On this Thanksgiving Day in America -- I know Canada celebrates it earlier and I don't know about other countries -- I am grateful for circumcision, a very minor procedure that has a major impact on the health of so many.
I am thankful I live in a country where the right of every parent to circumcise is both maintained and encouraged. It is true that a very very small minority of fanatics is trying to take that right away, but freedom to raise your children in a healthy way is inherent in American values. As long as parents are guaranteed those rights, circumcision will be as American as the pumpkin pie we eat today. Every baby boy has the right to be circumcised, clean-cut, and disease-free, and I give thanks that America will always be a circumcised country.
I am thankful for all the US doctors who work hard to produce the scientific studies that support universal circumcision. I am thankful for the Centers for Disease Control and the American Academy of Pediatrics for resisting the absurd claims of foreskin lovers. I hope both the CDC and AAP can resist political pressure from these few and declare, once and for all, that every male should be circumcised.
I am thankful for all of you -- whether pro or anti-circ -- for engaging in this debate in a positive manner. I hope this blog has been a positive contribution to the ongoing debate. As long as you enjoy it and use it, I'll keep posting.
Happy Thanksgiving!
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I am thankful my son has his entire penis. I am thankful I had the wits to ask if such a procedure was necessary when I was pregnant. I am thankful it isn't hard to find the right info about circ here in Canada if you ask any trained medical professional. I am thankful circumcision isn't covered by OHIP anywhere in Canada. I am thankful the western world seems to be slowly catching on about routine circumcisions being barbaric and wrong. Happy Thanksgiving.
ReplyDeleteMr. Morris,
ReplyDeleteAmerica was founded based on religious freedom. Many of us have religious reasons for keeping our sons and daughters intact. Circumcision is mainly a risky cosmetic procedure and it is not the parent's choice to make.
Additionally, there are significant sexual reasons for keeping both boys and girls intact. The foreskin contains tens of thousands of highly speciallized nerve endings, as you are well aware. I will educate my intact son to use condoms during non-monogamous sexual encounters (as should all young adults)... this has *proven* effectiveness in reducing both STD risks and unintended pregnancies.
It's remarkable how confidently anti-circumcision activists make unsupportable claims. "The foreskin contains tens of thousands of highly speciallized nerve endings" is an amusing statement, given that no study to date has counted the number of nerve endings in the foreskin, specialised or otherwise.
ReplyDeleteBy the way, who is the Mr Morris to whom your message is addressed?
It's remarkable how Jake, who got his penis cut to his own specification as an adult, is so quick to continue his smirking comments, this time with his "amusing statements." This is not the first time Jake has said he is amused over things others find painful. I have a large ring of scar tissue that I didn't ask for - a result of mandatory circumcision from my point of view - and scars don't feel a thing, whether 2 or 10,000 nerve endings were lost. But Jake would need a study to believe that.
ReplyDelete"It's remarkable how confidently anti-circumcision activists make unsupportable claims. "The foreskin contains tens of thousands of highly speciallized nerve endings" is an amusing statement, given that no study to date has counted the number of nerve endings in the foreskin, specialised or otherwise. "
ReplyDeleteStudies do show that the five most sensitive part of the male penis are removed during circumcision and that the glands on the intact male penis are more sensitive than that of the circumcised penis.
http://www.nocirc.org/touch-test/bju_6685.pdf
Studies do show that the five most sensitive part of the male penis are removed during circumcision and that the glands on the intact male penis are more sensitive than that of the circumcised penis.
ReplyDeleteI think you'll find that's a study, not "studies", and - as Prof Morris and I showed in the Letter to the Editor cited below - the claim was erroneous.
http://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTART
And I see the faulty statistical analysis by Waskett & Morris was in turn debunked. Waskett's whole claim depends, as it turns out, on the misuse of the Bonferonni Correction to draw the opposite conclusion that anyone with eyes would make from the data. Waskett did this by claiming that there were multiple comparisons between circumcised and intact men that skewed the results in favor of intact men, in effect claiming that structures missing from circumcised men could be mapped to those present in intact men, and structures in intact men could be mapped to those missing in circumcised men.
ReplyDeleteThe synopsis of Jake's position is this bit of absurdity: there's no evidence that the amputation of sexually sensitive tissue results in the loss of sexual sensation.
That's a fine belief for men who want to get circumcised, as indeed Jake did.
The majority of men who get circumcised later in life are doing so because of medical conditions ( ie phimosis ). Studies done on these men are obviously going to be flawed, because they don't have a normal functioning foreskin to compare to. For example, if you did a "study" on a group of 50 people who had painful tumors on their hands that had been there since adolescence and were then advised to get the infected parts amputated, it is very likely they would be happy with the amputation, and relief of pain. Does that then mean that people with healthy functioning limbs who had the same parts amputated would have the same satisfaction? no.
ReplyDeleteHere is one quote of many on a website from men who were circumcised as adults without a medical condition.
" After thirty years in the natural state I allowed myself to be persuaded by a physician to have the foreskin removed—not because of any problems at the time, but because, in the physician’s view, there might be problems in the future. That was five years ago and I am sorry I had it done. . . . The sensitivity in the glans has been reduced by at least 50 percent. There it is, unprotected, constantly rubbing against the fabric of whatever I am wearing. In a sense, it has become callused. . . . I seem to have a relatively unresponsive stick where I once had a sexual organ.( 7) "
http://www.circumcision.org/adults.htm
Taking things to the extreme, you cannot say that every man is satisfied with his circumcision. Look at any foreskin restoration site to see how many men wish they had been left intact. There can be ugly scars, tight painful erections from too much skin being removed, and bent penises. Taking that into consideration, there is no way of knowing whether or not your 2 day old infant would choose circumcision for himself. You are forever taking that choice away. Let him decide for himself.
I also find it humorous how many pro circumcision advocated site UTIs as a legitimate reason to circumcise infants. They never discuss Meatal Stenosis. This is a condition that effects 8-10 percent of circumcised boys that requires surgery to correct. "Meatal stenosis is an abnormal narrowing of the urethral opening (meatus). If the narrowing becomes significant, urine will have difficulty flowing from the bladder and may cause the bladder to not empty completely. If left untreated, this can lead to urinary tract infections and kidney problems.
Meatal stenosis is a common complication of circumcision, caused from chronic exposure of the irritating effects of urine on the meatus and rubbing of the meatus on a diaper or clothing."
"Another hypothetical cause of this condition is ischemia due to damage to the frenular artery during circumcision, resulting in poor blood supply to the meatus and subsequent stenosis. In a prospective study of circumcised boys, Van Howe (2006) found meatal stenosis in 24 of 239 (7.29%) children older than 3 years, making meatal stenosis the most common complication of circumcision.1
Frequency:
Meatal stenosis affects 9%-10% of males who are circumcised."
http://emedicine.medscape.com/article/1016016-overview
http://www.cincinnatichildrens.org/health/info/urinary/diagnose/meatal-stenosis.htm
I am thankful for Dr David Shaw:
ReplyDeleteDaily Telegraph (London)
November 27, 2009
Circumcising boys for religious [or other non-theraputic] reasons 'could breach Human Rights Act'
By Rebecca Smith, Medical Editor
Dr David Shaw, lecturer in ethics at Glasgow University, argues that circumcising boys for no medical reason is unethical.
He wrote in the journal Clinical Ethics that any doctor who does perform circumcision without a medical reason could be guilty of negligence and in breach of the Human Rights Act as the child cannot consent to the operation and it can be argued it is not in their best interests.
how about the sorrell's fine touch study where they proved the parts removed are up to 4 times as sensitive, you pro genital mutilation people are sick, I have a restored my foreskin (as far as what can be restored) and it's incredible how much of a difference it makes and sad that you want to bring other people down to your reduced level of pleasure
ReplyDeleteCircumcised and grateful
ReplyDeleteI am a male, circumcised as a one-day old infant. I want to add a few more things to the blog owner’s original post that apparently had sparked all this anti-circ rhetoric. Not all of us, btw, buy into the anti-circ rants.
I thank my parents for caring enough to do what was probably a difficult decision: whether or not to circumcise their newborn son. They gave me the gift of circumcision because they love me and wanted to give me a problem-free, infection-free, hygienic penis. So thank you. I appreciate it every day.
Yes, I’m thankful I was circumcised in infancy. While I did not choose circumcision of my free will, I do not miss being uncircumcised. I have never experienced a penis with a foreskin, so why would I possibly miss it? In any event, I have no memory of the circumcision procedure or the healing process. Better to get the procedure over and done with before you can remember the pain.
I’m thankful for being with a beautiful, caring, loving woman. A woman who is very sensual, and who thinks my penis is a thing of great beauty. She also happens to think that circumcised penises are more handsome, and believes all baby boys should be circumcised. She has told me she, too, is thankful for having a circumcised man, and even teases me during foreplay by trying to cover the glans with my remaining shaft skin (of course she can’t, but just trying is fun). She has told me in no uncertain terms that cleanliness of the male genitals is extremely important for her, and that circumcision helps keep the penis clean and makes it easier to keep that way.
