Changes

The indigenous people of Australia, the [[Aborigines]], have variously practiced [[subincision]] and [[circumcision]] since before the first contact with Europeans.

[[Douglas Gairdner]]'s famous, classic 1949 paper, ''The Fate of the Foreskin: A Study of Circumcision'',<ref name="gairdner1949">{{GairdnerDM 1949}}</ref> seems to have had no effect in Australia. However, criticism of the practice of non-therapeutic circumcision accelerated in 1967.

|last=Morgan

|init=WKC

|etal=No

|title=Penile plunder

|journal=Med J Aust

|date=1967

|volume=1

|pages=1102-3

|url=http://www.cirp.org/library/general/morgan2/

|pubmedID=4226264

|pubmedCID=

|accessdate=2019-10-31

}}</ref>

|last=Wright

|init=JE

|etal=no

|title=Non-therapeutic circumcision

|journal=Med J Aust

|date=1967-05-27

|volume=1

|pages=1083-7

|url=http://www.cirp.org/library/general/wright4/

|pubmedID=6028342

|accessdate=2019-10-28

}}</ref>

|last=Leitch

|init=IO

|etal=no

|title=Circumcision: the continuing enigma

|journal=Aust Paediatr J

|date=1970-03

|volume=6

|pages=59-65

|url=http://www.cirp.org/library/general/leitch1/

|pubmedID=5535347

|accessdate=2019-10-27

}}</ref><ref>{{REFjournal

|last=Birrell

|init=RG

|etal=no

|title=Circumcision

|journal=Aust Paediatr J

|date=1960-06

|volume=6

|issue=2

|pages=66-7

|pubmedID=5527602

|accessdate=2019-10-27

}}</ref><ref>{{REFjournal

|last=Smith

|init=ED

|etal=no

|title=Another view of circumcision

|journal=Aust Paediatr J

|date=1970-06

|volume=6

|issue=2

|pages=67-9

|pubmedID=5527603

|pubmedCID=

|accessdate=2019-10-27

}}</ref>

==Position statements of medical societies==

|last=Belmaine

|init=SP

|title=Circumcision

|journal=Medical Journal of Australia

|date=1971-05-22

|volume=1

|pages=1148

|url=http://www.cirp.org/library/statements/apa1971/

}}</ref>

|title=Guidelines for Circumcision

|url=http://www.cirp.org/library/statements/aaps/

|url=http://www.cirp.org/library/statements/acp1996/

|title=Routine circumcision of normal male infants and boys

|last=Statement

|publisher=Australian College of Paediatrics

|date=1996-05-27

|accessdate=2019-10-28

}}</ref>

|last=Spilbury

|init=K

|last2=Semmens

|init2=JB

|last3=Wisniewski

|init3=ZB

|etal=no

|journal=Med J Aust

|date=2003-02-17

|volume=17

|issue=4

|pages=155-8

|url=https://www.mja.com.au/journal/2003/178/4/circumcision-phimosis-and-other-medical-indications-western-australian-boys

|pubmedID=12580740

|DOI=0.5694/j.1326-5377.2003.tb05130.x

|accessdate=2021-12-16

|url=https://www.ama.com.au/media/warning-unnecessary-child-circumcision

|title=Warning on unnecessary child circumcision

|last=Tokley

|first=Judith

|publisher=Australian Medical Association

|date=2003-02-13

|accessdate=2021-12-16

}}</ref>

The [https://www.qlrc.qld.gov.au/ Queensland Law Reform Commission] (1993) researched the legality of non-therapeutic circumcision of children. The Commission concluded:

<blockquote>

The common law operating in Queensland appears to be that if the young person is unable, through lack of maturity or other disability, to give effective consent to a proposed procedure and if the nature of the proposed treatment is invasive, irreversible and major surgery and for non-therapeutic purposes, then court approval is required before such treatment can proceed. The court will not approve the treatment unless it is necessary and in the young person's best interests. The basis of this attitude is the respect which must be paid to an individual's bodily integrity.<ref name="qlrc1993">{{REFdocument

|title=Circumcision of Male Infants Research Paper

|url=http://www.cirp.org/library/legal/QLRC/

|publisher=Queenland Law Reform Commission

|date=1993

|accessdate=2019-10-31

[[Davis Richards]] (1996) discussed non-therapeutic circumcision of boys. He concluded:

