Circumcising USA

[entericoated]

Over 60% of men in the United States are circumcised.

1. Center for Disease Control. Percent of newborn males with circumcisions performed in short-stay hospitals by race [online]. 2002 [cited 2004 Sep 19]. Available from: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions_race.htm
2. Percent of newborn males with circumcisions performed in short-stay hospitals by region [online]. 2002 [cited 2004 Sep 19]. Available from: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions_region.htm

Should circumcision be routine in the USA? Comment, Flame...

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[Mayfly]

That's a pretty tricky question... the procedure from the viewpoint of many parents is partly religious, partly medical, and probably partly cosmetic. (I guarantee you that some mothers would see a foreskin and want it removed because it looks "funny.") However, should we be doing surgical procedures on children for religious or cosmetic purposes, if the medicine behind it may be in question?

From what I've read (please correct me if I'm wrong and don't know ****) the foreskin is removed to ensure that potential infections and conditions can be avoided when the child is young. However, I've also read that with proper care and cleaning from the parents (and education for the child), most of these problems don't arise. Isn't most of the rest of the world un-circumcised? How DO they manage?

There was a report about a year ago that showed circumcision on a male may reduce the male's chances of acquiring HIV, but I'm not sure if that has been further tested.

I guess the idea is that even though we can prevent many infections and conditions through proper cleaning, we'd rather just chop off the unnecessary bits to make sure it's done right and we don't have to worry about it. However, should we NOT routinely have circumcisions, try to teach parents and children how to avoid infection, and then fall into a load of **** when 100 kids come back with life-altering problems because they forgot to clean their wee-wee?

 

[Law2Doc]

From what I've read (please correct me if I'm wrong and don't know ****) the foreskin is removed to ensure that potential infections and conditions can be avoided when the child is young. However, I've also read that with proper care and cleaning from the parents (and education for the child), most of these problems don't arise. Isn't most of the rest of the world un-circumcised? How DO they manage?

In industrialized nations with the practice of good hygiene, it is possible for uncircumcised folks to avoid a lot of these infections. But you say "with proper care ... from the parents... and education..." as if these are insignificant tasks. Many doctors have large percentages of their patient population that they can't even convince to take necessary medications, eat normal diets, give up risky behaviors, let alone follow hygiene instructions. You will see diabetics come in with absurdly high sugar levels after downing 2L of pepsi. you will see folks who never took their prescription for an antibiotic to a drug store to get it filled because their kid "looked better". you will see AIDS patients seeking a prescription for Viagra. You will see all sorts of abscesses that resulted from bad hygiene, unclean needles, unattended wounds. So yeah it's possible to keep stuff clean and avoid circumcision. But from a public health standpoint, I don't know if you can expect most patients to follow these instructions, so maybe you just avoid the issue in the name of cosmetics, religion or tradition.

 

[entericoated]

From what I've read (please correct me if I'm wrong and don't know ****) the foreskin is removed to ensure that potential infections and conditions can be avoided when the child is young. However, I've also read that with proper care and cleaning from the parents (and education for the child), most of these problems don't arise. Isn't most of the rest of the world un-circumcised? How DO they manage?

I believe the number is near 85% of the world's male populatin are in-tact. I think you're right on with the cleanliness issue. From a medical point of view, the potential for infection is a valid argument for routine circumcision. However... I wonder if there's any desensitization of the glans as a result of circumcision.

 

[eyesarecool]

No medical association in the world recommends newborn circumcision. The American Academy of Pediatrics advises that the intact penis requires no special care and is easy to keep clean. The boy should simply clean his penis, as he would any other body part.

After exhaustive review of research on HIV/AIDS and STDs, all medical association reviews have concluded that behavioral factors (such as risky sex practices, etc.) are by far the key determinant in contracting HIV or other STDs. Some studies suggest a slight decrease in UTIs in the first year of life. However, this potential benefit does not outweigh the risks and possible complications of the circumcision surgery, including infection, hemorrhage, buried penis, penile damage, and surgical mishap.

Males rarely care about what their father's penis looks like. Should the boy ask, a simple explanation is all that is needed, "We now know circumcision is unnecessary." With nearly half of American parents now choosing to keep their sons intact, boys will have plenty of intact peers. Having surgery performed on your son just because "others do it" is never a good reason.

