Male Ge*ital Mu*ilation(MGM) as a Human Rights Vi*lation

Circumcision is a surgical procedure that removes the foreskin, the skin covering the head of the p*nis. It is performed for various reasons, including religious, cultural, and medical ones. There are claims about various health benefits of male circumcision, but many of those are unconvincing, and the topic has led to division within the medical community. In fact, in some countries, it has even become a subject of public debate and legal challenges.

The United States is the number one country that propagates “male circumcision” via the former “USAID” and by funding medical institutions. The American Academy of Pediatrics (AAP) carried out a “research” and then a policy statement that was opposed by various European medical institutions.

The Europeans argue that the AAP’s conclusion on circumcision reflects an American “cultural bias.” “Doctors are not free of their cultural biases; they placate their culture and work to save sources of income and avoid liability by refusing to admit their practices are harmful. Money is the system’s highest priority, and many doctors are ignorant of the long-term real harm they cause.”

Also Read: The Feminist Approach to Men’s Mental Health By Using The Terms Like – “K*ll all men,” “I drink male tears,” and “Male, pale and stale” etc.

What Does the AAP Say?

In their 2012 policy, the American Academy of Pediatrics (AAP) concluded that the health benefits of newborn male circumcision, such as reduced risks of urinary tract infections, penile cancer, and some sexually transmitted infections, outweigh the risks of the procedure. However, they also stated that these benefits are “not great enough to recommend universal newborn circumcision,” leaving the decision up to parents after they’ve been informed about the risks and benefits. Their 2012 technical report emphasized that while there are medical advantages, they do not justify mandating the procedure for all infants.

European Countries and Medical Bodies’ Response to AAP’s Policy Statement

The European response is more critical or opposed. In 2013, a group of 38 European physicians from 16 countries published a commentary titled “Cultural biases in the AAP’s 2012 technical report and policy statement in pediatrics.” They argued that the AAP’s conclusion reflects an American cultural bias favoring circumcision, as non-therapeutic infant circumcision is far more common in the USA and differs sharply from the views of physicians in other Western nations.

Their commentary contends there are no compelling health benefits but significant potential long-term downsides—urological, psychological, and sexual—and that non-therapeutic infant circumcision may conflict with medical ethics and children’s rights. They also said the benefits attributed in the American report to circumcision, including protection against HIV, genital warts, genital herpes, and penile cancer, are questionable, weak, and likely to have little public health relevance. They do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

The European physicians found only one argument put forward by the “American Academy of Pediatrics”—the possible protection circumcision offers against urinary tract infections in infant boys—but this can “easily be treated with antibiotics without tissue loss,” they wrote.

Numerous European medical bodies (in Germany, the Netherlands, Belgium, and Nordic countries like Sweden, Norway, Denmark, Finland, and Iceland) have concluded that non-therapeutic infant circumcision:

Conflicts with a child’s bodily integrity and autonomy.
Should be deferred until the individual can consent.

The Council of Europe Parliamentary Assembly (2013) called infant circumcision (without medical need) a “violation of physical integrity,” urging better regulation and debate, but not mandating a ban. In Nordic countries, children’s ombudsmen specifically recommend banning non-therapeutic male circumcision of minors.

Australia, New Zealand, and Canada

Australia and New Zealand

The Royal Australian College of Physicians (2010) released a statement indicating that neonatal male circumcision is “generally considered an ethical procedure,” provided that 1) the child’s decision-makers, typically the parents, are acting in the best interests of the child and are making an informed decision; and 2) the procedure is performed by a competent provider, with sufficient analgesia, and does not unnecessarily harm the child or have substantial risks. They argue that parents should be allowed to be the primary decision-makers because providers may not understand the full psychosocial benefits of circumcision. The statement also established that “the option of leaving circumcision until later, when the boy is old enough to make a decision for himself, does need to be raised with parents and considered,” and that “the ethical merit of this option is that it seeks to respect the child’s physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future.”

