Monthly Archives: July 2014

2 [more] babies contract herpes during ritual circumcision and metzitzah b’peh

I’ve been trying to write this note for a few days, but I feel depleted. I don’t want to write it. I don’t want to have to write it. I’m tired of this happening over and over.

When I saw the news being shared on social media, I had a deja vu moment. I thought surely it wouldn’t be a new story. I had seen it, last year in April (before this blog started). But I had also seen it and written about another case in January of this year.

But no, it was indeed a new story, on July of  2014. Here’s the New York City Department of Health and Mental Hygiene’s alert.

Mohel performing metzitzah b'peh on a circumcised baby

Mohel performing metzitzah b’peh on a circumcised baby

Two more babies contracted herpes this year as a consequence of metzitzah b’peh (MBP), part of the Jewish ultra orthodox way of performing circumcisions or bris milah, in which the mohel (circumciser) performs oral suction on the freshly circumcised penis of the baby.

These babies join a string of affected babies in New York, that has resulted in at least 2 deaths and 2 cases of permanent brain injury.

Speaking of the NYC Department of Health and Mental Hygiene, do you readers know who works there? Dr. Susan Blank, a member of the American Academy of Pediatrics (AAP) 2012 Task Force on Circumcision.

The AAP 2012 statement on circumcision (coauthored by Dr. Blank) says: “there are social, cultural, religious, and familial benefits and harms to be considered as well. It is reasonable to take these nonmedical benefits and harms for an individual into consideration when  making a decision about circumcision.” In Circwatch, we object to this. There are no other surgeries performed on babies for “social, cultural, religious and familial” reasons, which are not valid medical indications for surgery.  The law against FGM/Female Genital Mutilation, for example does not condone cultural or religious reasons to perform genital surgery on female minors.

However, beyond that, the AAP Policy Statement did not take a strong stance on metzitzah b’ peh. This was their exact quote regarding this ritual:

The Task Force advises against the practice of mouth-to-penis contact during circumcision, which is part of some religious practices, because it poses serious infectious risk to the child. 

First, it is not part of SOME religious practices. It is specifically part of one religious practice, the one of circumcision by ultra orthodox jews, one practice that would not have been unknown to Dr. Andrew Freedman, also part of the AAP Task Force on Circumcision, and a man of Jewish ancestry.

But also, there is a strong difference between “advising against” and “strongly condemning”, and that is what the AAP should have done, they should have strongly condemned the practice of “orogenital suction”.

Due to the recurrent incidence of this problem, the NYC Department of Health in 2012 devised a “Consent to perform oral suction during circumcision” form. The NYC rabbis have resisted this consent form as an intrusion on their “religious freedom”.

This was one of the heated points during the recent NYC Mayor elections that led to Bill de Blasio’s election. De Blasio had promised to start over and remove the consent form requirement, something that so far he has not done, but also failing to do anything for the protection of the babies.

This consent form is on itself a travesty.  Can parents consent in any other instances, to allow an adult person to perform oral suction on the genitals of their children? Is this the “wide latitude in terms of the decisions [parents] make on behalf of their children” that the AAP argues for?

Wouldn’t there be an outrage if parents consented to an adult man performing oral suction on the genitals of baby girls? Would the intention of the person even be a question, as it is in the case of metzitzah b’peh?

But even then, this form does nothing to protect the children. It only serves to put the responsibility on the hands of the parents.

The AAP says: “the law has respected those decisions except where they are clearly contrary to the best interests of the child or place the child’s health, well-being, or life at significant risk of serious harm“. Well, isn’t the risk of herpes transmission to babies “clearly contrary to the best interests of the child or [placing] the child’s health, well-being, or life at significant risk of serious harm”? Why is the law not acting strongly to prevent this?

Notice that the consent form does not even require the mohel’s signature. Not only that, but these consent forms are not enforceable.

From this page, we ask the American Academy of Pediatrics, we ask Dr. Susan Blank, we ask the NYC Department of Health and Mental Hygiene, and we ask NYC Mayor Bill de Blasio, how many cases of babies infected with herpes are necessary? What does it take to take a strong, assertive stance for the right of children to life and to be free from torture and inhuman or degrading treatment or punishment? What does it take to include metzitzah b’peh among the list of Harmful Traditional Practices Affecting the Health of Children? What does it take to recognize that adult persons sucking the freshly wounded genitals of babies amounts to ritual abuse of minors?

