en-us https://www.intensedebate.com/users/422022 Comments by ml66uk http://forward.com/articles/198053/few-complications-with-circumcision-of-infants/#IDComment829761900 I don't have access to the full paper yet, but studies like this never seem to include meatal stenosis (seen almost exclusively in males circumcised shortly after birth) as a complication, or possible sexual difficulties later in life. Given the figures they're talking about it seems unlikely they included the chance of a revision or lysis of penile adhesions (both involving a second procedure) as "adverse events" either eg pubmed 23820002. Why not? and they won't have included this: Bauer, Kriebel, 2013, pubmed 23656698 "For studies including boys born after 1995, there was a strong correlation between country-level (n=9) autism/ASD prevalence in males and a country's circumcision rate (r=0.98). A very similar pattern was seen among U.S. states and when comparing the 3 main racial/ethnic groups in the U.S." (the authors postulate that this is due to paracetamol, though this doesn't seem clear) It's also worth noting that only around 10% of the world's circumcised men were circumcised as infants, and that in countries where neonatal circumcision is rare, medically-required circumcision later in life is also very rare - less than 1% in some countries. Tue, 13 May 2014 12:13:41 +0000 http://forward.com/articles/198053/few-complications-with-circumcision-of-infants/#IDComment829761900 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829753945 The glans is sensitive, and certainly far more sensitive than the middle of the shaft, but still nowhere near as sensitive as most people think. The nerve ending concentration is roughly the same as in the heel. Even on a circumcised man, the glans isn't the most sensitve part of the penis though, and the dorsal midline isn't even the most sensitive part of the glans, which is why that study doesn't realy make much sense. It's like trying to measure whether or clitoral surgery has an effect by measuring vaginal sensitivity. Most of the sexual sensation in men seems to take place in the sulcus (just under the ridge), the frenulum if it's still there, and around the scar line or inner foreskin (the outer foreskin isn't much different to the lower shaft). I've looked at the studies and made an informed decision, but believe that the choice should be choice should be that of the person whose body it is. Many national medical organizations seem to agree. Tue, 13 May 2014 11:45:46 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829753945 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829739786 Brian Morris isn't a pediatrician, urologist, or even a physician. PZ Myers: "But then, that’s Brian Morris all over the place. He actively tries to suppress work that doesn’t support his conclusions, he inflates any evidence that suggests circumcision might have a few benefits (there are some!), and dismisses any evidence to the contrary…or worse, twists it around to claim it supports the opposite of the author’s interpretations. All this in defiance of worldwide statements from pediatric organizations that say the evidence for health benefits from circumcision are weak, and that routine circumcision is not recommended." Another doctor (unfortunately links aren't allowed): "Having reviewed Dr. Morris’s study, I find his statements about the benefits of circumcision as a routine procedure overblown, and the comparison with vaccination baseless." Several national medical organizations continue to recommend against male circumcision. Tue, 13 May 2014 10:57:24 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829739786 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829738939 "The patients were tested on the dorsal midline glans of the penis" Huh? What was the point of that? The inner foreskin is the most sensitive part of the penis - it's not just there to protect the glans. Even on a circumcised man, the glans isn't usually the most sensitive part - it's normally the scar line, or the frenulum if that wasn't removed. Skeptical? Try stimulating only the glans and the shaft an inch below the glans, and see how much sensation is missing. Tue, 13 May 2014 10:54:17 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829738939 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829737473 AAP - "Care of the Uncircumcised Penis" "foreskin retraction should never be forced. Until separation occurs, do not try to pull the foreskin back — especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin." Canadian Paediatric Society "Keep your baby’s penis clean by gently washing the area during his bath. Do not try to pull back the foreskin. Usually, it is not fully retractable until a boy is 3 to 5 years old, or even until after puberty. Never force it." RACP policy statement on male circumcision "The foreskin requires no special care during infancy. It should be left alone. Attempts to forcibly retract it are painful, often injure the foreskin, and can lead to scarring and phimosis." Both the AAP and CPS suggest that early retraction is a lot more common than seems to be the case. A Danish study (Øster) found that only 23% of boys could retract by the age of 6-7, and an average age of ten. Why would anyone know or care though? We don't go poking around in the genitals of small girls. Tue, 13 May 2014 10:49:00 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829737473 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829735218 Having more sensitivity seems to mean more control. It's circumcised men that seem to have more of a problem with PE (Tang and Khoo 2011). Tue, 13 May 2014 10:41:06 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829735218 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829347106 Not all Jewish people believe in infant circumcision. Brit Shalom is an alternative naming ceremony to celebrate