Circumcision: Social, Sexual, Psychological Realities

I've posted a rebuttal at:

http://circumcisionnews.blogspot.com/2011/09/debunking-myths-part-3.html

Nobody cares about your rebuttal Jake. I don't know why you're so fascinated with the cutting of babies' genitals, but no amount of *possible* benefits can justify cutting off part of an unconsenting person's body. In the absense of a true medical need, it is absolutely unethical to perform surgery on an unconsenting person. The only one that has to live with the consequences of circumcision, is the unconsenting person who recieved it.

Please look here for pictures of circumcision damage.

http://www.circumcisionharm.org/gallery1.htm

“The rule is: do not operate on healthy children”, says Arie Nieuwenhuijzen Kruseman, chairman of the KNMG. “It is an unfortunate fact that any surgical procedure can cause complications. Doctors accept this to a certain extent because there are medical reasons for the procedure. However, no complications can be justified that occur as the result of an operation that is medically unnecessary.”
http://www.circinfo.org/doctors.html

Well, certainly complications can occur, but that's not a persuasive argument against performing circumcision. The problem with that argument is that adverse consequences can also be associated with the presence of a foreskin.

More logical approaches are a) to decide that a certain risk of adverse effects is acceptable, or b) to attempt to make a decision that minimises the risk of such effects. But clearly it doesn't make sense to consider one set of adverse effects but not the other; that's just prejudice masquerading as reason.

It's wrong to screw up someone else's body. Ever. Period. If a kid grows up and wants to modify his body as a consenting adult, *any* sort of modification whether it be tattooing, circumcision, body piercings or even something bizarre like tongue-slitting...it's HIS choice, not his parents' choice. It's very simple logic; if it can't be undone but could be done later, don't effing do it. You cannot ever take it back. Restoration is simulation, not regeneration of the real thing. But consensual adult circumcision is, as is ANY elective cosmetic surgery, entirely up to the one that owns the body part and that is as it should be. Again, for those that are slow on the uptake...cutting stuff off someone else's body without his or her say-so is just flat wrong and there is nothing anyone can say that makes it right.

I care about Jake's rebuttal and you should too.
He is scholarly and points people to the latest scientific
information showing that the people behind these articles
are the ones publishing myths.

As for botched circumcisions, you make a good point that
parents should find a qualified person to do a circumcision.

As for "screw up someone else's body... Circumcision removes
the weakest part of the penis thereby making it less prone
to problems. It's well documented.

It's as if you have not read the article.

I care about Jakes "rebuttal" too, but I can see he's wrong. I looked one of his studies ih the prior post and saw it did not say what he claimed it did regarding the frequency of the use of anesthesia. And I can see how in this recent "rebuttal" he cites a commentary by Brian Morris on the Sorrells study, but that commentary was totally refuted here. http://onl­­inelibrar­y­.wiley.c­om­/doi/10­.11­11/j.1­464-­410X.­2007.­0707­2_1.x/­ful­l

In fact, Brian Morris didn't even have his tables right. And the Australian medical association dissassociated itself from Brian Morris. www.smh.com.au/national/letters/no-evidence-to-support-routine-circumcision-20090911-fkna.html

And, while I do care about Jake's "rebuttal," I can see that what he says contradicts what the national medical associations say. No national medical association recomments *infant* circumcision, and more than ten denounce any medical justification.

The British Columbia College of Physicians and Surgeons' 9/09 report declared:

"There is no evidence to support routine circumcision of newborn and infant males."

"The stated benefits of protection against urinary tract infection are marginal, and do not justify mass circumcision. Our changing understanding of the relationship between urinary tract infection and chronic renal disease further weakens the case for routine circumcision."

"There is evidence that circumcision does result in memory of painful experiences, and is not quite as simple and low risk as your report suggests."

www.smh.com.au/national/letters/no-evidence-to-support-routine-circumcis...

The Dutch Medical Association's May 2010 report, backed by 7 other national medical associations, concluded:

"Contrary to what is often thought, circumcision entails the risk of medical or psychological complications."

"Non-therapeutic circumcision of male minors conflicts with the child's right to autonomy and physical integrity."

"There are good reasons for a legal prohibition of non-therapeutic circumcision of male minors, as there is for female genital mutilation."

"There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene."

www.norm-uk.org/news.html?action=showitem&item=1306

The Australian College of Physicians' 9/09 report declared:

"The benefits of infant male circumcision that have been promoted over time include the prevention of urinary tract infections and sexually transmitted diseases, and the reduction in risk of penile and cervical cancer. Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended."

www.cpsbc.ca/files/u6/Circumcision-Infant-Male.pdf

The South African Medical Association denounced infant male circumcision as unethical and illegal and expressed "serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The committee reiterated its view that it did not support circumcision to prevent HIV transmission."

http://www.intactnews.pfeyz.com/openpublish/article/south-african-medica...