In 2022, the organization published an updated stance on infant circumcision. In their executive summary, they wrote, “The frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia or Aotearoa New Zealand.”

Canada

The Canadian Pediatric Society (CPS) issued a position statement on September 8, 2015, which highlighted the ethical issue surrounding the child’s inability to give consent. Since children require a substituted decision-maker acting in their best interests, they recommend holding off on non-medically indicated procedures, such as circumcision, until children can make their own decisions. Yet the CPS also states that parents of male newborns must receive unbiased information about neonatal circumcision, so that they can weigh specific risks and benefits of circumcision in the context of their own familial, religious, and cultural beliefs.

On January 11, 2024, the Canadian Pediatric Society reaffirmed their 2015 position, stating, “While there may be a benefit for some boys in high-risk populations and circumstances where the procedure could be considered for disease reduction or treatment, the Canadian Pediatric Society does not recommend the routine circumcision of every newborn male.”

Danish and Dutch Stances

Denmark

The Danish Medical Association (Lægeforeningen) has released a statement (2016) regarding the circumcision of boys under the age of eighteen years. The organization says that the decision to circumcise should be “an informed personal choice” that men should make for themselves in adulthood. According to Dr. Lise Møller, the chairwoman of the Doctors’ Association’s Ethics Board, allowing the individual to make this decision himself when he is of age respects his right of self-determination. The Danish College of General Practitioners has defined non-medical circumcision as mu*ilation.

Netherlands

The Royal Dutch Medical Association (Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst) (KNMG) and several Dutch specialist medical societies published a statement of position regarding circumcision of male children on May 27, 2010. The KNMG argues against circumcising male minors due to a lack of evidence that the procedure is useful or necessary, its associated risks, and the violation of the child’s autonomy. They recommend deferring circumcision until the child is old enough to decide for himself. The KNMG questions why the ethics regarding male genital alterations should be viewed any differently from female genital alterations, when there are mild forms of female genital alterations like pricking the clitoral hood without removing any tissue or removing the clitoral hood altogether.

They have expressed opposition to both male circumcision and all forms of female circumcision; they do not advocate a prohibition of male circumcision, even though they argue that there are good reasons for it to be banned, and prefer that circumcisions be done by doctors instead of illegal, underground circumcisers.

Nordic Countries and the United Kingdom

Nordic Countries

In 2013, children’s Ombudsmen from Sweden, Norway, Finland, Denmark, and Iceland, along with the Chair of the Danish Children’s Council and the children’s spokesperson for Greenland, passed a resolution that emphasized the decision to be circumcised should belong to the individual, who should be able to give informed consent. The Nordic Association of Clinical Sexologists supports the position of the Nordic Association of Ombudsmen who reason that circumcision violates the individual’s human rights by denying the male child his ability to make the decision for himself. The medical doctors at Sørland Hospital in Kristian, Southern Norway, have all refused to perform circumcisions on boys, citing reasons of conscience.

United Kingdom

The medical ethics committee of the British Medical Association also reviewed the ethics behind circumcision. Since circumcision has associated risks with, in their view, no unequivocally proven medical benefits, they advise physicians to keep up with clinical evidence and only perform this procedure if it is in the child’s best interest. They say the procedure is a cultural and religious practice, which may be an important ritual for the child’s incorporation into the group.

Male Circumcision Does Not Prevent HIV/AIDS or Other STIs and Poses Harmful Risks to the Child

Study in Uganda

A study that was done on 922 men in Uganda showed circumcision doesn’t reduce or prevent HIV transmission. 922 HIV-positive men, uncircumcised, and asymptomatic, aged 15-49 years in Rakai District, Uganda, were randomly divided into two groups using a computer-generated sequence:

Intervention group “circumcised group” (n=448): immediate circumcision.
Control group “uncircumcised-group” (n=448): circumcision delayed by 24 months.

Female partners: HIV-negative female partners of these men were also enrolled: 93 in the intervention group and 70 in the control group.

Follow-up: Female partners were followed at 6, 12, and 24 months to assess whether they acquired HIV from their male partners.

