Tuesday, 20 April 2010

20 reasons revisited

SagaciousMama has posted an article entitled 20 Reasons I Did Not Circumcise My Son.

Now I'm supportive of parents who choose not to circumcise, as well as those who do, but this article is alarmingly misinformed. Here's my analysis.

1) The Pain is Excruciating


Always? Even when local anaesthetic is used? If that were so, men circumcised as adults would report unbearable pain. But in fact, men circumcised under local anaesthetic generally report only mild pain, if any. (Eg., Long et al. report "No patient experienced pain during circumcision.")

The foreskin is attached like a fingernail (see #4).


This is a common anti-circ myth. In fact, the fingernail is fused to the nail bed; in contrast the foreskin's attachment to the glans is primed to detach anyway, and can easily be separated. (This is quite obvious from the many circumcision technique videos on the Internet, which show that the foreskin can be detached through moving a probe around, without excessive force.)

2) The procedure and pain has long lasting consequences.


Here SagaciousMama cites only a number of weak sources. These sources speculate that neonatal circumcision causes numerous psychological problems, but they fall short of the most important quality of scientific work: testing one's hypothesis. In no cases do they provide any evidence showing that their theory is correct.

Until they do their theories don't really seem worthy of a response.

3) It is genital mutilation.


No, it isn't. "Mutilation" is defined as:

1. To deprive of a limb or an essential part; cripple.

The foreskin isn't a limb, and it is clearly not essential, since if it were we would not be able to survive without it.

2. To disfigure by damaging irreparably: mutilate a statue.

Circumcision neither damages nor disfigures. If it damaged the penis, then there would be clear evidence that the penis functioned better with a foreskin than without, but — if anything — the opposite seems to be true. "Disfigurement" is a little more subjective, but the fact that circumcision is widely perceived as a cosmetic improvement is incompatible with the notion that it is a disfigurement.

3. To make imperfect by excising or altering parts.

Again, this is somewhat subjective. That circumcision excises the foreskin is clear, but does this make the penis imperfect? Or does it make it more perfect?

Since SagaciousMama appears to indicate that her statement is a kind of timeless truth, frankly I think she needs something stronger than highly subjective assessments.

4) In babies, the foreskin is attached like a fingernail.


This is a repeat. See no. 1.

5) I wouldn’t alter a girl in this way, and boys count, too.


It would be impossible to alter a girl in this way: girls don't have penes. But, as a hypothetical, suppose that there was a form of minor surgery that could be performed on girls, that had multiple benefits, minimal risks, and no long-term harms. Would it be rational to oppose it?

Here SagaciousMama quotes the ever nutty circumstitions.com:

For over a hundred years, circumcision has been a solution looking for a problem, and the problem has typically been the most frightening disease of the day - ... “masturbation insanity” in the 19th century, ... then tuberculosis, ... Sexually Transmitted Diseases (then called Venereal Disease or VD) after World War I, ... penile cancer in the 1930s, and ... * cervical cancer in the 1950s, when cancers were terrifyingly untreatable, ... urinary tract infections from 1982 onward, ... * and now HIV.


Oh dear. It's troubling that anyone can find this line of argument convincing. The basic idea is this: construct a list of positive claims that have ever been made about a subject, regardless of merit or basis in evidence. Now present them side by side. For example, you can show that hand-washing used to be a religious ritual in ancient times, and more recently, as germs became known, it was promoted for that reason. It's true, but what does it prove? That we should abandon handwashing? Of course not — such a conclusion is ludicrous.

6) It is pointless and absolutely unnecessary. ... There are no advantages to genital mutilation for either a boy or a girl however there are many disadvantages and risks.


With a little interpretation, what SagaciousMama is claiming here is that there are no advantages to circumcision. That's wildly incorrect: there are multiple health benefits to circumcision, including prevention of phimosis, balanoposthitis, urinary tract infection, HIV, HPV and (some) other STDs, penile cancer, etc. Some of these benefits are very minor, some less so, but to say that they don't exist is simply absurd.

7) I don’t have the right.


Actually, you do, but you don't have to exercise that right if you don't want to.

8.) Decreases sensitivity. ... This is the most studied and obvious aspect of this topic. Regardless of the volumes of studies on the tissue, the science, etc, the best evidence of this comes from studies of intact men who get circumcised as adults. Regret is almost inevitable. They do this for newly adopted religious reasons, misguided ideas or information on benefits and other reasons.


What planet is SagaciousMama living on? There's a reasonable overview of study results at Wikipedia. Far from regret being "almost inevitable", high rates of satisfaction are commonplace.

The foreskin is full of nerve endings and is the cause of natural lubrication. It is also a protective cover. Removing that cover exposes the glans of the penis to constant stimulation and rubbing against clothing. This idea makes an intact male shudder. Where some people think the exposed glans heightens sensitivity and sexual pleasure, the reverse is actually true. The penis desensitises to cope. The newly cut man will experience heightened sensitivity, however it is usually uncomfortable more than enjoyable and it does not last.


According to what evidence? Almost none. Studies of penile sensitivity have almost invariably shown no statistically significant differences. See, eg., Masters & Johnson, Bleustein 2003, Bleustein 2005, Payne 2007. None of these studies were performed on recently circumcised men, and none were able to find evidence of this desensitisation.

If you ask a circumcised man about sexuality and sensitivity he will usually tell you everything is fine, great, just dandy. However, he doesn’t know it any other way. You can’t miss something you’ve never had. Only those who have been circumcised as adults have that perspective.


True, and what do they (we, strictly speaking) describe? "After the procedure 82% of patients referred an upgrade on the quality of their sexual intercourse, ...", "Compared to before they were circumcised, 64.0% of circumcised men reported their penis was "much more sensitive," ...", "Penile sensation improved after circumcision in 38% (p = 0.01) but got worse in 18%, with the remainder having no change."

9) Causes problems for female partners.


There's really no reliable evidence that this is the case. SagaciousMama cites a dubious website on the subject, which is full of speculative nonsense but very little evidence.

10) The option will always be there when he grows up.


True, though it's not exactly an argument against circumcision.

11) It is irreversible. ... Restoration is not the same.


This is technically true, but neither is adult circumcision the same as infant circumcision (it almost invariably causes heavier scarring, for example), so whatever choice you make will have lasting consequences.

12) Risk of Physical Damage and Death.


Yes, there are risks, albeit small. These should be considered alongside the risks associated with non-circumcision (such as death due to complications of UTI, for example).

13) Babies Tell You They Don’t Want To Be Circumcised.


This is too silly to deserve a response.

14) Interferes With Breastfeeding.


No. It doesn't.

15) It Goes Against Natural and Attachment Parenting


I'm going to skip this one because, as far as I can tell, SagaciousMama is basically just saying that it is incompatible with her personal parenting philosophy. That seems a good reason not to circumcise.

16) It is Medieval, Shocking Barbaric and Weird. ... and ... 17) Spread eagled restraint is like torture to a baby.


Not really, no.

18.) The historical reasons for it are morality based


Yikes. This is frighteningly irrational: deciding against something because of the reasons why people used to do it. It's like being opposed to dancing because some tribes, somewhere in the world, perform rain dances in the belief that it will induce precipitation. So what? Given the number of human societies and their longevity, it seems inevitable that sometimes people do good things for stupid reasons.

19) 80% of the World’s Males are Intact.


This isn't a very rational argument. A considerable fraction of the world's population lack clean water, but this doesn't strike me as a compelling argument for having my water supply disconnected. The correct figure is probably closer to 60%, by the way.

20) The Foreskin is a Necessary and Amazing Anatomical Structure.


This is simply nonsense.

36 comments:

Sagacious Mama said...

Your manipulative tactics became clear early in reading. Hence I won't spend too much time on your rebuttal as I would have liked it to be less hypocritical (eg, using irrational arguments to point out irrationality). Such as this of the word "mutilation":
*******
Definition: To make imperfect by excising or altering parts.

Again, this is somewhat subjective. That circumcision excises the foreskin is clear, but does this make the penis imperfect? Or does it make it more perfect?
*******
You're funny. Not to mention you first say circumcision is NOT mutilation, then you clearly agree it IS mutilation but give an argument as to how that is perhaps better than having a foreskin.

Let me guess, you have never had a natural penis, nor a partner with a natural penis, correct? Relying on "studies" only gets you so far, at some point you have to get out of the lab and into the reality of it, and with a cut penis, you have one tiny perspective on this.

To say I have the right to alter anything on my child is ludicrous. There is a boundary, cutting off functioning body parts has GOT to be that boundary. Why can't you see that? If the option will always be there for our children, WHY take that choice from them, WHY? It makes no sense whatsoever, because they CAN'T reverse it, but they can always be circ'd as an adult.

Yes, I did see that you have unearthed some weak studies that show that it is better done in an infant... have you even read those articles?

*Not* mutilating my child has lasting consequences? You are really clutching at straws. And when faced with the sticky questions, you resort to the ol' "this is irrational/unreasonable etc" argument. For instance, I noticed on an earlier post of yours that your retort to "no organisation currently recommends it" is to call that an irrational argument. Wow.

And yes, 80% of the world doesn't cut, and that includes almost all of Europe, full of the happiest people in the world according to every year's statistics, and much less sexual dysfunction and HIV. It is a pity you cannot see the compelling nature of that fact.

For every antiquated study you can find to support circumcision (data from 1977? Seriously?) I can find 10 to oppose it, such as these breastfeeding ones:
http://www.ncbi.nlm.nih.gov/pubmed/12587640

http://www.ncbi.nlm.nih.gov/pubmed/11847856

However, I do have a question...

On what basis do you support circumcision?