Susan Blank from FPHNY on Vimeo.

Vernon Quaintance pled guilty (pro circumcision – Gilgal Society)

A former sacristan for the Knights of Malta has pleaded guilty to nine sex offences including those against boys as young as 11 he had met in the 1960s and 70s.

(…)

On Wednesday this week a court heard that Quaintance, 71, was a paedophile who also ran a pro-circumcision group. Southwark Crown Court heard he accumulated images as recently as 2011.

He was also a leader of the Gilgal Society, a group claiming to promote male circumcision and “its benefits in terms of health, sexual satisfaction and self-image.”

In 2012, he was found guilty of possessing nine hours of child pornography on video tapes. This week he pleaded guilty to five counts of indecency with a child between 1966 and 1976 and four counts of possession of indecent images. An additional count of sexual assault alleged to have taken place in 2011 on a child was left to lie on file.

http://www.thetablet.co.uk/news/981/0/former-knights-of-malta-member-pleads-guilty-to-abuse-of-young-boys

* The Gilgal Society’s website has now been rebranded The Circumcision Helpdesk

A sport-based intervention to increase uptake of voluntary medical male circumcision

Last year we heard a story about HIV researchers / circumcision advocates in Africa. Of course, being just a story, having no evidence, we didn’t mention it. But the story seems to be now corroborated and will be presented at the AIDS 2014 Conference in Melbourne, Australia, July 20 to 25.

So this is what we heard:

“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.”

This story might come to be corroborated here: http://pag.aids2014.org/Abstracts.aspx?SID=1104&AID=5834

Abstract

MOPDC0106 - Poster Discussion Session

A sport-based intervention to increase uptake of voluntary medical male circumcision among adult male football players: results from a cluster-randomised trial in Bulawayo, Zimbabwe

Presented by Zachary A Kaufman (United Kingdom).

Z.A. Kaufman1, J. DeCelles2, K. Bhauti3, H.A. Weiss1, K. Hatzold4, C. Chaibva5, D.A. Ross1

1London School of Hygiene and Tropical Medicine, Epidemiology and Population Health, London, United Kingdom, 2Grassroot Soccer, Curriculum and Innovation, Cape Town, South Africa, 3Grassroot Soccer Zimbabwe, Bulawayo, Zimbabwe, 4Population Services International Zimbabwe, Harare, Zimbabwe, 5National University of Science and Technology, Bulawayo, Zimbabwe

The title of the abstract reads “adult male football players”. We are definitively interested in reading all the details.

We will be waiting for the full abstract, to be made public next Friday. But now you know what to wait for.

Manipulation. Peer pressure.

GRASSROOT SOCCER

PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, shared this photo a few hours ago through their facebook page:

In the Mchinji District of Malawi, local Peace Corps volunteer counterpart and Grassroot Soccer coach Henry Ching'ombe, works with the Kamwendo Youth Group on the GRS activity "Cut and Cover," which addresses medical male circumcision.

In the Mchinji District of Malawi, local Peace Corps volunteer counterpart and Grassroot Soccer coach Henry Ching’ombe, works with the Kamwendo Youth Group on the GRS activity “Cut and Cover,” which addresses medical male circumcision.

Notice that the photo mentions “Grassroot Soccer“. This is an organization with the following explicit goal, according to their facebook page: “Using the power of soccer to educate, inspire, and mobilize communities to stop the spread of HIV”

Combing through Grassroot Soccer’s website, the Bill & Melinda Gates Foundation makes its apparition:

The Bill & Melinda Gates Foundation and the Doris Duke Charitable Foundation (DDCF) are supporting Grassroot Soccer (GRS) in a unique and innovative randomized control trial in Zimbabwe that will assess the impact of an educational intervention using the power of soccer and its role models to increase awareness and uptake of medical male circumcision (MMC) as an HIV prevention measure. The trial, known as MCUTS (Male Circumcision Uptake Through Soccer), will target men ages 18-35 with educational outreach through soccer-related messages.

http://www.grassrootsoccer.org/2012/10/15/mcuts/

While this target age should be 18-35, some other articles on the website show a different panorama:

