PHILADELPHIA: Prostate protection claim refuted by four experts [edited June 5]

Circumcision again shown to have no benefit, despite researchers' best efforts to spin the data

MyFoxPhilly
May 29, 2014

Lower risk of prostate cancer seen in circumcised blacks

[Yes and green jelly beans cause acne.]
by Randy Dotinga
THURSDAY, May 29, 2014 (HealthDay News) -- A new study on prostate cancer suggests that circumcision might have a preventive effect in black men and men who undergo the procedure later in life.

The findings are preliminary, and they don't suggest circumcision lowers the risk of prostate cancer for most men. Nor are experts recommending the procedure as a cancer-preventive strategy.

Still, "it may be that circumcision should be considered as an option for men at higher risk, such as black men and men with a family history of prostate cancer, but we need more research to confirm this," said study co-author Marie-Elise Parent. She is an associate professor of epidemiology at the University of Quebec's INRS-Institut Armand-Frappier Research Center in Laval, Canada.

Prostate cancer is the second-leading cause of cancer death in U.S. men, behind only lung cancer, according to the American Cancer Society. About one in seven men will be diagnosed with the disease in his lifetime [and one in three have been found to have it on autopsy], and prostate cancer will kill one in 36, the cancer society estimates.

"We still know very little about the potential causes of prostate cancer. There are probably many factors associated with it, but so far we have not been able to pin down what factors could be modified in order to prevent this cancer," Parent said. [Um, smoking?]

"All that we know for sure is that risk of developing it increases with age, that having a father, brother or son with prostate cancer increases one's risk, and that this cancer is more frequent among men of African ancestry," Parent added.

There's no way to use these risk factors to prevent the disease, she said.

Previous research has suggested that circumcision could slightly reduce the risk of prostate cancer, Parent said. Circumcision has also been linked to lower rates of sexually transmitted diseases like HIV, the virus that causes AIDS. However, circumcision remains controversial, with critics calling it barbaric, unnecessary and an impediment to sexual pleasure.

In the new study, published May 29 in the journal BJU International, researchers examined the medical records of 1,555 men treated for prostate cancer at a Montreal hospital from 2005-09. They compared them to 1,586 similar men who didn't have prostate cancer.

The researchers couldn't find a statistically significant difference in prostate cancer rates between circumcised and uncircumcised men.

However, the researchers did find a 60 percent lower risk of prostate cancer among circumcised black men. They also found evidence linking circumcision after age 35 to a 45 percent lower risk of prostate cancer.

But the findings merely point to an association between circumcision and lower risk in these two groups, not a direct cause-and-effect relationship.

The researchers reached their conclusions after adjusting their statistics for traits such as age at diagnosis and family history of prostate cancer. Due to the design of the study, researchers cannot offer simple numbers to describe the levels of risk for various types of men.

Parent cautioned that the black men in the study, mainly of French descent, may not reflect black men as a whole. And she said the study included few men who were circumcised at a later age, so that finding is potentially questionable.

Dr. Stephen Freedland, a urologist and associate professor of surgery and pathology at the Duke University School of Medicine in Durham, N.C., pointed out that men circumcised after age 35 are unusual. "They're usually older guys who are sick and have medical problems," he said.

The study findings as a whole aren't convincing, Freedland added, especially since it included relatively few black men -- just 178 of more than 3,100 participants.

"I don't think we'll be recommending massive circumcisions to prevent prostate cancer," he said. [He may not, but Brian Morris and others, predictibly, have.] "And men shouldn't go around thinking, 'I'm circumcised, therefore I'm safe from prostate cancer.'"

If circumcision does have a protective effect against prostate cancer -- and that's not proven -- why would that be so?

Circumcision at an early age may possibly protect against later sexually transmitted infections, which are thought to increase the risk of prostate cancer, Parent said. [But studies such as the Dickson cohort study found no such protection.]

"We tried to take this into consideration into our study," she said. "It did not seem to be the main explanatory factor, but it cannot be ruled out entirely, either."

---

New York Daily News
June 2, 2014

Chemo, circumcision could affect prostate cancer rates

by Meredith Engel
...
"We've known for a long time that circumcision has definite health benefits," Dr. Baskies continued. "Circumcision decreases the chances of HPV infection, the development of cancer of the penis, and now it appears it decreases the risk of the development of prostate cancer." ["But wait! There's more!..."]

But not all doctors are convinced of this study's merit.

"Even with the study, the official medical stance is still that there's no medical evidence to suggest that routine circumcision is a medically prudent intervention," said Dr. James McKiernan, interim chair of urology at NewYork-Presbyerian/Columbia University Medical Center.

Dr. McKiernan noted that the study's results are not significant enough to warrant change, and that the study subjects are "an unusual subgroup of people."

"I don't think the quality of the data is there to change practice," he said.
Previous research has found that circumcision also ...