Can you put it in a summary? Please, I beg you, do NOT tell me it prevents disease because you'll blow any credibility you had left. America has the highest rates of HIV outside of Africa, and BOTH continents circumcise at the highest rates in the world.

What your HIV studies fail to mention is the fact that people who can afford to circumcise are in a better socioeconomic position, which you will know is the lowest HIV bracket. The studies are flawed.

You cannot see the violation of a newborn baby's right to a pain-free welcoming into the world. That is sad, because it is the main reason against it - we need no studies to come to that rational conclusion. If you do, I pity you.

You say to use anaesthetic, did you answer my questions on that? Is drugging our babies with pain medications for an unnecessary procedure in some cases for weeks really the goal you have for our new people?

I thank you for reading and linking.

Try restoration, THEN comment. You don't know what you're missing, and my friend - neither does your partner (or maybe they do?).

Scroll to the very bottom of this link and read the reasons to restore. They're true. Try it, and I guarantee you will delete your whole blog in enlightened disgust at your ignorance when your functions come back.

Regards,
Sagacious Mama

Jake said...

Hello Sagacious Mama,

First of all, thank you for your response. We obviously take very different positions on this issue, and consequently I disagree with much of what you say, but I'm pleased to be able to have a mature dialogue about it. I'll respond to a few points, if I may:

Regarding "mutilation", you say:

You're funny. Not to mention you first say circumcision is NOT mutilation, then you clearly agree it IS mutilation but give an argument as to how that is perhaps better than having a foreskin.

No, I'm not agreeing that it is mutilation. I'm agreeing that it excises parts, but that's not the definition of mutilation. To meet the definition, circumcision would have to excise parts and, as a result make imperfect. So the question is, does circumcision make the penis imperfect or not? That's what I'm getting at when I say that it's subjective: I can't see how you can objectively prove it either way. To you, perhaps it does. To me, it doesn't make the penis imperfect at all.

Let me guess, you have never had a natural penis, nor a partner with a natural penis, correct? Relying on "studies" only gets you so far, at some point you have to get out of the lab and into the reality of it, and with a cut penis, you have one tiny perspective on this.

I had an elective circumcision at age 26, for what it's worth. However, I prefer to avoid anecdotal evidence; I think it's better to rely on objective studies.

To say I have the right to alter anything on my child is ludicrous. There is a boundary, cutting off functioning body parts has GOT to be that boundary. Why can't you see that? If the option will always be there for our children, WHY take that choice from them, WHY? It makes no sense whatsoever, because they CAN'T reverse it, but they can always be circ'd as an adult.

Yes, it is irreversible (though see my response to your point 11), but is that really a strong argument against it? Plenty of decisions made for children are irreversible — the immune system can't be unvaccinated; the brain can't be uneducated. So it seems to me that irreversibility, by itself, isn't a very good argument for not making a decision.

Yes, I did see that you have unearthed some weak studies that show that it is better done in an infant... have you even read those articles?

Sorry, which studies do you mean?

*Not* mutilating my child has lasting consequences? You are really clutching at straws.

Yes, not circumcising has lasting consequences, just as circumcising has lasting consequences (though obviously the consequences in question differ). I genuinely don't understand why you have trouble with this concept.

And when faced with the sticky questions, you resort to the ol' "this is irrational/unreasonable etc" argument. For instance, I noticed on an earlier post of yours that your retort to "no organisation currently recommends it" is to call that an irrational argument. Wow.

(continued)

Jake said...

And when faced with the sticky questions, you resort to the ol' "this is irrational/unreasonable etc" argument. For instance, I noticed on an earlier post of yours that your retort to "no organisation currently recommends it" is to call that an irrational argument. Wow.

Do you mean here? To paraphrase, the argument was "this medical association should not recommend circumcision because no medical associations currently recommend it". If that were applied as a general rule, the inescapable consequence would be that policy statements could never change. Can't you agree that that's fairly irrational?

And yes, 80% of the world doesn't cut, and that includes almost all of Europe, full of the happiest people in the world according to every year's statistics, and much less sexual dysfunction and HIV. It is a pity you cannot see the compelling nature of that fact.

As I said in my comment, the figure is closer to 60% (or 66% according to the World Health Organisation), and while you haven't supplied sources for your claims, I'll assume they're true for the sake of argument. But the more important question is, what of it? Are you suggesting that lack of circumcision directly causes greater happiness, reduced dysfunction, and reduced rates of HIV? It seems to me that there are so many differences between the US and Europe, many of which could affect these things in various ways, and it seems rather foolish to just pick one of these, seemingly at random, and say, "that's the reason".

For every antiquated study you can find to support circumcision (data from 1977? Seriously?) I can find 10 to oppose it, such as these breastfeeding ones:
http://www.ncbi.nlm.nih.gov/pubmed/12587640 ... http://www.ncbi.nlm.nih.gov/pubmed/11847856


These are just letters — opinion pieces, in other words. They aren't studies in the sense that they don't present any data, they just comment on existing data.

Jake said...

However, I do have a question...

On what basis do you support circumcision?


I'm pro-parental choice rather than pro-circumcision. That means I'm supportive of parents' choices, whatever they are (I reserve the right to pick holes in their arguments, though ;-)). That hasn't always been the case. Back in 2003, I was mildly opposed to infant circumcision, but my views shifted over time as a result of digesting large amounts of information on the subject. It became apparent to me that the benefits of the subject were such that parental choice was justifiable.

Can you put it in a summary? Please, I beg you, do NOT tell me it prevents disease because you'll blow any credibility you had left. America has the highest rates of HIV outside of Africa, and BOTH continents circumcise at the highest rates in the world.

First, let me correct you. The US doesn't have the highest non-African HIV rate — it's actually 68th, after non-African countries such as Brazil, Latvia, Panama, Russia, and a few others.

Second, let's get to a more important point. Between-country comparisons tend to have poor reliability, because they're very susceptible to confounding. In epidemiology, this kind of analysis of aggregate data at the per-country level is called an ecological study, and this design is considered the weakest of all methodologies, suitable for forming hypotheses but not for testing them.

Let's consider some sources of confounding. For example, when compared with Britain, the US has "greater variability in sexual behavior, less tolerant opinions
about sexual behavior, ... and lower condom usage among men" (source), "The [European] countries fund sex education and reproductive health services for adolescents, including contraception and abortion services. Rather than leading to promiscuity, as compared to the US this policy has resulted in a higher average age at first intercourse, fewer sex partners, longer waits between partners, and reduced numbers of abortion" (source).

Many of these differences can reasonably be expected to affect STD incidence. So how can you hope to isolate the effect of circumcision? The answer is, you can't. There's no escaping the conclusion that we have to look to more reliable studies, ones that properly isolate the effect of circumcision.

Jake said...

(This is the final part of my reply!)

What your HIV studies fail to mention is the fact that people who can afford to circumcise are in a better socioeconomic position, which you will know is the lowest HIV bracket. The studies are flawed.

Maybe you don't understand the design of the three African randomised controlled trials. In these trials, all of the men were originally uncircumcised, but they were assigned to either the control (no circumcision) or intervention group (circumcision) on a random basis (think tossing a coin). This random assignment is the single most important property of these studies, because it means that the only difference between the circumcised and uncircumcised men in the study is caused by that toss of the coin. Differences (such as socioeconomic status, to use your example) cannot affect the assignment, so on average you get the same numbers of rich, poor, etc individuals in each group.

You cannot see the violation of a newborn baby's right to a pain-free welcoming into the world. That is sad, because it is the main reason against it - we need no studies to come to that rational conclusion. If you do, I pity you.

Actually, I think that circumcision should only be performed with appropriate anaesthesia. And yes, I would prefer to avoid giving children (or adults, for that matter) drugs where possible, but it's really only for a short time, and the harm it causes is probably minimal in comparison with the benefits of circumcision.

... Try restoration, THEN comment. You don't know what you're missing, and my friend - neither does your partner (or maybe they do?).

No, thank you. As noted, I had a foreskin for the first 26 years of my life, and have no desire to have one again. I much prefer being circumcised.

Sagacious Mama said...

You are basing much on logical fallacy. I knew a woman who had her foreskin removed (clitoral hood) and was happy with the result. I also know of women who have vaginal surgery in many different ways. Does that mean that all women should get it done as babies, to save the trouble and scarring as an adult? There is absolutely no credibility in that, and that is exactly what you are suggesting.

Don't pull the "girls and boys are different" argument on me, either. It doesn't wash. The prepuce is the prepuce, whether it be on the male or the female. My prepuce is not more important than yours unless you think it is in which case that is you opinion. Medical fact is, they are identical. Many countries concede that removing it in men or women (and they DO NOT differentiate) without consent is obviously a violation of many things including human rights. Pity America doesn't have the same consideration.


You made the point that many things are irreversible, therefore irreversibility isn't a sound argument. That is a logical fallacy, again. You say, without a trace of humour: “So it seems to me that irreversibility, by itself, isn't a very good argument for not making a decision.” Not a good argument? Tell my husband that.

Yes, real live people count too, not just studies and numbers.

The foreskin, at birth, is “fused” (to quote the medical journals) to the glans, they are one organ. This slowly erodes over time and use. You are stating something that is completely anatomically incorrect! If you peel back a baby's eye lids, he will grumble, if you stretch apart his fingers, he will wiggle. If you try to peel back his fingernails or foreskin he will likely scream in pain and may sustain serious damage. Even Wiki knows that, and I'm not a fan of wiki. If you had kids you'd know their fingernails are not like ours, they are like paper and can easily be peeled back and often are unfortunately. My son just two days ago lost part of his big toe nail when he fell down. This doesn't happen to adults as easily.