A recent study in Denmark just found "circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfillment." www.ncbi.nlm.nih.gov/pubmed?term=21672947

New research also find circumcised men are five times more likely to suffer from premature ejaculation. http://www.ncbi.nlm.nih.gov/pubmed/21492404 The sample size was small and needs further research, but it's certainly reason to pay attention.

Research also shows an intact penis gives women more pleasure too. http://www.drmomma.org/2009/10/improve-marital-sex-keep-foreskins.html

Anonymous on September 18, 2011 - 3:24pm said: As for botched circumcisions, you make a good point that parents should find a qualified person to do a circumcision.

How do you know if you've got a good surgeon or not? (I guess this question applies to any surgeon.) And I'm confused as to why obstetricians, who're trained to handle dysfunctional pregnancies and/or labors, are the ones who perform circumcisions in an hospital setting. Once born, isn't a baby then under the care of a neonatal specialist and/or pediatrician? Is it simply that neonatal and pediatric practitioners not trained to do this kind of surgery? Or do those kinds of doctors have an ethical issue with newborn circumcision as a routine procedure?

Jake cites a 2007 commentary by Brian Morris that supposedly refutes the Sorrels study on the sensation in the penis. But that commentary by Brian Morris was refuted here.
http://onl­­inelibrar­y­.wiley.c­om­/doi/10­.11­11/j.1­464-­410X.­2007.­0707­2_1.x/­ful­l

Brian Morris didn't even get his tables right. And the Australian medical associations disassociated itself from Brian Morris. See www.smh.com.au/national/letters/no-evidence-to-support-routine-circumcision-20090911-fkna.html

Logic, do not cut off healthy gentials.

"Well, certainly complications can occur, but that's not a persuasive argument against performing circumcision. The problem with that argument is that adverse consequences can also be associated with the presence of a foreskin."

The problem with this argument is that there needs to be a persuasive argument in FAVOR of performing circumcision. Standard medical practice requires that there be a medical or clinical indication for surgery, and even then, every other method of treatment has to have failed. Standard medical practice requires that scientists and doctors look for conservative ways of treatment and disease prevention.

There are adverse consequences that can be associated with the presence of a foreskin, but this view is myopic; adverse consequences can be associated with the presence of any other body part you name. Cancer can be associated with the breasts, pancreas, prostate and thyroid, for example, even the labia and clitoris. But usually, doctors are trying to find ways to treat and prevent cancer that do not involve the elimination of these parts of the body. The point of medical science is to find ways to PRESERVE the human body, not establish rationale for its deliberate destruction.

Because circumcision involves the excision of a normal, healthy body part, usually in healthy, non-consenting individuals, and because the diseases that circumcision is supposed to prevent are already better prevented with other, non-invasive methods, any botch or adverse consequence is unconcsionable.

"More logical approaches are a) to decide that a certain risk of adverse effects is acceptable, or b) to attempt to make a decision that minimises the risk of such effects. But clearly it doesn't make sense to consider one set of adverse effects but not the other; that's just prejudice masquerading as reason."

No, the more logical approach is to address problems as they come, and to prevent problems in conservative, non-invasive ways. If there is no problem or adverse condition, and if the potential problems can already be addressed without surgery, then it is illogical to think about "the risks" of a surgical procedure.

What is prejudice masquerading as reason is finding "risks" and hypothetical "problems" to legitimize, necessitate, even require a surgical procedure. Scientists and researchers need to be finding ways to make surgical procedure obsolete, not make it indispensable.

Jake or Brian's sockpuppet has said:
"I care about Jake's rebuttal and you should too. He is scholarly and points people to the latest scientific information showing that the people behind these articles are the ones publishing myths."

Well, if you call writing your own original "studies," maintaining your own website of "studies" and "rebuttals" that you wrote yourself, and referencing them on Wikipedia etc. "scholarly," then you might have a point.

"Latest" scientific information? I'm afraid much of what Jake cites is outdated and rebutted.

"As for botched circumcisions, you make a good point that parents should find a qualified person to do a circumcision."

Yes, I'm sure female circumcisions wouldn't be so bad if somebody "qualified" did them. When an act is medically fraudulent and charlatanistic, it really doesn't matter how "qualified" a person is.

Unless there is a medical or clinical condition that warrants surgery, doctors have no business performing them on healthy, non-consenting individuals, much less giving parents any kind of opportunity to make any kind of "choice."

"As for "screw up someone else's body... Circumcision removes the weakest part of the penis thereby making it less prone to problems. It's well documented."