---

Sense About Science
April 8, 2014

"Circumcision cuts risk of prostate cancer by 45%"

... Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK responded to the study saying:

“Although this study appears to show that circumcision after the age of 35 could reduce your risk of prostate cancer, the evidence presented is nowhere near strong enough that men should begin to consider circumcision as a way to prevent the disease. While the total sample studied was large, the number of men who had been circumcised after the age of 35 was very small, so this should not be seen as strong evidence of an association. There was no statistically significant association between prostate cancer and circumcision for men circumcised at all other ages. No reason was collected for circumcision, so we can’t say if the association is with circumcision later in life or with whatever causes men to have circumcisions after that age. It is also highly likely that diet, lifestyle, socioeconomic status and healthcare behaviours may have played a role in skewing these results.”

---

Philly.com
June 3, 2014

Circumcision Linked To Lowered Prostate Cancer Risk

by Krystnell Storr, Reuters
... Dr. Christopher Cooper, a professor and urologist at the University of Iowa told Reuters Health that the Canadian study does not justify promoting circumcision as prostate cancer prevention
The number of black men studied was too small for any conclusions to be drawn, he notes. Only 103 of the participants with prostate cancer were black men, and only 75 of the healthy men in the comparison group were black.

"The STD mechanism is possible but quite a stretch," Cooper said. He also pointed out that there were certain factors the researchers could not control in the study, such as how honest participants were about having STDs or, among the men circumcised as adults, the reason for their circumcision.
Parent told Reuters Health that even though the study was small, and she and her colleagues saw only a slightly reduced risk later in life among men who were circumcised as babies, the work is one more thing to consider when studying prostate cancer.

"We are too early in the game to make it a public recommendation. It could be that in the future it will be confirmed that it's a good thing and may have an added protection from other diseases," she added. [She virtually admits that this is advocacy research.]

SYDNEY: "Any cut or nick ... amounts to mutilation" - Judge

"Any cut or nick ... will amount to mutilation"

News.com (Sydney)
May 24, 2014

Sydney sheik, mum and nurse to face mutilation judgment

A SYDNEY mother stood in the dock holding her baby daughter as she became the first person in the state to be committed to stand trial for genital mutilation.

The mother, who can’t be named, and retired nurse Kubra Magennis became the first people in NSW to stand trial for female genital mutilation, accused in Parramatta Local Court yesterday of performing the circumcision ritual on the mother’s daughters, aged 6 and 7. The pair face a maximum sentence of seven years in jail if convicted.

Sheik Shabbir Vaziri is charged with being an accessory to the circumcision ritual, allegedly telling locals to lie to police about the prevalence of female genital mutilation in the community.

The alleged circumcisions took place in Wollongong and Sydney some time between October 2010 and July 2012.

Defence lawyers unsuccessfully tried to argue the girls were not victims of female genital mutilation because they only received a nick to their clitoris.

Magistrate Roger Brown dismissed the submission, saying: “Any cut or nick to the clitoris will amount to mutilation.”
...

The prosecution will largely rely on a police interview and a phone intercept between the mother and Ms Magennis.
...

The girls’ father, a GP, and four other female relatives, who can’t be named to protect the girls, were also charged over the circumcision but their charges were dismissed at earlier court appearances.

A lawyer has been committed to stand trial with perverting the course of justice over the ritual circumcisions.

A date for the trial of Sheik Vaziri, Ms Magennis and the girls’ mother will be set on June 20.

Earlier story

ZIMBABWE: Child circumcision ignites debate

Common sense breaks out....

Bulawayo24 (Zimbabwe)
May 25, 2014

Child circumcision ignites debate

Zimbabweans have expressed mixed feelings over an on-going male circumcision campaign, especially that which targets children.

Zimbabwe introduced ["voluntary"] medical male circumcision in 2009 following studies indicating that the procedure reduces chances of contracting HIV by 60 percent.

More than 40 local members of parliament volunteered to be circumcised in a campaign targeting 1,2 million males by 2015.

Population Services International, a US-based global health agency, is offering the testing and circumcision procedures.

There are others who believe the 2009 medical male circumcision campaigns being churned out through the media were misleading as they try to portray circumcised men as "confident, outgoing, sexually appealing, and set to succeed in life."

Raymond Majongwe, a National Aids Council, Nac board member said the media campaigns on male circumcision were mischievous in that they give a false sense of security to those who would have gone under the knife.

"They then think they are macho and can go on bedding girls. It is like a licence to be promiscuous.
"I also do not believe in those said ‘celebrities' that are being used to promote the idea. Stunner for example, is another male circumcision ambassador who after being circumcised went on to shoot a sex video that went viral, exposing his circumcised manhood," hit Majongwe at a recent gathering in Chinhoyi.

Stunner underwent circumcision in 2011 before he and Pokello recorded themselves having sex and the images later found their way on Internet and multimedia, first via Facebook and later circulated via WhatsApp.

Majongwe said it was puzzling that while God created man with the fore skin, there are others who now believe it has to be removed.

"God created us that way," said Majongwe adding that he has always been skeptical of the on-going male circumcision campaigns.