 

[Reimat]

I believe the number is near 85% of the world's male populatin are in-tact. I think you're right on with the cleanliness issue. From a medical point of view, the potential for infection is a valid argument for routine circumcision. However... I wonder if there's any desensitization of the glans as a result of circumcision.

I've heard that there's pretty good evidence that sensation is not lost, despite the common belief to the contrary. So, at least from my perspective there isn't great evidence to support circumcision one way or the other. It should (and probably will) just remain the decision of the parents.

 

[Kai Zhur]

I've heard that there's pretty good evidence that sensation is not lost, despite the common belief to the contrary.

That would be counterintuitive, since the foreskin itself is a sensory organ. That is confirmed by Sorrells.

 

[njbmd]

This is a Topic in Healthcare and not specifically related to medical education at allopathic schools. Now moved to Topics in Healtcare.

 

[oldpro]

No medical association in the world recommends newborn circumcision. The American Academy of Pediatrics advises that the intact penis requires no special care and is easy to keep clean. The boy should simply clean his penis, as he would any other body part.

After exhaustive review of research on HIV/AIDS and STDs, all medical association reviews have concluded that behavioral factors (such as risky sex practices, etc.) are by far the key determinant in contracting HIV or other STDs. Some studies suggest a slight decrease in UTIs in the first year of life. However, this potential benefit does not outweigh the risks and possible complications of the circumcision surgery, including infection, hemorrhage, buried penis, penile damage, and surgical mishap.

Males rarely care about what their father's penis looks like. Should the boy ask, a simple explanation is all that is needed, "We now know circumcision is unnecessary." With nearly half of American parents now choosing to keep their sons intact, boys will have plenty of intact peers. Having surgery performed on your son just because "others do it" is never a good reason.

Hmm In medical school and in Pediatric clinicals I was lectured on that Circumcision is associated with lower Cancer incidence.

Hers a couple articles I found 5 sec on Google

Circumcision reduces cancer risk
http://www.doctorndtv.com/news/detailnews.asp?id=314

The Highly Protective Effect of Newborn Circumcision Against Invasive Penile Cancer

Edgar J. Schoen, MD*, Michael Oehrli, MPA, CTRddager ; Christopher J. Colby, PhDDagger , and Geoffrey Machin, MD§
http://pediatrics.aappublications.org/cgi/content/full/105/3/e36

Circumcision cuts cervical cancer rates
http://www.newscientist.com/article/dn2157-circumcision-cuts-cervical-cancer-rates.html

http://www.geocities.com/hotsprings/2754/cervical042002.htm

Neonatal circumcision and penile cancer
Evidence that circumcision is protective is overwhelming
http://bmj.bmjjournals.com/cgi/content/full/313/7048/46/b


I think your research is flawed and you found anticircumcision activists that are Physicians to back up your conclusions when I found no less then the American Academy of Pediatrics that say Circumcision is protective.

 

[Sol Rosenberg]

Penile cancer is the best that you can do?

From the national cancer institute:

http://www.cancer.gov/cancertopics/types/penile/

Number of new cases = 1250/150,000,000 (I'm assuming 50% of the population is male) = 1 in 120,000

MRSA infection, one of the common complications of circumcision occurs at different rates at different hospitals, but the average rate of infection seems to be around 1 in 1000 (I wasn't a math major, but I can see that MRSA infection is 120 times more likely than penile cancer.) Why would any rational person risk MRSA for their son to lower his risk of penile cancer?

Also, you are twisting the text of the AAP's policy statement, the FULL text of which is summarized in the first sentence of:

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.

Twisting words to your benefit makes your argument disingenuous and, therefore, worthless.

EDIT: Furthermore, if the reason for circumcision is to prevent penile cancer (which usually occurs later in life,) why not let your son make the decision for himself once he is able?

 

[ml66uk]

Penile cancer is very rare. How rare?
1) more men get breast cancer(!) than penile cancer.
2) more women get vulval cancer than men get penile cancer

Penile cancer only seems to present in men with very poor hygiene, and there are some countries which don't circumcise that have lower rates of penile cancer anyway.

You might be interested in what other medical organisations say, besides the AAP:

American Academy of Family Physicians
Neonatal circumcision is one of the most common surgical procedures performed in the United States. However, little is known about the long-term risks and benefits. There have been few methodologically generalizable prospective studies concerning medical outcomes.

