Circumcision in the Media

This blog is an extension of my dissertation research about biomedical circumcision. All posts are links, unless they are marked as editorialized by me.

[cultureunseen]

Salute to Sister Soldier Yuri Kochiyama! Born May 19, 1921 (93 years young and strong) An extraordinary Japanese American woman who spoke out and fought shoulder-to-shoulder with African Americans, Native Americans, Latinos, Asian Americans, and Whites for social justice, civil rights, and prisoners and women’s rights in the U.S. and internationally for over half a century. A prolific writer and speaker on human rights, Kochiyama has spoken at over 100 colleges and universities and high schools in the U.S. and Canada. http://www.amazon.com/Heartbeat-Struggle-Revolutionary-Kochiyama-Critical/dp/0816645930

[circumcisioninmedia]

Circumcision: No harm in asking the question

To say that there was an outcry when the Mail & Guardian asked readers if they would be willing to share their initiation experiences with us would be an understatement. 

There was a deluge of angry tweets and Facebook posts. Many accused the M&G of undermining those who follow the practice, and claimed the media was disrespecting their culture.

"Such dialogues [are] not allowed to be shared with the public and I think such a survey violates respect for the sanctity of the ritual," said one reader.

Another reader told the reporter to "go ask the Jews".

Fortunately, I don't have to go ask the Jews. I am a Muslim, and circumcision is also part of my culture. 

In the days after my son was born, I was caught up in an internal struggle between what my culture told me to do, which is to have my son circumcised, and what my mind was telling me to do – leave him intact with the equipment God gave him. 

If I'd had it my way my son would still have his foreskin. As a mother, I didn't want to be the one responsible for putting my newborn through a world of pain. And my personal interpretation of the religious injunction to circumcise had me arguing that there was no reason to do it now and that we should wait until he was an adult and could make the decision for himself.

But in the end I couldn't hold out against the urging of my husband, my parents and my in-laws.

My mother and husband stayed with my son while a doctor applied a Plastibell device to my 10-day-old son's penis. I sat in the waiting room with my white-faced father, dabbing at my eyes with a tissue, imagining everything that could possibly go wrong with the procedure.

The anaesthetic they gave him was supposed to last for hours but we barely made it out the door before he began screaming blue murder. I had never known my son to cry that way and nothing I did consoled him.

He spent the next two days strapped to my chest and we nursed him through the initial period with regular doses of Panado.

By the third day he seemed okay but on day five he started to cry hysterically. When I opened his nappy I found the Plastibell had fallen off and my son's penis was bleeding. At that point, I almost collapsed. I burst into hysterical tears. This was it, the complications I'd dreaded. My son was going to bleed out, his penis would get infected, he would lose the organ.

My husband stayed calm and called the doctor, who told us to keep pressure on the site of the bleeding for a minute or two and see if it stopped. It did and by this time the baby was calm. The wound had healed. I've been assured that he got "a very good result". 

But that feeling of horror I had when considering the idea that my decision and actions might have changed the quality of life my son would have for the rest of his days comes back to me whenever I read about a boy who's lost his penis to infection from a botched circumcision. And my heart breaks for the hundreds of parents who have waited anxiously for their sons to return home from initiation school, only to be told that their children have died because someone failed to be diligent. 

The Constitution tells us that everyone has a right to practice their culture but also that everyone has a right to life and to healthcare. 

If people are not asking hard questions about how initiation practices can be made safer for boys, then as a society we are failing those who bear the brunt of the destruction wrought by charlatans, "culturepreneurs" and unskilled traditional surgeons.

When elected officials such as Mpumalanga health minister Candith Mashego-Dlamini state that they cannot get involved in an issue like the deaths of the 27 initiates in that province last month because culture forbids it, they are failing in their duty to uphold the Constitution and the Bill of Rights.

As a representative of government, Mashego-Dlamini cannot claim her hands are tied, as if there are no other alternatives to ensure accountability from those responsible, especially when provinces such as the Eastern Cape are doing so much more to maintain oversight and reduce the negative outcomes of poorly performed circumcisions.

I'm willing to bet that none of the people urging me to mind my own business when it comes to traditional circumcision have lost the tip of their penis, part of the shaft of their penis, or the entire penis as so many boys do each year. 

I am sure they are not among the dozens, if not hundreds, of boys – for we do not know the full extent of the damage caused by botched circumcisions in this country – who have to urinate sitting down and who will never be able to have what we consider a normal sex life.

The idea that no one should ever discuss what happens at initiation is a scary one, not least because it allows unscrupulous people to continue with dangerous practices without fear that they will be called to account.

The sheer lack of statistical data on how many boys undergo traditional circumcision, how many are mutilated and how many die, not to mention the lack of data on whether anyone is ever tried or prosecuted for negligence and malpractice, shows a failure of government to uphold the Constitution and protect the vulnerable. 

The annual handwringing on this issue is disingenuous if it is not accompanied by serious interventions in areas where there have been deaths or injuries.

If traditional leaders and the departments of health and traditional affairs are doing what they can to keep boys safe during the initiation season, we are not hearing enough about it and we are not seeing results – not least because there are no results to be seen.

I must admit I was taken aback by the angry tone of many of the responses to our request for those who are interested in sharing their experiences to do so in our survey. Our intention was merely to get a conversation going on this, which is so important to so many people in the country but only ever makes headlines when someone dies or is mutilated or assaulted. We never hear from the tens of thousands of men who go through culturally affirming, medically uncomplicated initiation each year. 

While cultural injunction not to discuss sacred matters in public is well known, it is not unreasonable to assume that some people would be comfortable discussing their experience and view on initiation with others. After all, culture is mutable and different people interpret their own culture for themselves in their own ways.

Last month, when Parliament held a snap debate about the spate of initiation deaths in Mpumalanga, the ANC's chief whip Mathole Motshekga spoke about initiation at length and described several rituals that form part of the initation process. 

He also quoted Nelson Mandela, who described his own initiation, saying: "It was a sacred time; I felt happy and fulfilled taking part in my people's customs and ready to make the transition from boyhood to manhood."

The M&G survey did not ask for details on the sacred teachings imparted to boys who underwent initiation. It asked a very broad, open-ended question: "Tell us more about your experiences during the initiation process", one which could be interpreted any way the respondent chose.

Some readers kept their responses brief ("To respect elders"), some focused on the circumcision aspect ("It only took me two weeks to recover") and others focused on the emotional aspects ("It was the first time I felt loved by … the whole community all at the same time"). One reader, who wrote at length about the importance of initiation in his belief system, responded simply by saying "It is difficult to explain … it is sacred and should be afforded the respect it deserves."

