In Taiwan, circumcision used to be routine according to a younger doctor friend of mine. Until about 10 years or so ago they had a health system like the USA. Then they circumcised most all boys. However that changed a decade ago and they now have a socialized medical system similar to the UK’s National Health Service. They too stopped routine circumcision of boys with that institution. Only wealthy families consider circumcision today in Taiwan, so I’m told. The vast majority of males born in the last several years are likely uncut.
China Consider Pro-Circumcision Policy
BEIJING (Reuters) - The rate of new HIV/AIDS infections in China is slowing
and is now mainly being transmitted through sex, which the government could
tackle with a circumcision campaign, the health minister said on Thursday.
The country will have an estimated 50,000 new infections in 2007, compared with
70,000 in 2005, though groups like men who have sex with men are increasingly at
risk, according to a report by the State Council, or Cabinet, and the United
Nations.That will mean there will be about 700,000 people living with HIV/ AIDS
this year in China, up from an earlier estimate of 650,000.Of the new
infections, 44.7 percent will come from heterosexual transmission, 12.2 percent
from men having sex with men, and 42 percent from intravenous drug use, the
report said. In the past, most infections were caused by intravenous drug
use. "At present, the AIDS epidemic in China continues to spread, but at a
slower rate," Health Minister Chen Zhu told a news conference. "Sexual
transmission is now the main route for the spread of AIDS."
Chen said more focus needed to be put on traditionally marginalized groups, like the gay community and drug users, though he added condom use by sex workers had risen from 14.7 percent in 2001 to 41.4 percent last year. Yet the report found risky behavior by men who have sex with men remained widespread, with just a third using condoms for anal sex. Chen said that with infections now primarily coming via sexual transmission, a male circumcision campaign could not be ruled out in China.
Studies have shown that circumcision could reduce the risk of HIV infection by up to 60 percent, though it does not offer total protection from the virus. The World Health Organisation has already recommended it as one of the ways developing countries, especially in Africa, could use to fight the spread of AIDS. "This is a technical question. I think our experts will evaluate it," Chen later told Reuters. "Even before the AIDS era some children in China were already being circumcised."
Circumcision rates are low in China compared to Asian countries like South Korea or Japan, where the foreskin is often removed at birth for hygiene reasons, or Muslim countries like Indonesia which practice it for religious reasons. China's Muslim minority, concentrated in the far western region of Xinjiang, likewise circumcise their male children, normally as they reach puberty. Chen said that were the government to decide to promote circumcision among the wider population, he did not think it would run into much opposition or cultural problems. "As long as there is evidence it is effective, I don't think it would be an issue," he said.
I've been dating a guy that was born in mainland China. He is loosely circumcised. He tells me that while the Chinese do not routinely circumcise infants, it is not at all uncommon to be circumcised during your teen and early 20's in China and that male circumcision is the single most commonly performed medical procedure in China.
He reports that approximately 25% of all Chinese males are circumcised, usually because of problems with their foreskins, which they discover as they become more sexually active. He also tells me that he believes this has to do with the fact that most families are extremely hesistant to discuss hygiene of the genitals because of cultural reasons. Consequently, he never was told (nor did any member of his family) to peel back the foreskin and wash the bared glans. He believes this leads to a higher incidence of problems with the foreskin, and hence the higher need for circumcision.
He was circumcised under local anaesthetic, freehand. They left plenty of inner foreskin, along with the frenulum. It is a loose circumcision by American standards, although the glans is never covered with skin even when completely soft. However, a large cuff of foreskin remains bunched up behind the glans when soft and their is ample loose skin during erection.
Although circ was practically unheard of in China, this practice is becoming quite popular in the past 10 yrs or so. It is obviously done in the big cities and in the well off families. A Chinese doctor even devised a special method, as parents were complaining about the residual scar. Apparently the scar tissue is more visible on the Asian type of skin than on whites. Therefore this Chinese doctor thought it was wiser to make the cut around the root of the penis rather than cutting the foreskin itself.
After the cut the skin is pulled back to completely uncover the glans and is stitched there. The end result is very much appreciated as it is just like an uncircumcised penis with the foreskin pulled back. No damage is done to the frenum and so on. This closely resembles the Japanese popular techniques.
