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“Despite the obviously irrational cruelty of circumcision, the profit incentive in American medical practice is unlikely to allow science or human rights principles to interrupt the highly lucrative American circumcision industry. It is now time for European medical associations loudly to condemn the North American medical community for participating in and profiting from what is by any standard a senseless and barbaric sexual mutilation of innocent children.” ~ Paul M. Fleiss. Circumcision. Lancet c1995.

Circumcision’s been on my mind for the last couple of days.

No, don’t get me wrong, I’m not about to undergo surgery; it all came about after reading an article on yesterday’s BBC website, entitled, “Call for higher circumcision rate”.^[1]

It concerned a study carried out in Uganda by a group of American doctors from John Hopkins University, monitoring the sexual activity of 3,500 men over a two year period.

Writing in the New England Journal of Medicine, Dr Matthew Golden and Dr Judith Wasserheit, stated:

These new data should prompt a major reassessment of the role of male circumcision not only in HIV prevention but also in the prevention of other sexually transmitted infections. …. All providers who care for pregnant women and infants have a responsibility to assure that mothers and fathers know that circumcision could help protect their sons from the three most common and most serious viral sexually transmitted infections, all of which cannot currently be cured.”

It was around this part of the report that my blood pressure went through the roof. The reason had little to do with the STD’s of Ugandan men, and was more about the culture differences between the USA and the UK – differences that lie dormant and unnoticed until one’s life is changed by moving from one country to the other.

I breathed a sigh of relief on reading the next part of the article, as I discovered I was not alone. A British doctor, a sexual health expert, shared my views.

Dr Colm O’Mahony, of the Countess of Chester Hospital in Cheshire, England, told the BBC that:

the US had an “obsession” with circumcision being the answer to controlling sexually transmitted infections.”

I couldn’t agree more, Doctor O’Mahony, except it doesn’t stop with circumcision. The US obsesses about everything.

Keith Alcorn, a spokeperson for the HIV information service NAM, in the UK,^[2] backs up Colm O’Mahony:

We have to be careful not to take evidence from one part of the world and apply it uncritically to others. Male circumcision will have little impact on HIV risk for boys born in the UK, where the risk of acquiring HIV heterosexually is very low. Girls can be vaccinated against HPV and so protected from cervical cancer, and condoms protect against herpes.”

Clearly, if experts in one part of the world are disagreeing with their counterparts in another, then further research is necessary to clarify which of them is correct.

With this in mind, I delved into the murky depths of male circumcision, and produced a result of sorts, though it was hardly what I expected. There’s plenty to go at, and medical studies abound. The problem is that those nations who genitally mutilate male babies as a matter of routine, and in the western world that’s mainly the USA (80%+ of newborn males, as of 1979, though this figure is known to have fallen), conclude that its beneficial to the recipient for a variety of medical reasons.

Unfortunately, none of those findings is supported, and they’re frequently disproved, by nations who don’t routinely circumcise: UK (less than 10% of newborn males), Canada (9%), Australia (13%).^[3]

Interestingly, there is no apparent increase in the incidence of diseases listed by American studies as more readily prevented by circumcision, in those nations that don’t routinely administer the procedure to male infants, which should, perhaps, be considered evidence of deficiencies in the US studies.

Of course, the push to circumcise in the United States may be driven by factors other than those of a medical nature.

Appeasing the deity has always been a good excuse for mutilating the genitals of little boys, and in the western world that practice is still widespread. Jews and Muslims are known to routinely snip their baby boys, but in the US that only accounts for a minority of those circumcised.

The procedure itself is a nice little earner. In the US the fee for circumcision averages around $250, but can be as high as $2000. And there’s a nice little trade in neonatal foreskins at $250 a time.^[4] The main factor behind a fall in UK circumcision rates was the NHS refusing to finance the procedure once its supposed benefits had been disproved.

Nevertheless, the conclusion I reached after much study has little to do with any of these factors. The often vicious and vindictive arguments over the subject, zooming back and forth across the Atlantic between medics, has almost certainly more to do with ego, than medicine.

It boils down to male pride and human nature.