In the past few days, the survey has already yielded as many responses as some of our previous surveys. Readers have been almost entirely positive and supportive of the practice and almost all said they would recommend it to their own sons and to other boys.

One reader described the sense of community and brotherhood that he gained from the experience.

"Men who have completed five years or more after being initiated and elderly men would visit initiates at the school to share their manhood experiences. In particular elderly men would teach us more about how as a man you would be expected to conduct yourself. Further, they would teach us about our community responsibilities and roles as young men. What you gain from them is undisputed wisdom that no money can buy," he wrote.

Another pointed to the significance of the experience for boys who have grown up without a father.

"Most of us who never really grew up with our fathers get a chance to experience that when you're there as you're surrounded by men only, who look after you, offer advice and pass on words of wisdom from their experiences and of those before them. For me it was one of the most interesting times, I learnt a lot about myself and I felt part of a team and surrounded by people who were there to listen, teach and counsel," he said.

A reader described how he went to initiation school at age 10, against the wishes of his mother and grandmother, because he didn't want to be left out of his group of friends, who were slightly older. He described the event as "one of the greatest things to ever happen in my life outside my career".

"It taught me that no challenge or hardship is big enough to break any person, for as long as a person is committed and determined to achieve the best possible results," he wrote.

Only one reader expressed conflict on the question of whether he would recommend that other boys undergo initiation, saying times had changed in the 20 years or so since his own initiation.

"People used to take leave-days from work, drive from Cape Town or Johannesburg to the Eastern Cape just to contribute and impart their wisdom in this process. The logic was simple: 'Today it's my son's initiation, tomorrow it's yours.' There was no room for error here, and everybody knew that any deviations from the traditional routine tend to have dire consequences. However, this is no longer the case," he wrote. 

"It's no longer a community event, elders are disrespected by youngsters and are no longer keen to be part of this. And as a result, we have lost people with tacit knowledge and experience of this practice. Also, most people nowadays live in urban or semi-urban lifestyles and do not necessarily practice their traditions."

The reader has a point. 

In the Eastern Cape the number of boys undergoing initiation has dropped from 60 812 in 2010 to 39 010 in 2012 – a more than 30% decline in just three years. Could this be due to rapid urbanisation of people originally from the Eastern Cape? Could it be due to fears over the medical outcomes of traditional circumcision? 

As with many things related to initiation, we simply do not know.

Meanwhile, according to the department of cooperative governance and traditional affairs, the number of initiates in Limpopo has jumped dramatically from 6 903 in 2010 to 35 621 last year – an 80% increase in three years.

Why? Has everyone there suddenly become more traditional? And has the sudden and dramatic jump in numbers been accompanied by a sudden and dramatic rise in the number of skilled traditional surgeons to attend to all of these boys? 

One assumes it would be difficult to train that many surgeons in just three years. So the question then is, are traditional circumcision-related deaths, amputations and injuries in Limpopo on the rise?

We don't know because the Limpopo health department does not keep those statistics and the department of cooperative governance and traditional affairs has not been able to provide them.

As for Mpumalanga, we do not even have year-on-year numbers to compare.

Culture may be sacred and it may be protected by the Constitution but we cannot willingly choose to disengage from this matter to the detriment on unknown numbers of boys.

There is no harm in asking the question.

[circumcisioninmedia]

My research project so far

I have decided to talk a bit here about my research, and what I am currently up to at the moment.

For the past month, I have been visiting a local clinic in Prince George’s County, Maryland. I will call that place, clinic 1. I have worked with clinic 1 before, which is why, ‘getting in’ in the anthropological sense, was easy this time around. I conducted a research project there last summer, that allowed me to refine my dissertation proposal (my current research project in its approved form).

IRB took three months. There was a lot of back and forth, because I suspect they quite didn’t understand my research project. After a visit on my part, and weeks of back and forth, all issues were resolved.

In the meantime, I was conducting a lot of archival research; this meant that I was actually looking for more literature (both in the media, and in scientific outlets).

For this past month, I have been trying to contact other clinics in the county. I have also been attending several health fair events, as part of my fieldwork. Recruiting key stakeholders in my research project, has been a bit of a difficult thing, but not impossible. I'm still brainstorming as to what is the best way to approach this particular fieldwork roadblock that we all go through.

[circumcisioninmedia]

How Circumcision May Stem H.I.V.

Circumcision reduces a man’s risk of acquiring and transmitting H.I.V. and other sexually transmitted diseases, and now researchers have found a possible explanation: the procedure reduces the quantity and diversity of bacteria at the head of the penis.

Researchers in Uganda studied 79 men randomly assigned to circumcision and 77 who remained uncircumcised, controlling for age, number of sexual partners and other factors. The study is in the March/April issue of the journal mBio.

After a year, the bacterial load had decreased in both groups, possibly because being in a study spurred behavior changes. But the decrease was significantly larger in those who were circumcised. Diversity of bacteria also decreased more in the circumcised men than in the uncircumcised, and almost all of the bacteria that decreased were anaerobic — the kind that do not survive when exposed to oxygen at the exposed tip of the penis.

“We’re not trying to prove that everyone should be circumcised,” said the senior author, Lance B. Price, a professor of occupational and environmental health at George Washington University. “We’re trying to understand how it works and, by understanding, possibly establish alternative strategies to reduce people’s risk for H.I.V.”

The effect of bacteria in H.I.V. acquisition is unknown, but bacteria may play a role in attracting T-cells, the immune system cells that the virus attacks, or cause inflammation that makes transmission more likely.

[circumcisioninmedia]

Circumcision study supports HIV theory

Researchers say the foreskin can shelter troublesome bacteria, so its removal may bolster the immune system to keep the AIDS virus at bay.

April 15, 2013|By Monte Morin, Los Angeles Times

Circumcision is known to reduce a man's risk of HIV infection by at least half, but scientists don't know why. A new study offers support for the theory that removing the foreskin deprives troublesome bacteria of a place to live, leaving the immune system in much better shape to keep the human immunodeficiency virus at bay.

Anyone who has ever lifted a rock and watched as the earth beneath it was quickly vacated by legions of bugs and tiny worms would be familiar with the principle, said study leader Dr. Cindy Liu: After the foreskin is cut away, the masses of genital bacteria that once existed beneath it end up disappearing.