Dr. Karin Hatzold, deputy head of Population Services International (PSI) Zimbabwe, said her organisation is using entertainers to persuade young men to get circumcised.

"We have campaigns that are specifically targeting adolescents, people in schools — so during school holidays we are doing massive mobilisations on mass media... "So get smart, get circumcised. Male circumcision is not only HIV prevention intervention, but it is improving hygiene, you are cleaner, you are smarter.'"

Matobo senator Sithembile Mlotshwa once touched off a storm when she called on the ministry of Health and Child Care to stop circumcising children under the 2009 medical male circumcision programme.

In media reports, Mlotshwa was quoted as saying: "In our constitution, everyone is born with a right to life and I think it is wrong for a father and mother to sit down and decide to circumcise this young child who is a month old whereas the father was circumcised at the age of 40.

"This circumcised man's parents gave him all these years to mature and know the uses of all the organs of his body so as to decide how best to remake what is God-given.

"So then why does this person want to agree with his wife to circumcise an infant who is a third person who has a right to be fully developed as he is so that he makes his own decisions about his body organs?"

Mlotshwa believes children should be allowed to make their own choices when they grow up instead of being circumcised under this programme funded by international donors.

"I want to take our minister of Health to task because I believe that you don't have to circumcise infants."

Celebrated writer Virginia Phiri said the fact is that circumcision of males has always been there. "That is either for religious or traditional beliefs and at times for medical conditions."

...

"As this procedure is not easily reversible or it can be expensive to do, so these sons will have to live with the situation that they will find themselves in," she said.

...

Legislator Jessie Fungayi Majome said it is a sad or happy (depending on the circumstances) fact of life that children are bundled with the fate and decisions of their parents.

"To cut or not to cut must be decided according to which of the two is in the best interests of the child as required in our new Constitution.

"I think more research must be done to give objective knowledge of the pros and cons of male circumcision.

"Any circumcision campaign must still and concurrently emphasise the necessity to either abstain, or be faithful or use a condom," said Majome. [Any of which makes circumcision irrelevant.]

...

Social commentator Precious Shumba ... added that from experiences of some residents, a circumcised person cannot abstain from sex, meaning there is reported increase in the demand for sex, risking infection.

Political activist Tabani Moyo said ... "... those agitating circumcision should engage in ethical advertising by outlining the dangers that come with the process so that when people decide to do it, they do so with all the critical information at hand.

"At the moment, there is too much high voltage advertising which borders on deceit that might end up leading to unintended consequences as the adverts seem to give an impression that your chances of getting HIV/Aids for example are reduced, this is irresponsible advertising," said Moyo.
 
...

Pan Africanist, Thomas Deve said what we know about circumcision makes us welcome it for health and religious purposes or as a rite of passage to manhood in some traditions.

"I am sceptical of the Americans pouring in money via the PSI-led initiative when they are withdrawing state-funded programmes in their own country," said Deve.

PSI's health director Louisa Norman has been quoted in the media as saying: "If we can circumcise 1,2 million men by 2015 we can prevent 750 000 new cases of HIV, which means we can really start to envision a country in which there are no new HIV infections." [These figures are based on "modelling", assuming the "60%" reduction claimed in the three trials translates exactly on to the real world - in other words, Just Made Up.]

Zimbabwe has 1,1 million people living with HIV, including 150 000 children, according to Nac.
[And more of the circumcised men have HIV than the non-circumcised:]

HOUSTON, TX: Congressman wants to protect circumcision - in Europe!

"Protecting" adults at the expense of children

Your Houston News
May 24, 2014

Stockman seeks to protect religious freedom in the European Union

In response to the growing number of religious freedom assaults in the European Union, Congressman Stockman introduced H.R. 4650, the "European Union Religious Freedom Act." It was referred to the Foreign Affairs Committee.

This bill seeks to amend the International Religious Freedom Act of 1998 to include religious freedom violations relating to homeschooling, Jewish and Islamic meat production, circumcision practices, and religious garb.

"In countries like Bulgaria and Lithuania, parents can't homeschool their children. In Sweden and Denmark, Jews and Muslims can't prepare meat according to their religious beliefs. In Sweden alone, they face legal restrictions on circumcision. In France, citizens cannot wear religious garb in public schools," said Congressman Stockman.

"These laws are unjust towards these Europeans. The International Religious Freedom Act of 1998 needs to be updated with provisions protecting their freedoms on these religious issues. My bill would do just that," Congressman Stockman added.

If enacted, this legislation would go into effect immediately.

[Breaking news: European Union passes gun-control laws for USA]

SYDNEY: Sheik, ex-nurse, mother to stand trial over cutting of sisters

Sydney Morning Herald
May 23, 2014

Female genital mutilation: three charged with circumcising girls committed to stand trial

by Emma Partridge
Crime Reporter
The first three people ever charged with female genital mutilation in NSW were committed to stand trial at a Sydney court on Friday.

A mother, a retired nurse and a sheikh have been accused of circumcising two girls, aged six and seven, at a Sydney home in 2012.