the birth of baby boys to Jewish families. There are several sites run by Jewish people opposed to infant circumcision. Mon, 12 May 2014 13:01:52 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829347106 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829346458 38 senior physicians (around half of them chairs or presidents of national medical organizations responded to the AAP's position statement as follows: "The American Academy of Pediatrics (AAP) recently released its new technical report and policy statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the eight task force members reflect what these individual doctors perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of non-therapeutic male circumcision in the US seems obvious, and the report’s conclusions are different from those reached by doctors in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a quite different view is presented by non-US-based doctors and representatives of general medical associations and societies for pediatrics, pediatric surgery and pediatric urology in Northern Europe. To these authors, there is but one of the arguments put forward by the AAP that has some theoretical relevance in relation to infant male circumcision, namely the possible protection against urinary tract infections in infant boys, which can be easily treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts and penile cancer, are questionable, weak and likely to have little public health relevance in a Western context, and do not represent compelling reasons for surgery before boys are old enough to decide for themselves." Mon, 12 May 2014 12:59:52 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829346458 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829341149 Whose body is it? Why shouldn't they get to choose? Only about 10% of the world's circumcised men were circumcised as infants, so it's not like it can't wait. The "other benefits as one gets older" are highly controversial. It's really esay to find circumcised doctors who are against routine circumcision, but surprisingly difficult to find male doctors in favor who weren't circumcised themselves as children. Mon, 12 May 2014 12:42:40 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829341149 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829332234 There was nothing new in the recent study published by the Mayo Clinic. The lead author isn't a pediatrician, urologist or even a physician, and several national medical organizations continue to recommend against infant circumcision. Girls get 3-4 times as many UTI's as boys, but we wouldn't consider routine genital surgery as an option. Mon, 12 May 2014 12:15:24 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829332234 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829300344 Whatever anyone's views on female or male genital cutting, it's wrong to categorize all forms of FGC as "a hideous form of castration". Many forms are considerably less invasive than the usual forms of male circumcision, and some remove no tissue at all. Even a pinprick on a girl is banned in most western countries though. Anesthesia is often used for FGC, it's usually done to babies in some countries, and its proponents (usually cut women) claim health benefits, so It's hardly "irrational" to compare male circumcision with FGC. In the words of the Hastings Center Report "Seven things to know about female genital surgeries in Africa": "Western media coverage of female genital modifications in Africa has been hyperbolic and onesided, presenting them uniformly as mutilation and ignoring the cultural complexities that underlie these practices. Even if we ultimately decide that female genital modifications should be abandoned, the debate around them should be grounded in a better account of the facts." Mon, 12 May 2014 10:32:14 +0000 http://forward.com/articles/197974/embracing-the-irrationality-of-circumcision-and-ka/#IDComment829300344 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817243509 Sigh... I despise anti-semites, as do all the intactivists I know, though we're aware that some people view being against infant circumcision as anti-semitic by definition. A disproportionate number of intactivists are Jewish btw. Sun, 13 Apr 2014 21:38:56 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817243509 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817229515 It's about human rights for children, not anti-semitism, unless you think the BMA, RACP, CPS, RDMA etc are all anti-semitic. They're all physicians too. There are also several websites run by Jewish people opposed to infant circumcision, and Brit Shalom is an alternative naming ceremony to celebrate the birth of baby boys to Jewish families. Most Muslims, Filipinos, South Koreans and many African males are indeed circumcised, but *not as babies*. Like I said, only 10% of the world's circumcised men were circumcised as infants. Sun, 13 Apr 2014 20:43:58 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817229515 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817225419 It was Joseph Lewis who suggesting they "tried to push the 'ritual nick' ". I'd actually agree more with your phrasing. Personally, I wouldn't have had a problem with the ritual nick as it would save some girls from far worse. The reaction to the AAP's statement was the same as when it was suggested in the Netherlands though, as many people have a zero-tolerance approach to any form of FGC. I know we'll disagree on this, but I find it very strange that many of the peopel who are adamantly against even a pinprick on a girl's genitals don't see a problem with a boy's foreskin being cut off. Sun, 13 Apr 2014 20:27:04 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817225419 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817146501 Sarcasm doesn't make anyone take your views more seriously, and this