The AAP and the Tribal Psychology of Circumcision

Psychology of Tribe borrowed from= http://www.writingsonthewall.net/morality-of-groups-1

The AAP & psychology of tribes applied to circumcision with my additions in bold italics:

1.When acting in ways which relate primarily to their membership of a group, a person’s behaviour changes to reflect the beliefs and aspirations of the group rather than those of the individual. Therefore if the group cuts the genitals of its members to denote group membership, male or female, the aspirations of the group will take precedence over the aspirations of an individual, which leads to infant male circumcision, and FGM of female children. You find parents and in-particular mothers from circumcision cultures handing over their newborns to be cut, even when it goes against their instincts to protect their baby from harm..  The AAP in this instance has written a policy on circumcision to defend its tribal custom, even tho the paper was scientifically and ethically flawed and drawn criticism from its peers around the world.  It would rather face shame and ridicule from its non-tribal peers, than go against its own tribe.

2. Tribal Psychology, is an important trait from hunter gatherer times when strong tribal identity was essential to survival, but it’s necessary for any group to find ways to emphasize the characteristic of group membership because it’s that identification with the group which helps promote cooperation and selflessness in the behaviour of its members. In genital cutting cultures, circumcision is then seen as a ritual which not only denotes tribal membership, but at some level is seen as essential to the survival of a group, an act of selfnessness & co-operation. You can see how circumcision cultures & its scientific institutions such as the AAP in America with its 2012 circumcsion paper scour the world for pro-circumcision research and ignore or deny any validity to research which contradicts circumcision's  so called health benefits or any evidence that the foreskin is a functional sex organ.  HIV Circumcision researchers from the circumcision culture of America go and look for data, and even create experiments such as the African HIV trials, to show that circumcision is essential to human survival. Look at the circumstances of the development of the trials. Epidemiological data from Africa showed that some uncircumcised populations had lower HIV infections than circumcised populations, however, the scientists ignored those populations, and the experiments were conducted where the uncircumcised populations had higher hiv infections. The methodologies of the experiment favoured the cut group, and conflicting data minimized or ignored. This selection process and methodology allowed a greater chance for the a priori hypothesis to be confirmed that circumcision protects against hiv which will ensure survival of the group. When the data favoured the circumcision group they ended the trials early exagerrating the results.  And then the unrelenting use of this data by the Pro-Circumcisers who use what happened in high prevalence HIV Africa, data from the experiments with adult volunteers, as a justification to circumcise male infants in low prevalence hiv nations such as the USA.  The AAP, and scientists from Circumcison cultures avoid or hide the fact that EU & Japan which dont circumcise have much lower HIV/STI's than the USA which has highest adult circumcision rates in the developed world.

Negative Elements of Tribal Psychology with my additions in bold italics include:

1. Grandiose tribal self image: one’s own tribe has certain positive characteristics.  Look at the 2012 AAP Circumcision Policy which has been highly criticised around the world.  Look at the messages in Pro-Circumcision Propaganda: Circumcision makes the tribe more hygienic and clean; Circumcision looks better; Circumcision is better for sex; Circumcision is healthier. Contrast this with actual world facts that no medical organisation in the world recommends routine circumcision for the above reasons nor agrees with any of the above premises, and people from non-circumcision EU & Japan are healthier, live longer have lower hiv/sti's, and view the intact penis as healthy and normal.
2. The tribal shadow: other tribes are evil and inhuman. The AAP calls EU Pediatricians biased against circumcision. Pro-Circumcision propaganda abounds with the demonization of the foreskin and the uncircumcised. Contrast this with actual world facts that most of the world 70 to 75% rejects circumcision, and the healthiest nations with the healthiest people are uncircumcised.
3. Group polarization Tribal identity gains dominance over that of an individual’s self identity in situations of tribal conflict and competition. The AAP gives priority to Parents Rights over its primamry patient the child. Pro-Circumcision uses the propaganda slogan of its the Parents Rights to decide on circumcision, denying the rights of the child to choose for himself. That intactivists are evil prople who want to deny parents rights. Contrast this with the strongest arguments against circumcision which are based on human rights and ethical grounds, that it needs to be the individuals right to choose when they are an adult and make an informed consent decision for themselves.  For the AAP to concede this would mean giving dominance to the individual over the tribe, which they have refused to do.
4. Group think: humans have evolved a tendency to conform to the predominant beliefs and opinions of groups to which they belong. Holding opinions contrary to the consensus engenders stress in the individual, and carries with it the risk of social exclusion. The AAP formed a committee made up of individuals who favoured circumcision to write a policy statement on circumcision, ensuring group think predominated. . EU Pediatricians who disagree with the AAP are labelled as more biased than Americans, and individuals who are against circumcision are labelled by Pro-Circumcision propagandists as foreskin fetishists, evil people, and extremists.