Actually, studies show that circumcision removes the most sensitive part of the penis, which is more sensitive than the most sensitive part of the circumcised penis. Some studies show that circumcision may actually INCREASE problems for a man.

Rather than "reduce problems" through surgery, rather than fix science around an ancient religious practice, scientists need to be finding better, more effective, less invasive ways to thwart disease.

Actually, what Jake and Brian aren't saying here, is the fact that most of the "problems" that they say circumcision can prevent can already be easily prevented and treated by other means.

A true scholar, someone who is truly interested in science and the well being of others will present ALL the evidence, not just the evidence that is convenient to your agenda.

SOME "studies" show that circumcision *MIGHT* reduce the likelihood of *SOME* diseases. There are other, better ways to prevent disease, however, and it is the owners of the penises themselves who need to weigh the risks and decide what methods of "protection" they want.

Rather than take Brian and Jake's skewed information, readers would do well to read what medical organizations around the world have to say on the matter. There is not a single medical organization in the world, not even in the United States, that endorses the circumcision of infants. Brian Morris has been publicly disowned by the Royal Australian College of Physicians.

The trend of opinion on routine male circumcision is so overwhelmingly negative in industrialized nations and no respected U.S. based medical board recommends circumcision for U.S. infants, not even in the name of HIV prevention. Respected medical organizations must all point to the risks, and they must all state that there is no convincing evidence that the benefits outweigh these risks. To do otherwise would be to take an unfounded position against the best medical authorities of the West, within and outside of the United States.

Brian Morris and Jake Waskett may present themselves as objective, impartial, neutral and "dispassionate," but when you step back and look at all the evidence, what other respected scientists, scholars and medical organizations are saying, when you look at who these two men are, Brian Morris and Jake Waskett are radicals that defy all of medicine.

To learn more about what Jake Waskett and Brian Morris are really about, visit the following links:
http://circleaks.org/index.php?title=Jake_waskett
http://circleaks.org/index.php?title=Brian_Morris

Marc:

"And I can see how in this recent "rebuttal" he cites a commentary by Brian Morris on the Sorrells study, but that commentary was totally refuted here." -- so, which part of Young's response do you find persuasive? The reason I ask is that almost everything he says appears to be wrong.

"And the Australian medical association dissassociated itself from Brian Morris." -- more accurately, David Forbes expressed disagreement with Morris on an unrelated issue.

"And, while I do care about Jake's "rebuttal," I can see that what he says contradicts what the national medical associations say. No national medical association recomments *infant* circumcision," -- it seems to me that you're attacking a strawman here, since nowhere in my rebuttal did I recommend infant circumcision.

"A recent study in Denmark just found "circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfillment." -- yes, that study was limited by the small number of circumcised men in the sample, as well as potential confounding due to the strong associations between race, religion and circumcision in Denmark. They did attempt to adjust for the latter, but there are limits to what can be done with such few cases.

"New research also find circumcised men are five times more likely to suffer from premature ejaculation." -- yet another example of cherry-picking. At least six studies (including the Danish study you cited in the previous paragraph, amusingly) found no difference, while four found that circumcision is protective.

"Research also shows an intact penis gives women more pleasure too." -- more cherry-picking.

The circumcised circumciser thinks he is doing you a favor by cutting off your prepuce as an infant because he doesn't know how to educate you on how to care for your prepuce because his was cut off as an infant or because no one taught him how to care for his own and he doesn't know what having a healthy one is like. He only beleives people who have bad or no experiences like his own. Everyone must be sacrificed/deprived because his was.

The circumcised intactivist want you to learn how to raise yourself with a healthy prepuces and to become educated on what the natural functions of the human prepuce are for, so you can enjoy it for your lifetime and avoid causing yourself the dysfunctions, risks and harms caused from circumcision/excision of the prepuce, to yourself or another human out of ignorance and denial.

A little knowledge can prevent and replace any potential benefit that the superstitious fanatic perceives as inevitable from his lack of and denial of knowledge. Prepuce excisions are rarely needed by those who are educated in the benefits of being intact and always caused by those who are ignorant on the functions of the prepuce.

The difference is the procirc will circumcise if it's needed or not, but the intactivist will only circumcise if needed, when caused from lack of education.

To whoever thinks I'm Jake...

Once again this nicely illustrates the tendency
of anti-circ fanatics to make wild claims without
any supporting evidence.

I've read all of the articles posed. Cannon writes fiction.
She barely even tries to support what she writes.

And of course we haven't been told anything about who she is.

Wow, what nastiness toward Jake.

Unfortunately, you anti-circ fanatics don't have the evidence
or you wouldn't have to attack people personally.

The evidence continues to mount showing the health benefits of
circumcision.