<blockquote>

Ritual male circumcision is non-therapeutic and is not warranted or justified by medical evidence. This form of mutilation should not be legally distinguished from female circumcision which is a form of female genital mutilation presently in the process of being prohibited throughout Australia and the Western world. As ritual male circumcision is non-therapeutic, may be against public policy, and clearly is not in the best interests of the child, a parent's consent may be vitiated, leaving persons involved in the procedure liable in negligence, notwithstanding parental religious beliefs. Alternatively, if a medical practitioner fails to give the parent reasonable information on the risks of and alternatives to ritual circumcision, the practitioner may also be liable in negligence.<ref name="richards1996">{{REFjournal

Boyle et al. (2000) suggested that non-therapeutic circumcision of boys is "criminal assault." They concluded:

<blockquote>

Enforced non-therapeutic genital cutting of unconsenting minors is overdue for recognition by the legal community as sexual mutilation. As we enter the 21st Century, appropriate legal action must be taken to safeguard the physical [[genital integrity]] of male children.<ref>{{REFjournal

|first3=Christopher P.

|init3=CP

|last4=Turner

|first4=J. Neville

|etal=no

|title=Circumcision of Healthy Boys: Criminal Assault?

|journal=J Law Med

|date=2000-02

|volume=7

|pages=301-10

|url=http://www.cirp.org/library/legal/boyle1/

|accessdate=2019-10-31

}}</ref>

</blockquote>

|title=Tasmania moves a step closer to circumcision ban

|url=https://www.smh.com.au/politics/federal/tasmania-moves-a-step-closer-to-circumcision-ban-20120821-24ju9.html

|accessdate=2021-09-23

|quote=Costs of the procedure included significant [[pain]], and a potential reduction in sexual pleasure.…"Trauma from circumcision in childhood can also have a long lasting and significant effect on a person's mental health," the report said.

}}</ref>

Despite the criticism in the above referenced papers, there has been no legislative or judicial action to protect boys in Australia from medically-unnecessary non-therapeutic [[circumcision]].

The [[Sixth International Symposium]] on Genital Integrity convened in [https://www.wesleycollege-usyd.edu.au/ Wesley College] at the {{UNI|University of Sydney|USYD}}, Sydney, {{AUSC|NSW}}, Australia on December 7-9, 2000. Professor [[Gregory J. Boyle]] gave the keynote address.

|first=Deanna

|init=D

|last2=Macdonald

|first2=Malcolm

|init2=M

|year=2009

|title=A Picture of Australia's Children 2009

|url=https://www.aihw.gov.au/getmedia/7f635082-69ca-4709-ae0f-52474a744cd1/phe-112-10704.pdf.aspx?inline=true

|chapter=4

|pages=12-16

|location=Canberra

|publisher=Australian Institute of Health and Welfare

|accessdate=2019-10-19

}}</ref>

<blockquote>

After reviewing the currently available evidence, the [[RACP]] believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and [[New Zealand]]. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons.

</blockquote>

But the statement also says:

<blockquote>

The option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered. This option has recently been recommended by the Royal Dutch Medical Association. The ethical merit of this option is that it seeks to respect the child’s physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future.<ref name="racp2010">{{REFdocument

|title=Circumcision of Infant Males

|url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf?sfvrsn=eaa32f1a_10

|publisher=[[Royal Australasian College of Physicians]]

|format=PDF

</blockquote>

|last=Darby

|first=Robert

Sliwinski et al. (2014) of the Department of Urology at the {{UNI|University of Melbourne|UM}} reported a case of [[Fournier gangrene]] in a 24-year-old man who had an elective non-therapeutic circumcision for “prophylactic hygiene reasons”. There was extensive debridement of infected tissue, which resulted in deficit of skin which was resolved by the use of a pedicle flap from the anterior abdominal wall, after which the patient recovered.<ref>{{REFjournal

