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BMJ. Aug 20, 2005; 331(7514): 422.
PMCID: PMC1188135

US group lobbies UN to outlaw male circumcision

A US lobby group is urging the United Nations to classify male circumcision as a violation of human rights violation.

The group wants the UN to outlaw the practice and wants a 1996 US federal law banning female genital mutilation to be amended to include circumcision of men and boys under the age of 18. Matthew Hess, president of MGMbill.org (MGM bill stands for the male genital mutilation bill), said that his group was working “to end male genital mutilation.” He said that male circumcision violated the UN's Declaration of Human Rights, the Convention on the Rights of the Child, and the International Covenant of Civil and Political Rights.

The organisation wants UNAIDS, the joint UN programme on HIV and AIDS, to issue a statement in response to its own press release of 26 July that would say that UNAIDS “recognises that male children have the same genital integrity rights as female children . . . If circumcision is practised at all, it should only be performed on fully informed consenting adults.”

Mr Hess pointed out that “in the real world circumcision is forced upon helpless children.” He said he found it ironic that the UN condemns female circumcision as a human rights violation but encourages male circumcision as a preventive health measure.

So far the UN has not responded to the group's complaints, and the group has not found a sponsor for a bill in the US Congress.

Meanwhile, a study has found that circumcision of male adults in Africa reduces their risk of female to male HIV infection by 65%, compared with uncircumcised men. The study was conducted for the French National Agency of Research on AIDS by Dr Bertran Auvert of the University of Versailles at Saint-Quentin-en-Yvelines, France, and Adrian Puren of the National Institute for Communicable Diseases in South Africa. As yet unpublished, the study was a randomised controlled trial involving more than 3000 men aged 18 to 24 from the Orange Farm Township near Johannesburg. It was presented at the third International AIDS Society conference in Rio de Janeiro on 26 July.

The men in the study, who would traditionally be circumcised around the age of 18 rather than soon after birth, agreed to be randomised to immediate circumcision under local anaesthesia or to be offered circumcision under local anesthesia at the end of the 21-month trial. All the men in the trial received intensive counselling on avoiding infection with HIV during heterosexual sex at the beginning of the trial and at 3-month, 12-month, and 21-month follow-ups. They were given free condoms. Men in the circumcised group reported slightly more sexual contacts than the uncircumcised men (7.6 contacts in the first 9 months of the trial compared to 6 contacts in the uncircumcised group) but had fewer cases of HIV infection. Eighteen men in the circumcised group and 51 in the uncircumcised group became infected. The trial was stopped early and circumcision offered to all participants.

Although the World Health Organization and UNAIDS, in responding to the study, cautioned that more research was needed, several experts in sexually transmitted diseases praised the results. King Holmes of the University of Washington, Seattle, said, “It's extremely exciting . . . It's essentially an anatomic vaccine for life” (Science 2005;309:860).

The American Academy of Pediatrics, in a 1999 policy statement, said that circumcision of newborn males showed some potential medical benefits but that data were not sufficient for routine circumcision of all male infants to be recommended (Pediatrics 1999;103:686-93).

The researchers in the South African study and MGMbill.org note that circumcision by traditional African practitioners in the community is less safe than circumcision in clinics and may transmit infections.

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Group
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