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


Thursday, August 14, 2014

UNITED STATES: Infant Circumcision Fails as STI Prophylaxis






A number of "researchers" are on a mission to "prove" that infant circumcision prevents STIs in adults, and therefore children ought to be circumcised as newborns. There are a few problems with this line of thinking, beginning with the ethics of removing normal, healthy tissue in healthy, non-consenting minors who are not sexually active, and therefore at zero risk for STIs, and the fact that even if the above reasoning held any water, condoms would still be more effective at preventing disease.

I recently came across this poster which tells of the sobering reality of STIs in the United States.



If the above poster is to be believed, 65 million Americans are living with an incurable STI. That's one in five of the population. The asterisk following the given 65 million figure indicates that this data is given by none other than the Centers for Disease Control (CDC).

If American circumcision pundit Edgar Schoen is to be believed, well over 80% of US males are circumcised from birth. With an adult circumcision prevalence rate of 80% or greater, the United States should serve as a prime example of the "benefits" of circumcision, or lack thereof. Yet, compared with other countries where circumcision is rare or not practiced, the United States does poorly when it comes to the prevention of STIs.

American doctors, "researchers," medical organizations and charity funds are currently placing much time, effort and precious funds in efforts to circumcise the majority of males in Africa under the pretext of HIV prevention. "Researchers" claim that that circumcision cuts HIV transmission rates by 55 to 65 percent, based on three African trials, and so PEPFAR and several other very well-funded and influential N.G.Os, including the Bill & Melinda Gates Foundation are funding, supporting and administering a multinational effort to circumcise over 28 million men in Sub Saharan Africa by 2015. And yet when it comes to circumcision and HIV prevalence rates, the United States isn't a very good model of reference.

In fact, AIDS rates in some US Cities rival hotspots in Africa. In some parts of the U.S., they're actually higher than those in sub-Saharan Africa. According to a 2010 study published in the New England Journal of Medicine, rates of HIV among adults in Washington, D.C. exceed 1 in 30; rates higher than those reported in Ethiopia, Nigeria or Rwanda. The Washington D.C. district report on HIV and AIDS reported an increase of 22% from 2006 in 2009. According to Shannon L. Hader, HIV/AIDS Administration, Washington D.C., March 15, 2009, "[Washington D.C.'s] rates are higher than West Africa... they're on par with Uganda and some parts of Kenya." (Hader once led the Federal Centers for Disease Control and Prevention's work in Zimbabwe.)


According to the CIA World Factbook, the United States has a higher HIV prevalence rate than 53 countries where circumcision is rare (e.g. under 20%) or not practiced. The United States has more HIV than:

Colombia, Argentina, Uruguay, Cambodia, Peru, Nepal, Switzerland, Vietnam, Ecuador, France, Chile, Spain, Moldova, Mexico, Italy, India, Iceland, Costa Rica, Canada, Belarus, Austria, Paraguay, Netherlands, Ireland, Denmark, Bolivia, Bhutan, United Kingdom, Belgium, Nicaragua, Laos, Bulgaria, China, Cuba, Cyprus, Czech Republic, Finland, Georgia, Germany, Greece, Hong Kong, Hungary, Japan, Lithuania, Mongolia, New Zealand, Norway, Poland, Romania, Serbia, Slovakia, Sri Lanka, Sweden

One would expect for there to be a lower HIV prevalence in the United States, where the great majority of males are circumcised from birth, and for HIV to be rampant in Europe, where circumcision is rare, if at all practiced. It is telling that the HIV epidemic struck in our country during the 1980s, when 90% of the male population was already circumcised. And not only did it strike, America was the one place in all of the developed world where the disease took root and spread. Somehow, we're supposed to believe that what never worked in our own country, is going to start working miracles in Africa. If ever there was an intervention that failed to prevent HIV transmission (and if this poster is to be believed, the transmission of most any other STI) it is routine infant circumcision.

I've already talked about how the magical 60% prevention figure simply doesn't manifest itself in the real world in other posts (see here and here), and I've already talked about the disgraceful actions that the WHO has given de facto endorsement to, including forced circumcisions in children and adult men (circumcision was supposed to be "voluntary," remember?), and the use circumcision as a condition for participation in sports. I've also already talked about how there is no scientifically demonstrable causal link between the presence of the foreskin and increased HIV transmission, and/or it's removal and decreased HIV transmission, all "studies" being based on correlational hypothesis.

Let's just assume for a moment that all of the science is solid. Let's assume the all too famous 60% figure we are given is 100% infallible (real world data tells us otherwise, but let's press on). Circumcision would still FAIL to prevent HIV or any other STI. It fails so terribly that circumcised men must still be urged to wear condoms. There isn't a single doctor or "researcher" that can deny this fact. At which point it must be asked, why even bother with circumcision?


What male in the right mind would choose to be circumcised given complete information?

