Circumcision update

In October, I posted about my own circumcision. I also wrote about the ongoing research into the link between circumcision and the reduced risk of HIV infection; at that time, studies were still in progress.

The New York Times reports today that the National Institutes of Health is convinced: circumcision works, and they are now formally recommending the procedure. This is powerful and important news.

Let’s get to snippin’.

63 thoughts on “Circumcision update

  1. Let’s not. Unless we’re living in Africa, the risk of a man getting HIV by heterosexual contact is negligible. Might as well cut off your daughter’s breasts to prevent her from getting breast cancer.

  2. I actually wouldn’t be surprised if circumcision CONTRIBUTED to the spread of AIDS in Africa. Traditional circumcision is a bloody business. Its performed by a “traditional surgeon” — a guy with a big knife. (And I mean a BIG knife). The knife is frequently not sterilized (but health education organizations have encouraged the practice of puring gin over it.) Infections are common, resulting in loss of the organ.

  3. X, are you suggesting that Africans have different biologies than the rest of us? Joe, I would imagine that the NIH has weighed out the costs and consequences in reaching their enthusiastic pro-circ stance.

  4. I’m pretty sure XLRQ is simply referring to the rate of HIV+ status amongst the population. It’s lower here, lower still for heterosexuals, so the risk is lower. At least, I hope that’s what he’s getting at.

  5. I’ve heard this before and tend to believe it, but my position has evolved in one respect: If a man is to be circumcised, let it be after he reaches the age of consent, let it be his own decision and let him have anesthesia for the procedure (just the way you had it done, Hugo). Why on earth have we decided it’s OK to routinely slice off a piece of a male’s anatomy with no anesthesia just because that male is too young to protest about it?

    X is right about the miniscule HIV transmission rate among heterosexual men, BTW. Some interesting reading….

    http://www.john-ross.net/aids.htm

  6. I bet HIV transmission goes WAY down if you just lop the whole damn thing off with a (clean!) machete! After all, if they don’t have it they can’t poke it anywhere dirty. Line ‘em up: it’s a public health issue!

    Alternatively, we could just kind of stand back and let people decide for themselves if their genitals need tinkering.

  7. There’s lots of reasons why the AIDS rate is higher in Africa. None of them have to do with Africans having different biology. Some of them are: Lack of sanitary conditions, open sores on the body, traditional practices such as ritual bloodletting, high instance of rape, “dry sex”, failure to properly sterilize needles and scalpels.

  8. I bet HIV transmission goes WAY down if you just lop the whole damn thing off with a (clean!) machete! After all, if they don’t have it they can’t poke it anywhere dirty. Line ‘em up: it’s a public health issue

    That would also solve the rape problem. ;)

  9. Well, Joe, “biological differences” is a pretty wide net to cast. I would take it to include immune-system differences, which are not only genetic but also affected by nutrition. I would imagine that malnutrition contributes to HIV transmission. If a single little virus gets inside, your immune system might kill it, if it’s healthy. But if your immune system is crap because you’ve never even seen a picture of an orange, then that virus is probably going to go to town.

    Even genetic differences contibuting to transmission are possible (though certainly we don’t know of any.) Actually, though, I would expect genetic differences to favor Africans NOT getting HIV, since it’s been such a severe problem for a generation, now. Seems that genomes good at fighting off HIV would be selected.

  10. Dennis, you can’t possibly take yourself seriously.

    To all,
    HIV transmission is primarily related to poverty, which causes poor health care and other difficulties practicing safer sex.

    A recent study was released indicating that westerners had more sex partners, but fewer STDs, indicating that factors beyond “promiscuity” lead to HIV transmission. Now I don’t think that circumcision is a solution, but cutting poverty is.

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  12. X, are you suggesting that Africans have different biologies than the rest of us?

    I find that question uncommonly silly, given the wording of my original comment, which was “unless we’re living in Africa,” not “unless we’re black.” Of course races share some biological traits internally – blacks are at a much higher risk than whites are for sickle cell disease, for instance – I’d be damned if I could think of a single salient biological trait shared by all denizens of Africa (including white South Africans) that is not shared by anyone here in the USA (including blacks who descended from Africa).

    The difference ain’t biology, but physiology. Anal sex frequently causes bleeding, as anuses are not designed to function as vagina-substitutes. That’s why AIDS is pandemic among gays but virtually unheard of among straights who aren’t heroin addicts (or, for that matter, among straights who are heroin addicts but don’t share their needles with anyone). Africa is different because not only AIDS, but other STDs as well are rampant there, some of which result in the open sores Joe alluded to earlier. Where straight sex routinely results in bleeding, it’s just as dangerous as gay sex that results in bleeding. Fortunately, that’s not the case here.