One special note on cleanliness. It’s not just the ladies who think it’s really important. Plenty of us guys want to be clean and that’s why we wash ourselves at least once a day. In between these washings, a circumcised penis stays clean and dry, and is usually odor-free (unlike the much harder to maintain uncircumcised version). That’s more than enough to make me thankful for my circumcision.
Last, but not least, I’m thankful for the way it feels. That’s right, being CIRCUMCISED FEELS GREAT!! Both for the man AND the woman.
For the woman, if feels good to feel the rim of the knob going in and out of her vagina. Not to mention, feeling the knob itself. It’s also more convenient for masturbating a penis and oral sex and: no foreskin getting in the way, freeing up both hands for better things.
For the man, the circumcision scar is a major hot-spot, as is the frenulum (or the frenulum area, if it was cut). I happen to like the tightness of the shaft skin when erect, and enjoy the feeling of the knob rubbing against clothing while I walk. I like the fact that my knob is permanently exposed, yet still extremely sensitive to any kind of touch – be it clothing, water, or mucous membrane like inside the mouth, vagina, or anus.
I don’t intend to offend anyone by this sometimes graphic post. I just want all the anti-circ people to know that many people think exactly the opposite of their views on the whole subject of circumcision. Can we not just agree to disagree?
"Last, but not least, I’m thankful for the way it feels. That’s right, being CIRCUMCISED FEELS GREAT!! Both for the man AND the woman. "
ReplyDeleteAs you stated earlier in your post, there is no way you could know what you are missing and therefore no way you could know which you prefer. I think the cleanliness issue is ridiculous. A woman has MANY more folds, crevices, skin and smegma than any intact man and yet we don't see that being used as an argument to circumcise girls in the United States. In fact, we condemn many African countries for circumcising their daughters for the very same reasons we circumcise our sons in the United States, cleanliness, ease to take care of, visually pleasing to the male, and reduction in STDs. Note that only 20 percent of female circumcisions actually involves cutting the clitoris. The majority of circumcision is cutting the labia and clitoral hood, leaving the most important parts intact, just like male circumcision.
Here is a study that was done to determine what most women preferred.
"A New Zealand study found that reduced female arousal and fewer female orgasms may be linked to women having sex with circumcised male partners. Women reported they were about twice as likely to experience orgasm if their male partner had a foreskin.
Nine out of ten women prefer having sex with intact men, the study finds.
"Presence of the movable foreskin makes a difference in foreplay, being more advertisement arousing to the female," the study says. "Most likely, reported vaginal dryness and the related clinical designation `female arousal disorder' is but a normal female response to coitus with a man with an iatrogenically [doctor caused] deficient penis."
The foreskin is double-layered. During intercourse, the moist and pliant foreskin rolls past itself massaging the vagina and exciting it more than the 'dry stick' of a circumcised penis. The foreskin keeps the glans moist and soft aiding in foreplay, insertion, and intercourse. Dry or painful sex is the number one sexual complaint of women in the United States.
"During intercourse, the skin of an intact penis slides up and down the shaft, stimulating the glans and the nerves of the inner and outer foreskin. On the outstroke, the glans is partially or completely engulfed by the foreskin with more skin remaining inside the vagina than is the case with the circumcised penis. This `valve' mechanism is thought to retain the natural lubrication provided by the female because the bunched up skin acts to block the lubrication escaping from the vagina, which results in dryness."
About 70% of American men alive today are circumcised. About 60% of U.S. baby boys are circumcised each year. It is illegal to circumcise girls in the United States. "
As a woman, this all makes sense and is completely true. I have been with both, and although my husband is circumcised, I do prefer the feeling of foreskin. With a circumcised man, I have to use lubrication because the ridge pulls out the natural moisture of most women.
I encourage you to look at this site http://www.sexasnatureintendedit.com/10F/1hook_scrapes.html
(( WARNING graphic material))
In any case, you are happy with your circumcision and that is great. I am in no way implying that all men who are circumcised are unhappy with their circumcision status, but you don't speak for every man. There are plenty who wish they had been left intact, just look at any foreskin restoration forum. No one can know what their 2 day old infant would choose for himself as an adult. Once you cut the foreskin, there is no way to restore everything that was lost. A man can always get circumcised later in life, however.
And I see the faulty statistical analysis by Waskett & Morris was in turn debunked.
ReplyDeleteIncorrect.
Waskett's whole claim depends, as it turns out, on the misuse of the Bonferonni Correction to draw the opposite conclusion that anyone with eyes would make from the data.
Incorrect again, I'm afraid. If you examine Sorrells' Table 2, you'll see that there is in fact only a single point with a p value less than 0.05 (that is, there is only a single comparison with a statistically significant result). So Sorrells' claim that there are five such points is clearly false. The Bonferroni correction comes into play when examining this single point.
Waskett did this by claiming that there were multiple comparisons between circumcised and intact men that skewed the results in favor of intact men,
Um, no, that isn't what we said. There were, however, multiple comparisons between different points, as evidenced by the multiple p values (one per comparison) in Sorrells' Table 2. And when you perform multiple significance tests, you increase the probability of a false positive occurring through chance alone. That's why you need to perform a correction, to adjust for this possibility. And when you perform that correction, that one point is no longer statistically significant.
in effect claiming that structures missing from circumcised men could be mapped to those present in intact men, and structures in intact men could be mapped to those missing in circumcised men.
Sorry, that's incomprehensible.
The majority of men who get circumcised later in life are doing so because of medical conditions ( ie phimosis ). Studies done on these men are obviously going to be flawed, because they don't have a normal functioning foreskin to compare to.
ReplyDeleteThere might be some bias, but I think you're overstating your case here somewhat. After all, if circumcision were half as damaging as anti-circumcision lobbyists would have us believe, the harm would be obvious even if the penis were not 100% beforehand.
Regardless, the following studies should address your concerns, since the study populations consisted of thousands of healthy volunteers. As you can see, the results were very positive:
http://www.ncbi.nlm.nih.gov/pubmed/18086100
http://www.ncbi.nlm.nih.gov/pubmed/18761593
I also find it humorous how many pro circumcision advocated site UTIs as a legitimate reason to circumcise infants. They never discuss Meatal Stenosis. This is a condition that effects 8-10 percent of circumcised boys that requires surgery to correct.
First, it seems rather an overstatement to claim that it affects 8-10%. I can think of several studies that have reported rates outside of that range - Griffiths (2.9%), Yegane (0.9%), Leitch (1.5%), Cathcart (0.01%), and Sorensen (0%) spring to mind.
Second, it doesn't require surgery. See: http://www.ncbi.nlm.nih.gov/pubmed/15008738
Third, it is remarkably simple to prevent. See: http://www.ncbi.nlm.nih.gov/pubmed/19101896
Thank you, Paul, for your very cogent additions to my list of "thanks" during this Thanksgiving weekend. You did so in a respectful manner that obviously picked up where I left off.
ReplyDeleteI bet 99.9 percent of circumcised dudes secretly thank their parents they were circumcised at birth, even if we fail to say so. I actually told my parents once -- yeah, it was kinda awkward -- but I did it with my parents while at an art museum I was dragged to a few years ago. LOL. Anyways, looking at some uncircumcised dude in a picture, I said to my parents, "Sure glad you had me clean cut so I don't look like that!" My dad laughed, "Of course. Why wouldn't we? Nobody really wants to look like that!"
That was about it, but I think he got the message loud and clear that I was grateful not to have a filthy foreskin.
We should all give thanks to our parents who do the right thing when we are born. In an earlier blog, I gave special praise and thanks to uncircumcised fathers who are smart enough to circumcise their sons. They are giving their boys the greatest gift of all.
Commenters to this blog can get off the track of the thread very easily. Thank you, Paul, for bringing us back. This is a weekend of thanks for circumcision!
"A surgical procedure called a meatotomy is the most reliable form of treatment. This procedure involves an incision to enlarge the meatus or opening, which can be performed in clinic or in the operating room depending on the degree of stenosis. Recurrence after this procedure is rare, as long as appropriate after care is given by the parent."
ReplyDeletehttp://www.thechildrenshospital.org/conditions/urinary/conditions/Meatal-stenosis.aspx
Although creams can be applied, the recurrence rate is significantly higher. The most reliable treatment is a meatotomy, which is surgery.
Also, "What can be done to prevent the condition?
Meatal stenosis cannot always be prevented. In a recently circumcised boy, frequent diaper changes may decrease the risk. " There is no way to prevent meatal stenosis, just ways of MAYBE decreasing the risk.
http://www.medicineonline.com/articles/M/2/Meatal-Stenosis.html
Also, changing diapers only decreases the risk of meatal stenosis via means of diaper rubbing.