will be my last comment on this thread. Have you never thought to wonder why it is that it's so hard to find doctors who are in favor of circumcision, but weren't circumcised themselves as children? They can't all be tyrants. If it has to be done shortly after birth, then why is it that only 10% of the world's circumcised men were circumcised as infants (most countries do it anywhere from the age of around seven to late adolescence). Yes, kidney failure is a big issue, but it's very rare, and male circumcision doesn't seem to have a big effect. You'd have to circumcise about 110 baby boys unnecessarily to prevent 1 from having a UTI, and most UTI's are just treated with antibiotics. Many of the 38 physicians that signed that rebuttal to the AAP statement were urologists. Girls get about three times as many UTI's as boys btw, but we wouldn't consider routine preventative surgery to prevent them. I wouldn't wish meatal stenosis on anyone, but it's a common complication of neonatal circumcision (though not circumcision later in life). It's rare , but there are also some horrible cases of infant circumcision going very badly wrong. I've had a UTI btw as a complication of surgery for kidney stones. I also volunteered to become a kidney donor, had the first interview, and was waiting for an appointment for a psychological interview (which is a requirement to be an altruistic donor), when they decided they'd have to turn me down because I'd had kidney stones (though I told them about those right at the start). They seem to prefer older donors, which is surprising, and they said I can apply again ten years after the treatment finished. Sun, 13 Apr 2014 15:43:22 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817146501 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817140150 Ok, two more comments from me, then I'm done. It's my concern for infants that's kept me posting here, and my views are in line with those several national medical organizations, and all the pediatricians who published a rebuttal to the AAP's position statement You may not be aware of this: [I can't post the link] "[30 September 2013] - At a meeting today in Oslo, the children's ombudspersons from the five Nordic countries (Sweden, Norway, Finland, Denmark, and Iceland), and the children's spokesperson from Greenland, in addition to representatives of associations of Nordic paediatricians and pediatric surgeons, have agreed to work with their respective national governments to achieve a ban on non-therapeutic circumcision of underage boys." Sun, 13 Apr 2014 15:25:32 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817140150 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817108665 I believe in choice too, but whose choice should it be? Whose body is it? The CPS, BMA, RACP etc are all highly respected too. There are countries where senior physicians believe that female genital cutting has significant health benefits btw, but that's banned in most western countries. Is the reasoning behind that "the basis of dictatorship and tyranny" too? You're circumcised right? Has it occurred to you that if you hadn't been and I had been, you we might be arguing opposite sides of the argument? It's really easy to convince circumcised men that circumcision is beneficlal, but much harder to find men who think neonatal circumcision a good idea, but weren't circumcised themselves as children. There are some intact men who choose to be circumcised, and I support them having that choice - his body, his choice. Given the choice though, almost all intact men choose to stay intact, and they're free to choose to be circumcised. Men who were circumcised as babies never have the choice to be intact though. ("foreskin restoration" is possible, but you can never get the nerve endings back). If you'd like to continue this discussion by email, my address is ml66uk at gmail dot com. Sun, 13 Apr 2014 13:20:09 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817108665 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817103975 "Deary dear dear. Its tough to hold a weak hand." Huh?!? You're not exactly helping your case. Quoting large parts of the study we're talking about doesn't really help either. I could quote large parts of the position statements on male circumcision of the CPS, RACP, BMA, RDMA etc. They've looked at all the evidence too and come to almost diametrically opposed conclusions. Sun, 13 Apr 2014 12:57:34 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817103975 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817102298 The AAP's Bioethics committee changed its policy on female cutting in 2010 saying "It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual [clitoral] nick as a possible compromise to avoid greater harm." Dr Diekema, the chair of the committee said "We're talking about something far less extensive than the removal of foreskin in a male". They were forced to retract this about six weeks later. Sun, 13 Apr 2014 12:49:40 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817102298 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817091310 It's most definitely an endorsement, but still not a recommendation, "no matter how you might twist it". This is from a direct response to the AAP's position statement on male circumcision, signed by 38 senior physicians, about half of them presidents or chairs of national pediatric or urological organisations): "The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves." Very different from what the authors of this latest study say: "When considered together with ethical and human rights arguments, neonatal circumcision should logically be strongly supported and encouraged as an important evidence-based intervention akin to childhood vaccination." Sun, 13 Apr 2014 12:00:03 +0000 http://forward.com/articles/196400/circumcision-studies-give-backing-to-supporters-of/#IDComment817091310