Unlike Jake, I'm for infant circumcision. I think it should
be an option for parents to offer their sons the life-long
health benefits of being circumcised at birth.

I'm glad that California passed a bill preventing people
like Hess from trying to make circumcision illegal.
There's a similar bill in the US congress which would prevent
any state from making circumcision illegal.

Then at least here in the US, we won't have to fight against
you crazies.

It's great to see another mainstream article on circumcision that explains the harms of circumcision and the functions of the foreskin.

Darcia Narvaez would like you to think this is what
Psychology Today endorses about circumcision.

But in fact, it's just her blog and the real author
Lillian Dell'Aquila Cannon has no relevant credentials
to be writing about circumcision.

This is a "feel good" blog for all you anti-circ fanatics.

There is little factual information in what these articles present.

Anti-cir freaks huh? Well then I guess the Dutch medical association and the seven national medical associations that backed them up were "anti-circ freaks" too right? Otherwise how could they say thing like: "There are good reasons for a legal prohibition of non-therapeutic circumcision of male minors, as there is for female genital mutilation." "There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene." "Contrary to what is often thought, circumcision entails the risk of medical or psychological complications." "Non-therapeutic circumcision of male minors conflicts with the child's right to autonomy and physical integrity."

www.norm-uk.org/news.html?action=showitem&item=1306

Yeah, a bunch of anti-circ freaks they are. And I guess the British, Australian, Canadian and South African medical associations are all "anti-circ freaks" too.

Sorry but I'll believe the national medical association over a bunch of pro-circ freaks like Brian Morris. Speaking of which, I saw his interview. Talk about a freak! I'm glad that other medical professional called his arguments "quackery." Everything he says is contrary to what the national medical associations say. http://www.youtube.com/watch?v=gdGbXdEo93U

Jake said, "more accurately, David Forbes expressed disagreement with Morris on an unrelated issue."

Unrelated issue? That letter was specifically about the issue of circumcision. What's "unrelated" about that?

Jake said: "It seems to me that you're attacking a strawman here, since nowhere in my rebuttal did I recommend infant circumcision."

Ok, then do you support infant circ, or don't you? I'd like to know. You seem to support Brian Morris who certainly does support infant circumcision.

Cherry picking? Ok, Jake. So any study I cite is cherry picking, and any study you cite is not. And I guess the national medical associations are cherry picking too.

"Unrelated issue? That letter was specifically about the issue of circumcision. What's "unrelated" about that?" -- it's unrelated to the subject of the merits (or lack thereof) of Sorrells' paper, which is what we were discussing.

"Ok, then do you support infant circ, or don't you? I'd like to know. You seem to support Brian Morris who certainly does support infant circumcision." -- I'm pro-parental choice; that is I support both the decision to circumcise a son and the decision not to do so. It's essentially the same position as that of the American Academy of Pediatrics, who state: "In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision." -- http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686

"Cherry picking? Ok, Jake. So any study I cite is cherry picking, and any study you cite is not." -- no, cherry-picking has nothing to do with the identity of the person concerned.

"And I guess the national medical associations are cherry picking too." -- generally speaking, no: with the occasional exception, most such organisations offer reasonably balanced summaries of the evidence (at least as existed when the statements were published).

The letter was not about Sorrells, but it was about about circumcision.

"cherry-picking has nothing to do with the identity of the person concerned."

Correct. And I didn't say it was about idenity. You're the one who accused me of cherry picking when I cited studies. Somehow the studies you cited weren't cherry picking by mine were?

"most such organisations offer reasonably balanced summaries of the evidence (at least as existed when the statements were published)."

Yes, and all of them said there is no medical jusitification for intant male circumcision. So if that's the case, then how it justified to forbid the removal of a girl's clitoral foreskin, and even the slightest ceremonial incision on a girl's genitals, but allow the removal of the male foreskin? The Dutch medical association correctly pointed out the double standard. And the South African medical association correctly called it unethical.

Young's response to Morris' criticism of Sorrells is as follows:

"Waskett and Morris [1] complain that Sorrells et al. [2]‘fail to compare the same points on the circumcised and uncircumcised penis’, but Sorrells et al. compared 12 points that the two have in common, as well as five the circumcised penis does not have, and two (of scar tissue) that only the circumcised penis has. By disregarding those seven points (which they miscount) in their table, Waskett and Morris have removed the major source of difference and restored the major fault of the undocumented, unreviewed and vaguely described (but widely quoted) study by Masters and Johnson [3], that of ignoring the foreskin.

