Aboriginal settlement circa 1770
Whole population in year 2000
The European Settlers
The Sun-Herald (Sydney), 25th April 1999
BABIES AT THE CUTTING EDGE : by Martin Chulov
Circumcision of male infants is making a comeback, reports Martin Chulov. After years of declining rates in Australia and opposition to the procedure from doctors, a growing number of parents are asking for their baby boys to be circumcised. And, for the first time, the Royal Australasian College of Surgeons has formed a policy position - it does not oppose the procedure.
Thirty years ago more than 60% of Australian males were routinely circumcised; that figure has fallen dramatically to less than 10% of male babies born. However, hospitals have reported a recent surge in requests for the procedure, which is typically performed when baby boys are about seven days old. A report released recently showed that pediatricians were receiving requests from parents to circumcise up to 20% of newborn boys.
The College of Surgeons said performing the procedure was at the discretion of parents and could be performed for religious, cultural, medical or social reasons. It said it should be performed only by “a competent operator... under sterile conditions designed to minimise hazards... using appropriate anaesthetic”.
The procedure is leading to widespread division among GPs and medical lobby groups with the Australian College of Pediatrics saying circumcision should not be performed until babies are at least six months. It said “neonatal male circumcision has no medical indication. It is a traumatic procedure performed without anaesthesia to remove a normal functional and protective prepuce”.
The Australian Medical Association (AMA) opposes routine circumcision and will only endorse it on “therapeutic grounds”. AMA New South Wales president Peter Thursby said: “And then we would need to be convinced of the reasons for exposing seven-day-old infants to this”. Dr.Thursby said Australians’ access to hygiene reduced the risks of penile cancers or diseases which were associated with non-circumcised men in some first and second world countries (sic). “Penile carcinoma rates have fallen dramatically in Australia over the past 50 years and are continuing to do so”, Dr.Thursby said.
But Professor Brian Morris from the University of Sydney’s Physiology Department claims, in a new book, that there are benefits to be had from the procedure at any age. Dr.Morris says lack of circumcision is responsible for increasing the rates of urinary tract infection by up to 12 times and offers increased exposure to penile cancers. He also says it increases the risk of acquiring the HIV virus and other sexually transmitted diseases.
|CIRCUMCISION OF INFANT MALES
Royal Australasian College of Physicians - September 2010
Ethical and human rights concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent.
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. When parents request a circumcision for their child the medical attendant is obliged to provide accurate unbiased and up to date information on the risks and benefits of the procedure. Parental choice should be respected.
When the operation is to be performed it should be undertaken in a safe, child-friendly environment by an appropriately trained competent practitioner, capable of dealing with the complications, and using appropriate analgesia.
Ethical and human rights concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent.How on earth did that get through the RACP’s editorial process? Neonatal circumcision isn’t meant to be therapeutic, it is meant to be prophylactic! What happened to the presumption that prevention is better than cure?
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.That is a subjective value judgement and also the fundamental conclusion reached by the RACP report. Fine, if arrived at on the basis of good evidence - not every conclusion reached in this world lends itself to objective analysis. But the detail of the report contains errors which, in CIRCLIST’s opinion, distort the factual basis upon which the RACP’s opinion has been reached. Again, more below.
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. When parents request a circumcision for their child the medical attendant is obliged to provide accurate unbiased and up to date information on the risks and benefits of the procedure. Parental choice should be respected.Fine as far as it goes, but this approach places on individual physicians a very onerous burden to act impartially. The report might benefit from some supplementary guidelines suggesting just how doctors opposed to the procedure should manage their dissent when faced with an enquiry about circumcision. This needs special consideration in areas of low population density; mere referral to another practitioner may not be geographically realistic. In situations where one’s existing family doctor is the only one around, maintaining a satisfactory doctor-patient relationship (both in reality and in perception) becomes a matter of increased significance. One solution might be to take the whole matter of prophylacitc circumcision out of the Family Practitioner’s remit, placing it instead in direct-access specialist hands as happens with, for example, opthalmics or dentistry.
When the operation is to be performed it should be undertaken in a safe, child-friendly environment by an appropriately trained competent practitioner, capable of dealing with the complications, and using appropriate analgesia.Only one minor quibble here: Surely it should say “...capable of dealing with the possible complications...” ? Complications are not inevitable! That said, the general sentiment that circumcision should be performed by a specialist, in appropriate surroundings and using appropriate pain relief, is one with which CIRCLIST wholeheartedly agrees.
The foreskin has two main functions. Firstly it exists to protect the glans penis. Secondly the foreskin is a primary sensory part of the penis, containing some of the most sensitive areas of the penis.This is a minority opinion. The rest of the paragraph of the original text correctly expresses the majority view, but it is given reduced prominence in the main body of the report and is omitted entirely from the Executive Summary.
