Boy circumcision - More than just a small cut

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Boy circumcision - More than just a small cut (German: Jungenbeschneidung - Mehr als nur ein kleiner Schnitt) is the title of an arte documentation by Insa Onken[1], which was first broadcast on 23 July 2022 on the German/French public ARTE TV channel. The approximately 52-minute documentary explores the question: "How useful is male circumcision really?" It combines recordings and interviews from Kenya and from Worldwide Day of Genital Autonomy 2017 in Cologne. The motto of WWDOGA in 2017 was: "Africans resist circumcision programs".[2]

Arte Jungenbeschneidung.jpg

Film description of the TV station

Removal of the foreskin is the most common operation performed on boys worldwide — for religious, cultural or medical reasons. But more and more doctors are saying that the damage outweighs the health benefits and that far too often surgeries are being performed without medical necessity.

Affected people who suffer from their circumcision are increasingly daring to go public. They demand that boys be protected from circumcisions that are not medically necessary, so that their right to physical integrity is protected. Just like Florian. The 22-year-old is certain that his circumcision as a child was not medically necessary. At the time, the doctor treating him did not inform his parents about alternative options. Now Florian wants to clarify in court whether the doctor acted wrongly.

Despite growing criticism, the notion that circumcision brings many benefits is still widespread. In Africa, the WHO recommended circumcision in the fight against AIDS. As a result, millions of infants and boys have been preventively circumcised. However, many scientists doubt that this can actually reduce the risk of infection with HIV. After growing criticism, the WHO stopped the circumcision program in 2020, but the effects of the campaign are still being felt today.

The documentary investigates when circumcision actually makes medical sense and critically questions the ethics of this millennia-old practice.

Sequence

  • 00:00: A teaser presents key scenes from the documentary.
  • 01:45: Main thread of the documentation: Florian, 22, from Germany, was circumcised when he was 5 years old. Reason: phimosis. Was he circumcised unnecessarily?

History and statistics of circumcision

  • 03:11: Prof. Dr. Maximilian Stehr, pediatric surgeon, shows a circumcision and makes it clear that this is not a trifle and that in most cases it is unnecessary.
  • 07:30: A study by the Robert Koch Institute found that around 10.9% of all men in Germany are circumcised. Maximilian Stehr assumes that only 1% of all cases are medically indicated.
  • 08:36: The history of circumcision is briefly summarized.

Africa: VMMC in adults and adolescents

  • 10:10: The WHO recommends "Voluntary Medical Male Circumcision" in Africa as a preventive measure against HIV/AIDS. It is shown with which advertising campaigns the WHO tried to achieve their goal of 2007 to circumcise at least 27 million men in the African countries most affected by AIDS by 2021.
  • 11:08: Dr. Jutta Reisinger from Aktion Regen has been fighting against FGM for many years. Now she's taking action against MGM.
  • 12:47: Two Kenyan boys describe how they were persuaded to be circumcised.
  • 14:12: The Kenyan philosopher and educator Dr. Atieno Kili K'Odhiambo speaks out clearly against medically unfounded circumcision of boys.
  • 15:34: French health demographer Prof. Michel Garenne explains why the preventive protection provided by VMMC against HIV/AIDS is exactly 0.0%.
  • 18:13: VMMC Kenya Regional Director, Otieno Kohn Anyango, proudly describes how easy it was to circumcise boys aged 0-14. Especially the 10 to 14 year old boys were easy to reach.
  • 19:05: The organization Intact Kenya is introduced. She wants to educate about the risks of circumcision.
  • 19:55: Teacher Godfrey Ouma explains why it is so easy in Kenya to get parents to fill out circumcision forms without adequately educating them about the operation and its consequences.
  • 21:10: Kennedy Owino Odhiambo, the director of Intact Kenya, describes that they took on this missing educational work.
  • 21:58: In 2020, the WHO reacted to the criticism of the VMMC and has since recommended that only young people aged 15 and over are circumcised. It remains questionable whether everyone on site will adhere to it.
  • 22:15: Back to Florian: He discusses his case with the urologist Dr. Thomas Kreutzig-Langenfeld who confirms Florian's assumption that he was circumcised unnecessarily.