    Bottom line: the AIDS crisis is so bad in Africa that circumcising infants there is probably a good idea. Doing it here, where such exigent circumstances do not exist, is pointless and cruel. Not nearly as pointless or cruel as female genital mutilation, mind you, but pointless and cruel nonetheless.

  13. If a man is to be circumcised, let it be after he reaches the age of consent, let it be his own decision and let him have anesthesia for the procedure

    This has some drawbacks in the AIDS prevention department, given that most people first have sex before they reach the age of consent.

    Not that I have a strong opinion one way or the other about circumcision, just that if the health benefits are sufficiently large, age of consent doesn’t seem to me to be really an issue.

  14. Very often there is no anesthetic (or a far less effective topical anesthetic) in an infant circumcision. No anesthetic + cutting = pain. The benefit of this cutting is that it reduces the transmission of AIDS. Is it your stance that the suffering of one is mitigated by the health benefits to society in general? If so, I honestly don’t see how that jives with your stance against testing on lab animals. Isn’t the rat suffering so that some humans might not have to suffer? (The suffering of one rat mitigated by the health benefits to society in general.)

  15. Even genetic differences contibuting to transmission are possible (though certainly we don’t know of any.)

    Actually, we do. It’s called the CCR5 gene.

    That’s why AIDS is pandemic among gays but virtually unheard of among straights who aren’t heroin addicts (or, for that matter, among straights who are heroin addicts but don’t share their needles with anyone).

    You got any data there, X? The CDC report indicates that in 2004 more people contracted HIV through heterosexual intercourse than IV drug use.

    Given the low rate of HIV infection in the United States, I don’t think that universal circumcision is necessarily the best response. If your risk of exposure is already very low, the most drastic steps should not be the first.

  16. Very nice, evil_fizz. Thanks for droppin’ knowledge. I was not aware of that gene. I’m partly surprised I haven’t seen a 60 minutes special on it… but then, scientists may avoid publicizing it, since it would make “europeans” (aka white folks) think they are invincible, even though whitness is no guarantee of having the gene (only 20% do, according to your link), and having the gene is not 100% protection.

    Still, in purely utilitarian terms, it’s unfortunate that human generational time is so long, or else Africans would probably predominantly have this gene, by now.

  17. When my son was born we got to decide whether or not to circumcise him before we took him home. Our decision? If he wanted one he could get one he could get a paper route or mow lawns to pay for it himself when he was old enough to make that decision.

    At the time circumcision was in serious decline, not least because insurers were no longer automatically paying for it.

    And, since it looked like the procedure was on its way out I joked that by the time his generation came of age they’re probably be doing circumcisions in tattoo and piercing parlors and that kids would be doing it just to upset their parents.

    Which, in a strong way, is similar to the main reason you disclosed for circumcising yourself: You wanted to make yourself new and different for your wife, the same way many couples today mark their unions with similar, permanent physical alterations like… tattoos and piercings.

    But, speaking very seriously, Hugo, had your parents made the choice for you you’d have been denied the obviously very real (psychic and spiritual… and, perhaps partly alt-macho?) fulfillment of doing so *as a conscious decision when you were old enough to choose!*

    So why deprive others of their own chances to decide?

    Other considerations: It’ll be ten to twenty years before boys born today will become sexually active. You’re hanging your reason for universal circumcision on infants on an assumption that it reduces the risk of HIV transmission. Can you say with authority that HIV will remain uncontrolled that far in the future? No. Furthermore can you say with authority that further research will only confirm and not refute the correlation? No. Can you say with authority that by then women born today and years hence still won’t have yet have the right to choose their partners or insist that they use condoms or be circumcised before having intercourse? No. And can you say with authority that the low-hygiene populations that would most benefit from circumcision today will have the anesthesia, the laser scalpels, and the antiseptic conditions you benefitted from when they receive their circumcisions? Again, no.

    For those, and for other fundamentally ethical reasons, it seems that to deprive an infant the right to decide on his own is therefore unconscionable.

    Lynn mentioned that people most often become sexually active before adulthood. Most cultures, and most ethical physicians, hold that children are able to participate in decisions about their spiritual, economic, and medical treatment well before then. Therefore I don’t think it’s too much to ask to wait till you can actually *ask.*

    figleaf

  18. EvilFizz:

    You got any data there, X? The CDC report indicates that in 2004 more people contracted HIV through heterosexual intercourse than IV drug use.

