Tuesday, January 31, 2012

NYTimes Plugs PrePex, Consorts With Known Circumfetish Organization

It's all happened before. And it's all happening again. But this time, it happened in New York.

Yes, it seems, that since the WHO used three dubious "studies" to endorse male genital mutilation as HIV prevention, circumcision advocates, each with their own different interests, have been looking for ways to promote so-called "mass circumcision campaigns" full speed ahead.

PEPFAR and Bill Gates are in Africa bankrolling so-called "mass circumcision campaigns." These have started a race to come up with an efficient gadget that will speed up circumcision. Eager circumcision advocates are trying to use the WHO judgement to get medical organizations around the world to endorse the practice of infant circumcision, and to recuperate public funding which once paid for it. In Australia, circumcision enthusiast Brian Morris can't seem to keep quiet about getting the Royal Australian College of Physicians to endorse "mandatory circumcision" for all boys. In America, Arleen Leibowitz laments the fact that 17 states have stopped Medicaid funding for infant circumcision.

All of this hullabaloo surrounding an eminent "scale-up" of circumcision seems to be focused on one concentrated purpose:

To secure acquiescence to the idea that circumcision actually does anything to prevent HIV transmission.

In recent months, a number of news outlets have run what appears to be an infomercial for a circumcision device, namely the PrePex device, developed by Israeli inventors.

A video version of the PrePex infomercial was published on the BBC, which wasn't even viewable to Britons. Perhaps the BBC knew that if Brits saw this ridiculous excuse for journalism there would be an outcry demanding an explanation. A few days later, a more dumbed down version of the infomercial was published on the Washington Post in news article form. The message and the purpose remained the same; to move the audience past the evidence (or lack thereof), and focus attention on "mass circumcision campaigns," and how the new PrePex device is the answer.

The PrePex Infomercial on the New York Times
The PrePex company has managed to get the New York Times to publish an infomercial for them, masquerading as a news article. This article goes a step further than its predecessors, however, as it is actually now calling circumcision, an amputative procedure, an actual "VACCINE."

I am going to go through the entire article and highlight all the deliberate misinformation that the New York Times tries to pass off as fact.

"AIDS Prevention Inspires Ways to Make Circumcisions Easier," reads the headline.

Already, the author is assuring his readers that yes, circumcision does in fact, prevents AIDS. No actual analysis of the "evidence" is needed, readers should just believe that this is a foregone conclusion.

Reads the caption under the picture of the "new" invention: "‘LIKE A FINGERNAIL’ One new product, PrePex, uses a ring to block blood flow. After a week, the dead foreskin falls off or can be clipped." 

Hardly innovative, the PrePex is nothing more than a glorified tourniquet device. A number of other devices use the exact same principle of cutting off blood circulation to the foreskin, including the TaraKlamp, the Smartklamp, the Ismail Clamp, the Zhenxi Ring and the Shang-ring before it.

"Like a fingernail" is an attempt to trivialize the foreskin. Tie off any part of the body and it will shrivel up and die. Reader, ask yourself; when was the last time you had to cut off circulation in your fingernails before you had to cut them off?

Let's continue with the article:
"The day of the assembly-line circumcision is drawing closer."

This seems more like wishful thinking on the part of the author, and the circumcision advocates he is writing the plug piece for. In actuality, "assembly-line circumcision" has been going on in the US for a few decades now. And actually, as per the CDC, the practice is in decline. This, I believe, is the real cause for concern for advocates of circumcision in the so-called name of disease prevention.

Moving on:
"Now that three studies have shown that circumcising adult heterosexual men is one of the most effective “vaccines” against AIDS — reducing the chances of infection by 60 percent or more — public health experts are struggling to find ways to make the process faster, cheaper and safer."

A deliberate lie, mashed together with a half-truth. "Studies" have shown no such thing.

Let us begin with this half-assed quantification of circumcision as a "vaccine." It needs to be made clear:

A vaccine functions by strengthening the immune system against pathogens that cause disease. When HIV, or any other disease, invades the body, it makes no difference to the immune system whether or not a man is circumcised. Saying that circumcision behaves ANYTHING like a vaccine is a deliberate LIE, it is an unscientific statement and a disservice in the fight against disease, and news outlets have got to stop repeating it.

It may be true that health "experts" (Experts? WHAT experts? Who are they?) are scrambling to find ways to spread circumcision, but there is absolutely no "study" in the world that can demonstrate that circumcision functions anything like a vaccine.

The worn 60% figure is never addressed. 60% of what? What did the supposed "studies" actually show?

The "studies" supposedly involved 10,908 men, 5,411 of which were circumcised, and 5,497 which were left intact as a "control" group. By the end of the studies, 201 men contracted HIV. The famous 60% figure we hear repeated over and over comes from the comparison of 137 intact men  vs. 64 circumcised men who contracted HIV. This figure quickly shrinks to an insignificant 1.37% however, when we factor in the rest of the 10,707 men who didn't get HIV. Circumcision is being heavily promoted using a ridiculously inflated number, but the New York Times etc. are touting it as gospel truth.

No, even if the "research" were correct, circumcision could not hold a candle to condoms.