In the USA, so many males are circumcised it is considered the ‘norm’ condition for a penis. While researching, I actually discovered a YouTube video, shot by a girl, describing the first time she dated a non-circumcised male. In her own words, she ‘freaked out’, ‘didn’t know what to do’, found the guy’s penis ‘ugly and unattractive’, compared to those she was used to. She did eventually get over her reaction and learned to love the offending member.

One reason in favor of circumcision, as given by a US medical website, was to prevent your boy from being mocked by his classmates for not being ‘the same as the other boys’.

During my schooldays, uncut males were the norm. A circumcised penis was a rare sight in the changing rooms after games. I don’t ever remember anyone being mocked or bullied because of it.

The male penis is more than just a bodily organ. It’s a symbol. It has to be perfect in every way if a man is to feel he can ‘hold his own’ (no pun intended) with other males. While there are those who would deny this fact, it is irrefutably true. One of the most frenetic arguments abounding on the internet is whether intercourse is more satisfying, cut, or uncut.

Little genuine medical research is available on the subject, and needless to say, those who are circumcised insist their way is the best; those who aren’t, are equally pedantic at the other extreme.

It’s my belief this male egotism clouds any research and is the main reason experts across the western world cannot agree on the findings. Circumcised US medics subconsciously need to prove a good reason for their lack of foreskins, whereas in the UK, Australia, and Canada, the uncut brigade admire their prepucium intacto, and defend it to the hilt.

Where, then, does this leave our American researchers and their Ugandan males? Are the Americans subconsciously defending their own circumcised penises? At least one of them is a woman – Dr Judith Wasserheit.

As our YouTube lady teaches us, the penis isn’t just a symbol for the male. Its attraction for the female is based on appearance and apparent normalcy. Being a female researcher, then, doesn’t necessarily mean less biased data.

It would be ludicrous to decry the conclusions of two years of study as no more than the offshoot of some male ego-trip. The data resulting from this work probably does has some relevancy in its country of origin, namely Uganda, but as Keith Alcorn of NAM says, “We have to be careful not to take evidence from one part of the world and apply it uncritically to others.”

Researching this subject has done nothing to alter my own opinion of the procedure of male circumcision, as practiced on small children who have no say in the matter, and who will live the rest of their lives with the result of the medic’s knife. Genital mutilation has no place in modern society, and certainly not under the guise of medicine. Even if it could be proved beyond doubt that it was medically beneficial, surely we should look to other alternative cures for diseases rather than the mutilation of our offspring.

As to research into the medical efficacy, or otherwise, of the procedure, we need to eliminate all those male researchers with circumcised penises, and those with uncircumcised penises, and all the female researchers with preferences for circumcised or uncircumcised penises, before we can be certain the results obtained are free from the bias introduced by our own subconscious pride and the frailties of human nature.

But, would there be anyone left?

“A remedy [for masturbation] which is almost always successful in small boys is circumcision…The operation should be performed by a surgeon without administering an anaesthetic, as the pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment…” ~ John Harvey Kellogg (of cornflake fame) Plain Facts for Old and Young. Burlington, Iowa: F. Segner & Co. c1888.

^{[1] “Call for higher circumcision rate” BBC, March 26th 2009}

^{[2] NAM Website}

^{[3] “THE CASE AGAINST NEONATAL CIRCUMCISION” BMJ, May 5th 1979}

^{[4] “Coriell Institute for Medical Research” Catalogue Order Page NHFK}

^{NOTE: The references supplied here are only a small selection of the vast information available. Interested parties will find a wealth of literature, from both sides of the divide, by utilizing a simple Google search.}

Filed under: Child abuse

No-one would deny the American health service is usually efficient, for those able to pay for it. One could use the word ‘afford’, but the percentage of US citizens who can realistically afford healthcare is so ridiculously small that it would be misleading to do so.

To pay for healthcare means having suitable medical insurance, but of itself, that’s no guarantee of a free service. If a British citizen, for example, spent three days in an NHS hospital following chest pains, and required a forty-five minute procedure to insert an artery stent, to be given a bill for $3,000 (£2,000) at the end of it would probably negate any benefit the procedure afforded. He’d have an immediate heart attack.

Nevertheless, Americans can have the best medical insurance available and still expect to pay that sort of fee.

A few days after arriving home, the hopital’s bill drops into the mailbox. For the procedure outlined above, it will be in the region of $55,000 (£38,000). Sometime later, the insurance company sends it’s own account, setting out how much of that $55,000 it will pay.