    Unless you think that needle-sharing and heterosexual sexual relations are equally popular activities, comparing the two by raw numbers is pointless. You might just as well look at the number of people who have been killed operating a motor vehicle, vs. the relatively small number that have been killed by jumping off the Empire State Building, and conclude that driving is much more dangerous. To draw a meaningful comparison, one would have to know what percentage of the population engages in heterosexual relations, vs. what percentage abuses intervenous drugs with used needles. The smart money says that the former group will be a wee bit larger than the latter.

    That said, the numbers do get interesting when you look beyond 2004 and compare the aggregate numbers through 2004, where the relatively rare practice of needle-sharing produces more AIDS cases not only by percentage, but evne in gross numbers. One possible explanation of this trend, albeit a retarded one, is that new advances in needle technology have made needle-sharing a safer activity than it used to be (albeit still not all that safe). Another, equally retarded explanation is that humanity has undergone some drastic biological change that makes heterosexual contact much more dangerous today than it was a mere 10-20 years ago. A third, more sensible explanation is that neither heterosexual contact nor the sharing of intravenous needles is any safer or less safe now than before, but far fewer people share needles today (either because there are fewer junkies to begin with, or because more of them use clean needles) than did a decade or two ago.

  19. Your point is taken about the CCR5 gene; however, that alone cannot account for the extreme levels to which HIV has spread across Africa, vs. its relative rarity in industrialized countries. Nor, of course, can it explain why so many gays get it while so few heteros do.

  20. The benefit of this cutting is that it reduces the transmission of AIDS. Is it your stance that the suffering of one is mitigated by the health benefits to society in general?

    Actually, in the study Hugo cites (conducted in Uganda and Kenya by the CDC), circumcision was of direct benefit to the men involved; it reduced their own chance of getting AIDS by roughly 50%. That it also reduced their chances of transmitting AIDS to anyone else was certainly a nice side benefit, but not sufficient reason to say that they were being obliged to suffer in order to benefit someone else’s health.

    That said, I agree with evil_fizz that it’s far less clear that universal circumcision in the US is the best response, given the much lower rate of HIV infection here. I’m mainly concerned, not to advocate universal circumcision in infancy, but rather to be sure that herd immunity arguments don’t get misunderstood, because that misunderstanding can hurt beyond this issue. For example, universal HPV vaccination for girls has been recommended, in the US, at junior high school age (and, given STD epidemiology in the US, there’s a stronger case for this than there is for circumcision); one could use similar arguments about waiting till the girls are of the age of consent, or about not imposing a risk on them for the sake of the health of the population as a whole, and one would be wrong in doing so; HPV vaccination is a serious net benefit for any girl receiving it (as well as boosting herd immunity if given sufficiently widely), and is better administered earlier than later.

    On the greater level of HIV infection in Africa, it’s my understanding that there are multiple reasons for that difference.

  21. Unless you think that needle-sharing and heterosexual sexual relations are equally popular activities, comparing the two by raw numbers is pointless

    Actually, that tells us that your odds of contracting HIV are higher if you are an IV drug user than if you are engaging in heterosexual intercourse. I don’t think there’s any dispute that sharing dirty needles is the higher risk activity. And for a long time in the United States, the big populations of seropositive individuals are gay men and IV drug users. However, that’s changing, but I don’t think it’s for the reasons you cite. It’s that HIV is now entrenched among heterosexual individuals who think their risk is low. And so it spreads. Also, most common mode of HIV transmission varies widely. In most of Africa, heterosexual sex is the primary mode of transmission. The US is still an anomaly.

    As an aside, I wasn’t trying to suggest that CCR5 accounts for all or even a sizable fraction of the difference in transmission rates, just throwing its existence out there.

  22. Why doesn’t Christianity advocate circumcision? Judasim and Islam both do. Babies are snipped early in life (first few weeks of their lives). I know it pretty common procedure in the States but over here in England it’s not carried out often. I think a circumcised man’s penis looks better than a man whose penis isn’t circumcised. I suppose it’s all down to personal preference. It’s not just about asthetics though, it’s aslo about sexually transmitted infections and hygiene. The foreskin has been known to have porous qualities for a while now. I recall a documentary about circumcision and AIDS, many years ago (about 6) on the BBC; it was about Africa and the spead of HIV there. The studies showed Muslim men in one village (all snipped) when compared to a village of unsnipped men had 40% less chance of catching the HIV virus. At the time I thought if this isnt proof then what more do people want. The programme was definitely an eye opener. I am pleased the results have been finalised by the NIH becuase many people in the UK still see the procedure as mutilation and worse. Here here to the snip and may the British here all welcome the snip!

