Male Genital Mutilation

[floo]

Sorry but you are wrong, or if I am being charitable, misunderstanding the details.

The only credible evidence for reduction in HIV transmission due to circumcision is for infection of men during heterosexual sex with a woman. There is no evidence that circumcision reduces transmission for homosexual sex nor for infection of women during heterosexual sex.

So the critical issue isn't overall infection rates, but infection rates of men from heterosexual sex. And those rates have reduced dramatically over the past decade, indeed they have halves since 2005.

And in fact overall infection rates have been gentle reducing over time, so for example in 2016 6,095 people  were diagnosed with HIV in the UK compared to 7,892 in 2005. And yet levels of circumcision have also reduced in the sexually-active population during this time.

But, of course the best way to prevent infection is to use a condom.

Of course it is.

[Bubbles]

What planet are you on - those numbers are fanciful.

The total number of circumcisions in the UK is estimated to be around 12,000 per year (about 3.5% of boys) so massively different to your 270,000 which is not far off the total birth rate of boys.

What do you mean by that (do you mean not Jewish - ooh that's telling of your prejudices) - given that the vast majority of the 12,000 circumcisions a year are performed on boys of Muslim parents, again you are talking junk. Given that there are under 4000 births to Jewish parents in the UK per year (and less than 2000 circumcisions) again you ill-informed non-sense statistics are rather telling of you lack of knowledge.

That post of yours is a mess.

[Shaker]

 Care to explain (rather than merely assert) what's wrong with it?

[Aruntraveller]

It made perfect sense to me Rose. Unless you are disagreeimg with the avtual figures. In which case I'm sure you will be able to provide alternative data to rebut the Profs post.

[Bubbles]

What planet are you on - those numbers are fanciful.

The total number of circumcisions in the UK is estimated to be around 12,000 per year (about 3.5% of boys) so massively different to your 270,000 which is not far off the total birth rate of boys.

What do you mean by that (do you mean not Jewish - ooh that's telling of your prejudices) - given that the vast majority of the 12,000 circumcisions a year are performed on boys of Muslim parents, again you are talking junk. Given that there are under 4000 births to Jewish parents in the UK per year (and less than 2000 circumcisions) again you ill-informed non-sense statistics are rather telling of you lack of knowledge.

Not on the same planet as you 🙄 obviously.

270,000 wasn't supposed to be circumcisions a year, try reading it properly.

Muslims don't have quite the same commandment to circumcise boys early although there are Hadiths that seem to say seven days after birth, mainly because that's what Mohammed was thought to have done.

[Bubbles]

Depends what you mean by 'lots' but I think the reality is actually very few.

Once again let's look at the actual data rather than you plucked out of thin air nonsense.

About 97% of children of muslim parents attend state schools. Somewhat smaller proportion of children of jewish parents, but still around 70% attend state schools. Given that about 2000 of the current circumcisions a year are for boys of jewish parents, and about 10,000 for children of muslim parents, that equates to over 92% of circumcised boys attending state school. In effect over 92% of the children of muslim and jewish parents are in state school.

Doesn't really back up your 'Lots of Jewish and Muslims don't go to a state school' hand waving.

70% of Jewish children attend state schools? Where did you get that from?

According to the NSS two thirds of Jewish children attend Jewish faith schools

You can't both be right.

[Nearly Sane]

70% of Jewish children attend state schools? Where did you get that from?

According to the NSS two thirds of Jewish children attend Jewish faith schools

You can't both be right.

Yes, they can. A Jewish faith school can still be a state school. I went to an RC state primary.

[floo]

Rose seems to make proclamations without always checking to see she is correct.

[Nearly Sane]

Rose seems to make proclamations without always checking to see she is correct.

Perhaps, but then she isn't alone in that.

[ProfessorDavey]

70% of Jewish children attend state schools? Where did you get that from?

According to the NSS two thirds of Jewish children attend Jewish faith schools

You can't both be right.

NS has beaten me to it.