[May 12th 2012, GRS Zambia] for the first time ever at GRS, we held mobile Medical Male Circumcision (MMC) at the school grounds. The procedure was conducted by Marie Stopes International (MSI), and was sanctioned by the Ministry of Health for outreach service delivery.  There were four boys, between the ages of 16 and 24, who elected for the medical procedure. The operation takes between 25 to 30 minutes, and there is an additional pre and post counseling session dedicated to MMC. Each boy left the post counseling session knowing they now had 60% more protection against acquiring HIV.

http://www.grassrootsoccer.org/2012/05/25/grassroot-soccers-first-mobile-mmc/

 

“Make The Cut” (MTC)

Navigating more through the website we found a poster/report of just the very same abstract discussed above, the one that is still embargoed until next Friday. But now you can read it here: http://www.grassrootsoccer.org/wp-content/uploads/ICASA-Poster_MCUTS-Qual_6-Dec-2013_FINAL.pdf

Participants found MTC (in particular the Coach’s Story) persuasive because the MTC coaches had been circumcised and could discuss the procedure.

Future implementation should incorporate home-based follow-up and small incentives while avoiding delivery during the holidays and mid-season for professional soccer players.

http://www.grassrootsoccer.org/wp-content/uploads/ICASA-Poster_MCUTS-Qual_6-Dec-2013_FINAL.pdf

Goal Trial: targeting teenagers

goal

Generation Skillz is an eleven-session sport-based HIV prevention intervention delivered in secondary schools in South Africa, primarily focusing on age-disparate sex, multiple partnerships, gender-based violence, and male circumcision 

http://www.grassrootsoccer.org/wp-content/uploads/GOAL-Trial-IAC-Poster_Final-A4.pdf

 

Katharina von Kellenbach – feminist? religious? pro-circumcision?

 

Katharina von Kellenbach

Katharina von Kellenbach

Katharina von Kellenbach is Professor of Religious Studies at St. Mary’s College of Maryland. A native of West Germany, she studied Evangelical Theology in Berlin and Göttingen (1979-1982) and received her PhD in 1990 at Temple University. She became active in Jewish-Christian dialogue and Holocaust Studies while studying in Philadelphia and completed her dissertation on Anti‑Judaism in Feminist Religious Writings (Scholars Press, 1994). Her areas of expertise include feminist theology and Jewish-Christian relations, the ordination, life and work of the first female Rabbi Regina Jonas of Berlin (1902-1944), who was murdered in Auschwitz, as well as the theological, ethical, personal and political issues raised by the Holocaust.

Article: What’s wrong with the movement for genital autonomy

On July 9th of 2014, Katharina von Kellenbach published an article on Feminist Studies on Religion, titled “What’s wrong with the movement for genital autonomy”. In this article, Katharina attributes the creation of the Genital Autonomy to the Cologne case of 2012 which led to temporary age restriction of circumcision in Germany. In this regard, Katharina is wrong, as the genital autonomy movement can be formally traced at least to 1970 in Florida (Van and Benjamin Lewis), although there are individual books and articles (mostly by physicians but also by humanists) prior to this time, mostly in the countries where secular circumcision had become a custom (United Kingdom – Gairdner, 1949, United States – AP Morgan Vance, 1900, and Joseph Lewis, 1949), some as old as 1894 (Elizabeth Blackwell).

Katharina uses double quotes when the descriptions do not match her ideal view of reality. For example in reference to the Cologne case, she uses double quotes when she writes the words “grievous bodily harm”. These were the words used by the local judge in Cologne to describe the condition of the Muslim child, who had to be put under general anesthesia and operated as a result of the injuries sustained during and as a consequence of his circumcision.

Genital Integrity in Europe

Von Kellenback’s article states that “By December 2012, German lawmakers passed a law defending the right of Jewish and Muslim religious communities to circumcise their sons—though not their daughters.

The law however required a physician or trained practitioner to perform the surgery and limited the maximum age for the surgery (which could be a problem for some Muslim communities). The law allows non-physicians to perform the procedure until the 6th month (something definitively oriented to allow Jewish religious practitioners to perform the procedure). The Bundestag ignored the opinions of the German Academy for Child and Youth Medicine (DAKJ), the umbrella organization of all pediatric associations in Germany (German Society for Child and youth medicine DGKJ, Professional Association of the Child and Youth doctors, German Society for social pediatrics and youth medicine DGSPJ) and relied on the recently released statement of the American Academy of Pediatrics, in spite of the harsh critique by most European medical associations.

