The California Senate passed bill AB768 37-0 without debate. The bill states: "Infant circumcision has a wide array of health and affiliative benefits". This statement directly goes against what every major medical association in the world has stated about circumcision.

These false claims need to be addressed. Medical organizations are the ones responsible for making these types of claims, not politicians who have no medical background whatsoever. Even the American Academy of Pediatrics (AAP) takes a position of not recommending circumcision. Consistent with all previous AAP reports, no proven, actual benefits for circumcision are found. The same is true for all medical organizations in the world.

Please, write to the California governor and let him know what you think about these false claims. You can contact him here. Below is an example of a letter that was sent (thank you, Cassandra!)

Hello Governor,

I'm writing to tell you I am strongly opposed to this bill, AB 768, and I ask that you carefully look over it's claims. The claims made in this bill, such as that circumcision has health benefits, are not in par with the rest of America's health organizations, or the recommendations of various health organizations around the world. There are no potential benefits that justify cutting off bits of genitals from unconsenting people. Absent of a real medical need, it is illegal and unethical to perform surgery, cutting off a healthy body part, on an unconsenting person. The only person to choose circumcision should be the person who has to bear it's consequences. Genital cutting (euphemistically called circumcision) is a crime.

The medical code that is often used for circumcision surgery (ICD-9-CM Diagnosis Code 605) is "redundant prepuce and phimosis." There is no such thing as redundant prepuce and it is not possible for infants and children to have phimosis, as the foreskin is fused to the penis in infancy and not supposed to be retractile, that is the normal, natural state. It is not a birth defect and it is not grounds for surgery.

There are documented cases of accidental partial or complete amputation of the penis during "routine" infant circumcisions, why should that be a choice a parent can make with risks like that? Nobody has to live with that except the boy who did NOT ask for circumcision. There are documented cases of babies DYING from circumcision complications. Why should we be risking the lives of children for a surgery that is medically UNnecessary (as stated by every medical organization in the world, including the American Academy of Pediatrics)?

I plead with you to take the time to read through this list (link below) of various medical organizations around the world for their recommendations on circumcision. It would be a grave mistake for America to enact into law a bill that stated circumcision has any real medical benefit when the rest of the world, and even our own AAP, states it is medical unnecessary.

Thank you for your time and consideration.
Cassandra S.

‎The San Fransisco Bill- which banned circumcision- was taken off of the November ballot. Additionally, there was a bill that was passed the judiciary committee yesterday: AB 768, which protects circumcision.

The bill that was passed the judiciary committee yesterday states: "existing law regulates various subjects relating to the protection and preservation of personal health, including infant, child, and adolescent health, reproductive privacy, and the prevention of the practice of female genital mutilation.

This bill would preclude a city, county, or city and county ordinance, regulation, or administrative action from prohibiting or restricting the practice of male circumcision, or the exercise of a parent’s authority to have a child circumcised. This bill would provide that the Legislature finds and declares that the laws affecting male circumcision must have uniform application throughout the state.

This bill would declare that it is to take effect immediately as an urgency statute."

1. Proponents and opponents of AB 768 were invited to submit, by 5 pm on Friday last week, any briefs, letters, emails, faxes, etc to Ms. Ronak Daylami, an attorney who serves as staff counsel to the committee. Her job was to use the next ...3 days to digest the relevant data points and arguments, evaluate and analyze the proposed bill in terms of how it changes existing law, how well it achieves its stated goals, whether it passes the "Lemon test" [using e.g. California Educational Authority v. Priest
(1974) 12 Cal.3d 593; and East Bay Asian Local Development Corp. v. State of California (2000) 102 Cal.Rptr.2d 280], and whether it is constitutional. Ms. Daylami was supposed to present both sides of the argument and analyze each. Several parties on each side submitted amicus briefs.

2. The Judiciary Committee consists of 5 members: Chairwoman Noreen Evans (D), Vice Chair Tom Harman (R), Sam Blakeslee (R), Ellen Corbett (D), and Mark Leno (D).

3. Senator Evans called the hearing to order. She explained that proponents and opponents of AB 768 would each get 3 speakers at 3 minutes each. If others in the gallery wished to be recognized, they could later state their name and their support or opposition for the record.