  23. Why doesn’t Christianity advocate circumcision? Judasim and Islam both do.

    Back before Christianity had fully split from Judaism, when it was first spreading to Gentiles, there was much debate over whether circumcision would be required of Gentile converts. St. Paul vigorously argued against requiring it (see Galatians). And a council in Jerusalem (described long after the fact by Luke in Acts) concluded not to require it (arguably even a decision consistent with Judaism, given that the Noahide law that Judaism believes applies to Gentiles doesn’t include circumcision, but one which, nevertheless, contributed to Christianity splitting from Judaism).

  24. Let’s get to snippin’.

    Well, maybe not. That study looked at what happens when you circumcise adults in a Third World situation. When you look at what happens when you circumcise infants in the First World …

    Well, let’s see. Out of the U.S., Japan, France, and Germany, the only nation which routinely circumcises its male infants is the U.S.

    But its AIDS rate is actually only lower than … uh … actually it has the highest AIDS rate of any First World country.

    Huh.

    Frankly, as long as it’s YOUR OWN penis you’re ‘snippin’, then I defend the right of any adult man to have himself circumcised for whatever reason he chooses. If someone lives in an area where the chance of contracting AIDS is 1% (as it was in one of the African studies — time period unspecified), and wants to remove skin and nerve tissue from their sexual organs to lower their chance of getting AIDS to 0.5%, then they have my support. After all, older women with certain kinds of diagnoses face similar dilemmas with breast cancer: they sometimes must choose between a radical mastectomy (which has a higher chance of removing all the potentially malignant cells) and other options that leaves their breast largely intact. After all, life isn’t simply about reducing the risk of dying; there are vital issues of psychological impact and quality of life that only the woman can judge. As long as it’s the possessor of the organ in question making the choice, all options should be on the table.

    Of course, no one should compel the woman to have a mastectomy. That would be a gross and fundamental violation of her autonomy and human rights.

    And no child should have their sexual organs mutilated for some avowed ‘prophylactic’ reason. After all, in our unceasing zeal to find Some Justification for pursuing this procedure, we forcibly shut our eyes to the known and potential harm it does. We know that it removes highly sensitive skin and nerve tissue from a sexual organ, and individual reactions to this loss vary widely. (BTW, it is reasonable to ask whether the reduced penile sensitivity that many circumcised men experience may lead them to resist using condoms, and thus partially explain why the highly-circumcised U.S. has higher rates of AIDS than its relatively uncircumcised First World counterparts.)

    We know that the procedure is painful, and many — including a significant group of Canadian doctors — believe it is traumatizing as well. (Sadly, general anaesthesia is very risky for infants and topical anaesthesia limited in effectiveness.)

    We don’t know if such trauma has serious side effects. There is evidence to suggest that, indeed, it might. Boy toddlers in the U.S., for example, are far more vulnerable to early onset disorders like SIDS and autism than girl toddlers. It is legitimate to wonder if the risks for these disorders are materially increased by the infantile trauma of circumcision. Indeed, this question alone makes it morally irresponsible to advocate for routinely performing the procedure on infants.

  25. “Let’s get to snippin’.”

    Hugo, perhaps if you look back upon your word choice here you will better understand the cavalier attitude that hurts so many of us who express consternation over this. This isn’t trimming a mustache, you know.

  26. Zarina said: “The studies showed Muslim men in one village (all snipped) when compared to a village of unsnipped men had 40% less chance of catching the HIV virus.” This is weak evidence at best and in no way is proof that circucision prevents HIV transmission. What other cultural differences were there between the Muslim men and the men of the other village? Were the non-Muslims more or less promiscuous? Did they have different sexual practices? The list is endless. Even if the researchers controlled for all of the potential confounding variables they measured, what about the ones that they didn’t measure?

    You folks seem to be vigorously reaching to find good excuses to justify mutilating male children’s genitalia – with or without their consent – which to me is really, really creepy.

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  28. I think a circumcised man’s penis looks better than a man whose penis isn’t circumcised. I suppose it’s all down to personal preference.

    Seriously. I don’t get this argument at all. It’s just sick. If I said I thought my daughter’s labia was yucky and tried to have someone tidy it up for aesthetic reasons they’d put me in jail. But some people think it’s totally fine for me to get someone to perform cosmetic surgery on my son’s penis for that reason. I’m just mystified…

  29. David, obviously honesty doesn’t strike a good cord with you. What is your objection to it? Are you one of those people who refuse to have their child vaccinated too? It’s your perogative if you want to put your childs health at risk. The male snip is not comparable to FGM.