Sex crimes police allege the procedure was done for cultural reasons.

The mother accused of allowing her two daughters to be "cut" stood before Parramatta Local Court clutching a crying baby girl.

She told the court she did not wish to say anything in relation to the charges or offer any evidence in her defence.

The court heard one of the victims had talked about how she had been cut on a ‘‘private part’’, while another little girl had said in an interview that she was hurt on her ‘‘bottom’’.

Nine people were originally charged with their involvement in the alleged mutilation, including the girl’s father, a Sydney doctor, whose charges were later dropped.

Auburn Sheikh Shabbir Vaziri, 56, had his bail continued after he was committed to stand trial on two counts of being an accessory after the fact to female genital mutilation and with hindering the police investigation.

The retired nurse charged with performing the procedure remained silent in court but hit the shoulder of a journalist with her hand outside court as she covered her head.

The case is next before court on June 20.

Earlier story

DENMARK: Baby in coma after circumcision

BT (Denmark) May 23, 2014 Læge: Omskæring gik helt galt i Nordvest - baby i koma Af: Silla Bakalus En lille baby er kommet så slemt til skade i forbindelse med en omskæring på en privatklinik på Nørrebro, at han er blevet lagt i koma. Sådan forlyder det i et facebook-indlæg, der de seneste dage er blevet spredt med lynets hast på facebook. Bl.a. har personer som Suzanne Bjerrehus samt den kendte overlæge og forsker i seksuel sundhed, Morten Frisch spredt indlægget. Sidstnævnte bekræfter, at historien er sand overfor BT. - Jeg kan bekræfte, at historien er sand. For jeg har talt med lægen, der har udført indgrebet, og han bekræfter, at drengen ligger i respirator, siger Morten Frisch. Ifølge indlægget, der angiveligt er skrevet af et familiemedlem til den lille dreng, havnede babyen i koma, efter han tirsdag blev omskåret på en privatklinik i Københavns Nordvest-kvarter. Efterfølgende måtte drengen indlægges på Hvidovre Hospital, hvor han altså blev lagt i koma. - Inden omskæringen gav han (lægen, red.) bedøvelse, desværre kom den amatør til at give babyen for meget bedøvelse ca. 8ml. (Han burde højst give 3ml. da babyen kun vejer 3 kg.) Kort efter omskæringen og mens babyen stadig var på klinikken begyndte han at havde svært ved at trække vejret og farven i ansigtet ændrede sig samtidig med der kom væske ud af munden på babyen, lyder ordlyden i indlægget... Dansk Folkepartis Liselott Blixt stillede i torsdag følgende spørgsmål til sundhedsminister Nick Hækkerup (S). - Kan ministeren af- eller bekræfte den historie, der florerer i medierne, om en baby der har fået for meget bedøvelse i forbindelse med en omskæring og nu er indlagt på Hvidovre Hospital? Liselott Blixt oplyser fredag formiddag til BT, at hun endnu ikke har fået svar Nick Hækkerup. ...

Bing translation (edited) May 23, 2014 Doctor: Circumcision went badly wrong in the Northwest - baby in a coma By: Silla Bakalus A little baby has suffered so badly in connection with a circumcision at a private clinic in Nørrebro, that he has been put into a coma. This was reported in a Facebook post that has gone viral. People like Suzanne Bjerrehus and the well-known consultant and researcher in sexual health, Morten Frisch, among others, have spread the story. He confirms the story to BT. -I can confirm that the story is true. For I have spoken with the doctor who performed the surgery, and he confirms that the boy is on life support, says Morten Frisch. According to the post, allegedly written by a family member of the little boy, the baby ended up in a coma after he was circumcised on Tuesday at a private clinic in the Northwest District of Copenhagen. Subsequently the boy was hospitalized at Hvidovre Hospital, where he was put into a coma. -Before circumcision, [the doctor] gave him too much anesthetic, about 8ml. instead of the maximum of 3ml. for a 3 kg baby. Shortly after circumcision and still at the clinic, the baby had difficulty breathing, the color of his face changed and fluid was coming out of his mouth, according to the initial post... Danish people's Party member Liselott Blixt asked to health minister Nick Haekkerup (Social Democrat) on Thursday: - -Can the Minister of-or confirm the story, which is rife in the media, about a baby who has gotten too much anesthesia for a circumcision and now is hospitalized at Hvidovre Hospital? Liselott Blixt told BT on Friday morning that she has not yet received a reply from Nick Hækkerup. ...

KENYA: CIRCUMCISING IS NOT PROTECTING AGAINST HIV

The real news: CIRCUMCISING IS NOT PROTECTING AGAINST HIV

Standard Digital (Kenya)
May 22, 2014

Male cut staff overwhelmed by work

by Gatonye Gathura
Kenya: The national male circumcision programme is in problems with most workers claiming burnout from high workload and impossible targets.

A survey of the programmes in Kenya, South Africa, Tanzania, and Zimbabwe shows local workers are the most fatigued.

