Strode, A.E., Toohey, J.D., and Slack, C.M. South African Medical Journal (December 2016), 106(12):1173–1176. doi:10.7196/SAMJ.2016.v106.i12.11215.
This article reviewed the regulatory, normative, and protective frameworks governing adolescent access to male circumcision (MC) in South Africa—specifically the Children’s Act (No. 58 of 2005); the General Regulations Regarding Children, 2010; and the National Department of Health’s national guidelines. In South Africa, MC is practiced for religious reasons or as part of cultural initiation practices, as well as for medical reasons to reduce the risk of HIV infection. The authors identified ambiguities and inconsistencies among MC regulations, in regards to counseling, parental involvement, and consent. For example, for boys aged 16 and 17, the Children's Act implies that self-consent is sufficient, while the national guidelines imply that parental involvement is necessary. The authors also noted variations in the terminology used in MC regulatory documents. They made recommendations for law and policy reform to ensure better access to MC for adolescent males, including specifying minimum standards for circumcisions done for medical, religious, and/or cultural reasons; and being more consistent and specific regarding consent for health-related circumcisions. They further recommended that the national guidelines make clear that HIV prevention is a valid medical reason for circumcision of boys under age 16.