"It's the same as if you clear-cut a forest," said Liu, a pathologist at the Translational Genomics Research Institute in Flagstaff, Ariz. "The community of animals that once lived in that forest is going to change."

Of particular note is that circumcision undercuts anaerobic bacteria, the microbes that thrive in oxygen-deprived environments, she said. By reducing the number of anaerobic bacteria, the body's immune cells may be better able to destroy the virus — and less likely to fall prey to its Trojan horse-style of attack, the authors suggest.

Liu and her colleagues present their case in a paper published Tuesday in the journal mBio.

Numerous studies conducted over the last two decades have shown that male circumcision reduces the risk of HIV infection in men who have heterosexual intercourse by 50% to 60%. Some researchers have speculated that the foreskin is prone to tearing, giving the virus more routes of entry. Others have argued that removal of the foreskin simply reduces the surface area available to be infected.

Liu and coauthor Lance Price, a professor of environmental health sciences at George Washington University in Washington, suspected it had to do with the bacterial species that inhabit the coronal sulcus, the shallow groove behind the head, or glans, of the penis.

To establish a possible connection, study authors enrolled 156 Ugandan men in a randomized trial in which half of them were circumcised and the other half were not.

Study participants ranged in age from 15 to 49. While the prospect of undergoing circumcision as an adult might not appeal to many American men, 5,000 Ugandan males volunteered for the study. In a region where 1 in 6 people are infected with HIV, circumcision's "powerful potential" to reduce the risk of infection was strong motivation, said coauthor Dr. Aaron Tobian, a health epidemiologist and pathologist who teaches at Johns Hopkins University School of Medicine.

On average, there was an 81% reduction in bacteria in the circumcised men one year after surgery, the researchers reported. Some of the biggest drops were recorded for anaerobic bacteria, they said.

Bacteria on the coronal sulcus fell by more than 33% in the circumcised men, Liu said.

Interestingly, the men in the uncircumcised control group also experienced a reduction in bacteria, but not to the degree that the circumcised men did, Liu said. This was probably because of health and hygiene information that was given to all study participants.

"That's not an uncommon outcome," she said. "Just being in a trial can confer some benefits."

The study only examined the effect of circumcision on reducing or altering bacterial colonies on the penis. Further research must be done to draw a direct connection between these changes in the microbiome and subsequent HIV infection.

However, the study offers strong support for the idea that bacteria — particularly anaerobic bacteria — can cause inflammation that will trigger the body's immune system and summon a variety of cells to fight a threat. Among those fighters are T4 cells, which are infected by HIV. The virus needs those cells to survive and replicate over time.

The study authors argue that the large populations of bacteria in uncircumcised men attract these T4 cells, giving the virus a means of entry during intercourse with an infected person. However, circumcised men are much less likely to mobilize these susceptible cells; therefore, the virus can be destroyed by other types of immune cells.

Dr. Alexandra Levine, chief medical officer at the City of Hope Cancer Center in Duarte, said scientists have long been searching for the connection between circumcision and reduced HIV infection. The authors of the new study make a convincing argument, she said.

"This is an important paper in beginning to document what the reason might be," said Levine, who was not involved in the research. "Their data are convincing to me."

Price said that colleagues were already working on follow-up studies. If the connection can be proved, there might be less-invasive ways of altering bacterial populations that do not rely on circumcision.

"As a society, we've gotten used to thinking about alterations to the microbiome as having negative outcomes," said Price, who is married to study leader Liu. "We think about the person who takes antibiotics in the hospital and ends up with an infection in their gut because we've knocked out the natural microbiota. But here's a situation where we're flipping that notion on its head. The disturbance of the microbiome could have a positive effect."

[email protected]

[circumcisioninmedia]

Opposing NYC Circumcision Rule Does More Harm Than Good

Predictably, given the minimal burden the rule imposes and the current weak state of religious liberty protection, a trial judge refused to block enforcement of the informed consent rule while litigation continued. Those challenging the rule have appealed—an appeal they are certain to lose, given the substantial, if not ironclad, evidence that the practice of MBP creates a risk of illness or death—a small risk, but a real one.

But the very act of bringing the appeal poses a larger danger. In the course of challenging a trivial regulation of religious practice, defenders of MBP are handing opponents of circumcision around the world a gift. Instead of confusing substance with shadow, a far-sighted Haredi leadership would have avoided this fight. It would have taken into account the negative impact of highlighting MBP at a time when circumcision was under attack in Germany and elsewhere, with opponents seeking to implement a total ban on the practice.

The entire Jewish community was united in opposition to attempts in San Francisco and Germany to ban circumcision altogether. New York’s informed consent rule, in contrast, drew opposition only from the Haredi sector. Other Jews (including many Orthodox Jews) either did not know of the practice, or had long ago substituted the use of a glass tube that allowed oral suction without physical contact.

Though the Department of Health had pointedly refused suggestions that it ban MBP altogether, much of the Haredi community treated the proposed rule as banning MBP, or even circumcision itself. A rabbinic friend tells of being in a Haredi elementary school during Hanukkah when children were told that the Health Department had banned circumcision, just as the Syrian Greeks had in the second century BCE. There is no excuse for such distortions. Even if one believes direct MBP is an indispensable element of circumcision, the city did not ban it.. The Haredi overreaction shows both a leadership pandering to the fears of its constituency and 150 years of continued rejection of any change in religious practice, no matter how innocuous or peripheral, treating any challenge as if it were a wholesale assault on all of Judaism.

Not so long ago there were highly respected Orthodox rabbis who considered MBP with direct physical contact unnecessary, some even banning the practice as unsafe. But now, with the rush to protest a by-and-large innocuous informed-consent requirement, a permissive halakhic tradition has been pushed to the side not for halakhic reasons, but for what can only be labeled as political considerations. Ironically, those claiming to fight for halakha distort halakha.

Also, to its shame, some segments of the Haredi community disregard any scientific findings that cast doubt on traditional practice. As filed, the complaint challenges the conclusion that MBP creates any health risk. The dispute now centers on how one “proves” a medical fact. To oversimplify a bit, opponents of the City’s informed-consent requirement argue that there is no DNA testing tying a particular mohel to a specific infection, and that there has been no testing to eliminate all other possible sources of infection.

The city, for its part, relies primarily on the modern, statistical-based approach commonly accepted in medicine today, which does not require DNA proof to establish a cause-and-effect relationship.

