Okay, let me get this straight: your formulation that the fact that because europe (very low circumcision rate) has lower STD ratings than america (75% circumcision rate) we should mandate full circumcision because supposidly circumcision lowered the prevalence of HIV in some african countries...
That research was funded by medical corporations (who fund lobbies-whom then influence the UN [think people, follow the $!]); Who make money from circumcision in the first place!!!! Conflict of interest anyone?!

In fact, your constructed argument in the first paragraph suggests that it is in fact MEDICALLY WORSE for you due to the higher incidences of HIV found in societies with that of HIGHER circumcision rates rather than lower. The pro-circumcision lobby destroys its own argument by that evidence.

In other terms, X + X does NOT = 2Y

It is primarily hygene, not being uncut/cut, that affects this.

Of course, theres no money to be made if people won't perform this purely cosmetic procedure!

Personally, I think the Medical/Religious lobby needs to sit down and stop being greedy.

The blogger's cultural bias in favor of circumcision is glaring.

"there's some evidence that it reduces sexual pleasure. Fair points. But others oppose circumcision for anyone on human-rights grounds, terming it a "mutilation". That stance is even sillier and more invasive than the position that all boys should be obliged to get circumcised would be."

If it reduces sexual pleasure, it is mutilation by definition just as surely as female genital mutilation is mutilation. If the Economist has a problem is that, take it up with the World Health Organization.

I understand your desire for religious solidarity by circumcising your son. But, I do not appreciate your discounting my desire for autonomy of my body. My desire was to keep my foreskin when I was born. That choice was never offered to me. Instead, my foreskin was removed for whatever reason. It is illegal to perform non-medically required genital surgery on infant girls in the US. Why is there a double standard that allows genital surgery on baby boys?

I am not the only one wishing for a foreskin. Many men also miss their foreskin. See www.RestoringForeskin.org to read accounts of men who wish they had never been circumcised and are doing something about it. These are normal men. But, they have learned the value of the foreskin and want one back.

What I forgot to say is that I generally follow a simple rule when it comes to that (or any other part) of the body. When in doubt, don't chop it off.

If the US has a much more widespread application of circumcision than Europe already, and at the same time has a higher prevalence of aids, wouldn't that suggest that circumcision is not a very effective way of preventing it?

If the position that circumcision of infants without a specific medical need is a violation of the child's rights is "silly and intrusive", would that also be true of comparable variations female circumcision, i.e., removal of the prepuce of the clitoris? Mind you, I am not talking about obviously criminal excision of the clitoris itself. But why should removal of the flap of skin covering it be a crime in the case of girls, and removal of the flap of skin covering the male glans be acceptable and even desirable?

cerny,

any epidemiologist worth her/his salt would tell you that you still live at the transition between 19th and 20th century when it comes to diseases spread. With your logic lead shouldn't have been banned from gasoline because lead poisoning is not contagious (just one example).

If there are control measures that can be mandated over a population, controls that have the ability to improve the health status of the population, then these mandates should be implemented, damn be libertarians.

But in this case I do question CDCPs recommendation. It seems that condom is still a dirty word in the us.

I'm reminded, and was able to find the script, of an old SNL parody of a actual Ford television as where I diamond was cut in the back seat of a ford rumbling over potholes through NYC streets.

In the parody, a rabbi performs a circumcision on the moving car.

Spokesman.....Dan Aykroyd

Spokesman: Introducing the 1978 Royal Deluxe II. A luxury name and a luxury ride at a middle-range price? Impossible? We've come to Temple Beth Shalom in Little Neck, New York, and asked Rabbi Mayer Taklas to circumcise 8-day-old Benjamin Kanter while riding in the back seat
of the elegant Royal Deluxe II.

Performing circumcision is demanding. It requires a sure hand and a steady cutting surface. [ the car
takes off ] To show you that our ride is the finest, sweetest in the world, we've deliberately picked this road because of its rough, uneven surface. This was an actual demonstration. Speed: 40 MPH.

The stylish Royal Deluxe II rides smooth because we built it right! [ the car drives over potholes ] Unique hydrodine suspension
system, rack and pinion steering to ensure outstanding durability and control. And every new stylish Royal Deluxe II offers, as standard equipment, power front disc brakes.

[ a toy ball bounces into the street, as the car brakes
sharply and we hear the baby cry after the Rabbi makes his final snip ]

Rabbi: Poifect!

Spokesman: You may never have to perform a circumcision in the Royal Deluxe II, but if you do, we're sure you'll agree with Rabbi Taklas..

Rabbi: That's a beautiful baby.. and a beautiful car!

Announcer: Royal Deluxe II. A beautiful car.

http://snltranscripts.jt.org/77/77aroyaledeluxe.phtml

http://vids.myspace.com/index.cfm?fuseaction=vids.individual&VideoID=221...

Cherny, I think I was working in public health in Atlanta just after they added the "and Prevention," so early to mid 90s, most likely. I remember the transition because I kept expecting the initials to change. The Centers for Medicare and Medicaid Services still went by CMS last time I was aware. I guess in the allied health professions they like their acronyms short and misleading.