I am correct because although the Board of Deputies of British Jews claims that 63% of children of Jewish parents are in Jewish schools (which broadly divides 57:43 between what they describe as 'mainstream' and 'orthodox' schools) they are also clear that over 85% of the children in 'mainstream' schools are in state Jewish schools, and about 13% of those in orthodox schools are in state schools.

So add that all together and only about 30% of children of Jewish parents are in independent Jewish schools, the rest are in state schools (actually to be absolutely correct there will be a tiny fraction in independent non-Jewish schools.

But this is related to your comment:

'Lots of Jewish and Muslims don't go to a state school, they have their own schools, and I can't see them allowing social workings in to meddle with their children.'

If kids are in a state schools, regardless of whether it is non faith or Jewish (or other) faith that school is regulated by Ofsted and accountable to the LEA or DfE. Were the law to change and a state funded school to refuse to comply with the new law that school would be in special measures and taken over by leadership that would comply with the law before you could blink.

[ProfessorDavey]

270,000 wasn't supposed to be circumcisions a year, try reading it properly.

I did and I fail to understand what that number represents;

You original quote:

'It's not a problem for me, but it will be a problem for the 270,000 + who have their sons circumcised.'

Makes no sense - is this an annual value, or some kind of cumulative over some years (in which case why chose a timeframe which is about 25 years worth of circumcisions.

[ProfessorDavey]

That post of yours is a mess.

I disagree - I think I am actually providing some numbers that stand up to challenge.

[ProfessorDavey]

https://www.theguardian.com/world/2005/sep/10/aids.adrianlevy

But this article is from 2005 and as I have pointed infection rates of the type that might be reduced due to circumcision have halved in the UK, while circumcision rates in the sexually active population have also reduced.

Also to note even if we take the most optimistic research on reduction in HIV transmission to heterosexual men, were we to circumcise all baby boys this year, we might end up with approx. 5 fewer diagnoses of HIV per year in 20 years time. But that's assuming infection rates remain as they are in 2015. If the trend from 2005 to 2016 continues that would reduce to 1 less infection.

And before you claim that even one less infection is worth it, the date on serious complications suggests that circumcision of all boys would result in 25-30 deaths due to complications.

[The Accountant, OBE, KC]

Sorry but you are wrong, or if I am being charitable, misunderstanding the details.

The only credible evidence for reduction in HIV transmission due to circumcision is for infection of men during heterosexual sex with a woman. There is no evidence that circumcision reduces transmission for homosexual sex nor for infection of women during heterosexual sex.

So the critical issue isn't overall infection rates, but infection rates of men from heterosexual sex. And those rates have reduced dramatically over the past decade, indeed they have halves since 2005.

And in fact overall infection rates have been gentle reducing over time, so for example in 2016 6,095 people  were diagnosed with HIV in the UK compared to 7,892 in 2005. And yet levels of circumcision have also reduced in the sexually-active population during this time.

But, of course the best way to prevent infection is to use a condom.

The WHO has never made an argument that circumcision is useful for preventing HIV among Men who have sex with Men (MSM) nor has it argued that it is useful in preventing HIV among drug users, in case you were going to bring that into the argument. And the WHO also highlighted that the best way to prevent an infection was to use a condom.

My contribution was only intending to focus on the WHO policy regarding promoting circumcision among men having heterosexual sex as one measure to control HIV rates in certain parts of Africa and how that influences black communities living in the UK. Given migration patterns and the different cultures in the UK and the WHO policy in relation to circumcision of heterosexual men in parts of Africa, it seemed that people from that part of the world living in the UK may have an interest in the UK not banning infant circumcision, if infant circumcision has lower risks compared to adult circumcision.

And yes I agree that MSM remain the group most affected by HIV with 47 per 1,000 living with the infection according to the HIV in the United Kingdom: 2013 Report.

The same report reported that heterosexual Black-African men and women were the second largest group affected by HIV with 38 per 1,000 living with the infection (26 per 1,000 in men and 51 per 1,000 in women). It also said that of the 31,800 (29,700-34,600) black-African men and women living with HIV, 23%remained unaware of their infection in 2012 and that over the past five years, an estimated 1,000 black-African men and women probably acquired HIV in the UK annually.