It IS like a fingernail, please stop saying things like fact when they are medically untrue. It isn't opinion here, it is medical fact they are fused like epithelium just like a fingernail.

I did supply sources. For the 80% global intact quote, the source was in that particular note.

I do understand that all things have consequences, in a cause and effect way. However, I didn't remove anything from my son, I didn't remove his ears, not a hair on his head and yes, there are consequences of leaving them intact on his body ... but seriously, you are reaching to suggest what you are suggesting by these "consequences".

If you had sexual difficulty and reefing off your foreskin helped in this area, that does NOT automatically mean ALL foreskins are faulty. Can't you see that?

Sorry, I have to run but I will address the other points you made. Thank you for the discussion.

Sagacious Mama said...

Mutilate means to destroy or injure severely (wordnet). The foreskin is destroyed, it meets this criteria. However, let's look at the definitions you accepted:
1) To deprive of a limb or an essential part; cripple.
2.To disfigure by damaging irreparably: mutilate a statue.
3. To make imperfect by excising or altering parts.

You said:
"The foreskin isn't a limb, and it is clearly not essential, since if it were we would not be able to survive without it."

This is a based on a mistaken idea of “essential”. Would you say that you could live with one kidney? One eye? Actually, I've seen a man who has no arms and no legs living quite happily. Yet if you removed any of those things from someone, I assure you, you've mutilated them.

You're incorrect, it is mutilation, and not only according to two definitions but it also disfigures by damaging irreparably.
Wiki: disfigure: "Disfigurement is the state of having one's appearance deeply and persistently harmed medically, as from a disease, birth defect, or wound. Causes include circumcision."

Three criteria it fits. Like I said, mothers defend mutilating their daughters with this same drivel also, and like you, they believe it and buck against the idea they're “mutilating” their child.

As for drugs, no disrespect but you seem to have little knowledge in the area. Health is my area, it is what I was trained to do at university. Children are a special area of mine. To say there are “probably” no effects to outweigh the benefits is the problem with most of your arguments, you simply don't know, and therefore have to go on online studies and you have outdated info.

The medical associations released the protocol here (Australia) and in the US to stop doing the procedure as it just keeps having myth after myth blown apart.
Circumcision is banned in Australia unless medically necessary.

http://www.abc.net.au/news/stories/2007/12/09/2113665.htm

You might want to read about circ and the law: http://en.wikipedia.org/wiki/Circumcision_and_law

And then look at the AMA's circ policy: http://www.circumstitions.com/AMA.html

You got a benefit from being circumcised as an adult. Good for you. Do you know how rare that is? You were given the choice, why take that choice from others? I can imagine how the passion might have flared in you, you got a benefit and made a site about it and want to spread the word. However the word you neglect most of all is "choice". My husband resents his cut, and many men do, they didn't have the choice you did. Any (mythological) risks of having a foreskin involve sex, and a baby does not have sex, so there is time, it isn't urgent.

If I CAN give my child a choice, I DO.

See how that works?

My children will get an education whether I keep them home or send them off, I don't really have much choice in that, only in HOW they are educated to a small degree. They will learn regardless.

To say I take other liberties "so why not this one" is cruel to children and a reaching argument.

Jake said...

Mutilate means to destroy or injure severely (wordnet). The foreskin is destroyed, it meets this criteria.

But you didn't describe circumcision as "foreskin mutilation", you described it as "genital mutilation". Are the genitals destroyed through circumcision? I don't think so.

[...] You said:
"The foreskin isn't a limb, and it is clearly not essential, since if it were we would not be able to survive without it."

This is a based on a mistaken idea of “essential”. Would you say that you could live with one kidney? One eye? Actually, I've seen a man who has no arms and no legs living quite happily. Yet if you removed any of those things from someone, I assure you, you've mutilated them.


Strictly speaking, I guess these body parts are not essential either, though one's abilities and quality of life would doubtless be affected by their absence. Arms and legs are limbs, of course, so their removal meets the definition of "mutilation" regardless of whether they are essential. I would suggest that most people would agree that removing an eye would disfigure, so it meets one of the senses whether or not the eye is essential.

You're incorrect, it is mutilation, and not only according to two definitions but it also disfigures by damaging irreparably.
Wiki: disfigure: "Disfigurement is the state of having one's appearance deeply and persistently harmed medically, as from a disease, birth defect, or wound. Causes include circumcision."


To quote from the prominent warning notice at the top of that page: "This article does not cite any references or sources." In other words, it's just the opinion of some random person that circumcision causes disfigurement. Not a strong argument.

Three criteria it fits.

That's odd. I count zero.

Like I said, mothers defend mutilating their daughters with this same drivel also, and like you, they believe it and buck against the idea they're “mutilating” their child.

Your point being, I assume, that female genital cutting must constitute mutilation because it's so horrible, therefore any argument to the contrary must be in error. I don't find that argument very persuasive; I'd prefer to consider each argument on its merits. I'm getting the impression that it's very important to you that FGC (and circumcision) should be mutilation — it's almost as though you're offended by the idea that either might not be — and I wonder why that is. The word "mutilation" doesn't mean "wrong": it has a very precise meaning, as I've shown. Why not use the word "wrong" to express one's feelings about it, and keep an open mind about whether it is or isn't "mutilation"?

(continued.)

Jake said...

As for drugs, no disrespect but you seem to have little knowledge in the area. Health is my area, it is what I was trained to do at university. Children are a special area of mine. To say there are “probably” no effects to outweigh the benefits is the problem with most of your arguments, you simply don't know, and therefore have to go on online studies and you have outdated info.

Then please cite up-to-date studies on the subject.

The medical associations released the protocol here (Australia) and in the US to stop doing the procedure as it just keeps having myth after myth blown apart.

That is incorrect. Both Australian and US medical associations support parental choice. They do not recommend routine circumcision (that is, circumcision of all baby boys), but that should not be confused with recommending against it.

Circumcision is banned in Australia unless medically necessary.

Also incorrect. It is banned in public hospitals, but no laws prevent it from being performed privately.

You might want to read about circ and the law: http://en.wikipedia.org/wiki/Circumcision_and_law

I actually help to maintain that article, so I'm quite familiar with the subject. :-)

And then look at the AMA's circ policy: http://www.circumstitions.com/AMA.html

The correct link is here. I'm perplexed that you mention it, though, because it largely supports what I'm saying. It identifies several benefits of circumcision, as well as risks, and suggests that parents should make the decision.

You got a benefit from being circumcised as an adult. Good for you. Do you know how rare that is?

What question are you asking? Are you asking what proportion of men get benefit from being circumcised, or what proportion of men get circumcised as adults?

I can imagine how the passion might have flared in you, you got a benefit and made a site about it and want to spread the word. However the word you neglect most of all is "choice". My husband resents his cut, and many men do, they didn't have the choice you did.

I'm sorry to hear that. It's very easy to focus on the feelings of those close to us, and to assume that what they desire is best for everyone. Sometimes it's difficult to sit back and take a more detached perspective, but it is important. Some men resent being circumcised as infants. Others resent not being circumcised as infants. Fortunately, most are contented regardless.

(contd)

Jake said...

Any (mythological) risks of having a foreskin involve sex, and a baby does not have sex, so there is time, it isn't urgent.

Actually, there are several risks associated with having a foreskin that affect males before they're sexually active. Consider UTIs, for example.

You are basing much on logical fallacy. I knew a woman who had her foreskin removed (clitoral hood) and was happy with the result. I also know of women who have vaginal surgery in many different ways. Does that mean that all women should get it done as babies, to save the trouble and scarring as an adult? There is absolutely no credibility in that, and that is exactly what you are suggesting.

But of course that isn't what I'm saying. What I am saying is that one disadvantage of not circumcising in infancy is that he will face obstacles and scarring if he is circumcised as an adult. And that is broadly comparable to the trouble and "not quite the same" quality of foreskin restoration.

Don't pull the "girls and boys are different" argument on me, either. It doesn't wash. The prepuce is the prepuce, whether it be on the male or the female. My prepuce is not more important than yours unless you think it is in which case that is you opinion. Medical fact is, they are identical.

If that were so, then the consequences of removing them would be identical. Evidence does not support that hypothesis.

Many countries concede that removing it in men or women (and they DO NOT differentiate) without consent is obviously a violation of many things including human rights. Pity America doesn't have the same consideration.

Name some of these countries & cite some evidence.

The foreskin, at birth, is “fused” (to quote the medical journals) to the glans, they are one organ. This slowly erodes over time and use. You are stating something that is completely anatomically incorrect! If you peel back a baby's eye lids, he will grumble, if you stretch apart his fingers, he will wiggle. If you try to peel back his fingernails or foreskin he will likely scream in pain and may sustain serious damage. Even Wiki knows that, and I'm not a fan of wiki. If you had kids you'd know their fingernails are not like ours, they are like paper and can easily be peeled back and often are unfortunately. My son just two days ago lost part of his big toe nail when he fell down. This doesn't happen to adults as easily.

It IS like a fingernail, please stop saying things like fact when they are medically untrue. It isn't opinion here, it is medical fact they are fused like epithelium just like a fingernail.


No, it isn't. Watch some videos of infant circumcision, and judge the difficulty of separating the two surfaces. Ask a professional. The two aren't even remotely comparable.

I did supply sources. For the 80% global intact quote, the source was in that particular note.

I agree, but of course not all sources are equal.

If you had sexual difficulty and reefing off your foreskin helped in this area, that does NOT automatically mean ALL foreskins are faulty. Can't you see that?

What makes you think that I had sexual difficulty? I did state that my circumcision was elective.

Sagacious Mama said...

