likely to acquire HIV from a circumcised partner, but this fact is ignored. In sub-Saharan Africa, women constitute 60% of people living with HIV, according to none other than the WHO itself. Circumcision promoters, however, still insist that male circumcision eventually benefits women "because less men being infected with HIV means less women will be infected."

To be quite sure that women will be interested in making sure their partner is circumcised, other dubious claims are sprinkled into the mix, such as a claimed reduction in HPV, which exclusively affects women, and other STDs. (Actually, studies are conflicting regarding the HPV claim. The claim falls apart in light of recent data, but circumcision proponents continue to adorn HIV propaganda with it none the less.)

But now, it seems, circumcision promoters are through with trying to use pseudo-scientific alibis to get women to influence the men, and are now turning to flat-out emasculation and harassment.

The following posters are apparently being used as part of the circumcision propaganda going on in Africa:





Even when the Soka Uncobe campaign was underway in Swaziland, promoters tried to appeal to masculinity, implying that circumcision would make them more attractive in the eyes of women.

Is this what it has come to?

Circumcision Now a Matter of "Respect"
Recently, I came across PLoS' Facebook page, on which it was promoting the release of circumcision propaganda articles. Intactivists, such as myself, as well as other concerned people have posted questions on their Facebook page, but it seems the best they or anyone else can do is offer the same canned responses always given. It's always the same "Research shows circumcision to prevent HIV by 60%, but it must be used with condoms" soundbites. When asked for answers, all they can do is post links to other articles that repeat the same thing. "The programs are working. Circumcision reduces HIV transmission. Circumcision is as effective as a vaccine. Our studies show that." They can't seem to offer any real answers to the questions we ask directly though.

What is the demonstrable causal link between the foreskin and increased HIV transmission? Or between circumcision and decreased HIV transmission?
Even if one can be furnished, what does it matter that a man is circumcised if he still has to wear a condom for real protection?
Wouldn't said causal link also apply to female genitals, seeing as the same tissues and cells exist in the vulva as they do in males?
What if a man is faithful to his wife? Why would a faithful couple be encouraged to have the male partner circumcised?
Have HIV organizations considered that males may not want to get circumcised, even given the information?
Are there any information packages prepared for males who do not want to undergo circumcision?
Are women encouraged to support their male partner in being faithful and using condoms if the male doesn't want to get circumcised?
Or is circumcision the only option?
If circumcision is so effective at preventing HIV, why must men still wear condoms?
If circumcision is so effective at preventing HIV, why was HIV found to be more prevalent in circumcised men in 10 out of 18 African countries, according to USAID?
If circumcision is so effective at preventing HIV, why does the United States have a higher HIV prevalence rate than 53 countries where circumcision is rare (e.g. under 20%) or not practiced, according to the CIA Fact Book?
How is something that never worked in a first world country like the United States, going to suddenly start working miracles in Africa?
How is it "voluntary" if there's a quota of 80% of African men?

The photo at the head of this article shows a man in a T-shirt. The T-shirt reads "EARN RESPECT: TEST AND CIRCUMCISE."

Is this what it has come down to?

A man can't be respected unless he is circumcised?

What if he tests, is STD-free, and consistently wears condoms?

This is not enough to earn "respect?"

As an intact man who is STD-free and faithful to his wife, I am insulted. Is what I do not enough? Do I not deserve respect until I have part of my penis cut off? Is this what they call "voluntary?" How is this not outright coercion?

Circumcision/HIV propaganda has gotten out of hand. I think it's about time human rights organizations stepped in and stopped this madness. This isn't HIV prevention, this is outright harassment and humiliation masquerading as medicine and foreign aid.

A Disservice in the Fight Against HIV/AIDS
We intactivists keep saying time and time again; the promotion of circumcision is going to make the HIV/AIDS problem WORSE, because it gives men and women a false sense of security, and an excuse to forgo condoms, which, even given the so-called "evidence," would still supersede circumcision. News outlets and organizations report that men are already saying they don't have to wear condoms, and that it is hard for women to convince emboldened circumcised men to wear condoms. In a Botswana sex scandal, a woman claims that the health minister she slept with couldn't have infected her with HIV because he's circumcised. (The research says SHE can't infect HIM IF she were HIV+.)

In response to questions about risk compensation, circumcision promoters like PLoS and Richard Wamai assert flatly that the evidence for it "doesn't exist," that the evidence that does exist (theirs, of course) says that risk compensation isn't a problem. However, absence of evidence is not equivalent to evidence of absence.

The following articles certainly show that a false sense of security in circumcised males is a problem:

UGANDA: Myths about circumcision help spread HIV

ZIMBABWE: Circumcised men abandoning condoms

Here is evidence of risk compensation that “simply does not exist” – according to some:

Botswana – There is an upsurge of cases of people who got infected with HIV following circumcision.