Why violate the integrity of a healthy, non-consenting minor, to afford a dubious benefit better afforded by the use of condoms which would be cheaper, less invasive and more effective in preventing STIs?

Again, infant circumcision never prevented anything in our country. The data is staring us right in the face, and not even the CDC can deny it. How is it suddenly going to start working wonders in Africa?

Upworthy presents the above poster under the following heading:

"People Say The Dumbest Things Right Before They Have Sex. Here Are Some Of Them."

This can be added to the poster; "I don't have to wear a condom; I'm circumcised."




Related Posts:
Where Circumcision Doesn't Prevent HIV

Where Circumcision Doesn't Prevent HIV II

MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

AFRICA: Creating Circumcision "Volunteers"

CIRCUMCISION "RESEARCH": Rehashed Findings and Misleading Headlines

Saturday, August 9, 2014

QUICK POST: "Just a Little Piece of Skin"


It's been a while since I last posted, as life keeps me busy. I still don't have much time to write, but I just saw this picture making the rounds on Facebook, and I decided I'd make a quick post.

It always pisses me off to hear people write off circumcision as "just a little snip" and the foreskin as "just a little piece of skin." Well, I'd like to see them cut off "just a little piece of skin" this size off a little baby girl and away with it...

Just as a point of reference...
If we are to believe a certain blogger from South East Asia who had her baby girl "sunat" to fulfill social obligations, pictured below is the severed clitoris of a little baby girl.


Original Text: "It happens so fast, with a bismillah and a snip,
a little bit blood and that's it, Zahra dah sunat!
She didn't cry even a drop, in fact giggling2 lagi.
I guess it wasn't painful for her, alhamdulillahh.."
(The blog post has been now taken down. Gee I wonder why...)


Come to think about it, you know what else pisses me off?

When people say "Don't you dare compare male and female circumcision. They're not the same!"

Ch' Yah! You're right! They're not.

Related Posts:
Circumcision is Child Abuse: A Picture Essay

CIRCUMCISION: "Just a Little Piece of Skin?"

Male and Female Infant Circumcision: Which One is Worse?

Politically Correct Research: When Science, Morals and Political Agendas Collide

AFRICA: Creating Circumcision "Volunteers"

Monday, July 21, 2014

AFRICA: Creating Circumcision "Volunteers"


In a previous blog post, I talk about how HIV organizers are having trouble getting men to "volunteer" for circumcision, because they're falling behind on their quotas, and the men don't seem to be breaking down the doors at clinics to have part of their penis cut off (no big surprise there). I talk about how they are desperately stooping lower and lower, in order to get men to "volunteer" for circumcision out of their own "free will" (if by "free will" they mean "coercion"), from bribery, to sex appeal, to outright insults and emasculation.


Because "being smart" can only come from having part
of your penis removed?I wonder what Africans would think
if we told them the great majority of Europeans
aren't circumcised... Not to mention the rest of
the world... That man in the purple striped shirt
is smart; he's not buying it.

It seems now, that organizers are aiming to "create" so-called "voluntary demand," or bust, by making Africans offers they can't refuse.

"Sports-based Interventions"
It looks like organizers are now using sports as an incentive to get men to get circumcised "voluntarily." You know? To keep the "voluntary" in "voluntary male medical circumcision." And no, I don't mean by celebrity endorsement by local footy legends. From what it looks like, organizers are now looking to make circumcision as a condition for participating in soccer programs.



In other words, you have to "volunteer" to have your genitals mutilated in order to play.

Intactivists first heard of this last year in what we hoped would just be an exaggerated rumor. Being only hearsay, with no evidence, intactivists like myself couldn't see fit to mention it. This is what a fellow intactivist reports hearing directly from so-called HIV "researchers":

“In one presentation I sat through at a world AIDS conference (summer of 2010), a young doctor with these circumcision campaigns [in Africa] (he was marketing chief) took to the podium and explained a “successful” program. They went into the poorest communities, where the boys were mad for soccer, and bought them all new equipment and uniforms. Built them beautiful pitches to play on. Brought in well-known soccer players to inspire the boys, and got coaches. Let the boys play and get to love it. And when it came time to play in the regional tournaments, the bar came crushing down: they’d be sponsored to travel and play only if the team captain could convince most of the boys on the team to get circumcised. The peer pressure was tremendous not to let the team and community down. This doctor was positively gleeful at how successful this strategy was.”

We really hoped this would be just a bad rumor, but now it seems making circumcision a condition for participation in soccer programs is an actually strategy being implemented in Africa, which is to be presented at the AIDS 2014 Conference in Melbourne, Australia, which is happening right now (July 20 - 25). A more detailed report about this can be read here.