Yet although the challenge to MBP is misguided, the dispute has exposed a series of worrisome actions by government or the courts. By not only warning about the risks of MBP but also noting the views of other Orthodox authorities who permit suction via a tube, the Health Department appears to be intervening in an internal halakhic dispute. Furthermore, even as calculated by the Department, MBP’s risk of infection is not large in absolute terms, something like 1 in 4,000 cases, though this probably is at least twice the normal occurrence for new born babies. This raises the questions of at what level of risk the government should interfere with parental decision making, and why other risks to children engaging in hazardous activities not connected to religion—like skiing or football—go unregulated.  

This is, in fact, a regulation targeting religion, despite the City’s cleverness in dressing it up as a neutral regulation. In this particular case that shouldn’t matter, since the rule is justified in any case. But it will matter in future cases, and all who care about religious liberty should worry about this part of the trial court’s decision.

Marc Stern is general counsel of the American Jewish Committee.

[circumcisioninmedia]

Protesters decry infant circumcision

The people carrying signs Saturday in Pine Grove Park across from Port Huron Hospital were protesting cuts — but not to health care spending or state government.

Members of Intact Michigan were protesting infant circumcision.

“We believe that since girls are protected under the law from genital cutting, males also should be protected under the law from genital cutting until they’re old enough to decide,” said Kaitlyn Young, who organized the protest.

Mandi Owczarzak, of Sterling Heights, is one of the co-directors of Intact Michigan. She said the group picked Port Huron as a protest site, not because it’s a center of circumcision, but “it was a good place for all those who wanted to come.”

She has three children, two daughters and a son.

“This is important to me because nobody told me and I almost did it to my son,” she said. “Nobody told us we didn’t have to.”

Young said male infant circumcision is an American cultural tradition and usually is not done for religious reasons.

She said the group advocates religious circumcision be delayed until the male is old enough to make his own decision.

“It he wants to do it for religious decisions, it makes more sense for him to make that decision himself,” she said.

Young said the infant can suffer harm from the procedure, including death.

“A lot of people say it’s parental right or parental decision,” she said.

“It should be a son’s right whether or not he should have his foreskin.”

Young said the procedure is harmful.

“It did hurt the son, it did hurt the husband, it did hurt themselves if they are a man,” she said.

“We don’t need to perpetuate it on future generations.”

[circumcisioninmedia]

Are New York Hospitals Hiding Herpes From Metzitzah B'Peh Circumcision Rite?

Are some New York City hospitals and the city’s Department of Health suppressing disclosure of cases in which a dangerous herpes virus is being transmitted by mohels to newborns?

As his source for the allegation, Rabbi Hershel Schachter, the influential YU rabbinical leader who made the charge publicly, cited his own daughter who, he said, works as a nurse at New York Presbyterian.

In a public lecture last February in London, Schachter, who is a rosh yeshiva, or senior chief rabbinic authority, at Y.U.’s Rabbi Isaac Elchanan Theological Seminary, claimed that his daughter’s hospital treated three cases per year of Hasidic babies infected with herpes. The infections were “obviously because of metzitzah b’peh,” Schachter told his audience. The remarks were first posted March 14 on the website Failed Messiah.

The Hebrew term metzitzah b’peh, often shortened to MBP, refers to a procedure practiced by some ultra-Orthodox mohels as part of a male infant’s circumcision rite in which the mohel orally sucks the blood away from the infant’s genital area after cutting away his foreskin. The practice can infect newborns with Herpes Simplex Virus Type 1, according to medical authorities, a virus that, while not serious for adults, can be fatal for infants, or cause permanent cognitive or physical harm.

Since 2004, the New York City Department Of Health And Mental Hygiene has reported 12 cases, with two deaths. Schachter cited his daughter as claiming that there are, in fact, about 15 such cases per year in the city, including the three cases or so she claimed per year at her own hospital.

Schachter said his daughter explained that the hospitals do not report these cases because Hasidic clients would not return if they were made public.

Mohels from outside the ultra-Orthodox community use a sterile pipette for this purpose. But many ultra-Orthodox mohels consider direct suction of the genital area by mouth to be mandated by the Talmud as part of the religious rite.

In contrast to New York Presbyterian and the New York City Department of Health, Maimonides Hospital in Brooklyn, which has perhaps the largest clientele of Orthodox patients in the city, strongly denied Schachter’s allegation.

Eileen Tynion, assistant vice president, public relations for Maimonides, wrote in an email that, “Like all hospitals, Maimonides is required to report cases of infant herpes to the DOH, and we remain in compliance at all times with that requirement.” In September 2011, a two-week old boy died at Maimonides after contracting herpes following MBP, according to the city medical examiner.

Efforts to reach Schachter and his daughter were unsuccessful.

The ultra-Orthodox umbrella group Agudath Israel of America, which has filed a lawsuit against the city’s effort to regulate MBP, also declined to comment on Schachter’s allegations.

Schachter’s remarks on the issue were part of a broader talk he gave to an audience of British rabbis that has sparked intense controversy. During the lecture, Schachter also said that allegations of child sexual abuse within the Orthodox community should not be directly reported to law enforcement authorities; instead, he said, they should first be brought before a special panel of Torah scholars who are also psychologists to determine their validity. He voiced caution about sending cases to law authorities because such action could result in a Jew being sent to a state prison, where he could be locked up “with a shvartze, in a cell with a Muslim, a black Muslim who wants to kill all the Jews.”

[circumcisioninmedia]

“Bloodstained Men” Provocatively Protest their Circumcisions in D.C. as Genital Integrity Awareness Week Marks 20th Year

* A growing international movement asserts that all children have a human right to protection from unnecessary genital surgery 

Bloodstained Men will perform on the Capitol West Lawn Saturday March 30 at 1 p.m.

Genital autonomy activists demonstrate on the Capitol West Lawn March 26 - April 1, will march from the Capitol West Lawn to the White House Saturday March 30 at 2 p.m.

The “Bloodstained Men” protest their circumcisions by performing political theater in white coveralls with bloody crotches symbolizing the genital wounds that were forced upon them in childhood. “Circumcision permanently amputates the most sensitive parts of the penis and diminishes sexual experience for life,” states Bloodstained Man Jonathon Conte. “Our bloodstained coveralls force people to face the reality that infant circumcision inflicts permanent physical, psychological and sexual damage upon boys and the men they become. Our mission is to make people understand that infant circumcision is sexual violence, and a serious human-rights violation.”

