From evidence-based knowledge to technicisation: the controversial medicalisation of male genital cutting by global health International Organisations

‘Male circumcision’ refers to a wide range of practices of genital cutting and modification from 1 or 2 cm cuts to complete removal of the skin surrounding the penis, to urethrotomy. In 2007, leading global health International Organisations (IOs) World Health Organisation (WHO) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) have established male circumcision as the 1st surgery ever used as a preventive health policy as part of their anti-HIV voluntary medical male circumcision programme (VMMC). In the midst of global protests to recognize male circumcision as a violation of human rights and despite literature showing how this practice not only has social and political meaning in the countries beneficiary of the programme but also that the practices associated with these meanings could lead to an increase of HIV transmission, 22 million VMMC surgeries have been performed on men aged 10-29 years in Eastern and Southern Africa since the beginning of the programme. At first sight, the desociologisation and legitimation of medicalised circumcision by WHO by UNAIDS through “evidence-based” discourse and rhetoric of expertise might seem a perfect case to illustrate the current debates happening in the field of IOs and knowledge. However, the fact that the global medical community itself has denounced the lack of evidence supporting the policy and the (denied) cultural dimension of medicalised circumcision – practised only in the United States before this Global Health initiatives – is not easily accommodated by the literature. To understand the situation, I put into perspective IOs policy discourses in the context of the different forms of knowledge engagement with male genital cutting that have preceded and co-existed with the VMMC policy and develop a theory of technicisation capable of accounting for IOS simultaneous and contradictory deliberative and normalising institutional engagements with knowledge about male circumcision. Doing so, this article makes an empirical contribution to the field of global health and transnational body norms, as well as a theoretical contribution to the IOs literature in a way that builds a bridge between the often-opposed Habermassian and Foucauldian approaches to knowledge.