4. First speaker in favor of the bill was Spencer ??? representing the California Medical Association. He spoke for only 2 minutes, and emphasized that the CMA has long considered circumcision an effective public health measure. He also stressed that no local jurisdiction should interfere with the practice of medicine. Second speaker was Cliff Berg, representing a Jewish Congress. He stated that the bill was necessary to prevent future attempts to curtail religious rights. He spoke less than 2 minutes. Last speaker was Valerie Small-Navarro with the Northern California ACLU. She was the most impassioned of the speakers, and said that there were important civil liberties at stake and that her organization was firmly behind AB 768. She spoke for less than 3 minutes.

5. No one else stepped up to be recognized as being in favor of the bill.

6. Senator Mark Leno made a special request of the representative from the CMA. Leno said he anticipated that opponents of AB 768 were going to liken male circumcision to FGM, and he wanted a clarification that the CMA distinguishes between them. The response he got was probably not what he was looking for; the CMA spokesman merely said that the CMA hadn't studied female circumcision much. He said there were initial indications that male circumcision helped with sexually transmitted diseases like HIV, but he wasn't aware of much research connecting FGM and HIV. (This was actually a great opportunity for us.)

7. First speaker opposed to the bill was Brian Levitt. He spoke for just over 2 minutes about how he felt harmed, how AB 768 was bad law, and the "emergency" nature of the bill was moot. Second speaker was Tina Kimmel. She listed very impressive educational and professional credentials, and spoke passionately about how biased Ronal Daylami's legislative analysis was. She also denounced the culture of circumcision. Third speaker was Lloyd Schofield, party in interest of SFMGMbill. He explained how MGMbill has been mischaracterized as a ban, when it is clarification of circumcision as an emergency medical procedure. Lloyd explained the anatomy of circumcision and touched on the trauma it causes. Both TIna and Lloyd ran a fair bit over the allotted time and were reminded by the Chair to wrap up their points.

8. Several opponents of AB 768 took the opportunity to register their objections at the podium. They were Marilyn Milos, Steve Brown, Kirsten Barquist, Jonathan Conte, Sophia Williams and Frank McGinniss (who spoke a bit on foreskin restoration).

9. Chairwoman Evans noted that circumcision is a controversial issue, and a YES vote by the committee should not necessarily be construed as an endorsement of circumcision. (This was preposterous to even say, because the language of the bill clearly praises circumcision.) She noted that she was once married to a Jewish man and they had a son. She did a lot of soul-searching before they decided it was in their son's best interest that he be circumcised. So she knows how painful this is, or something like that. She said she would be voting YES.

10. Chairwoman Evans called for discussion to close and a vote to be held. It was 5 "ayes", no "nays", in favor of sending AB 768 on to the full California Senate for a vote. Unanimous.

Martin, a genital integrity activist, writes, "I have very strong opinions about what happened today within the proponents' group, the opponents' group and the Committee. I am very disturbed by the biased job the Staff Attorney did.

Now...It's time to get outraged.

Are you a circumcised man? Do you know a circumcised man? Did you know that circumcision is illegal? The FGM (Female Genital Mutilation) ban and the 14th Amendment require that protection be given to infant girls as well and infant boys. You can not protect one from harm and not the other. Please join us it a class action lawsuit against the doctors and hospitals that forced this surgery on you without your consent.

We need a class action lawsuit and plenty of them! Doctors circumcise for the money. If they are more worried about being sued, they will stop! It is already illegal to circumcise! The FGM (female genital Mutilation) ban and the 14th amendment make it so it's unconstitutional to protect baby girls but deny those same rights to baby boys! Contact me with your name, phone number, and email so we can get this going! Spread the word!"

Contact Intact Sonoma on facebook for details.

Posted with Permission

Over the last 170 years, a Jewish and Israeli movement to stop circumcision has emerged. The movement is inspired by modern notions of an individual’s right to their own body, new historical information about the non-Judaic origin of circumcisions in Africa and Egypt, scientific discoveries about the damage caused by circumcision, and a desire to live a higher level of spiritual ethics. They include Jewish mothers, fathers, families, scholars, intellectuals, educators, and Jews around the world. More and more Jewish parents in Israel, America, and the rest of the world are choosing to bypass circumcision, and to keep their new sons intact. Alternative rituals called the Brit B’lee Milah or Bris Shalom are serving as covenant ceremonies rather than surgical circumcision. More Jews are beginning to live their spiritual values and ethics by respecting their son's bodies and refining their rituals accordingly.