"Sure you can eat... IF you volunteer to get circumcised first..."
As if making circumcision a condition for soccer programs weren't enough, it now sounds like organizers are using food, FOOD, as an incentive to get men to "volunteer" to be circumcised. This has got to be the most insulting strategy for "demand creation" that can be imagined for Africans.

African countries suffer poverty. They don't have adequate medical facilities. Men and women have to travel for miles to get medical attention. They don't have enough to eat. But yes, let's CIRCUMCISE them. Sure you'll get medicine, you'll get food, you'll get advice for better living. But the price is circumcision. Give us part of your penis, and part of your children's penises if you want food, the most bare of necessity for life. We can't actually guarantee that circumcision will actually DO anything for you, but it will guarantee some food for you and your family to eat.

All of this has got to be some sort of psychological experiment with Africans as guinea pigs. You can get men to do almost anything with the proper motivation. But how is this any different than lab mice in a skinner box?




The above scenario is basically being recreated with Africa, except instead of rodents, they're using Africans, and instead of a lever, it's circumcision, and instead of an electrifying wire mesh, it's social stigma.

If it's "get circumcised, or get fried," how in the world is this "voluntary?"

Is it not obvious that organizers have crossed over to the realm of madness?

This is outright exploitation of Africans using HIV prevention as pretext.

There is a problem when "success" in the fight against HIV is measured, not in how much less infections we have per year, not in how much closer we are to a vaccine, but by how many people we have brainwashed about circumcision, which, even if the best "research" is correct, still fails as HIV prevention (ergo circumcised men must still use condoms).

 Smart men ask themselves, "If I still need to use a condom, 
why even bother with circumcision?"

For heaven sakes, could we not just GIVE Africans food and water?

Could you we not just give Africans condoms and education MINUS the genital mutilation?

Please?

Related Posts:
Where Circumcision Doesn't Prevent HIV

Where Circumcision Doesn't Prevent HIV II
MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa
CIRCUMCISION "RESEARCH": Rehashed Findings and Misleading Headlines
COUNCIL OF EUROPE: Non-Medical Circumcision a Human Rights Violation

Tuesday, July 15, 2014

CANADA: Circumcision Evangelist Sets His Sights for Haiti, Caribbean


Neil Pollock, flashing the tools of his trade

In a recent article on the Jewish Independent, Neil Pollock expresses his intentions to fly to Haiti, with the goal of proselytizing doctors there, training them to perform circumcisions, hoping those doctors will train other doctors in the region, and that thus, that circumcision will flourish under the guise of HIV prevention. A very lovely thought, if you're a stark Jewish advocate of infant circumcision, or if you're a doctor whose main source of income happens to be infant circumcision (Neil Pollock happens to be BOTH), but is this endeavor feasible? Practical? Realistic? Based on sound evidence? Honest?

Are Neil Pollock's intentions based on a genuine concern for public health? Or is this nothing more than a PR project to redeem infant circumcision by making it relevant to medicine? After all, it looks real good for your business to go to other countries training doctors in infant circumcision under the guise of medicine, if you happen to be a doctor who makes a living entirely from infant circumcision. Not to mention the fact that Pollock also happens to be a Jewish mohel, is affiliated with other mohels, not to mention other Jewish physicians that promote infant circumcision as medicine, where ritual infant circumcision is seen as divine commandment.

Male infant circumcision has been increasingly under fire from human rights groups, not to mention the recent herpes scandals in New York, and the latest developments in Europe zeroing in on infant circumcision.

So is this about HIV prevention?

Or about the continuous fight for Jews and gentile circumcision doctors to redeem the dying practice of infant genital mutilation?


It is difficult to get a man to understand something, when his salary depends on his not understanding it. ~Upton Sinclair

I'm going to go through the Jewish Independent article on this blog post and post my insights about it bit by bit.

The headline is already dubious, as it starts with a definite claim:


Vancouver doctor will train physicians in Haiti in circumcision

If one reads the article to the end, one realizes whether or not Pollock flies to Haiti depends on whether or not he can collect funding for his project. So the headline would be more accurate if it read something more like "Vancouver circumcision doctor asking for funds to train physicians in Haiti".

Begins the article:

"Dr. Neil Pollock specializes in circumcision, from newborn to adult, and adult vasectomy."

This is the first time I've heard of Pollock "specializing" in anything other than newborn circumcision and adult vasectomy. To my knowledge, he is first and foremost a mohel, who doubles as a circumciser of gentile newborns on the side. I guess he's trying to make more money now?

"As a leading expert in circumcision, he has traveled around the world to train physicians and, this summer, he will head to Port-au-Prince, Haiti, to teach a team of doctors in medical newborn and infant circumcision."

Not if he doesn't raise enough funds, he won't...

Now let's look at that first sentence; "...he has traveled around the world..." I know he went on a circumcision tour in Rwanda once, but I haven't heard of him going anywhere else... A rather modest exaggeration if I do say so myself...