Von Kellenback then writes: “This spurred a movement across Europe that demanded the protection of boys’ bodily integrity in the name of gender equality. Their declarations and websites use gender-neutral language and declare “genital autonomy” a “fundamental right of each human being,” which includes “personal control of their own genital and reproductive organs; and protection from medically unnecessary genital modification and other irreversible reproductive interve.

In this paragraph we can see again the use of double quotes around the words “genital autonomy” and “a fundamental right of each human being” which seems to denote her disagreement with those expressions.

Ayan Hirsi Ali

Von Kellenbach extends her critique to “Somali anti-Muslim activist Ayan Hirsi Ali, never known to shy away from controversy“. Apparently the feminist branch of Von Kellenbach does not extend its compassion to women who have been subjected to female genital mutilation and death threats by religious extremists from patriarchal groups, if said women criticize male circumcision. (Shortly after posting the article online, the comments section was closed due to “continued ad hominem attacks” – this didn’t prevent Katharina from employing ad hominem attacks and generalizations throughout her article, most notably this one on Ayan Hirsi Ali).

While von Kellenbach initially quotes many scientific facts from intact positive websites, she then goes on a religious-politic tirade, neglecting to address rationally any of the facts she previously quoted.

Ironies

In ironic terms, Von Kellenbach assumes that the Genital Autonomy movement “aims to outman the political battle against FGM” and seems to mock the movement by saying that “suddenly, men must be rescued from marginalization and traumatization“. In this she ignores that the Genital Autonomy movement aims to protect all children, not adult men (or women for the matter). The Genital Autonomy movement also aims to protect intersex children, often the victims of horrific medical experiments. In fact, in the United States, the Genital Autonomy movement represented in Intact America, was one of the first organizations to oppose the Policy Statement on Ritual Genital Cutting of Female Minors of the American Academy of Pediatrics in 2010, one statement that tried to argue for allowing American pediatricians to perform a ritual nick on the genitals of female minors to appease parents from regions where female genital mutilation is practiced.

Von Kellenbach commits a logical fallacy frequently repeated by critics of the Genital Autonomy movement, in misrepresenting that male circumcision is considered by intactivists to be biologically equivalent to female genital mutilation. The intactivist argument is explained to be on an ethical level: non-medically indicated procedures that remove part of the external genitalia of a minor who has no need for the procedure, did not consent to it and cannot remove himself or herself from the situation, performed mostly to appease the cultural or religious traditions of the parents, in spite of real existent risks and harms.

Feminism?

Von Kellenbach goes on to say that “The gender-neutral code of “genital autonomy” serves to conceal the “seamless garment” of coercive violence that aims to control women’s sexual and reproductive bodies.“. In this she ignores that historically secular circumcision and secular female genital mutilation were implemented in English speaking countries during the 19th century to punish children for touching their genitals (control of their sexual bodies) and that it was known, even to ancient Jewish philosophers and physicians, that circumcision “excised the superfluous pleasure” and “weakened the organ of generation”.

She then takes a skewed point of view in writing that “The religious reasons for men’s “mutilation” are fundamentally different from the arguments that drive the wounding of women. Women are cut for aesthetic reasons in order to purify and protect men from promiscuous female sexual pleasure. Women’s pleasure and agency is the target of the knife and it serves no religious signification. Men’s circumcision, on the other hand, does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision and loaded with religious meaning.

First, groups which “circumcise” girls often give a religious meaning to the ritual. It may be the Western position to deny this (perhaps for political correctness), but Muslim women have argued that it is “an honor” and a “purification”, in other words, religious values denied by von Kellenbach.

In arguing that women are cut for aesthetic reasons, Von Kellenbach also ignores the globality of the debate. It is often heard from pro-circumcision women in the United States especially, that circumcised penises look “prettier”, that “uncircumcised” (intact) penises “look weird, gross, ugly, dirty, like an anteater, like an elefant trunk, are smelly”, etc, in other words, aesthetic reasons, and intact males are ostracized in some communities, i.e. considered children in Africa, called “supot” to ridicule them in Philippines, and supposedly made fun of in the locker room in the United States.