Intactivism

Religious and cultural circumcision

  • 28:16: For Seyran Ateş, lawyer and liberal imam from Berlin, the child's right to physical integrity is the top priority.
  • 29:17: The blogger Funda Celik, mother of two sons, describes how she managed to convince her sons' father that circumcision is not necessary for Muslims either.
  • 30:30: She interviews the victim Tayfun Aksoy, who tells her how he was circumcised in the hospital against his express will under another pretext.
  • 32:15: The film briefly touches on Jewish circumcision Brit Milah, which is usually performed on the 8th day after the birth of a boy.
  • 32:34: It then introduces a bloodless alternative Jewish ritual, the Brit Shalom.
  • 32:48: The French organization Brit Shalom l'Alliance sans Souffrance supports Brit Shalom in France. The Jewish couple Sarah and Victor are introduced, who did not have their son circumcised.
  • 35:15: In a video conversation with them, the Israeli Rabbi Nardy Grün made it clear that the topic circumcision is still taboo in Israel and that an estimated 2% of all Jewish boys and men are not circumcised. But as a liberal rabbi, he sees no obligation to "mark" someone's body to enter into covenant with God.

Study about circumcision trauma

  • 37:47: Back to Florian again. The film presents a study by Prof. Matthias Franz at the Uni Düsseldorf that examines the long-term psychological consequences of circumcision in early childhood.

Africa VMMC in children and infants

  • 40:39: Back to Jutta Reisinger, who visits a young mother in Kenya whose young son was circumcised when urinating after a bloated foreskin, although this alone is not a medical indication. The boy then had a so-called "buried penis" that retracted completely into the abdominal cavity.
  • 42:38: Dr Reisinger sends diagnostic photos to Prof. Maximilian Stehr, ...
  • 43:44: ... who advises a reconstructive post-op and finds it "contemptuous" when doctors operate on healthy children without a medical indication.
  • 44:40: The mother in Kenya has no money to have such an operation performed.
  • 44:57: dr Reisinger can watch and assist with an infant circumcision in a hospital in Kenya. The documentary shows that the boy feels the strongest pains despite being given a pain reliever and then falls into rigidity of shock.
  • 46:06: dr Reisinger notes that the mother who consented to circumcision was informed, but the boy himself could not consent and that the medical indication is questionable.

Florian's lawsuit

  • 47:03: Back to Florian. He is shown in front of the Düsseldorf Higher Regional Court, where his lawsuit is ultimately dismissed in the second instance. The circumcising doctor would have done everything right. "The plaintiff was unable to prove that the diagnosis made was incorrectly. There were also no proven medical errors and the duty to provide information was not breached." This verdict is surprising because Florian's mother was never informed about alternative methods.
  • 49:14: The medical lawyer Prof. Jörg Scheinfeld, who accompanied the trial, found that children's interests are often evaluated differently in court than the interests of adults. It is incomprehensible to Florian that the doctor was allowed to circumcise him at the time, even though he was symptom-free.

New guidelines for phimosis, requirements, conclusion

  • 50:13: Under the leadership of Prof. Maximilian Stehr, new guidelines for circumcision of boys[3] were published in 2021, which set the framework for medical indications much more narrowly.
  • 50:48: Victor Schiering calls for an open discussion in society on this topic.
  • 51:48: In conclusion, the documentation states that circumcision that is not medically indicated violates "the right of the child to physical integrity and self-determination".

Video

YouTube provides a copy of the documentation with German, Dutch, and English subtitles:

Press reactions

External links

References

  1. REFweb Insa Onken, ThurnFilm. Retrieved 24 July 2022.
  2. REFweb World Wide Day of Genital Autonomy 2017. Retrieved 24 July 2022.
  3. REFweb (31 December 2021). Leitlinie: Phimose und Paraphimose bei Kindern und Jugendlichen. Retrieved 24 July 2022.