Category Archives: Media

The Skeptic – Does science support infant circumcision?

We often criticize Brian Morris’ methods and advocacy of circumcision, particularly his underestimating of risks and complications, his denial of the harm, his overestimation of benefits, and his recurrent self-referencing.

It’s good to read others who share our concern. This is a great article by Brian D. Earp and Robert Darby, published on The Skeptic: http://www.skeptic.org.uk/magazine/onlinearticles/articlelist/711-infant-circumcision

It calls attention to an interesting contradiction. Morris argues for circumcision to avoid having to treat urinary tract infections with paracetamol (pain medication) in light of new studies that associate early exposure to paracetamol with an increase in the risk of autism… yet fails to correlate the fact that paracetamol is used after newborn circumcisions.

Anyway, great read. It’s sad that people are still being fooled by Brian Morris’ air of respectability and the scientific community continues playing his game and not exposing his pseudoscientific arguments. Really sad.

Response to IBT “Brian Morris (author of circumcision study) denies link to Gilgal Society”

Dear Editor,
I see your apology and remarks that Brian Morris denies involvement with the Gilgal Society. I would like to point that the Publications page of the Gilgal Society, url: http://www.gilgalsoc.org/pubs.html
Has a link to the Reference Centre, url: http://www.circinfo.com/index.html which at the bottom specifies “Sponsored by The Gilgal Society“. This page includes a document, “Circumcision, a guide to the parents“, url: http://www.circinfo.com/parents_guide/gfp.html
At the bottom of this document you can clearly see: Copyright © 2006 Brian Morris and The Gilgal Society
I also want to point that Brian Morris website has a page on testimonials, url: http://www.circinfo.net/circumcision_testimonials_from_men.html, at the bottom of this page there is a link to a Next Section: Humor, which currently produces a page not found error. This page, however, can be found in the Internet Archive, at this url:
Points to notice:
  • Photo of a nude infant with a flip phone grasping the tip of his foreskin. Why did Mr. Morris ever consider this worth of publishing on his website, we can only guess.

  • Immediately following, a poem called “Decision“ 

Decision
Some people claim that foreskins are fun
And keep the ‘muzzle’ on the gun.
But many doctors do declare:
‘It’s healthier with the glans laid bare’
So, mum & dad, we say to you,
You must decide what’s best to do,
Your son will benefit throughout his life,
As, incidentally, will his wife;
If you make the choice that’s always wise
and do decide to circumcise.
Written
by Vernon Quantance


This poem is attributed to Vernon Quantance, the founder of the Gilgal Society (currently a convicted pedophile).
In internet comments, Mr. Morris has confirmed having previous contact with Mr. Quantance and having texts published under the Gilgal Society, which fell out of his favor with Quantance’s arrest last year. And while Mr. Morris objects to the Gilgal Society’s religious name, the Gilgal Society does not pretend to be a religious entity, but according to their home page “THE GILGAL SOCIETY is a not-for-profit publisher of medical educational material for the general public.” http://www.gilgalsoc.org/
While it is sad that Mr. Morris would feel offended by your article, truth is he has association to this group and previous cooperation that he has been quick to try to erase in face of Quantance’s misfortune.

hodgekiss

It’s official: Brian Morris is desperate

Back in August, the “Daily Telegraph” in Australia, reported on a new study by Morris and Krieger published on the “Journal of Sexual Medicine” called “Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?-A Systematic Review.“. Back then, we replied: “No Morris, it doesn’t work that way

Anna Hodgekiss


For some reason, the Daily Mail in England has, just today, published a review of the same study, called: “It’s official: Circumcision DOESN’T affect sexual pleasure, according to biggest ever study of the issue“, authored by Anna Hodgekiss. This is interesting to the vigilant reader, as just in February 15th of this year the same newspaper published another article, this one by Claire Bates, titled: “Circumcision DOES reduce sexual pleasure by making manhood less sensitive

Have the male genitals adapted so much in a few months, that early this year circumcision reduced sexual pleasure, but now by December it doesn’t anymore?

No, of course not. But stay with us reader, so you can see through the words of Emeritus Professor Brian Morris, who -we never get tired of repeating it- is not a medical doctor, a sexologist, an epidemiologist, a pediatrician, an urologist or anything similar, but a molecular biologist and a circumcision enthusiast, one who, apparently, manages to convince naïve or biased reporters every few months.