“'After carrying out 50,000 infant circumcisions and traveling recently to Turkey, China and Africa to exchange ideas, I have evolved my technique to make it applicable to infants, children, teenagers and adults,' Pollock told the Independent in a recent interview."

The story changes a bit here. So he HAS traveled "around the world." He has traveled to Turkey, China and Africa "to exchange ideas," but that's slightly different than "to train physicians." Rather wishy-washy here.

But here we read that Pollock has "evolved his technique." He attempts to sound so matter-of-fact and so sure of himself, and most people reading this would be forgiven if they believed that Pollock came up with something totally new, unique and original that only he could do. Not mentioned here is his so-called "technique," which, if people cared to investigate, is nothing more than a glorification of the Mogen clamp technique, which is in and of itself, a circumcision method that dates back hundreds of years.

I'm sitting here asking myself... Pollock isn't actually using a Mogen clamp to circumcise children, teenagers and adults, is he?

“I have developed a technique to do circumcision in this older age group under local anesthetic without using sutures and using, instead, a cyanocrylate skin glue that closes the wound. Being able to do the procedure under local anesthetic and with skin glue instead of a general anesthetic in hospital provides for a much simpler, easier, quicker, safer and improved cosmetic outcome for patients.”

Ad novitam.

Here, Pollock is trying to sound "new" and "innovative." Let's not forget that circumcision is a few thousand years old.

Not addressed here are the questions of, why are children and teenagers being circumcised? Were these circumcisions medically necessary? Or were these healthy minors being forcibly circumcised at the whim of their parents?

Without medical or clinical indication, how is it doctors like Pollock are performing surgery on healthy, non-consenting minors, let alone be giving parents any kind of "choice?"

Maybe what he does is "much simpler, easier, quicker, safer," etc., but isn't reaping profit from performing surgery on healthy, non-consenting individuals the epitome of medical fraud?

Let's ask a different question; would female circumcision ever be justified if someone came up with a "simple, easy and safe" way to perform it?

"This method, he said, is unique. 'I’m unaware of this approach being used anywhere in [Canada] except in my clinics. The older age group is currently requesting circumcision for reasons like reduction in disease transmission, preference of their partners and improved hygiene.'"

What about the younger age group? Are they requesting it? Or is he performing circumcision on them against their express wishes?

"In 2008, Dr. David Patrick was the head of the B.C. Centre for Disease Control. Pollock said he was asked by his colleague “to teach my surgical techniques for circumcision in Rwanda, where they were using scissors and stitches, without anesthetic, and their surgeons desperately required training in an alternative quick, safe and painless infant circumcision technique that would be accepted by their population. In coordination with their surgeons, I planned with my team a five-day surgical training mission that year and flew to Rwanda. I have been in contact with these surgeons by email since my trip and they have informed me that they are using my technique effectively and safely throughout the country now."

Here, Pollock toots his own horn; he tries to make his "work" indispensable. Towards the end of my post, we will look at another circumcision technique which basically makes Pollock and his "new and improved techniques" obsolete.

“'The impact of our humanitarian effort became known in the international medical community, which led to Dr. Jeffrey Klausner, professor at [the University of California, Los Angeles] Medical School, contacting me recently and asking me to essentially replicate the work I did in Rwanda, but this time in Port-au-Prince, Haiti, where they are being overwhelmed by the number of patients requiring treatment for AIDS and would receive huge benefit from introducing a preventative strategy to reduce AIDS transmission, such as infant circumcision, which will reduce the risk of their circumcised infants later contracting AIDS when they hit sexual age, by over 60 percent.'"

This sounds rather fictitious to me!

I'd be interested to know who this Jeffrey Klausner is, what his religious affiliations are, and whether or not he had any affiliations with Pollock prior to his so-called "humanitarian effort." Methinks Klausner is nothing more than another circumcision enthusiast, trying to look for venues to take advantage of to push circumcision, particularly infant circumcision.

Who IS Klausner? And does he also just "happen" to have ties with Edgar Schoen?

I have a hard time believing that Pollock was such a prominent figure in the international medical community a man in UCLA just "happened" to take notice. Klausner might not happen to have any affiliations with Arleen Leibowitz, who is working to try and restore Medicaid coverage in states that no longer pay for infant circumcision, does he?

A quick Google search reveals that Klausner has published with circumcision "researcher" Daniel Halperin, another circumcision advocate in Africa who wants to make circumcision as HIV prevention his legacy. (Halperin also happens to be Jewish and is quoted saying he wants to make his mohel grandfather proud.) He has also published with Australian circumcision enthusiast Brian Morris, whose reputation we all know about. Klausner has been "researching" was to increase circumcision in India and elsewhere. Is it really any wonder that Pollock and his "work" caught his eye?