|last=Sliwinsk

|init=A

|last2=Kavanagh

|init2=LE

|last3=Bolton

|init3=D

|last4=Lawrentschuk

|init4=N

|last5=Crock

|init5=JG

|etal=no

|title=Fournier’s gangrene - delayed pedicle flap based upon the anterior abdominal wall

|journal=Int Braz J urol

|date=2014

|volume=40

|issue=3

|pages=423-6

|url=https://www.scielo.br/j/ibju/a/TC3tkRhqGS8577ywNNkJ8dj/?lang=en

|pubmedID=25010310

|pubmedCID=

Na et al. (2015) considered whether Australian boys should be circumcised. They concluded:

<blockquote>In conclusion, although there is a benefit of circumcision in those with urogenital tract anomalies, in a healthy newborn,the disease in the foreskin is non-existent. There is insufficient scientific evidence to support routine newborn circumcision in Australia done for UTI risk and [[HIV]] transmission issues alone. Therefore, any surgical complication and financial cost of routine newborn circumcision for these reasons in Australia currently cannot be justified. From a medical point of view, the‘price’ is still too high.<ref name="na2015">{{REFjournal

|last=Na

|first=Angelika F.

|init=AF

|last2=Tanny

|first2=Sharman P.T.

|init2=SPT

|last3=Hutson

|first3=John M.

|init3=JM

|etal=no

|title=Circumcision: Is it worth it for 21st-century Australian boys?

|journal=J Paediatr Child Health

|date=2015

|volume=51

|pages=580-3

|url=https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.12825

|pubmedID=25683279

|DOI=10.1111/jpc.12825

}}</ref>

</blockquote>

|url=http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=30654&qt=item

|title=Medicare Benefits Schedule - Item 30654

|accessdate=2019-11-02

}}</ref> This subsidy exists for political reasons, not medical reasons.<ref name="darby1985">{{REFjournal

|etal=no

|title=Scientific Advice, Traditional Practices and the Politics of Health-Care: The Australian Debate over Public Funding of Non-Therapeutic Circumcision, 1985

|journal=Hygiea Internationalis

|date=2011

|volume=10

|pages=53-73

|url=https://docplayer.net/5261996-.html

|accessdate=2019-11-02

}}</ref>

<!-- This information is dubious. On 18 September 2020 the Department of Health announced changes in the Medicare medical benefit schedule. Effective 1 November 2020, claims submitted for circumcision must be for "clinically relevant" circumcision. In other words, non-therapeutic circumcision will no longer be covered and no payment will be made.<ref name="medicare2020">{{REFdocument

|url=http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/1C7B3AED38006462CA2585E80009D95C/$File/factsheet-Circumcision-20200918.pdf

|publisher=Australian Government Department of Health

|format=PDF

===Continuing decline in practice of non-therapeutic circumcision===

Na, Tanny & Hutson (2015) discussed the matter of non-therapeutic circumcision of children in Australia. They concluded:

The incidence of non-therapeutic [[circumcision]] of children in Australia has continued to diminish. [[Circumcision Info Australia| Circumcision Information Australia]] (2017) reported an incidence of infant circumcision of 9.66 percent in fiscal 2015.<ref>{{REFweb

}}</ref> The majority of living Australian males are [[intact]]. The percentage of living intact males increases year-by-year.

<blockquote>

According to a report on SBS,<ref>{{REFweb

|url=http://www.circinfo.org/news_2018.html#fall

|title=Foreskins rule! Australians rush to abandon circumcision

|publisher=Circumcision Information Australia

|date=2018

|accessdate=2019-11-06

}}</ref>

</blockquote>

|url=http://www.circinfo.org/index.php

|title=Circumcision in Australia

|accessdate=2020-12-14

}} </ref>

However, traditional male genital mutilation remains popular among [[Aborigines]] in the Northern Territory where it is supported by the local government.<ref>{{REFnews

|title=Anger in NT community after circumcision rite ends with three boys airlifted to hospital

|last= Hermant

|first=Norman

|first2=Alison

|publisher=ABC News

|date=2014-01-22

|accessdate=2021-11-19

}}</ref>

A Seville Grove, {{AUSC|WA}} family presented two brothers for elective non-therapeutic circumcision surgery at Gosnells Medical Clinic (A medical clinic populated by Muslims) on 7 December 2021.