Each of the points at which Sorrells et al. measured stands surrogate for a surrounding area of the penis, of varying size. The areas corresponding to the two points of circumcised scar tissue (which were the most sensitive points on the circumcised penis) are very small; those of the foreskin, as sensitive or more so, amount to half or more of the average penile skin [4]. The Bonferroni correction is not applicable because only one hypothesis is being tested.

Sorrells et al. found not only that the foreskin is more sensitive than most of the rest of the penis, but that the exposed corona glandis, at least, of the circumcised penis is slightly less sensitive than that of the intact penis. The Waskett and Morris critique of the selection process in misplaced. Are they suggesting that one’s attitude toward circumcision differentially affects the outcome of a ‘blinded’ test of penile sensitivity, according to the subjects’ circumcision status?

Their reliance on the study of Williamson and Williamson [5] is misguided. In that survey, of Iowa women who had just given birth to boys, the useable response rate was only 54%, of whom only 16.5% (24 women) had experience of both kinds of penis.

They write ‘The existence of a market for lidocaine-based products to reduce penile sensitivity attests to the desire by some men for a penis with reduced, not heightened, sensitivity’ but they give no indication of what proportion of that market comprises circumcised men. ‘Sensitivity’ is not one-dimensional. There are issues of the quality of the sensation from different areas, and that from the scarred area of a circumcised penis might be confounded by the presence of iatrogenic neuromata, sensitive only to pain. A circumcised man might well benefit by having such sensations dulled.

They say that ‘sexual sensation depends upon the types of mechanical stimulation generated during intercourse, which might in turn be influenced by circumcision status’. Indeed they might, especially by the rolling action, or its lack, of the foreskin. There are many anecdotal accounts (including but not limited to those collected by O’Hara and O’Hara [6], both first- and second-hand, of circumcised men having to thrust harder and longer to achieve ejaculation, as you would expect when the great majority of the fine-touch receptors, which Waskett and Morris dismiss, have been removed. Formal confirmation or disproof of this awaits another (more rigorous) ‘Masters and Johnson’.

Circumcision is a ‘cure’ looking for a disease. Morris [7] even promotes it to prevent zipper injuries! That the foreskin itself has a sexual function was well-known for centuries before secular circumcision became widespread [8]. What would need to be proved rigorously is that excising a significant part of the distal penis does not diminish sexual pleasure."

Male genital mutilation needs to be banned for infants and boys. Adult men can make their own choices. All children - regardless of gender - have a human right to a whole and intact body.

"The letter was not about Sorrells, but it was about about circumcision." -- yes, I think we've established that. And it makes me wonder why you referred to it. Was it your intent to engage in argumentum ad hominem?

"Correct. And I didn't say it was about idenity. You're the one who accused me of cherry picking when I cited studies. Somehow the studies you cited weren't cherry picking by mine were?" -- I haven't checked every study you've cited, so I'm not willing to say that every one is an example of cherry picking. The ones I identified as such were. I'm happy to discuss specific examples if you like. It's possible to cite individual studies without misleading, but where citing such studies would paint a non-representative view of the literature, I think cherry-picking is an apt description.

"Yes, and all of them said there is no medical jusitification for intant male circumcision." -- not quite, no. They generally make such statements about routine infant circumcision (that is, of all newborn boys), rather than individual cases.

"So if that's the case, then how it justified to forbid the removal of a girl's clitoral foreskin, and even the slightest ceremonial incision on a girl's genitals, but allow the removal of the male foreskin?" -- the obvious difference is that female genital cutting (FGC) doesn't have any medical benefits. Circumcision does. And so, since they both have risks (to varying extents), FGC can only be a net harm on balance. Circumcision, on the other hand, is neutral or a net positive (according to most reasonable observers).

Society has to take responsibility for protecting the vulnerable from harm, and laws against FGC make sense in this context (one could argue that the potential harm from a ritual nick is small enough not to worry about, but clearly the more severe forms of FGC are harmful). But in the case of circumcision, where it is neutral or beneficial, there's no logical argument for society to intervene in parental choices.

"The Dutch medical association correctly pointed out the double standard. And the South African medical association correctly called it unethical." -- I've yet to find confirmation of the South African position. The only record of it seems to be on anti-circumcision websites.

"Young's response to Morris' criticism of Sorrells is as follows:" -- I imagine that any reasonably competent reader would be able to copy the URL you provided into a web browser and read it for themselves. There's no need to reproduce it verbatim. But to repeat my earlier question: which specific arguments in Young's response do you find persuasive? Or is it merely the existence of his letter that you find compelling?

"yes, I think we've established that. And it makes me wonder why you referred to it. Was it your intent to engage in argumentum ad hominem?"

It was to point out what the chair of the medical association said about any associaton between them and Morris, as well as their opinion on the issue of circumcision. That's not an ad hom.