The one concern I have is, why is a newspaper now in December reporting about a study that was published in August? Is it just that Mrs. Hodgekiss suddenly stumbled upon it and decided to talk about it? Or is Morris trying to get his study to do a second round, perhaps frustrated about recent developments regarding his beloved mutilating surgery?

Brian Morris


Because, unlike what Mr. Morris would like you to believe dear reader, circumcision is a multidimensional problem that can’t be simply resolved with an “evidence based appraisal”.

Circumcision, when performed for non-therapeutic reasons on non-consenting patients, becomes a human rights issue. Morris would like to cover this truth with his finger, but truth outshines him. Even the World Health Organization in its Manual for early infant male circumcision under local anaesthesia“, an extremely pro-circ document related to the intent of circumcising 20 million African males, recognizes that:


A concern about early infant male circumcision is that the child cannot give informed consent for the procedure. Moreover, some of the health benefits, including reducing the risk of HIV infection, will not be realized until many years later when the person becomes sexually active. If circumcision is postponed until an older age the patient can evaluate the risks and benefits and consent to the procedure himself.


More important, just two months ago (October 1st) the Parliamentary Assembly of the Council of Europe voted on and approved a resolution that declares that:


Despite the committed legislative and policy measures which have been taken by Council of Europe member States to protect children from physical, sexual and mental violence, they continue to be harmed in many different contexts. One category is particularly worrisome, namely violations of the physical integrity of children which supporters tend to present as beneficial to the children themselves despite evidently negative life-long consequences in many cases: female genital mutilation, the circumcision of young boys for religious reasons, medical interventions during the early childhood of intersex children …


Where this resolution reads “religious reasons” we need to read “non-therapeutic reasons”, in other words, not with the intent of treating a condition or disease. A social or religious surgery.

A few days later, October 10th, the Nordic Association for Clinical Sexology expressed its support to the Council of Europe, and declared that:


The penile foreskin is a natural and integral part of the normal male genitalia. The foreskin has a number of important protective and sexual functions. It protects the penile glans against trauma and contributes to the natural functioning of the penis during sexual activity. Ancient historic accounts and recent scientific evidence leave little doubt that during sexual activity the foreskin is a functional and highly sensitive, erogenous structure, capable of providing pleasure to its owner and his potential partners.

As clinical sexologists, we are concerned about the human rights aspects associated with the practice of non-therapeutic circumcision of young boys. To cut off the penile foreskin in a boy with normal, healthy genitalia deprives him of his right to grow up and make his own informed decision.

Unless there are compelling medical reasons to operate before a boy reaches an age and a level of maturity at which he is capable of providing informed consent, the decision to alter the appearance, sensitivity and functionality of the penis should be left to its owner, thus upholding his fundamental rights to protection and bodily integrity.

Every person’s right to bodily integrity goes hand in hand with his or her sexual autonomy.

This statement involves two aspects: human rights, and bodily integrity. It doesn’t matter if a doctor, a researcher, or even a parent, is convinced that a part of the body of a child, a) has no function, and b) is of no value to the child. While that part is healthy and does not represent an immediate threat to the life or health of the child, it’s the child’s right to discover, explore such part, and make a determination when his mental maturity allows for it.

Overriding this right to bodily integrity and self-ownership, is very problematic. That is why circumcision promoters try to blur this line and dismiss it with statistics of potential benefits.


We mentioned back in August that Morris must have been feeling desperate with the 2011 publication of Frisch’s “Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark” in 2011 and Bronselaer’s “Male circumcision decreases penile sensitivity as measured in a large cohort” early in 2013, so maybe he decided to play professor (maybe he had not retired yet at the time) and “grade” those previously published studies. Given that his coauthor, Krieger, is the author of one of such studies, it’s not surprise that Krieger’s study was the second highest graded study. We could suspect some bias.

But of course, given the recent developments in Europe, Morris and Krieger’s meta-analysis pretty much lost its momentum, so perhaps Morris found a new reporter, strategically located in Europe, with the hopes of bringing attention back to his paper and try to counter the effect of these European changes.