No, this was no coincidence; all of these so-called circumcision/HIV "experts" know each other and sniff each others rear ends. I don't believe for a second that Klausner contacted Pollock "out of the blue," asking for his "assistance." They're probably on each other's contact lists and sat around on Skype or Facetime brainstorming the whole thing. They must look at every country with HIV prevalence and sit around thinking "How can we make circumcision part of the picture?"

For the record, there is simply no evidence whatsoever that infant circumcision has any effect on HIV transmission. Additionally, there is no scientifically demonstrable causal link between male circumcision and reduced HIV transmission. Unproven and disproven theories abound, but it cannot be demonstrably shown that circumcision reduces HIV transmission at all, let alone by the fabled 60%.

Interesting fact; according to American circumcision pundit Edgar Schoen (good friends with Pollock), 80% of US males are already circumcised from birth. And yet, according to the CIA Factbook, we have a higher HIV prevalence rate than 53 countries where circumcision is rare (below 20%) or not practice. The United States has a higher HIV prevalence than MEXICO.

Pollock continues:

"'Its impact and effectiveness has been referenced metaphorically to be like a vaccine.' Circumcision, he added, 'works to reduce AIDS by removing the portal of entry of the virus, which is the foreskin.'"

Referenced by WHOM?

And here, we have Pollock spewing an unproven, if not disproven theory as matter-of-fact. It simply cannot be demonstrated under a microscope that the foreskin facilitates HIV transmission, nor that removing it reduces it. Actually, the Langerhans cells, which have been indicted as "the main port of entry" for HIV have been shown to actually effectively destroy the HIV virus. Pollock is hoping to ride the HIV gravy train to redeem infant circumcision, to which he has religious convictions, and to promote his business.

"Klausner, a professor of medicine in the division of infectious diseases and the program in global health at UCLA, is an advocate in the use of medical male circumcision for the prevention of sexually transmitted diseases and HIV. He volunteers with GHESKIO, an organization run out of the Centre for Global Health at Weill Cornell Medical College in partnership with the Haitian government. Operating primarily in Port-au-Prince, their work is supported by Haiti’s first lady and has a mission to combat HIV and improve conditions of maternal and child health. GHESKIO will host Pollock’s training in Port-au-Prince."

It will be interesting what more information I will find on this Klausner fellow and this GHESKIO. A question that rises in my head is, if Pollock is to be hosted by GHESKIO, why is Pollock asking for funds? Are there not enough funds at Weill Cornell or the Haitian government?

"Raised in Winnipeg, Pollock explained that he decided to become a doctor 'because I had a strong interest in sciences, medicine and surgery from a young age.'"

Really? As someone raised in the Jewish faith, he wasn't interested in brit milah first, and vindicating it through medicalization second? It makes me wonder, what is his area of focus? Urology? Does he treat penile problems? Or is cutting up babies and neutering men all he does for a living?

 "Early in his career, he decided to create a special focus on circumcision and vasectomy, and built a highly focused practice and a well-tested – and respected – technique."

"Respected" by whom?

What is this "technique," and did he actually come up with it?

Answer: He is using the Mogen clamp technique, and it is not his own original idea. The Mogen company has been put out of business by million dollar circumcision mishap lawsuits it couldn't afford to pay. The Mogen clamp is notorious for partial or full glans amputations, even in the hands of skilled practitioners.


A common mishap in the Mogen clamp circumcision method
is that part of, or all of the glans gets pulled up into the clamp,
resulting in the partial or full ablation of the glans penis.


Will one week of training provide enough experience to prevent these injuries? And if it isn't, are hospitals in Haiti equipped to deal with these life altering complications? 


"'My interest in developing a safe, quick and painless approach to circumcision for the medical community in B.C. arose initially from some of the rabbis approaching me approximately 20 years ago and encouraging me to become a mohel in Vancouver,' Pollock said."

I'm sure it did not arise because he's Jewish and he has a religious conviction to defend circumcision. And I'm sure this has nothing with wanting to cash in on the business of mutilating the genitals of healthy, non-consenting minors.

"The benefits of newborn and infant circumcision are many, but the rates of the procedure vary from region to region, and remain contentious to those opposed to what’s seen as elective (non-consenting) surgeries for babies"

The "benefits" have not convinced a single medical organization in the world to recommend infant circumcision. Circumcision in healthy, non-consenting minors IS elective, non-medical surgery.

"Pollock noted, 'The most important change recently in how the medical community has come to view circumcision is expressed in the … consensus statement from the American Academy of Pediatrics released in late 2012 declaring that ‘the medical benefits of infant circumcision outweigh the risks.’ This is the strongest statement of support ever issued by the American Academy of Pediatrics.'"

Though the AAP  tries to make the claim that "the benefits outweigh the risks," it falls short of a recommendation. (Not to mention it was formally rejected by 38 pediatricians, urologists, epidemiologists, and professors, representing 20 medical organizations and 15 universities and hospitals in 17 countries.) But Pollock will not be telling us that.