According to page 16 of HIV and Black African Communities in the UK June 2014: A POLICY REPORT - at the time of writing, a total of 40,251 African men and women have been diagnosed in the UK. The report also said that diagnoses reached a peak in 2003 with 4,063 black Africans being diagnosed and since then the number of new diagnoses has declined year on year. In 2012 the total was 1,522, the lowest total since 1999.

However, the report states there is consensus that the main reason for this decline in HIV diagnoses is a fall off in migration from sub-Saharan Africa, a result mainly of changes in UK immigration policy.

It indicates that over time the proportion of new diagnoses in the UK of HIV acquired in Africa is declining and the proportion of HIV acquired in the UK is increasing amongst black African men and women in the UK, but as an absolute number of new diagnoses it has remained fairly constant over the last few years, at about 1,000.

And your response did not address the other issue I raised about the BMA guidance on what is in the best interests of the child. It may well be that over time the autonomy of the child will take precedence in the minds of parents rather than a shared cultural heritage and parents will decide to wait until the child makes an informed decision as a teen regarding circumcision, even if this carries more risk of complications compared to circumcision as an infant. We'll just have to wait and see. In the meantime the BMA currently seems to think that it is in the best interests of the child in this particular instance, to be brought up in the culture of his parents.

[The Accountant, OBE, KC]

But this article is from 2005 and as I have pointed infection rates of the type that might be reduced due to circumcision have halved in the UK, while circumcision rates in the sexually active population have also reduced.

Also to note even if we take the most optimistic research on reduction in HIV transmission to heterosexual men, were we to circumcise all baby boys this year, we might end up with approx. 5 fewer diagnoses of HIV per year in 20 years time. But that's assuming infection rates remain as they are in 2015. If the trend from 2005 to 2016 continues that would reduce to 1 less infection.

And before you claim that even one less infection is worth it, the date on serious complications suggests that circumcision of all boys would result in 25-30 deaths due to complications.

Sorry- you lost me - where are these figures from again? For example, how did you arrive at 5 fewer diagnoses of HIV per year in 20 years time among heterosexual men?

[ProfessorDavey]

Sorry- you lost me - where are these figures from again? For example, how did you arrive at 5 fewer diagnoses of HIV per year in 20 years time among heterosexual men?

By working out the annual rate of infection of heterosexual men, combined with annual numbers of new circumcised boys (based on birth rate and assuming all are circumcised) and assuming a 50% reduction in infection if circumcised rather than uncircumcised.

Worth noting that pretty well all the HIV infections for heterosexual men are a result of unprotected sex.

[ProfessorDavey]

By working out the annual rate of infection of heterosexual men, combined with annual numbers of new circumcised boys (based on birth rate and assuming all are circumcised) and assuming a 50% reduction in infection if circumcised rather than uncircumcised.

Worth noting that pretty well all the HIV infections for heterosexual men are a result of unprotected sex.

Point being HIV infection of men caused by hetersexual sex is incredibly rare - effectively 1 per 65000 of the population.

It is of course also worth recognising that although HIV infection was once a death sentence it isn't anymore. So in 2016 HIV infection was very well managed, so only 300 people were actually diagnosed with AIDS and about a similar number died of AIDS related causes. If your become infected with HIV you are now more likely to die with HIV (i.e. of a completely unrelated to the HIV infection) than die of AIDS, i.e. HIV related.

[ProfessorDavey]

According to page 16 of HIV and Black African Communities in the UK June 2014: A POLICY REPORT - at the time of writing, a total of 40,251 African men and women have been diagnosed in the UK. The report also said that diagnoses reached a peak in 2003 with 4,063 black Africans being diagnosed and since then the number of new diagnoses has declined year on year. In 2012 the total was 1,522, the lowest total since 1999.

However, the report states there is consensus that the main reason for this decline in HIV diagnoses is a fall off in migration from sub-Saharan Africa, a result mainly of changes in UK immigration policy.

But the report clearly indicates that only 5% of those infected were born in the UK, so I am struggling to see how infant circumcision for new born boys in the UK is going to make any difference.