"Meatal stenosis is common in circumcised boys, and is thought to be from scarring of the meatus, which usually occurs prior to potty training, and as the result of the glans rubbing on the wet diaper or from poor blood supply due to ligation of the frenular artery during circumcision (Brown et al., 1997). "
Only way I know of preventing ligation of the frenular artery during circumcision is to leave a baby intact.
In any case, I only brought up Meatal Stenosis because it's a common condition that pro circumcision advocates rarely discuss. I am by no means suggesting that this is a serious complication, but I think it it no more serious than a UTI. And since meatal stenosis comes with an increase risk of UTIs....
Anyway, I am a 23 year old female and I have had two UTIs in my lifetime. Once at 13 and once at 19. Although they are not fun by any stretch of the imagination, I have menstrual cramps every month that cause me more discomfort than my UTI. I didn't cut off my parts to prevent future ones because it was easily treated with a weeks worth of antibiotics, and I don't see why boys should be different. This is the United States we are talking about here, not some third world country where some doctors still think tying a chicken leg around your neck is a cure for diabetes. ( not really, you get what I'm saying haha )
I can imagine if I were a man, I would rather have an increased risk for a UTI in the first year of life that I wouldn't remember than have to have surgery at four years old that I would most likely remember. ( minor though it is )
Evangeline, you previously said that meatal stenosis "is a condition that [...] requires surgery to correct." I provided evidence showing that this is not the case - there are proven non-surgical treatments. In the study I cited, of eighteen patients, 14 (78%) were successfully treated with home dilatation, in other words is not always required.
ReplyDeleteNow, it may well be the case that "The Children's Hospital" prefer other treatments, but we weren't talking about treatments preferred by that particular hospital.
Furthermore, I also provided evidence showing that meatal stenosis is easily prevented. In the study I cited, which is a randomised controlled trial, 6.6% of 197 boys in the control group developed meatal stenosis. However, of 197 boys in the group given topical use of a lubricant jelly after circumcision, none (0%) developed meatal stenosis. That seems a very effective method of prevention to me - do you disagree?
I hadn't actually mentioned changing diapers in order to decrease the risk of meatal stenosis, so I am perplexed as to why you bring that up. Did you actually read the links I supplied?
Let me clarify. I didn't mean that you had stated changing diapers would decrease the risk. I was attempting to distinguish the difference of the two ways meatal stenosis has been shown to occur via circumcision. From the diaper rubbing the glands, and damage to the frenular artery during circumcision.
ReplyDeleteAlso, I was hoping you would reply to my comment on your earlier post asking how sexually active men in Africa have equal risk factors to infants in the United States? Since you said, I quote, " if you want to compare two or more countries by examining their HIV and circumcision rates, you MUST ensure that their exposure levels to all other risk factors are equal."
Sorry to bring this up in this post, but I really wanted to hear your opinion as these African trials, which are extremely flawed, as these studies have been used countless of times by pro circumcision lobbyists as a reason to circumcise infants in the United States, who are not having sex and are not in a country where, in some cases, over 20 percent of its population has HIV/AIDS.
Forgot to mention one other point about Thanksgiving.
ReplyDeleteI am thankful to ProvokingDebate for this excellent blog. It gives a voice to the silent majority of men and their partners who are perfectly happy with their circumcisions and who appreciate the benefits of a clean-cut penis. The Internet is full of anti-circs, who are a small, but vocal minority.
ProvokingDebate and a few other brave souls aren't afraid to tell the world about the benefits of infant male circumcision and to promote and encourage the routine circumcision of all newborn baby boys. Keep up the good work, our fight is a good one, and we have thousands of years of proven benefits on our side.
As a side note, I realize some men (and their female partners) don't share our view. You're entitled to your opinion, and if you feel very strongly against your own circumcision, there's nothing stopping you from restoring your precious little skin if you so very much want to be uncircumcised. But I do have a problem with people who want to deny boys their right to circumcision and the many health and hygiene benefits of owning a clean-cut circumcised penis.
Let me clarify. I didn't mean that you had stated changing diapers would decrease the risk. I was attempting to distinguish the difference of the two ways meatal stenosis has been shown to occur via circumcision. From the diaper rubbing the glands, and damage to the frenular artery during circumcision.
ReplyDeleteOkay, thanks for clarifying.
Circumcision hasn't actually been shown to cause meatal stenosis through either of these ways. (In fact, strictly speaking it hasn't even been shown that it causes meatal stenosis, but it seems plausible that it does.) Both of the ways you mention are hypothetical, as is obvious from the source you cited, which says "..is thought to be from..." Anyway, the glans rubbing on diapers hypothesis is quite consistent with Bazmamoun's study, which showed that applying lubricant to the glans (thus protecting against rubbing) effectively eliminated the risk.
Also, I was hoping you would reply to my comment on your earlier post asking how sexually active men in Africa have equal risk factors to infants in the United States?
Infants become adults, obviously, but the two environments are certainly different. Specifically, the prevalence of HIV is about 0.6% in the United States, but in parts of Africa can be as high as 35%.
Fortunately that doesn't matter, because relative risk is what is of interest, and that's unaffected by the absolute risk.
I'm sure that the exposure to many risk factors is different between the two environments, but that's not an issue because we're not trying to draw conclusions about the association between circumcision and HIV by comparing the two. We already have high-quality studies, and all that remains is to apply the results of those studies to another environment.
" As a side note, I realize some men (and their female partners) don't share our view. You're entitled to your opinion, and if you feel very strongly against your own circumcision, there's nothing stopping you from restoring your precious little skin if you so very much want to be uncircumcised. But I do have a problem with people who want to deny boys their right to circumcision and the many health and hygiene benefits of owning a clean-cut circumcised penis."
ReplyDeleteI, personally, don't want to "deny" men their right to circumcision. I find nothing wrong with adult men choosing circumcision for themselves, but they should not deny children the right to a whole body. Foreskin restoration never restores everything that was lost. It only stretches existing skin over the glands. Getting circumcised as an adult, however, yields the same if not better results than the the average infant circumcision. Adult circumcision can be done by a plastic surgeon who is able reduce the look of scars and, as the penis reaches its adult size by teenage years, the likelihood of taking too much skin is reduced and a man can dictate to a doctor how loose/tight he wants his circumcision as an adult. It is his penis, after all. He should decide whether or not he wants the foreskin removed.
Why do this on a non consenting baby? why not wait until they are older? Any alleged "benefit" of HIV/AIDS reduction, penile cancer, sexual pleasure, and other STD reductions will not be applicable until a person is sexually active. Circumcision will still give these alleged "benefits" when done on an adult.
"Infants become adults, obviously, but the two environments are certainly different. Specifically, the prevalence of HIV is about 0.6% in the United States, but in parts of Africa can be as high as 35%. "
ReplyDeleteRight. Any alleged benefit of circumcision would not be applicable until a person is sexually active, usually between the ages of 16-20. Not infants.Even proponents of circumcision acknowledge a man must still use condoms to prevent HIV/AIDS. Condoms already provide an almost 100 percent protection against HIV/AIDS.
The idea that we should apply studies that were highly flawed to infants in the United States is ridiculous. HIV/AIDS is not even considered an epidemic in the United States. Not to mention that female to male HIV transmission in the US (which has been the only form of transmission that has shown any kind of reduction via circumcision) is extremely rare and one of least common means of HIV transmission in the United States. Homosexual anal sex being the most common. Also, as I stated in my other post, circumcision has been shown to increase the chance of women getting HIV/AIDS from men, largely in part as a result of the increased friction to the vagina that circumcised penises produce.
I'm thankful to be circumcised, especially now that so much scientific evidence is coming to light about the benefits of circumcision. I don't think there is any need for rage on either side of this debate. To me the scientific evidence is clear and it supports universal male circumcision. Those who are against circumcision are free to keep their boys uncircumcised even if the scientific community in the U.S., based on scientific evidence, decides to promote the universal use of circumcision. Why get upset about the choices people make for their children? There may be some men who are upset about having been circumcised as infants. But does anyone have statistics as to the percentage who are upset? I have only met one man who claims that he was robbed of something because he was circumcised as an infant. But this is a man who has so many other issues and can't stop talking about them that he has lost friends who just don't want to hear his issues anymore. No one else has ever complained and those who have been around my friend when he has complained have said they have no problem being circumcised. All I can say is that if the scientific evidence supports universal circumcision, the scientific community has an obligation to support it. No one is forced to follow recommendations. I have not had the flu shot for several years even though it is highly recommended. But I wouldn't go into a rage trying to convince others not to get the flu shot. I understand that in the case of routine infant circumcision a choice is being made for someone who can't make a choice, a male infant. But I believe parents should have the right to make that choice. There are those who want to take that right away. I don't agree with them. They don't agree with me. If those against routine infant circumcision want to pass legislation to take away the parents' right to circumcise their son, they can work to do that. I don't believe they will win as I would wager that most of our male legislators are circumcised and most have no problems with their lack of a foreskin. As the scientific evidence mounts in support of universal circumcision, there may be few if none who would vote to take away the parents' right to circumcise their baby boy.
