I am writing to you to attract your attention to the issues raised by the position you hold on male circumcision.  Your general position is that male circumcision should be promoted as it helps prevent HIV.

First, male circumcision is a form of physical and psychological violence.  Removing part of the foreskin of the male genitalia is an act of violence that at best causes physical discomfort and at worst causes pain if done under proper medical supervision.  If not it can lead to castration and even death.  In South Africa, boys are dying following circumcision.  See a BBC report from June 18, 2010 at http://news.bbc.co.uk/2/hi/world/africa/10350471.stm.

From a psychological standpoint it can be asserted that as with any form of physical violence it causes psychological trauma.  Too few studies exist at this point to contradict the assertion.

Second, male circumcision may help protect against HIV but does not demonstrably do so.  Some experts are convinced that it does.  Others are less so.  See in particular the current policy statement of the American Association of Pediatrics at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686.  Even if male circumcision does really protect against HIV, it does not protect against the other numerous sexually transmittable diseases.  Promoting male circumcision as a measure to fight HIV thus sends the wrong signal.

Third, linking male circumcision to HIV protection creates risks of increased HIV spreading with circumcised males having unprotected sexual relationships thinking that they are protected against HIV.  There are more and more reports from different agencies in Africa that show an increase in the number of sexual relationships, more unprotected sex and the involvement of younger people in sexual relationships justified on the basis that circumcision protects against HIV.

Fourth, unreservedly linking between male circumcision and HIV protection helps promote harmful traditional practices.  Male circumcision is most often practised in developing countries within the framework of traditional rituals.  See again http://news.bbc.co.uk/2/hi/world/africa/10350471.stm.  Jewish and Islamic traditions are also proponents of male circumcision.  Male circumcision done as a traditional practice is harmful because it is a form of violence.  Further, it is performed on beings that have no possibility to consent or make informed choices.  It is thus undignified.  Today, those who perpetrate these acts of violence in the name of traditional practices use the link created by WHO between male circumcision and HIV protection to perpetrate a form of violence that would not otherwise be justifiable.  This leads to pain, suffering, injury and sometimes deaths. 

Fifth, other means such as the use of condoms are more efficient and less controversial to protect against HIV.  There is a choice between using violent and non violent means to fight HIV with the non violent means offering a far better protection.  The use of condoms should be unequivocally promoted as (i) it is a far better means of protecting against HIV, (ii) it is non violent, (iii) it cannot be used to help perpetrate violent traditional practices, and (iv) it effectively protects against other sexually transmitted diseases.  Finally, as explained before the risk of promoting circumcision is that the use of condoms may be relinquished.

Sixth, some interviews conducted in France in homosexual communities appear to show that circumcision has a negative effect on male sexual pleasure.  Although the research is not complete and more research needs to be conducted on this, it raises important human rights questions and circumcision should only be conducted if scientific research clearly shows that there are no such effects.

Seventh, if male circumcision helps protect against HIV, so does female circumcision since it prevents women from having sexual relationships before marriage.  Based on this should female circumcision, considered one of the worst forms of harmful traditional practices, be promoted?

Finally, it is difficult not to see male circumcision as a violation of the United Nation’s 1989 Convention of the Rights of the Child and in particular Article 19 which concerns “all forms of physical or mental violence”.  When many countries are either adopting or proposing “anti-smacking laws”, it is difficult to envisage how male circumcision, unless performed for irrefutable medical reasons, should not be considered a harmful practice. 

As a result of this I urge your organization to rethink its promotion of male circumcision and take into account the potential consequences of such promotion.