Information coming directly from the workers indicates more than two thirds is already stressed while colleagues say this could be as high as 90 per cent.

“This is a worrying trend but not totally unexpected considering the repetitive nature of such procedures,” Dr George Githuka, the head of the programme, told The Standard yesterday.

He said with the new evidence, they will now seek a way out to save the workers from burnout while retaining them in the programme.

The survey carried out by among others Dr Peter Cherutich, deputy director at the National Aids and STI Control Programme, and edited by Nathan Ford of the World Health Organisation says worker fatigue could threaten what has become an example of success in Africa.

About seven years ago, Kenya set a target to increase the percentage of circumcised men nationally from 85 per cent to 94 per cent in three to five years by performing 860,000 procedures by last year.
But this work, which has won Kenya international accolades, is now said to have left workers totally exhausted.

The survey published two weeks ago in the journal Plos One had sampled 235 sites locally and some more in the other countries, with Kenya, which was the first to start the programme, having more workers say they are tired.

“The workers are burning out from performing a single task repeatedly in a high volume work environment that produces long work hours of intense effort,” says the study, which was funded by the American Government.

The physical strain of standing for many hours, and the monotony of repeating the same procedure are claimed to be some of the factors contributing to the fatigue.

EXTENDED PERIODS
“Other factors include attending to high volumes of clients over extended periods which translates into emotional exhaustion.”

These, the researchers say could be attributing to possible high rates of worker attrition from the programme. When asked about the impact of the scale-up of their work, the staff, both male and female, said the targets were not realistic which was leading to increased workload and hence the burnout.

“I don’t think the targets are the problem but it is mostly the repetitive nature of the job which can become monotonous,” says Dr Githuka.

Most studies on male circumcision, including the Kenya Aids Indicator Survey 2013 (KAIS), have so far concentrated on the quantity of procedures but none has shown it is achieving its primary objective of reducing HIV infections.

Started almost seven years ago, on the promise that it could reduce the risk of infection by 60 per cent, the KAIS report showed a spike in prevalence in places like Nyanza where the circumcision programme is most intense.

“Circumcision status, condom use, and sexual behaviour were measured through participants’ self-report, and therefore, responses may have been biased toward socially desirable answers,” says the KAIS report, which was commissioned by the Ministry of Health.

But if Kenya is to meet her ambitious targets, the authors say it will need to retain experienced workers who are willing to complete large numbers of procedures in high volume settings.

“The country may have to consider how best to continue to motivate these workers to maintain job-fulfillment, reduce burnout, prevent attrition and maximise performance.”

CAIRO: Doctor to stand trial after girl's circumcision death

The Guardian
May 21, 2014

Egyptian doctor to stand trial for female genital mutilation in landmark case

Raslan Fadl, a doctor in a Nile delta village, is accused of killing 13-year-old schoolgirl Sohair al-Bata'a in a botched operation
by Patrick Kingsley in Diyarb Bektaris

A doctor is to stand trial in Egypt on charges of female genital mutilation on Thursday, the first case of its kind in a country where FGM is illegal but widely accepted.

Activists warned this week that the landmark case was just one small step towards eradicating the practice, as villagers openly promised to uphold the tradition and a local police chief said it was near-impossible to stamp out.

Raslan Fadl, a doctor in a Nile delta village, is accused of killing 13-year-old schoolgirl Sohair al-Bata'a in a botched FGM operation last June. Sohair's father, Mohamed al-Bata'a, will also be charged with complicity in her death.

Fadl denies the charges, and claims Sohair died due to an allergic reaction to penicillin she took during a procedure to remove genital warts.

"What circumcision? There was no circumcision," Fadl shouted on Tuesday evening, sitting outside his home where Sohair died last summer. "It's all made up by these dogs' rights people [human rights activists]."

In the next village along, Sohair's parents had gone into hiding, according to their family. Her grandmother – after whom Sohair was named – admitted an FGM operation had taken place, but disapproved of the court case.

"This is her destiny," said the elder Sohair. "What can we do? It's what God ordered. Nothing will help now."

According to Unicef, 91% of married Egyptian women aged between 15 and 49 have been subjected to FGM, 72% of them by doctors, even though the practice was made illegal in 2008. Unicef's research suggests that support for the practice is gradually falling: 63% of women in the same age bracket supported it in 2008, compared with 82% in 1995.

But in rural areas where there is a low standard of education – like Sohair's village of Diyarb Bektaris – FGM still attracts instinctive support from the local population, who believe it decreases women's appetite for adultery.

"We circumcise all our children – they say it's good for our girls," Naga Shawky, a 40-year-old housewife, told the Guardian as she walked along streets near Sohair's home. "The law won't stop anything – the villagers will carry on. Our grandfathers did it and so shall we."

Nearby, Mostafa, a 65-year-old farmer, did not realise that genital mutilation had been banned. "All the girls get circumcised. Is that not what's supposed to happen?" said Mostafa. "Our two daughters are circumcised. They're married and when they have daughters we will have them circumcised as well."

