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18/12/2003 Evidence Mounts Against Male Circumcision ---BEGINS--- 18 December 2003 FOR IMMEDIATE RELEASE Evidence Mounts Against Male Circumcision Circumcision is a traumatic experience for children, often causes complications, problems so treated can almost always be treated without surgery, the male foreskin provides better health and better sex, recent evidence suggesting circumcision may prevent HIV infection is under question and more are calling for circumcision to be made illegal. These are the conclusions of an independent series of surveys and reports published around the world over the last six weeks. "Male circumcision is simply not justified as a medical procedure", said Dr John Warren, Chairman of NORM-UK, the UK charity representing thousands of men dissatisfied with the operation, "Yet again we are seeing medical professionals around the world recognising that children are suffering needlessly because many doctors simply fail to recognise the alternatives. It is particularly worrying that some are starting to claim that circumcision prevents HIV infection. Countless HIV positive circumcised men are living evidence that this simply is not true. I advise men to avoid surgery and use a condom." Li and Lam of the The Nethersole School of Nursing, Hong Kong, writing in the November 2003 issue of the Journal of Clinical Nursing, studied the psychological impact of paediatric day surgery on children and their parents. They studied 112 children admitted to a day surgery unit for circumcision and found a high level of preoperative anxiety level for both children and their parents. They concluded "preoperative intervention to minimize children and parents' anxiety is crucial and that there is still room for improvement". Yilmaz and colleagues of the University of Kirikkale in Turkey took this conclusion a stage further in the current issue of the International Journal of Urology. Their study compared the psychological trauma of circumcision with that of children having their apparent phimosis treated with topical steroids.They found that 0.05% betamethasone cream was highly effective for the treatment of phimosis (84% success rate) and that the children avoided significant anxiety compared to the circumcision group. They conclude that steroid treatment is suitable for patients from any religious or cultural background. A study by Mayer and colleagues of the University Hospital, New Brunswick, New Jersey, USA found that a circumcision complication was present in 57/68 (84%) of infants who were circumcised in their study. In an article "Foreskins have their purpose - for health and better sex" published in the Sydney Morning Herald on 6 November 2003, the chairman of the West Australian section of the Urological Society of Australia stated that there is no scientific evidence to justify a policy of involuntary mass circumcision as a public health measure. Stan Wisniewski, who is also a clinical associate professor at the University of Western Australia, stated, "There is no scientific evidence that the prophylactic removal of the foreskin sustains any benefit and there is no solid epidemiological evidence to support the theory that circumcision prevents STDs or justifies a policy of involuntary mass circumcision as a public health measure". A recent Cochrane Review found insufficient evidence to support a causal effect of male circumcision on HIV acquisition in heterosexual men. It has reviewed all the research into circumcision and HIV and concluded that that there is insufficient evidence to support the idea that circumcised men have less chance of contracting HIV. Writing on malehealth.co.uk, the website of the UK Mens' Health Forum, editor Jim Pollard says "Circumcision is increasingly a religious issue not a health one. Certainly, the implication that circumcised men could behave more recklessly is very worrying and a diversion from the key message which is that the only way to prevent HIV infection is to use a condom." A research letter published in the 1 December 2003 edition of Sexually Transmitted Infections. uses data from the Sexual Attitudes and Lifestyles Survey 2000 to investigate the relationship between male circumcision and sexually transmitted disease (STDs) among British men. This investigates the issue in more detail than the 1994 Sexual Attitudes and Lifestyles Survey and shows that there is no significant difference in the rate of any common STDs between circumcised and intact men. The Danish National Council for Children has called on lawmakers to make male circumcision illegal. The chairman of the council told Danish media on 4 December 2003 that while media reports of the "unacceptable practice " of female circumcision in Denmark have caused a public outcry and prompted lawmakers to amend existing legislation it is still a lot less common than the circumcision of boys. The chairman is now calling on legislators to ban male circumcision for the benefit of the children. This follows a similar move in nearby Sweden two years ago. --ENDS-- --CONTACT-- For further information contact NORM-UK http://www.norm-uk.org NORM-UK, David Smith: tel/fax 01785 814044, 07751 915921, info@norm-uk.org --NOTES TO EDITORS-- * Dr Warren is a consultant physician at the Princess Alexandra Hospital in Harlow, Essex. * NORM-UK was founded in 1995 and gained charity status in 1998. The registered charity number is 1072831 * The charity is run by volunteers and relies entirely on private donations for funding * In May 2002 a study in the Journal of Urology reported that circumcision appears to result in worsened erectile function, decreased penile sensitivity and that 38% of men circumcised as adults reported harm to sexual function. [http://www.lwwonline.com/article.asp?J=162] * In 2001 Sweden outlawed circumcision of boys under 18 years except where medically indicated or specially licensed. [http://news.bbc.co.uk/1/hi/world/europe/1572483.stm] --SOURCES-- (1) Li and Lam "Paediatric day surgery: impact on Hong Kong Chinese children and their parents." - The Jounral of Clinical Nursing, November 2003 [J Clin Nurs. 2003 Nov;12(6):882-7 - follow link at http://www.norm-uk.org/news.html?568]. (2) Yilmaz "Psychological trauma of circumcision in the phallic period could be avoided by using topical steroids." - [Int J Urol. 2003 Dec;10(12):651-656. - follow link at http://www.norm-uk.org/news.html?568] (3) Mayer "Anatomic variants associated with newborn circumcision complications." - Canadian Journal of Urology - [Can J Urol. 2003 Oct;10(5):2013-6. - follow link at http://www.norm-uk.org/news.html?568] (4) Wisniewski "Foreskins have their purpose - for health and better sex" - Sydney Morning Herald [http://www.smh.com.au/ - Search archive for "Wisniewski"] (5) Cochrane Library - [http://www.nelh.nhs.uk/cochrane.asp] (6) Jim Pollard/Mens Health Forum [http://www.malehealth.co.uk/userpage1.cfm?item_id=1101] (7) Dave et al. "Male circumcision in Britain: findings from a national probability sample survey" - Journal of Sexually Transmitted Infections [Sex Transm Infect.2003; 79: 499-500. - follow link at http://www.norm-uk.org/news.html?577] (8) The Danish National Council for Children says male circumcision should be illegal - press release (in Danish) [http://www.boerneraadet.dk/sw1826.asp] ##### |