“His body, His Rights” – Intactivist Protest by Jews for the Rights of the Child

Intactivist Jewish Groups in the United States
♡  Jews Against Circumcision
♡  Jews for the Rights of the Child
♡  Questioning Circumcision by Ron Goldman, PhD.
♡  Officiants of Bris Shalom / Brit B'lee Milah by Mark D. Reiss, M.D. (50+ Rabbis and Jewish Leaders)

Intactivist Jewish Media (Movies, Blogs)
♡  Cut - Slicing Through the Myths of Circumcision - A Film by Eliyahu Ungar-Sargon
♡  Beyond the Bris Milah: Jewish Intactivist Parenting Forum
♡  Officiants of Bris Shalom / Brit B'lee Milah by Mark D. Reiss, M.D. (50+ Rabbis and Jewish Leaders)

Peaceful Intactivist Covenants: Brit B’lee Milah, Bris Shalom, Brit Chayim, Brit Ben and more.
♡  Officiants of Bris Shalom / Brit B'lee Milah by Mark D. Reiss, M.D. (50+ Rabbis and Jewish Leaders)
♡  Brit Shalom: An Alternative Naming Ceremony by Mark D. Reiss, M.D.
♡  Jewish, and uncircumcised by Hayley Mick, The Globe and Mail (Canada)
♡  Bris Shalom Officiants by Mark D. Reiss, M.D.♡  The Measure of His Grief by Lisa Braver Moss

Peaceful Covenant/Naming Texts for Intactivist Jewish Parents.
♡  Our Son's Bris Shalom, or Welcoming Covenant By Brenda Platt
♡  Bris Shalom Ceremony by Norm Cohen
♡  The Bris Shalom Ceremony
♡  Brit Shalom-Covenant of Wholeness
♡  Brit B'lee Milah Ceremony Text #1
♡  Brit B'lee Milah Ceremony Text #2

“Genital Integrity is a Human Right” – Intactivist Protest by Jews for the Rights of the Child

Voices of Intactivist Jewish Parents – Mothers
♡  My Son: The Little Jew with a Foreskin by Stacey Greenberg
♡  Lucking Into Bris Shalom by Sarah Rockwell
♡  Open Letter from Dr. Jenny Goodman.
♡  A Jewish Woman Denounces Circumcision by Laura Shanley
♡  Intact and Jewish on Natural Parents Network
♡  How "Cut" Saved My Son's Foreskin: A Movie Review by Diane Targovnik
♡  Circumcision: A Jewish Mother Has a Change of Heart

Voices of Intactivist Jewish Parents – Fathers
♡  The Kindest Un-Cut Feminism, Judaism, and My Son's Foreskin by Professor Michael S. Kimmel
♡  Ending Circumcision in the Jewish Community? by Moshe Rothenberg, MSW

Intactivist Jewish Voices - Many Jews Question Circumcision
♡  Jewish Voices: The Current Judaic Movement to End Circumcision: Part 1
♡  Jewish Voices: The Current Judaic Movement to End Circumcision: Part 2
♡  Jewish Voices: The Current Judaic Movement to End Circumcision: Part 3
♡  Jews Speak Out in Favor of Banning Circumcision on Minors

Intellectual and Moral Foundations of Jewish Intactivism
♡  Israeli Linguist Vadim Cherny: How Judaic is circumcision?
♡  Being rational about circumcision and Jewish observance by Moshe Rothenberg
♡  Brit Milah : Inconsistent with Jewish Ethics? By D.A. Huffman-Parent,
♡  One Rabbis' Thoughts on Circumcision by Rabbi Nathan Segal
♡  Intactivist of the Month: Leonard Glick, MD, PhD.
♡  Eli Ungar-Sargon Debates Rabbi Shmuley Boteach on the Ethical Problems of Circumcision
♡  An Alternative Perspective by Jenny Goodman, MD.
♡  Defying Convention: An Interview With Miriam Pollack
♡  A Case for Bris without Milah.
♡  Jerusalem Post: Challenging the Circumcision Myth by Jan Jaben-Eilon [PDF]

Jewish mother and childbirth educator Kathryn Mora who Testified in Support of the MGM Bill at the Massachusetts State House.