The Bloodstained Men concept has been embraced by activists on both sides of the Atlantic — see photo of a December 2012 performance in Berlin on next page — and performers come from a wide range of cultural backgrounds, including Jews such as Brooklyn resident Jonathan Friedman. “When I was eight days old, a mohel (Jewish traditional circumciser) botched my circumcision and then sucked my bleeding penis afterwards,” Friedman states. “I was sexually assaulted and mutilated by my family and religious community, and that is why I will be joining the Bloodstained Men in Washington D.C. on Saturday [March 30].

The March 30 Bloodstained Men performance is a highlight of a week of demonstrations to mark the 20th Genital Integrity Awareness Week, an annual event where activists from across the USA and around the world converge on the West Lawn of the Capitol to demonstrate for a ban on child circumcision.

This year’s event also marks the 16th anniversary of the passage of the 1997 Female Genital Mutilation Law (FGM Law), which protects females under the age of 18 from all forms of unnecessary genital surgery. As event organizer David Wilson of the Stop Infant Circumcision Society (SIC Society) notes, “the FGM Law currently discriminates against boys by leaving them unprotected. Boys deserve equal protection according to the Equal Protection Clause of the Fourteenth Amendment.” On Saturday March 30 at 2 p.m., activists will march from the Capitol West Lawn to the White House to demand that the FGM Law be extended to ban the medically-unnecessary genital cutting of all children.

In the 20 years since the debut of Genital Integrity Awareness Week, child circumcision has become more controversial than ever. “Each year our demonstrations will be bigger and bolder,” Wilson promises. “Our momentum is building, and we will not stop until all children are protected from the sexual abuse known as ‘circumcision’.”

[circumcisioninmedia]

Columnist Jean Wagemans analyses the discussion on a potential ban on circumcision for boys and concludes that a ban wouldn’t make any difference. One of the items in news programme Brandpunt last Sunday concerned the potential ban on circumcision for boys. It’s a controversial subject and the expectation was that sparks might fly. Nothing could be further from the truth. Champions and opponents explained their arguments calmly and deliberately. It looked like a party political broadcast for the reasonable party. Criterion As constructive as it was, the exchange did not bring a solution to the conflict any nearer. This comes as no surprise seeing that the views of the two parties are diametrically opposed. Moreover, and this is crucial in cases like this, the lack of a criterion to weigh the arguments against and in favour made itself felt. One of the people in favour of a ban based his argument on the principle that circumcision is a non-essential medical intervention on a legally incapable child. That is why it mustn’t happen, even if the intervention is performed by a doctor. The doctors present rallied with pragmatic arguments. They help perform circumcisions in order to prevent botch jobs on the kitchen table and avoid medical complications. Isn’t that what doctors do? Blind eye The choice between principles and pragmatism is not the only one lacking an ultimate decision criterion. Suppose the law decides that the rights of the child are more important than freedom of religion. The ban is imposed. Does that mean no boys will be circumcised? Of course not. Some opponents of the ban suggested a circumcision boat which the newborn and its relatives could be flown to in a helicopter. So if there is no ban the circumcisions will continue to take place and if there is a ban they will continue as well. I think I’m beginning to understand the Dutch predilection for turning a blind eye. - See more at: http://www.dutchnews.nl/columns/2013/03/a_ban_on_circumcision_wont_ban.php#sthash.8k2ooVzd.dpuf

[circumcisioninmedia]

Length and girth are no longer the main categories in determining the performance of a penis; let me introduce you to a new one: circumcision.

—-read more at link

[circumcisioninmedia]

Circumcision needs to be talked about

On Sunday night I was on the SABC3 show Interface, where we discussed the issue of forced circumcisions.

There are few issues more sensitive to the Xhosa nation than circumcision. It is almost as sacred and secretive as the papal conclave.

Traditionally, the only people who could discuss it were circumcised men – and then only to one another.

I can understand that because of these complexities, many Xhosa men might have been reluctant to appear on the show to discuss the issue.

A staunch traditionalist might argue that there are already three contraventions Xhosa prince Manene Tabane, who is also the chairman of the Congress of Traditional Leaders in Gauteng, and I made:

* Talking about it in public.

* Talking about it in public to uncircumcised men.

* Talking about it in public to a woman.

On the issue of talking about it in public, we have to deal with the fact that the deaths we witness every year have made it an issue of public interest. No culture or tradition supersedes the law of the land and the constitution.

First, I was glad a person who is a leader of traditional leaders had no qualms about talking about circumcision to a woman (the interviewer) or about discussing it in public. This means our traditions are beginning to evolve.

The way I have always understood the nature of Xhosa circumcision is that the choice to go to the bush was always self-made.

There were two choices: you go or you stay and don’t become a man but instead remain a boy for the rest of your life.

Going does not automatically make you a man in the first place, but the lessons you learn and put in practice make you one. If you decide not be circumcised, you make the choice to be excluded from a lot of things. If there is a traditional ceremony, you will eat with the boys – even if you are 50, you can’t hang out with the men.

No one will represent you when you want to negotiate lobola, because boys cannot get married, only men have the privilege, according to Xhosa tradition. One who decides not to go to the bush makes these choices. This is harsh but that is how it is.

No one was ever forced to go to circumcision school.

In fact, in my experience, boys always looked forward to going to the bush, not because they were worried about exclusion, but because they were looking to being counted among the men.

Therefore, I will be so bold as to say that it is un-Xhosa to force someone to go to circumcision school; they have to make the choice while understanding the benefits and the consequences of not going.

We live in a free country, after all. Forced circumcision is wrong. You can’t and shouldn’t force someone to do something to themselves they clearly do not want done.

The issue of forced circumcision goes beyond just what is traditionally correct. It goes to the heart of the law.

What happens when I am taken by force to be circumcised? Can I report the case to the police? Can I press a charge of kidnapping, assault and grievous bodily harm? Of course I can.

There is a larger question for me, and it deals not just with Xhosa culture, but with the preservation of African culture within the context of the 21st century.

All African cultures are under severe strain. Most Africans want to have it both ways – lead Western lives while not leaving our customs and practices behind. How do we marry the two?

This is the challenge.

* Khaya Dlanga is a social commentator and author of In My Arrogant Opinion.

The Star

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Announcement: Journal of Medical Ethics – Special Issue on Circumcision

The Ethics of Male Circumcision

by Brian D. Earp. Special Issue Edited by Julian Savulescu, Brian D. Earp and Bennett Foddy.