Additionally, real world empirical evidence fails to correlate with the WHO's select studies.

Let's continue...
"The goal is to circumcise 20 million African men by 2015, but only about 600,000 have had the operation thus far."

Which raises a few questions. The WHO endorsed these "studies" since 2006, and campaigns such as Soka Uncobe have been blasting the message in Africa for at least a year now.  "Those foreskins are flying," assured Robert Bailey in a past article on the very New York Times. If the programs are being so "successful," how is it that there are efforts to "streamline" circumcision? Have organizers thought of the possibility that they may never even reach one or two million men, let alone 20? That despite all of the "science" and "research" thrown at them, the men may not be interested in having part of their penis cut off? Have they thought of plan B? Have they envisioned a future where HIV might be prevented WITHOUT surgery? Why does it seem like organizers in Africa are more concerned about spreading circumcision, than they are about spreading HIV awareness, and education in the use of condoms, which, even according to "research" would far supersede it?

Aren't organizers concerned that promoting circumcision is going to discourage the use of condoms?

"Even a skilled surgeon takes about 15 minutes, most African countries are desperately short of surgeons, and there is no Mohels Without Borders."

And why on earth would you need RELIGIOUS practitioners of circumcision? What is this effort ACTUALLY about? Aren't circumcision advocates even going to try to conceal their ulterior motives anymore?

The questions continue. KNOWING that surgeons and doctors are in short supply, and that healthcare is needed elsewhere, how is it circumcision advocates insist on exhausting this limited supply? How is it they're not looking for less invasive methods of HIV prevention that are as effective, if not even more so than circumcision?

The article continues:
"So donors are pinning their hopes on several devices now being tested to speed things up."

Or, rather, using WHO endorsement of male genital mutilation as HIV prevention, circumcision device manufactures have managed to secure a piece of the circumcision/HIV pie.

"Dr. Stefano Bertozzi, director of H.I.V. for the Bill and Melinda Gates Foundation, said it had its eyes on two, named PrePex and the Shang Ring, and was supporting efforts by the World Health Organization to evaluate them."

Evaluate? Or endorse?

(And look who is doing the evaluating! None other than David R. Tomlinson, the "chief expert on circumcision" at the WHO, who also just happens to be an inventor of various circumcision devices himself, namely the AccuCirc device.)

Are Bill and Melinda Gates really interested in humanity? Or is this merely a PR endeavor?

The clincher:
"Circumcision is believe[d] to protect heterosexual men because the foreskin has many Langerhans cells, which pick up viruses and “present” them to the immune system — which H.I.V. attacks."

Here we see the New York Times, yet again, trying to merge science with quackery.

HIV most definitely attacks the immune system; this is an observable phenomenon that anyone can see and confirm for themselves. But there is absolutely no scientific evidence whatsoever that the Langerhans cells in the foreskin "picks up" viruses and "presents" them to the immune system.

Actually, scientific evidence proves quite the opposite: Not only do the Langerhans cells act as a natural barrier for HIV, they actually secrete Langerin, which destroys HIV on contact.

de Witte, Lot; Alexey Nabatov, Marjorie Pion, Donna Fluitsma, Marein AW P de Jong, Tanja de Gruijl, Vincent Piguet, Yvette van Kooyk, Teunis B H Geijtenbeek (2007-03-04). "Langerin is a natural barrier to HIV-1 transmission by Langerhans cells" (PDF). Nature Medicine. doi: 10.1038/nm1541. http://www.circumcisionandhiv.com/files/de_Witte_2007.pdf.

The claim that the Langerhans cells facilitate HIV transmission is categorically false.

The New York Times is "picking up" and "presenting" deliberate scientific falsehoods to the American public.

Let it be clear:
The idea that circumcision prevents male heterosexual HIV transmission is a belief; a belief that cannot be scientifically demonstrated. A "decrease" in HIV transmission can be "observed" in three hopelessly flawed, heavily skewed "studies" that fail to correlate with real world empirical evidence. That this "decrease" was indeed caused by circumcision, however, is a far-fetched belief that "researchers" have yet to substantiate. "Researchers" are trying to frame their cherished beliefs and traditions in "research," and that's not science.

The article continues:
"PrePex, invented in 2009 by four Israelis after one of them, a urologist, heard an appeal for doctors to do circumcisions in Africa, was approved by the Food and Drug Administration three weeks ago. The W.H.O. will make a decision on it soon, said Mitchell Warren, an AIDS-prevention expert who closely follows the process."

The inventors of the PrePex device are of Israeli origin which brings into question their true motives. The Jerusalem AIDS Project (JAIP) created Operation Abraham, which is an organization whose sole purpose is to promote circumcision any which way it can. They too have used the WHO's endorsement to travel all over the world to promote circumcision. Are they truly interested in public health? Or are they interested in safeguarding and promoting a religious ritual which is ever under scrutiny? Or is this purely an endeavor to cash in on the opportunity?

The PrePex plug piece continues:
"From the initial safety studies done so far, PrePex is clearly faster, less painful and more bloodless than any of its current rivals. And it relies on the simplest and least-threatening technology — a rubber band.

