China

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Flag of the People's Republic of China

China is a very large advanced, prosperous nation in East Asia. The population is about 1.4 billion, which makes it second only to India in population. In land area, it is the third largest nation on Earth.

The three main religions are Confucianism, Taoism, and Buddhism.[1] None of these religions have a tradition or a requirement for circumcision of boys, so China does not have a tradition of circumcision except for the small minority of Muslims who live in the northwest corner of China (Xinjiang) who adhere to the teachings of Islam. The adherents to Islam constitute only 0.45% to 1.8% of the population.[1]

There is no tradition of circumcision in China. Early infant male circumcision (EIMC) is very rare. Pan et al. (2012) reported that circumcisions are done later when needed to treat tight foreskin, so the incidence of circumcision of the newborn is only 2.66 percent.[2] The percentage of circumcised males in China (prevalence) is reported to be 14%.[3]

Promotion of male circumcision in China

Anecdotal evidence reports there are many posters seen in China which promote the practice of circumcision.

Use of HIV to promote circumcision in China

Circumcision has been falsely claimed to prevent infection with HIV by three African randomized controlled trials (RCTs). Boyle & Hill (2011) studied their reports and found disabling methodological and statistical errors that invalidated their purported findings.[4] Regardless of these findings, Chinese medical doctors seem to be pushing for adoption of circumcision to prevent HIV infection. Numerous papers in the Chinese medical literature advocate circumcision to prevent HIV infection among both heterosexuals and homosexuals.

September 2021 saw the publication of two huge population studies on the relationship of circumcision and HIV infection:

  1. Mayan et al. (2021) carried out a massive empirical study of the male population of the province of Ontario, Canada (569,950 males), of whom 203,588 (35.7%) were circumcised between 1991 and 2017. The study concluded that circumcision status is not related to risk of HIV infection.[5]
  2. Morten Frisch & Jacob Simonsen (2021) carried out a large scale empirical population study in Denmark of 855,654 males regarding the alleged value of male circumcision in preventing HIV and other sexually transmitted infections in men. They found that circumcised men have a higher rate of STI and HIV infection overall than intact men.[6]

No association between lack of circumcision and risk of HIV infection was found by either study. There now is credible evidence that the massive, expensive African circumcision programs have not been effective in preventing HIV infection.

Zhang (2024) reported the cost of each circumcision surgery in China to be US$270-US$540,[7] so physician compensation may be the actual leading indication for circumcision in China.

Circumcision contest

A urological group recently staged a circumcision contest to promote the practice of circumcision.[7]

Shang Ring

The Shang Ring circumcision device is manufactured in China. Cheng et al. (2014) report it has been "used for over 600 000 males in China since 2006."[8]

See also

External links

References

  1. a b REFweb Wikipedia article: Religion in China
  2. REFjournal Pan L, Zhang A, Shen R, Wang Z. Acceptability of early infant male circumcision among Chinese parents: strategy implications of HIV prevention for china PDF. BMC Public Health. 4 September 2012; 12: [738]. PMID. PMC. DOI. Retrieved 21 March 2024.
    Quote: China lacks the history and cultural norms endorsing circumcision.
  3. REFweb (1 April 2024). Global Circumcision Statistics and Estimates, https://circstatistics.github.io. Retrieved 1 April 2024.
  4. REFjournal Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns PDF. Thompson Reuter. December 2011; 19(2): 316-34. PMID. Retrieved 30 December 2020.
  5. REFjournal Mayan M, Hamilton RJ, Juurlink DN, Austin PC, Jarvi KA. Circumcision and Risk of HIV Among Males From Ontario, Canada. J Urol. 23 September 2021; PMID. DOI. Retrieved 21 August 2022.
    Quote: We found that circumcision was not independently associated with the risk of acquiring HIV among men from Ontario, Canada.
  6. REFjournal Frisch M, Simonsen J. Non-therapeutic male circumcision in infancy or childhood and risk of human immunodeficiency virus and other sexually transmitted infections: national cohort study in Denmark. Eur J Epidemiol. 26 September 2021; 37: 251–9. PMID. DOI. Retrieved 16 January 2022.
  7. a b REFnews Zhang, Zoey (18 March 2024)."‘Sexual shame’: China holds online professional circumcision contest to correct misconceptions, promote positive attitudes, levels of acceptance", South China Morning Post. Retrieved 21 March 2024.
  8. REFjournal Cheng F, Lü N, Xu H, Barone MA, et al. [Clinical studies of shang ring male circumcision in China and Africa]. Zhonghua Nan Ke Xue. April 2014; 20(4): 291-8. PMID. Retrieved 23 March 2024.