Actually the report (all 72 pages of it) never mentions circumcision once - so clearly they do see this as a way forward. By contrast (and obviously) there is a huge focus on improving education and condom use.

[ProfessorDavey]

In the meantime the BMA currently seems to think that it is in the best interests of the child in this particular instance, to be brought up in the culture of his parents.

Which 'particular instance' is that.

Remember that determining best interest has to be done on a case by case basis and we are simply not aware of the number of cases where parents request circumcision and the doctor considers whether that would be in the best interests of the child (as they are required to do) and concludes that it is not and therefore refuses to perform the operation.

[Bubbles]

Which 'particular instance' is that.

Remember that determining best interest has to be done on a case by case basis and we are simply not aware of the number of cases where parents request circumcision and the doctor considers whether that would be in the best interests of the child (as they are required to do) and concludes that it is not and therefore refuses to perform the operation.

They think that " generally speaking" it's not on a case by case basis.

It is possible to think that the best interests of children generally, is to be brought up within their community.

This is what they say on it.

"There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues. Indeed, it would be difficult to formulate a policy in the absence of unambiguously clear and consistent medical data on the implications of the intervention. As a general rule, however, the BMA believes that parents should be entitled to make choices about how best to promote their children’s interests, and it is for society to decide what limits should be imposed on parental choices. What those limits currently are is discussed below, together with the legal and ethical considerations for doctors asked to perform non-therapeutic circumcision."

As a general rule, however, the BMA believes that parents should be ENTITLED to make choices about how to promote their children's interests..........

Which is what I've been saying all along.

[Bubbles]

BMA

"It is important that doctors consider the child’s social and cultural circumstances. Where a child is living in a culture in which circumcision is required for all males, the increased acceptance into a family or society that circumcision can confer is considered to be a strong social or cultural benefit. Exclusion may cause harm by, for example, complicating the individual’s search for identity and sense of belonging. Clearly, assessment of such intangible risks and benefits is complex. On a more practical level, some people also argue that it is necessary to consider the effects of a decision not to circumcise. If there is a risk that a child will be circumcised in unhygienic or otherwise unsafe conditions, doctors may consider it better that they carry out the procedure, or refer to another practitioner, rather than allow the child to be put at risk."

Another point I made further up about back street circumcisions.

Further up in red this also indicates what Gabriella was saying about being brought up in the culture of his parents

Plus it talks about harm by excluding a child from their community.

[Bubbles]

BMA

"Many aspects of good practice – including careful assessment of best interests, balancing conflicting rights and consulting with patients and their families – have taken on added importance as a result of the Human Rights Act, which makes them a required part of the decision making process. As yet, the full impact of the Act on medical decision making is not known, and the rights in the Act are used by commentators to both support and reject non- therapeutic circumcision. One reason why it is not clear where the balance of rights lies is that the medical evidence is equivocal. Some argue that circumcision is a relatively neutral procedure, that, competently performed, carries little risk but can confer important psychosocial benefits. Others argue that circumcision has, or can have, profound and long-lasting adverse effects on the person who has been circumcised. If it was shown that circumcision where there is no clinical need is prejudicial to a child’s health and wellbeing, it is likely that a legal challenge on human rights grounds would be successful. Indeed, if damage to health were proven, there may be obligations on the state to proscribe it. The UN Convention on the Rights of the Child, which has been ratified by the UK, requires ratifying states to “take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health ofchildren”.14 Atpresent,however,themedicalevidenceis inconclusive."


The evidence is " inconclusive "

Hence ATM its legal!

[Gordon]

Maybe some 'cultures' need to have a re-think and come to the view that mutilating their children is no longer acceptable.

[Bubbles]

Maybe some 'cultures' need to have a re-think and come to the view that mutilating their children is no longer acceptable.

You can't bully them Gordon, only me.

They don't go on message boards where they are like to meet the bullying self righteousness you get on here.

[Rhiannon]

Yeah. 'We welcome you, you cute baby boy you,  into our community once you have had a bit chopped off your penis.'

Wtf?