The band compresses the foreskin against a plastic ring slipped inside it; the foreskin dies within hours for lack of blood and, after a week, falls off or can be clipped off “like a fingernail,” said Tzameret Fuerst, the company’s chief executive officer, who compared the process to the stump of an umbilical cord’s shriveling up and dropping off a few days after it is clamped."

Again, this is hardly innovative; the PrePex is nothing but a glorified tourniquet device. A number of other devices use the exact same principle of cutting off blood circulation to the foreskin, including the TaraKlamp, the Smartklamp, the Ismail Clamp, the Zhenxi Ring and the Shang-ring before it.

"Like a fingernail" is an attempt to trivialize the foreskin. Any part of the body will shrivel up and die if you cut off circulation to it. Unlike the foreskin, or any other part of the body, fingernails are a dead part of the body, and don't need to be tied off to cut off circulation before trimming them. The umbilical cord does not need to be tied off either, as it too is a dead part of the body which will eventually shrivel up and fall off on its own.

Focus on PrePex
I'd like to zero in on this Tzameret Fuerst woman. Who is she? Why is she so enthusiastic about circumcision? Particularly this new "PrePex" device? And why does it seem like she's more excited about getting millions circumcised, than she is about HIV prevention? Why is the fact that, even if "studies" were correct, circumcision is not "100% effective" an afterthought?

If my presumptions are correct, she is the wife of Oren Fuerst, co-inventor of this device. Millions of men circumcised means that millions of PrePex devices will be bought and used. She's cashing in on the HIV gravy train, and that's why she's so enthused.

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

Continues the PrePex ad:
It is done with topical anesthetic cream, and there is usually no bleeding. And PrePex can be put in place and removed by nurses with about three days’ training.

All really irrelevant afterthoughts... If there is no scientific proof that circumcision prevents HIV, and even given the "evidence" condoms still do a far better job, what does the minimalization and the simplicity of the procedure even matter...

The rings come in five sizes, A through E, Ms. Fuerst said, “and you won’t believe how high-tech the rubber band is.”

She's right! I don't!

"Each size must apply just enough pressure to cut off blood flow without being tight enough to cause pain"

Fuerst, does PrePex have an AIDS prevention method that DOESN'T involve cutting off part of my penis, please?

"The W.H.O., Mr. Warren said, is also evaluating the Shang Ring, a plastic two-ring clamp developed in China to treat conditions in which the foreskin becomes so tight that it cuts off urination."

And here we see the injection of a condition which necessitates circumcision, and another device that facilitates it. Are we even going to be given a scientific explanation as to what these "conditions" are? If they actually cut off urination, and they actually need circumcision viz Shang Ring?

What is the name of the condition where the foreskin becomes so tight it cuts off urination? What causes it? Is circumcision the only option? More gratuitous promulgation of non-science.

Moving forward:
"However, it requires cutting off the excess foreskin beyond the clamp, which means the circumciser must inject anesthetics directly into the penis and groin, wait for them to take effect, create a sterile surgical field and be trained in minor surgery."

“The Shang is not as fast, but it’s faster than full-fledged surgery,” Mr. Warren said. “And it hasn’t submitted as much safety data."

"In a safety study presented at an AIDS conference last month, scientists from Rwanda’s health ministry said they had used PrePex to circumcise 590 men. Only two had “moderate” complications; one was fixed with a single suture, and one required a new band in a different spot."

All useless information that draws attention more and more away from whether or not circumcision actually prevents anything... I'm sure with just the right amount of "research" one could invent a device that facilitates the extraction of the labia with only "moderate" complications...

Or better yet, come up with an actual solution that doesn't involve genital mutilation...

Continuing on: 
"According to Dr. Jason Reed, an epidemiologist in the global AIDS division of the Centers for Disease Control and Prevention, 2 of 590, or 0.34 percent, is a tenth the typical complication rate of surgical circumcision."

More statistics to blind the reader with. That's 2 out of 590 in a controlled study. What does that look like for the rest of Africa outside of the scientific environment? And what does this figure look like at 20,000,000 men? One in 295 men will suffer complications. Over 20,000,000 men that these people plan to circumcise, that's about 67,800 men who will suffer complications.

And that's *if* the people writing these "studies" were writing the truth. Remember, they're trying to MARKET their device.

I'm also being kind in assuming that all 20,000,000 African men will have undergone circumcision using the PrePex device; surgery will still be used, and, given the WHO green light, tribes will continue to circumcise youth and men traditionally. The number of complications is going to exceed 70,000, as will the number of iatrogenic HIV transmission. (In Africa, visiting a health center in and of itself is a risk for HIV. Is Daniel McNeil Jr. not aware of this fact?)

All of this, when HIV can already be easily and effectively prevented via education and condoms???

There is another lie that Jason Reed is trying to slip by here; that 0.34 percent is a "tenth" of the typical complication rate of surgical circumcision.

What kind of circumcision could Jason Reed possibly be referring to? Adult circumcision? Child circumcision? What is being counted as a "complication?"

There are reasons to believe that CDC statistics on circumcision in the United States is flawed, namely that they report "zero deaths" when intactivists have a long list of deaths documented. They report an infinitesimally small number of "complications," when we have reports that botched circumcisions have been on the rise for the past few years. Is the CDC telling the truth? Or are they circumcising it?

