SYDNEY MORNING HERALD, Sydney, NSW, 6 November 2003.

Foreskins have their purpose - for health and better sex

November 6, 2003

There is no scientific evidence in the case being put for circumcision, writes Stan Wisniewski.

A Fertility Society of Australia conference was told on Monday that recent studies showed circumcision protected men against HIV and lowered the risk of cervical cancer in their partners.

However, there is no scientific evidence that circumcision prevents the distribution of sexually transmitted diseases in modern Western societies.

To believe that undertaking circumcision will prevent HIV infection is irresponsible. Boys and their parents need to be taught appropriate hygiene methods of managing the foreskin in childhood and maintain appropriate hygiene measures throughout their lives.

It is alarming that statistics taken from regions where men practise unprotected sex, and may have dubious hygiene information, are being used to support the practice of neonatal circumcision.

The studies on papilloma virus in circumcised men have been conducted in communities where men are usually in monogamous relationships.

It is not circumcision but the number of partners and the practice of unprotected sex that leads to papilloma virus being established and passed on.

I wonder if proponents of circumcision would believe that circumcising the male population of Africa would prophylactically stop the spread of AIDS in that continent without there being a change to public and sexual health strategies?

The motives for circumcision in our culture are difficult to define, but include rites of passage, blood sacrifices and cultural markings. Foreskin, however, is a normal part of the external genitalia and has a special function in protection of the glans penis in childhood and enhancing sexual activity in adult life.

Studies have shown that the skin of the circumcised penis has a greater friction and abrasion within the vagina, and may lead to changes in sexual function and pleasure, in the male and his partner.

Studies have shown that women prefer vaginal intercourse with an anatomically complete penis.

Such studies show circumcision may diminish the female's sexual enjoyment and affect her relationship with the male partner.

In all discussions on circumcision in the newborn child one needs to understand that "informed consent" needs to be considered, and the impact of such consent may not only affect the male but his future sexual partner as well.

In modern Western societies the rate of elective circumcision in newborn males is dropping, and continues to do so.

The rate of circumcision in adult males continues to fall where appropriate hygiene measures are maintained.

There is no scientific evidence that the prophylactic removal of the foreskin sustains any benefit and there is no solid epidemiological evidence to support the theory that circumcision prevents STDs or justifies a policy of involuntary mass circumcision as a public health measure.

Stan Wisniewski is chairman of the West Australian section of the Urological Society of Australia and a clinical associate professor at the University of WA.

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(File prepared 6 November 2003)