Zimbabwe – Circumcised men indulge in risky sexual behaviour

Nyanza – Push for male circumcision in Nyanza fails to reduce infections

Providing a dubious form of "protection," which can, and is being perceived in Africa by men and women, as an alternative to the most conclusively effective mode of prevention, condoms, is a disservice in the fight against HIV/AIDS.

If indeed men are walking away with the message that they don't have to wear condoms because they're circumcised, then intactivist predictions were right all along; the promotion of circumcision is spreading HIV/AIDS, and millions, if not billions in precious funds are being squandered on a dubious mode of prevention that is not only not helping, but making things worse, where the money could be better spent on promoting more effective ways of HIV prevention, if not on other, much needed medicine.

A Crime Against Humanity
It is simply despicable that the very idea that circumcision could do anything to prevent HIV transmission was even considered at all. It horrifies me that some people actually took it a step further and decided to test this hunch, with absolutely no demonstrable causal link, by circumcising thousands of men to see which ones would get HIV and which ones would not. One would think that scientists and researchers learned their lesson after Tuskegee. I don't even know what to think, now that entire "mass circumcision campaigns" are being carried out based on dubious "studies" which continue to have no scientific foundation, whose results were ill-conceived and exaggerated, where the claim that circumcision has anything to do with HIV transmission is pure correlation hypothesis.

I ask, what if it could be proven with "research" that the removal of the labia and clitoral hood "reduced the likelihood of HIV transmission" from female to men? The disproven hypothesis that the Langerhans cells facilitate HIV transmission in males, as they are found in the mucosal lining of the foreskin, would also apply to female genitalia, whose mucosal lining is lined with the same cells. In at least one study, it would appear that HIV was less prevalent in circumcised women. And yet, there was no rush to test and see if this worked. No "trials" to circumcise thousands of women to see what "effects" this might have on HIV transmission.

Why?

Because no one is interested in justifying female genital cutting; it is clear to everyone that female circumcision is unethical, and no amount of "research" could be used to justify it. The converse is true with circumcision, where "researchers" are trying to "prove" that male circumcision, particularly the forced circumcision of males, is "ethical" by showing it is "not harmful," even "beneficial" to males. We have this double-standard where the vindication of female genital cutting through "science" and "research" is unacceptable and flatly rejected, but the vindication of male genital cutting is not. No organization would ever approve of similar "trials" in African women as they were in African men. Dissenters would argue that if positive findings were published, advocates of FGM would pounce upon them as vindication, and rightly so.

And yet, this wasn't a concern with male circumcision.

It wasn't a concern that advocates of circumcision would use the "research" to justify forced genital mutilation in boys and men.

I will go as far as to wager that the justification of forced genital mutilation in boys and men is precisely what the "researchers" had in mind.

No, actually, I KNOW for a fact that is what they had in mind; the idea that circumcision could "prevent HIV/AIDS" was actually heavily promoted by Jewish circumcision advocate Aaron J. Fink, out of disdain for policy statements of medical organizations at the time, which were already saying that infant circumcision was harmful. Others jumped on the idea, and they've been trying to "prove" that male circumcision "prevents HIV" ever since.

Much media attention is given to the fact that girls and women suffer FGM by amateurs in the African bush. Attention is brought to the fact that FGM is performed using crude instruments such as glass shards and rusty blades. Attention is brought to the fact that girls are abducted to be circumcised. Attention is brought to the fact that FGM results in death. But little attention is given to the fact that boys and men being circumcised in Africa suffer the exact same predicaments.

In criticizing Sara Johnsdotter and Lucrezia Catania, Hussein Ghanem said that their research, which showed that FGM isn't as detrimental as often portrayed, "played right into the hands of people who defend female genital cutting." But for whatever reason, this wasn't a concern when the WHO endorsed male circumcision as HIV prevention.

Yes, they try very hard to sell the slogan "Voluntary Male Medical Circumcision," as if adding the words "voluntary" and "medical" are supposed to make the fact that male genitals are being cut any more rosy. Somehow, I don't think the words "Voluntary Female Medical Circumcision" could ever be successfully juxtaposed.

But are people aware that boys and men are being forcibly circumcised in Africa? Are they aware that the pretext of "HIV prevention" is being used by some tribes to abduct and forcibly circumcise men in rival tribes? Are they aware that men are going around stopping men, asking them to take down their pants to see if they're circumcised? No doubt some may see this as "poetic justice" for the harassment Jews experienced in the Holocaust. Was this not a concern? Or was this actually an intended consequence to "create demand" for so-called "Voluntary Male Medical Circumcision?"