Instead of investigating, the New York Times takes Reed's presentation of CDC statistics at face value. Let's hear it for American journalism!

"None of the men became infected."

That's great! Does circumcision prevent HIV? Is it even relevant in light of HIV prevention methods which already supersede it?

"On the 10-point pain scale, they reported [a]n average [of] only about 1 when the ring was placed and only 3 when it was removed (about the same level of pain caused by erections during the week they wore it).

By the end of the study, the two-nurse teams could do a procedure in three minutes.

By contrast, Dr. Reed said, the best surgical “assembly lines” — a practice being pioneered in Africa with American taxpayer support — can get down to seven minutes per patient, but only by getting six nurses and a surgeon into a tight harmony."

"Looking busy" is but a distraction from the main points:

Does circumcision prevent HIV? Even if it did, even if the science were correct, is it even worth it in light of less invasive, more effective methods of prevention that already exist? Is it ethical to promote deliberate genital mutilation in the name of "research" and "public health?" Would we ever promote female circumcision if we had the same "research" to support it? What if it could be made "painless" or "bloodless?" What if we could make it so it doesn't decrease a woman's sexuality? Would we consider female circumcision then?

"In theory, he said, breaking that into three two-nurse PrePex teams could mean circumcising around 400 men a day, rather than the 60 to 80 a busy team now does. And the surgeon could go do something more important."

That's assuming 400 men a day would indeed line up to get circumcised. Many programs, such as Soca Uncobe, have completely missed their mark.

Or, instead of spending millions of dollars on needless devices, instead of emburdening surgeons with a time-consuming, needless procedure to mutilate the genitals of millions of men, they could be spending money on condoms and sex education, which, even if the "science" were correct, is worlds more effective. HIV transmission could be decreased WITHOUT genital mutilation, WITHOUT the need for these ridiculous devices. Men could keep their organs, condoms and sex education would prevent HIV in both men and women, and no time, money or energy has to be wasted on a dubious form of "prevention."

"In fact, Dr. Reed said, American AIDS dollars for circumcisions often go toward an operating room with lights and an instrument sterilizer. Instead of circumcisions, hospitals are more likely to use it for procedures like saving women in obstructed labor"

"Which is understandable — of course that takes precedence,” he said. “But then the circumcisions don’t get done."

Which doesn't make a whole lot of sense.

It doesn't make any sense to be spending millions on genital mutilation, when, even if the science is correct, would fail to live up to a condom. It doesn't make sense that there are other, more important issues to address; healthcare in general, mother-to-child HIV transmission, food, water, etc., and "experts" like Reed are more concerned that money isn't wastefully being spent on circumcision, for which there is already cheaper, less invasive, more effective ways to prevent HIV.

What is this all about? Is this about healthcare? HIV prevention?

Or is this purely about circumcision?

Some "experts" need to get their priorities straight.

"Robert C. Bailey, an epidemiologist at the University of Illinois at Chicago who helped design Kenya’s circumcision efforts, opposes timesaving devices because training nurses in minor surgery has other benefits, he said. A trained nurse could close a wound or take out an appendix, for example. And the time-consuming parts of the process are counseling and H.I.V. testing, Dr. Bailey said, so 'doing it in five minutes instead of 20 is trivial.'

"But he conceded, 'If PrePex really doesn’t require anesthesia, that’s truly an advance.'"

This part of the article is a bit confusing, and I'm not sure I understand it myself.

First off, am I to understand that nurses are being trained in surgery OTHER than circumcision? But furthermore, am I to understand that circumcision is being used as an "opportunity" for counseling and HIV testing? Couldn't circumcision simply be skipped and men could be given counseling and HIV testing directly? Or are intact men simply incapable of receiving these things?

Imagine, for a moment, a dentist using a total tooth extraction as a pretext to hand people information on oral hygiene and dental care. But his patients still have to use false dentures.

Imagine the converse. What if we started offering circumcision to the women so that doctors can then “take the opportunity” to tell them about better hygiene practices and sex education?

The million dollar question is, since when does a man need surgery to learn how to wash his penis and use a condom properly? Does not being circumcised somehow impede a man’s learning of these concepts? Does not being circumcised somehow nullify the protective effect of condoms?

The article continues:
"Rwanda is training 150 two-nurse teams; it is a small country, but it serves as a bellwether for Africa because its health care system is well organized, government corruption scandals are rare, and it is heavily supported by donor funds."

Rwanda is also a country where HIV has been shown to be more prevalent amongst the CIRCUMCISED. According to a demographic health survey taken in 2005,  the ratio of circumcised vs. intact men who contracted HIV was 3.8% vs 2.1%.

And, incidentally, 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 Rwanda. (In America, 80% of the male population is circumcised from birth.) 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.

Somehow, though, something tells me that the New York Times is not going to publish this part of the story.

The PrePex ad continues:
"Other, rival devices are not far along in safety testing or are failing it."

Hint hint... it's the PrePex, everyone!