Voices of Intactivist Jews - Men
♡  On Circumcision, Authority, and the Perpetuation of Abuse by Jonathan Friedman
♡  Howard Stern: Jewish Intactivist by Rebecca Wald, J.D.
♡  To the Mohel Who Cut Me by Shea Levy

Voices of Intactivist Jews – Women
♡  Circumcision: Identity, Gender, and Power by Miriam Pollack
♡  Circumcision: A Jewish Feminist Perspective by Miriam Pollack
♡  Jewish mom: Circumcision spiritually wounds, breaks bonds and trust

Intactivist Groups in Israel
♡  Kahal - Giving Up Brit Milah [In Hebrew] [In English]
♡  Af-Mila - Israeli Intactivist Magazine [In Hebrew] [In English]
♡  Intact Son - the Israeli Association Against Genital Mutilation (In Hebrew)
♡  Protect the Child (In Hebrew)

Detailed information on the normal development of the foreskin and its natural separation process.

Written by: Doctors Opposing Circumcision
(see the original article here)

Introduction
There is much uncertainty among health care workers about when the foreskin of a boy should become retractable.1 This has caused many false diagnoses of phimosis, followed by unnecessary circumcision, when, in fact, the foreskin is developmentally normal.

History
The first data on development of retractile foreskin were provided in 1949 by the famous British paediatrician, Douglas Gairdner.2 His data have been incorporated into many textbooks and still is repeated in the medical literature today. Gairdner said that 80 percent of boys should have a retractable foreskin by the age of two years, and 90 percent of boys should have a retractable prepuce by the age of three years.2

Unfortunately, Gairdner’s data are inaccurate,3-4 so most healthcare providers have been taught inaccurate data.4 Retractability usually occurs much later than previously believed.3 This page provides accurate data, derived from newer and better studies, for healthcare providers.

Current View
Almost all boys are born with the foreskin fused with the underlying glans penis. Most also have a narrow foreskin that cannot retract. Non-retractile foreskin is normal at birth and remains common until after puberty (age 18). Some boys develop retractile foreskin earlier, and about 2 percent of males have a non-retractile foreskin throughout life. Non-retractile foreskin is not a disease and does not require treatment.

There are three possible conditions that cause non-retractile foreskin:

• Fusion of the foreskin with the glans penis
• Tightness of the foreskin orifice
• Frenulum breve (which is rare and cannot be diagnosed until the previous two reasons have been eliminated)

The first two reasons are normal in childhood and are not pathological in children. The third can be treated conservatively, retaining the foreskin.

Infants and pre-school
Kayaba et al. (1996) reported that before six months of age, no boy had a retractable prepuce; 16.5 percent of boys aged 3-4 had a fully retractable prepuce.5 Imamura (1997) examined 4521 infants and young boys. He re-ported that the foreskin is retractile in 3 percent of infants aged one to three months, 19.9 percent of those aged ten to twelve months, and 38.4 percent of three-year-old boys.6 Ishikawa & Kawakita (2004) reported no retractability at age one, (but increasing to 77 percent at age 11-15).7 Non-retractile foreskin is the more common condition in this age group. Compare these data with Gairdner’s data!

School-age and adolescence
Jakob Øster, a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in Denmark, where circumcision is rare.8 Øster (1968) found that the incidence of fusion of the foreskin with the glans penis steadily declines with increasing age and foreskin retractability increases with age.8 Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5 Kayaba et al. also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42 percent of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9 percent in boys aged 11-15.5 Imamura (1997) reported that 77 percent of boys aged 11-15 had retractile foreskin.6 Thorvaldsen & Meyhoff (2005) conducted a survey of 4000 young men in Denmark.9 They report that the mean age of first foreskin retraction is 10.4 years in Denmark.9 Non-retractile foreskin is the more common condition until about 10-11 years of age.

Discussion
Boys usually are born with a non-retractile foreskin. The foreskin gradually becomes retractable over a variable period of time ranging from birth to 18 years or more.8,9 There is no “right” age for the foreskin to become retractable. Non-retractile foreskin does not threaten health in childhood and no intervention is necessary. Many boys only develop a retractable foreskin after puberty. Education of concerned parents usually is the only action required.10

Avoidance of premature retraction
Care-givers and healthcare providers must be careful to avoid premature retraction of the foreskin, which is contrary to medical recommendations, painful, traumatic, tears the attachment points (synechiae), may cause infection, is likely to generate medico-legal problems, and may cause paraphimosis, with the tight foreskin acting like a tourniquet. The first person to retract the boy’s foreskin should be the boy himself.3

Making the foreskin retractable
Occasionally a male reaches adulthood with a non-retractile foreskin. Some men with a non-retractile foreskin happily go through life and father children. Other men, however, may want to make their foreskin retractile.