Here is a list of reports of boys and men being forcibly circumcised:

UGANDA: 220 men forcibly circumcised

UGANDA: HIV campaign confused with circum-rape: no effect on HIV rate


ZIMBABWE: 6 years for kidnapping, forced circumcision

UGANDA: Forced circumcision campaign stopped


UGANDA: Men flee "life-threatening" forced circumcision

UGANDA: Prisoners forcibly circumcised


KENYA: Circumcision forced on men and women - boy dies for refusing

UGANDA: Pretty women entrap intact men for enforced circumcision


SOUTH AFRICA: Taxi drivers fear forced dircumcision

Are people aware that, as in FGM, boys and men also die as a result of their initiation? That boys and men are also being circumcised out in the African bush with crude utensils by amateurs? That many boys and men do in fact lose their penises to gangrene, forcing them to live their life in shame? Why are these facts only a problem when we talk about female circumcision?

Here is a list of reports of boys and men suffering complications, or dying as a result of annual initiation rites:

EASTERN CAPE: Doctor who showed botched circumcisions defended, attacked


SOUTH AFRICA: 27 die from circumcision

SOUTH AFRICA: 29 die: ANC wants faster inquiry


SOUTH AFRICA: 23 die from circumcision

SOUTH AFRICA: Nearly 80 circumcision deaths

SOUTH AFRICA: More than 15 die from circumcision


SOUTH AFRICA: 33 die from circumcision

SOUTH AFRICA: More than 20 die from circumcision


SOUTH AFRICA: "Time to stop this practice"

FREE STATE, SOUTH AFRICA: Four more circumcision deaths


SOUTH AFRICA: Hospitals running out of beds for botched circumcisions


EASTERN CAPE: Circumcision deaths resume: 15 this season

EASTERN CAPE: 42 Circumcision deaths in three weeks

EASTERN CAPE: 20 circumcision deaths

The WHO endorsement of circumcision as HIV prevention has served to embolden forced circumcision wars among rival tribes, and to endorse traditional initiation practices which put the lives of boys and men in danger.

Would the WHO ever endorse female circumcision, even if this were "research-based?"

No. For the reason that they know that it would result in the de facto endorsement of human rights violations. They would not do anything that would "play into the hands of FGM advocates."

So why the different set of rules for male circumcision?

Why the blind eye and deaf ear to the forced MGM inflicted on boys and men? 

Out of Touch
Eight years following the WHO endorsement of circumcision as HIV prevention, and millions of dollars later, African men aren't too keen on the idea of cutting off part of their genitals, and organizations intent circumcising the whole of the African male population seem to be puzzled and frustrated that their programs simply aren't taking off as they would have liked. Here and there one can read articles about circumcision promoters and organizations thinking out loud, asking themselves "What went wrong?"

I've read articles on the PEPFAR website. I've seen videos and articles published by the Bill and Melinda Gates Foundation. I've seen articles published in peer reviewed journals. "Studies" and "research" on the "feasibility" of circumcision scale-up projects, the "acceptability" of circumcision, attitudes in men and women, their views of circumcision.

Instead of seeking to better educate Africans about the sexual transmission of STDs, it seems, promoters are intent in looking for the best way to brainwash them into both, believing circumcising their men and boys is desirable, and that they need to continue using conventional methods of STD prevention, such as fidelity and condoms.

The buzz words going around in circumcision/HIV circles is "demand creation." These words ought to strike audiences as odd, because one would think that the magic words "reduces HIV by 60%" would be a good enough incentive for men to go out and get circumcised, would they not?

"If you build it, they will come" didn't work. And millions have been squandered in ad campaigns all over Africa. In some areas, promoters are turning to bribery.

What could be the problem?

Africans Aren't Stupid
It doesn't take a rocket scientist to figure out why circumcision promoters are having trouble achieving their quotas. You don't need "studies" and "surveys" to figure out why.

Men simply don't see the value of getting circumcised, to undergo a painful, life-altering, permanent surgical alteration, which will permanently change the appearance and mechanics of their penises, if it means they only get "partial protection." Being told that "circumcision reduces HIV transmission by 60%" isn't all that impressive if it means that they still have to wear condoms.

Married men simply don't see the value of getting circumcised if they are faithful to their wives, and therefore not at risk for sexually transmitted HIV.

Women certainly don't want to be made to feel like their man is going out on them with other women. They want to be able to trust their partners with fidelity. So why would they encourage their men to go get circumcised? What can having their husbands go get circumcised mean, other than that they are expecting them to be unfaithful?

That the people up at HIV organizations think that they can actually get away with promoting circumcision the way they do can mean only one of to things; either HIV organizations are dense and stupid, or they believe the African public is.

From an outside, non-African perspective, I simply can't believe the bullshit that western HIV organizations are attempting to feed the people of Africa. Looking at what's going on in Africa, I'm simply insulted as an intact male.