I'm unclear, are you saying FGM is not mutilation? You'll have to take that up with the medical arena, not me. And tell tptb to adjust the name of International Day of Zero Tolerance to Female Genital Mutilation to whatever your preference is. It is internationally recognised as mutilation, it removes a functioning anatomical structure whether you like it called "functioning" or not. Do you REALLY think the foreskin has no purpose?

You are very focused on studies, which allows you to overlook what is the most important aspect here: choice, human rights.

A person should consent to having a functioning body part removed for cosmetic purposes. You would agree with that I assume? Correct me if I'm wrong. If I am, I'm ditching this discussion because that means I'm dealing with a whacko but you don't seem like one so far. If you believe that cosmetic surgery on an non-consenting adult OR minor is a violation, then we can talk further.

I shall assume you do for the moment. Due to this, you focus on the medical argument largely. There is note of the idea it is "just a flap of skin", and other such antiquated fallacies in your responses (15 inches of erogenous tissue?
http://www.youtube.com/watch?v=QGlqzQf5Qvs
30000 nerve endings?? Medical journals showing the FUNCTION of the foreskin?? Nothing? Drawing a blank still? The articles showing the direct functioning during intercourse, and how the exposed coronal hook removes 90% of lubrication with ONE thrust?) but overall, the medical reasons seem to be your baby. Right? Medical reasons and studies.

So that means any updated studies showing you there is no benefit would seriously hamper your argument, yes?

http://www.6minutes.com.au/articles/z1/view.asp?id=515210

siting this study: http://www3.interscience.wiley.com/journal/123344442/abstract

These studies keep blowing apart the myths and will continue to until it is fully illegal here, as FGM is. Banning in public hospitals is just the beginning because the AMA is determined to woo the public into accepting the it is a pointless, cosmetic procedure.

As for the ethical position, the one you most like to thrust to the side and the hardest one to give you "evidence" of (and you know it, cheeky sod lol), enjoy this light bit of reading from the QUEENSLAND LAW REFORM COMMISSION (sorry, not yelling, just copy pasting)

http://www.cirp.org/library/legal/QLRC/

I am only half way through but the conclusion is interesting:

"The court will not approve the treatment unless it is necessary and in the young person's best interests.(132)... The basis of this attitude is the respect which must be paid to an INDIVIDUAL'S BODILY INTEGRITY.... On a strict interpretation of the assault provisions of the Queensland Criminal Code, routine circumcision of a male infant COULD BE REGARDED AS A CRIMINAL ACT."

The AMA is pushing these things here, the overwhelming majority wants it illegal and sees it as MGM and sexist to only make the female counterpart illegal. Interestingly, the same is true in America, they have the same reports, but doctors have been slow in implementing the changes, although the US medical assoc. shows no benefit except a tiny HIV margin, which pro-circers milk for all its worth, because it's basically all you have in the modern studies.

Must run for now.

Jake said...

I'm unclear, are you saying FGM is not mutilation? You'll have to take that up with the medical arena, not me. [...]

What I'm saying is that, while I may personally regard it as mutilation, I think it would be difficult to prove without a shadow of doubt that FGC is mutilation. Certainly it is widely regarded as mutilation, but that doesn't make it a universal truth. If there are counterarguments, I'm willing to consider them, and with an open mind. I'm not prepared to declare that those counterarguments are wrong without having read them. Do you find that unacceptable?

A person should consent to having a functioning body part removed for cosmetic purposes. You would agree with that I assume? Correct me if I'm wrong. If I am, I'm ditching this discussion because that means I'm dealing with a whacko but you don't seem like one so far. If you believe that cosmetic surgery on an non-consenting adult OR minor is a violation, then we can talk further.

I'm afraid you may have to dismiss me as a whacko, then, because I don't think I agree. It seems to me that there are quite a few examples of surgery that is, technically, cosmetic and which are performed on non-consenting minors. The list would depend on how one defines "cosmetic" (sometimes it's easier than others), but consider, for example, birthmark removal, harelip repair, some dentistry, and even repair of minor hypospadias. To be absolutely clear, however, I am not saying that any and all cosmetic surgery is acceptable without consent.

I shall assume you do for the moment. Due to this, you focus on the medical argument largely. There is note of the idea it is "just a flap of skin", and other such antiquated fallacies in your responses (15 inches of erogenous tissue?

An exaggeration. The only study in the literature reports the surface area of the foreskin as 36.8 square centimetres (5.7 square inches). No study has ever shown that part or all of this is erogenous.

http://www.youtube.com/watch?v=QGlqzQf5Qvs

Could I ask that you cite credible sources, please? Peer-reviewed articles are ideal, but please something weightier than an amateur video produced by a random person.

30000 nerve endings??

Not according to any study in the literature. No study has ever counted the number of nerve endings. This is a myth created by the anti-circumcision lobby. It was (in the form of 20,000) originally a guess presented by Ken McGrath at a NOCIRC conference. Since then, it has been repeated so many times that people frequently assume it is a fact, but it isn't.

Medical journals showing the FUNCTION of the foreskin??

None have been proven.

(continued)

Jake said...

Nothing? Drawing a blank still? The articles showing the direct functioning during intercourse, and how the exposed coronal hook removes 90% of lubrication with ONE thrust?)

That's just a hypothesis presented by Kristen O'Hara on her website. Why do you assume it's proven?

but overall, the medical reasons seem to be your baby. Right? Medical reasons and studies.

That's my primary area of interest, yes.

So that means any updated studies showing you there is no benefit would seriously hamper your argument, yes?

http://www.6minutes.com.au/articles/z1/view.asp?id=515210

siting this study: http://www3.interscience.wiley.com/journal/123344442/abstract


Yes, the Richters study is an interesting one. Unlike many (but not all) other studies, it found few associations between circumcision and STDs. That's surprising in a sense, but in another it should be expected. After all, if observational studies were completely reliable there would be no need for randomised controlled trials.

These studies keep blowing apart the myths and will continue to until it is fully illegal here, as FGM is.

I find it interesting that you perceive this study to "blow apart myths". Why is that? Is it just that it supports your viewpoint, or do you genuinely believe that this study is vastly superior to the others (and if that's the case, what makes it so)?

As for the ethical position, the one you most like to thrust to the side and the hardest one to give you "evidence" of (and you know it, cheeky sod lol), enjoy this light bit of reading from the QUEENSLAND LAW REFORM COMMISSION (sorry, not yelling, just copy pasting)

http://www.cirp.org/library/legal/QLRC/

I am only half way through but the conclusion is interesting:

"The court will not approve the treatment unless it is necessary and in the young person's best interests.(132)... The basis of this attitude is the respect which must be paid to an INDIVIDUAL'S BODILY INTEGRITY.... On a strict interpretation of the assault provisions of the Queensland Criminal Code, routine circumcision of a male infant COULD BE REGARDED AS A CRIMINAL ACT."


Saying that something could be regarded as a criminal act is not the same as endorsing that opinion. It's simply recognising that the argument could be made.

The AMA is pushing these things here, the overwhelming majority wants it illegal and sees it as MGM and sexist to only make the female counterpart illegal. Interestingly, the same is true in America, they have the same reports, but doctors have been slow in implementing the changes, although the US medical assoc. shows no benefit except a tiny HIV margin, which pro-circers milk for all its worth, because it's basically all you have in the modern studies.

Oh dear, you are misinformed. I suggest that you browse through PubMed, or for that matter read through one of the more detailed medical policy statements on the subject. There are a number of benefits, and these are recognised by most medical associations. Their existence is not really disputed in any serious way; serious debate largely focused on how to weigh benefits against the risks.

Sagacious Mama said...

Jake, if it isn't too personal, I have some questions for you.

How long ago was your circumcision?

Do you have children?

Why did you get circumcised?

You believe in parental rights. Define that. What are your personal boundaries regarding parental right to removal of a child's healthy body parts?
- Is it limited to the male foreskin, or would it expand to incorporate the removal or impediment of any structure or function if studies showed a benefit in said removal/impediment?
- Are there qualifiers, ie, must there be benefits; must those benefits be medical and must those medical benefits outweigh the risks?
- do you consider cosmetic/preference treatment a valid reason for parental rights to trump integrity rights?


Have you seen this study: http://www.circinfosite.com/11.html

Did you watch the video at the start of my article? If you aren't a parent, it won't affect you. I was childless once, I know the difference between before and after having one. No parent can watch that video and not get a gut, instinctual reaction on a visceral level unless they are somewhat disconnected. A reaction that screams “This is wrong!” that you will not find when a parent watches a gruesome procedure on a baby if it is for a *medical emergency*.


That's all for now. I will have more later.
Thanks.

Jake said...

Jake, if it isn't too personal, I have some questions for you.

No problem.

How long ago was your circumcision?

It was seven years ago in July.

Do you have children?

No, I don't.

Why did you get circumcised?

Mostly for cosmetic reasons, but I also preferred the function of the circumcised penis.

You believe in parental rights. Define that. What are your personal boundaries regarding parental right to removal of a child's healthy body parts?
- Is it limited to the male foreskin, or would it expand to incorporate the removal or impediment of any structure or function if studies showed a benefit in said removal/impediment?


I'll answer your question immediately below.

- Are there qualifiers, ie, must there be benefits; must those benefits be medical and must those medical benefits outweigh the risks?

Yes, there are qualifiers. Consider the following illustration:

A--------|-----B-----|--------C

This "line" is intended to show the full range of possible procedures (medical or otherwise) that could be performed on a child.

At one end (labelled "A") are those procedures that are extreme net harms (for example, murdering a child). At the other end ("C") are those procedures that are extreme net benefits (for example, giving a child urgent medical care).