  30. Zarina: the characterization of infantile male circumcision as a “snip” betrays a breathtaking ignorance of what it actually involves. It implies that the foreskin is simply ‘excess skin’ without nerve endings which serves no particular purpose and is easily and painlessly removed. In the case of infantile circumcision, all of those assumptions are demonstrably false.

    And BTW, David’s labia analogy is a good one precisely because what he is talking about is NOT FGM, which in the majority of cases involves the removal of the clitoris. Please don’t (dishonestly) claim that someone here is saying that male circumcision is equal to FGM. But it is certainly mutilation.

  31. In Africa, circumcision makes sense. Given the poverty, the lack of medical care, and the Catholic church pushing against condoms, it’s a logical, inexpensive method of slowing the HIV epidemic. In other words, it’s a crappy partial solution to a very big problem, better than nothing.

    Antimicrobial creams are probably better in the long run. There are a couple good anti-HIV creams the woman could apply long before sex that are in the pharmaceutical pipeline and should become available soon.

    I’ve been in a monogamous relationship with my wife since we were married 23 years ago. We’re both HPV and CMV negative, which is unusual. I’m no longer a paramedic, which means I’m not likely to have to go through another year of HIV testing (also negative, thank God) like I did after one patient attacked me (we now know I had a 1 in 50 chance of turning HIV positive — I didn’t know at the time, and I’m glad). And no, I don’t know how I stayed CMV negative after all that years of blood exposure. Luck, I guess.

    I see no reason to “let’s get snippin’.”

    As a diabetic, circumcision might become necessary at some point. The foreskin is a piece of skin with less blood flow and it can be prone to infections and neuropathy in the presence of poorly controlled diabetes. I’m not getting circumcised because of that, though. One, it’s more appropriate to take appropriate care of my blood glucose levels (sort of like it’s more appropriate to wear condoms when having sex with a non-monogamous partner or if you’re non-monogamous) and, should I ever have to get circumcised because of the diabetes, nerve death in the penis would have preceded the need for circumcision, making the operation less painful. Waiting has definite advantages, advantages I hope I never need.

    4-6 weeks of no sex after circumcision? My wife and I would have trouble with 4-6 days! Granted, we’ve slowed down after all these years — we’re way down. We only manage sex 4-5 times a week now. Aging is a pain. Still. After 23 years of marriage, I’m not sure I could abstain 4-6 weeks for post-surgical healing if I wanted to. Perhaps having my foreskin torn off might change my mind. Ew.

    Not gonna do it, and I see no need to, at least not in the foreseeable future.

  32. Wow, I say… I have to agree with ballgame. Suddenly someone gives an apt analogy of a “snip” on another’s body, and then suddenly it’s a comparison to FGM? The analogous body part to the foreskin would be the clitoral hood, correct? “Snipping” or otherwise removing it would rightly be called what it is, the mutilation of a child’s genitalia. The removal of the clitoris in even more serious cases would be like taking off 1/3 of a male’s penis.

    The aesthetic argument, literally, made me physically ill. So we should start ignoring the presence of nerves, as well as the function of various flaps of skin on our bodies to improve our aesthetics? Hopefully there are still folks out there who realize that genitals are not pretty and exist to serve a specific purpose, one which isn’t “look attractive according to current societal tastes”.

    And then the study is something else. There’s so many factors not even covered, I’m amazed they’re so sure of all this. Sorry if I got all worked up, but I’ve got twin boys and back when they were born we decided not to get them “snipped”. It’ll be their decision to make, if and when they choose to have it done. I loathe the way it’s described by folks over here as if you’re cutting off a puppy’s tail to make it look nicer. Same thing applies to vasectomies.

    In general the jovial tone most people have towards the penis and male reproductive organs in general is sickening and immature.

  33. Zarina,

    First, it’s irrelevant to infant circumcision that you find the circumcised penis more aesthetically pleasing than an intact penis because you’re not going to be having sex with your sons. The decision as to what would be most attractive should be left to him, with input from his sexual partner(s) if he wishes.

    Second, the male “snip” is exactly the same thing. Just because FGM usually involves more tissue loss does not change the qualitative nature of both procedures. They’re both forced genital cutting for non-medical reasons on an non-consenting individual. The difference is degree, not kind.

  34. Female genital mutilation (FRM) takes many forms, from minor “snipping” of the labia to removing the clitoris and ligating the vagina shut (infibulation), however, as is sadly typical, feminists use only the most extreme example of FGM and the most minor example of circumcision to try and make their case re. contrasting the male and female versions. However, some circumcisions performed on males removes the entire glans (likely performed with about the same frequency as infibulation), therefore, we are justified in calling it male genital mutilation (MGM) to the same degree as feminist activists use FGM.

