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US Doctors Back Circumcision
ananyo writes "On 27 August, a report by the American Academy of Pediatrics concludes for the first time that, overall, boys will be healthier if circumcised. The report says that although the choice is ultimately up to parents, medical insurance should pay for the procedure. The recommendation, coming from such an influential body, could boost U.S. circumcision rates, which, at 55%, are already higher than much of the developed world. The researchers estimate that each circumcision that is not performed costs the U.S. health-care system $313."
I'm forfeiting a mod point for this, sorry to whoever I modded up... The actual abstract of the actual paper backing up this claim (BOLD IS MINE):
IOW, no, we're not recommending anything, we're simply saying there are POTENTIAL medical benefits. Well there are potential medical benefits to getting my appendix removed, or my tonsils cut out, it doesn't mean I should be forced to make that decision.
Stupid journalists, we need to seriously trim the fat in that industry and start with these jackasses who misrepresent science for political gain.
I swear they give me mod points to shut me up.
Penile cancer rates are not zero among circumcised and it's such a none issue as it's also incredibly rare among the un-circumcised too. The recent HIV studies are very poor, and quite frankly, bad science (the circed men were given condoms and extra counciling the others did not, and the study was cut short, thus skewing the data as there was a good period where the circed men had to heal up before engaging in sexual activity).
-- oldthinkers unbellyfeel ingsoc
More or less. Several prominent advocates of circumcision, such as John Harvey Kellog, liked the idea that it would reduce masturbation (especially if the pain was remembered!).
The medical benefits are dubious, particularly as there are indications that any reduction in male infection rates are outweighed by increased rates of female infection rates. Either way condoms and HPV vaccinations are far, far, far, far more effective and appropriate.
It depends on whom's facts you read:
The British Medical Association said it had no policy on the issue because of the “absence of unambiguously clear and consistent medical data on the implications of the intervention."
As far as I'm concerned if the evidence is so ambiguous after all this time then there's no necessity for the operation. Look at it this way if it prevents the spread of HIV then why is the infection level in the UK a third of that in the US in percentage terms yet circumcision in the UK is very tiny.
> Paid for by the "Protect the Appendix" campaign.
Educate yourself: the appendix serves as a haven for useful bacteria when illness flushes those bacteria from the rest of the intestines, and thereby helps maintain normal intestinal flora.
Gah, another one. "Take away your studies and facts, I'm not listening, la la la la, I can't hear you..."
Go read it
From the 'Task Force' article:
There is fair evidence that men circumcised as adults demonstrate a higher threshold for light touch sensitivity with a static mono lament compared with uncircumcised men; these ndings failed to attain statistical signicance for most locations on the penis, however, and it is unclear that sensitivity to static monolament (as opposed to dynamic stimulus) has any relevance to sexual satisfaction.
And what does the actual article marked as source for this say:
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..
I've never read 'an article' that as blatantly cherrypicks things supporting their view...
It is what it is.
1) The AAP omitted the fact that the foreskin is an important part of male anatomy with specific sexual, sensory, and protective functions. How can the AAP possibly recommend removing part of the body when they won't even discuss its functions? (Google functions of the foreskin)
2) The AAP failed to address the ethical problems with amputating healthy tissue from a child without that child's consent. Doing so without absolute medical necessity is a violation of the child's basic human right to an intact body and the right to choose for himself when he is an adult.
3) HIV prevention is not a valid reason for circumcising an infant who is not sexually active. HIV is easily prevented in other, less invasive ways. Other modern nations are not endorsing circumcision as an HIV prevention method. To learn more see this handout from Intact America. Also, a recent study from Puerto Rico shows that circumcised men in that area have higher rates of HIV and other STDs than intact men.
4) The AAP cannot credibly say the benefits outweigh the risks since they don't have good data on what the risks are. Few good studies have been done on the risks of circumcision, and no state or national system exists for collecting adverse event reports. Further, very little data is available on long-term complications. Without solid data on the risks and long-term complications of circumcision, any conclusion which weighs benefits vs. risks, or benefits vs. cost, is fundamentally flawed.
5) The AAP is out of step with the statements from other countries. Other nations are moving away from newborn circumcision, even to the point of considering bans on newborn circumcision in some areas, but the AAP is moving in the opposite direction. This shows just now biased the AAP has become and that they are really just trying to justify an outdated practice rather than view the situation objectively. I hope that the AAP comes under international pressure to retract this new statement, as occurred with their ill-conceived female genital cutting statement a few years ago.