It is important to stress that so far I've just discussed the extreme ends of the spectrum. As we move towards point "B" we find increasingly neutral procedures. There comes a point (which I've labelled with "|" symbols) at which a procedure is sufficiently harmful that we, as a society, say "this must not be done, regardless of what parents think". Similarly, there is also a point at which we find that denial of extreme benefits is likewise unacceptable.

In the centre, around point "B", is a kind of "neutral zone", in which parental discretion holds sway.

To return to your questions, then...

This principle extends to any medical or non-medical procedure — it is not limited to the foreskin.

The benefits (or risks) need not be exclusively medical, and some may be subjective and hence may be assessed differently by different observers, but I would expect a) the parent to act in what (s)he believes to be the child's best interests, and b) a "reasonable person" (to use the overused phrase) to agree that there is no significant net harm.

The benefits need not outweigh the risks, but the procedure should fall into the "neutral zone", such that there is neither a large net harm nor a large net benefit.

- do you consider cosmetic/preference treatment a valid reason for parental rights to trump integrity rights?

Even if I believed that "integrity rights" were violated through circumcision, I don't see this as having anything to do with parental "rights". It's not about rights — it's about responsibilities. A parent does not choose to circumcise a child because it's fun or because (s)he wants to exercise his/her rights; (s)he makes the decision because (s)he wants to do what's best for the child.

Have you seen this study: http://www.circinfosite.com/11.html

It's not a study. It's a claim about an investigation which was never published and the results were allegedly destroyed. (How convenient.)

Did you watch the video at the start of my article? ...

Yes, I have watched it. It is a video of a circumcision using insufficient anaesthesia. (There is a vague remark indicating that topical anaesthesia of some sort has been used, but it is clearly insufficient and certainly falls short of the ring block that is best practice.) The child is obviously in distress, and it is uncomfortable even to watch. And if you say that circumcision with inadequate anaesthesia is inappropriate, I agree with you.

Anonymous said...

Sagacious Mama:

If you had just circumcised your son, we wouldn't have to be having this pointless argument now!

Sagacious Mama said...

Thank you for the info. It's a shame that our culture has made a natural body part feel unattractive. All our porn/erotica features circ'd penises.


I may have messed up my attempt at html in this post. Ack.


First I'll quickly address your recent additions.


We can argue semantics, dissect each other's studies and whatever else but it is obvious we differ fundamentally and not just in this subject. What you reject as a veritable non-issue in this is THE important one to me - human rights, the right of the child to bodily integrity and choice. You believe that conflicts with “parental responsibility” but I can tell you as a parent that it does not. If you trusted in nature as I do, you'd see that yourself. More on that in later posts.


"Even if I believed that "integrity rights" were violated through circumcision..."


You say that as though they aren't. This then becomes a three level breakdown, first, “is the child born with bodily integrity?” then, “does the child have a right to bodily integrity” and finally, “are those rights violated?”


Integrity: “an undivided or unbroken completeness or totality with nothing wanting”.


The child is born with bodily integrity. The other two speak for themselves.


I've had this discussion more times than I care to admit, and am currently running a few of them at once. I've yet to hear ONE person say they are doing it for medical reasons. Not ONE. Not even you.

THE most common reason I hear is “I like the look of a circumcised penis”. What if his future wife doesn't, cos after all, the mother ain't going to be the one looking at it!


Kind of blows your fairy tale version of parents who are doing what is best for the child. Cosmetic reasons are NOT within the realm of “what's best for the child”. Societal norms and cultural expectations will cause a parent to “believe” they are doing the best thing for the child, but it is arbitrary and ultimately shallow and always fear-based.


What is best for the child is having a parent who thinks they are beautiful and perfect from the day they are born.

Sagacious Mama said...

This principle extends to any medical or non-medical procedure — it is not limited to the foreskin.

The benefits (or risks) need not be exclusively medical



Unbridled parental authority over the child's body with no repercussions based on nothing but trust in the parent's desire to do what is best for the child is a commendable ideal and one I share but in reality rife with danger. Parents hurt their children, water board them because they can't recite the alphabet, molest them... I HATE laws, I loathe that we are in such a state that we need to be told not to cut off our children's toes but we do. You say we don't. I guess you don't watch the news.

Removing a body part is not to be done routinely or taken lightly but it also has it's rare, limited applications obviously. Prophylactic removal, however, is a joke.

Even if there was some miraculous benefit to circumcision to prevent STDs, it is of no benefit to babies, babies don't get STDs! Sexually ACTIVE people get STDs.

It can wait.

And if it can wait, then the reasons for INFANT circumcision become cosmetic and/or preferential.

We cannot know which male babies will grow into the ones who resent losing their foreskin, just as your parents couldn't know you didn't want a foreskin. In fact, most of us wouldn't know we didn't want one until we had lived with it for some time, maybe 5 years, maybe 20, but we need time inside our own body to know that. My mother could not know that about me anymore than my friend's mother could know she would alter her vagina as an adult. The surgery is more complicated as an adult and there is more scarring, but at least you can ask for exactly what you want, how much you want taken off, etc. That I need to spell this out is ludicrous.

I am not against circumcision, I'm against ROUTINE INFANT CIRCUMCISION. This puts me in the company of ALL the associations who's recommendations are that routine infant circumcision cannot be recommended. Here is the American Assoc of Pediatrics, which the AMA states it agrees with:
"The existing scientific evidence is not sufficient to recommend routine circumcision."

There is no benefit for routine infant circumcision. It is a moot point if there is benefit for circumcision overall because once we have a teenager, we have the ability for informed consent. At that point, we can bring in the risks vs benefit argument and have it make some kind of sense.

The study I linked is relevant because it is the most recent. Are you going to debunk a 2010 study with one from 2003? It is possible, but usually up-to-date studies tend to trump outdated ones.

Since you have tried to convince there is a medical benefit, perhaps you'd like to address that.

The argument on parental rights is another topic altogether. A child has rights, you are saying the parent trumps those rights, including in unnecessary situations and even for simple preference. You've split the whole thing wide open in this regard, because you have let in abuse and as long as it is done with the parent's belief it is in the child's best interest, that's ok with you. Unless you clarify or tell me I'm mistaken, there is no more to say on that.

Jake said...

[I originally wrote] "Even if I believed that "integrity rights" were violated through circumcision..."

You say that as though they aren't. This then becomes a three level breakdown, first, “is the child born with bodily integrity?” then, “does the child have a right to bodily integrity” and finally, “are those rights violated?”

Integrity: “an undivided or unbroken completeness or totality with nothing wanting”.

The child is born with bodily integrity. The other two speak for themselves.


Firstly, I think you're overlooking an important question: is "integrity" an absolute quantity? That is, if the skin is broken through, say, a heel stick procedure, then there may be a technical violation of integrity (sense 3 or the definition you quoted), but is there a meaningful violation? It seems to me that an absolute interpretation doesn't make a lot of sense; instead it's more meaningful to ask where the line should be drawn.

Secondly, there are multiple senses of the word "integrity", so it is important to consider which sense(s) are intended; using this dictionary, the following senses could in principle apply:

2. The state of being unimpaired; soundness.
3. The quality or condition of being whole or undivided; completeness.

Personally, I would say that a child has a right to integity in sense 2, but I'm not so sure about sense 3 if it is understood in an absolute sense.

I've had this discussion more times than I care to admit, and am currently running a few of them at once. I've yet to hear ONE person say they are doing it for medical reasons. Not ONE. Not even you.

THE most common reason I hear is “I like the look of a circumcised penis”. What if his future wife doesn't, cos after all, the mother ain't going to be the one looking at it!

Kind of blows your fairy tale version of parents who are doing what is best for the child.


I disagree. It's perfectly natural to extrapolate from one's own preferences, and in some societies the statistical chances are good that others will agree.

Cosmetic reasons are NOT within the realm of “what's best for the child”.

You don't think so? So, if a child has the misfortune to have a large, unsightly birthmark, you don't think it would be in his best interests to have it removed? No, that's not quite the right question: do you believe that other people would think it in his best interests?

Societal norms and cultural expectations will cause a parent to “believe” they are doing the best thing for the child, but it is arbitrary and ultimately shallow and always fear-based.

Is that true if they make a decision that you approve of as well? Or are only decisions that meet your disapproval arbitrary and shallow and fear-based?

(continued)

Jake said...

What is best for the child is having a parent who thinks they are beautiful and perfect from the day they are born.

I guess what differs between us is that you believe you know what is best for all children, whereas I am prepared to accept that others know better than I.

Unbridled parental authority over the child's body with no repercussions based on nothing but trust in the parent's desire to do what is best for the child is a commendable ideal and one I share but in reality rife with danger. Parents hurt their children, water board them because they can't recite the alphabet, molest them...

This is true, but thankfully these are exceptions to the rule. And, as I said previously, society can and should step in where a parent's decision would result in obvious harm to a child.

Even if there was some miraculous benefit to circumcision to prevent STDs, it is of no benefit to babies, babies don't get STDs! Sexually ACTIVE people get STDs.

You do agree that babies become adults?

It can wait.

And if it can wait, then the reasons for INFANT circumcision become cosmetic and/or preferential.


I disagree.

Firstly, infant circumcision offers protection that cannot be attained later. For example, the protection against urinary tract infections is of greatest value in infancy (since UTIs are frequent and more serious in the first year of life), the protection against penile cancer may be greatest when performed in infancy, protection against balanoposthitis in childhood, etc.

Secondly, if circumcision is to be performed, then greatest benefit is obtained by performing it in infancy. Complications are fewer, cost is lower, there are no days lost from education or work, no period of abstinence, there is no embarrassment or fear of surgery to overcome, etc.