His healthy seven-month-old brother, who also had a non-therapeutic circumcision on the same date, narrowly survived [[Bleeding| hemorrhage]] after emergency surgery at [https://www.pch.health.wa.gov.au/ Perth Children's Hospital] and spending the night in intensive care.<ref name="white2021">{{REFnews

|title=Toddler, 2, dies and his baby brother is fighting for life 'after botched circumcisions' as homicide cops are called to investigate

|last=White

|first=Nic

|publisher=Daily Mail

|date=2021-12-08

|accessdate=2021-12-08

}}</ref><ref>{{REFnews

|title=Toddler dies, baby fighting for life after allegedly botched circumcision at Perth medical clinic

|website=news.com.au

|date=2021-12-08

|accessdate=2021-12-08

}}</ref>

St. John Ambulance service was called to the home for the two boys in the evening. A spokeswoman from [https://stjohn.org.au/ St John Ambulance] confirmed the toddler was in a ‘critical condition’ when emergency workers arrived at the home at about 6:30 pm.<ref>{{REFnews

|title=Likely cause of WA toddler’s death after circumcision revealed

|last=Foster

|first=Ally

|website=news.com.au

|date=2021-12-10

|accessdate=2021-12-16

|url=https://olxpraca.com/a-two-year-old-child-from-seville-grove-in-perth-washington-died-after-a-failed-circumcision/

|publisher=Olx Praca

|date=2021-12-09

|accessdate=2021-12-16

}}</ref> The two boys were transported to nearby Armadale Hospital.

[https://www.amawa.com.au/news/mark-duncan-smith-elected-as-new-president-of-ama-wa/ Dr Mark Duncan-Smith], the president of the AMA (WA), issued a warning to parents on 10 December 2021 regarding non-therapeutic child [[circumcision]]. Dr. Duncan-Smith said parents should only "follow through with the procedure if there is a valid medical reason." According to Dr Duncan-Smith only about ten percent of boys in Western Australia are now being circumcised.<ref>{{REFnews

|title=Parents are warned against circumcising their children after a toddler, 2, died 'of a reaction to anaesthetic' and his baby brother almost bled out

|last=Wondracz

|first=Aidan

|publisher=Daily Mail

|date=2021-12-09

|accessdate=2021-12-12

}}</ref>

* [[Trauma]]

* [[Western Australia Medical Association]]

{{LINKS}}

* {{REFweb

|url=http://www.circumstitions.com/Australia.html

|title=Circumcision in Australia

|last=Young

|first=Hugh

|author-link=Hugh Young

|publisher=Circumstitions

|date=2013

|accessdate=2019-10-28

}}

* {{REFweb

|url=http://www.circinfo.org/index.php

|title=Circumcision Information Australia

|accessdate=2019-10-28

}}

* {{REFweb

|url=http://www.intactaus.org/

|title=Intact Australia

|last=Hely

|first=Lou

|website=Intact Australia

|date=2014-08-01

|accessdate=2019-11-17

}}

* {{REFweb

|url=https://15square.org.uk/2019/07/16/circumcision-in-australia/

|title=Circumcision in Australia

|last=Smith

|first=David

|author-link=David Smith

|publisher=15 Square

|url=http://aiga.org.au/home2/

|title=Australia Institute for Genital Autonomy

|date=2013-05

|accessdate=2019-11-21

}}

* {{REFweb

|url=https://intactivistsofaustralasia.wordpress.com/

|title=Intactivists of Australasia

|date=2021-05-19

|accessdate=2022-07-07