The essay drew the following conclusions and I add my interpretation in bold italics:

• Tribal group environments have been important in the evolution of the underpinnings of human psychology, and for that reason people are powerfully influenced by factors which reinforce group identity. Therefore we have a very difficult task ahead of us to convince those in the AAP that believe circumcision is important to group identity, that they have erred.  Look at how they have childishly and churlishly attacked EU Pediatricians.  . WE need to select and use our strategies carefully, and slowly emphasise that genital status has nothing to do with group identity in a modern world. That observance of individual human rights in the modern world, helps us belong to the world of civilised & moral human beings. Obviously one strategy is to use education and informed discussion to educate that the foreskin is normal and healthy and the circumcision harms & violates. The arguments that reinforce the essentiality of circumcision for survival have to be debunked, because they are such a powerful reinforcer, and why the ProCirc’s use fear as a motivator to circ. Also note how some Jews themselves have abandoned the circumcision rite for the brit shalom a non-cutting ceremony to admit membership to the jewish community. So the message here is that Tribal Elders and people of influence within Tribes can say "you dont have to cut to be a jew". "You dont have to be cut to Belong"  "You dont have to be cut to be OK"  "You dont have to be cut to be loved".
• Identification with a group polarizes divisions between the group and a category of others who form the group’s enemies. Strategically, WE need to be careful if we are to persuade , we need to be careful as not to seem like "The other tribe" and that we are not the enemies. We can educate & say that belonging to the group of humanity or any social group is completely independent of genital status Cut or UnCut.
• Individuals are inclined to conform their thinking to that of the group, even against their personal self interest. This is where individual human rights have to be emphasised, that group think cannot allow the violation of these rights. Note individual psychological defence, “I;m so glad I was circumcised as a baby” never matter they were denied their functional anatomy and they never had a say.  Education is the key here, combat myths with facts.
• Leaders understand how to take advantage of this psychology with jingoistic posturing and celebration of romanticised historical icons. This creates a narrative for the group which engenders heightened levels of polarization and group think. This is where we have to Challenge medical organizations such as the AAP and their leaders, including  law-makers and politicians, to emphasise individual human rights over that of group cultural rights.  The AAP has cleverly used its status and the apparatus of scientific literature to favour its own tribal position, this needs to be strongly challenged, and using the EU Pediatricians criticism of the AAP 2012 Circumcision policy is a good resource.

Where this process of Tribal Psychology may have been an advantage to the survival of a tribe or the individuals which made up that tribe in the past, it is clearly not in the interests of the individuals in the modern world to blindly follow tribal traditions. For that reason it is essential that individuals become aware of this psychology and insist that politicians/medicos/law makers refrain from allowing circumcision to continue. It needs to be emphasised that Circumcision of babies and children male or female is not important for the survival of any group, and is a violation of the individual human rights of that individual. We need to educate how genital cutting rituals are outdated and have no relevance in modern societies when it come to group membership or tribal identity.  Elders can just say "You Belong with Intact Genitals, male or female". The modern world needs to give pre-eminence to individual human rights particularly those of children, and that they be protected from genital cutting practices. If adults want to choose to have their own genitals cut, then that is an individual choice they can make for themselves.

Many of the myths and beliefs around the importance of circumcision for tribal identity have existed for millenia and are deeply rooted in the human psyche, therefore the task of separating circumcision from tribal identity will not be an easy one, and requires patience and hard work.

Tribal Psychology has the potential to directly conflict with individual human rights. AMEN

Problems with RCT's & Circumcision

What you'll find those with a pro-circumcision agenda doing is that they cite that only data derived from RCT research is valid in determining the validity of any circumcision research outcomes. ie. if its not RCT derived it is not valid.

While RCT's tend to be the gold standard of research studies, they are not without fault, and can lead to very misleading future predictions, particlularly when the assumptions they are based on are incorrect.

1. The first incorrect assumption of the African RCT circumcision trials was blaming the male foreskin as the cause of HIV infections.  Because some African population groups of non-circumcised men, had higher HIV infection rates than circumcised populations, the male foreskin was seen as the predominant cause of the differences in HIV infection rates.  What the researchers ignored was the fact that many African circumcised populations had higher hiv infection rates than non-circumcised populations.  Therefore the correct assumption about the cause of sexually transmitted  HIV infections has to be behavioural, eg. unsafe sex with multiple sex partners.

2. The second incorrect assumption was that circumcision confers an absolute lifetime protection against HIV infection, and that an 18 to 24 month trial was enough to prove this.  WRONG, the studies needed to have been longitudinal, over a complete lifetime, to determine the validity of circumcisions protective effect over a lifetime. If as seems to be the case that circumcision in a highly controlled environment with extra resources, than are normally available in aAfrica, can confer a small delay in time before infection occurs, then the assumption of life-time protection is also WRONG.  The desperation of researchers, and particularly the WHO in trying to do something about the HIV epidemic in Africa, has led to premature endoresment of something the research did not find or prove, ie. lifetime protection against HIV.  The RCT's did not prove a lifetime protective effect from circumcision, there is no evidence from the RCT';s of this claim. 

3. The third incorrect assumption is that men wont change their behaviour after circumcision, believing they are protected from HIV, and therefore disinhibiting their behaviour and practicising less safe sex behaviour.  Recent evidence from Africa confirms behavioural disinhibition is already occurring.  Therefore the assumption that men wont change their behaviour which will increase risk is also wrong.

The WHO has endorsed medical circumcision in Africa becuase it is claiming circumcision will reduce millions of infections, but this is made on an assumption that is not proven and most probably incorrect.  If you just change the assumptions slightly, ie. that circumcision may increase behavioural dis-inhibition and increase in unsafe sex behaviours, then the reduced infections become meaningless.  If as most data shows, that circumcision does not provide a lifetime protective effect against infection, then the protective effect of circumcision is incorrect, and again the predictions of reduced infections are meaningless.

Lets look at some research evidence which disputes the lifetime protective effect of circumcision. For instance,there is much data from around the world that shows some circumcised populations have higher HIV infection rates, than non-circumcision populations.  The EU where circumcision is uncommon has much lower rates of HIV than the USA where circumcision is very common. What this tells us, is that over a lifetime, whatever protective effect circumcision may have, is insignificant over a whole life, and meaningless in populations where circumcised groups have higher HIV infections than non-circumcised pouplations.

Therefore if you set up RCT's to last 18 to 24 months, end them early, and resource them in ways that will never be available in real life, and the reality is that the protective effect of circumcision is only short term, lets say 12 to 24 months, & not effective over a lifetime of 30 to 50 years of sexual activity as claimed, And you advertise and convince men that the protective effect of circumcision is for a lifetime, then you have made a grave public health error. What you have done is created a false sense of securty, and potentially created an environment where behavioural disinhibition occurs, where circumcised populations begin to practice less safe sex, & you end up with a public health disaster with higher HIV infections.

RCT's as with Computers, are only as good as the theoretical assumptions they are based on, or the data that is put into them.  Its Basically garbage in & garbage out!!!!!!!!!!

Fully Informing Africans about Medical Circumcision

There are a number of reports emerging out of Africa that many men who have elected medical circumcision now believe they are protected from HIV, and are having unprotected sex with women.  In the rush to promote medical circumcision Africans have not been fully informed about the true effectiveness of circumcision which is very limited, nor the true nature and causal spread of the HIV virus.

It is important that Africans in the 21st century, have access to education & are fully informed as the 21st century is the informtion age.  Partially informing Africans to promote circumcision is Unethical.

Lets start an internet campaign to Inform Africans about HIV & Medical Circumcision.

Important Information is as follows =

1. Circumcision does not prevent HIV infection, Circumcised men all over the world are infected with HIV.  Many circumcised populations have higher infection rates than populations that do not practice circumcision.
2. The HIV reduction risk via circumcision has been poorly explained, or just plainly over-stated. At best (and this is debated in the scientific literature) the widely publicised 60% reduction in HIV infections  (which is the most optimistic figure) from medical circumcision,  can mean that if you have sex with 10 women who are HIV infected, you can be infected by 4 of them.  Or if you have 10 sexual encounters with a single woman who is infected with HIV, you will get infected on 4 of those occassions.  Therefore the 60% figure that is talked about is very misleading, and over a lifetime you are still at significant risk of becoming infected with HIV even if you have medical circumcision.
3. Africans have also not been fully informed that for women having sex with a circumcised man can increase the risk of HIV infection by up to 54%, particularly if sex occurs within several months of the circumcision.  Also not explained is that if a circumcised man has HIV, circumcision offers zero protection to a woman.
4. Without knowing someone's HIV status when you have sex with them ( which is the true cause of sexually acquired HIV) you are at risk becoming infected with HIV circumcised or not.
5. HIV virus does not hide in the foreskin itself, it hides in human blood, and human semen.
6. The major cause of sexually acquired HIV infections is having unprotected sex with a person who is infected with HIV, and therefore Without behaviour change the HIV epidemic in Africa will never be defeated.
7. Behaviour is the cause of HIV infections in adult sexual relationships. Having unprotected sex with a partner who is infected with HIV is the cause of infections, and having unprotected sex with multiple sex partners multiplies HIV infection rates greatly, and the cause of Epidemics.
8. Exposure to contaminated blood is also a common way of becoming infected with HIV.
9. The male foreskin does not cause HIV infections, therefore it is OK if your cultural tradition is to remain intact and refuse circumcision.
10. HIV infections are caused by contact with the virus, usually through bodily fluids such as blood or semen.
11. The only ways to eliminate contact with the virus sexually= is through avoidance (ie. Do not have sex with a person who is infected with HIV) or using a barrier method during sex, between your body and the virus.
12. Condoms are a barrier method, which form a barrier between the exchange of bodily fluids such as blood and semen during sex, and is the only way to ensure protection from the HIV virus.  Circumcision is not a barrier method, skin contact and bodily fluid can & does occur with a circumcised penis.
13. Condoms are ethical, they provide barrier protection from the HIV virus to both the man and the woman, this is particularly important as women get zero protection from male circumcision.
14. Having sex in a monogomous relationship where neither partner is infected by HIV, makes it impossible to become infected with HIV via having sex with your partner alone.  Circumcision is not required.
15. If you make the choice to have sex with multiple sex partners, be the new modern African, be fully informed and use a barrier method such as a condom, and use it properly to ensure no contact or exposure to the virus occurs.

• Slogan options?
• "I'm a 21st Century African & I'm Fully Informed about HIV"
• "I'm a 21st Century African & I use condoms"

Giving up psychological defenses for circumcision

In order for future generations of males to be free of circumcision and its losses, harms and deprivations, currently circumcised men, as those in the intactivist movement have already done, have to give up their psychological defences of justifying circumcision in order to mitigate against the harms done.  It hurts less to be in denial about circumcision's losses and deprivations, it feels better to tell yourself that having a circumcised penis is fantastic, that its better! Psychological defenses work But........' The cost of mainataining this psychological defence is that circumcision's harms, losses and deprivations will continue forever generationally.   Therefore the psychological pain about the truth of circumcision's harms losses and deprivations, has to be endured by this current generation of men in order to end it for future generations of men. 

Bravery and courage awards to the men who break thru their own psychological defences, & feel the pain of what was done to them and what was taken from them, and who fight for furure generations of men to be free of circumcision, and fight for future men to have the freedom to make the choice for themselves.  These men have to fight the dominant ideology of their culture, they face ridicule, but they do not flinch, truly BRAVE!!!

Suspending human rights & Requiring balance in debating

Its funny how only on the subject of infant male circumcision are we required to suspend human rights and and demand BALANCE to both sides of the argument,  In female circumcision, or genital cutting or FGM, no such suspension of human rights or balance ever seems required (in western nations), its rightly denounced with no excuses for it. One word HYPOCRACY!!!!

A ritual nick on the genitals of a female child is seen as a human rights violation (No tissue is lost, sexual function is unaltered), but you can slice off the whole of the male foreskin, a functional male sex organ which is lost forever in male circumcision, and the subject of human rights is to be suspended, and balance is required?  My morals and ethics tells me there's something disgustingly wrong in all this!! Some people call it cultural relativism, that because male circumcision has been common, and it is part of certain religious or tribal practices then it is to be tolerated.  Well if there;s such a thing as human rights, then they are either universal to both male and female, and the right to genital integrity is fundamental to both sexes, or human rights are just meaningless.

Narcissism & Circumcision

Its just been re-highlighted to me, the narcissism thats involved in the circumcision of children.  We have a talentless TV & Radio personality here in Australia, who creates outrageous stunts to entertain, because he's basicly just talentless narcissist. Several Years ago he had his son circumcised, and he bought his son's foreskin into the radio studio to shock his fellow disc jockey's and his audience, making fun of his son's foreskin. 

I mean......... How Narcissistic is that, a complete lack of empathy for his son, and what his son may feel about this radio stunt one day if he finds out?  The stunt It was all about him and his needs, getting fame, noteriety at his son's expense.  Obviously the decision to circumcise, was a narcissistic one, because in Australia the RACP Australia's authority on circumcision of children, recommends against the procedure less than 10% of newborns are circumcised, so he did it because "he" wanted his son circumcised.  Narcissism pure and simple, putting his own interests ahead of his sons, with no empathy for what his son might have wanted, and also growing up circumcised, in a country where most of the boys are left intact.  Pure Narcissism.

This is also another reason why circumcision still happens, the Narcissism of the parents, putting their own needs ahead of their childs.  If they were really empathic & enlightened parents they would investigate not only what circumcision is/was, but also its harms, and the role and function of the foreskin which is lost to circumcision.  Given the male foreskin has a functional role in male sexuality, to remove this from your son, because its your preference is just pure Narcissism.

The AAP has a Gross sense of Entitlement

What a Gross sense of Entitlement the American Academy of Pediatrics  has, demanding the freedom to cut babies genitals something babies cannot protest to, and then try and deny freedom of speech to demonstrators who protest routine infant circumcision..... Shows u the blinkered vision and mentality of these priveleged unethical doctors.

At the 2012 AAP annual conference, Intact America was banned from having a booth at the conference, and the Police were called to move and ban the protesters from exercising their right to freedom of speech and protest.  WOW....... Ya want the freedom to cut kids, yet ya wanna deny freedom to those who protest this!!!!!!  WHAT A SENSE OF ENTITLEMENT!!