As an intact man, I am expected to believe that, a) circumcision "reduces the likelihood of HIV transmission by 60% (from female to male)," and b) that I still have to wear condoms.


 


I ask, why in the world would any man in the right mind choose to have part of his penis removed, if it meant that one still had to wear condoms?

I ask, if I'm not convinced by this argument, why would I expect any other man to be? Let alone the men in Africa?

No intact man in the right mind could ever go for this. Men who are fully informed, men who have been made aware of all the facts simply cannot see any value in undergoing circumcision, and can clearly see that it is complete madness that organizations are spending millions in funds trying to convince other men to part with their foreskins for only "partial protection." If you went around pushing this nonsense in Europe, people would laugh in your face. They're pushing this shit in Africa because they think Africans are gullible idiots.

The only people who see the value in circumcision campaigns are those men and women who already have religious or cultural convictions for the practice of circumcision. They would like circumcision to be a free service, performed at hospitals by trained professionals, as opposed to the African bush, performed by amateurs using crude utensils, where men are more likely to suffer complications, including infection, loss of their organ, and even death. People with religious or cultural convictions for circumcision cannot verily declare this to be the case, so they are more than likely to disguise these convictions and desire to have circumcision as a free service by parroting the circumcision/HIV propaganda. "I am glad I am protected," they will say, when they truly mean to say "I cashed in on a free circumcision, thanks to these HIV programs!" "Everybody should be circumcised in order to prevent HIV infection," they will say, when they mean to say "We want all men to be circumcised and must submit to our tribal or religious tradition."

THE SOLUTION: More Money, More Propaganda
So eight years and several million dollars later, the great scheme to circumcise Africa in the name of HIV transmission hasn't taken off. Africans simply aren't buying it. Worse than that, the risk compensation nightmare intactivists have warned about from the very beginning is coming true.


Men are walking away with the message that condoms aren't necessary once they're circumcised. This false sense of security makes it difficult for female partners to convince them to wear condoms.

The endorsement of circumcision as HIV prevention is seen as a green light for traditional, rite-of-passage circumcision practices, as well as the forced circumcision of men by men in rival circumcising tribes, resulting in infections, loss of genital organs and death, not to mention an increased risk of HIV transmission due to the usage of dirty, crude equipment.

These "mass circumcision campaigns" are a massive failure. But how are circumcision promotion agencies responding? What is their solution?

More money, more propaganda.


"Insanity is doing the same thing over and over again and expecting different results."


"Demand creation," say the circumcision "experts," is the key.

HIV promoting organizations are observing what's happening, and their solution is to up the ante, use more coercive tactics to get the men to circumcise themselves "voluntarily."

The problem, the reason they aren't seeing men flocking to get circumcised, according to them, is that men simply don't understand what's good for them. The women don't either. The solution is to "understand" "why" people aren't buying it, in order to hit the right buttons, come up with the necessary "studies" that quell people's fears, and people will start banging down the doors.

In Swaziland, the US wants to spend another 24.5 million to attempt to circumcise the male Swazi population again. This time, they're through with the "voluntary" part of the slogan, and they have their eyes set on newborns. (There is zero evidence that newborn circumcision does anything to reduce HIV transmission, not to mention the reality that is the United States of America, where 80% of US males are circumcised from birth, and yet the United States has a higher HIV prevalence rate than 53 countries where circumcision is rare [under 20%] or not practiced, according to he CIA Factbook.)

Because, apparently, enough money hasn't been squandered in circumcision campaigns as it is.

"Demand Creation": What does it mean?
Currently "demand creation" are the buzz words among circumcision promoters. But what do these words mean? To me this can only mean brainwashing and counterproductive propaganda.

When the goal of HIV organizations is no longer to prevent HIV, when the goal is, instead, to circumcise as many men, boys and children as possible, when the goal is to gain the "acceptance" of circumcision, when the goal is to achieve a quota within a certain time frame, then the only outcome of this is can be lies and deception.

In order to achieve "demand creation," one can expect more attacks on African masculinity. More coercion through sex appeal. More "studies" exaggerating the "benefits" of circumcision. More diseases that circumcision is supposed to cure. With the promotion of male infant circumcision, there will be more "studies" minimizing the risks and harms of circumcision. (Is it any wonder that the CDC has already published a "study" saying when the best time to circumcise male is?)

Men and women who fully understand the facts, that circumcision is a painful, permanent alteration which, even if the current "research" were correct, could only provide "partial" protection, that circumcision fails and therefore condoms must still be used, do not, cannot possibly see any value in circumcision. Men fully aware of the facts do not, cannot be convinced to accept this for themselves. Parents fully aware of the facts, do not, cannot be convinced to accept this for their children. Therefore the only possible outcome is that, in order to realize quotas and meet deadlines, the facts must be denied, lies must be told, and the truth must be hidden at all costs.