Local support for Fadl, who is also a sheikh [elder] in his village mosque, remains high. "Most people will tell you he is a very good man: don't harm him," said Reda el-Danbouki, the founder of the Women's Centre for Guidance and Legal Awareness, a local rights group that was the first to take up Sohair's case. "If you asked people about who is the best person to do this operation, they would still say: Dr Raslan [Fadl]."

Most villagers said they thought the practice was prescribed by Islamic law. But female genital mutilation is not mentioned in the Qur'an and has been outlawed by Egypt's grand mufti, one of the country's most senior Islamic clerics. It is also practised in Egypt's Christian communities – leading activists to stress that it is a social problem rather than a religious one.

"It's not an Islamic issue – it's cultural," said Suad Abu-Dayyeh, regional representative for Equality Now, a rights group that lobbied Egypt to follow through with Fadl's prosecution. "In Sudan and Egypt the practice is widespread. But in most of the other Arab countries – which are mostly Muslim countries – people don't think of it as a Muslim issue. In fact, there has been a fatwa that bans FGM."

Campaigners hope Sohair's case would discourage other doctors from continuing the practice. But villagers in Diyarb Bektaris said they could still easily find doctors willing to do it in the nearby town of Agga, where practitioners could earn up to 200 Egyptian pounds (roughly £16.70) an operation. "If you want to ban it properly," said Mostafa, the farmer, "you'd have to ban doctors as well."

Up the road in Agga, no doctor would publicly admit to carrying out FGM operations, and said the law acted as a deterrent. But one claimed FGM could be morally justified even if it caused girls physical or psychological discomfort.

"It gives the girl more dignity to remove [her clitoris]," said Dr Ahmed al-Mashady, who stressed that he had never carried out the operation but claimed it was necessary to cleanse women of a dirty body part.

"If your nails are dirty," he said in comparison, "don't you cut them?"
A few hundred metres away, sitting in his heavily fortified barracks, the local police chief agreed the practice needed to end. But Colonel Ahmed el-Dahaby claimed police could not work proactively on the issue because FGM happened in secret. He also said they were held back by the nuances of the Egyptian legal system – something that would surprise those who argue police officers have readily contravened due process in other more politicised cases.

"It's very hard to arrest a doctor," said Dahaby. "Why? You don't know when exactly he is going to do this operation. In order to arrest him legally you have to have the papers from the prosecutor, and only then can you go. But you don't know when the operations will take place, so you have to catch them in the act or it has to be reported by the father. And that's difficult because the father will deny what happened."

In Sohair's case, her family did initially testify that she died after an FGM operation but then changed their testimony a few days later, leading the case to be closed. It was only reopened following a triple-pronged pressure campaign led by Reda el-Danbouki, Equality Now and Egypt's state-run National Population Council.

Thursday's hearing will likely be short and procedural. In subsequent sessions, Sohair's family is expected to waive the manslaughter charges against Fadl, after Dahaby said the two sides reached a substantial out-of-court compensation agreement.

But the family has no say over the FGM charges levelled at both Fadl and Sohair's father – and the state will continue to seek a conviction against them both. But whether such a result will serve as a major deterrent against FGM remains to be seen.

For Equality Now's Suad Abu-Dayyeh, the answer is a systematic educational programme that would see campaigners frequently visit Egypt's countryside to start a conversation about a topic that has previously never been questioned. "You need to go continuously into the communities. We need to find a way of really debating these issues with the villagers, the doctors and the midwives."

And for the victims themselves, says Abu-Dayyeh, this process cannot start soon enough. "They should enjoy their sexual relations with their future husbands. They are human beings."

FLORIDA: Disputed circumcision order goes on hold

The Pulp (Broward Palm Beach, FL)
May 14, 2014

Florida Mom Fights Court Order to Circumcise Her 3-Year-Old Son

by Deirdra Funcheon
Update, 11 a.m.: The appeals court has granted the emergency order. A copy of the ruling is posted below.
Original story:
A Florida mother is hoping the Fourth District Court of Appeals will intervene and stop a court order that her 3-year-old son be circumcised.

Heather Hironimus of Boynton Beach and Dennis Nebus of Boca Raton had a child together in 2010 and entered into a parenting agreement more than a year later. The agreement clearly stated that the father would be responsible for scheduling and paying for the boy's circumcision.

But now that the boy is 3 and has not yet been circumcised, the mother objects, because, as court documents explain it, the procedure is "not medically necessary and she did not want to have the parties' son undergo requisite general anesthesia for fear of death."

However, Judge Jeffrey Gillen last week ordered that there's no reason the parties shouldn't abide by the parenting agreement and that the father can go ahead and schedule the procedure.

"Putting aside what they agreed to, if you're going to enforce this contract, you have to look in what is the best interest of the child," says Hironimus' attorney, Taryn Sinatra. "The best interest of the child should always trump" any such agreement, she said.

Sinatra says that a pediatric urologist testified at a hearing and was asked what he would do in such a situation, and the urologist said he would not circumcise the boy at this age.