ReplyDeleteRight. Any alleged benefit of circumcision would not be applicable until a person is sexually active, usually between the ages of 16-20. Not infants.
ReplyDeleteLast time I checked, though, infants grow up to become adults.
Even proponents of circumcision acknowledge a man must still use condoms to prevent HIV/AIDS. Condoms already provide an almost 100 percent protection against HIV/AIDS.
80 percent, actually. See:
http://www.cochrane.org/reviews/en/ab003255.html
The idea that we should apply studies that were highly flawed to infants in the United States is ridiculous. HIV/AIDS is not even considered an epidemic in the United States. Not to mention that female to male HIV transmission in the US (which has been the only form of transmission that has shown any kind of reduction via circumcision) is extremely rare and one of least common means of HIV transmission in the United States.
It's important to bear in mind that circumcision is already widespread in the United States, so to a large extent your argument is (to paraphrase) "there's no point in doing X (which reduces HIV) because we already do X and HIV rates are low". The obvious response is, if the US didn't do X, wouldn't it be reasonable to expect that rates of HIV would be higher?
Homosexual anal sex being the most common.
And there is some evidence (albeit not as conclusive as for heterosexual sex) that circumcision is protective for the insertive partner here, too.
Also, as I stated in my other post, circumcision has been shown to increase the chance of women getting HIV/AIDS from men, largely in part as a result of the increased friction to the vagina that circumcised penises produce.
Incorrect, I'm afraid. The only randomised controlled trial found no statistically significant difference. See: http://www.ncbi.nlm.nih.gov/pubmed/19616720
"It's important to bear in mind that circumcision is already widespread in the United States, so to a large extent your argument is (to paraphrase) "there's no point in doing X (which reduces HIV) because we already do X and HIV rates are low". The obvious response is, if the US didn't do X, wouldn't it be reasonable to expect that rates of HIV would be higher?"
ReplyDeleteIt is also important to bear in mind that circumcision has not produced the same results in modern industrialized nations, which are more similar by huge proportions than the US and Sub Saharan Africa.
"The United States HIV incidence rate is 3.5 times higher than that of the closest advanced industrialized nation. Storms 28 and Nicoll 32 noted that the high incidence of male circumcision in the US did nothing to prevent the spread of this infection. Nicoll, in fact, states that "the US is the industrialized country most burdened with HIV."32
These observations should not necessarily lead us to conclude that circumcision increases HIV risk. However, it does suggest that attempts to control HIV by imposing mass circumcision on populations are unlikely to be successful. "
You said " Incorrect, I'm afraid. The only randomised controlled trial found no statistically significant difference."
Wrong. See : http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
Dr. Maria Wawer conducted that study and said in an interview with VoA, "Yes, of course we are disappointed," she said. "But the data are what the data are."
It ended early due to futility.
Even if the only trial found no difference in male to female transmission that still makes a huge difference when applying the African studies to the United states, as male to female transmission is much more prevalent than female to male transmission here.
So, by your own admission, circumcision has at best shown no difference in male to female AIDS/HIV transmission, has not shown any conclusive evidence of reducing transmission through homosexual anal sex or heterosexual anal sex, and obviously can't account for any decrease in HIV transmission through drug needles.
Hmmm. So out of the five most prevalent means of contracting HIV in the United States it has shown, at best, no conclusive evidence in preventing four of them. Interesting. The only one it has shown any prevention in is consequently an extremely rare form of HIV/AIDS transmission in the United States.
I'm thankful that circumcision is not mandatory in the U.S., despite advocates like Jake and PD. I'm thankful that circumcision rates, and rates of all sexual surgeries performed on non-consenting minors, e.g. clitordectomy, are declining in U.S., despite the efforts of circumcisers and "doctors." I'm thankful that the sick sexual fetishes and fantasies displayed by PD and Jake do not excite most people, and more and more parents are deciding not to cut off sexual tissue from their children.
ReplyDeleteAs someone who was circumcised as an adult, I agree with Paul:
ReplyDelete1. Better to get the procedure over and done with before you can remember the pain.
It would have been so much better to have had the procedure as an infant. The pain is not major but it still exists. And then there is the recovery period during which sex is out. Blue balls are more painful than the circumcision itself.
2. Circumcision helps keep the penis clean and makes it easier to keep that way.
There is no doubt about this. I used to feel nasty after sex and couldn't wait to clean up under the skin which would cover the head leaving a moist environment between the head and foreskin. Now there is no skin covering the head so I feel clean after sex.
3. Being CIRCUMCISED FEELS GREAT!!
It truly does feel great. The sensations are much better than before.
4. The circumcision scar is a major hot-spot, as is the frenulum (or the frenulum area, if it was cut). I happen to like the tightness of the shaft skin when erect, and enjoy the feeling of the knob rubbing against clothing while I walk. I like the fact that my knob is permanently exposed, yet still extremely sensitive to any kind of touch.
These are several of the reasons being circumcised feels great and much better than before. Being permanently exposed, the scar and frenulum area (my frenulum was removed) are highly sensitive to touch which is very pleasurable. The tightness is the best part. If you are uncircumcised, try holding your skin very tightly back as you masturbate and see if you don't explode as never before. Just like the scar and frenulum, since the knob is always exposed it naturally rubs against things like clothing and underwear which, again, is very pleasurable.
I certainly am thankful to be circumcised.
It is also important to bear in mind that circumcision has not produced the same results in modern industrialized nations, which are more similar by huge proportions than the US and Sub Saharan Africa. "The United States HIV incidence rate is 3.5 times higher than that of the closest advanced industrialized nation."
ReplyDeleteOnce again, this isn't a valid argument because comparison between nations cannot produce valid results unless those nations are identical except for a single factor.
Storms 28 and Nicoll 32 noted that the high incidence of male circumcision in the US did nothing to prevent the spread of this infection.
That's irrational: how could Storms or Nicoll know what HIV rates would have been if circumcision were less common?
Nicoll, in fact, states that "the US is the industrialized country most burdened with HIV."32
Whether Nicoll states it or not, it is a patently false claim. The HIV prevalence in Russia, for example, is nearly twice that in the US.
These observations should not necessarily lead us to conclude that circumcision increases HIV risk. However, it does suggest that attempts to control HIV by imposing mass circumcision on populations are unlikely to be successful. "
A nonsensical argument. Clearly the US will be doing some good things (from the viewpoint of HIV prevention) and some bad things. The only thing that we can reasonably conclude is that most industrial nations would be best advised not to be exactly like the US in every respect.
You said " Incorrect, I'm afraid. The only randomised controlled trial found no statistically significant difference."
Wrong. See : http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
That's a different link to the same study that I cited! And, just as I said, it reported: "adjusted hazard ratio 1·49, 95% CI 0·62—3·57; p=0·368". That p value is more than 0.05; in other words it is not statistically significant.
"Whether Nicoll states it or not, it is a patently false claim. The HIV prevalence in Russia, for example, is nearly twice that in the US."
ReplyDeleteSorry, I should have given a link to the site, the names had links and those numbers also had links to studies you could click. It wasn't just some random person named Nicoll ha! http://www.cirp.org/library/disease/HIV/#n72
And your statement about Russia is exactly my point. There is NO correlation between any countries that show circumcision or lack there of reducing or increasing HIV/AIDS transmissions. Just because studies have shown a decrease in transmission in Africa, where they don't have soap and clean water in many parts mind you, does not mean it will have any effect on the United States.
I find it funny how you mention that you can't compare statistics between countries when it shows a correlation between a higher circumcision rate and a higher circumcision rate but often use studies done in Africa, which is vastly different from the United States in almost every way possible as "reliable studies" that should then be applied to the United States.
There are many variables in Africa that are not applicable to the United States and weren't even controlled for during these "reliable studies". Such as the prevalence of HIV/AIDS transmission through dentist equipment, shots given by doctors, *Dry Sex practiced by many women in African countries, Genital Ulcer Disease ( which is endemic in many parts of Africa), whether or not their female partners were circumcised, whether or not they used drugs... I could go on. Almost none of these factors were controlled for when doing these African studies.
* Dry Sex: Studies from Zimbabwe, Zaire, Malawi, Zambia,The Central African Republic, and South Africa have documented the popular practice of drying and/or tightening the vagina by various methods of douching and/or application of leaves and powders to absorb the vaginal lubrication. Dry sex is a pervasive practice in sub-Saharan Africa. This practice is purported to increase sexual pleasure.
