Lessons from Tuskegee
Having used unknowing and poverty-stricken African-Americans to study a deadly disease, the Tuskegee syphilis study (1932–1972) has gone down in textbooks as the epitome of racist medical experiments in the United States.
What is most remarkable about Tuskegee is not its racism — it is that its ethics went unchallenged for decades. The study was conducted in plain view of the American public through the Civil Rights era: supported by the public health community, its findings published in mainstream journals and innocuously propagated in newspapers. Even a 1968 blue ribbon panel by the US Public Health Service (PHS) to evaluate the ethics of the famously racist experiment found insufficient evidence to discontinue it.
Tuskegee researchers were not knowingly being insensitive — it took two decades of historical hindsight before former US President Bill Clinton made his famous apology for “a study so clearly racist.”
With its similarities to Tuskegee, how will history remember the mass circumcision of Africans?
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VMMC and race
Malawians have questioned the motives of the US and other Western NGOs that are promoting circumcision despite evidence showing that the questionable initiative does not reduce HIV as claimed. Vetting their anger and frustrations on social media, the people took to task the US for “prioritizing sex” and not real development.
—Kondwani Mkhalipi-Manyungwa, Malawi24
A history of racism
The first African mass circumcision proposal, titled “Circumcision Enforced by Law,” was presented at the 1889 Loue State Medical Society Conference in Houston, Texas (USA). A write-up of the presentation, titled “Enforced circumcision of the colored race” (1889) was published in the Texas Medical Journal.
Similar mass African circumcision proposals of the era included:
- “Sexual crimes among the southern Negroes – scientifically considered” (Virginia Medical Monthly, 1893).
- “The solution of the Negro rape problem” (New England Journal of Medicine, 1894).
- “Circumcision for the correction of sexual crimes among the Negro race” (Maryland Medical Journal, 1894).
More articles proposing male circumcision as an antidote to the alleged hypersexuality of Africans include:
- “Negro rapes and their social problems” (National Popular Review, 1894).
- “Circumcision and rape” (The Times and Register, 1894).
For more information, visit Dr. Robert Darby’s History of Circumcision.
The HIV/AIDS connection
In 1894, the Boston Medical and Surgical Journal (now the New England Journal of Medicine) published a circumcision-promoting editorial titled “The solution of the Negro rape problem.” At the height of the AIDS pandemic in 1986, the same journal published a letter by the late Aaron J. Fink, a well-known male circumcision advocate, which implicated male foreskins as a leading factor in Africa’s AIDS epidemic. This letter is the first known proposal of circumcision to prevent HIV/AIDS, and continues to be cited in VMMC-promoting articles to this day.
Conclusion
The first printed African circumcision proposal was published not by the WHO in 2007, but in a scathing Texas Medical Journal write-up titled “Enforced circumcision of the colored race” in 1889.
Whereas much of the present campaign research originates from Johns Hopkins University in Maryland, a century ago the Maryland Medical Journal published a chilling variation on the theme. An editorial titled “Circumcision for the correction of sexual crimes among the Negro race” presented circumcision as a panacea for the “ungoverned sexual passion” stemming from African men’s “enlarged prepuce.”
The first publication to implicate a lack of male circumcision in the African HIV/AIDS epidemic appeared in the very journal that printed “The solution of the Negro rape problem,” a circumcision advocacy piece, less than a century prior.
Proposals to mass-circumcise African males have existed for over a century, with disturbing racial implications.
Critical questions
- What of the problematic racial history around mass African circumcision proposals?
- Do all African cultures fit the “hypersexed” racial stereotype?
- Do Africans need surgical correction to prevent them from acquiring sexually transmitted infections?
- How will future generations interpret this effort?
- How can a surgical campaign targeting only one race, with no more oversight than an animal spay-and-neuter programme, be justified in the modern world?