We cannot know which male babies will grow into the ones who resent losing their foreskin, just as your parents couldn't know you didn't want a foreskin. In fact, most of us wouldn't know we didn't want one until we had lived with it for some time, maybe 5 years, maybe 20, but we need time inside our own body to know that. My mother could not know that about me anymore than my friend's mother could know she would alter her vagina as an adult. The surgery is more complicated as an adult and there is more scarring, but at least you can ask for exactly what you want, how much you want taken off, etc. That I need to spell this out is ludicrous.

There are four possibilities:
* A boy is circumcised and is contented.
* A boy is circumcised and resents it. He has the option of foreskin restoration.
* A boy is uncircumcised and is contented.
* A boy is uncircumcised and resents it. He has the option of circumcision.

I am not against circumcision, I'm against ROUTINE INFANT CIRCUMCISION. This puts me in the company of ALL the associations who's recommendations are that routine infant circumcision cannot be recommended.

As far as I can tell, you're against elective infant circumcision, which is what we've been discussing. Routine infant circumcision would be circumcision of all newborn boys, something that very few advocate.

Here is the American Assoc of Pediatrics, which the AMA states it agrees with:
"The existing scientific evidence is not sufficient to recommend routine circumcision."


Indeed, they don't recommend that all newborn boys are circumcised, but instead recommend that parents should make that decision. Are you saying that you agree with that?

(continued)

Jake said...

There is no benefit for routine infant circumcision. ...

On what basis are you making that claim?

The study I linked is relevant because it is the most recent. Are you going to debunk a 2010 study with one from 2003? It is possible, but usually up-to-date studies tend to trump outdated ones.

That's a fallacious argument: more recent studies are sometimes of higher quality, but that is by no means guaranteed. Serious assessment of the evidence needs to take stock of all the evidence, paying attention to its quality.

Since you have tried to convince there is a medical benefit, perhaps you'd like to address that.

What, specifically, would you like me to address?

The argument on parental rights is another topic altogether. A child has rights, you are saying the parent trumps those rights, including in unnecessary situations and even for simple preference. You've split the whole thing wide open in this regard, because you have let in abuse and as long as it is done with the parent's belief it is in the child's best interest, that's ok with you. Unless you clarify or tell me I'm mistaken, there is no more to say on that.

Well, you seem to maintain the position that a child has a right not to be circumcised. I don't believe that to be the case.

Sagacious Mama said...

Here's a little secret: I didn't choose not to circumcise my son for any of the reasons I listed. I didn't “choose” anything. To say I “chose” to leave him intact is like saying I chose to leave his earlobes on. Likewise, to say a parent has the choice to amputate her son's foreskin, one must also, by virtue of logic, say that the parent has the choice to amputate anything else from her son.


The benefit vs risk discussion is meaningless without benefit vs loss. You believe the foreskin is not only a non-issue with little or no function but you go further than that... you actually dislike it, are perhaps repulsed by it, this is evidenced in your language, comparisons and surgery. It is no great loss to you; consulting you about circumcision is like consulting a veterinarian who doesn't like animals. This skews your perspective, and is important to note.


Whose body, Whose rights



The breast cancer statistics are 1 in 9. Extremely high. Mastectomy can be done under local anaesthetic with externals (eg nipples) left intact. Prophylactic mastectomy reduces the chances of cancer in some cases by 90%. Yet, removal of breast tissue in infancy would not be considered due to benefit vs loss and ethics.


What is more interesting is that men suffer breast cancer at a rate of 2000 new diagnoses a year, death of 500 p/y.


Did you know that is more than penile cancer (1400, 300 deaths)!?


There are no other amputations done to infants under the guise of prophylactic medical benefit. The idea of amputation for such low return medical benefit is ludicrous.


Interesting dialogue: The hazards of circumcision are considerable,5-7 and the indications for the procedure are few.8


"When an American physician says that circumcision prevents UTI or cancer of the penis, he is sincere. But, it is like a medieval Chinese physician saying that foot binding prevents flat feet. If someone asks me, "What rate of preventable UTI would justify male circumcision?" I respond by asking, "What rate of preventable UTI would justify female circumcision?" The second question is patently absurd unless one's cultural bias allows a sympathetic view of female circumcision. Therefore, the first question can be only slightly less absurd."- Martin S. Altschul MD


But since you insist on this absurd notion of Good Medicine...


2. The state of being unimpaired; soundness.

Personally, I would say that a child has a right to integity in sense 2.



You agree the child has the right to being unimpaired, do you therefore see the foreskin as having no function that circumcision impairs? What evidence do you have for this conclusion?


This isn't about degrees. Removing an organ is black and white, you either take the organ, or you don't. Leaving the body INTACT and WHOLE is a different topic to things such as tattoos, needles and so on. If you do want to compare apples, then bring apples, not minivans.


I disagree. It's perfectly natural to extrapolate from one's own preferences, and in some societies the statistical chances are good that others will agree.


Cultures do all kinds of interesting things to their bodies. Show me one that does it to their infants.


If you can, you'll be showing me cranial modification, which isn't practiced anymore. Most cultural modifications are coming of age rituals, and in some unfortunate cases young childhood but it is as unanimous as a planet can be, with extreme exceptions, that infancy is sacred, and left well enough alone, trusting that what the child is born with, the child gets to keep. Circumcision is the only one left.

Sagacious Mama said...

I fear for a planet who's people need the ethics spelled out. Some babies vomit, some stop screaming and their heads just quiver, the trauma and pain so overwhelming they later die from shock. And yes, this includes anaesthetised babies. EMLA is a joke, but I see we agree there, but you would jab them with the block instead.


You've overlooked an important difference between adult and infant anaesthetics - an adult can tell you if it hurts, if the block has worked, if it needs more time to kick in, if they have more after-pain...


All observational pain studies and treatments are based on, or include, crying. Children are troopers, not crying does not = not feeling pain, yet this is concluded in many of the pain studies. As a mother this is obvious, I know when they may not be crying but are in a lot of pain. I've seen the studies on anaesthetic for circ, loads of them, and they are flawed.

We, esp America, have the ignorance to scratch our heads and wonder what has gone wrong in society... If a society can't see the brutality of the way they treat their newborn babies, the easiest thing to see, how can we expect them to see the more subtle areas of harm? Research: Continuum Concept by Leidloff, The Vital Touch by Heller, both anthropological studies (not limited to circ). Documentaries and so on also contain the science and I can't be bothered getting up to look at the titles but if you want them, ask.


So, if a child has the misfortune to have a large, unsightly birthmark, ... do you believe that other people would think it in his best interests (to have it removed)?

Yes, I think other people would think it is in his best interests. What is generally recommended is to wait until the child at least has the ability to partially understand what is happening to him, and preferably ask for change himself. I think if the child can make the call, let them make the call.

All of this is deeply linked to your idea of the foreskin itself. Removing a healthy body part is never in the best interests of the child, most of the planet don't need “evidence” of that. I agree a parent may think it is in his best interests, but I also have a friend who had four of the fingers of her left hand removed with a bench saw because her father thought it was in her best interests. Does the fact that the majority of people think that is offensive make it so? If so, then by that rationale, circumcision is offensive.

A child born with something outside the realm of normal or healthy is a different argument with different parameters, and until you can wrap your head around the fact that the foreskin is a normal, healthy body part, you'll never get the rest of it.


Is that true if they make a decision that you approve of as well? Or are only decisions that meet your disapproval arbitrary and shallow and fear-based?

When a parent does anything to or for a child, even if that is just choosing his shirt, it is subject to that element, yes. Whether I approve of the shirt chosen is irrelevant. When I let my child choose for himself, that element does not exist in the choice.

We are products of our society, our thinking is a result of that and our emotions are a result of our thinking. Avoidance of negative emotions and desire for positive ones are powerful motivators. Many decisions a parent makes are based in love, but love and fear are often confused. Any decisions made for the child that do stem from conditioning are fear based. Cosmetic surgery is a massive mountain of fear: avoidance of rejection, desire for belonging... etc and so forth. That is one ugly emotional furnace that has no place anywhere near a baby. The parent should get some kind of counselling in acceptance, non-judgment and inner peace instead of altering her child's genitals.

Sagacious Mama said...

I guess what differs between us is that you believe you know what is best for all children, whereas I am prepared to accept that others know better than I.

Are you suggesting it ISN'T best for all children to have a parent that thinks they are beautiful and perfect from birth? Do you believe there are exceptions to that?


This is true (abuse of parental power), but thankfully these are exceptions to the rule.

So is circumcision.

Except in the Middle East and America.


And, as I said previously, society can and should step in where a parent's decision would result in obvious harm to a child.

What is "obvious harm" and who makes that call? You demonstrate that it is subjective, because circumcision is obvious harm to the majority of the world, "benefits" and all.

Which is it: carte blanche parental authority – because what is forced cosmetic surgery if it isn't abuse of power?? - or is it “with boundaries”, arbitrary and subject to change according to era and culture?
The law in many countries does NOT think FGM is ok. It took a lot to reach that conclusion and it is still a battle in some places (not unlike this battle). Is the law a fair indicator of “obvious harm” boundaries?


You do agree that babies become adults?

Yes. You do agree babies are not adults?

Again, it requires the view that the foreskin is a non-issue to think that removing it for prophylactic purposes makes any sense. Circumcision is a treatment looking for a disease.

The adult male circumcision rate is tiny, esp in the West. This fact alone shows that even given information of what circ can prevent, men do not choose it. In fact, if they choose it at all, it's for cosmetic reasons. So if men are not choosing it for themselves based on medical reasons, they are showing it doesn't matter to them enough.