Katharina argues that “Men’s circumcision, [...] does not aim at sensation and potency. On the contrary, men’s virility is enhanced by circumcision“. In this she ignores not only the writings of Philo and Maimonides, but also scientific studies by John Taylor, Sorrells, Bronselaer and Frisch.

In stating that “God seals the covenant with Abraham promising him progeny, land, and everlasting life” von Kellenbach seems to ignore that not all the world ascribes to the Judeo Christian tradition and that babies are not aware of these dogmas when they are subjected to such “covenant”.

Von Kellenbach then compares “The sacrifice of (fore)skin” to “the pain and blood of breaking the hymen“, comparison that ignores that women have a right to choose if, when and with whom they will break their hymen, a right to genital autonomy not granted to baby boys who unwillingly undertake their “sacrifice“.

Strange for a feminist, von Kellenbach then writes that “Male circumcision and the penetration of women constitute the basis of the “covenant between me and you, and your offspring after you throughout their generations as an everlasting covenant.”“. In this statement women are sexually objectified and conceptualized as valuable only for their reproductive power.

Uncircumcised men?

In her opinion, “The movement to criminalize ritual circumcision is spearheaded by uncircumcised men who feel morally obliged to protect innocent boys from “ancient stone age rituals”“. This, of course, ignores the testimonials of men of all nationalities who were hurt physically and psychologically by their circumcision or simply oppose the idea of submitting babies to this painful and unnecessary procedure, and continue to push for the age restriction of the procedure, such as Richard Duncker of Men Do Complain (UK), Christian Bahls, president of Association of Children Victims Affected by Violence Against their Physical Integrity (MOGiS eV), Eran Sadeh Israeli founder of “Protect the Child” and many others.

Von Kellenbach goes on to say that “It is Christian men who want to prevent the medically unnecessary suffering of Muslim and Jewish boys” – Again, this is an attempt at creating a division that does not exist. There are Jewish, Muslim, African, Christian, American, Atheists, Pagans and men and women of all races, nationalities and faiths, expressing their opposition to circumcision. The attempt to re-frame and create this division is simply an attempt to frame the opposition to circumcision with anti-Semitism, something far from the truth.

Another common way to derail the discussion, used also by von Kellenbach, is to argue that the arguments against circumcision are simply emotional. This is simply countered by the opposition of medical associations, the existing studies showing the negative effects, not only the sexual effects, but also the traumatic effect of neonatal pain.

Von Kellenbach keeps trying to divide the readers by arguing that “Feminists, who work against sexual violence, such as FGM, are recruited into campaigns to outlaw gender-neutral ritual circumcisions“. In other words, feminists do not join the movement for genital integrity, they are recruited, they are deceived, with the purpose of “criminalizing Muslim and Jewish minorities” (and she still has the nerve to say that the arguments against circumcision are emotional!)

So basically, in von Kellenbach’s view, the genital integrity movement is created by European uncircumcised Christian men who recruit feminist women with the purpose of criminalizing Muslim and Jewish minorities. Perhaps Ms. von Kellenbach should visit the United States and speak with some of the intactivists here before writing about a movement that she evidently didn’t take the time to understand and learn about.

Conclusions

She concludes that “Feminists should insist on the fundamental difference between male and female circumcision and speak out against criminalizing male circumcision in countries where such bans serve to marginalize religious minorities.” So feminists should insist in denying the rights of male baby boys to their physical integrity.

It is sad when one has to argue for the physical integrity of children against political and religious entities and individuals who insist on being dense in ignoring the pain, trauma and vulnerability of babies. Of all babies, regardless of their gender.

Vernon Quaintaince’s trial starts – Gilgal Society website is down

Vernon Quaintance

Vernon Quaintance

The founder of the Gilgal Society, Vernon Quaintance, accused of a string of child sex offenses, is scheduled to start trial today July 14th of 2014.

The Gilgal Society’s website has suddenly gone blank. But it has been rebranded.

Vernon Quaintance also owns the International Circumcision Information Centre’s website (circinfo.com), which used to read “The International Circumcision Information Reference Centre is sponsored by The Gilgal Society”. Today it reads: “The International Circumcision Information Reference Centre is sponsored by The Circumcision Helpdesk”

Sure enough, The Circumcision Helpdesk website (registered since 2003 by Vernon Quaintance) now contains the information formerly on the Gilgal Society’s Website.

What is this guy playing? Who does he want to fool?