"The Tara KLamp, manufactured in Malaysia since the 1990s, has created controversy in South Africa. It is a hinged plastic bracket the size of a small drinking cup. A plastic tube goes over the head of the penis, and the foreskin is pulled up it and painfully crushed by the bracket. Then the whole contraption must be worn at least five days. A 2005 clinical trial in South Africa was stopped early after the device caused far more injuries and infections than surgery did."

It is essentially the same exact contraption as the PrePex, and follows the exact same mechanism and principle of cutting off circulation to the foreskin, thereby facilitating its excision. Rest assured, though readers, the PrePex is the better design.

But again, a man needs a PrePex likes a fish needs a bicycle.

 "The national health ministry has banned it in most of South Africa, but it is still used heavily in KwaZulu-Natal Province, which has the country’s highest AIDS rate and where the Zulu king, Goodwill Zwelithini, reversing 200 years of tradition, ordered that all Zulu men circumcised. 

The W.H.O. knows about the stopped trial and is not considering the KLamp, Mr. Warren said."

Oh thank heavens! They don't seem to be too concerned that non-authorized devices and circumcision methods are being used in their name, though.

One must wonder as to the relevance of the Zulu king anecdote; is the author more concerned with HIV prevention, or with "reversing 200 years of tradition?" This really shows you where his heart actually is.

Reed continues:
"Dr. Reed said he had heard that another device, Ali’s Klamp, was being tested in Kenya under protocols that seemed to match W.H.O. requirements. According to Circlist.com, a circumcision information Web site, it is a Turkish device dating to 2007, and works on principles similar to those of the Tara KLamp and another device, the SmartKlamp, approved by the F.D.A. in 2004."

For all intents and purposes, all of these devices are essentially the same. They all function under the exact same principle of cutting circulation off to the foreskin. The PrePex is simply a different design.

Now, I'd like to take the time to correct a horrific error that this article commits, and that is present circlist.com as a mere "cirumcision web site."

What is Circlist? What do they do?
Circlist is a circumfetishist organization. A circumfetishist is someone who has a sexual fixation for the circumcised penis, and/or derives sexual gratification from the act of circumcision itself. The Circlist organization has a website and discussion group for men who sexually fantasize about performing and receiving circumcisions, often on small children. Circlist members openly admit to a morbid fascination with circumcision, to the point of being a sado-masochistic fetish. Circlist has been long known to intactivists as a meeting place for circumfetishists, where they discuss the erotic thrill they experience from watching other males being circumcised, swap fiction and non-fictional stories about it, and trade in videotapes of actual circumcisions. They are a fetishistic organization comparable to NAMBLA, and yet, here they are, being given credibility on the New York Times.

The fact that Circlist is being used as a reference in this piece, even though it doesn't rely on them for any facts, demonstrates how uninterested the New York Times is in logic and ethics. The site’s inclusion with a direct link to it is absolutely shameful. What a sick, disgusting shame that Daniel McNeil Jr. of the New York Times has decided to quote them as any kind of reliable resource.

SHAME on you, Daniel McNeil Jr. for daring to give publicity to this sick, disgusting group in the New York Times.

On to the end:
"PrePex was cleared by the F.D.A. because it was judged “substantially equivalent” to the SmartKlamp, Ms. Fuerst said. Proving equivalence in safety to an approved device is the fastest way to get approval, she said..."

Which seems to be her actual main concern...

"...although the technology is quite different."

No, the technology is the same, and it's rather old.

And finally:
PrePex’s ultimate cost is still being negotiated with donor agencies and foundations, Ms. Fuerst said, but may end up in the $15-to-$20 range, about the same as a surgical circumcision kit.

Let's see, at 20,000,000 men, that's $300,000,000 at minimum, and $4,000,000,000 at most.

For a useless, extraneous device looking for a purpose, not bad.

Not bad at all.

Closing comments
The "science" behind this massive effort to stuff circumcision down African people's throats is horrendously flawed. Why news outlets simply publish lies without questioning their validity is perplexing. A question that I keep encountering on the blogosphere is "Whatever happened to actual journalism?" But that's a different discussion for another blog post.

Even IF we lent any credibility to the latest twaddle some people dare to call "science," we have got to ask, why is the solution always circumcision?

Contrary to what is published here in the New York Times, there is actually no demonstrable scientific proof that the Langerhans cells "pick up viruses and "present" them to the immune system." But let's just assume just for a moment, that the claims were true. Let's just assume for a moment, that the Langergans cells, as they claim, "presents HIV to the immune system."

Is there any reason why the so-called "researchers" aren't looking for ways to deactivate Langerhans cells, as opposed to cutting them off?

Is there any reason why PrePex is not looking for non-destructive ways to prevent HIV transmission, and instead facilitating male circumcision which just happens to be a cherished tradition in their own country of origin?

Let's ask other questions. Assuming the Langerhans cells behave the way circumcision advocates claim, is there a reason why "researchers," PREPEX etc. aren't looking into FEMALE CIRCUMCISION? It is irrefutable scientific fact that Langerhans cells are found in the genital mucosa in BOTH sexes. If the Langerhans cells "facilitate" HIV transmission for men, then it would also do so for women. Circumcision, would only be offering "benefit" to men; women would still be vulnerable to the viral load in semen.