Medical insurance companies have their own private arrangements with the hospital. The bill of $55,000 will be magically reduced to around $30,000 (£20,500). The patient will be expected to fork out approximately ten percent of that, depending on their policy.

Of course, for the unfortunate with no medical insurance, the hospital will demand their full $55,000 pound of flesh. These days they usually employ debt collection agencies to insure they get it.

No insurance, plus chest pains, can equal no house plus no car plus, possibly, a future career as a down-and-out.

All-in-all, a very fair system. Or, so most Americans seem to think, given their virulent opposition to social reform.

While certainly not worth the enormous expense, one benefit of the US system over a National Health Service, is its ability to not keep you waiting most of the time. Hospitals are efficient places, and waiting to see a doctor, or receive an X-ray, is a generally speedy process. After all, medical establishments are in competition for your lumbago, or cancer, or heart disease, and keeping a customer waiting is not good business practice.

Unless, of course, you’re not the customer.

A random drug/alcohol test is a necessary evil for any bus or truck driver in America. But, hell, how long can it take to pee in a cup and blow into a machine?

The answer, certainly in this part of the Heartlands, is about an hour and a half.

Now, don’t get me wrong; the process itself takes less than five minutes, of which four and a half are spent signing forms and reciting your social security number. The remaining eighty-five minutes are spent in a dingy waiting area while an inadequate number of medical personnel laboriously sift their way through the half dozen patients who were lucky enough to beat you to the reception desk and claim priority in the queue.

The only entertainment is the inevitable widescreen TV, tuned to the banalities of the NBC ‘Today’ program, and featuring two over-the-hill, toothily-grinning, female anchors who look like they’ve just leapt out of an archaic women’s fashion magazine – though definitely not Cosmopolitan, as NBC may relish banality, but only good wholesome banality.

After thirty or so minutes of these clucking hens boosting each other’s ego and smirking condescendingly into the camera, your torture is temporarily interrupted by a laconic receptionist thrusting forward forms, with a demand to, “Sign and date by the marks,” before retiring once more behind her grubby glass panel.

Finally, just as the advert for that cancer drug airs for the fifth time, a door opens and you hear your name called by some anonymous person within, who turns out to be armed with a plastic cup and even more forms.

Having waited for so long that a plastic bucket might be more realistic, the order comes to “Fill to the line, but no further,” and one is ushered to a toilet, with decor in keeping with the rest of the establishment, for the process to finally begin.

These places are businesses just like the hospitals; indeed, many are run by local hospitals. In this instance, though, you are not the customer; you are merely a chattel. They have no interest in your welfare because you cannot go elsewhere. You are condemned to be the victim of your employer’s choice, for it is the employer who’s the client, not you.

The aim of a drug/alcohol test station is to secure the employer’s custom, and the only criteria is cost. My employer – the Head Office where these things are decided – is somewhere deep in the smelly, turgid, bowels of Tennessee. No-one there gives a damn that I have to spend eighty-five minutes of my valuable time bored to death, while audibly assailed by two overly-mature vixens prancing and preening themselves before a TV camera.

In fact, someone in Head Office has probably received a hefty bonus, and a pat on the back, for securing a much cheaper contract than with the place they sent us to last year, which was clean, airy, and had you in and out in twenty minutes.

But, that’s capitalism; that’s business, and that’s American healthcare.

Filed under: Piss pot

The pope’s advisors should do more to protect him from controversy, says the British archbishop of Cardiff, Peter Smith. He said the recent rows over the pope’s remarks on condoms when issued as an HIV/AIDS preventative, showed how the pontiff’s message was being misunderstood:

One of the difficulties we all have as bishops is to put the message of the gospel across in language which ordinary people will understand. We tend to be using rather theological language and this applies also to the pope, because he is at heart an academic. He has been in the academic life for donkey’s years and I think sometimes he may assume a little too much on the part of his hearers.” ^[1]

During his recent visit to Africa, Pope Benedict XVI condemned the “condom mentality”.

I guess that’s too darned theological for my layman’s brain.

^{[1] “Archbishop attacks pope’s advisers” Guardian, March 22nd 2009}

Filed under: Arrogant archbishops