Infant Male Circumcision Male Infant

Infant Male Circumcision

Male infant circumcision has recently become an issue of increasing contention. In addition to religious grounds for the procedures, other promote it for assumed medial and hygienic benefits. Opponents on the other hand believe that male circumcision is a cruel practice that causes unnecessary harm to babies on both the psychological and physical level. While there are strong arguments both for and against the procedure, the most important consideration is human rights and the individuals' sovereignty over his own body. For this reason, and also because of the risks inherent in the procedure when not specifically necessary for medical reasons, male circumcision should as far as possible be the decision of the individual undergoing the procedure.

Bering (2010), in support of the procedure, notes that, although the perception that infant male circumcisions as a "somewhat bizarre, bloody and frightening" ritual was probably reasonable in the past, this is no longer necessarily the case. Instead, the benefits of the procedure can be said to greatly outweigh its risks, particularly in the light of new studies regarding its possible mitigation of the risk of contracting HIV / AIDS.

Bering (2010) cites "mounting evidence" to this effect, beginning with a physical breakdown of the factors that prevent HIV infection after circumcision in heterosexual males. Researchers found for example that high densities of HIV target cells occur in the inner mucosal surface of the foreskin. These are beneath a layer of keratin, which is not present on the inner surface of the prepuce. When the foreskin is removed, the target cells are removed with it, thus reducing the risk of HIV contraction in such men. According to the trials conducted, male circumcision could reduce the risk of HIV infection by as much as 62%.

Although Bering admits that these studies were limited to high-risk African population, the author appears confident that the data could be applicable to all part of the world. Specifically, the trials were conducted on HIV-negative adult males who were uncircumcised and sexually active. The focus groups were all living in Kenya, Uganda or South Africa, and were randomly assigned to a circumcision or no-circumcision group. Those in the circumcision groups underwent the procedure and abstained form intercourse for at least a three-week period. Both groups revisited the clinic at six-month intervals to test for HIV. After two years of ongoing trials, evidence suggested that those who were circumcised were significantly less likely to contract the virus. Indeed, so obvious were the results that the trial was ended early for ethical reasons because of the higher risk in non-circumcised men for contracting the virus.

The authors' conclusions, according to Bering's report, were based upon a number of 22 Ugandan males out of 2,387 circumcised men contracting the virus over a two-year period, compared with 45 out of a group of 2,430, where the sexual behaviors of the two groups were significantly similar. Bering explains the relative insignificance of the numbers by the fact that the time of testing was relative brevity of the time of testing. He claims that over a lifetime, the benefits of circumcision would be even more significant, and that the trial prove without a doubt that circumcision has a positive correlation with protection from the virus.

Further expounding the potential of circumcision, especially when performed on neonatal males, Bering cited a study emerging from the South African trial, in which computer modellers found that as many as 300,000 Southern African lives could potentially be saved by neonatal male circumcision over a 10-year period. This translates to 2 to 7 million lives over a period of 20 years in the region.

There are however important limitations to this study. Bering admits that studies yet have to reveal the potential benefits, if any, upon the homosexual male population. According to a specialist in Beijing, however, the likelihood is that circumcision could protect insertive homosexual partners to a greater degree than receptive partners, because of the high susceptibility of anal mucosa to trauma and thus HIV infection. According to Bering, this could also apply to the female partners of heterosexual males, where male circumcision would do little to protect them from infection. Once the male partner therefore has the virus, there is nothing short of abstinence or condom protection that he can do to protect his partner.

The conclusion may therefore be that male circumcision benefits only heterosexual or insertive gay men. However, according to Bering, the statistical benefit of circumcision are sufficiently significant to merit attention to the issue.

On the other hand, there are also significantly strong arguments against infant male circumcision from notable professionals such as the American Medial Association (AMA) and the American Academy of Paediatrics. According to Manimale (2010), most medical organizations in the United States indeed do not recommend circumcision for newborn babies. The author further claims that the African studies mentioned above do not seem to be as persuasive as Bering would claim, precisely because of their focus upon a population that may not be applicable to populations in the United States. According to studies conducted by CDC researchers and published in the latest issue of AIDS, circumcision does not make any difference in HIV transmission among gay men in Western countries, regardless of the type of sexual activity they engage in.

Another important consideration in this regard is the fact that infants do not engage in sexual activity, making the likelihood to contract HIV minimal until they are at the puberty stage. Surely they can then be informed of the risks and benefits of male circumcision and make an autonomous decision on the recommendation of their elders and medical professionals.

Two other arguments for the procedure is hygiene and conditions such as penile cancer.

Manimale refutes these; the penis needs washing, whether it is circumcised or not, while penile cancer is such a rare disease that it does not merit circumcising all new babies for the dubious benefit of preventing it. Indeed, Manimale strongly opposes the procedure, as it "irreversibly violates a person's sovereignty over his own body with dubious benefits." The author compares the reasons for discontinuing the standard practice of circumcising new babies with those for discontinuing female circumcision. It is a violation of the human body over which the infant has no control. Therefore one could even go as far as saying that infant male circumcision is a violation of the fundamental right of the person to decide on the procedures conducted on his body.

Manimale also provides further strong arguments against male circumcision on infants where there is no medical reason to do so. Possible complications for example include methicillin-resistant Staphylococcus aureus (MRSA), a potential risk highlighted by a CDC study. Risk factors reported by the AMA include sepsis, skin bridge formation, scalded skin syndrome and partial penile amputation. Furthermore, there are significant psychological risks associated with infant male circumcision, such as stress and pain during the procedure. Furthermore, the procedure could have lifelong consequences for the adult male as well, with the loss of nerve endings affecting the ability to experience sexual pleasure.

The author furthermore suggests that any type of circumcision, whether male or female, is comparable with removing body parts. It is in effect the mutilation of the human body, and should therefore only be done in the most extreme circumstances for children who cannot yet make such decisions for themselves, or for those who are old enough to make such a decision. In the light of these risks and the uncertainty of benefits, Manimale is therefore of the opinion that the reasons for infant male circumcision are not sufficient to impose the procedure as a matter of countrywide policy.

Hinchley (2007) states this viewpoint in even more certain terms. Referring to infant male circumcision as an "unnecessary mutilating practice," the author advocates that child protection laws and principles should also include the prohibition of the procedure. One of the reasons for the strong feelings of the author regarding the issue is the many unsupported and even superstitious reasons purported over the centuries in support of the practice.

In addition to religious reasons, for example, some conditions previously believed to be prevented by infant male circumcision included masturbation, blindness and insanity. Even in the light of the evidence to the effect that the risk of HIV infection may be reduced in circumcised males, the author makes a much stronger case for adult males making the choice rather than parents making the decision for them.

Hinchley goes as far as claiming that neither the U.S. And UK legal systems discriminate against young boys when it comes to ritual genital mutilation, which is in effect what infant male circumcision for religious reasons amounts to. He therefore calls for professionals and advocates to work against potential policy implementation that would make the procedure compulsory for newborns. According to the author, the procedure has little concern either for logic or for the rights of the child.

K. Patrick, debating the issue in the same article, however disagrees. According to this professional, circumcisions that are competently performed under local anaesthesia cause no more pain or harm than an immunisation injection. Furthermore, male circumcision ahs shown benefits such as the reduction of sexually transmitted infections such as the human pailloma virus, chancroid and syphilis. She also cites studies that indicated a reduced risk of HIV infection in males who have been circumcised.