San Francisco Group Pushes Circumcision Ban

A group in San Francisco says that they have collected enough signatures to put a ballot before voters banning circumcision in the city, an April 27 Reuters article said.

But any such ban would face an instant challenge based on freedom of religion, the article said. Circumcision of male offspring is an important element to both the Jewish and Muslim faiths.

Even so, anti-circumcision leader Lloyd Schofield argued for the practice to be discontinued. Schofield's group says that they have collected 12,000 signatures to get a question on circumcision on the ballot. They needed only 7,200 signatures, the article noted.

"It's excruciatingly painful and permanently damaging surgery that's forced on men when they're at their weakest and most vulnerable," Schofield said.

Schofield's comments echoed similar statements made by circumcision foes in the past. One anti-circumcision group, Intact America, views the procedure as a violation: "It's removing healthy, functioning, sexual and protective tissue from a person who cannot consent. You're mutilating a child," Intact America's executive director, Georgeanne Chapin, told the Associated Press last year.

The proposal provides exceptions for male children in medical need of the procedure, but does not provide for religious exemptions. In order to withstand a challenge on Constitutional grounds, the group would, at some point, probably have to prove in court that the procedure is harmful.

"So if circumcision is the harm that's being targeted--because circumcision is perceived as causing harm, and not because it is a religious practice--it might well be a constitutionally valid law," according to the University of San Francisco School of Law's Josh Davis.

Proving that circumcision is harmful might be an impossible hurdle, however.

"I don't think there's sufficient medical evidence that it is, which would place the law's constitutionality in question," said Loyola Law School professor Jennifer Rothman.

Claims that circumcision is harmful could also be undercut by competing--though controversial--claims that circumcised men are less at risk for contracting HIV. Other studies suggest that circumcised men may be less apt to pass along STIs such as the human papilloma virus, which can cause cancer.

In 2009, the CDC floated the controversial idea of recommending circumcision as a standard part of neonatal care as part of an effort to combat HIV in the United States. The proposal anticipated that the next generation will include more uncircumcised males than the current generation. Moreover, more Hispanics and African Americans are choosing not to have their male babies circumcised. Studies indicate that those populations are harder hit by HIV and AIDS than are Caucasians. Worldwide, only about 30% of all men are circumcised.

Although research indicates that circumcised men are less likely to be infected with HIV as a consequence of sex with HIV+ female partners, men who have sex with men (MSMs) have not been shown to have different rates of infection depending on whether or not they are circumcised. An Oct. 8, 2008 Associated Press article reported that no protective result had been found for circumcision among MSMs.

But some health authorities see circumcision as necessary in the fight against HIV and the disease that the virus leads to, AIDS. Dr. Peter Kilmarx, in charge of epidemiology for the CDC's HIV/AIDS prevention department, defended the practice, saying, "We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic.

"What we've heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks," added Dr. Kilmarx.

But the benefits in the United States might not be as dramatic as those observed in African countries where research into the issue has taken place. In Africa, the spread of HIV is much more prevalent in the heterosexual population. A 2010 study done in San Francisco seemed to refute that circumcision does much to prevent HIV transmission among men who have sex with men (MSM).

"Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention," said Chongyi Wei, a post-doc with University of Pittsburgh Graduate School of Public Health, which carried out the study, and an author of the paper on the results, which was presented at the 2010 International AIDS Conference in Vienna.

An anti-circumcision initiative might be a hard sell to voters to begin with, given that circumcision is so deeply rooted in some religious traditions. Davis suggested that a perception that the ban would infringe on religious liberties would turn off a majority of voters.

"I think that people are very likely to react to it as interfering with religious practices," Davis told Reuters.

"The measure, which would only apply in San Francisco, would make it a misdemeanor crime to circumcise a boy before he is 18 years of age, regardless of the parents' religious beliefs. The maximum penalty would be a year in jail and a $1,000 fine," the Reuters article reported.