According to Anna Hodgekiss, the “lead author of the study, Professor Brian Morris of the University of Sydney, told MailOnline: ‘This is a ground-breaking article’“. Of course Morris would say that, given that he wrote it. One thing we know is that Morris loves to toot his own horn.

Hodgekiss writes:

The professors found that the very high quality studies reported circumcision ‘had no overall adverse effect on penile sensitivity, sexual arousal, sexual sensation, erectile function, premature ejaculation, duration of intercourse, orgasm difficulties, sexual satisfaction, pleasure, or pain during penetration.’

In contrast, the studies which find negative effects were poor quality, Dr Morris said.

This begs the question of if the high quality studies did in fact report one way, and poor quality ones reported in a different way, or if the quality was assigned by the professors depending on what the studies reported. Furthermore, the title of “Dr” is not the appropriate one for a molecular biologist.

She continues: “He added: ‘The methodology was impeccable’” (he would say that, of course, the advantages of ranking one’s own work)

Hodgekiss provides as example the discussion of “One high-quality trial of nearly 3,000 sexually experienced men in Kenya” (surprise surprise, Krieger’s study!).

One quick observation of Krieger’s study shows three suspicious elements: 

  • The age range of the participants was 18 to 24 years. At this age, males are very sexually active, and even those circumcised in early infancy have not suffered the long term desensitization. Not only that, but all the participants already wanted to become circumcised, which would be a prejudice factor. This is selection bias
  • The length of the study is of only 24 months. The gradual desensitization of the glans takes much longer, which makes long term follow up almost impossible.
  • One of the most surprising elements is that “For the circumcision and control groups, respectively, rates of any reported sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at month 24“. In other words, by participating in the study, even if assigned to the control group (no treatment), the final result was a decrease of dysfunction. Exactly how is this possible?
In his study Morris spends considerable space trying to debunk those “poor quality” studies. We might go over them later. Morris also promises to review histological information in a future article, a hint at an upcoming attempt to discredit Taylor’s “The prepuce: specialized mucosa of the penis and its loss to circumcision“. 

As usual, it is amusing to check his references and see Morris’ last name repeated several times. He often refers to his own studies in third person. For example he writes: “In the Danish study that found more frequent orgasm difficulties in circumcised men, a number of flaws have been identified [58]“, and subsequent evaluation of reference 58 reveals Morris BJ,Waskett JH, Gray RH as the authors.

In the end, the authors report no conflicts of interest. Considering that Morris is author of a book called “In favour of circumcision” and a website called “circinfo”, and co-founder of the “Circumcision Foundation Australia” -an entity created to present a Policy Statement when the RACP disowned him, and that Krieger is the author of one of the highest quality studies referred, as ranked by Morris and Krieger, this lack of conflicts does not appear sincere.

Oh Morris, it’s official. You should retire from this debate too. You are getting too repetitive.


Circumcision by Deborah Tolmach Sugerman, the usual crap

Another day, another circumcision post.

Today’s post by Deborah Tolmach Sugermen, MSW, with the JAMA (Journal of American Medicine Association) Network, starts, as they always do, reminding us that the procedure goes back thousands of years in time (in this case, to “prehistoric times“).

The article then says that “People worldwide continue to circumcise their sons for hygienic, cultural, and religious reasons“. The hygienic reasons are quite debatable, as it is generally accepted that “uncircumcised boys can learn how to clean beneath the foreskin once the foreskin becomes retractable” (after all, it’s easier than brushing teeth and more fun). As for cultural and religious reasons, one could also argue that people worldwide continue to circumcise their daughters for cultural and religious reasons (and those who do it argue that it’s not mutilation when they prick the hood of the clitoris to draw some blood, a procedure the AAP admitted is “less extensive than the newborn male circumcision commonly performed in the West” in their now retracted Policy Statement on “Ritual Genital Cutting of Minors”), and yet the law in the United States leaves no cultural or religious exceptions for non-therapeutic procedures on a female minor’s genitals.

Deborah then writes that “Circumcision in infancy is very safe“, which is in contrast with the AAP’s assertion that “The true incidence of complications after newborn circumcision is unknown“. She then states that “When it is performed by a trained professional under sterile conditions, few babies have complications“. I would challenge this statement given that some complications, such as the development of adhesions, buried penis and meatal stenosis, have little to do with the way the procedure is performed. But perhaps we are running into what the AAP considers “differing definitions of “complication” and differing standards for determining the timing of when a complication has occurred (i.e., early or late)“.