Reports indicate that dry sex dramatically increases HIV infection risk. Several reports document that dry sex causes various problems with condom usage. Dry sex is associated with an increased report of STDs in men. Several studies report increased HIV incidence among women. Vaginal dryness is associated with increased lesions, lacerations,peeling of the vagina, chlamydial infection, and epithelial trauma in both male and female, thus creating a portal of entry for HIV.
Because of this increased risk, dry sex is an obvious confounding factor in any study of HIV seroconversion vs. circumcision in sub-Saharan Africa. However, all of the approximately forty existing studies have ignored this potential confounding factor.
http://www.cirp.org/library/disease/HIV/#n72
"...in other words it is not statistically significant."
ReplyDelete"So, by your own admission, circumcision has at best shown no difference in male to female AIDS/HIV transmission, has not shown any conclusive evidence of reducing transmission through homosexual anal sex or heterosexual anal sex, and obviously can't account for any decrease in HIV transmission through drug needles.
Hmmm. So out of the five most prevalent means of contracting HIV in the United States it has shown, at best, no conclusive evidence in preventing four of them. Interesting. The only one it has shown any prevention in is consequently an extremely rare form of HIV/AIDS transmission in the United States."
CDC concluded no evidence showed circumcision effected the HIV/AIDS transmission through anal intercourse of homosexual or heterosexual anal intercourse.
"Circumcision, which has helped prevent AIDS among heterosexual men in Africa, doesn't help protect gay men from the virus, according to the largest U.S. study to look at the question.
The research, presented at a conference Tuesday, is expected to influence the government's first guidance on circumcision.
Circumcision "is not considered beneficial" in stopping the spread of HIV through gay sex, said Dr. Peter Kilmarx, of the U.S. Centers for Disease Control and Prevention.
...While HIV spreads primarily through heterosexual sex in Africa and some other parts of the world, in the United States it has mainly infected gay men. Only about 4% of U.S. men are gay, according to preliminary CDC estimates released at the conference this week. But they account for more than half of the new HIV infections each year.
Previous research has suggested circumcision **doesn't make a difference when anal sex is involved**. The latest study, by CDC researchers, looked at nearly 4,900 men who had anal sex with an HIV-infected partner and found the infection rate, about 3.5%, was approximately the same whether the men were circumcised or not."
http://blackchristiannews.com/news/2009/08/circumcision-doesnt-protect-homosexual-men-from-aids.html
Sorry, I should have given a link to the site, the names had links and those numbers also had links to studies you could click. It wasn't just some random person named Nicoll ha! http://www.cirp.org/library/disease/HIV/#n72
ReplyDeleteIt's okay, I realised you were quoting (and even if I hadn't recognised the prose, I would probably have guessed it was CIRP from the combination of pomposity and irrational argument). Anyway, my point remains the same.
And your statement about Russia is exactly my point. There is NO correlation between any countries that show circumcision or lack there of reducing or increasing HIV/AIDS transmissions.
Actually, there is quite a consistent correlation among developing countries. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1764746/?tool=pubmed
Just because studies have shown a decrease in transmission in Africa, where they don't have soap and clean water in many parts mind you, does not mean it will have any effect on the United States.
Are you suggesting that penes are different in Africa from those in the US?
I find it funny how you mention that you can't compare statistics between countries when it shows a correlation between a higher circumcision rate and a higher circumcision rate but often use studies done in Africa, which is vastly different from the United States in almost every way possible as "reliable studies" that should then be applied to the United States.
It's fairly simple science: when trying to ascertain the effect of a possible factor, you hold everything else equal so that you isolate the influence of that factor. Once you've established the effect of a factor, though, you can apply that knowledge anywhere.
There are many variables in Africa that are not applicable to the United States and weren't even controlled for during these "reliable studies". Such as the prevalence of HIV/AIDS transmission through dentist equipment, shots given by doctors, *Dry Sex practiced by many women in African countries, Genital Ulcer Disease ( which is endemic in many parts of Africa), whether or not their female partners were circumcised, whether or not they used drugs... I could go on. Almost none of these factors were controlled for when doing these African studies.
I beg your pardon? Almost all of these factors were effectively controlled for as part of the design of the studies themselves. Remember that something can only introduce bias if it affects circumcised vs uncircumcised groups unevenly. The whole point of randomisation to either the control or intervention group is to ensure that exposure to other risk factors is equal between the two groups. So, for example, whether a person engaged in dry sex would have no influence on which group he was assigned to. Consequently each group would have approximately equal numbers of dry sex enthusiasts, and as such it would not influence the results.
CDC concluded no evidence showed circumcision effected the HIV/AIDS transmission through anal intercourse of homosexual or heterosexual anal intercourse.
Presumably you're referring to Millett's 2008 meta-analysis (http://www.ncbi.nlm.nih.gov/pubmed/18840841). That meta-analysis is a little out-of-date; more recent studies that were not included have indicated that circumcision may offer some benefit to men preferring the insertive role. Millett has since co-authored a more recent review, cautiously suggesting some benefit for MSM: http://www.ncbi.nlm.nih.gov/pubmed/19935420
I don't think I am explaining myself well, here is an excerpt that might clarify what I am trying to say when talking about control factors.
ReplyDelete"So how do you go about conducting a randomized, controlled intervention trial looking at HIV infection in circumcised adult men? Probably not the way that these researchers did.
First, to be included in the study, men had to be HIV-negative and uncircumcised. The men also had to consent to "avoid sexual contact (except with condom protection) during the 6 weeks following the medicalized circumcision."
The experimental group which underwent the circumcisions was given the following instructions:
"When you are circumcised you will be asked to have no sexual contact in the 6 weeks after surgery. To have sexual contact before your skin of your penis is completely healed, could lead to infection if your partner is infected with a sexually transmitted disease... If you desire to have sexual contact in the 6 weeks after surgery, despite our recommendation, it is absolutely essential that you use a condom."
So the males in the study that underwent circumcision were not only told to abstain from sex for a significant time period after the operation -- reducing their exposure time by six weeks compared to the uncircumcised (control) group -- but told to use condoms, taught how to use them, and educated about their benefits. During this six week period, the men in the uncircumcised group did not have the same restrictions.
There also doesn't seem to be any mention of the researchers calling up the circumcised men after six weeks to say, "Okay, time's up. Ease up on the condom use from here on." The possibility that many of these men might have become accustomed to using condoms, armed with knowledge about their benefits, didn't seem to be much of a concern.
Also, other routes of HIV transmission like blood transfusion, IV needle sharing, or a dentist with dirty instruments (not unimaginable in Africa) don't seem to have been taken into account. Individual variables like hygiene were also poorly controlled for."
Another excerpt :
There is no debate that condom use is a better preventive for HIV infection than male circumcision. No debate. The world’s biggest fan of circumcision would tell you that condoms worked better. With the condom out of the mix, it’s no wonder that the HIV prevention effort in Africa gravitated towards a silver-bullet solution that wouldn’t run foul of the sex-negative dogmatism coming out of Washington. Now that Bush is out of the way, can we please just spend our efforts on getting condoms in circulation? Condoms work.
You might be thinking, “OK, I agree; let’s get condoms back in the mix, but if circumcision helps, why not do that too?” The danger of circumcision is that it implies an immunity it cannot deliver. Circumcision advocates concluded a recent article by saying “The authors believe it is at least as good as the HIV vaccine we have been waiting for, praying for and hoping to see in our lifetimes.”
This is a dangerous idea. Circumcision is in no way a vaccine. If circumcision is an HIV vaccine, me washing my hands is a flu vaccine. A real vaccine confers long term immunity to infection. Circumcision doesn’t confer any kind of immunity; it has only been shown to reduce infection risk and only for men, not for women. To make an analogy, a classic vaccine, like smallpox, is the equivalent of saying, “I’ve taken all of the bullets out of this revolver, go ahead and play Russian Roulette with it.” A risk reduction is like saying, “I’ve taken one of the two bullets out of this revolver. Good luck.”
One last excerpt about females and HIV/AIDS:
ReplyDeleteI view studies that highlight the advantages of male circumcision with the same suspicion that I, and most people, would view a study implying an advantage to female circumcision. But in case you think those don’t exist, they do: Check out this study showing reductions in female HIV rates among circumcised women. Ridiculous!? Not at all. It actually makes sense if the pro-male circumcision camp is correct about the mechanism of risk reduction conferred by male circumcision. The CDC reports on their website that male circumcision reduces risk because the foreskin has the penis’s highest concentration of Langerhans cells (immune system cells that actively protect against HIV until the viral load becomes too great, and then they transport the virus into the body).
Now take a wild guess about where ladies have their highest concentration of Langerhans cells: In their vulvas (all the fun parts outside of the vagina like the labia and clitoral hood). The concentration of Langerhans cells drops off towards the cervix.
A little critical thinking leads to the disturbing conclusion that safely performed female circumcision should give women an HIV risk reduction similar to that given men by safe male circumcision.
