Circumcision: To cut or not to cut?
By Vivien Marx and Graham Lawton IMAGINE a quick and simple surgical procedure that trials have shown could give your newborn child lifelong protection against HIV and may ward off sexually transmitted diseases and cancer too. It involves a little pain and bleeding, and occasionally goes wrong, but the risk of serious adverse effects is tiny. Would you have it done? Chances are you would. But what if you found out that other trials have called the procedure’s benefits into question, and that it involves cutting off part of your child’s penis. Now how do you feel about it? This, in a nutshell, is the dilemma facing the parents of newborn baby boys. According to the increasingly vocal advocates of male circumcision, slicing off the foreskin is one of the most effective public-health measures ever invented and should be done routinely, like vaccination. Not so fast, say opponents. They insist that circumcision has no medical benefits and damages a man’s sex life. The debate has rumbled on for decades, but recent findings about the role circumcision can play in preventing transmission of HIV have placed the foreskin – or its absence – firmly back on the public-health agenda. Globally, approximately 30 per cent of men have been circumcised, making it probably the world’s most common surgical procedure, says epidemiologist Helen Weiss of the London School of Hygiene & Tropical Medicine. Most circumcisions are carried out for cultural or religious reasons, but there have long been those who advocate the procedure on medical grounds, to improve hygiene and prevent infections. The latest disease claimed by the circumcision lobby is HIV. Back in the mid-1980s,