Ditto -- one of our kids had a UTI. The prescription? Drink more water and pee more often. Cleared it up in less than a week. Compare that to trying to stick a foreskin back on.
Not only that, from what I can tell the African trials were an exercise in how not to conduct a reliable scientific study and it's a mystery that everyone takes them so seriously. Some of the screw-ups were pretty spectacular - the circumcised group had additional counselling on condom use and safe sex compared to the control and weren't allowed or able to have sex for a relatively large proportion of the study period. Others were more subtle. For instance, they terminated the trial early and circumcised the control group, supposedly because the benefits were so great that they couldn't ethically leave, and this kind of early termination has been shown to cause researchers to find effects that did not in reality actually exist in trials like this one.
They also noticed that the rate of HIV infection amongst the members of the study decreased after the end of the trial and somehow concluded that this was the result of circumcision somehow becoming more effective over time, despite the fact that this could just as easily be caused by (for instance) their exposure decreasing as they got older for unrelated reasons and the lack of a plausible mechanism through which this would happen. They then extrapolated out this decrease into the future and quoted this extrapolated figure prominently as evidence of the effectiveness of circumcision. That prominent journals and institutions were willing to buy into this is truely bizarre.
Source: http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds
See also: http://www.psychologytoday.com/blog/moral-landscapes/201109/myths-about-circumcision-you-likely-believe http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds http://www.psychologytoday.com/blog/moral-landscapes/201109/circumcision-social-sexual-psychological-realities http://www.psychologytoday.com/blog/moral-landscapes/201109/the-ethics-and-economics-circumcision http://www.psychologytoday.com/blog/moral-landscapes/201110/what-is-the-greatest-danger-uncircumcised-boy http://www.psychologytoday.com/blog/moral-landscapes/201110/why-continue-harm-boys-ignorance-male-anatomy
Perl Programmer for hire
Three studies in Africa several years ago that claimed that circumcision prevented AIDS and that circumcision was as effective as a 60% effective vaccine (Auvert 2005, 2006). These studies had many flaws, including that they were stopped before all the results came in.
See http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds
Perl Programmer for hire
So, I would masturbate even more if I hadn't been circumcised? Is this even possible?!
Probably not, but you might enjoy it more.
From the article
There is fair evidence from a cross-sectional study of Korean men of decreased masturbatory pleasure after adult circumcision
Or as they say in the referenced article
There were no differences in sexual drive, erection and ejaculation, but circumcised men reported decreased masturbatory pleasure and sexual enjoyment. We conclude that adult circumcision adversely affects sexual function in a signicant number of men, possibly because of loss of nerve endings.
It is what it is.
The three WHO Africa studies did not survive review:
http://blog.practicalethics.ox.ac.uk/2012/05/when-bad-science-kills-or-how-to-spread-aids/
http://www.publichealthinafrica.org/index.php/jphia/article/view/jphia.2011.e4/html_9
Not application:
http://www.theafricareport.com/index.php/20120711501815186/southern-africa/zimbabwe-concern-over-high-hiv-rates-among-circumcised-males-501815186.html
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf (botton of p135)
Also, infection of men by heterosexual sex is the least important transmission vector in the West, nor does circumcision apparently influence the infection of women by men:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
Besides, how rational is it to tell men that they must be circumcised to prevent HIV, but afterwards they still need condoms to be protected from STDs?
I'm not American, and I can't quite understand where does the custom in the US comes from. Is it religious in origin? I know muslims, jews and americans practice it, but that's about it. Does anyone know?
As far as I know, it's not common at all on other countries.
Apparently, we can thank our puritan roots
Routine circumcision as a preventative or cure for masturbation was proposed in Victorian times in America. Masturbation was thought to be the cause of a number of diseases. The procedure of routine circumcision became commonplace between 1870 and 1920, and it consequently spread to all the English-speaking countries (England, Canada, Australia and New Zealand). None of these countries now circumcise the majority of their male children, a distinction reserved today for the United States (in the UK, in fact, nonreligious circumcision has virtually ceased). Yet, there are still those who promote this social surgery, long after the masturbation hysteria of the past century has subsided.
"By about 1880 the individual... might wish[to]... tie, chain, or infibulate sexually active children... to adorn them with grotesque appliances, encase them in plaster, leather, or rubber, to frighten or even castrate them... masturbation insanity was now real enough--it was affecting the medical profession."