But if we were over in Africa engaged in a principled effort to reduce Langerhans cells to stem an AIDS crisis, wouldn’t we be “saving” everyone by trimming off everyone’s Langerhans cells, not just men’s Langerhans cells. Why do the male circumcisionists hate ladies so much that they’re leaving all their death-inviting Langerhans cells on them? Don’t they deserve the same protection from HIV that we’re blessing the African men with?
I point out this hypocrisy to put a bold question mark by the idea that the African male circumcision movement is an unbiased, principled public health effort. I believe instead that it is a misguided exercise of cultural bias.
I regress, there is no way you are going to convince me that cutting of a perfectly healthy part of a baby's penis is going to reduce the least likely means of AIDS/HIV transmission in the US by any dramatic amount in a country where AIDS is not even an epidemic. We don't propose cutting out girl parts to prevent AIDS or other STDs, why should men be any different? OK I am done.
I don't think I am explaining myself well, here is an excerpt that might clarify what I am trying to say when talking about control factors.
ReplyDeleteOkay, I'm happy to analyse it.
So how do you go about conducting a randomized, controlled intervention trial looking at HIV infection in circumcised adult men? Probably not the way that these researchers did.
First, to be included in the study, men had to be HIV-negative and uncircumcised.
Good grief, really? We want to study the rate at which men in each group become HIV positive, so it doesn't matter if they're HIV positive to begin with, does it? After all, you can just make them HIV negative again before the start of the trial. Oh, wait, that's impossible, so perhaps it would be sensible to select HIV negative men. And you want to randomise men to either the circumcision or the control group, so I guess it's okay if they're already circumcised. Oh, wait, same problem!
The men also had to consent to "avoid sexual contact (except with condom protection) during the 6 weeks following the medicalized circumcision."
Really? What would you prefer? Encourage them to have intercourse with an open wound? Come on, seriously?
The experimental group which underwent the circumcisions was given the following instructions:
[...]
So the males in the study that underwent circumcision were not only told to abstain from sex for a significant time period after the operation -- reducing their exposure time by six weeks compared to the uncircumcised (control) group
My goodness! I bet that never occurred to the researchers. I mean, if they'd thought of that, they might have tested HIV status at multiple intervals, so that they could determine whether any difference occurred in those six weeks, or whether the difference continued thereafter. But, of course, that's precisely what they did. See, for example, Auvert's Table 2: http://www.plosmedicine.org/article/slideshow.action?uri=info:doi/10.1371/journal.pmed.0020298&imageURI=info:doi/10.1371/journal.pmed.0020298.t003
-- but told to use condoms, taught how to use them, and educated about their benefits. During this six week period, the men in the uncircumcised group did not have the same restrictions.
Really? Men in the uncircumcised group weren't given condoms? Weren't educated about safe sex? Wrong. Quoting from Auvert: "At each of the four visits, each participant was invited to answer a face-to-face questionnaire, to provide a blood sample, and to have a genital examination and an individual counselling session. ... The counselling session (15–20 min) was delivered by a certified counsellor and focused on information about STIs in general and HIV in particular and on how to prevent the risk of infection. ... Condoms were provided in the waiting room of the investigation centre and were also provided by the counsellor."
There also doesn't seem to be any mention of the researchers calling up the circumcised men after six weeks to say, "Okay, time's up. Ease up on the condom use from here on." The possibility that many of these men might have become accustomed to using condoms, armed with knowledge about their benefits, didn't seem to be much of a concern.
As noted above, both groups were given condoms and educated about their use. The problem here seems to be failure to read the studies.
Also, other routes of HIV transmission like blood transfusion, IV needle sharing, or a dentist with dirty instruments (not unimaginable in Africa) don't seem to have been taken into account. Individual variables like hygiene were also poorly controlled for."
We've discussed these points above, where I explained how randomisation works.
I've reached the 4096 character limit; more in a moment.
Another excerpt :
ReplyDeleteThere is no debate that condom use is a better preventive for HIV infection than male circumcision. No debate. The world’s biggest fan of circumcision would tell you that condoms worked better.
Absolutely, when condoms are used consistently, they are roughly 80% effective vs roughly 60% for circumcision.
With the condom out of the mix, it’s no wonder that the HIV prevention effort in Africa gravitated towards a silver-bullet solution that wouldn’t run foul of the sex-negative dogmatism coming out of Washington. Now that Bush is out of the way, can we please just spend our efforts on getting condoms in circulation? Condoms work.
You might be thinking, “OK, I agree; let’s get condoms back in the mix, but if circumcision helps, why not do that too?”
Which is a logical question.
The danger of circumcision is that it implies an immunity it cannot deliver. Circumcision advocates concluded a recent article by saying “The authors believe it is at least as good as the HIV vaccine we have been waiting for, praying for and hoping to see in our lifetimes.”
This is a dangerous idea. Circumcision is in no way a vaccine. If circumcision is an HIV vaccine, me washing my hands is a flu vaccine. A real vaccine confers long term immunity to infection.
Not necessarily; many vaccines effectively reduce, but do not eliminate, risk.
Circumcision doesn’t confer any kind of immunity; it has only been shown to reduce infection risk and only for men, not for women. To make an analogy, a classic vaccine, like smallpox, is the equivalent of saying, “I’ve taken all of the bullets out of this revolver, go ahead and play Russian Roulette with it.” A risk reduction is like saying, “I’ve taken one of the two bullets out of this revolver. Good luck.”
Not entirely unlike condoms, then. With a condom, you're taking four bullet from five (80%). With circumcision, you're taking three from five (60%). So, don't bother with either, eh? Or wouldn't it be more sensible to say, use whatever's available, but don't be complacent?
More in a moment.
One last excerpt about females and HIV/AIDS:
ReplyDeleteI view studies that highlight the advantages of male circumcision with the same suspicion that I, and most people, would view a study implying an advantage to female circumcision.
And just how would people view such a study? The implication seems to be that the author would be suspicious of a scientific result because of horror towards a procedure. That doesn't seem very rational. In fact, it's nothing more than prejudice.
But in case you think those don’t exist, they do: Check out this study showing reductions in female HIV rates among circumcised women. Ridiculous!? Not at all.
You haven't copied the link, but presumably it is to Stallings' IAS presentation, a study that noted a spurious association between FGC and HIV, noted (slide 11) that this result was different from three previous studies, all of which found no significant associations, and concluded that the result was due to confounding (slide 38).
So, basically, this is a situation quite unlike male circumcision.
It actually makes sense if the pro-male circumcision camp is correct about the mechanism of risk reduction conferred by male circumcision. The CDC reports on their website that male circumcision reduces risk because the foreskin has the penis’s highest concentration of Langerhans cells (immune system cells that actively protect against HIV until the viral load becomes too great, and then they transport the virus into the body).
The author is being a little economical with the facts. The CDC identify this, along with multiple other mechanisms: "Compared with the dry external skin surface, the inner mucosa of the foreskin has less keratinization (deposition of fibrous protein), a higher density of target cells for HIV infection (Langerhans cells), and is more susceptible to HIV infection than other penile tissue in laboratory studies [2]. The foreskin may also have greater susceptibility to traumatic epithelial disruptions (tears) during intercourse, providing a portal of entry for pathogens, including HIV [3]. In addition, the microenvironment in the preputial sac between the unretracted foreskin and the glans penis may be conducive to viral survival [1]. Finally, the higher rates of sexually transmitted genital ulcerative disease, such as syphilis, observed in uncircumcised men may also increase susceptibility to HIV infection [4]."
Now take a wild guess about where ladies have their highest concentration of Langerhans cells: In their vulvas (all the fun parts outside of the vagina like the labia and clitoral hood). The concentration of Langerhans cells drops off towards the cervix.
A little critical thinking leads to the disturbing conclusion that safely performed female circumcision should give women an HIV risk reduction similar to that given men by safe male circumcision.
And still more critical thinking would recognise that this is a hypothesis that can be tested. If true, then most studies of FGC and HIV should have found that FGC reduces the risk of HIV. But in fact, 75% of studies (3 of 4) have shown no statistically significant association. Time to reevaluate that hypothesis?
But if we were over in Africa engaged in a principled effort to reduce Langerhans cells to stem an AIDS crisis, wouldn’t we be “saving” everyone by trimming off everyone’s Langerhans cells, not just men’s Langerhans cells. Why do the male circumcisionists hate ladies so much that they’re leaving all their death-inviting Langerhans cells on them? Don’t they deserve the same protection from HIV that we’re blessing the African men with?
The author is apparently unaware of the importance of testing a hypothesis before using it as a basis for argument.
Will finish shortly.
I point out this hypocrisy to put a bold question mark by the idea that the African male circumcision movement is an unbiased, principled public health effort. I believe instead that it is a misguided exercise of cultural bias.