Which raises the question:

How is it conscionable to be spending millions of dollars on the promotion of an alternative to the most conclusively effective mode of HIV prevention known to us?

Why aren't the WHO, PEPFAR, PrePex etc. worried at all that the promotion of male circumcision is going to result in the grossest of violation of the most basic of human rights?

The Bottom Line
The foreskin is not a birth defect. Neither is it a congenital deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair, or fingernails. The foreskin is normal, natural, healthy tissue with which all boys are born.

Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

Genital mutilation, whither it be wrapped in culture, religion or "research" is still genital mutilation.

Consider this: There would never be enough "science" or "research" to endorse the promotion of female circumcision to prevent ANYTHING.

It wouldn't matter if female circumcision were made "painless," "bloodless," and it didn't affect a girl's sexuality. It wouldn't matter if female circumcision were performed in the clean environment of the hospital, by a trained professional, using pain killers and the most pristine, and most "advanced" utensils. Why do "researchers" grope for reasons to promote male circumcision?

The day will come when anyone whoever endorsed this despicable human rights violation will be too embarrassed to ever admit that they did.

May god have mercy on their souls.

Thursday, January 26, 2012

Circumcision in Africa: We Keep Warning. Is Anybody Listening?

Ever since the WHO endorsed circumcision as HIV prevention in 2006, we intactivists have been trying our best to warn promoters of circumcision, and organizers of so-called "mass-circumcision" campaigns that this is going to backfire.

We keep warning that the studies are horribly flawed, that empirical data completely contradicts the results in the so-called "research," and that African men are going to see this as nothing other than a green light for unprotected sex, putting millions of men and women in danger of sexually transmitted HIV.

Nope, major charities and organizations such as Bill and Melinda Gates and PEPFAR are in Africa bankrolling so-called "mass circumcision campaigns" full-speed ahead. Whenever any of these organizations puts out any sort of statement, it's always "circumcision, circumcision, circumcision." Abstinence, faithfulness and condoms seem to have been placed on the back burner, and are barely even mentioned, if at all.

How is it possible that we are over-stating an alternative to the most effective mode of protection against sexually transmitted HIV known to us?

In May last year, I wrote a similar post to this one. PANOS Eastern Africa had put out a report that showed that the circumcision/HIV messages meant to reduce the prevalence of the disease were actually facilitating its spread. I also gave instances of others warning that this is precisely what would happen, as well as many cases in point in vivo.

It is now the end of January, starting a new year, and neither PEPFAR nor Bill Gates etc. have changed their message. In fact, these organizations and more have come out stronger than ever in their drive to circumcise the whole of Africa. In December last year, PEPFAR kicked off another year reinforcing the circumcision campaigns in Africa. Very recently, Bill Gates released his 2012 annual letter, and, as expected, he pushed circumcision. Circumcision, claims Gates, reduces AIDS transmission by a whopping 70%. Where IS he getting this number from? Why ISN'T this number manifested in the real world?

More Reports Come In
While you'll hear in the news about how "successful" the "mass circumcision campaigns" have been (not so much in reducing HIV, but in how many men they've managed to dupe), you won't hear about reports warning that men and women are taking home the wrong message.

According to AllAfrica.com, "Nyanza provincial director of public health and sanitation, who is also the task force chairman Jackson Kioko, said there have been reports that those who have been circumcised are taking it as immunity against HIV."

PlusNews reports of a study in Kenya conducted by the University of Illinois' Chicago School of Public Health, which found, among other things, that "most women were happy with the appearance of their partner's penis and enjoyed sex more after circumcision." (Others studies will find that there are men that like the experience of their partner's circumcised vulvas, and that they enjoy sex more, but we'll not ever hear about them.) As sexist and degrading as this "study" is to men, it was supposed to be the study's "plus" side. On the negative, the study found that the women believed that condoms were less necessary than circumcision, that they were more likely to have more than one sexual partner, and to have sex without a condom. One would think that these issues would have been addressed BEFORE rolling out these so-called "circumcision campaigns?"

Nevermind the ethical dilemma of endorsing genital mutilation in the name of  public health interests, and nevermind the sexist, misandrist marketing practices of trying to sexify circumcision, and stigmatize intact men. And nevermind the fact that plans are already underway to forcibly circumcise newborns and youth.

Is nobody concerned that the promotion of circumcision will deprecate the value of cheaper, more effective, less invasive HIV prevention measures, thereby putting the lives of millions of African men and women in danger???

The Warning Continues...
The promotion of circumcision as HIV prevention is a catastrophic mistake. Even if the "research" was correct, and it is horrendously flawed, circumcision would fail to deliver the efficacy of HIV prevention methods which far exceed it. In light of condoms and education, which have been conclusively proven to prevent HIV, promoting circumcision is an impertinent disservice in the fight against HIV/AIDS.

The promotion of circumcision will result is already resulting in Africans perceiving the most effective HIV prevention known to us as an expendable option. The promotion of circumcision is going to backfire, sending the wrong message, putting the lives of men and women in danger. The promotion of circumcision is going to be a waste of precious funds, where they are desperately needed in other areas (i.e. food, water, access to actually needed healthcare, etc). The promotion of circumcision is an ethical, scientific scandal waiting to explode. The promotion of circumcision is going to be a disaster that is going to haunt any organization and individual that ever endorsed it.