MyopiaRocks,

The CDC was created to combat infectious diseases, like malaria and tyflus, that had potential to become epidemics--and not all diseases. Cancer doesn't spread for person to person. Even STDs aren't truly public health issues. I mean, you can't catch AIDS by being in the public the way you can with SARS or the swine flu. How the notion of "public health issue" has expanded to mean essentially any condition that affects a lot of people I find rather troubling. Our individual well-being is not part of the public good, subjected to government management. That which does not requires the coercive power of the state should be left to elements of the civic society.

Incidentally, has the CDC always been "Centers for Disease Control and Prevention"? I just looked at its web site and noticed the "and Prevention" part.

OK, so circumcision decreases the risk of heterosexual HIV transmission by 50%. As others have alluded to, I'd like to know:

* What the decrease in transmission is when good hygiene is practiced.

* What the decrease in transmission is when condoms are used regularly.

* What the decrease in transmission is when considered in a monogamous relationship in which neither partner had been promiscuous in the past.

As an extreme example, I suspect the decrease in transmission would approach 100% if just a bit more were taken off, eh?

Perhaps we should look at all of the preventive treatments and vigorously advocate the least intrusive?

Just a thought...

What bugs me about this circumcision-lowering-HIC infection study is that any time I see it referenced, I never see anyone putting forth a plausible reason why this might be the case. As anyone who has taken a statistics class knows, correlation does not equal causation. Medical studies often will make the step from a link to a cause, but typically only when they explain why this might be the case. Does anyone have more information about this study, and whether or not it proposes a credible reason (doesn't have to be right, just credible) why circumcised men would be less likely to become infected.

Apart from this one study, any health benefits to circumcision can be replaced by proper washing. Thus, I'll prefer that painful and potentially dangerous elective surgery not be performed on unwilling infants.

Also, I'll side with Cherny for one of a few times and agree that some vaccines shouldn't be mandated. I'm all in favor of a lot of vaccines, like ones against measles or other highly infectious and deadly diseases, but HPV doesn't fit that mold.

Painful for the baby?

I don't recall feeling a thing. ;~)

Ricardo, I appreciate your point that leaving babies uncircumcised allows them the possibility of having the operation as adults, but from what I know (many years ago I worked with a 50-something-year-old who had to be circumcised ), it is a highly unpleasant thing to go through.

Cherny: You're right, and the HPV vaccine also has a higher-than-average risk of side effects. As a valid comparison I wonder if circumcision rates (and approval for the procedure, in general) would increase if there were a TV campaign akin to Gardasil's "One Less" advertisements? Then again, there's no money to make with a 4000+ year-old procedure...

BradleyGardner: Shouldn't the CDC recommend (not mandate) any behaviors that lead to healthier, less-disease-ridden, lives? Eat right, exercise, get vaccinated, men should get circumcised, women should get mammograms, etc? Isn't that 1/2 of their purpose?

The medical benefits are quite small I believe, and serious research suggests that the actual cultural motive is (like female circumcision) just to reduce sexual pleasure. This probably still has appeal but fighting the results of natural selection looks pretty strange and to European eyes a bit barbaric. To be sure the damage (for men) is fairly small but remains real (or nature would have done it!) - and the same might be said of cutting off your little toe! (any volunteers?! - must be some 'benefit' we can come up with...)

And of course you could let people choose after reaching adulthood - as with other sexual signs like beards. But perhaps you think they might not make the 'right' choice?

The fear that a government recommendation would evolve into a government mandate is not entirely unfounded. A couple years ago Texas (governed by a Republican, I know) became the first state to mandate the HPV vaccine to young girls. In other states the debate is still on-going. A vaccine is not the same as a surgical procedure that remove a part of one's body, obviously. It's extremely intrusive to have foreign substance injected into one's body nonetheless. And it's happening. The argument in favor of a mandate is as in this case: A child is incapable of consenting, thus the state must step in, over the objection of parents, and force a preventative treatment upon the child in order to save it from a potentially fatal sexually transmitted disease in adulthood.

I'm going to have to agree with Ricardo. My mother worked in Labor and Delivery and chose not to cut with me after seeing several botched circumcisions. The evidence of reduced sexual pleasure is fairly strong, and its effectiveness as a protective measure is fairly low: 50% lower chances, in one of the less likely transmission mechanisms, and assuming you're not in a high risk group, then the risks don't even get close to measuring up to the benefits.

I don't think that should stop anyone from getting circumcisions if they're planning on having unprotected sex with IV drug users. But, unless your born in the Southern part of Africa, I don't think the risks, and strait up negatives, balance out.

Reducing HIV in America would be better served by more and better sex education (which would address other issues like teen pregnancy and other types of STDs as well). "Recommending" circumcision to cut HIV is treating the problem, not the cause. There are also things called condoms that already do the job.

Ricardo: Given the medical evidence about the reduced risk of STIs, isn't opposing circumcision akin to opposing vaccination?

If the pediatrician gives my child an injection that hurts at the time and carries a small risk of side-effects... but it dramatically reduces the risk of my child contracting a specific illness.... I mean, this is the reasoning behind 50+ years of medical practice we're talking about.