Analysis type: A modified intention-to-treat (ITT) approach was used. Only couples where the female partner had at least one follow-up visit were included in the final analysis (92 in intervention, 67 in control). Survival analysis and Cox proportional hazards model were used to assess HIV transmission rates over time.

Findings:

HIV transmission results: 17 women (18%) in the intervention group (whose male partners were circumcised) acquired HIV. 8 women (12%) in the control (uncircumcised) group acquired HIV.
Cumulative HIV infection at 24 months: 21.7% in the intervention group (95 CI: 12.7-33.4) vs. 13.4% in the control (intact) group (95 CI: 6.7-25.8).
Adjusted hazard ratio (HR) = 1.49 suggests a 49% higher risk in the intervention group.

The study concluded that circumcision of HIV-positive men did not reduce the risk of transmitting HIV to their female partners within the 24-month follow-up period. In fact, transmission was numerically higher in the intervention group.

Study in Denmark

A large study was carried out in Denmark from 1977-2013. The study concluded there was no reduction in HIV risk among those circumcised early in life and no significant protective effect against other STIs (sexually transmitted diseases).

Study purpose and design:

Objective: To investigate whether non-therapeutic circumcision (i.e., not medically required) performed in infancy or childhood has any long-term protective effect against acquiring HIV or other sexually transmitted diseases (STIs) up to age 36.
Population: A total of 810,719 non-Muslim males born in Denmark between 1977-2003.
Follow-up period: From birth up to age 36 (1977-2013), yielding about 17.7 million person-years of observations.

Data sources: Recorded circumcision from national health registries (hospital and outpatient surgical codes) and STI and HIV diagnoses from health records.

Analysis: Cox proportional hazard regression was used to compare risks between circumcised vs. intact males. Adjusted hazard ratios (HRs) were calculated with 95 confidence intervals (CIs).

Result: Out of the cohort, only about 0.42% (3,375 males) had undergone non-therapeutic circumcision, meaning only 3,375 males were circumcised out of 810,719 males. This is because Denmark does not routinely circumcise boys, and the study excluded Muslim males, because circumcision is highly prevalent in that group and would have introduced cultural confounding or uproar.

Circumcision did not reduce the risks of contracting any specific STI or HIV up to age 36; in fact, circumcised males experienced a 53% increase in overall STI risk compared to intact (uncircumcised) males. The study also found no evidence of protection against HIV, nor against other STIs in males circumcised early in life.

Medical Evidence on Non-Therapeutic Child Circumcision

What is the medical evidence on non-therapeutic child circumcision? https://www.nature.com/articles/s41443-021-00502-y: concluded that “non-therapeutic” circumcision performed on otherwise healthy infants or children has little or no high-quality medical evidence to support the overall benefit. Moreover, it is associated with rare but avoidable harm and even occasional deaths. From the perspective of the individual boy, there is no medical justification for performing a circumcision prior to an age that [he] can assess the known risks and potential benefits and choose to give or withhold informed consent himself. We feel that the evidence presented in the review is essential information for all parents and practitioners considering non-therapeutic circumcision on otherwise healthy infants and children.

Male circumcision decreases penile sensitivity as measured in a large cohort: https://pubmed.ncbi.nlm.nih.gov/23374102/: conclusion “This study confirms the importance of the foreskin for penile sensitivity, overall sexual satisfaction and penile functioning. Furthermore, this study shows that a higher percentage of circumcised men experienced discomfort or pain and unusual sensation as compared with the uncircumcised population.”

“Fine-touch pressure threshold in the adult p*nis: https://pubmed.ncbi.nlm.nih.gov/17378847/: Conclusion- The glans (tip) of the circumcised p*nis is less sensitive to fine touch than the glans of the uncircumcised p*nis. The transitional region from the external to the internal prepuce (foreskin) is the most sensitive region of the uncircumcised p*nis and more sensitive than the most sensitive region of the circumcised p*nis. Circumcision ablates the most sensitive part of the p*nis.