Even if the "research" was accurate, circumcision fails. Circumcision fails, and this is why even the very authors cannot stress the importance of condoms enough. Condoms would prevent, not only the transmission of HIV, but the transmission of other STDs more effectively, and more efficiently. Condoms would prevent STD transmission not only in men, but in their partners as well. Additionally, condoms prevent unwanted pregnancy. Circumcision does not.

It is going to prove a fatal mistake to have ever endorsed a dubious alternative to the only effective method of HIV prevention ever known to us.

It is endorsing the grossest violation of  the most basic of human rights.

Consider this: There would never be enough "science" or "research" to endorse the promotion of female circumcision to prevent ANYTHING.

It wouldn't matter if female circumcision were made "painless," "bloodless," and it didn't affect a girl's sexuality. It wouldn't matter if female circumcision were performed in the clean environment of the hospital, by a trained professional, using pain killers and the most pristine, and most "advanced" utensils. Why do "researchers" grope for reasons to promote male circumcision?

Genital mutilation, whether wrapped in "science," "research," and feigned interests in public health, is still, in the end, genital mutilation.

The day will come when anyone whoever endorsed this despicable human rights violation will be too embarrassed to ever admit that they did.

May god have mercy on their souls.

Tuesday, January 17, 2012

Male and Female Infant Circumcision: Which One is Worse?

In the battle against male genital mutilation, intactivists always point out that while male circumcision is defended on the grounds of "religious freedom," "parental choice" and "medical benefits," the same is not true for female circumcision. At the same time, advocates of male infant circumcision always shoot back "male and female circumcision aren't the same!" There are some that even go as far as feigning offense and demanding "How dare you compare male and female circumcision! We're not moving forward until we agree that they're not the same!"

So we hear that male and female circumcision "aren't the same." But what is the basis for this claim? Are we supposed to believe it at face value without any demonstrable proof? When a circumcision advocate asserts that male and female circumcision "aren't the same," what does that person mean? What exactly is he comparing?

I've already written an extensive blog post on the matter here, so I won't spend too much time on this one.

I'm just going to briefly cover a few points of consideration for this debate that tend to be completely ignored, if ever even brought up.

Male circumcision as it happens in the United States to newborns and children is always compared to female circumcision as it happens in the African bush to teens and adult women.
This is a false comparison. Circumcision advocates always compare male infant circumcision, which is usually conducted by a professional, with sterile equipment, in the pristine environment of a health facility (sometimes) with analgesia, with the kind of female circumcision that is conducted in the African wilderness as a rite of passage, which is usually conducted by a shamaness priestess, using raw tools such as a rusty razor blade or a glass shard, under the harsh conditions of the bush. They are also comparing two different genital cutting procedures that are not analogous to each other.

Not all female circumcision is performed in the bush.
In fact, female circumcision is also performed by doctors with sterile utensils under pristine conditions. Some doctors also claim there to be "medical benefits," citing works and studies. They do this out of genuine concern for their patients, and not because they wish to justify their profession I'm sure.

Not all female circumcision is performed on teens and adult women.
Male circumcision advocates elicit an emotional response when they present the image of a teen or an adult woman being forced to undergo genital cutting. Male circumcision is supposed to somehow be justified by the fact that it is often performed on newborn babies that will not remember.

The fact is that circumcision is performed in baby girls in various parts of South-East Asia, namely Indonesia, Malaysia, Singapore and Brunei. "She won't remember," however, seems to fail this litmus test.

Not all female circumcision is forced.
As in adult male circumcision, adult female circumcision is also often a rite of passage that a girl or woman is expected to undergo willingly. "Willingly" is a misnomer, as succumbing to social pressure can hardly be called "free will." This seems to be a good enough reason, however, to look the other way, when it concerns male circumcision as it happens in African tribes. In the "mass circumcision campaigns" in Africa, one often hears the acronym "VMMC," which stands for "voluntary medical male circumcision." With all the social pressure to get circumcised, lest one be seen as an HIV risk, one must wonder how much of the circumcisions in Africa are actually "voluntary."

For better or for worse, however, there are communities where a woman submits herself to get circumcised out of her own free will. While this is enough to justify male circumcision in various situations in Africa, "social pressure" only seems to be a problem when it involves female circumcision.

Not all female circumcision removes the same parts.
Male circumcision advocates always compare male infant circumcision as it occurs in the United States, to infibulation, which is a kind of female circumcision that removes the clitoris, inner and outer labia, and the remaining wound is sewn shut to leave only a small hole for menstruation.

In reality, infibulation is the WORST kind of female circumcision, and it is actually the rarest, comprising of 15% of female circumcision globally. There are various other forms of female circumcision, and not all of them remove the same parts of the genitals. There are forms of female circumcision that are as equal to, or less severe than male circumcision. At least in the United States, ALL forms of female genital cutting is considered "mutilation," and against the law.

What is true for female circumcision, is also true for male circumcision.
Just as female circumcision is often performed by shamanesses and priestesses with glass shards and rusty razor blades under harsh conditions, the same is true for male circumcision.