Chinese families in Hong Kong do not practice circumcision routinely. However, if you were born in the United States in the 60's, it was almost mandatory! My family immigrated from Hong Kong to the US in 1961; the same year that I was born, and which the circumcision rate in the US for that year was 95%.
My parents never explained to me about my circumcision. However, I remember from several incidents, at a very young age, that made me aware that I was different, and something was done to my penis. My earliest recollection was about 4 year-old and seeing my father's penis. He was born in the country-sides of China and is uncircumcised. I remember seeing this dark hairy root, much like an old rotten carrot. Another incident was when my aunt's family first arrived to the US, also immigrated from Hong Kong six years after us. My mother was so proud to be the first to come to America, and just became a citizen. She was about to showing her sister all she knew about the American way of life. She explained that American boys are different - they are all circumcised. She made me pull off my pant to show her my penis. I remember my aunt's expression. Her son, my cousin Stan, who is 6-months younger than me, was born in Hong Kong, and was not circumcised. Growing up together, Stan and I were constantly being compared by the two families, and my competitive nature added to the friendly rivalry from physical differences to academics.
I attended Columbia University and he attended Stanford. Because of my father and Stan, I felt very self conscious in my early childhood. This quickly changed, when my brother and Stan's brother were born. Both of them were born in 1967. My brother was routinely circumcised, and I guess my mother talked my aunt into circumcising, this time, their "American" son. I remember my brother having to stay an extra day in the hospital to be circumcised, and my mother complaining about having boys and the need to paid $10 more for the circumcision. Times have changed, but circumcisions in America have not. When my son was born in 1994, in Mount Sinai Hospital New York, the price for circumcision was $600, and we had to take him home only a few hours after he was circumcised. My mother had it easy.
The biggest break through was in junior high school; where after gym class, showers were mandatory. I got to see all my friends that I know from elementary school naked. Now, I realized that they are all circumcised like me! With only a few Asians in my school, being picked on was quite common. I remember the few who were uncircumcised, and were teased. For the first time, I understood my mother, and appreciate being circumcised. It was my only proof that I was not just Chinese, but an American-Chinese.
Circumcision is not a daily topic for discussion. All of my previous partners, including my wife, during the first time, were surprised that I was circumcised. They all claimed that they would not have given me oral sex, if I was uncircumcised. My cousin Stan, after seeing how everyone was circumcised, eventually chose circumcision just prior to his marriage.
I was born in the US in the 60’s and was routinely circumcised. I grew-up in a community that was racially diverse with approximately 30% White, 25% Black, 25% Hispanic, and 20% Asian. Most of the Asian-Americans is of Japanese descant. A third of them was 2nd generation with parents who lived through the concentration camps of WWII. The majority of them were born to immigrant parents who were gardeners and nursery owners. Since showers were mandatory after gym classes, I know the status of all my classmates, and have probably observed over 200 boys, during the 6 years of junior and senior high school. 99% of Whites and 80% of Blacks were circumcised. Concurring with Enrique’s findings, only 50% of the Hispanics were cut. On the other hand, I can remember only 4 Asian boys who were uncut. Two of them were Koreans and one Vietnamese. They were foreign-born in their respective countries. The fourth is a good friend of mine, whose parents were also Chinese immigrants. His father was an engineer for the US Air Force, and his mother was a nurse. I suspect it was his mother’s decision. He is now a medical doctor and has a son, similar in age as mine. I believe his son is circumcised.
All of my Asian-American friends, except for a few foreign-born (who may be uncircumcised), have all choose circumcision for their sons. There may be some truth that Asian immigrants, in my parent’s generation, choose circumcision to improve their social status in America; however, I believe that it was simply their lack of knowledge in the subject, and their tendency not to question authorities, namely the doctors. Subsequent generations are different and are more assured. We are well educated (Harvard and Berkeley are 50% matriculated by Asians), and our income level is perhaps in the top 20%. We have earned the respect of fellow Americans. I know that this is not a forum to debate RIC, so I will not get into the subject. Basically, my wife and I made a conscious decision to circumcise our son based on the same information available to the average American. For this reason, I believe the rate of circumcision among Asian-Americans will follow the nation’s average.
Gene
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