Parents should be told about these possible post-operative complications (which are not even mentioned in Deborah’s article), since they can result in the need for further “revision” surgeries, particularly when the AAP warned about a 119% increase on revision surgeries from 2004 to 2009.

She then states that “There are no long-term studies of the health benefits of children who have been circumcised” – which is particularly striking given that the practice of “medical” circumcision in the United States goes back to 1870, plenty of time for such studies to have been done. In lack of those studies, it could be easily argued that circumcision should be left to be a personal decision of the person, since it’s not demonstrated that circumcision improves the health of the children.

Following this, Deborah mentions the African studies on HIV, and uses this to support the idea that “male circumcision provides substantial medical benefits“. By contrast, Andrew Freedman, member of the AAP Task Force that wrote the 2012 Policy Statement on Circumcision, has publicly called circumcision a procedure with “modest benefits and modest risks“, which shows something that has been known for years, that those interested in promoting circumcision will “dismiss the harm and exaggerate alleged benefits“.

She then moves on to explain the benefits. Reduction of UTIs (no mention that after the first year, boys have less risk of UTIs than girls regardless of their circumcision status), risk reduction of HIV (no mention that this is only considered to be so for heterosexual transmission from female to male, not for male to male, not for male to female and not through non-sexual paths such as blood transfusions, and that the total risk reduction attributed to circumcision is 1.8% of the already small risk of transmission from female to male, and no mention of condoms and safe sex as better alternatives to HIV prevention), and of course, penile cancer (no mention that penile cancer is a very rare disease that occurs in old age, mostly related to phimosis during adulthood and to HPV, and that according to the AAP’s own Technical Report on circumcision “The clinical value of the modest risk reduction from circumcision for a rare cancer is difficult to measure against the potential for complications from the procedure” as 909 to 322,000 circumcisions would be needed to prevent one penile cancer event, at a cost of 2 to 644 complications ranging from mild to severe).

She then goes to explain that “Male circumcision does not appear to affect sexual function, sensitivity, or sexual satisfaction“, a statement that has been the subject of an intense information war, with circumcision promoters such as Brian Morris rabidly attacking or willfully dismissing the studies that contradict this view, such as Sorrells (2007), Frisch (2011), Bronselaer (2013), histological studies explaining the anatomy of the foreskin such as Taylor (1996-1999), or Tim Hammond’s preliminary poll of men circumcised in infancy or childhood.

The author then says that the AAP recommends that “Doctors talk to parents about the health risks and benefits” (one would hope doctors would be more forthcoming on the actual risks and complications than Deborah, a Master of Social Work who is potentially biased for religious reasons – as it’s simple to find that she is a member of the Adath Jeshurum Congregation- has just been) and that “Parents weigh this information together with their religious, ethical, and cultural beliefs and practices“.

This final statement deserves a little bit more of attention.

Circumcision is a surgery. It’s the excision (amputation) of normal healthy genital tissue with sexual functions (the article doesn’t mention that the foreskin is normal sensitive genital tissue or that it has sexual functions).

In most cases this is done for “religious and cultural reasons” (including Deborah’s religion).

Religion and culture are not medical indications for surgery.

Circumcision is “elective” surgery, that does not treat a condition, disease or abnormality. But the patient, a minor, is not given the chance to “elect” or “refuse” the procedure.

In a recent article in the Journal of Medical Ethics, Robert Van Howe and Steven Svoboda declare that “When physicians decide whether to do a procedure, they must, and normally do, exclude from their medical decisions non-medical factors regarding the parents’ culture. Contrary to what the AAP suggests, doctors are not cultural brokers. Their duty is promoting and protecting the health of their patients, not following practices lacking a solid ethical and medical foundation.

But Tolmach Sugerman makes no mention of this ethical issue.

Why Deborah? Why?

Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?- No Morris, it doesn’t work that way

So, a new day and the news already report a new study. “Sydney researchers find that contrary to perception circumcision actually increases sexual satisfaction“. That Sydney researchers would seem to have nothing else to do but to research circumcision seems strange, until you find the same old name: Same old Professor Brian Morris, author of circinfo.net the most rabid fanatic pro-circumcision site on the web, and who is not a sexologist or a urologist, but a molecular biologist. Oh, also founder of the Circumcision Foundation of Australia and author of the book “In favour of circumcision“. Do we need to point any more bias?