I disagree (that it can wait).

Firstly, infant circumcision offers protection that cannot be attained later. For example, the protection against urinary tract infections is of greatest value in infancy (since UTIs are frequent and more serious in the first year of life), the protection against penile cancer may be greatest when performed in infancy, protection against balanoposthitis in childhood, etc.


Look, the stats of penile cancer are too small to include as an option for removal of a healthy organ (1 in 100000).

As for UTI's, at least their statistic is a whole number, at 1 or 2% for males, depending who's stats you buy. (female 8%) However discussing this is problematic for me as I cure them so easily in clinic within 24 hours, 100% of the time. For argument's sake though, let's pretend I don't. The pain and psychological ramifications, not to mention ethical considerations do not, in any way, come close to the problems with UTI's, even when complications such as kidney involvement are factored in - the stats are too small or non existent, hence why they focused on the few (flawed) studies that showed the hiv link for Africa, it was the only one that wasn't laughable.
(read the books and research the massive subject of infant psychology before trivialising said).

Sagacious Mama said...

Surely you have something of significance to show me? Seriously, UTI's? The rest are “in case” they get sick as an adult? Breastfeeding is a significant deterrent to UTIs , btw.

http://www.circinfo.org/utis.html#Breast"


http://www.informaworld.com/smpp/content~content=a713941290&db=all

http://www3.interscience.wiley.com/journal/119921989/abstract">

Secondly, if circumcision is to be performed, then greatest benefit is obtained by performing it in infancy.
No. Infant circ carries less risk, not greater benefit. There is a difference.

The benefits are greater for sexually active people. Conditional upon the prerequisite belief in old flawed studies of any benefit at all of course.


You got it done for cosmetic reasons and at best so does everyone else. Most get it done because that's just what's done. Prophylactic amputation in newborns is a serious offense, and makes not one iota of sense when weighed against the few things it has shown a correlation of decrease in and those are either extremely rare or easily treatable (or not even an issue, as some studies show). Hey look ma, I can cherry pick data, too!


The medical theatrics change with new information and are really just a modern hook to hang the status quo on and an attempt to find a way to make this violation to our most vulnerable make sense.

The “medical studies” merry go round High School Debate Skills 101. Good times. Good times.

The origins were not medical (source: wiki, perhaps even written by your own keystroke), and if you're paying attention, it still isn't.

Complications are fewer, cost is lower, there are no days lost from education or work, no period of abstinence, there is no embarrassment or fear of surgery to overcome, etc.

It seems evident you have no idea about infants.

No fear of surgery to overcome? Where do you think a fear of surgery might originate? No loss from work? Bonding, undrugged and without convalescence from surgery is an infant's job, amongst other things. It secures the survival of mammalian infants. In humans, the complexity of the requirements of the bond is beyond the scope of a blog comment. As a mother who has been there and a healer who has helped others, if the bonding is messed with, there are serious long term repercussions. Do you think that because you don't remember your infancy it doesn't matter what you do to an infant? It is akin to “infants don't feel pain”, and only low EQs with the empathy of a lizard needed to actually do studies to prove such an ignorant statement.

The foundational hours have been proven to be essential to establishing breastfeeding and bonding, the foundation weeks, months, years all contain their own importance in ways we are only just beginning to get into our thick materialistic heads - as we stand around with our wires and data and white coats and attempt to understand the complexity of a baby. It's amusing.

There are SO many things we don't know, yet we carry on like we know it all and base huge decisions with amputation stakes on our limited information. Did you know that breast milk will change according to who is feeding from the breast? The milk actually puts in more protein or vit A or whatever according to the needs of the baby. How in hell it does that is beyond science, some kind of body to body communication. However, what that tells us is... we don't have a clue what is going on and we are making assumptions based on infantile scientific knowledge. "the foreskin has no purpose" is as medieval as circumcision (which I guess makes perfect sense).

Sagacious Mama said...

There are four possibilities:
* A boy is circumcised and is contented.

This is the most flawed argument. The reason they are generally "contented" is because they don't know it any other way. Some men are often relieved to find out about the loss of sensation because they had no idea why they need so much porn, so much stimulation.

* A boy is circumcised and resents it. He has the option of foreskin restoration.
Restoration is a misnomer, you cannot restore it, it was cut off and thrown away. 30000 nerve endings, mucosal tissue, frenulum... the list goes on and doesn't yet even include the immeasurable. You can only stretch the skin so that it covers the glans, but it isn't the foreskin, it is stretched penile skin. It is an uncomfortable procedure that goes on for over TWO YEARS. Your cavalier attitude is a luxury afforded you by the fact that you could get what you wanted. You could even ask for how much you wanted to have removed. Babies can't do that. But I waste my time, you really do not care.


That's a fallacious argument: more recent studies are sometimes of higher quality, but that is by no means guaranteed. Serious assessment of the evidence needs to take stock of all the evidence, paying attention to its quality.

Will you be adding the latest study I linked to your blog? It is only a couple of weeks old, and this is Circumcision News, after all. Poorly named, as I believe Pro-Circumcision Propaganda might be more appropriate. You take issue with the bias of Intactivism and then serve a steaming hot cup of hypocrisy with this blog. At least with my article I clearly mark the bias in the title.

Well, you seem to maintain the position that a child has a right not to be circumcised. I don't believe that to be the case.
You are saying I didn't have the right not to be circumcised. Is this correct?

Jake said...

Here's a little secret: I didn't choose not to circumcise my son for any of the reasons I listed. I didn't “choose” anything. To say I “chose” to leave him intact is like saying I chose to leave his earlobes on.

With respect, I think you're posturing. I believe you did make a conscious choice, and thought about it at length, as is evidenced by your blog post.

... The benefit vs risk discussion is meaningless without benefit vs loss. You believe the foreskin is not only a non-issue with little or no function but you go further than that... you actually dislike it, are perhaps repulsed by it ...

I think perhaps we misunderstand each other. I would say that loss is essentially a form of risk. It can certainly be modelled in the same way: a probability of occurrence and a degree of severity. I'm afraid you have an incorrect impression about my views, incidentally.

Whose body, Whose rights

To repeat my earlier request, could we try to cite credible sources, please?

The breast cancer statistics are 1 in 9. Extremely high. Mastectomy can be done under local anaesthetic with externals (eg nipples) left intact. Prophylactic mastectomy reduces the chances of cancer in some cases by 90%. Yet, removal of breast tissue in infancy would not be considered due to benefit vs loss and ethics.

I agree: the risks would outweigh the benefits.

What is more interesting is that men suffer breast cancer at a rate of 2000 new diagnoses a year, death of 500 p/y. ... Did you know that is more than penile cancer (1400, 300 deaths)!?

Yes, it is, but I'm not sure what point you're trying to make.

There are no other amputations done to infants under the guise of prophylactic medical benefit. The idea of amputation for such low return medical benefit is ludicrous.

I'm not sure whether it is intentional or not, but you've only listed one of many medical benefits, and you haven't set that against risks.

Interesting dialogue: The hazards of circumcision are considerable,5-7 and the indications for the procedure are few.8

Not an assessment with which I would agree.

(continued)

Jake said...

"When an American physician says that circumcision prevents UTI or cancer of the penis, he is sincere. But, it is like a medieval Chinese physician saying that foot binding prevents flat feet. If someone asks me, "What rate of preventable UTI would justify male circumcision?" I respond by asking, "What rate of preventable UTI would justify female circumcision?" The second question is patently absurd unless one's cultural bias allows a sympathetic view of female circumcision. Therefore, the first question can be only slightly less absurd."- Martin S. Altschul MD

Argument by analogy is always weak at best. What Altschul appears to be saying here is that he is sufficiently biased against female circumcision that he would not consider any evidence in its favour. As one trained in scientific thought, I find that disturbing. We should always be willing to consider evidence with an open mind.

[I wrote] 2. The state of being unimpaired; soundness.
Personally, I would say that a child has a right to integity in sense 2.

You agree the child has the right to being unimpaired, do you therefore see the foreskin as having no function that circumcision impairs? What evidence do you have for this conclusion?

I have studied a very large proportion of the literature on the subject, and have found no evidence of any function that is impaired by circumcision.

This isn't about degrees. Removing an organ is black and white, you either take the organ, or you don't. Leaving the body INTACT and WHOLE is a different topic to things such as tattoos, needles and so on. If you do want to compare apples, then bring apples, not minivans.

Actually, once tattoos and needles are introduced, the body is no longer intact, if one wishes to be pedantic. Perhaps it seems ridiculous to you to say that, but I assure you it is no more ridiculous than claiming that a circumcised male is not intact. Let me explain. You can make a technical argument, using careful definitions, to argue that circumcision violates bodily integrity. But if you do that, you must also accept an equally technical argument, using similarly careful definitions, to make a point that you find absurd. And that brings us back to my point: where do you draw the line?

I fear for a planet who's people need the ethics spelled out. Some babies vomit, some stop screaming and their heads just quiver, the trauma and pain so overwhelming they later die from shock. And yes, this includes anaesthetised babies. EMLA is a joke, but I see we agree there, but you would jab them with the block instead.

Indeed — ring blocks are highly effective.

You've overlooked an important difference between adult and infant anaesthetics - an adult can tell you if it hurts, if the block has worked, if it needs more time to kick in, if they have more after-pain...

I agree — infant anaesthetics need to be used with care.

(continued)

Jake said...

All observational pain studies and treatments are based on, or include, crying. Children are troopers, not crying does not = not feeling pain, yet this is concluded in many of the pain studies. As a mother this is obvious, I know when they may not be crying but are in a lot of pain. I've seen the studies on anaesthetic for circ, loads of them, and they are flawed.