CIRCUMCISION, PROSTATE CANCER, and AUTISM: Misleading Headlines and Selective Reporting

A few months ago, in reference to the publication of an article by Brian Morris on Mayo Clinic Proceedings, we argued that:

Media headlines are used to manipulate the general opinion by using the more dramatic claims from the abstract to embed them in the collective consciousness. Most people will not read past the headlines, and will reach their conclusions based on this limited information. Few reporters and authors dare to criticize peer reviewed publications.

We recently saw this phenomenon at work again,  regarding a possible link between circumcision and prostate cancer. A combination of fear-mongering and wishful thinking are being used to promote America’s favorite forced genital surgery. We are also listening to the deafening silence regarding a study that correlated the use of paracetamol during routine infant circumcisions with increasing rates of autism, arguably because the media has no interest in reporting negative side effects from circumcision procedures.

Prostate Cancer

Let’s take a look at the headlines:

June 4th, 2014. Fox News: Circumcision Linked to lower risk of prostate cancer 

May 30, 2014. Daily Mail. Circumcision reduces the risk of prostate cancer by up to 60% – but is most effective when done after the age of 35

Apr 7, 2014. Science Daily: Circumcision could prevent prostate cancer

Apr 11, 2014. Men’s Health. Should You Get Circumcised? New research suggests a surprising benefit to getting snipped—but here’s why we’re skeptical

Jun 5, 2014. Jerusalem Post: Study links circumcision, lower rates of prostate cancer

May 29, 2014. Medline Plus: Lower Risk of Prostate Cancer Seen in Circumcised Blacks: Study. But findings still preliminary, need confirmation (linked by National Institutes of Health)

Apr 8th, 2014. Prostate Cancer UK: Not enough evidence to suggest that circumcision could reduce risk of prostate cancer

All of these headlines and more, are in reference to a single paper:

March 24, 2014
BJU. Circumcision and prostate cancer: a population-based case-control study in Montréal, Canada
Spence AR1, Rousseau MC, Karakiewicz PI, Parent ME.

 

Marie-Élise Parent

Marie-Élise Parent

So, you can see, dear readers, the disparity in the headlines. “Could prevent“, “Linked“, “Reduces the risk“, “Links“, “Lower risk is seen“, “Not enough evidence“. Some of the headlines appear to be conclusive (“reduces the risk“, “linked“, “links“), some are conditional (“could prevent“) and a few are skeptical (“not enough evidence“). Depending on which media outlet you read, you may get a different impression just from reading the headline.

So what does the study really say?

The results of the study read: “Circumcised men had a slightly lower risk, albeit not statistically significant, of developing prostate cancer“. Among the conclusions: “Circumcision appeared to be protective only among Black men, a group that has the highest rate of disease.

In Sense About Science, Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK responded to the study saying:

Although this study appears to show that circumcision after the age of 35 could reduce your risk of prostate cancer, the evidence presented is nowhere near strong enough that men should begin to consider circumcision as a way to prevent the disease. While the total sample studied was large, the number of men who had been circumcised after the age of 35 was very small, so this should not be seen as strong evidence of an association. There was no statistically significant association between prostate cancer and circumcision for men circumcised at all other ages. No reason was collected for circumcision, so we can’t say if the association is with circumcision later in life or with whatever causes men to have circumcisions after that age. It is also highly likely that diet, lifestyle, socioeconomic status and healthcare behaviours may have played a role in skewing these results.” – See more at: http://www.senseaboutscience.org/for_the_record.php/148/quotcircumcision-cuts-risk-of-prostate-cancer-by-45quot#sthash.w3uMSk3Y.dpuf

While the main benefit boasted in the study has been for black males circumcised over the age of 35, Fox News cites Dr. Christopher Cooper, a professor and urologist at the University of Iowa, declaring that ”The number of black men studied was too small for any conclusions to be drawn. Only 103 of the participants with prostate cancer were black men, and only 75 of the healthy men in the comparison group were black.“. The Fox News article finishes quoting one of the researchers, Marie-Elise Parent, saying: “We are too early in the game to make it a public recommendation. It could be that in the future it will be confirmed that it’s a good thing and may have an added protection from other diseases“.

Being early, however, didn’t stop the media from planting the idea that circumcision prevents prostate cancer, through the use of misleading and manipulative headlines.