South Africa: Section 12 of the Children’s Act 2005 makes the circumcision of male children under 16 unlawful except for religious or medical reasons. It also creates a statutory right for a competent child to refuse circumcision. (Stop for a moment and think: Why would this right of refusal be included in the legislation if all circumcision of children is illegal?)
What the RACP Policy Statement fails to explore is the reason why this law was introduced - to put an end to botched tribal circumcision ceremonies. Properly conducted child circumcisions continue as part of the Public Health drive against HIV, as does circumcision of older males. Such prophylaxis is deemed to be a valid medical reason to circumcise a child; no case law is known to CIRCLIST that has placed a contrary interpretation on the primary legislation.
Sweden: In Sweden, only persons certified by the National Board of Health can legally circumcise infants. The law requires a medical doctor or an anesthesia nurse to accompany the circumciser and for anaesthetic to be applied beforehand. After the first two months of life circumcisions can only be performed by a physician. It is totally untrue that circumcision is illegal.
The original law dates from 2001. During subsequent reviews of the effects and effectiveness of the legislation, the Swedish National Board of Health and Welfare found that the law had failed with regard to the intended consequence of increasing the safety of circumcisions but had resulted in poor availability of legal circumcisions, partly due to induced reluctance among health professionals. To remedy this, the review (March 2007, Omskärelse av pojkar, National Board of Health and Welfare. Docket 2007-107-7) suggested that all county councils should offer non-therapeutic circumcision in their hospitals in order to ensure that safe circumcision was available to all. Hardly a ban, is it?
Finland: Again, proper research of the facts shows the RACP report of illegality to be untrue. In 2008 the Supreme Court of Finland delivered a judgement specifically stating that circumcision, carried out for religious or social reasons and in a medical manner, “does not have the [characteristics] of a criminal offence”. According to the judgement, banning all circumcisions would violate the constitutional guarantee of privacy in family life and freedom of religion. That constitutional guarantee derives from Finland’s membership of the Council of Europe and consequent adherence to the European Convention on Human Rights. The judgement therefore has the makings of a precedent applicable in all 47 member countries.
The benefits of circumcision (or disadvantages of non-circumcision) are not readily assessable by doctors (unless they happen to belong to the same religious or social community as the parents), as they depend upon the role of circumcision within that community.Not quite the same thing as it being “reasonable” for parents to make the decision, is it? The main text suggests that the parents should be in control of the decision, with doctors exercising a veto only where patient-specific contra-indications exist. With that, CIRCLIST agrees. However, the Executive Summary omits to make clear the primacy of the parental position and slips in the subjective opinion that...
This suggests that parents are in principle better placed than doctors to weigh up the risks and benefits of circumcision for male infants.
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....doing so at a critical a position within the document that will, almost inevitably, be taken as “professional guidance in a nutshell” on the whole issue of circumcision. In CIRCLIST’s opinion, this misleads.
Doctors who have a conscientious objection to performing infant male circumcision should make this known and refer parents to another doctor.I do wonder how many "anti" doctors would do this? Knowing that almost all parents will be unaware of the policy statement clause above, how many parents would have the balls to challenge it. My wife and I came up against this. In all other matters, our man & wife General Practitioners were excellent and gave us first class NHS care over many years. They were genial good company socially too when we sometimes met them with mutual friends at functions. Their firm but friendly geniality made it all but impossible to press for circumcision of our boys.
|The Australian Army at the time of the Vietnam War
(Correspondence received by CIRCLIST in the 1990s)
The Aboriginal People
The oldest rock paintings... are in the Cape York peninsula of Australia’s tropical north Queensland. They were made by Ang-Gnarra Aborigines as long as 35,000 years ago and were unknown to whites until the 1950s.
Most of the pictures were blood red, finger-painted with hematite (powdered iron ore). The pigment had permanently bonded to the sandstone, to remain visible for millennia. An archaeologist from the University of New England led a scientific excavation of a site near Jowalbinna and concluded that it was first used for religious ceremonies 40,000 to 60,000 years ago, although a severe drought caused it to be abandoned about 32,000 years ago and it wasn’t used again until about 12,500 years ago.
To understand some of the rock paintings requires a knowledge of secret Aboriginal traditions. One gallery seemed to have an especially mysterious aura. There was a rock wall with a deep undercut at the bottom that formed a shallow cave. Many silhouettes of small handprints stenciled near the entrance indicated that this had been a boy’s initiation place. Allan [the Aboriginal guide] used his walking stick to point out the strange tableau of humanoid figures painted on the ceiling. We had to crouch very low to see them. “Look at this monster”, he said. “A boy would be brought to this place to learn about sexual taboos. Elders would tell him the legend about some poor fella who committed incest and was turned into a hideous creature!”