But enough with Morris, let’s cut to the meat and potatoes and take a look at the abstract. The article is being published on the Journal of Sexual Medicine (how he gets publishers is something we can’t really understand).

And what is this “new” research, one would ask? Well, it’s nothing but a recycle of the same old papers. In his own words, “A systematic review of published articles retrieved using keyword searches of the PubMed, EMBASE, and Cochrane databases was performed.

From this, 2,675 publications are identified (several of them authored by Morris himself, no doubt), and they are “rated” on their quality level, to conclude that “The highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction.“. The problem is, what is the criteria for this rating? Which were the “low quality” studies and what did they reveal?

But, at this point we are not even really discussing the meat and potatoes of the subject, are we? Because, how can we evaluate sexual function, sensitivity, sensation and satisfaction, if we don’t start by defining what those are and how to measure them? Guess what, Morris didn’t.

For being a biologist, Morris willingly overlooks the question of what is sexual function, and skips the topic by going to statistics. Do you see anything wrong there?

Histological studies such as those by John R. Taylor (published in the British Journal of Urology) are evidently ignored, and most likely Sorrells’ “Fine-touch pressure thresholds in the adult penis” (also published in BJU) is most likely rated with low quality, given that Morris (and his friend Jake Waskett, a computer programmer) took it upon himself to criticize that paper by distorting, eliminating and reprocessing the data, as pointed out by Hugh Young. In fact in the Daily Telegraph’s article, Morris is quoted saying “There are no legitimate studies which have found a lack of sensitivity”. Sorry Morris, just because you don’t like the findings of Sorrells et al. doesn’t mean that it’s not legitimate. You can’t remove 20,000 soft-touch receptors from an organ and claim that there is no difference in sensitivity.

Circumcision promoters prefer to ignore Sorrells study while paying attention to Payne et al’s “Sensation and sexual arousal in circumcised and uncircumcised men” which was based on a similar methodology with a fatal flaw: Payne didn’t take sensitivity measures for the foreskin, only for the glans, thus ignoring the main difference between the circumcised and the uncircumcised penis in what can only be called “researcher’s bias” or “researcher’s prejudice”.

Anyway, the question of what constitutes sexual function is not even asked by Morris. Of course that would have to get him to explain about frenulum, ridged band, gliding function (described by Lakshman in the Indian Journal of Surgery in 1980), etc, things that he really doesn’t care to talk about… because he doesn’t have them.

So let’s be clear here.

If sexual function means simply being able to sustain an erection and ejaculate, then, in most cases there would be no difference… except perhaps at an older age (40, 50…) as keratinization of the glans progresses.

But if sexual function means that the penis works as it was intended to work:

  • The foreskin glides over the glans and allows the ridged band and the ridge of the corona to stimulate each other,
  • Pre-ejaculate collects in the subpreputial space for additional lubrication instead of falling down on a useless liquid thread,
  • The intact frenulum and ridged band perceive a lot of sensation and produce tingling sensations and help control the orgasmic threshold,
Then there is no doubt that removing the foreskin changes the function.
Some of the “high quality” studies would have been, no doubt, those by Kigozi et al, in Uganda (including circumcision promoter Ronald Gray) where the men that volunteered for circumcision as part of the “randomized trial” for HIV prevention, were followed up at 6, 12 and 24 months. Participants reported on “sexual satisfaction and function”. Of course at 24 months, keratinization wouldn’t have been enough to represent a good difference (some men circumcised during the neonatal stage report the effects of keratinization when they are past their 40 or 50 years – but I’m sure Morris would dismiss them as case-studies in the best case, or as being brainwashed by anticircumcision literature on the internet at worse).

But given that this is nothing but a “systematic review” of existing literature, then comes the question of what’s the relevance of this paper. Why did Morris even bothered looking for all these articles and writing a new paper based on no new research whatsoever?