Therefore the only outcome of "demand creation" is that the public will believe that circumcision prevents HIV transmission, that being circumcised means condoms are disposable, that unsafe sex with a man is acceptable as long as he is circumcised.

Therefore the only outcome of "demand creation" is, necessarily, that the HIV epidemic in African countries will be exasperated.

At the expense of the American taxpayer.

At the expense of the truth.

At the expense of scientific credibility.

At the expense of the human dignity of Africans.

At the expense of African lives.

At the expense of basic human rights of minors.

The problem isn't that African men and women "don't understand" and that they need to be "educated," no. The men and women and Africa understand what circumcision and HIV are. They understand that circumcision, even if the "research" were accurate, could only provide "partial protection," that men would still have to wear condoms, and simply aren't interested.

The problem is that the people at HIV organizations, the people at the American CDC, the people at PEPFAR, the people at Bill and Melinda Gates, the people at the WHO have all lost their senses completely.

It is absolute madness that they've all made it the end goal of the HIV movement to circumcise Africa, if not the world. While precious funds could be put to better use, millions are being squandered on promoting a dubious form of HIV prevention which is already superseded by the cheaper, less invasive, more effective modes of prevention which are condoms and education.

Beyond Circumcision
Circumcision does not, cannot stop HIV transmission. Even if the research is accurate, circumcision fails to prevent HIV transmission, which is why circumcised males must still be urged to wear condoms. There is no doctor, researcher or HIV organization that can deny this fact. Circumcision is a stop-gap at best, and scientists and researchers need to be looking for other, better ways to prevent HIV. Or, at least they're supposed to be.

Are circumcision scientists and researchers thinking of a time where HIV can be stopped in less invasive ways, without surgery? Is there a time in their minds when there will be a method of HIV prevention so effective circumcision can be discontinued? What non-cutting way are "researchers" looking into? Or is circumcision all they got?

Has anyone up at the WHO, up at PEPFAR, etc. stopped to consider that maybe perhaps the men aren't stupid and don't WANT to be circumcised?

Here's a question I've got to ask; do these "mass circumcision campaigns" offer men alternatives?

Have "researchers" considered the possibility men may not want to get circumcised despite the much touted "benefits," that "60%" may not be all that convincing, and that they're just going to have to accept that some men may not want to get circumcised?

Do HIV information packages that are given the men and women include the option NOT to circumcise?

Something that reads along these lines:

"Circumcision only provides partial protection against HIV in the event a couple decides to have unprotected sex, or if you are male and plan on having casual sexual encounters without condoms. If you are a faithful man, if your partner is a faithful man, circumcision may not be appropriate for you. For men who are faithful to their partners, and/or use condoms consistently, not circumcising is an option."

These are the facts.

I somehow doubt that men and women in Africa will be give them, seeing as knowing these facts will defer them from opting in favor of circumcision, and HIV organizations are given quotas for funds from PEPFAR, Bill and Melinda Gates, etc.

HIV organizations, what's plan B?

Or is circumcision all you have?

Is it just that HIV organizations are spending millions in precious funds on a dubious, invasive, expensive form of HIV prevention that nobody wants?

When condoms are already cheaper, less invasive, and more worlds more effective?

Circumcision Promotion vs HIV Prevention: What Is the Objective of HIV Organizations?
It is clear that the HIV movement has been hijacked by mad individuals with the twisted world view that all boys and men in the world ought to be circumcised. Instead of the prevention of HIV transmission, their goal has become to circumcise boys and men in and outside of Africa at all costs.

The actions of circumcision advocates at HIV organizations, their resolve to keep spending millions on promoting circumcision, even after having previously spent millions more, indicate that they believe Africans are incapable of deductive reasoning. A separate experiment is being carried out in Africa, with African men, women and children as guinea pigs. This is not about how much HIV can be prevented, but about how people can be more effectively brainwashed, about just how gullible and stupid people can be, and what they could be manipulated into doing.

Look at the latest in circumcision "research." It focuses on "acceptability" and "feasibility." It has nothing to do with HIV prevention mechanisms; the research is in how people can be more efficaciously brainwashed. It's almost as if they've given up on researching for an actual HIV solution. All their eggs are in the circumcision basket. Circumcision promoters are taking advantage of the impoverished state of African nations in order to conduct social experiments on them.

There is a problem when the slogan to promote circumcision is no longer "reduce your chances of contracting HIV prevention," but has been replaced with "become popular with women" and "last longer in bed." There is a problem when HIV organizations are more concerned with "demand creation" for a dubious mode of HIV prevention with human rights implications, than they are in making sure Africans understand how they can be HIV/AIDS free.