    Therefore, when using rational and legitimate comparisons, trimming the vaginal labia is indeed comparable to the surgery Hugo recieved, and in fact, is probably more conducive to creating more sanitary conditions than is circumcision. This is because the vagina, with all its labial folds, evaginations, etc., is much more susceptible and conducive to harboring infectious microorganisms than is the male foreskin. Therefore, removing the excess labial tissue is every bit as conducive to hygiene as is removing foreskin; the major reason we’re even having this debate is due to the lower value we put on men’s lives. Women are considered valuable, even sacred, while men are considered disposable.

    So hey, if we’re looking to reduce the chance of HIV and other infections, cosmetic considerations, etc., I think we should get with the program vis-a-vis female labial reduction and “snip away!” After all, feminists at least say they’re all about equality, sharing the burden, etc. Or is that only when men are compelled to take on more burden and/or risk?

  35. It’s your perogative if you want to put your childs health at risk. The male snip is not comparable to FGM.

    Perhaps not, but it’s a lot closer to FGM than it is to a vaccination, or to anything remotely warranting such a flippant verb as “snip.”

  36. “owever, some circumcisions performed on males removes the entire glans (likely performed with about the same frequency as infibulation)”

    Really? Where is this done? Wouldn’t that render the penis nonfunctional?

  37. Joe, in Africa (where practically all of the cases of female “snips” are performed) circumcision of males is many times a barbaric operation performed without anaesthetic under non-sterile conditions by persons who are not trained in surgical techniques. If you refer to a previous post of Hugo earlier in ’06 re. circumcision, I provided a citations to a couple of articles documenting the fact that in Nigeria alone, botched circumcision resulted in a very high number (tens of thousands) of operations where the entire glans was removed. This number is comparable to all the cases of infibulation performed in Africa, showing that botched circumcision was in fact much more common than infibulation. So going strictly by the numbers, compared to botched circumcisions of males, female “snips” are relatively rare and FGM is insignificant and a non-issue.

  38. “David, obviously honesty doesn’t strike a good cord with you. What is your objection to it?”

    Just that advocating cosmetic surgery on children’s genitals because they offend your aesthetic sensibilities seems a bit much. The socially acceptable thing to do if you hold these views is to lie about them.

    “It’s your perogative if you want to put your childs health at risk. The male snip is not comparable to FGM.”

    How does not circumcising infants put a child’s health at risk? Is there a big problem with kids catching HIV from vaginal intercourse before they’re old enough to make their own choice about whether to undergo surgery?

  39. “In general the jovial tone most people have towards the penis and male reproductive organs in general is sickening and immature.”

    Bingo. And I’ve gone through this on several boards/blogs. Someone will make a hideous attempt at a joke involving mutilating a man or boy, someone else will object, first person will accuse second person of not having a sense of humor, second person will make the devil’s advocate argument of switching the genders and asking if it’s still funny in that case, and then the first person angrily hurls epithets and closes the thread. Yup.

  40. CIRCUMCISION IS VERY BENEFICIAL, its cleaner and several research bodies have concluded that circumcised men have less risk of contracting STD’s such as AIDS-HIV or herpes.

    Uncircumcised penises are difficult to keep clean, and more prone to infections and penile cancer, studies have shown.
    A circumcised penis is naturally clean and virtually free from urinary infection. You will not have to worry again with careful washing of your penis.

    Is it NOT true that the AAP (American Academy of Paediatrics) does not recommend circumcision. They simply say they leave the decision to parents. But recently, and specially after the recent studies by the US National Institutes of Health, the AAP has been discussing if it may be necessary to change their policy and recommend circumcision to all newborns as they used to do, so in the future we may see that the AAP advocates again circumcision.
    Have a look at: http://www.baby-health.net/articles/381.html

    About STD’s:

    As I said, several studies carried out by prestigious research bodies have concluded that uncircumcised penises are more prone to infections and contraction of STD’s, including AIDS-HIV. Circumcised men have been proved to be up to seven times less likely to be infected than those who are uncircumcised. Have a look at this site: http://www.torontodailynews.com/index.php/HealthNews/2006121404Circumcision

    As for women, studies also show that circumcision also protects female partners from AIDS-HIV and other STD’s. Browse this article: http://www.hopkinsmedicine.org/Press_releases/2006/02_08_06.html

    About sensitivity of a circumcised penis:

    No medical or physiological study has proved that circumcision reduces sensitivity, opposed to common belief. It is completely FALSE that circumcision reduces penis sensitivity. The American Academy of Paediatrics (AAP) confirms this on their web site; have a look at: http://www.aap.org/pubed/zzzjzmemh4c.htm

    Circumcision is an easy and nowadays *painless* procedure, which has many benefits, and virtually no risks.
    Circumcision is NOT an amputation. Circumcision is NOT comparable at all to female circumcision, which is something completely different.