ReplyDeleteThe author hasn't even established that there is any hypocrisy to point out. His/her apparent method of doing so is as follows. First, (s)he selects a single, anomalous study that happens to suit his case, ignoring the inconvenient fact that the others fail to do so. Next, (s)he selects a single biological mechanism that he can use to argue his case, ignoring the others. This is laughable!
I regress, there is no way you are going to convince me that cutting of a perfectly healthy part of a baby's penis is going to reduce the least likely means of AIDS/HIV transmission in the US by any dramatic amount in a country where AIDS is not even an epidemic.
I admire this person for having the honesty to admit that they cannot be convinced. I can't say that I admire the position - I think we should all be willing to revisit our positions when faced with new evidence - but I admire the willingness to admit it.
We don't propose cutting out girl parts to prevent AIDS or other STDs, why should men be any different? OK I am done.
Since the preponderance of evidence indicates that FGC wouldn't have any effect on HIV prevention, it would seem rather pointless to propose such a thing, wouldn't it?
Now, is there any chance, Evangeline, that you and I can actually discuss this issue? I'm interested to learn what you think, rather than what other, randomly selected misinformed and/or irrational people have said on the subject? Fun as it is to show how wrong they are, it's more interesting to debate with someone who is willing to offer opinions of their own.
"Really? Men in the uncircumcised group weren't given condoms? Weren't educated about safe sex? Wrong. "
ReplyDeleteIt never said that the uncircumcised men were not given condoms, it said they did not have the same RESTRICTIONS during those first six weeks. Meaning they were not told to abstain from sex.
The first several parts were just simply just giving an outline of the study for people who may not be aware of what the study entailed, they were obviously not implying that all men in the study shouldn't be circumcised. *rolls eyes*
"Absolutely, when condoms are used consistently, they are roughly 80% effective vs roughly 60% for circumcision."
The consistent use of latex condoms continues to be advocated for primary prevention of HIV infection despite limited quantitative evidence regarding the effectiveness of condoms in blocking the sexual transmission of HIV. Although recent meta-analyses of condom effectiveness suggest that condoms are 60 to 70% effective when used for HIV prophylaxis, these studies do not isolate consistent condom use, and therefore provide only a lower bound on the true effectiveness of correct and consistent condom use. A reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently, i.e. consistent condom users are 10 to 20 times less likely to become infected when exposed to the virus than are inconsistent or non-users. Similar results are obtained utilizing model-based estimation techniques, which indicate that condoms decrease the per-contact probability of male-to-female transmission of HIV by about 95%. Though imperfect, condoms provide substantial protection against HIV infection. Condom promotion therefore remains an important international priority in the fight against AIDS.
http://www.ncbi.nlm.nih.gov/pubmed/9141163
Furthermore, in a previous study published on the effectiveness of condoms in preventing HIV acquisition, heterosexual couples that included an HIV-infected partner used condoms consistently in a total of 15,000 instances of intercourse. None of the uninfected partners became infected.(7) That’s why the American Medical Association states that “behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, and circumcision cannot be responsibly viewed as ‘protecting’ against such infections.”
"You haven't copied the link, but presumably it is to Stallings' IAS presentation, a study that noted a spurious association between FGC and HIV, noted (slide 11) that this result was different from three previous studies, all of which found no significant associations, and concluded that the result was due to confounding (slide 38). "
ReplyDeleteThe link you supplied didn't work but here is the link I believe: http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
"The author hasn't even established that there is any hypocrisy to point out. His/her apparent method of doing so is as follows. First, (s)he selects a single, anomalous study that happens to suit his case, ignoring the inconvenient fact that the others fail to do so. Next, (s)he selects a single biological mechanism that he can use to argue his case, ignoring the others. This is laughable!"
I couldn't copy and paste everything he wrote because I was running out of room, so his statement of a hypocrisy was a full paragraph under something else he said, so I apologize if it was confusing.
Here is the link to the full blog post : http://www.adriancolesberry.com/life/?p=135
"I regress, there is no way you are going to convince me that cutting of a perfectly healthy part of a baby's penis is going to reduce the least likely means of AIDS/HIV transmission in the US by any dramatic amount in a country where AIDS is not even an epidemic." was obviously written by me.
I am really just worn out discussing this emotionally. Almost all proposed "benefits" that you have mentioned are not applicable to infants. Sure, infants turn into adults. Independent, self thinking adults that should weigh their lifestyle choices and personal preference when deciding whether or not to get circumcised. It should not be imposed on them as two day old infants. No one can look at their two day old infant and know who or what they will be. They could become a priest, a bishop, or they could meet the love of their life in high school and never have sex with anyone else. Just as I don't agree with the intactivist argument that " there could be a vaccine in 20 years that would prevent AIDS/HIV" as a reason to not circumcise, I also don't agree with circumcising infants for possible future benefits. There is no way to know whether or not there will be a vaccine, just as there is no way to know whether or not your son would choose to be a priest and live a life of abstinence. There is no way of knowing if your son may end up being one of many men restoring their lost foreskin with weights and sometimes surgery because they are unhappy with the results of their circumcision or wish they had remained intact. This is at the core of my issues, I feel it is unethical.
In the Uganda study, investigators estimated that 67 circumcisions were needed to prevent one HIV infection while the rate of moderate and severe circumcision complications was about 4%. So 66 out of 67 people receive no HIV benefit from circumcision.
I am probably more emotional than most on this issue because I am five months pregnant with a perfect little boy, and I accept that. I also know that if in 18 years my son came up to me and said " I wish I had been circumcised at birth so that I don't have to go through the pain now" I could accept that. He might wish I had made a different choice, but it is reversible and if the pain is worth it to him he can get circumcised, and I will even pay for it.
I cannot handle, however, to think of my son coming to me and saying " Why would you circumcise me without my consent? If I had had the choice, I would have wanted to remain intact. Now I will never know what it is like to have a foreskin, or a fully functioning penis, and there is nothing I can do about it." It is irreversible. That I cannot handle.
It never said that the uncircumcised men were not given condoms, it said they did not have the same RESTRICTIONS during those first six weeks. Meaning they were not told to abstain from sex.
ReplyDeleteAnd, as I pointed out, the studies were designed in such a way that it was easy to determine whether that six week period was the sole cause of the difference.
Re my comments about condom use being 80% effective, you quoted:
A reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently ...
http://www.ncbi.nlm.nih.gov/pubmed/9141163
This is a 1997 review. The 2001 Cochrane review that I cited earlier may be more reliable. Either way, it doesn't make all that much difference. http://www.cochrane.org/reviews/en/ab003255.html
The link you supplied didn't work but here is the link I believe: http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138
The link I provided works perfectly - I've just tested it. It's the same study - you've linked to the abstract, while I linked to the full presentation.
I couldn't copy and paste everything he wrote because I was running out of room, so his statement of a hypocrisy was a full paragraph under something else he said, so I apologize if it was confusing.
Here is the link to the full blog post : http://www.adriancolesberry.com/life/?p=135
That's okay, never mind.
I am really just worn out discussing this emotionally. Almost all proposed "benefits" that you have mentioned are not applicable to infants. Sure, infants turn into adults. Independent, self thinking adults that should weigh their lifestyle choices and personal preference when deciding whether or not to get circumcised. It should not be imposed on them as two day old infants.
So it would be more accurate to say that the benefits do apply to infants, but you think that parents shouldn't make the decision for them. That's fair enough. You're entitled to that view, and obviously you should make your own parenting decisions on that basis.
In the Uganda study, investigators estimated that 67 circumcisions were needed to prevent one HIV infection while the rate of moderate and severe circumcision complications was about 4%. So 66 out of 67 people receive no HIV benefit from circumcision.
As they stated, though: "However, this estimate does not include [...] the probable long-term effectiveness of circumcision in men. Mathematical models have been used to estimate the number of surgeries required per HIV infection averted in both men and women over varying periods of time. In Rakai, a stochastic simulation model suggested that, with a circumcision efficacy of 50% and an HIV incidence of 1·3 per 100 person-years in uncircumcised men, the number of surgeries per HIV infection averted over 10 years was about 35, assuming all uncircumcised men accept the procedure.12 In South Africa, with a circumcision efficacy of 60% and HIV incidence among uncircumcised men of 3·8 per 100 person-years, the number of surgeries per infection averted over 20 years is much lower.23 Thus, the number of surgeries needed to prevent one HIV infection will vary depending on background HIV incidence, the level of acceptance, and the duration of projected protection."
In other words, 67 was a very conservative estimate based only on the 2-year duration of the study. That is, for the purpose of producing this estimate, they assumed that only men who became HIV positive during the study would ever become HIV positive.
I am thankful for foreskin restoration and the fact that I live in a country that is starting to change thier ways. People are realising the major mistakes they have been making with so many innocent children. The circumcision rate in the US is now at 50% I hope to live to see the day when that rate matches Europes at under 10% (for ifants AND adults).