By all means propose some alternative criteria for measuring pain, but with respect I think you'll need to come up with something more objective than motherly intuition.

[I wrote] So, if a child has the misfortune to have a large, unsightly birthmark, ... do you believe that other people would think it in his best interests (to have it removed)?

Yes, I think other people would think it is in his best interests. What is generally recommended is to wait until the child at least has the ability to partially understand what is happening to him, and preferably ask for change himself. I think if the child can make the call, let them make the call.

I can see arguments either way, and I don't think we need to argue the point (and I'm not altogether sure which way I'd argue anyway). My point was that people can perform cosmetic surgery in the belief that it is in the best interests of the child, and I'm pleased that you seem to acknowledge that.

A child born with something outside the realm of normal or healthy is a different argument with different parameters, and until you can wrap your head around the fact that the foreskin is a normal, healthy body part, you'll never get the rest of it.

I'd agree that the situation is a little different, but it seems strange to apply a completely different set of arguments. Surely if an approach is good and solid then it ought to apply in multiple situations?

[I wrote] And, as I said previously, society can and should step in where a parent's decision would result in obvious harm to a child.

What is "obvious harm" and who makes that call? You demonstrate that it is subjective, because circumcision is obvious harm to the majority of the world, "benefits" and all.

Where is your evidence that circumcision is obvious harm to the majority of the world? If that were so, wouldn't it likely be illegal in the majority of countries?

Which is it: carte blanche parental authority – because what is forced cosmetic surgery if it isn't abuse of power?? - or is it “with boundaries”, arbitrary and subject to change according to era and culture?
The law in many countries does NOT think FGM is ok. It took a lot to reach that conclusion and it is still a battle in some places (not unlike this battle). Is the law a fair indicator of “obvious harm” boundaries?


The law is probably a reasonable indicator of majority viewpoints, but those are certainly subject to change over time, both in response to social and cultural changes, and also in response to the availability of evidence.

(continued)

Jake said...

[I wrote] You do agree that babies become adults?

Yes. You do agree babies are not adults?

Naturally.

The adult male circumcision rate is tiny, esp in the West. This fact alone shows that even given information of what circ can prevent, men do not choose it. In fact, if they choose it at all, it's for cosmetic reasons. So if men are not choosing it for themselves based on medical reasons, they are showing it doesn't matter to them enough.

There are several flaws in this argument. First, the actual adult circumcision rate in the West is unknown, which is the first problem, because you're basing the rest of your argument on an assumption. (I'm not saying that the assumption is wrong, just that it's an assumption.) Second, what evidence have you that men are "given information of what circ can prevent"? Are there large-scale programmes to educate men on these issues? Not to my knowledge. So an alternative explanation for the low rate (assuming it is indeed low) is that men simply have no knowledge of the benefits. You don't have enough data to make the argument you're trying to make. If you want to look at studies of attitudes towards circumcision among uncircumcised men, try this, this, this, or this.

[I wrote] Firstly, infant circumcision offers protection that cannot be attained later. For example, the protection against urinary tract infections is of greatest value in infancy (since UTIs are frequent and more serious in the first year of life), the protection against penile cancer may be greatest when performed in infancy, protection against balanoposthitis in childhood, etc.

Look, the stats of penile cancer are too small to include as an option for removal of a healthy organ (1 in 100000).

Firstly, that's the annual incidence — lifetime risk for an uncircumcised male is approx 1 in 600 to 1 in 1400. Secondly, while it may not be sufficient justification for circumcision by itself, it's just one of many benefits, and it would be shortsighted not to include all benefits, even those affecting low-risk conditions, when weighed against the risks.

As for UTI's, at least their statistic is a whole number, at 1 or 2% for males, depending who's stats you buy.

1-2% in infancy is probably about right. More over a lifetime.

(continued)

Jake said...

(female 8%) However discussing this is problematic for me as I cure them so easily in clinic within 24 hours, 100% of the time. For argument's sake though, let's pretend I don't. The pain and psychological ramifications, not to mention ethical considerations do not, in any way, come close to the problems with UTI's, even when complications such as kidney involvement are factored in - the stats are too small or non existent, hence why they focused on the few (flawed) studies that showed the hiv link for Africa, it was the only one that wasn't laughable.
(read the books and research the massive subject of infant psychology before trivialising said).


I think you should quantify and substantiate your claims.

Surely you have something of significance to show me? Seriously, UTI's? The rest are “in case” they get sick as an adult? Breastfeeding is a significant deterrent to UTIs , btw.

Yes, breastfeeding also reduces the risk of UTIs.

[I wrote] Secondly, if circumcision is to be performed, then greatest benefit is obtained by performing it in infancy.

No. Infant circ carries less risk, not greater benefit. There is a difference.

Less risk and greater benefit. The greater benefits are those I outlined: protection against UTI, balanoposthitis, phimosis, penile cancer, etc.

The medical theatrics change with new information and are really just a modern hook to hang the status quo on and an attempt to find a way to make this violation to our most vulnerable make sense.

And you would prove this how, precisely?

No fear of surgery to overcome? Where do you think a fear of surgery might originate? No loss from work? Bonding, undrugged and without convalescence from surgery is an infant's job, amongst other things. It secures the survival of mammalian infants. In humans, the complexity of the requirements of the bond is beyond the scope of a blog comment. As a mother who has been there and a healer who has helped others, if the bonding is messed with, there are serious long term repercussions. Do you think that because you don't remember your infancy it doesn't matter what you do to an infant? It is akin to “infants don't feel pain”, and only low EQs with the empathy of a lizard needed to actually do studies to prove such an ignorant statement.

So where is the evidence? Where is the evidence showing behavioural or psychological harm from infant circumcision? There basically isn't any. There are a handful of speculative, hypothetical papers theorising that it might do this or might do that, but without any evidence they're hard to take seriously.

[I wrote] There are four possibilities:
* A boy is circumcised and is contented.
This is the most flawed argument. The reason they are generally "contented" is because they don't know it any other way. Some men are often relieved to find out about the loss of sensation because they had no idea why they need so much porn, so much stimulation.

Oh, come on! There's no loss of sensation. Anyway, the issue is whether they're contented, not whether you think they should be.

[I wrote]* A boy is circumcised and resents it. He has the option of foreskin restoration.
Restoration is a misnomer, you cannot restore it, it was cut off and thrown away. 30000 nerve endings, mucosal tissue, frenulum...

I feel like I'm repeating myself here: no study has ever counted the number of nerve endings.

the list goes on and doesn't yet even include the immeasurable. ...

What objective evidence is there that the restored foreskin is unsatisfactory when compared with a natural foreskin? As far as I can tell, there is none: sure, restoring men sometimes imagine that a natural foreskin must be better, but that's not evidence.

Anonymous said...

Poor Jake....
Only 7 years since his circumcision...He doesn't even have a clue. And ever heard of "Having children changes everything..." Well, Jake doesn't know, he hasn't changed, he is still in his cocoon.

Anonymous said...

I am a female with INTIMATE knowledge of both circumcised and normal functioning penises. I can assure you that some of these statements that Jake can't see on a paper, I can feel.. and would NEVER take that away from my husband or child.
It would be like cutting off all of his toes.

Jake said...

To the recent anonymous poster:

Being condescending isn't a substitute for presenting evidence in support of your position.

Amanda said...

When surveyed, my husband says that the tip of his foreskin is the most sensitive area of his penis. Another male erogenous zone is the frenulum and the frenulum is continuous with the foreskin and removing the foreskin is going to remove some percentage of it, perhaps 100%.

Yes, this is anecdotal. Here's a study:

http://www.nocirc.org/touch-test/bju_6685.pdf

The study concludes:

"The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce
is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis."

While men differ and you may personally have had no sensation in these areas worth keeping, how can you think it is ethical to remove this from unconsenting minors? For my husband, and based on what I have read, for most men, removing the foreskin is comparable to removing a female's clitoris (women/girls vary a great deal and perhaps for a few, removing the clitoris would not result in a great loss of sensation either.)

I find it amusing, in a dark way, that you don't think it justified to remove a girl's breast buds to prevent breast cancer. Apparently, no disease risk is too great when your own aesthetic preferences are involved. Yet you seem very concerned with minute risks of UTIs, and with STDs which have known, extremely effective, and non-invasive preventatives (unlike breast cancer).

Jake said...

When surveyed, my husband says that the tip of his foreskin is the most sensitive area of his penis.

While interesting, I can't see why that's more compelling than the fact that many men report nothing of the sort.

Here's a study:

http://www.nocirc.org/touch-test/bju_6685.pdf

The study concludes:

"The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce
is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis."


Yes, I've published a critique of that study here.

While men differ and you may personally have had no sensation in these areas worth keeping, how can you think it is ethical to remove this from unconsenting minors? For my husband, and based on what I have read, for most men, removing the foreskin is comparable to removing a female's clitoris (women/girls vary a great deal and perhaps for a few, removing the clitoris would not result in a great loss of sensation either.)

If that were so, studies would consistently show huge losses in sensation and satisfaction among adult circumcision patients. But they don't. In fact, they indicate that such an outcome is unusual, consistent with the idea that the foreskin really doesn't matter very much.

I find it amusing, in a dark way, that you don't think it justified to remove a girl's breast buds to prevent breast cancer. Apparently, no disease risk is too great when your own aesthetic preferences are involved. Yet you seem very concerned with minute risks of UTIs, and with STDs which have known, extremely effective, and non-invasive preventatives (unlike breast cancer).

It seems quite clear to me that the risk:benefit balance is very different for the two procedures. I'm at a loss to understand why you appear to feel otherwise.