    Circumcision rates are INCREASING nowadays, both in the United States and overseas. Many African and South American countries with little circumcision tradition are starting to promote the procedure to help to reduce the AIDS-HIV infection rates.

    Finally, this site has a lot of useful and *unbiased* information. Make sure you have a good look: http://www.circinfo.net

  41. Oh really? Let’s take a glance at that “unbiased” web site, why don’t we:

    BENEFITS OF CIRCUMCISION

    What, only the benefits? That seems a bit one-sided, coming from an “unbiased” site. It basically goes downhill from there, which all goes to show that “unbiased” doesn’t mean what Sean seems to think it means. My favorite part was where they prattled on about how “policy statements of professional pediatric bodies have been misused by others as part of an ‘appeal to authority’ fallacy,” only to go onto fallaciously appeal to other authority figures in the very next section.

  42. Why blame the foreskin for promoting the spread of AIDS.
    The studies that were done are as flawed as all studies done by those promoting male circumcision.
    Cant people accept that the foreskin is as neccessary as any other part of our bodies that developed over millons of years.
    It is mostly people who’s religion demands male circumcision who are looking for some “scientific” proof of the benefit thereof.

  43. “Why blame the foreskin for promoting the spread of AIDS. The studies that were done are as flawed as all studies done by those promoting male circumcision.”

    Why do I picture this person shutting their eyes real hard, sticking their fingers in their ears, and humming loudly in the dark? If you’re going to criticize the study, describe why it’s flawed. Don’t just sit there and say “Any study I object to is flawed because I disagree with it.” Argue statistical analysis, methodology, whatever you can from a scientific basis. Propose alternate strategies that are economically viable. But just because you don’t like the conclusion, don’t decide that the universe must bend to your teensy-weensy demands. Welcome to reality.

    I’m opposed to circumcision here in the U.S. and in other developed countries where HIV is far less common and the medical establishment is robust enough to control the infection rate using methods other than circumcision. There’s no need for it in most circumstances. In an comment earlier in this thread, I mentioned the one medical situation I might advise it in; there might be a few others, but they’re danged rare and don’t apply to pediatric patients.

    In Africa, I’m forced to grudgingly admit it is both necessary and a good idea. Triage is a medical term for “things are fracked up and we’re doing the best we can, and it sucks.”

    The church I go to has a sister church in Malawi that we help. [Note: Presbyterians believe that there is no religious reason to circumcise, in case you were wondering.] 1 in 10 children in that Malawi church is an orphan because of HIV. The rate of adult HIV infection is absurd. HIV is destroying the social, political, and medical infrastructure. There are too few adults to raise the next generation. The medical professionals have to do what they can so that there is a Malawi 100 years from now where they complain about how circumcision was a cruel but necessary step in saving the people of the country.

    You’re entitled to your ideology, but when your ideology condemns an entire society to death, we are under no obligation to consider your nonsense. Come back with something more scientific than your precious beliefs and we can talk.

  44. While I support the choices of people who think they ought to have circumsision, I can’t in good conciense support the procedure being done to young boys who can’t consent.

    There are plenty of other (more effective) ways to reduce the risk of transmission of AIDS. As for the “hygiene” argument, it’s not all that hard to wash under your foreskin. I suspect that many don’t because of anti-masturbation indoctrination, but if you do, you’re not going to have as huge a risk of infection as those studies say.

    I wouldn’t go so far as to compare circumsision to FGM, but it’s still taking part of someone’s body off. I don’t think that should be done without consent unless it’s absolutely neccesary.

    If you want to help protect people in Africa from AIDS, fight imperialism and economic neo-liberalism. And send condoms.

  45. alrightcircing them loweres therisk of them contracting. But if they continue the raping and rest of the stuff they will still get AIDS. To actually stop aids you must stop the problem not slightly reduce the risk.

  46. Steve,

    If you do some computer modeling, you’ll find that changing the rate of infection can dramatically alter the time-course of an epidemic. A small change can result in actual saved lives — and a lot of them, at that.

    If someone has access to Visual Basic, I can explain how to set up a basic computer model.

  47. The primary reason for male circumcision is simple: it was invented by men to gain sexual control of women. How surprising is that?