The foreskin can be made retractable by:

• Manual stretching11-12
• Application of topical steroid ointment13-14

Male circumcision is outmoded as a treatment for non-retractile foreskin, but it is still recommended by many urologists because of lack of adequate information, and perhaps because of the fees associated with circumcision. Nevertheless, circumcision should be avoided because of pain, trauma, cost,15,16 complications,15 difficult recovery, permanent injury to the appearance of the penis, loss of pleasurable erogenous sensation,17 and impairment of erectile and ejaculatory functions.18-20

References:

1. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3. [Full Text]
2. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7. [Full Text]
3. Wright JE. Further to the "Further Fate of the Foreskin." Med J Aust 1994;160:134-5. [Full Text]
4. Hill G. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust 2003;178(11):587. [Full Text]
5. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5. [Full Text]
6. Imamura E. Phimosis of infants and young children in Japan. Acta Paediatr Jpn 1997;39(4):403-5. [Abstract]
7. Ishikawa E, Kawakita M. [Preputial development in Japanese boys]. Hinyokika Kiyo 2004;50(5):305-8. [Abstract]
8. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3. [Full Text]
9. Thorvaldsen MA, Meyhoff H. Patologisk eller fysiologisk fimose? Ugeskr Læger 2005;167(17):1858-62. [Full Text]
10. Spilsbury K, Semmens JB, Wisniewski ZS. et al. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust 2003 178 (4):155-8. [Full Text]
11. Dunn HP. Non-surgical management of phimosis. Aust N Z J Surg 1989;59(12):963. [Full Text]
12. Beaugé M. The causes of adolescent phimosis. Br J Sex Med 1997; Sept/Oct: 26. [Full Text]
13. Orsola A, Caffaratti J, Garat JM. Conservative treatment of phimosis in children using a topical steroid. Urology 2000;56(2):307-10. [Full Text]
14. Ashfield JE, Nickel KR, Siemens DR, et al. Treatment of phimosis with topical steroids in 194 children. J Urol 2003;169(3):1106-8. [Abstract]
15. Van Howe RS. Cost-effective treatment of phimosis. Pediatrics 1998; 102(4)/e43. [Full Text]
16. Berdeu D, Sauze L, Ha-Vinh P. Blum-Boisgard C. Cost-effectiveness analysis of treatments for phimosis: a comparison of surgical and medicinal approaches and their economic effect. BJU Int 2001;87(3):239-44. [Full Text]
17. Williams N, Kapila L. Complications of circumcision. Brit J Surg 1993;80:1231-6. [Full Text]
18. Denniston GC, Hill G. Circumcision in adults: effect on sexual function. Urology 2004;64(6);1267. [Full Text]
19. Shen Z, Chen S, Zhu C, et al. [Erectile function evaluation after adult circumcision]. Zhonghua Nan Ke Xue 2004;10(1):18-9. [Abstract]
20. Masood S, Patel HRH, Himpson RC, et al. Penile sensitivity and sexual satisfaction after circumcision: Are we informing men correctly? Urol Int 2005;75(1):62-5. [Full Text]

Have you heard that circumcision reduces HIV transmission? Here's an accurate breakdown of exactly why circumcision does NOT prevent HIV.

Written by: Joseph4GI
(read the original article here)
Posted with Permission from Author



There's currently a lot of hype surrounding circumcision and the transmission of HIV. The word on people's lips is that "circumcision reduces HIV transmission by 60%." The claim is based on the result of three major "studies" that were carried out in Africa, but there are a few confounding factors that bring the validity of these so-called "studies" into question. One of the greatest confounding factors in these studies is empirical evidence to the contrary; real world data from countries where circumcision is already a widespread practice and studies with contrary results.

Countries in Africa
Let's begin with countries in Africa, where these "studies" would be relevant. According to demographic health surveys performed in other countries in Africa, HIV transmission was prevalent in circumcised men in at least 6 different countries. I go one by one, analyzing some of the commentary in these surveys, some of which seems to be revealing of the researchers' bias.

Cameroon
In Cameroon, where 91% of the male population is circumcised, the ratio of circumcised men vs. intact men who contracted HIV was 4.1 vs. 1.1. (See p. 17)
http://www.measuredhs.com/pubs/pdf/FR163/16chapitre16.pdf

Ghana
"...the vast majority of Ghanaian men (95 percent) are circumcised... There is little difference in the HIV prevalence by circumcision status..." (1.6 vs 1.4 See p. 13)
http://www.measuredhs.com/pubs/pdf/FR152/13Chapter13.pdf

Lesotho
In Lesotho, 23% of the men are circumcised, and the ratio circumcised men vs. intact men who contracted HIV was 22.8 vs 15.2.