And here, Pollock gives his circumcision sales pitch:

"'The benefits of circumcision are multiple; they include reduction in the risk of urinary tract infection, which can lead to kidney infection and renal failure (How common is UTI, and furthermore, these complications? When and if they occur, are there non-surgical intervetions?), reduced risk of cancer of the penis (Which is already quite rare at approximately 1 in 100,000 males; according to the American Cancer Society, 1 in 6 US males will be diagnosed with prostate cancer annually. They also do not recommend circumcision as a way to prevent cancer by the way...), cancer of the cervix in partners (...for which there are already effective vaccines), reduced risk of balanitis (which is a [rare] infection of the foreskin), and other foreskin-related problems, like phimosis (Which is already rare, and does not always require surgery for treatment).'  As well, circumcised males also experience a 'reduction of multiple sexually transmitted diseases, like HPV, herpes and AIDS transmission. The latter is exponentially more important in places like Haiti and Africa, where a large number of the population has AIDS in comparison to other regions of the world where AIDS is less common.' (According to USAID, HIV was more prevalent among circumcised men in 10 out of 18 countries. Real world data shows that circumcision does not correlate with a lower HIV prevalence rate.) Possible risks include 'bleeding and infection,' he added, 'but, in experienced hands (Like his, right?), risks are extremely low.'

After all is said and done, no medical organization recommends infant circumcision. All of them, including the AAP, say that the "benefits" are simply not great enough.

"Rwanda and Haiti share a history of national trauma, which has led in both countries to poor health outcomes. In 1994, at least 800,000 Rwandans were massacred by their countrymen in a genocide. In 2010, Haiti, already the victim of more than two centuries of extreme poverty, dictatorships and U.S.-led military interventions, experienced a 7.0 earthquake that resulted in the deaths of more than 100,000, and displaced 1.5 million of the tiny country’s 10 million people. Since then, Haitians have been hit by serious outbreaks of preventable disease, including cholera, tuberculosis and AIDS. According to the United Nations, life expectancy is 61 years for men and 64 for women."

Poor, poor Haiti... Let's circumcise them and worry about feeding them and improving conditions for them later!

"The health challenges that Haitians are very similar to those experienced in Africa, and the training is seen as critical in addressing those obstacles. 'Like there was in Rwanda, there is a need to train surgeons in Haiti to carry out a quick, safe and painless infant circumcision technique,' Pollock explained."

 More like "Hatians are as vulnerable as the Rwandans, I know a good PR opportunity when I see one, and I need to be there to take advantage."

"'In regards to what accounts to gaps in circumcision rates, there may be a deficiency in trained surgeons to carry out the surgery in an acceptable manner, along with variations in social and cultural norms that influence the choice to have circumcision.'"

That Haiti's problems are attributable to "gaps in circumcision rates" and "deficiency in trained surgeons" and that "the social and cultural norms that influence the choice to have circumcision"(because having circumcision is the only acceptable choice?) are Pollock's own conjecture. Here, we see Pollock trying to justify and necessitate himself. Haitians "need" circumcision, and he's the man they should send to give it to them.

"The ultimate intention of the training, Pollock said, is 'to set up a national program accepted by the population, to introduce infant circumcision safely and effectively, and have it evolve to become a widespread practice throughout the country, thereby reducing the transmission of multiple diseases, including AIDS.'"

What he means to say, of course is that his ultimate objective is to proselytize Haiti, and to install infant circumcision as part of their culture, under the pretense of HIV prevention. He hopes to complete the training, and then be able to boast about it on newspapers, whatever the outcome. The training hasn't even happened yet; Pollock is asking for funds in this article, but he is already boasting the project as eminent.

"Pollock’s visit to Haiti will involve intensive training. 'My goal is to carry out a similar plan to what we executed in Rwanda. I worked with physicians there weeks ahead to set up a surgical schedule of 20-to-30 infants per day, over four-to-five days of operating. After working with doctors on models that I brought to demonstrate the technique and do the primary teaching, they moved to assist me with the surgeries and eventually carry them out under my supervision on the infants booked for circumcision.'"

He hopes to replicate in Haiti, what he did in Rwanda, but there is a huge difference; whereas circumcision is already a part of the culture in Rwanda and the rest of Africa, it is not part of the culture in Haiti, or the rest of the Caribbean. It has been very easy for circumcision advocates to get people on-board the circumcision gravy train in countries in Africa where circumcision is already prevalent as a cultural practice, but it is proving to be a challenge in areas where it is not; Swaziland, where the Soka Unkobe project failed to yield results, is a good example. Whether or not Pollock achieves the same results in Rwanda will remain to be seen; will he be able to convince enough Haitians to circumcise their newborns, enough to yield his 20-to-30 infants per day?