ReplyDeleteI was circumcised as a child.. however I am not diease free I have excema as well as other medical conditions that circumcision has nothing to do with. Circumcision does nothing to prevent any diseases or infections for that matter since I have had 6.
I'm thankful that so many boys are being granted their rights to be circumcised or uncircumcised through the right of bodily intergity and choice.
"I am grateful for circumcision, a very minor procedure that has a major impact on the health of so many." Yes: a major negative impact on their health.
ReplyDelete"I am thankful I live in a country where the right of every parent to circumcise is both maintained and encouraged. It is true that a very very small minority of fanatics is trying to take that right away..." You cannot take away a right that doesn't exist. No parent has or has ever had the "right" to mutilate their child, in the U.S. or any other country. They often simply do it anyway, despite having no right to do so.
"Every baby boy has the right to be circumcised, clean-cut, and disease-free..." is a non sequitur. Circumcised does not imply disease-free, nor does disease-free imply circumcised.
"I am thankful for all the US doctors who work hard to produce the scientific studies that support universal circumcision." In spite of the fact that their "scientific" studies are useless and mendacious pseudoscience?
"I hope both the CDC and AAP can resist political pressure from these few and declare, once and for all, that every male should be circumcised." But why? Why should the CDC and AAP lie to people?
As a child:
ReplyDeleteWhen my parents make a decision on what religion I should follow, I can later choose to do so when I become an adult.
When they choose the type of education they think is best for me, I can later direct my learning as I grow older.
Whatever they choose to feed me now, I can later choose to eat as I please.
Whatever I am vaccinated with now, I can later choose to be revaccinated with.
But when they choose to surgically alter my body, I will not have a choice when I get older.
I would not have known what I truly wanted, I would have been robbed what was given to me at birth, I would have been robbed of my right to true autonomy, a right I believe we are all entitled to.
How hypocritical we are as Americans, fighting for the rights of the rest of the world, while robbing our males of those that are essentially theirs, the same males we send off to fight those wars.
I laugh at our ignorance, and I cry for our loss.
For centuries Men had lived with a foreskin hugging their glans. Once this barbaric practice is abolished. Then men will again have say in what happens to their bodies for their whole lives. If he decides to poke holes in it of tattoo it or circumcise it. That should be his choice, no one else. After all he is the user/owner of that body, no one else.
ReplyDeletehttp://www.nocirc.org/touch-test/bju_6685.pdf
ReplyDeleteA link with some research that everyone should read.
America's government and evil people who support genital mutilation should be totally ashamed of themselves. This is a total tragic violation of a human's rights! First of all there is debate about what's cleaner, less disease prone, and better for sex. Understand that these people arguing these issues are totally crooked, and are speaking for one reason and one reason only. Money, they in one way or another, profit on male genital mutilation, whether its from the skin itself, or the medical community that profits from men seeking help for dysfunctional sex, such as premature ejaculation or erectile issues, lack of pleasure etc. Also they profit from the industry of selling KY Jelly and other lubricants, making women believe that their vagina's don't make enough lubrication. Again all BS. It's the mutilated penis that causes sexual dysfuntion, or a dry vagina. (Read the book, "Sex As Nature Intended It") Its not that these people don't understand the array of problems that circumcision causes, its that they want men to have problems, because these evil SOB's profit from our miseries! Then we come to the idea that its cleaner and less likely to contract disease. Again all BS. Understand that with lack of moving skin, and a dried out vagina, the skin on the penis begins to tear, exposing droplets of blood, believe me I am a man who's been mutilated, I know first hand! However I am in the process of restoring, thankfully! These evil people want to inflict suffering, and shame. All men, I repeat all men feel deep, deep feelings of anger and hatred! Especially those that can't admit it. For those men the feelings are so bad and deep that they will cover them up for their entire lives so that they don't have to confront the truth. America a total tragedy, we let evil money seekers destroy the integrity and basic human rights of man kind. I am mid 30's and still can't believe the evil taking place in this country. I am totally ashamed of America. If confronted with the SOB who mutilated me, I would do the same to him as he did to me, with my bare hands, I would cause him great pain, make him bleed while screaming and crying, make his body swell, make his level of fear escalate so high that he begins to think that he is going to die, his heart will beat extremely fast, his cortisol (death hormone) will become dangerously elevated, and when I am through with him, he will never be the same. He will be so ashamed of what I did to him that he will try to bury the feelings down deep within his soul and never admit them to anyone. But those very feelings will haunt him for the rest of his life! We must stop sexually assaulting and damaging defenseless baby boys, Lets stop kidding ourselves and call this what it actually is, "Genital Mutilation"'
ReplyDeleteWe need to start a revolution
Jake said:
ReplyDeleteSo it would be more accurate to say that the benefits do apply to infants . . .
No, it would be more accurate to say that the benefits are potential and prospective, but the harms are certain. These harms include altered sexual function, loss of nerves, and the formation of scar tissue. More serious harms are proven to occur, including insufficient skin for erection, laceration, damage to the glans, amputation of penis, and death. It's also proven that circumcised males (and presumably females) display a heightened response to pain for months after the trauma of circumcision. How long this effect lasts is unknown, but given that it lasts for months, it's not unreasonable to assume that at least in some people it lasts a lifetime.
Another proven harm - it's all over this blog - is the psychological damage circumcision inflicts on some men. Just as interesting, Jake, PD, and other defenders and advocates of circumcision prove over and over again that they simply cannot understand the psychological harm, and often they ridicule men who resent their forced circumcisions. I would count this behavior of some circumcised men as another complication. It also seems to be connected with their desire to circumcise all males, i.e. mandatory circumcison, what this blog is all about.
-John
Whatever pervert writes this blog should be ashamed of himself. Circumcision is a repulsive, dying fetish. That's it. There's simply no evidence that is not canceled by other evidence that would convince me to do it as an adult, let alone to a child who likely will regret it later. What should be mandatory is a moratorium on infant circumcisions outside of religion.
ReplyDeleteI love my foreskin, so does my girlfriend, I like how it looks, how it feels inside her, and I cant imagine being without it. I have never had any problems with sensitivity, in fact I take way too long to come most times....
ReplyDeleteIve never had any infections, and since I shower every day i never have any bad smells emanating. if i ever have children i will leave it up to them whether they choose to alter their genitals. its quite brash to make such major decisions for an infant who has no idea of any of the pros or cons of the procedure, and ridiculous to consider it mandatory in any sense, especially on a national scale. its pure selfish cosmetic gore....
I have never had any problems with sensitivity, in fact I take way too long to come most times...
ReplyDeleteAssuming that you mean to equate sensitivity with ejaculatory latency, aren't you contradicting yourself?
"Assuming that you mean to equate sensitivity with ejaculatory latency, aren't you contradicting yourself?"
ReplyDeletei mean problems with over sensitivity some intact men complain of
"I give thanks that America will always be a circumcised country."
ReplyDeleteWow. Simply wow. This post is just all kinds of jaw-dropping crazy.
For all the spin of the pro-circumcision crowd about how ‘loony’ people are for favouring the natural body, posts like this elucidate the sad, deep-seeded insecurity that seems to motivate ardent circumcision promoters. Not content with circumcision merely being a lawful option, this blog reaches the natural extreme of limiting free choice. By ensuring that all boys are equally deprived, the advocate cannot be less than them as a man.
The comments from “Paul” nicely evidence this insecurity, where he feels the inexplicable need to tell us about his wife: “A woman who is very sensual, and who thinks my penis is a thing of great beauty.” That is just creepy and screams sexual insecurity, but more importantly if she really loves, you she would hold that attitude regardless of your being circumcised (hence it being inappropriate, irrelevant information).
why is circumcision necessary ? the rest of the world manages to live a long and happy life without circumcision or the problems that the pro-circumcision brigade keep going on about. Circumcision is only a big thing in the USA most Europeans are not circumcised and their penis does not drop off.
ReplyDeleteI wash my dick each day with soap and water. no problem. Everyday $hit comes out my hole but it doesn't mean i have to have it filled in with polyfila to be healthy
Circumcision is unnessary in most cases - unless there is a medical reason it is genital mutilation and child abuse.
ReplyDeleteIf men want to be circumcised, let them make that decisioon themselves as adults.
Hey all,
ReplyDeleteI am amazed that people still think that this outdated religious ceremony is necessary! As with any human activity... there are going to be studies pro and con.
The fact is that ... there is "absolutely" no need for circumcision unless there is a deformity found at birth.. or later in life ...an accident or health condition gives no options...
I am circumcised... and as I became aware that this was not the natural state of my body... I disowned my christian family for following an old...outdated... jewish ritual... It most definitely is child abuse... any act..ritual.. based on any phylosophy..forced onto a child before the age of reason should be punishable by death.. << sound extreme... child body mutilation is also extreme... If your "god" / religion.. asks you to do this ...then you know your god/religion is false.