The Journal of Medical Ethics is pleased to announce the forthcoming release of a Special Issue, ‘The Ethics of Male Circumcision’ — to be published in full in the coming days. Selected papers have already been posted Online First and can be seen by clicking here. Contributions cover a wide range of perspectives, and were invited from leading legal scholars, bioethicists, political theorists, pediatricians, and medical historians with expertise in this area. All essays were subjected to rigorous peer review. A list of main contributors and highlights from the arguments showcased in this Special Issue can be found below.

Background

Recent events have re-ignited controversy around the oft-debated issue of the moral and legal permissibility of infant male circumcision.

According to a recent German court ruling, circumcising minors on religious grounds amounts to grievous bodily harm. The court held that children have fundamental rights to bodily integrity and self-determination that cannot be outweighed by the right of parents to practice their religion and raise their children as they see fit. German chancellor Angela Merkel suggested that the ruling was an affront to religious liberty, while anti-circumcision groups as well as a number of ethicists hailed it as a victory for child rights. In December of 2012, the German parliament passed a law to protect religious circumcision from future legal threats.

Meanwhile, in New York City, health officials recently succeeded in enacting a consent form requirement for circumcision after it was revealed that dozens of infants have contracted herpes in the last decade from a form of the surgery practiced by some Orthodox Jews. This form, called metzitzah b’peh, involves the sucking of blood directly off of the infant’s penis. Disagreements about the relative importance of religious tradition versus health concerns have shaped the ensuing controversy there.

Finally, in late summer of 2012, the American Academy of Pediatrics (AAP) issued a new circumcision policy statement and technical report, in which the child health organization suggested that the possible health benefits of circumcision outweigh the risks and complications. This pronouncement was cited favorably by some commentators, while other groups, such as Doctors Opposing Circumcision, issued harsh criticisms. The Journal of Medical Ethics announces today that it is hosting a continuation of this debate in the pages of its Special Issue, publishing a further critique of the AAP report and policy statement, alongside a formal reply by the AAP.

Ethical issues

Given the controversy following the Cologne ruling mentioned above, as well as the discussion surrounding metzitzah b’peh in New York City, the main focus of the Special Issue on circumcision is on religiously-motivated forms of the procedure, although “health benefits” and secular circumcisions as performed in the United States are also addressed.

Justifications for ritual circumcision are sometimes given in terms of parental rights or religious freedoms. Of course, few would argue that parental rights—religious or otherwise—are boundless. Parents may not, for example, withhold life-saving medical care from their children, whether on the basis of their spiritual beliefs or for other reasons. The question, then, is not whether a court or legislature may ever justifiably prohibit, restrict, or regulate a religious- or culturally-motivated practice, but under what conditions it may do so, for which reasons, concerning which practices, on what legal, ethical, or health grounds, and so on.

A 2004 symposium on circumcision in the Journal of Medical Ethics covered a wide array of issues, ranging from health justifications for the procedure to professional guidelines for medical practitioners. For this new symposium, we welcomed in particular papers that sought to address the ways in which medical harm and benefit are weighed against the array of non-medical goods and harms associated with the practice of male infant circumcision. We invited submissions from both religious and secular perspectives which we think will move the conversation forward, both in favor of and opposed to the position that non-therapeutic circumcision is either morally permissible or legally tolerable in pluralistic, contemporary societies.

Highlights

The full symposium on circumcision, to be released online in the coming days and to appear in print this month, includes the following perspectives:

A defense of circumcision by political theorist Joseph Mazor. Mazor argues that appeals to parental rights and religious freedom are not necessary to show that infant male circumcision is morally permissible. Instead, Mazor proposes that the best interests of the child himself, especially if the child is being raised in a religious environment, can reasonably serve to justify the procedure in most cases.

Bioethicist Dena Davis suggests that it may be time to re-open the conversation on the most mild forms of female genital cutting, on the assumption that analogous interventions on infant male genitals might also be justified. However, Davis shows concern about the metzitzah b’peh form of circumcision in particular, asking whether the risk of harm to the child (i.e., transmission of herpes) is consistent with other tolerated risks.

Political scientist Matthew Johnson argues that religious circumcision should be permitted in secular, multi-cultural societies, but that religious groups must “bear the burden and consequences of belief” and that mechanisms should be put in place so that children who are harmed by, or come to resent, their circumcisions can raise a complaint and seek damages against the community.

Medical historian Robert Darby assesses the narrow question of whether the principle of the child’s right to an open future applies to non-therapeutic, infant male circumcision. By drawing analogies with the case of “designer deafness” (in which deaf parents deliberately seek to have children with diminished sensory capacity), Darby argues that circumcision is indeed in violation of this principle, and hence is objectionable from an ethical and human rights perspective.

The Israeli philosopher Hanoch Ben Yami sees religious circumcision as a barbaric custom, rooted in superstition and a pre-Enlightenment worldview. However, he argues that to ban circumcisions outright would bring about more harm than good, and proposes instead a series of gradual reforms, including the prohibition of metzitzah b’peh, mandatory anaesthesia, and age limits on when the procedure can be performed.

Pediatrician Robert Van Howe considers the normative basis of the doctrine of parental rights—sometimes used to justify circumcisions in both the secular and religious case—and argues that parental rights are a “dead dogma” that have outlived their usefulness for conceptualizing the relationship between parents and their children. Instead of rights, Van Howe suggests that parents have an obligation to preserve and protect their children’s rights, including those of bodily integrity and the preservation of an open future.

Human rights lawyer J. Steven Svoboda goes a step further and argues that circumcision is a clear-cut human rights violation, whether it is performed on boys or girls, and whether for religious or secular reasons. Surveying the basis of human rights law in Western societies, Svoboda shows that circumcision may be considered inconsistent with the most widely accepted interpretations of key human rights documents, including the Universal Declaration of Human Rights and the United Nations Convention on the Rights of the Child.

Leading German legal scholars Reinhold Merkel and Holm Putzke provide an in-depth analysis of the now-notorious Cologne court ruling, and criticize the normative foundation of the later law passed by the German legislature to enshrine a religious right to circumcise. Merkel and Putzke also point out a number of troubling internal inconsistencies in the new law, and suggest that these inconsistencies are emblematic of the sorts of logical difficulties any circumcision-protecting law is bound to face in Western constitutional democracies.