There is a problem when millions of dollars are being pumped into a mode of prevention that men don't want, and for good reason. There is a problem when the goal of circumcision promotion replaces HIV prevention.

The goal of HIV organizations needs to be brought back into focus, which is to prevent HIV and find a cure. If the end goal is to make sure everyone is circumcised, regardless of whether or not HIV is being prevented, not to mention other medical problems where precious funds are needed, then HIV organizations seriously need to reevaluate their priorities.

Conclusion
The promotion of male circumcision as HIV prevention is not based in science, but on unproven, or even disproven theories and correlation hypothesis based on exaggerated numbers. There is no scientifically demonstrable causal link between the foreskin and increased HIV transmission, and conversely, between circumcision and decreased HIV transmission. Without it, the campaigns in Africa are belief-based, not science-based medicine.

Real world data does not support the claim circumcising 80% of the male population results in decreased HIV transmission.

It is simply irrefutable that circumcision does not, cannot prevent HIV transmission. Circumcision fails to prevent HIV, and no doctor, researcher or scientist can deny this fact; this is the reason why circumcised men must still be urged to wear condoms.

The promotion of male circumcision is doing more harm than good, as it is a dubious form of HIV prevention which is being seen as an alternative to more effective sex practices, such as abstinence, fidelity and condoms.

The promotion of male circumcision is resulting in the violation of basic human rights of boys and men in and out of Africa; rival tribes are forcibly circumcising each other, boys and men are being abducted and forcibly circumcised, and the forced circumcision of minors is being promoted.

The promotion of male circumcision is resulting in yearly massacre in Africa, where WHO endorsement is seen as a green light for traditional rites of passage.

The promotion of male circumcision is resulting in the humiliation and sexual harassment of men who are not circumcised and do not want to be circumcised.

The promotion of male circumcision is a gross waste of funds which could be being put to better, more productive use.

The promotion of male circumcision is a sexist, misandrist, mean-spirited attack on male sexuality, upon African males, upon children in other parts of the world, and the male sex in general, and the WHO should have NEVER endorsed it.

The "mass circumcision campaigns" have got to be stopped. The WHO needs to retract it's recommendation of male circumcision as HIV prevention, and the forced circumcision of healthy, non-consenting individuals needs to be recognized for the mutilation and violation of basic human rights it is.

I call on reputable scientists, researchers, doctors and medical organizations with a conscience, to speak out and demand that the WHO retract their endorsement of circumcision as HIV prevention, and to call out that these "mass circumcision campaigns" be brought to a halt.

Update (5/27/2014):
Latest ploy in Zimbabwe: "Circumcision makes you smarter."

"We have campaigns that are specifically targeting adolescents, people in schools — so during school holidays we are doing massive mobilisations on mass media... "So get smart, get circumcised. Male circumcision is not only HIV prevention intervention, but it is improving hygiene, you are cleaner, you are smarter.'"
~Dr. Karin Hatzold, deputy head of Population Services International (PSI) Zimbabwe

If circumcision makes you smarter, what does this imply if you have a foreskin? Are African boys and men aware they're basically being slapped in the face?

Tuesday, August 27, 2013

GUEST BLOGGER: WHO Retrocedes 150 Years


In my last post, I wrote about the WHO and its codifying of a completely bogus diagnosis. I just read another blog post which goes into greater detail regarding the history of the diagnosis "adherent prepuce," and the normal development of anatomically correct male organs, which has already been well-documented in medical history. I thought it warranted a re-post on my blog, so I asked permission from the original blogger, dreamer, if he would allow me to do so and he complied. I feel it will be a good lesson in history and male anatomy for my readers.

The balanopreputial synechiae conspiration - or when medicine reverses 150 years thanks to a committee 

By dreamer - August 27, 2013
 
Or can the World Health Organization can be hijacked by special interest groups?

The description of the circumcision procedure often includes a step, described as follows in the circumcision advocacy site circinfo:

"The adhesions between glans and foreskin are divided with a hemastat (artery forceps). "

Yet Douglas Gairdner in his 1949 "The Fate of the Foreskin" article, indicated that "It will be seen that preputial "adhesions" is an inapposite term to apply to the incompletely separated prepuce, suggesting as it does that the prepuce and glans were formerly separate structures."

In Intactivist circles, these adhesions are often referred to as "balanopreputial synechiae", "balanopreputial lamina", "balanopreputial membrane".

"Balanopreputial" means specifically something that is related to the glans ("balano") and the foreskin ("prepuce").

Synechiae is defined as an adhesion between two parts of the body.

Lamina refers to a structure, particularly a flat structure (2D)

In Anatomy, a membrane may refer to a thin film that is primarily a separating structure.

