Infant circumcision has been an American norm since the mid-twentieth century. At the dawn of the twenty-first, health officials harnessed it as a public health intervention against HIV abroad. No other surgery has ever been deployed this way, much less one performed on children too young to consent. This led to inevitable controversy.

The Normal Thing to Be is an in-depth account of how a small network of primarily American researchers and government officials made it happen. Drawing on years of Freedom of Information requests, internal government correspondence, and original interviews, Ryan Jones traces a decades-long campaign that stretched across the CDC, the NIH, and the WHO. Its architects tried to box skeptics out of the policy process, fought running battles in academic journals and the press, and dismissed every dissenter as fringe, regardless of credentials. Intense pushback from the concerned public was largely ignored. The goal was to normalize the needless removal of healthy tissue from children, at home and abroad. What was the result?

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The following review is by Darbon Institute Chair, Jonathan Meddings:

Just when I thought I’d seen it all, Ryan Jones comes out with The Normal Thing to Be.

This is an explosive account of how the global "Voluntary Medical Male Circumcision" (VMMC) campaign was built—as an exercise in communications management and policy-based evidence, where the policy imperative appears to have driven the interpretation, presentation, and deployment of evidence rather than the other way around.

The paper trail is damning. Drawing on years of Freedom of Information requests, private correspondence and interviews, Jones gets behind the polished public narrative and exposes the machinery of ill-conceived VMMC policymaking: who was trying to shape the message, how dissent was handled, and how inconvenient questions could be managed rather than answered.

Despite its use of the word “voluntary”, the book raises deeply troubling questions about how often VMMC was anything but voluntary or genuinely consensual in practice. For anyone who has a general interest in public health policy and programming, or has followed the American-led push to circumcise tens of millions of African boys and men, this is a startling look at what can happen when the conclusion comes first and the evidence is made to follow.