"not quite, no. They generally make such statements about routine infant circumcision (that is, of all newborn boys), rather than individual cases."

That's exactly right. It's the routine cutting of infant boys that's the issue here, not individual cases that may involve specific medical justification. The national medical associations denounce any medical justification for routine infant circumcision, I believe them more than I do someone like Morris who goes around alarmingly claiming millions of people will die if we don't circumcise babies.

"the obvious difference is that female genital cutting (FGC) doesn't have any medical benefits. Circumcision does."

Not according to the national medical associations. I quoted straight from the Dutch, British, Australian and South African medical associations saying there is no justifiable medical benefit to infant male circumcision.

And in fact, there are *alleged* medical benefits to FGM, many of which are the same or similar to MGM, such as preventing HIV. Stallings, R. Y., and E. Karugendo. “Female Circumcision and HIV Infection in Tanzania: For Better or for Worse?” Abstract of paper given at Third International AIDS Society Conference on HIV Pathogenesis and Treatment. Rio de Janeiro, July 25–27, 2005.

"I've yet to find confirmation of the South African position. The only record of it seems to be on anti-circumcision websites."

The link I gave is to the letter from the South African Medical Association calling infant male circumcision illegal and unethical.

"I imagine that any reasonably competent reader would be able to copy the URL you provided into a web browser and read it for themselves. There's no need to reproduce it verbatim."

I provided it because the link was giving me trouble sometimes, so others might have had trouble too.

"But to repeat my earlier question: which specific arguments in Young's response do you find persuasive? Or is it merely the existence of his letter that you find compelling?"

I could ask you the same - what part of Young's response do you find unpersuasive, since you said it appears to be wrong. In any event, I find it persuasive when he points out how Morris et al. incorrectly claim Sorrells et all did not compare the same points on the circumcised and uncircumcised penis, when they did.

"It was to point out what the chair of the medical association said about any associaton between them and Morris, as well as their opinion on the issue of circumcision. That's not an ad hom." -- so in other words it had nothing whatsoever to do with the subject we were discussing. I see.

"That's exactly right. It's the routine cutting of infant boys that's the issue here, not individual cases that may involve specific medical justification." -- I think you've misunderstood. "Routine" means circumcision of all newborn boys; it doesn't happen. We're talking about elective circumcision of infants.

[Re "the obvious difference is that female genital cutting (FGC) doesn't have any medical benefits. Circumcision does."] "Not according to the national medical associations. I quoted straight from the Dutch, British, Australian and South African medical associations saying there is no justifiable medical benefit to infant male circumcision." -- wrong. With the notable exception of the Dutch, most medical associations acknowledge that circumcision has benefits. What they say, however, is that these benefits don't outweigh the risks to a sufficient extent to recommend that all newborn boys are circumcised. But that's not the same as saying that it doesn't have benefits.

"And in fact, there are *alleged* medical benefits to FGM, many of which are the same or similar to MGM, such as preventing HIV. Stallings, R. Y., and E. Karugendo. “Female Circumcision and HIV Infection in Tanzania: For Better or for Worse?” Abstract of paper given at Third International AIDS Society Conference on HIV Pathogenesis and Treatment. Rio de Janeiro, July 25–27, 2005."

The other study reporting reduced risk of HIV was Kanki (1992). Monjok (2007) found increased risk, while Pepin (2006), Mboto (2009), Msuya (2002), Klouman (2005), Kapiga (2002), and Foglia (2005) found no difference. Maslovskaya (2006) and Brewer (2007) found more complex relationships. (If you want full refs I'm happy to oblige.) So, put another way, of eleven studies, 9 (or 82%) did not find that result. See what I mean about cherry picking?

"The link I gave is to the letter from the South African Medical Association calling infant male circumcision illegal and unethical." -- but how can I verify that the letter is genuine?

"I could ask you the same - what part of Young's response do you find unpersuasive, since you said it appears to be wrong. In any event, I find it persuasive when he points out how Morris et al. incorrectly claim Sorrells et all did not compare the same points on the circumcised and uncircumcised penis, when they did." -- That's worrying. The caption to Sorrells' Table 2 quite clearly states that it shows differences between each point and position 19: "differences in fine-touch pressure threshold between the ventral scar (Position 19) and the position found only on the uncircumcised penis". In the event that you don't believe the caption you can recalculate the p values from the means and SEMs; that will confirm it. Sorrells' paper doesn't include the results of comparing each point on the circumcised penis with the same point on the uncircumcised penis.

"Well, certainly complications can occur, but that's not a persuasive argument against performing circumcision. The problem with that argument is that adverse consequences can also be associated with the presence of a foreskin."

- Then why not wait it out a bit? And if the foreskin does pose a problem later on then you are at least old enough to decide for yourself if you want to do away with it or not.