However, the judge's order claims the urologist also testified that "penile cancer occurs only in uncircumcised males " -- which is untrue -- and "uncircumcised males have a higher risk of HIV infection than circumcised males," which is debatable.

Hironimus' case has drawn support from anticircumcision activists around the country who argue that the foreskin is a useful part of the human body and that men should decide for themselves whether to circumcise when they are old enough to research it for themselves and consent.

Circumcision has become controversial in recent years. There is evidence that circumcision was performed by ancient Egyptians, and Jews believe that Abraham made a covenant with God, getting long life and fertility if he agreed that all his male descendents would be cut. In the 1800s, circumcision grew popular as a supposed cure for masturbation, and the procedure was popularized in America as hospital births became the norm after World War II, but rates have been steadily declining in the past decade. In Europe, circumcision is considered barbaric and generally not practiced.

Hironimus' lawyer filed an emergency motion with the Fourth DCA to get a stay on Gillen's order so they could argue the matter before an appeals court.

Hironimus is a stay-at-home mom and has started a fundraising page to fight the matter. She describes the judge as "very pro-circumcision" and says:
"My attorney and I are going to be appealing this decision as neither of us believe it should be a decision left to anyone other than Chase, who is 3 1/2 and fully aware. As a stay at home mom, I do not have the funding to be able to fully accomplish this on my own. I am pleading with fellow intactavists, parents and all others to help me save my son, his foreskin, his rights and hopefully other children from allowing the 'system' to make these decisions." Sinatra said she expects the Fourth DCA to issue a ruling by sometime today on whether to grant the stay.

Dennis Nebus hung up when reached by phone for comment.

A group called Intact Florida is trying to organize a protest.
See the order of the court below.

TORONTO: Complaint against doctor who sucks baby blood

May 12, 2014

Complaint against doctor who sucks baby blood (through a tube)

by Hugh Young
A doctors' disciplinary body in Toronto is considering a complaint against a doctor who performs circumcision using oral suction (metzitzah) to remove blood from the wound.

Dr Aaron Jesin practises as both a doctor and a mohel. He says he does not suck the wound directly (metzitzah b'peh), but through a glass tube.

A Toronto resident brought a complaint to the College of Physicians and Surgeons Ontario, (CPSO) alleging a dangerous lack of antisepsis and unnecessary blood loss.

The College dismissed the complaint, but the complainant appealed against the dismissal to the Health Professions Appeal and Review Board, (HPARB).

About 12 demonstrators supported the complaint outside the hearing. One had a lifelike doll in a circumstraint™ with clamps on its penis.

The Chair began by ruling out any discussion of the merits or demerits of circumcision, nor any use of the Canadian Charter of Rights, saying only the victim could use the Charter. He specifically said the rule had been changed because of the Baby Y death case. [Catch 22! You can't use the Charter unless you're dead....]

(Baby Y died in Ontario days after his urethra was blocked by a Plastibell™. Neither the College of Physicians and Surgeons nor the Health Professions Appeal and Review Board found any fault with the doctors involved.)

Canada and Ontario both have case law that suggests the Charter is so fundamental it can be raised in any setting, but this body somehow exempted itself.

The complainant was represented by John Geisheker, attorney for Doctors Opposing Circumcision (DOC). He was interrupted when he tried to discuss the lack of any regulation of circumcision. Instead he relied on the CPSO's admission that it had not investigated Dr Jesin's claim that he "does not do direct oral suction".

The Board Chair asked what the investigation should have entailed. Mr Geisheker replied, “Perhaps observing Dr Jesin at a circumcision, or inquiring from his staff would have been a better method than just reading his explanatory letters.”

He said Public Health Canada has published best practices in perinatology [health of young babies], and that the practice of metzitzah - even modified by use of a 10cc syringe, 3 inches (7.5 cm) long - still poses a health risk that would certainly violate PHC standards.

"How could one get only 3in or 7.5cm away from a child’s open wound, with a bare face, and not risk wound contamination by hair, dander [dandruff], sputum [saliva], etc.?" Mr Geisheker asked. Also at issue is whether Dr Jesin is regulated by the CPSO when he is acting as a Mohel. The complaint argues that he is.

The Board is considering its decision, which could involve sending the case back to the College for further investigation.

Mr Geisheker, from Seattle, took the case pro bono (free) supported by donations raised by Toronto Circumcision Resources

KENYA: Boy bows to peer pressure, cuts himself

Cowed by his peers: foolish boy cuts part of his own genitals off

The Nairobian (Kenya)
May 8, 2014

Ready for manhood: Brave boy circumcises himself

by David Odongo
A teenager stunned villagers from Rwamburi in Limuru when he circumcised himself using a kitchen knife.

Samuel Waweru, 15, the eldest son of a single mother decided to initiate himself into adulthood after realising most of his agemates had left him behind.

Villagers were alerted when his younger brother raised the alarm after he started bleeding profusely. Samuel was rushed to a nearby dispensary where he was treated and discharged.