"The relationship between male circumcision and HIV levels in Lesotho does not conform to the expected pattern of higher rates among uncircumcised men than circumcised men. The HIV rate is in fact substantially higher among circumcised men (23 percent) than among men who are not circumcised (15 percent). Moreover, the pattern of higher infection rates among circumcised men compared with uncircumcised men is virtually uniform across the various subgroups for which results are shown in thetable. This finding could be explained by the Lesotho custom to conduct male circumcision later in life, when the individuals have already been exposed to the risk of HIV infection. (Additional analysis is necessary to better understand the unexpected pattern in Table 12.9.)" (p. 13)

What is disturbing here is that it seems researchers grope for a reason to dismiss these results because they are not what they are looking for; a positive result for circumcision. The above is an interesting defense of male circumcision, given the fact that the latest "studies," if they can even be called that, observed HIV trasmission in men circumcised as adults. Then again, this demographic health survey was conducted in 2004, BEFORE the newer "studies" in 2006. None the less, the unproven assertion that "circumcision is only effective in reducing the risk of HIV when done in infancy" persists in some circles.
http://www.measuredhs.com/pubs/pdf/FR171/12Chapter12.pdf

Malawi
In Malawi, 20% of the male population is circumcised. The ratio of circumcised vs. intact men who contracted HIV was 13.2 vs 9.5.

"The relationship between HIV prevalence and circumcision status is not in the expected direction. In Malawi, circumcised men have a slightly higher HIV infection rate than men who were not circumcised (13 percent compared with 10 percent). In Malawi, the majority of men are not circumcised (80 percent)(...where one would expect HIV to be the most rampant... note the "expected direction.") (p. 10)
http://www.measuredhs.com/pubs/pdf/FR175/12Chapter12.pdf

Rwanda
According to a demographic health survey taken in 2005,  the ratio of circumcised vs. intact men who contracted HIV was 3.8 vs 2.1. (See p. 10)
 http://www.measuredhs.com/pubs/pdf/FR183/15Chapter15.pdf

Swaziland
In a recent demographic health survey (2006-2007), the ratio of circumcised vs. intact men who contracted HIV was found to be 22 vs. 20.

As Table 14.10 shows, the relationship between HIV prevalence and circumcision status is not in the expected direction. Circumcised men have a slightly higher HIV infection rate than men who are not circumcised (22 percent compared with 20 percent). (p. 256)
http://www.measuredhs.com/pubs/pdf/FR202/FR202.pdf

Here is that "expected direction" again. The majority of Swazi men are uncircumcised, and one would especially expect to see HIV prevalence here. HIV transmission was more prevalent in the circumcised men here, yet our (the US) government has decided to spend millions on a campaign to circumcise 80% of the men in Swaziland.
http://joseph4gi.blogspot.com/2011/05/soka-uncobe-our-us-tax-dollars-at-work.html

Other Countries Where HIV/Circumcision Rates Don't Correlate

Malaysia
According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia, most, if not all Muslim men are circumcised, whereas circumcision is uncommon in the non-Muslim community. 60% of the Malaysian population is Muslim, which means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.
http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council

The Philippines
In the Philippines, the majority of the male population is circumcised, as it is seen as an important rite of passage. In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.
http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

Israel
Despite circumcision being near-universal, it hasn't stopped HIV transmission in Israel.
http://www.haaretz.com/print-edition/opinion/failing-the-aids-test-1.249088
http://www.haaretz.com/print-edition/features/israeli-gays-shun-condoms-despite-worrying-rise-in-aids-1.249372
http://www.haaretz.com/news/has-the-aids-cocktail-worked-too-well-in-israel-1.258520
http://www.haaretz.com/print-edition/news/hiv-diagnoses-in-israel-climb-new-cases-among-gays-up-sharply-1.248651

The most obvious smoking gun: The United States of America
Circumcision hasn't stopped HIV in our own country.
http://data.unaids.org/pub/Report/1998/19981125_global_epidemic_report_en.pdf

And, it hasn't stopped other STDs either.
http://www.reuters.com/article/2009/01/13/us-infections-usa-idUSTRE50C5XV20090113?pageNumber=1&virtualBrandChannel=0

