I perceived our interaction with the delegates who chose to come by our booth as mostly positive. A few wanted to argue. A few said they agreed with us, but felt powerless to oppose the juggernaut. Almost none knew anything about foreskin anatomy or the purpose of the foreskin. Those who said they agreed with us were from non-circumcising countries, including Cambodia, Russia, Brazil, Colombia, Italy, South Africans descended from non-South African tribes, Australians, and really anyone who has had or experienced a foreskin outside of Africa.
The ones who know what a foreskin is and how it impacts comfort, health, and sexual pleasure were with us. Those who did not have this experience or knowledge were skeptical. I concluded somewhere through the middle of the four days of the conference that our message was not going to succeed on refuting the risk reduction impact of circumcision, but on informing about the benefits of the foreskin. Ignorant people, including Auvert, Piot, Fauci, Bailey, Westercamp, Gray, Weiss, and others, cannot be expected to provide informed consent in their circumcision consent generating interviews when they know little about the appendage they propose to cut off – and couldn’t care less anyway.
Worse still is the possibility that the information told to circumcision candidates is inaccurate or may trivialize foreskin anatomy and function. One argument that came up with a group of Ugandans was that a little bit of pleasure was worth losing for the benefit gained. Clearly, this common counter-argument had been subsumed in the discussion and discounted long before IAS 2011. Not once but often we heard the refrain, do you have any evidence to support your position? Our answer was to refer to the myriad published studies that support our contentions usually through reinterpretation. This was not often convincing to a skeptical scientific audience.
The question is how can we provide any plausible counter-arguments if we are not in Africa, not doing the research, not involved in the roll out or planning phases of circumcision campaigns, and generally confined behind our screens and keyboards. At the very least, we need to present something even if it is only within our booth and not part of the official program. We either get involved or sit it out and let the circumcisers continue to drive developments. This conference clarified this for me.
I call on the community of intactivists to think this through and come up with a strategy that will arm us with better information and counter-arguments to face this threat to genital integrity and informed consent in Africa and ultimately the United States.