(B. Berkeley, quoted from _Circumcision: The Painful Dilemma_, by Rosemary Romberg, Bergin & Garvey Publisher, Inc, S. Hadley MA, USA, 1985, ISBN 089789-073-6)
Dr. E.J. Spratling, who promoted this surgery by telling his colleagues that "...circumcision is undoubtedly the physician's closest friend and ally..." prescribed in 1895 the method of circumcision as it is practiced in hospitals today.
"To obtain the best results one must cut away enough skin and mucous membrane to rather put it on the stretch when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the penis, for should there be any play the patient will be found to readily resume his practice not begrudging the time and extra energy required to produce the orgasm... We may not be sure that we have done away with the possibility of masturbation, but we may feel confident that we have limited it to within the danger lines."
(E.J. Spratling, MD. Medical Record, Masturbation in the Adult, vol. 48, no. 13, September 28, 1895, pp. 442-443.)
Here is an example of what another sexaphobic American doctor had to say about masturbation in 1903:
"It (self abuse) lays the foundation for consumption, paralysis and heart disease. It weakens the memory, makes a boy careless, negligent and listless. It even makes many lose their minds; others, when grown, commit suicide.... Don't think it does no harm to your boy because he does not suffer now, for the effects of this vice come on so slowly that the victim is often very near death before you realize that he has done himself harm. It is worthy of note that many eminent physicians now advocate the custom of circumcision..."
(Mary R. Melendy, MD, The Ideal Woman - For Maidens, Wives and Mothers, 1903.)
(The above material is quoted from J. Bigelow, The Joy of Uncircumcising, Hourglass Book Publishing, Aptos, CA, USA. Thanks to Robin Verner.)
In America, foreskins were not rare at the time circumcision was introduced into widespread practice. Paradoxically, then, the understanding of the intact male organ at that time was somewhat greater than it is today. (In particular, it never would have been possible to promote circumcision on the basis that it was "necessary for hygienic reasons"---this came later, when doctors themselves were mostly circumcised men.)
[...]
Oh, and you've got to love this quote, which can be found on the same page:
Is that over the price of doing the surgery?
Because from what I could find, it's in the 2-3k range; so if you have to pay $2000 to save $313, that might not be the best idea.
If you're paying 2 to 3 K, you're probably doing it wrong.
A remedy for masturbation which is almost always successful in small boys is circumcision. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment. In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement.
(John Harvey Kellogg, M.D., "Treatment for Self-Abuse and its Effects," Plain Fact for Old and Young. Burlington, Iowa: F. Segner & Co. (1888). P. 295) http://www.cirp.org/pages/whycirc.html
What's the going price of carbolic acid (phenol) these days? ~ $10. And mind you, this added cost is only for females. For males, if you forego anesthesia and all the hassles that come with it, you could probably get a normal Barber to do it for only twice his going rate.
In certain countries they do that, and the West refers to it as "female genital mutilation"
FGM involves removal of the clitoris, and the inner and outer labia to varying extents.
FGM is absolutely intended to deny females sexual pleasure; it's a prophylaxis of sorts against adultery. In actuality, it causes them pain for the rest of their lives.
In these cultures, the men often demand that their bride be cut in this way, otherwise they're undesirable.
I'm not sure that FGM and male circumcision are comparable. Circumcision came about during a time when hygiene was lax, awareness of causes of infection nonexistent.
O lord, bless this thy holy hand grenade, that with it thou mayest blow thine enemies to tiny bits, in thy mercy.
From Nicework there above who did some nice work in bringing some other info to this discussion:
------------------
There already have been two longer replies to the AAP's statement:
http://www.circumcision.org/aap.htm [circumcision.org]
http://www.doctorsopposingcircumcision.org/pdf/2012-08-26A_Commentary.pdf [doctorsopp...cision.org]
Their most important points:
1. The AAP chose to overblow purported benefits by cherry-picking studies and advertising their results past their proportionality, misleading the public with doublespeak of "pro" while admitting circumcision still does not qualify as routine amputation.
2. The AAP omitted both contradicting studies and objections to those it used, such as to the three WHO HIV studies.
3. The AAP omitted any discussion of the foreskin's functionality and notice of possible complications after circumcision (incl. death, an estimated 117 boys in the US per year).