In America, the majority of the male population is circumcised, approximately 80%, while in most countries in Europe, circumcision is uncommon. Despite these facts, our country does poorly.
http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=419&Itemid=177

In fact, AIDS rates in some US Cities rival hotspots in Africa. In some parts of the U.S., they're actually higher than those in sub-Saharan Africa. According to a 2010 study published in the New England Journal of Medicine, rates of HIV among adults in Washington, D.C. exceed 1 in 30; rates higher than those reported in Ethiopia, Nigeria or Rwanda.
http://www.nejm.org/doi/full/10.1056/NEJMp1000069

The Washington D.C. district report on HIV and AIDS reported an increase of 22% from 2006 in 2009:

"[Washington D.C.'s] rates are higher than West Africa... they're on par with Uganda and some parts of Kenya." Shannon L. Hader, HIV/AIDS Administration, Washington D.C., March 15, 2009

She once led the Federal Centers for Disease Control and Prevention's work in Zimbabwe.http://www.washingtonpost.com/wp-dyn/content/article/2009/03/14/AR2009031402176.html

One would expect for there to be a lower transmission rates in the United States, and for HIV to be rampant in Europe; HIV transmission rates are in fact higher in the United States, where most men are circumcised, than in various countries in Europe, where most men are intact. It is telling that the HIV epidemic struck in our country in the 1980s, 90% of the male population was already circumcised. Somehow, we're supposed to believe that what didn't worked in our own country, or anywhere else, is going to start working miracles in Africa.

Studies With Contrary Conclusions

According to USAID, "there appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

"Conclusions: We find a protective effect of circumcision in only one of the eight countries for which there are nationally-representative HIV seroprevalence data. The results are important in considering the development of circumcision-focused interventions within AIDS prevention programs."
http://www.iasociety.org/Default.aspx?pageId=11&abstractId=2197431

Results: ...No consistent relationship between male circumcision and HIV risk was observed in most countries.
http://apha.confex.com/apha/134am/techprogram/paper_136814.htm

One study which aimed at measuring male to female HIV transmission was ended early, because the results were not looking favorable. The Wawer study showed a 54% higher rate of male-to-female transmission in the group where the men had been circumcised. The figures were too small to show statistical significance, but there will be no larger scale study to find out if circumcising men increases the risk to women. Somehow that's considered unethical, yet it's considered ethical to promote male circumcision while not knowing if the risk to women is increased (by 54%?, 25%?, 80%? - who knows?)
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2960998-3/fulltext

The latest study in Kenya finds no association between male circumcision and lowered HIV rates:
'Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding that circumcised men are less likely to become infected with HIV.'

Conclusion
A few select studies show a prevalence of HIV transmission in uncircumcised men, but real world empirical data shows that circumcision hasn't stopped HIV in countries where there is already a prevalence of the practice of circumcision, nevermind the United States. Yet, for whatever reason, leaders at the WHO continue to endorse it as HIV prevention policy and millions are being spent on so-called "mass circumcision campaigns," even in countries where HIV transmission was shown to be prevalent among the circumcised.

As if the waste of money weren't bad enough, reports are showing that these "mass circumcision" campaigns are actually proving to be disastrous, as they are confusing African citizens, and many now believe to be fully protected by circumcision.
http://joseph4gi.blogspot.com/2011/05/male-circumcision-and-hiv-in-africa.html

Something must be done to alert our world leaders. Millions of precious funds are being used to promote a worthless surgical procedure that leaves men with permanently altered organs, and they are no better protected. The false security that the promotion of circumcision creates is actually helping to facilitate the spread of HIV. Funds are already scarce, and they could be better spent promoting cheaper, less invasive modes of prevention that have actually been proven to be conclusively effective, such as condoms and education. In light of the real-world evidence, promoting a worthless surgical procedure is an impertinent disservice in the fight against HIV/AIDS and governments need to be told to stop. Africans deserve better.

No national or international medical association recommends routine infant circumcision. Below are the actual position papers and guidelines of medical associations worldwide.

(Thanks to NOCIRC for this list)

• The Royal Australasian College of Physicians 2002 Position Statement.
 Routine Circumcision of Normal Male Infants and Boys - Summary Statement.


• The American Academy of Family Physicians 2002 Statement. Position Statement on Neonatal Circumcision.


• The American Academy of Pediatrics states: "Existing scientific evidence demonstrates potential medical benefits of newborn circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."


