(no subject)

("It’s not hard to understand. Health and hygiene have always been the reasons. Also, it’s been proven to stop std infection. Getting circed as a baby beats getting it as an adult.")

Literally none of that is true though.

HEALTH:
Three national medical organizations (Iceland, Sweden and Germany) have called for elective infant male circumcision to be *banned*, and two others (Denmark and the Netherlands) have said they'd support a ban if they didn't think it would drive the practice underground.
"Routine" circumcision *is* banned in public hospitals in Australia (almost all the men responsible for this policy will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%).
If it weren't a religious thing, elective circumcision of boys would have been banned in lots of countries decades ago, same as it was for girls.

HYGIENE:
Female genitals are harder to clean than male genitals, and they get way more infections down there, but we wouldn't cut parts off baby girls.  Hygiene is about washing, not surgery.

ORIGIN:
It's worth remembering that no-one except for Jewish people and Muslims would even be having this discussion if it weren't for the fact that 19th century doctors thought that :
a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tuberculosis etc), and
b) circumcision stopped masturbation.
Both of those sound ridiculous today I know, but that's how they thought back then, and that's how non-religious circumcision got started.  If you don't believe me (and it seemed bogus to me at first too), then check out this link:
A Short History of Circumcision in North America In the Physicians' Own Words
or just look for any medical text from about 1850-1950 that mentions male circumcision or masturbation.  Heck, they even passed laws against "self-pollution" as it was called.
Over a hundred years later, people keep looking for new ways to defend the practice.

STIs:
1) Almost no-one in Europe is circumcised unless they're Jewish or Muslim, but they have lower rates of almost all STIs including HIV.
2)  Babies aren't going to be getting any STIs before they're old enough to decide for themselves whether or not they want part of their genitals cutting off.  It's their body; it should be their decision.
3) A 29 year study of males in New Zealand showed a very slightly *higher* rate of STIs among circumcised men:
"After adjusting for known confounders, men in our study who were uncircumcised were not any more likely to report a history of STI."
Other studies:
"There was no significant association between circumcision status and STI in the multivariable logistic regression model."
From a USAID report:
"There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
"The percentage of circumcised men reporting a diagnosis of genital warts was significantly higher than uncircumcised men"
Results.  Almost a third (32.4%) of the men were circumcised (CM). Compared with uncircumcised (UC) men, CM have accumulated larger numbers of STI in their lifetime (CM = 73.4% vs. UC = 65.7%; P = 0.048), have higher rates of previous diagnosis of warts (CM = 18.8% vs. UC = 12.2%; P = 0.024), and were more likely to have HIV infection (CM = 43.0% vs. UC = 33.9%; P = 0.023). Results indicate that being CM predicted the likelihood of HIV infection (P value = 0.027).
(found that intact men had a 20% lower risk of HPV and a 30% lower risk of high risk HPV)
Sexually Transmitted Infections and Male Circumcision: A Systematic Review and Meta-Analysis
Robert S. Van Howe
"In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections."
3) If we found out that cutting off part of a girl's genitals reduced her risk of contracting an STI, would that make it acceptable?
These studies shows exactly that:
"In the final logistic model, circumcision remained highly significant [OR=0.60; 95% CI 0.41,0.88] while adjusted for region, household wealth, age, lifetime partners, union status, and recent ulcer."
"Conclusions: A lowered risk of HIV infection among circumcised women was not attributable to confounding with another risk factor in these data."
Stallings and Karugendo 2005
"Increased years of sexual activity were associated with HIV-2 seropositivity, while a history of excision and BCG vaccinations decreased the risk of HIV-2 infection.
Kanki et al 1992

BEST AGE TO CIRCUMCISE
I think it's only the USA (at around 60% and dropping) and Israel where more than half of baby boys are circumcised.  Other countries circumcise, but not till anywhere from the age of seven to adolescence.  Only about 12% of the world's circumcised men were circumcised as babies.  Around two thirds of the world's men (88% of the world's non-Muslim men) never get circumcised.
In Scotland, you have to wait till a baby is six months old before getting a circumcision on the NHS, and in Switzerland, they make you wait two years.