The Daily Mail also cites Dr. Parent saying: “We do not know why a protective effect was observed for men circumcised after the age of 35. These men may have had a pathologic condition of the foreskin that lead to them being circumcised“.

Medline Plus quotes Dr. Parent cautioning that the black men in the study, mainly of French descent, may not reflect black men as a whole. And she said the study included few men who were circumcised at a later age, so that finding is potentially questionable. (Only potentially?)

Some of the articles indicate that the researchers suspect the connection may be a “lower rate among circumcised men of sexually transmitted diseases (STD), which raise prostate cancer risk” but they are not conclusive.

To this, Fox News cites Dr. Christopher Cooper, a professor and urologist at the University of Iowa indicating that the number of black men studied was too small for any conclusions to be drawn, and saying: “The STD mechanism is possible but quite a stretch“. He pointed out that there were factors the researchers could not control in the study, such as how honest participants were about having STDs or, among the men circumcised as adults, the reason for their circumcision.

Medline Plus cites Dr. Stephen Freedland, urologist and associate professor of surgery and pathology at the Duke University School of Medicine in Durham, N.C., pointing out that men circumcised after age 35 are unusual. “They’re usually older guys who are sick and have medical problems,” he said. The study findings as a whole aren’t convincing, Freedland added, especially since it included relatively few black men — just 178 of more than 3,100 participants. “I don’t think we’ll be recommending massive circumcisions to prevent prostate cancer,” he said. “And men shouldn’t go around thinking, ‘I’m circumcised, therefore I’m safe from prostate cancer.‘”

Men’s Health adds a healthy dose of skepticism: “…if this study was done in a healthy population, you might get different results.

What is important to know is that the authors of the study do not explain why there would be such a protective effect, do not claim their results to be statistically significant, and furthermore acknowledge that the sample of black males over 35 was small. So, in other words, this study is very far from being conclusive, or even useful for the general public at all. If anything, this study could motivate further studies, but as for being applicable right now, it is not, and it would be irresponsible to act based on it. The media circus around this overall pointless study is atrociously misleading.

Autism

In the meantime, Environmental Health published a study last year about prenatal and perinatal analgesic exposure and autism. This study found correlations between indicators of prenatal and perinatal paracetamol exposure and autism/ASD. While the available data cannot provide strong evidence of causality, biologic plausibility is provided by a growing body of experimental and clinical evidence linking paracetamol metabolism to pathways shown to be important in autism and related developmental abnormalities.

While the abstract and title themselves do not specify circumcision, there is a detailed analysis of circumcision rates in the full text of the study. As our readers may remember, anesthesia during neonatal circumcisions was not common until a 1997 randomized controlled trial had to be halted due to trauma from pain. Lander et al’s early terminated study suggested that pain control should be administered prior to circumcision and that ring block was the most effective method.

Fast-forward to 2013, Bauer and Kriebel analyzed country-level data for the years 1997-2006, and found a strong correlation (r = 0.98) between circumcision and autism spectrum disorder prevalence rates for boys born after 1995, around the time when circumcision guidelines began recommending analgesia for routine infant circumcision. The slope of this trend for 9 countries with available data indicates that a change of 10% in the population circumcision rate was associated with an increase in autism/ASD prevalence of 2.01/1000 persons (95% CI: 1.68 to 2.34).

Again, when evaluating circumcision data for the United States, it is sobering to remember that approximately 1.2 million baby boys are circumcised every year. Could the use of paracetamol be causing autism and autism spectrum disorders in 2,400 baby boys annually?

A comparison of autism rates in boys and girls  found that male to female prevalence ratio increased from 3.9 to 1 prior to 1995, to 5.6 to 1 after 1995. The researchers suggested biological plausibility based on the infant’s lower capacity to metabolize drugs due to the underdevelopment of the glucuronidation pathway and inefficiency and immaturity in renal function.

So, basically we find two positions, one that circumcision without anesthetics is severely traumatic, and another one, that commonly used analgesia can increase rates of autism.

In spite of this strong data, practically no media outlets published any articles about this study and its implications on newborn circumcision.

In Summary

In summary, we have two studies that looked at correlations. One was not statistically significant; the other was. One did not offer a biological plausibility, the other one did.

And yet, which one got extensive media coverage? The one that suggested a benefit from newborn circumcision.