Circumcision promoters have suffered some backslash in the recent years. In 2011 the International Journal of Epidemiology published Morten Frisch’s “Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark” which concluded that “Circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfilment.” In spite of the expected anonymity of reviewers, Morris outed himself as one of the reviewers, as the one reviewer opposing the publication of Frisch’s study, when he asked the members of his mailing list to write letters to the editor protesting the publication of the article. Quite unethical on his part.

In 2013 BJU published Bronselaer’s “Male circumcision decreases penile sensitivity as measured in a large cohort“, a study in Belgium, which concluded that “This study confirms the importance of the foreskin for penile sensitivity, overall sexual satisfaction, and penile functioning. Furthermore, this study shows that a higher percentage of circumcised men experience discomfort or pain and unusual sensations as compared with the uncircumcised population. Before circumcision without medical indication, adult men, and parents considering circumcision of their sons, should be informed of the importance of the foreskin in male sexuality“. Strangely for a study that suggest negative consequences of male circumcision, Reuters covered the study so it reached several global news outlets. In some of the media, particularly in American news sites, a critique by circumcision promoter Aaron Tobian (Johns Hopkins University college of Ronald Gray) was included in an attempt to “balance” the information (or reduce the impact of the study, we could say).

And this would be the reason why circumcision promoters needed some “new” publication to “find” that circumcision “does not affect -or actually increases- sexual satisfaction”, even if it means just recycling all the old articles, even the old and utterly debunked excuse of a “study” by Masters and Johnson from 1966 (here explained and refuted by Hugh Young).

So this is the issue. Awareness of the consequences of male circumcision has been growing. It was already reported in 1997-1999 by Tim Hammond. The past two years have seen two European articles denouncing the reported loss of sensitivity and sexual consequences of circumcision for European males and their partners. 2012 also saw the results of the Global Survey of Circumcision Harm. There is also growing awareness of the possibility of Non-Surgical Foreskin Restoration for men who feel harmed by their circumcision and wish to recover some of the function of their lost foreskin.

So obviously, circumcision promoters are not happy, especially when African men are not rushing to get circumcised as they expected them to. Aaron Tobian prepared the path for the AAP’s new Policy Statement on Circumcision by publishing his “findings” (actually a computer simulation applying premises from African data to the United States) that healthcare cost would increase if circumcision rates continue decreasing. Of course even if this was true, this unethical paper is only putting a price tag on a valuable part of the male genitalia, and most of the public could see through it. More was needed, so Professor Morris did what he knows how to do: review old information to produce new publications, while denying everything that doesn’t fit his model of the world.

Well, Professor Morris, it doesn’t work that way. You can’t deny the changes in function by simply refusing to discuss function. Good try though.

One thing we appreciate of Morris “study”, and it would be pointing us to his coauthor, Krieger JN. Professor John Krieger from the University of Washington. We’ll definitively be learning more about Krieger’s work, such as his previous 2008 study on “Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya“, which no doubt is one of the studies reviewed in this new publication, it’s not like Morris has been known for self-referencing his own publications, what’s the cost of sharing that trick with his coauthor?

One final thought is, why is it that European males report sexual difficulties related to their circumcision while African males don’t? And why is it that the perception of African males would be more relevant to English speaking countries than the perception of European males?

But let’s listen to Brian Morris for a moment, let his words give you an idea of his character. He would be quite amusing if he didn’t think he was being serious.

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Rick Steves pays for a circumcision for his show

Rick Steves says:

If ever you’re making a TV show about village and traditional culture in Turkey, be sure to arrange to film a circumcision. For a few hundred dollars you can hire the band, the doctor, and the horse, and pay for all the pizzas and soft drinks. We even paid for the boy’s prince outfit. From a TV production point of view, it was a marvelous value. And the most beautiful moment for me was the heartfelt thanks the dad gave me as we left. I promised we’d send him a copy of the show as soon as it was finished.

The photos say:

Before meeting the doctor, the young man of the hour was having a wonderful time. [..]” (of course there are no words about AFTER meeting the doctor)

A good circumcision comes with a decorated horse and a three-piece band. The extended family, and anyone who hears the commotion and wants to drop by, is welcome. It’s a grand festival.

We left the family and doctor alone in the home, put the camera down, and joined the party outside. The doctor said things went just fine…but we never saw the boy again.

 
How would you feel if he was documenting a female circumcision in Africa, Malaysia or Indonesia?