The Special Issue will also include two editorials, one by Julian Savulescu, Editor-in-Chief of the Journal of Medical Ethics, and one by Brian D. Earp, Guest Associate Editor of the Journal of Medical Ethics. Associate Editor of theJournal of Medical Ethics Bennett Foddy will provide the “concise argument” summarizing and analyzing the entire issue. Additional commentaries have been invited from the philosophers David Benatar and David P. Lang, and will be published following internal peer review. Be sure to keep an eye on the Journal of Medical Ethics Blog for further announcements, additional postings on this topic, and any updates on the Special Issue.

[circumcisioninmedia]

European Pediatricians: American Academy of Pediatrics' Recommendation to Circumcise Baby Boys Is "Questionable, Weak"

[circumcisioninmedia]

Argument: Is male circumcision harmful?

Richard Wamai and Ronald Goldman go head to head.

Richard

Why would so many human cultures, historically dominated by males, have for thousands of years removed a piece of skin that wraps around the end of the penis if doing so caused harm or impeded sexual enjoyment?

Richard Wamai is an assistant professor of Public Health at Northeastern University in Boston, Massachusetts. He conducts research in HIV/AIDS – male circumcision for HIV prevention and the cost efficiency of interventions – neglected tropical diseases, and health systems and policy in Africa. He comes from Kenya.

The answer is, of course, that male circumcision (MC) does no harm. In fact, when the World Health Organization (WHO) and, later, the American Academy of Pediatrics (AAP – the largest association of paediatricians in the world) considered the best available scientific evidence on MC for adults and infants, they concluded that thehealth benefits far outweigh its minor risks. The benefits includeprotection against a horde of sexually transmitted infections, including HIV. Additionally, a circumcised penis has been found to improve sexual function, sensation and satisfaction, to be more appealing to women both cosmetically and for hygiene reasons, and, when done purely for religious or cultural reasons, it promotes a sense of identity and belonging.

Despite the solidity of evidence on its benefits, opposition to MC by groups or individuals in non-circumcising societies remains. Since their claims are not supported by quality research and fail to withstand scrutiny by academic and medical experts, the opposition appears motivated by ideological or other reasons. Such opposition has failed spectacularly: in Germany, politicians last year voted four to one that infant circumcision does not violate children’s rights or endanger their welfare.

Thus, while evoking strong sentiments – perhaps because it targets a vital sexual organ – circumcision for men and infant boys is not harmful.

Ronald

Most of the world instinctively avoids circumcision, recognizing it as just as harmful as cutting off other natural, healthy, functioning body parts.

Ronald Goldman, Ph.D is a psychological researcher, educator, and Executive Director of the Circumcision Resource Center in Boston, a non-profit educational organization. Dr Goldman is internationally known for his work on circumcision and is the author of Circumcision: The Hidden Trauma and Questioning Circumcision: A Jewish Perspective.

AAP and WHO’s positions on circumcision are influenced bypersonal, cultural, financial, and professional conflicts of interest. Nomedical organization finds any proven medical benefit for circumcision, and European organizations oppose circumcision.

Circumcision is painful andtraumatic. Some infants do not cry because they go into shock. After circumcision, infants exhibitbehavioural changes and disruptions in mother-child bonding. Anaesthetics, if used, do not eliminate pain. There are manysurgical risks, including, in rare cases, death. Some doctors refuse to perform circumcisions because ofethical considerations.

Circumcision removes about a third of the erogenous tissue on the penile shaft, including several kinds ofspecialized nerves, resulting in thickening and progressive desensitization of exposed erogenous tissue. The adult foreskin is a double-layer movable sleeve of approximately 75 square centimetres. It protects the penile head, enhances sexual pleasure, and facilitates intercourse. Circumcised men are more likely to have erectile dysfunction, orgasm difficulties and premature ejaculation. Female partners have more problems with sexual function, fulfilment and painful intercourse. Conflicting studies onsexual effects of circumcision leave the burden of proof on those who advocate circumcision.

Dissatisfied men wish they had a choice and report anger, feelings of loss, sadness, sexual anxieties, and reduced emotional expression. Psychological factors affect every aspect. Circumcised men often have difficulty acknowledging the harm and generally accept information favouring circumcision.

Richard

The series of statements about circumcision and the foreskin made by you are either outright wrong, or not supported by quality research. Simply making a statement does not make it true, no matter how ‘believable’ it might sound.

There is no evidence to support the suggestion that low rates of circumcision worldwide (about 70 per cent of men are uncircumcised) therefore means the practice is harmful. Nevertheless, the focus here is on whether there is harm where MC is practised.

Almost everything you say has been examined in well-designed studies, including large randomized controlled trials and reviews carried out by reputable bodies of multi-disciplinary researchers. Not only have these statements been, on the whole, proven to lack scientific merit, but almost all the sources you cite have been debunked repeatedly in peer-reviewed quality publications. This literature – most of which can be found on websites such as Clearinghouse on Male Circumcision and Circinfo.net – is well-referenced by scientific and policy bodies such as the WHO, the AAP and the Centers for Disease Control and Prevention (CDC).

Furthermore, the assertions you make about the AAP and WHO have no credibility whatsoever. Such an argument appears to serve a self-fulfilling proposition of a personal anti-circumcision position; the position of these global medical organizations on adopting MC for its medical benefits is a matter of public knowledge. The reader can therefore be assured that circumcisiondoes not adversely affect overall health, sexual function, sensation, pleasure or satisfaction.

Ronald

Repeated references to AAP, WHO, and CDC do not change the facts. These groups have lost global credibility1 on circumcision because of their highly biased pro-circumcision positions. In addition to its other conflicts and deficiencies, the AAP has legal and political reasons to defend circumcision. Circumcision policies in countries that do not circumcise recognize the functions of the foreskin and the psychological effects of removing it.

Circumcision advocates’ biases include seeking to show ‘benefits’ only and receiving millions of dollars of funding for that view, consequently weakening the reliability of their research, including randomized controlled trials. The WHO pro-circumcision ‘expert’ promotes the sale of his own circumcision devices! Conversely, circumcision critics often work as volunteers trying to help protect males from this traumatic genital surgery.

One example of psychological factors producing bias is that circumcision is more often supported by doctors who are circumcised. Advocating circumcision, denying harm, and ignoring psychological factors help them avoid the emotional discomfort of questioning their own circumcision. Instead, they accept presumed medical ‘authorities’, without questioning conflicts of interest, motivations, defences and emotions that led to the cascade of flawed research and policies.

Psychological factors do not magically disappear from advocates involved in presumed ‘reputable bodies’, ‘well-designed studies’ and ‘quality publications.’ Actually, these factors multiply due to less attention to detail, more conformity, and fear of debate, as erroneous ideas about circumcision spread like an epidemic.