Some of the other figures included a circumcision scene, a voluptuous woman and a man with one of his front teeth knocked out. The coming of age of an Aboriginal boy involved an elaborate ceremony, during which he would be pushed through a dark, narrow opening. There, he was met by tribal Elders, including one dressed as a spirit, who circumcised him. Following the operation, he was not allowed to talk to anyone or touch anyone until his scar had healed. Afterwards, he would be taken away by one of the older women of the tribe, who would teach him about sexual intercourse.
© 2005, Robert Scheer and New Age Travel. All Rights Reserved.
Waga is led to the center of the ground by his visitor Activist "Grandfathers", one of whom lights the main fire while the remaining Mourner men lie down facing away from the ground. Some of the Activists sit nearby, softly singing. Two Visitor Activists leap to their feet and do a rapid dance up and down the ground, holding shields. They then crouch over the weapons near the big fire, to be joined by six more local and visitor Activists, who crawl beneath them from both sides and raise them on their backs to form a human platform for the operation. One of the assistants carries Waga and lays him on his back on the table, then sits on his chest, facing his penis and the large fire. He pulls up the foreskin and twists it, being careful to keep the head of Waga’s penis under the thumb of this other hand. The other "WB" operator supports his head and gives him a boomerang to bite on during the cutting. Several "grandfathers" (both "MF" and "FF") circle the table to watch the cutting and comfort Waga, while the rest of the Activists quietly sing, and the Mourners softly wail.
The Two "MB", each with his own newly sharpened and magically prepared stone knife, take turns at cutting the foreskin. Waga neither utters a sound nor struggles in any way, but his teeth have sunk into the hard mulga of the boomerang; he lies inert, as if self-anesthetized, betraying his suffering with an ocasional grimace. Beneath him, the men forming the table joke with one another, complain of the discomfort and Waga’s weight and urge the operators to hurry up and get the job over with, while the "grandfathers" hover and keep up a chorus of reassurances, for the benefit of Waga and the Mourners, saying that the operators have almost finished.
Once the foreskin is finally severed, the "MB" who finishes the cutting pushes what remains down to reveal the head of Waga’s penis. Then the operators retire to a small fire that has been set for them, and the "grandfathers" lead Waga to a small fire they have lit close to the two circles of Men. He is told to kneel on a shield over the smoke, with an "EB" supporting him on each side. The "Grandfathers" inspect his penis and report to the rest of the men present that the operation was a good one and that there is little bleeding. The Mourners sit up and view Waga from a distance, and the Activists recommence singing. The operators collect several hair belts and weapons they had left near the ground earlier, and then file past him.
Waga sits over the smoke fire, dazed and in pain, but silent. One of his "EB" tells him to open his mouth and swallow some "fat" or "good meat", but without chewing on it. The foreskin is dropped into his mouth and he swallows it, gulping at the effort. His "grandfather" Diludu now tells him that he has eaten "his own boy" and that his foreskin will grow inside him and make him strong, and will give him the ability to become a skilled cutter himself when the time comes.
Nine months after the circumcision Waga is subincised. Several 'grandfathers' stand nearby to comfort him, and one gives him a boomerang to bite on. One of the operators then sits on his chest and holds his penis upright while the other carefully cuts it open, while the Activists sing and the Mourners quietly wail. The operation takes about ten minutes, since great care must be taken to center the incision, and cutting delayed while a small wooden rod is inserted into the urethra to act as a backing for the knife as it cuts. As soon as the operaton is completed, Waga is led to a small fire that has been made nearby; he sits astride it so that the heat and smoke will stop the bleeding.
Personal testimony of members of the CIRCLIST discussion group.
Australian Bureau of Statistics.
Policy Statement CIRCUMCISION OF INFANT MALES, Royal Australasian College of Physicians - September 2010. [Link in text above, accesssed 10.Oct.2010.]
Roberts, A. The Incredible Human Journey. London:Bloomsbury, 2009. pp 118-120, 128-142 and the accompanying BBC-TV series.
Scheer, R. Aboriginal Magic in the Land of the Quinkans, published in New Age Travel. [Accessed 12.Oct.2010]
Tonkinson, R. The Mardudjara Aborigines. New York:Holt, Rinehart and Winston, 1978.
Maps courtesy of Baedeker and the Australian Bureau of Statistics. Note: The map showing areas of Aboriginal occupation pre-1788 is approximate. It lacks sufficient accuracy to be used for Land Rights Claim purposes.
and the Law