Wikipedia used to have an article on the balanopreputial membrane. This article was marked for deletion in 2007. The argument for deletion is that these words basically are an expression used by "lobbying" groups (in other words, "anticircumcision" or intactivist groups) to refer to "the epithelial layer fusing the foreskin to the glans". There is no equivalent article describing the "epithelial layer fusing the foreskin to the glans".

While this term is difficult to find, I've found references to the process of "balanopreputial separation" as an external sign of puberty in rats! More details here.

A book on Pediatric Drug Development includes the term "balanopreputial separation" again in reference to rats.

What about people?
It is known and reference in literature even as old as 1933, that "the prepuce in the human penis is adherent to the glans at birth, a layer of stratified squamous epithelium being interposed, and shortly after birth these parts become separated so that the prepuce may be retracted.", and the presence of this epithelium is referenced in this article as being described as far back as 1860.

In 2012 a group of Brazilian researchers studied the development of the foreskin in the fetal period and found "the presence of preputial lamella and a large amount of mesenchymal tissue between the foreskin and glans"

The glandulopreputial lamella is defined as "a layer of embryonic epithelial tissue that gives rise to the prepuce."

A lamella is a thin plate-like structure.

The development of the balanopreputial cavity in one humped camels has also been studied, finding references to the same lamella.

A 2010 paper describes the Development of the Glandopreputial Lamella and Sulcus in Female Fetuses, including the presence of a "stratified squamous epithelium" - the same epithelium mentioned in 1933 and in 1860.

So, this epithelium as a normal part and stage of the development of the foreskin has been known for at least 150 years. Whether we call it epithelium, or membrane, or synechiae, or lamina, we are referring to the same thing. A normal structure that connects the glans and the foreskin during their development.

The same 1933 paper describes that "The separation of the prepuce in the human penis is essentially a process of keratization of the intervening epithelium. It begins anteriorly and posteriorly at about the same time and proceeds toward the center. When confined on all sides the separation manifests itself as an epithelial pearl formation. On the surface, as is possible in the anterior region, it appears as a desquamation."

What's more important is that the paper then indicates that "Separation is not completed at birth, but is accomplished sometime during infancy or early childhood."

The exact age of retraction has been a subject of debate. This old paper indicated that " Unless the prepuce has been retracted, slight adhesions may persist in the posterior regions of the glandar lamella at 5 and 6 months. Separation is sufficient at the 10-day stage to allow mechanical retraction without danger of a tear, apparently an important factor in completing the division."

 Based on more recent observations, the Royal Children's Hospital in Melbourne posted in 2013 that "The normal foreskin is attached to the glans and is non-retractile in most newborns. Over time the foreskin separates and becomes retractile. The proportion of boys with retractile foreskins is: 40% at 1 year, 90% at 4 years and 99% at 15 years."

By what means are the foreskin and the glans attached? By the presence of a synechiae, or a membrane, or a lamina, or an epithelium.

So basically, it doesn't matter if we call it a synechiae or a membrane or a lamine or an epithelium. There is a normal structure that appears during the normal development of the fetus (male or female), which later starts to dissolve and separate, and the final product, usually years after birth, is the presence of a separate glans and prepuce, either the glans penis and the foreskin on the male, or the clitoris and the clitoral hood on the female.

So there is no need to play thug of war over the use of one word or another. This structure exists, has been described, has been sufficiently observed and it's normal. There is no denying this.

Which is why it can only generate shock that the new 2013 ICD-10 codes of the World Health Organization, scheduled to go into effect in October 2014, include a code (N47.0) for "adherent prepuce, newborn" as part of the disorders of the male genitals.

With this new code, every human male will be born with a medical condition N47.0 - not because it's a medical condition, but because it has been codified as such. A normal stage of the human development has been pathologized by the World Health Organization.

And who can guess what procedure cures this condition?

If this doesn't sound like a conspiracy to circumcise the world, then I don't know what is it. I can only conclude that the World Health Organization has been hijacked by a special interest group.

Original post can be read here.

Related Links:
WHO: Codifying Medical Fraud

Sunday, August 25, 2013

WHO: Codifying Medical Fraud


How do you justify the forced genital mutilation of minors?

  1. Invent pathological conditions that make it indispensable.
  2. Link anatomically correct male organs to the proliferation of disease.

It used to be that forced genital mutilation, particularly the forced genital mutilation of males at any age, was sanctioned under the immunity of "religious freedom." Additionally, parental privilege and cultural relativism could be invoked in order to justify the forcible amputation of a male child's foreskin.

Given other practices that fall under this category, however, the alibis of "religious freedom, "parental choice" and "cultural immunity," have lost validity.