    It’s quite simple: both males and females, as they come equipped by nature, have some control over their sexual encounters. The delicate tissue of the foreskin and frenulum, hung-up on a dry and tight labium of an unwilling female, is simply going to rip if the owner tries to push. This is a rather painful rebuke. Circumcised men, with a pole devoid of its protective sheath, are thus equipped to rape if they so wish, and take sexual control with less fear of injury. Haven’t you heard the American term “rough sex?” Circumcisers happily promote this outcome when they fret that the foreskin is prone to tears and injury. Circumcision was designed for sexual control by allowing men to penetrate under conditions not possible with a normal penis.

    The evidence abounds where genital mutilation is the norm. In large parts of Africa circumcision is a man’s sexual coming-of-age ceremony, while the first sexual experience of many females is rape. We know this and read about it in the New York Times and wonder what we can do to help those poor Africans, missing the obvious connection because America too is a mutilating and raping society.

  48. Hugo,
    I getting “done” in Dubai at the end of February. Also by laser
    I hope it’s painless.

  49. i found a study (in pdf form) that compared the sensitivity of circumsized and uncircumsized penises.

    “The study shows that the foreskin is the most sensitive portion of the penis,” said study coauthor Robert Van Howe, a pediatrician at the Marquette General Health System in Marquette, Michigan. “It’s not like you’re chopping off plain old skin. The analogy would be like removing your lips, because the lips are more sensitive than the skin around them.”

    here’s the article:
    http://www.nerve.com/dispatches/festa/howinsensitive/

    here’s the actual study:
    http://www.nocirc.org/touch-test/bju_6685.pdf

  50. Theverycold, thanks for the link. That absolutely contradicts my own experience, and the experience of many who have been circumcised as adults, with plenty of before-and-after sexual expression… More than two years after my circumcision, I’m quite happy with the results.

  51. Hugo,

    Anecdotes are difficult to use in medicine, which is why most people prefer peer-reviewed studies with statistical validity. Nerves are concentrated in the foreskin, but the brain is the most important sex organ, so how the brain interprets it is different from person to person and influenced by expectations.

    If you are in a committed relationship and neither partner is infected with anything, I see no reason to run out and get circumcised.

    In Africa, poverty and lack of supplies might make circumcision a good health preventative. Recognize that it’s a statistical thing — circumcision will slow down the rate of infection, and overall, it will help with the HIV problem in Africa. As an individual African, though, if you are relying on circumcision to protect you, the results could be fatal.

    For Americans, the math is far different. Anyone having unprotected sex and relying on circumcision is an idiot or drug user. Ok, so that’s sort of redundant. Will people think of circumcision as a “backup” emergency plan rather than frontline defense? In the event of condom failure, will they be less likely to seek intervention with antivirals? In theory, circumcision should cut the HIV rate. Now, maybe I’m just cranky today, but I wouldn’t be surprised to watch the HIV rate go up with the recent push for circumcision. The jury is still out on whether humanity is too stupid to live.

    Ever wonder why cars with ABS get in as many accidents as those without? Now you know.

    I’m firmly in favor of the HPV vaccine, by the way, but it I’ve always thought that those receiving the vaccine should be carefully taught about what the vaccine can and can’t do, or the paradoxical stupidity of humans might make things worse rather than better.

    Were I sexually active with multiple partners, I would certainly get circumcised. I’d still use condoms and I’d still seek medical help in the case of condom failure.

    As someone in a stable relationship, no way. We have fun with things as they are, thank you.

    If I had a boy baby…I honestly have no idea what I would do, and that gives me the creeps.

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  53. “The primary reason for male circumcision is simple: it was invented by men to gain sexual control of women. How surprising is that?”

    Silly me, I thought it was a victorian anti-masturbation attitude and an attempt to portray males as inherently vile or bad, and females as inherently enlightened. I heard petticoating was an effective and widespread practice in the UK in the 1800s to ‘make boys more civil’ (thus assuming they inherently were not, and that by, becoming more like girls (and dressing as), they would).

    Sorry for reviving an old topic like this. Just couldn’t let this pass.

    I also don’t agree on forcing an infant to be circumcized. I have three brothers (14, 17 and 23), all intact foreskins, and I’m glad it wasn’t forced on them (I live in Canada).

  54. The research subjects numbered not more than 42 in this particular study. By Western standards, there is not enough evidence to claim male circumcision slows HIV transmission. The study did not account for evidence of the practice of “dry sex” in that population. Dry sex means that the female partner dries her vagina with herbs and salt water prior to coitus. As you can imagine, HIV transmission rate in populations practicing dry sex is very high. The reported lower HIV transmission rate could be better attributed to men and women not practicing dry sex – and not due to male circumcision.

    I wouldn’t go snipping just yet.

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