A GREAT EXAMPLE is the human appendix. Now I don't know the amount of people who suffer from an inflamed appendix but you certainly don't see people going to hospitals en masse to have it removed for preventative reasons, do you? I mean ... if we're circumcising babies why not remove their appendix too? Imagine the trouble we'd save them later on - just in case their appendix were to inflame.

It's a faulty logic that causes one to take more risks then needed.

I hope people get to cite my appendix analogy to help prove their point.

X:

The first problem with your analogy is that appendectomy is (relatively speaking) major surgery, requiring general anaesthesia, and is associated with substantially more risks than circumcision. Obviously, this counts against prophylactic appendectomy: the total risk of performing appendectomies in 100% of children will likely outweigh the total risk of appendicitis and subsequent appendectomy in a much smaller percentage of cases.

The second problem with your analogy is that these risks are unlikely to be age-dependent: the risk of performing appendectomy early is broadly similar to the risk of performing appendectomy later on. In contrast, it's well documented that neonatal circumcision carries fewer risks than circumcision of older children or adults.

The third problem with your analogy is that circumcision isn't necessarily a required (or even appropriate) treatment for the conditions that it helps protect against. For example, there's little point in circumcising a man who has become HIV positive (it certainly won't treat him), but circumcising him beforehand can (statistically speaking) prevent that from occurring.

I'd like to give everyone a chance to see who Jake really is. Please go here (every statement has a source to check the validity of the claim):
http://circleaks.org/index.php?title=Jake_H._Waskett

Where a source seeks to convince by a claim of authority or by personal observation, it is generally well accepted that an "authority" needs to be objective and impartial, and that an audience can only evaluate information from a source if they know about conflicts of interest that may affect the objectivity of the source.

Some pretend to have an objective and impartial point of view regarding the practice of circumcision, when in fact, they have a special, vested interest in defending the practice; they have a bias in favor of circumcision, which poses a conflict of interest for said authorities.

A circumcision bias may cause one to view the practice of circumcision in a positive light, to welcome evidence that it is medically beneficial, perhaps even necessary or required, and to dismiss arguments and evidence to the contrary. Positive findings may be exaggerated, and negative findings may be minimized, if they are reported at all.

To learn more about Jake's particular bias, see this page:
http://circleaks.org/index.php?title=Circumfetish

PS: Please save the claims of "ad hominem attack". It's important to understand someones motives when considering their position.

Even if what you say about Jake is true, so what?
He doesn't just state opinions and wave his hands like you and
others do. His arguments are always supported by evidence.
I've never seen him dismiss arguments and evidence to the contrary.
He always points out what's wrong with the arguments and
shows evidence which is more compelling than what was presented.

I don't know Jake. I have never met him, and never talked with him.
I've read a lot of what he's written and it's always well written
and to the point. Instead of saying that he's biased or
wishing he go to hell as someone here did, why don't you
respond to what he writes? Then you could have a rational
discussion.

Whether or not another male is circumcised will have NO effect
on my life in any way. I am for circumcision because of the
well-documented health benefits and I'd like everybody to have
the truth about circumcision.

The articles here are just emotional eye candy for people against
circumcision.

Someone said I called them "anti-circ freaks."
Actually what I've said is anti-circ fanatics. I think you're
fantics because no amount of evidence, no matter how compelling,
will ever convince you that there are health benefits to being
circumcised.

Mathew Hess (the person behind the circumcision ban attempt
in SF) said that even if circumcision were 100% effective to
prevent HIV infection he'd be against circumcision.
That is pretty crazy.

"so in other words it had nothing whatsoever to do with the subject we were discussing. I see."

We were discussing circumcision and Morris' position on it. I think that's relevant. But ok.

"I think you've misunderstood. "Routine" means circumcision of all newborn boys; it doesn't happen. We're talking about elective circumcision of infants."

You're avoiding the issue with a play of words. The national medical associations said there is no medical justification for male circumcision other than in specific situations where there is an actual medical condition calling for it. Obviously, by "routine" I don't mean all boys get mutilated, because of course a number of parents choose not to.

"wrong. With the notable exception of the Dutch, most medical associations acknowledge that circumcision has benefits. What they say, however, is that these benefits don't outweigh the risks to a sufficient extent to recommend that all newborn boys are circumcised. But that's not the same as saying that it doesn't have benefits."

Jake, read again. I said no *justifiable* medical benefit. Meaning no medical benefit justifies it.

Jake, you cite reports on the HIV issue, yes I'd like to see the links, because the studies I've seen that say there's no loss in sensation either were done on men who came from the clinics in Africa that benefit from the circumcisions, or on men who were cut as adults for medical purposes. And alot of the prior studies had mixed results. The Korean study, on the other hand, had no financial incentive and was not done on men who were cut for medical reasons, but merely out of a tradition introduced by U.S. miliary.