Even if you think male circumcision is a good idea, there are very good reasons *not* to circumcise babies.
You can't use general anesthetic for a start - it's not that you don't have to, you can't.
The foreskin has to be separated from the glans (the most painful part).  If you wait, it separates naturally, usually by around puberty.
The post-operative pain will also be worse, and the wound will be in a diaper which is primarily there to contain urine and feces.                                                                                                                                                                                                                                         
The risk of major injury or death is higher, since you're working with something smaller.  The record payout for a botched circumcision is $22.8 million (since September 2018, it's now $31 million).  It was said at the time that the victim "will never be able to function sexually as a normal male and will require extensive reconstructive surgery and psychological counseling as well as lifelong urological care and treatment by infectious disease specialists."  Sure, cases like that are very rare, but why should they happen at all?
A newborn can die of blood loss after losing about three tablespoons of blood - way less than will be absorbed by a modern diaper.
There is a 5-10% risk of a "revision" (effectively a second circumcision) after circumcising a neonate, versus almost a zero rate for juvenile or adult circumcision.
Babies don't have much of an immune system.  At least one baby died after circumcision in New York after being infected with the coldsore virus for instance, and another got brain damage.
It's almost exclusively males circumcised as infants that get meatal stenosis.
The child can't give informed consent, and there are lots of men out there who are seriously unhappy about having parts of their genitals cut off.  It's *his* body, so why shouldn't it be his decision?

A recent paper found that infant male circumcision is strongly correlated with Sudden Infant Death Syndrome (SIDS):
"The global SIDS prevalence and MNC rates are strongly and significantly correlated (N=16, r=0.7, Student’s t-test, p-value=0.003) (Figure 3). The results remain significant even if the MNC rates for the estimated cohort are halved or doubled (r=0.69, pvalue=0.003, 95% CI: 0.004-0.015). The slope of this trend indicates that a 10% increase in the MNC rates is associated with an increase of 0.1 per 1000 SIDS cases."
Elhaik, 2018 https://www.biorxiv.org/node/103753.full

Two papers also show a strong correlation between infant male circumcision and autism/ASD.  The problem might be neonatal exposure to paracetamol, but it's still another reason not to operate on babies.

Bauer, Kriebel, 2013  http://www.ncbi.nlm.nih.gov/pubmed/23656698
"For studies including boys born after 1995, there was a strong correlation between country-level (n=9) autism/ASD prevalence in males and a country's circumcision rate (r=0.98). A very similar pattern was seen among U.S. states and when comparing the 3 main racial/ethnic groups in the U.S."

Frisch, Simonsen, 2015  http://jrs.sagepub.com/content/early/2015/01/07/0141076814565942.abstract (free to download)
"Results: With a total of 4986 ASD cases, our study showed that regardless of cultural background circumcised boys were more likely than intact boys to develop ASD before age 10 years (HR = 1.46; 95% CI: 1.11–1.93). Risk was particularly high for infantile autism before age five years (HR = 2.06; 95% CI: 1.36–3.13)."

(no subject)

A lengthy report "Levels and Spread of HIV Seroprevalence and Associated Factors: Evidence from National Household Surveys" by USAID is available here:

www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

One of the "key findings" is this:

"There appears to be no clear pattern of association between male circumcision and HIV prevalence. In 8 of 18 countries with data, as expected, HIV prevalence is lower among circumcised men, while in the remaining 10 countries HIV prevalence is higher among circumcised men".

It also says this:

"Findings from the 18 countries with data present a mixed picture of the association between male circumcision and HIV prevalence (Table 9.3). In eight of the countries (Burkina Faso, Cambodia, Côte d’Ivoire, Ethiopia, Ghana, India, Kenya, and Uganda), HIV prevalence is higher among men who are not circumcised, although the difference between circumcised and non-circumcised men is slight, except in Kenya, where the difference is substantial (HIV prevalence of 11.5 percent for non-circumcised men compared with 3.1 percent for circumcised men) (Figure 9.1). In 10 of the countries (Cameroon, Guinea, Haiti, Lesotho, Malawi, Niger, Rwanda, Senegal, Tanzania, and Zimbabwe) HIV prevalence is higher among circumcised men."

So why are so many people so keen to promote male circumcision in Africa?