Perhaps the best example of this is none other than female circumcision; a federal law makes the forced cutting of girls of any kind, and at any age, a punishable offense, and there are no exemptions for "religious" female genital cutting, or cultures where female genital cutting is practiced.

For this reason, advocates of circumcision, particularly male circumcision, have sought to, not only justify the forced circumcision of healthy, non-consenting minors, but to make the practice indispensable.

For over a century, circumcision "researchers" can be seen trying to link circumcision with the prevention of feared diseases; there is no shortage of "studies" that say that circumcision prevents this or that, all written by "researchers" who promote its universal adaption. They can also be seen trying to pathologize the presence of anatomically correct male genitalia, and the many stages of its development, setting arbitrary ages by which the foreskin should be "retractable for cleaning."

While there will never be enough "research" to justify the forced circumcision of girls, it seems circumcision advocates have made the covert contract with themselves, that the forced circumcision of boys will one day be justified, even made compulsory, if only they could come up with the right amount of "studies" that say circumcision prevents disease. We see them trying very hard today, promoting "mass circumcision" in Africa, in the so-called name of AIDS prevention.

Despite their hard work and efforts, however, not a single respected medical organization has found the latest HIV/circumcision propaganda to be convincing enough to recommend the circumcision of minors. In their latest statement, the AAP tries to sell the one-line "benefits outweigh the risks" slogan, but still concluding that the same "benefits" are "insufficient to recommend the practice."

Not quite having achieved the recommendation they wanted, it appears circumcision advocates are returning to the older tactic of trying to pathologize anatomically correct genitals.

WHO Codifies False Conditions Into Existence
The World Health Organization (WHO) has just released their new 2013 ICD-10 codes, which are scheduled to go into effect in October 2014. ICD, which stands for "International Classification of Diseases", is the global system for reporting morbidity and mortality statistics, for billing, and for health care automated decision support.

The new codes for conditions of the foreskin include a prominent (first on the list) billable code, for a condition whoever wrote these codes want to call "adherent prepuce in the newborn." If these codes go into effect, it means that doctors and hospitals will be able to claim "adherent prepuce" as a valid medical diagnosis in neonates (valid in the sense that a billable code exists in the WHO ICD system, not that it is an actual medical condition necessitating surgical correction), and be able to legally charge to "correct" it, thereby possibly justifying routine infant circumcision.


The new proposed codes under classification N47, "Disorders of the Prepuce," can be seen here. (To view, click on the hyperlink for "9 codes" in the second bullet point to read the full list of nine, beginning with N47.0 - Adherent Prepuce, Newborn.)

Without medical or clinical indication, doctors have no business performing surgery on healthy, non-consenting newborns, let alone asking parents to make any kind of "decision." However, if these codes, which the US Centers for Medicaid and Medicare use, go into effect, doctors will have a code available to justify routine infant circumcision, starting next year unless the new code is rescinded. A whole new ICD-11 code system is slated to be introduced for 2015.

Who Did It?
Research documents the normal development of anatomically correct male organs,(1-5) and there is no such thing as a pathological condition known as "adherent prepuce in the newborn"; all boys are born with the prepuce fused to the glans at birth, and if we are to believe the WHO, then all boys are born with a pathological condition which doctors can charge for "correcting." In essence, the WHO's board of physicians has declared the newborn foreskin, which is normally fused to the glans at birth, to be a disorder.

"How many legs does a dog have if you call the tail a leg? Four. Calling a tail a leg doesn't make it a leg." - Abraham Lincoln

The fact that the WHO's board of physicians have decided to call a normal stage of development in the male infant penis a medical disorder, and have even made an ICD code for it does not make it a medical disorder. The foreskin is not a congenital birth defect. 

What I want to know is, who was responsible for writing these codes?

I suspect it was Americans who are in cahoots with fellows at the American Academy of Pediatrics; judging from their last statement, the AAP would like nothing more than to force the 18 state Medicaid programs who dropped coverage for male infant circumcision to start covering it again.

It is despicable to know that interested individuals at the WHO can use their ICD system to codify anatomically correct organs as pathological disorders, in order to warrant medical reimbursement for their "correction."

Who wrote these codes?

Who is responsible for this deplorable travesty? 

Why would a Geneva-based international organization do such a thing as pathologize all males at birth? I would expect that coming from a country where circumcision is rare, that the people of Switzerland would have a better understanding of anatomically correct male genitalia.

The WHO needs to be called on this immedeiately.
  1. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5.
  2. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5.
  3. Ishikawa E, Kawakita M. [Preputial development in Japanese boys]. Hinyokika Kiyo 2004;50(5):305-8.
  4. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3.
  5. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62.
Related Posts:
Politically Correct Research: When Science, Morals and Political Agendas Collide

AAP: Around the Bush and Closer to Nowhere