Lack of Open Debate Results in Flawed Policy
BOSTON - Ronald Goldman, Ph.D., executive director of the Circumcision Resource Center and author of Circumcision: The Hidden Trauma, is concerned about the International AIDS Conference in Washington, DC starting July 22. He says it offers a one-sided view by promoting male circumcision to reduce HIV transmission in Africa. "There is nothing scientific about a process that excludes opposing views. Circumcision advocates are afraid to debate circumcision critics," states Goldman. "This shows up at professional conferences where critics are not provided equal opportunity to participate. The fear of open discussion was also apparent when two circumcision advocates refused to debate me on two different radio talk shows." He also notes that circumcision advocates tend to be circumcised and have personal, political, and financial conflicts of interest connected with circumcision.
There is support for Goldman's critical view of circumcision. Many professionals have questioned the reliability and validity of studies claiming that circumcision reduces HIV transmission. (See link below for references.) Such studies were not consistent with other evidence. For example, African national population surveys in eight countries found a higher rate of HIV infection among circumcised men compared to men who were not circumcised. There are at least 17 observational studies that have not found any benefit from male circumcision in reducing HIV transmission. "The campaign to promote circumcision in Africa is a tragic waste of resources that could be used to make a real difference," he says.
Goldman explains that advocates ignore the significant harm of circumcision. "Most circumcised men, including doctors and researchers, do not know what they are missing. Studies show that circumcision removes up to one-half of the erogenous tissue on the penile shaft. The foreskin protects the head of the penis, enhances sexual pleasure, and facilitates intercourse. Cutting it off removes several kinds of specialized nerves and results in thickening and progressive desensitization, particularly in older men." A survey showed that circumcised men were 4.5 times more likely to use an erectile dysfunction drug. He describes the psychological harm of circumcision in detail in his book.
There are better methods to prevent HIV transmission, according to Goldman. He states that research shows that most HIV infections in Africa are transmitted by contaminated injections and surgical procedures. "The advice is simple: sterilize any instrument that will be used on a person's body. For sexual contact, condoms are more than 99% effective, less invasive, and the cost of one circumcision in Africa can pay for 3000 condoms. Unlike circumcision, condoms also have the advantage of also protecting women, and there are no surgical risks and complications."