Here are some more interesting facts; while HIV prevalence rates are high in both Rwanda and Haiti (2.9% and 2.1% respectively) as well as a low prevalence of circumcision (less than 20%), the HIV prevalence rates in both of these countries are relatively lower than in Swaziland (HIV rate 26.5%) as well as other countries with higher circumcision prevalence (25-50%). Kenya and Tanzania, with circumcision rates of 84% and 70% respectively, also higher rates of HIV (6.1% and 5.1%).


And here's where it gets interesting...

"The training in Haiti, part of a nongovernmental public health initiative, will be partially supported by charitable donations."

 In other words, it hasn't happened yet...

"The commitment from my end for Haiti will include a week away from my practice and the commitment to help raise the $25,000 for the mission to take place. The plan is to raise $25,000 from the Vancouver community in the next seven days or so as to be able to launch the teaching mission in Haiti by the end of the summer."

"If you build it... they will come..."

"'During the week in Haiti, I will train two physicians, who will then train other physicians once our team leaves. I will maintain follow-up with these physicians to help them manage any issues that should arise.'" The goal is to create a sustainable public health campaign and donated funds not only will go towards covering the costs for the week, but also for 'the next 500 infants once we leave.
Readers who would like to donate to the effort “will support an initiative, which will undoubtedly over the years save thousands and thousands of lives,” Pollock said. “It’s intended that Haiti will become a training centre for circumcision in the Caribbean. It is likely that my technique, once taught in Haiti, will soon be shared with multiple countries throughout the Caribbean, multiplying its effect to save lives throughout the entire region.'"

Tho goal is clear:
Pollock hopes to drop a circumcision PR bombshell in Haiti. He hopes this will start a brushfire, which will then spread to the rest of the Caribbean. He has pipe dreams that his little project will plant a seed that will flourish and that he'll be given credit for circumcising the whole of the Caribbean.

I like how he uses the term "saving lives" as a euphemism for getting everyone circumcised, as if circumcision actually did anything to prevent HIV; the sad reality is that circumcision does not, cannot prevent HIV transmission. Not a single doctor or "researcher" can deny this fact. It fails so terribly that circumcised men must still be urged to wear condoms if they want any real protection.

Pollock must be on crack; in Africa it's very easy to convince people in cultures where circumcision is already present, that circumcising their children as newborns is a good idea. What is more likely to happen is that he'll go to Haiti, he'll go back to Canada, and instead of flourishing his project would fizzle, because people would be horrified at the proposition of having the genitals of their children mutilated for dubious benefits no medical organization in the world deems sufficient. And what other Caribbean countries in the right mind would listen to Haiti for anything?

Continues Pollock:

"'So, I’m asking readers and members of the community to reach deep and consider making a financial donation to help us raise $25,000 in the next [several] days to allow this mission to proceed.'"

So in short, this entire article can be summarized as thus; Pollock sees a circumcision PR opportunity in Haiti and he wants people and/or organizations to give him money to do it.

It ought to interest readers that Pollock went to Rwanda on the dime of the Canadian Institutes of Health Research, and the Shusterman Foundation, whose vision, by the way is "To help the Jewish people flourish by spreading the joy of Jewish living, giving and learning," and their mission is "ensuring vibrant Jewish life by empowering young Jews to embrace the joy of Judaism, build inclusive Jewish communities, support the State of Israel and repair the world."

At least for me, the question is, with financial guarantors like Shusterman Foundation, what is Pollock really up to? With this article published on a news outlet that primarily targets Jewish readers, what kind of donors is he hoping to attract for funds? My guess is that Pollock is hoping to attract monies from other Jewish advocates of circumcision, who share his vision of redeeming infant circumcision. Safeguarding a cherished tradition that is increasingly under public scrutiny (not to mention Pollock's main source of income) is the goal, and "saving lives" is the pretext.

Other questions arise...
So in this article, Pollock is both plugging himself, AND he's asking for money. Which leads to asking, if Pollock is performing so many circumcisions, why is he simply not flipping the bill himself? Pollock is trying to come off as if he would be doing the world a favor by traveling to evangelize circumcision in Haiti, but it doesn't sound like he could be too generous if he's basically asking to be reimbursed.

I have two theories:
a) With increasing intactivist activity in the US, and the latest developments in Europe, pickings are slim for him and other mohels, and he feels he should do a kind of PR tour. Since he's not making too much money, he needs the funds.

b) Having others pay his way is simply more PR for him; he can later claim that not only he was "asked" to go to Haiti (like I believe that), he was also given a full ride by "generous people in the international community" who wanted him to go to Haiti that bad.