Waweru who lives with his mother and only brother could not recuperate from her mother’s house as per Kikuyu customs. He was, therefore, taken to his uncle’s home but under the care of a volunteer sponsor George Mukono, since it is against tradition for his uncles to handle him during this period.

Meanwhile, pastors from Limuru organised a mini harambee to help put up a small house for him. George Ngugi, a children’s officer from Limuru asked parents to engage more with their children to avert such incidents. He also promised to introduce Samuel to a counsellor to check on his progress.

Ngugi urged Samuel’s mother to transfer him from his present school to avoid being teased by his fellow youths.

COLOGNE: 2nd anniversary of historic genital autonomy ruling marked.

May 7, 2014

World Day of Genital Autonomy commemorated in Cologne

by Hugh Young
The second anniversary of a historic court ruling against male genital cutting has been commemorated where it happened.

A crowd gathered outside the Cologne district courthouse to mark two years since the court ruled that infant circumcision was contrary to Germany's Grundgesetz (Basic Law).

intaktiv e. V.

This followed the botched circumcision of a four-year-old boy of Muslim parents, putting him in hospital for ten days, and requiring corrective surgery under general anaesthetic.

The Grundgesetz was put in place in Western Germany in 1949, and later the whole country, at the same time as the Universal Declaration of Human Rights. Both were written in reaction to the horrors of the Nazi regime, such as the evil medical experiments on children by Dr Josef Mengele.

Under pressure from religious interests, the ruling was overthrown by a law whose constitutionality is still to be tested.

At the gathering, messages from genital autonomy organisations were read outside the courthouse, before the crowd of about 50 people marched to Cologne Cathedral for more speeches. Visitors came from France, Switzerland, Austria and Panama. The mood of everyone there was described as "good humoured". A similar event was taking place simultanously in London.

NORM-UK

Organisers plan to repeat the event annually.

LOS ANGELES: Actress Alicia Silverstone shuns genital cutting

Times of Israel
May 4, 2014

Alicia Silverstone nixes circumcision

Jewish actress cites medical studies in speaking out against performing a 'brit'
by Aron Dónzis

Count actress Alicia Silverstone among those Jews advocating against circumcision.

In her new book, “The Kind Mama: A Simple Guide to Supercharged Fertility, a Radiant Pregnancy, a Sweeter Birth, and a Healthier, More Beautiful Beginning,” the celebrity explains her personal decision not to circumcise her son, Bear, according to the website Beyond the Bris: News and Views on Jewish Circumcision.

“I was raised Jewish, so the second my parents found out that they had a male grandchild, they wanted to know when we’d be having a bris (the Jewish circumcision ceremony traditionally performed 8 days after a baby is born),” Silverstone writes. “When I said we weren’t having one, my dad got a bit worked up. But my thinking was: If little boys were supposed to have their penises ‘fixed,’ did that mean we were saying that God made the body imperfect?”

The 37-year-old actress, best known for roles including the 1990s classic “Clueless,” offers a number of other explanations in her book in favor of preserving the male foreskin, including rejecting as outdated the notion that circumcision is a health precaution, and arguing that sexual pleasure is increased when the foreskin remains intact.

Silverstone grew up in a traditional Jewish household, the website explains. Candles were lit on Friday nights, she attended Hebrew school and has fond memories of her bat mitzvah. As an adult, her ties to Judaism remain strong.

“Judaism turned me into who I am today, and I definitely feel I live a very spiritual life. I got that from my parents,” she has said.

Silverstone has a blog, entitled The Kind Life, and another book on healthy eating.

ZIMBABWE: Doctor cuts off boy's penis during circumcision

CrazyNews 24 (Zimbabwe)
April 29, 2014

Clinic cuts off boy's little manhood during circumcision

ZIM: What started as a simple surgical procedure went horribly wrong for a 12-year-old Bulawayo boy after his penis was also cut off during circumcision.

The nightmare unfolded at the new Lobengula Circumcision Clinic on Thursday last week.

Sources at the clinic yesterday told Bulawayo24 News that the doctor was supposed to hold only the foreskin and cut it off; "But somehow nipped off the head of the penis as well. Although the boy was under local anaesthetic, he screamed as blood gushed out of his organ."

"On realising his gory mistake, the doctor arranged for an ambulance to rush the child to hospital as he battled to stem the copious bleeding," said a source.

The boy is admitted at the United Bulawayo Hospitals (UBH) where the cut off organ has been sewn back on.

A source at UBH said while he was in stable condition, it was too early to know if his penis would be normal again.

His father, who identified himself as A Sibanda said he was devastated by the gruesome incident.
"This could be a one in a million case and I am crushed in spirit. We are waiting for a specialist doctor from Harare to look at him. We will then sit down as a family and decide on the next step," said Sibanda.

Population Services International (PSI) spokesperson Paidamoyo Magaya was unreachable for comment. PSI sponsors the circumcision drive in Zimbabwe. Removal of the foreskin is believed to reduce chances of one contracting HIV by as much as 60 percent.