Dutch policy on male circumcision

http://knmg.artsennet.nl/Diensten/knmgpublicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm

"The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."

references

Cameroon http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf table 16.9, p17 (4.1% v 1.1%)
Ghana http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf table 13.9 (1.6% v 1.4%)
Lesotho http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf table 12.9 (22.8% v 15.2%)
Malawi http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf table 12.6, p257 (13.2% v 9.5%)
Rwanda http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf , table 15.11 (3.5% v 2.1%)
Swaziland http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf table 14.10 (21.8% v 19.5%)


See also http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."

http://apha.confex.com/apha/134am/techprogram/paper_136814.htm

"Results: … No consistent relationship between male circumcision and HIV risk was observed in most countries."

The South African National Communication Survey on HIV/AIDS, 2009
"12-22% of men and 12-17% of women across age groups (15% in total) also believe that circumcised men do not need to use condoms."
http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71656?oid=158053


The one randomized controlled trial into male-to-female transmission:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

circumcision doesn't work against AIDS

Circumcision is a dangerous distraction in the fight against AIDS.  There are six African countries where men are *more* likely to be HIV+ if they've been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland.  Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men.  In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men.  If circumcision really worked against AIDS, this just wouldn't happen.  We now have people calling circumcision a "vaccine" or "invisible condom", and viewing circumcision as an alternative to condoms.  The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".

The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw.

ABC (Abstinence, Being faithful, Condoms) is the way forward.  Promoting genital surgery will cost African lives, not save them.

Medical society statements and other information on circumcision

Canadian Paediatric Society
http://www.cps.ca/english/statements/fn/fn96-01.htm
"Recommendation: Circumcision of newborns should not be routinely performed."

http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"Circumcision is a 'non-therapeutic' procedure, which means it is not medically necessary."

"After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions."

Royal Australasian College of Physicians
http://www.racp.edu.au/download.cfm?DownloadFile=A453CFA1-2A57-5487-DF36DF59A1BAF527
"After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."

 (those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%.  "Routine" circumcision is now *banned* in public hospitals in Australia in all states except one.)

British Medical Association
http://www.bma.org.uk/ap.nsf/Content/malecircumcision2006?OpenDocument&Highlight=2,circumcision#Circumcisionformedicalpurposes
"to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."


National Health Service (UK)
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=649
"Many people have strong views about whether circumcision should be carried out or not. It is not routinely performed in the UK because there is no clear clinical evidence to suggest it has any medical benefit."

Canadian Children's Rights Council

http://www.canadiancrc.com/Circumcision_Genital_Mutilation_Male-Female_Children.aspx
"It is the position of the Canadian Children's Rights Council that 'circumcision' of male or female children is genital mutilation of children."

drops in male circumcision:

USA: from 90% to 57%
Canada: from 47% to 9.2%
UK: from 35% to about 5% (less than 1% among non-Muslims)
Australia: 90% to 12.6% ("routine" circumcision has recently been *banned* in public hospitals in all states except one, so the rate will now be a lot lower)
New Zealand: 95% to below 3% (mostly Samoans and Tongans)
South America and Europe: never above 5%

It's worth remembering that no-one except for Muslim and Jewish people would even be having this discussion if it weren't for the fact that 19th century doctors thought that :
a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tuberculosis etc), and
b) circumcision stopped masturbation.

Both of those sound ridiculous today I know, but if you don't believe me, then check out this link:
A Short History of Circumcision in North America: In the Physicians' Own Words

Over a hundred years later, circumcised men keep looking for new ways to defend the practice.

The record payout for a botched circumcision is $22.8 million.  It was said at the time that the victim "will never be able to function sexually as a normal male and will require extensive reconstructive surgery and psychological counseling as well as lifelong urological care and treatment by infectious disease specialists."

Sure, cases like that are very rare, but why should they happen at all?  If you look up the galleries of botched jobs, one thing that may surprise you is just how many jobs were botched cosmetically, rather than medically.  Skin tags and skin bridges and hair growing half way up the shaft are not normal, but would not be counted as medical complications.

News just in last week: A jury in Atlanta has awarded $1.8 million to a boy whose penis was severed in a botched circumcision five years ago. The Fulton County jury also awarded the boy's mother another $500,000.