"but how can I verify that the letter is genuine?"

Well that's up to you Jake but here's the letter from the South African medical association. www.icgi.org/Downloads/SAMA-NOCIRC-2011-06-25.pdf In case anyone has problems with the link, the letter states: "The matter was discussed by the members of the Human Rights, Law & Ethics Committee at their previous meeting and they agreed with the content of the letter by NOCIRC SA. The Committee stated that it was unethical and illegal to perform circumcision on infant boys in this instance. In particular, the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission."

"Even if what you say about Jake is true"

It is true. You can check the sources. Everything is verified.

"so what?"

Apparently you don't understand the dangers of ulterior motive. Actually, I think you do, and you'd rather prefer to think that this is admissible because of your own pro-circumcision bias. i.e., to support your position. Nobody is going to admit wrong in this discussion, but I hope that in learning about Jake (and others like him), you (and others) will change your tune after you leave this chat.

The idea that we should wait for evidence as to whether circumcision has sufficient benefits to recommend it is the position these people (like Jake) want you to have, so that you will come to his conclusion. They never mention the function of the foreskin; why it's there, what it's for, what benefits it has. Their entire premise is a red herring, and you fell for it. Learn their motives.

Anon said: "I think you're fantics because no amount of evidence, no matter how compelling, will ever convince you that there are health benefits to being circumcised."

Well ok Anon, but I think if anyone is fanatical it is those who call people fanatics for believing the national medical associations.

As for ad him attacks, there are plenty going in both directions here. Neither side in this thread can accuse of other of it without being hypocritical.

Oh but I do understand the dangers of "ulterior motive".
And you and others posting messages here should look in the mirror.

I doubt that anything will change after this chat.
What I see is the people here against against circumcision
have an emotional attachment to foreskin.
And this is evident is what you said:

"They never mention the function of the foreskin; why it's there, what it's for, what benefits it has."

Actually, there have been a lot of comments about that not being
true. And no studies to support what you say. Just emotional
attachment like I said before.

"Well ok Anon, but I think if anyone is fanatical it is those who
call people fanatics for believing the national medical
associations."

Have you checked out the CDC website?
Or the American Urological association?
Or the Cochrane Institute which says that RCT's in Africa are
conclusive and no more studies need to be done?

Need links? I'll send them again.

I understand you have an emotional attachment to foreskin for
some reason. What I don't understand is that you can ignore
the overwhelming evidence showing the health benefits of
circumcision.

Anon, if anyone here is a "fanatic" it is those who call people "fantcics" for believing what the national medical associations say.

If you choose not to believe them, and instead believe people like Brian Morris and Jake, that's your right, but to call the others fanatics for believing the national medical association makes you sound very fanatical IMO.

IMHO, I call people fanatics who will not change their
view point no matter what evidence is presented.

There is a plethora of evidence for the health benefits of
circumcision. And all of the "evidence" against circumcision
has been shown to be incorrect.

I don't "believe" people like Brian Morris and Jake, I look
at what they have to say, and what evidence they present.

They have a lot more to offer about this topic than any of
the anti-circ people here.

The British Columbia College of Physicians and Surgeons' 9/09 report declared:

"Infant male circumcision was once considered a preventive health measure and was therefore adopted extensively in Western countries. Current understanding of the benefits, risks and potential harm of this procedure, however, no longer supports this practice for prophylactic health benefit. Routine infant male circumcision performed on a healthy infant is now considered a non‐therapeutic and medically unnecessary intervention. . . . Circumcision removes the prepuce that covers and protects the head or the glans of the penis. The prepuce is composed of an outer skin and an inner mucosa that is rich in specialized sensory nerve endings and erogenous tissue. Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death. The benefits of infant male circumcision that have been promoted over time include the prevention of urinary tract infections and sexually transmitted diseases, and the reduction in risk of penile and cervical cancer. Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended.

www.cpsbc.ca/files/u6/Circumcision-Infant-Male.pdf

But I didn't see any pointers to evidence supporting what they said.

Here in the US, the AAP and CDC are overdue to update their
statements. At least the CDC said its statement would be
evidence based. Let's hope the AAP does thinks the same way.

So then the national medical associations are "fanatics" because tehy don't believe your "plethora" of evidence. Again, I think it's you who sounds fanatical.

I haven't called you a fanatic for believing Brian Morris and Jake. I say you sound like a fanatic when you call others fanatics for believing the national medical associations. Again, by your reasoning, the national medical associations are fanatics. That sounds very fanatical to me.