• The American Cancer Society, states in a letter to the AAP: "We would like to discourage the American Academy of Pediatrics from promoting routine circumcision as a preventive measure for penile or cervical cancer... Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate."


• The American Medical Association has joined all national medical organizations in NOT recomending routine circumcision.


• The Australasian Association of Paediatric Surgeons states, "It is considered to be inappropriate and unnecessary as a routine to remove the prepuce, based on the current evidence available."


• The Australian College of Paediatrics, citing the Australasian Association of Paediatric Surgeons, states: "Routine male circumcision should not be performed prior to 6 months of age." In addition, it considers that, "neonatal male circumcision has no medical indication. It is a traumatic procedure, performed without anaesthesia to remove a normal functional and protective prepuce."


• Summary of the American College of Obstetricians and Gynecologists: Circumcision Policy 2001
The American College of Obstetricians and Gynecologists supports the current position of the American Academy of Pediatrics that finds the existing evidence insufficient to recommend routine neonatal circumcision. [Policy statement removed at the request of the American College of Obstetricians and Gynecologists. ]


• The British Medical Association Guidelines advise "The BMA opposes unnecessarily invasive procedures being used where alternative, less invasive techniques, are equally efficient and available."


• The Canadian Paediatric Society recommends: "Circumcision of newborns should not be routinely performed."

Many medical professionals are misinformed when it comes to the proper techniques of testing intact boys with catheters. So, what's the proper procedure?

For a variety of reasons, sometimes it is medically necessary to test urine. But with misinformation surrounding the proper care of the intact penis, it is important to know a few facts before having your intact son tested. 

First of all, it is likely that a catheter is not even necessary. There are a few techniques that allow urine testing without the need for a catheter, such as a sterile urine bag or a "clean catch". Both of these techniques can be performed at home or at the hospital/doctor's office. 

"Clean Catch"

• involves 'catching' a sample of clean urine from an infant or young child as they urinate
• give your son a drink or breast feed to help fill the bladder
• clean the outside of the child’s genital area with soap and water (no soap underneath the foreskin, however)
• leave your child’s diaper off and wait for him to urinate- quickly catch a small amount in a sterile container (from your doctor)
• on the container write your child’s first name, surname, date of birth, and the date and time you collected the sample
• it is important that the urine sample is fresh when tested so deliver it to your laboratory within two hours or put it in the fridge (not the freezer) until you can deliver the sample
• it can be difficult to time when a young child urinates, so several attempts may be needed
  

Urine Bag Collection

• you attach a plastic bag, which has a sticky strip, over your baby’s genital area after cleaning very well with soap and water (again, do not use soap underneath the foreskin)
• for boys, the entire penis can go in the bag and you can put a diaper on over the bag
• urine collects in the bag when your child urinates; sometimes it can take several attempts to get some urine
• transfer the urine sample from the bag into the sterile container (from your doctor)
• on the container write your child’s first name, surname, date of birth, and the date and time you collected the sample
• it is important that the urine sample is fresh when tested so deliver it to your laboratory within two hours or put it in the fridge (not the freezer) until you can deliver it; don’t leave the bag on your baby overnight
• a bag urine sample can be contaminated by germs from the skin; which might make it look like your child has a UTI (urinary tract infection) even if they don’t. In some situations (for example if your child is only mildly unwell) a repeat bag urine collection can be used to confirm whether a UTI is actually present

Testing With a Catheter

• if a catheter is necessary, know that there is absolutely NO MEDICAL REASON to retract your son's foreskin to insert a catheter
  
• talk to the hospital staff and make certain that they know not to retract
• a catheter can be inserted when the foreskin is pulled back just enough to see the meatus (urinary opening). If the foreskin's opening is too small to retract far enough to see the meatus, a catheter can be inserted through the foreskin's opening and into the meatus "by feel"
  
• if it makes you feel more comfortable, offer to be the one that handles his penis during catheter insertion. You can bring your own sterile gloves, and gently open his foreskin (about as much as when he urinates) so the catheter can be inserted by a nurse or doctor

If you're interested in more detailed information, or something to print and give to a medical professional, please see this article:

"Urine Samples and Catheter Insertion for Intact Boys"
http://www.drmomma.org/2011/12/urine-samples-and-catheter-insertion.html

Read more about forced retraction and why it is dangerous:
Only Clean What Is Seen - Reversing the Epidemic of Forcible Foreskin Retractions