Every year, millions of men undergo circumcision  as a rite of passage in various parts of Africa, and every year, scores of men succumb to infection, lose their penises to gangrene, or die.

While these are concerns regarding female circumcision, they don't seem to be a concern regarding male circumcision.

Perhaps less women would succumb to infection or bleed to death if only these procedures would be done in hospitals. Perhaps it would be less traumatic if only these women were circumcised as babies so that they wouldn't remember the pain and anguish.

The suggestion that African states should provide sterile equipment and proper training to provide "infant female circumcision" would probably not make it very far.

So what is being compared?
The comparison of male infant circumcision as it occurs in America to female circumcision as it occurs in the African bush is self-serving hyperbole.

A more accurate comparison of male infant circumcision as it occurs in American hospitals would be female infant circumcision as it occurs in Singapore, Indonesia, Malaysia, and Brunei.

A more accurate comparison of female circumcision as it occurs in Africa would be male circumcision as it occurs in Africa.

Apples to apples
So what do people mean when they assert that "male and female circumcision aren't the same?"

When someone makes this claim, can we trust that this person has actually taken the time to do their research? That s/he has actually witnessed both male and female circumcision? Adult and minor?

How can we be sure that they're aren't blowing female circumcision out of proportion in order to trivialize male circumcision?

I dare say that comparing male infant circumcision as it is performed in US hospitals to female circumcision as it is performed in the African wilderness is a false comparison. It ignores the fact that circumcision is performed in males under the exact same conditions as it does in females. It ignores the fact that there are actually various kinds of female circumcision, some equal to, if not less severe than male circumcision as we know it. It ignores the fact that we would never accept female circumcision, not even the kind that can be compared with male circumcision, or even dwarfs in comparison.

Let's compare the same exact thing:

A baby in South-East Asia undergoes "sunat"
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 slit clitoris if you can find it (on the lower blade)

You can read the whole thing here:

We're often told that male infant circumcision is "just a little snip," "he doesn't even cry," and they remove "only a little flap of skin."

Well, let's have "a little flap of skin,"

..and let's compare it to the slit clitoris above.

I'm somehow not convinced that the foreskin is "just a little flap of skin."

And I'm not convinced that female circumcision, as we see above, is "worse."

Remove the same exact amount of flesh you see above from the genitals of a baby girl, that would be "mutilation."

When we actually sit down and compare like with like, I dare say male infant circumcision is more severe than female infant circumcision.

Recap of the facts:
Female circumcision is not always as severe as male circumcision advocates would like their audience to believe. While it is often performed by a shamaness priestess, using raw tools such as a rusty razor blade or a glass shard, under the harsh conditions of the bush, the same is also true for male circumcision.

While male infant circumcision is often conducted by a professional, with sterile equipment, in the pristine environment of a health facility, the same can also be true of female circumcision.

While infection and hemorrhaging to death are risks of female circumcision, the same is also true of male circumcision.

Claims of "hygiene" and "medical benefits," as well as "literature" to back these claims exist for both male and female circumcision. While these seem to be perfectly good rationale to justify circumcision in males, there would never be enough literature that would ever make female circumcision "acceptable."

Comparing the severity of male and female circumcision, citing "potential medical benefits," "religion and culture," and "parental choice" are all red herrings that draw attention from the point that intactivists are trying to make:

Circumcision, male or female, is always abuse, genital mutilation, and a gross violation of basic human rights, when it is conducted on healthy, non-consenting individuals.

Whether it is performed by professional or amateur, in the hospital or in the bush, on babies, children or adults, with pain killers or without, with a glass shard or a scalpel, whether it removes a "tiny flap of skin," or a substantial chunk of flesh, for "potential medical benefits" or for "religious reasons" is irrelevant.

The Bottom Line
The foreskin is not a birth defect. Neither is it a congenital deformity or genital anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair, or fingernails. The foreskin is normal, natural, healthy tissue with which all boys are born.

Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

Doctors have absolutely no business performing surgery on healthy, non-consenting individuals, much less stoking a parent's sense of entitlement.

For more information regarding female circumcision as it is performed in South East Asia, I recommend the following article:

The WHO classifies female circumcision into four types. Read more about them here:

Closer investigation reveals that, contrary to popular belief, women who have undergone infibulation, which is the worst kind of female genital cutting, are still able to orgasm:

"Studies show" that female circumcision "reduces" the risk of HIV:

"Female circumcision results in a reduction of infections resulting from microbes gathering under the hood of the clitoris"
"Attacks of herpes and genital ulcers are less severe and less harmful with women who have been circumcised"

A mother in South East Asia blogs about her daughter's circumcision, or "sunat," as it is known there. The picture used in this blog post was also taken from here:
Another blog similar to the one above:

In the following parenting forum for South East Asia, mothers describe their experiences in having their daughters circumcised, their own circumcisions as adults, and there are even some recommendations for doctors who perform it.

Note that if the forum above were discussing boys instead of girls, it would read like almost any other parenting forum on the internet, such as CafeMom or what have you. Cutting genitals in the name of "religion," "parental prerogative," or "potential medical benefits" is only an issue with girls; never with boys.