But lastly, and here's the kicker, with the technological innovations the race to circumcise Africa has spawned, of what use are his "techniques" to circumcise older males? PrePex, for example, boasts a painless, bloodless technique to circumcise older males, which doesn't have to be performed by doctors. Why pay Pollock $25,000 to train doctors to perform cumbersome surgery when the money could be used for PrePex devices? (Not to mention that even if the latest "research" held any water, condoms would still be much cheaper, less invasive and more effective than circumcision?)

In short, given the new technology that doesn't require doctors, aren't Pollock's "techniques" pretty much obsolete?

Indeed, they are. But then Pollock couldn't take advantage of HIV-afflicted Haiti to PR infant circumcision, which is what actually matters to Pollock and his financial supporters.

Neil Pollock's conflicts of interest should be immediately obvious to anyone who investigates his background. He's not interested in HIV prevention or public health. He's concerned with staying in business, not to mention vindicating circumcision to which he has a religious conviction for. This is nothing more than a thinly-veiled circumcision crusade and Haitians ought to be put on alert. It is clear who would donate funds for him, and what their true intentions are.

"All abuse of babies is easier. They are powerless and history will judge us by how we protect the powerless." -Paul Mason, Commissioner for Children, Tasmania, Australia 2007-2010

Related Posts: 
Where Circumcision Doesn't Prevent HIV

Where Circumcision Doesn't Prevent HIV II

MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

CIRCUMCISION "RESEARCH": Rehashed Findings and Misleading Headlines

Edgar Schoen Showing His Age

AUSTRALIA: "Circumcision Debate" - Australian Sensationalism?

OUT OF LINE: AAP Circumcision Policy Statement Formally Rejected

AAP: Around the Bush and Closer to Nowhere

The Cologne Ruling and the Limitations of Religious Freedom

COUNCIL OF EUROPE: Non-Medical Circumcision a Human Rights Violation

The Ghost of Mogen

CINCINNATI: Intactivists Protest Circumcision "Experiment" at Good Samaritan Hospital

NYTimes Plugs PrePex, Consorts With Known Circumfetish Organization

Sunday, June 29, 2014

CIRCUMCISION PHALLUSIES BLOG SERIES: Ad Antiquitam


Long time no see...
Well, it's been a while since my announcement that I wanted to start this blog series, and I must admit, I've been rather busy and unable to sit down and dedicate any time to it. Not to mention I haven't written anything this month, and I've been aching to. I will begin the series by talking about "ad antiquitam," or appeal to antiquity, because it's rather easy to tackle, and because it's quite possibly the logical fallacy most often used when defending the practice of the forced genital cutting of either sex.

AKA: "Because it's old"
Ad antiquitam is the fallacy of appealing to antiquity, culture, and/or tradition. It assumes that a belief or an assertion must be automatically correct by mere virtue of age. "It's always been done this way," the old refrain goes. "My father, his father, and his father did it." Simply put, it's nothing more than a habit with no real decision making process. Capitalizing on comfort in the familiar, it is a philosophy at best, which is often embellished by talk of continuity.
This is the way is always been done, and this is the way we'll continue to do it.

The practice of circumcision long precedes any attempt to scientifically "study" its so-called "medical benefits." In fact, it seems no discussion about circumcision "research" and "scientific discoveries" is complete without an obligatory reference to the antiquity of the practice, be it the fact that it is commanded to Jews in the biblical book of Genesis, or the fact that the practice predates Judaism, being depicted on ancient Egyptian hieroglyphics, as if the antiquity of the practice were of any relevance. 


We've all seen this image before...


The age of a belief may attest to experience, but it has no relevance to its truth. It is fallacious to assume that something is "better" or "correct" merely because it is old. Progress is defined by replacing the older with the better. The fact that a belief may be thousands of years old does not automatically make it correct. Old values aren't necessarily "the right ones." And yet, the fallacy prevails, and interested individuals and parties continue to appeal to it.


Slavery too has been around since the time of the Egyptians.
Child labor was practiced into the 20th century in this country.


Women used to not be able to vote.


Traditionally, women are subservient to men.

In older Asian culture, women walk several paces behind their husbands.
Of course, female circumcision is also several thousands of years old, and it's a very important custom to different tribes in Africa, as well as Muslim sects in South East Asia, but for whatever reason ad antiquitam is not a valid argument here.


In Indonesia, an infant girl undergoes "sunat" to fulfill religious and cultural tradition.

Not too far away, an infant boy undergoes circumcision for precisely the same reasons.
(Notice the mother: "Shh! Quiet!")

And there are other instances where ad antiquitam doesn't work.


A father slashes his child's head for the Holy Day of Ashura
Child marriage in India
 Ritual scarification

In short, ad antiquitam ultimately fails as an argument for male infant circumcision, which is why circumcision advocates who appeal to age and tradition must ultimately fall back on arguments of "potential medical benefits." Attempting to make arguments sound legit by dressing them up in pseudo-science is yet another form of logical fallacy, but that's a topic for another blog post.

Related Posts: