Many Australian public hospitals maintain a ban on circumcision. The Royal Australian College of Phsyicians (RACP) recommends against circumcision, and it is now so unpopular that 80% of Australian boys are uncircumcised. However, a committee of public health experts has recommended reversing this ban and moving to encourage circumcision, on the basis of the many health benefits of circumcision. These health benefits have been known for a long time, but the medical fraternity have responded to strong public pressure in advising against non-medical circumcision, because it is seen as a form of child abuse. Indeed, in America recently there were efforts to ban the practice on the basis that it is a form of child abuse.

This would all be a largely irrelevant debate about men’s willies and the aesthetics thereof, except that circumcision has now been shown to be an extremely effective tool in the battle against HIV. The Bill and Melinda Gates Foundation and various international aid agencies are scrambling to fund circumcision programs in Africa, where they believe that this simple and harmless procedure can significantly reduce the transmission of one of the world’s nastiest diseases. Recently at a training course in the UK I met people involved in this process and saw examples of the kinds of non-surgical devices being used to circumcise adult men (it’s a kind of ring, and after just 1 or 2 days the whole process is over and you can go back to work).

Australia is undoubtedly contributing financially and organizationally to this effort as part of its increasing aid contributions to Africa. But isn’t there something wrong here? Circumcision is essentially banned in government run hospitals in Australia, is on the nose in the USA and is frowned upon in the UK, yet these same countries are recommending circumcising the entire African continent. It’s morally unacceptable child abuse in Australia but an acceptable public health intervention in Africa? How does this kind of attitude differ from previous eras when population control was conducted through sterilization, often not clearly explained to the recipients? Is it just another example of aid-as-imperialism? How is this different to a country where abortion is strictly illegal (say, Ireland) funding abortion-based population control programs in Africa? And how can the Australian aid community (or its public health activists) criticize Chinese aid programs while we’re doing something like this?

It’s also worth remembering that historically white colonialists have been extremely uncomfortable about black men’s sexual fecundity (and their mythically enormous willies). Yet here we are – advocating chopping the end off of those massive, fecund members in the interests of stopping a disease which (apparently) cannot be stopped in Africa through behavioral change alone. Even though in Australia we have it under control through – you guessed it – behavioral change. The public health double standard is disturbingly close to the sexual insecurity …

Don’t mistake me here – HIV is a desperate situation and circumcision a minor operation that I don’t think we should shy away from as a control technique. Furthermore, I think the western bans on circumcision are silly and of the same character as the AMA’s opposition to boxing. It’s not liberal. But this hypocrisy, in which doctors won’t tolerate it in Australia or the UK but will support funding for its widespread use in Africa, reeks to me of cultural imperialism. If you won’t tolerate it here, don’t do it there.

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