Psychologists know there is a compulsion to repeat trauma. As a trauma, circumcision is a psychological issue disguised as a medical issue.

Richard

Rejecting values and conventions of science, opponents of MC are entitled to their own personal opinions. Declarative statements denying the credibility of the AAP, WHO and CDC and fallacious arguments about adverse effects of MC will be recognized by educated readers as specious in fact.

The fact is that the AAP, the WHO, the CDC, UNAIDS and other bodies (whose members include uncircumcised bioethicists and psychologists) have painstakingly examined hundreds of research studies and weighed the evidence for and against MC, including that provided by opponents, and endorsed MC for infant males, older boys and men. They have delineated its considerable benefits for disease prevention, finding no adverse effects on sexual function, sensation or satisfaction or human rights. These bodies would lose credibility if they pandered to the extremist views of opponents, or if they came to conclusions discordant with the scientific evidence.

Global medical, policy and funding organizations, governments, civil society groups, human rights, gender and women’s health advocates, and youth in numerous countries endorse MC. Men need to understand that its benefits vastly exceed risks and that over their life-time up to half of uncircumcised males may suffer an affliction attributable to foreskin retention. MC produces enormous health and economic benefits and not providing it to males who want it and to parents choosing it for their infant boys would be an ethical violation.

Proponents of MC strongly support acceleration of its implementation to save lives and promote health as a biomedical and ethical imperative.

Ronald

Your previous statements are unsupported, false and misleading. Deficiencies and biases found in pro-circumcision literature are illustrated by the findings of renowned meta-researcher John Ioannidis. He shows much of medical research is ‘misleading, exaggerated and often flat-out wrong’. His work is widely accepted by medical people.

Ioannidis says: ‘Claimed research findings may often be simply accurate measures of the prevailing bias.’ The prevailing bias is pro-circumcision. Circumcision advocates design studiesto produce desired results. ‘There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded,’ says Ioannidis. ‘At every step in the process, there is room to distort results.’ He notes that opposing views are often suppressed.

Circumcision harms have been ignored, not refuted. (I asked the WHO’s pro-circumcision ‘expert’ to describe the anatomy and functions of the foreskin. He didn’t know!) Psychological and sexual harms of circumcision are reported by clinicians and circumcised men. Women withcomparative sexual experience greatly prefer genitally intact men. Other studies find more sexual difficulties for circumcised men and 4.53 times higher likelihood of using drugs for erectile dysfunction. Thousands of dissatisfied circumcised men have had their foreskins restored. Questions about harm remain unanswered.

Beware of biased ‘authorities’. Pro-circumcision researchers often ignore feelings and common sense. Don’t make that mistake. Watch a circumcision video and trust your feelings. Imagine having your genitals cut by force. Common sense tells you that losing 75 square centimetres of erogenous tissue has negative consequences, and involuntary surgery on a natural, healthy,functioning body part and inflicting trauma is harmful

[circumcisioninmedia]

All Hell Breaks Loose After Nurse Writes About Her First Circumcision: ‘Watch Out Boys, Here I Come

All Hell Breaks Loose After Nurse Writes About Her First Circumcision: ‘Watch Out Boys, Here I Come’

 Laura Beck

We're all guilty of sometimes overutilizing social media. We use it to complain about friends, family, coworkers, jobs, and the many questionable characters on public transportation. We solicit advice, whine about Anne Hathaway, and share our dreams and desires. Facebook feeds can sometimes read like a damn Taylor Swift song for all the emotional ups and downs.

Since we're always sharing, we're bound to eventually say something slightly controversial, or make an offhand remark that offends someone else. It happens. Why, just the other day, I ranted about the anxiety involved in finding a good squee, and I might've used the words "motherfucking" right before the words "adorable puppy." This did not sit well with some Twitter followers, and so they unfollowed me. That's OK, and it's the social media price I pay by having a public feed. Lucky for me, my Twitter missives have landed me into deeper trouble no more than email exchanges with sexist idiots.

Someone who's not so lucky? A pediatric nurse in Spokane, WA, who posted to Facebook:

Did my first circumcision on Friday.. watch out boys...here I come

Seems like something relatively harmless to post to a Facebook wall that's only supposed to be seen by family and friends. The problem? Her page was set to public. Ruh roh. Anti-circumcision activists in the Facebook group "Cutting Culture" were not pleased. Okay, they're pissed. Comments range from "pervert ...so sick," to "how does she live with herself!?" It's harsh in there.

There's two sides here. One, is that the nurse is sharing a work detail that was probably best suited for her friends. Unfortunately, since her Facebook page was set to public, anyone could grab a screenshot. And screenshots are forever. Since her place of employment was simple enough to ascertain, the comment can easily get back to her bosses. It has all the makings of that shitshow last month when the OB-GYN complained about a patient on Facebook.

In these volatile (and viral) times, this is yet another cautionary tale about your social media settings. You have to be careful, especially if you're posting a joke about something ascontroversial as chopping off foreskin. It's not hard to see how this comment would offend; it's a sensitive topic and needs to be treated as such by people in the medical community.

Professionally, that is.

When this nurse is out of the office, it's reasonable to expect that she might share things — and yes, even joke — about her life and job. We all do it. She didn't name names, nor did she give out any identifying information. A flippant comment like hers is often a way to let off steam; many of us crack wise about the more bizarre aspects of our work.

The person I know with the most morbid, fucked-up sense of humor is an ER burn care nurse. She deals with the absolute saddest, most horrific situations every day, and after one round of drinks with her and her co-workers, shit gets brutal. Shock comics have nothing on these fools. When you confront awful, difficult things daily, joking about them can be a vital release. It's not hurting anyone, and it's obviously fulfilling something for those who bear witness to trauma. That doesn't mean she isn't one of the most compassionate, caring people I know. She is — she's also human.

This pediatric nurse has the right to share and vent about work, but if she's going say things that are potentially enraging, she really needs learn Facebook's privacy settings. It can be difficult; even the co-founder's supposedly internet-literate sister has a tough time with it. Maybe she screwed up a little, but she doesn't deserve to be fired as some on these anti-circumcision boards are calling for. She's already been reprimanded by the internet tribunal, and the post has since been made private or removed. May this be a lesson to us all — your real world privacy is only as strong as your social media settings.

[circumcisioninmedia]

Circumcision May Not Protect White U.K. Gay Men From HIV