The AAFP Commission on Science has reviewed the literature regarding neonatal circumcision. Evidence from the literature is often conflicting or inconclusive. Most parents base their decision whether or not to have their newborn son circumcised on nonmedical preferences (i.e. religious, ethnic, cultural, cosmetic). The American Academy of Family Physicians recommends physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son.

American Urological Association
The American Urological Association, Inc.® (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks.
...
the American Urological Association recommends that circumcision should be presented as an option for health benefits.

Canadian Paediatric Society
Recommendation: Circumcision of newborns should not be routinely performed

Canadian Pediatric Society: Information for parents Circumcision is a "non-therapeutic" procedure, which means it is not medically necessary. Parents who decide to circumcise their newborns often do so for religious, social or cultural reasons. To help make the decision about circumcision, parents should have information about risks and benefits. It is helpful to speak with your baby’s doctor.

RACP Policy Statement on Circumcision
After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision. (their bolding)

British Medical Association: The law and ethics of male circumcision - guidance for doctors
Circumcision for medical purposes:
to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate.
...
Non-therapeutic male circumcision:
There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly.

National Health Service (UK)
Many people have strong views about whether circumcision should be carried out or not. It is not routinely performed in the UK because there is no clear clinical evidence to suggest that it is has any medical benefit.

 

[oldpro]

Penile cancer is very rare. How rare?
1) more men get breast cancer(!) than penile cancer.
2) more women get vulval cancer than men get penile cancer

Penile cancer only seems to present in men with very poor hygiene, and there are some countries which don't circumcise that have lower rates of penile cancer anyway.

You might be interested in what other medical organisations say, besides the AAP:

American Academy of Family Physicians
Neonatal circumcision is one of the most common surgical procedures performed in the United States. However, little is known about the long-term risks and benefits. There have been few methodologically generalizable prospective studies concerning medical outcomes.

The AAFP Commission on Science has reviewed the literature regarding neonatal circumcision. Evidence from the literature is often conflicting or inconclusive. Most parents base their decision whether or not to have their newborn son circumcised on nonmedical preferences (i.e. religious, ethnic, cultural, cosmetic). The American Academy of Family Physicians recommends physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son.

American Urological Association
The American Urological Association, Inc.® (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks.
...
the American Urological Association recommends that circumcision should be presented as an option for health benefits.

Canadian Paediatric Society
Recommendation: Circumcision of newborns should not be routinely performed

Canadian Pediatric Society: Information for parents Circumcision is a "non-therapeutic" procedure, which means it is not medically necessary. Parents who decide to circumcise their newborns often do so for religious, social or cultural reasons. To help make the decision about circumcision, parents should have information about risks and benefits. It is helpful to speak with your baby’s doctor.

RACP Policy Statement on Circumcision
After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision. (their bolding)

British Medical Association: The law and ethics of male circumcision - guidance for doctors
Circumcision for medical purposes:
to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate.
...
Non-therapeutic male circumcision:
There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly.

National Health Service (UK)
Many people have strong views about whether circumcision should be carried out or not. It is not routinely performed in the UK because there is no clear clinical evidence to suggest that it is has any medical benefit.

You know these sources you posted refuse to aknowledge the evidence there is benifit with circumcision, funny how emotions seem to outwiegh good studies and science.

 

[ml66uk]

You know these sources you posted refuse to aknowledge the evidence there is benifit with circumcision, funny how emotions seem to outwiegh good studies and science.

You're telling me that the national medical organisations of all those countries are biased, but you're not?!?

A majority of the male doctors that wrote those policies will be circumcised, especially in Australia and New Zealand, where the circumcision rate was over 90% in 1950. Why would all those circumcised doctors be against circumcision?

It's worth remembering that we wouldn't even be having this discussion if it weren't for the fact that 19th century doctors thought that :
a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tubercolosis etc), and
b) circumcision stopped masturbation.

Both of those sound ridiculous today I know, but if you don't believe me, then check out this link:
http://www.noharmm.org/docswords.htm
A Short History of Circumcision in North America In the Physicians' Own Words

Over a hundred years later, circumcised men keep looking for new ways to defend the practice.

 

[San_Juan_Sun]

Over a hundred years later, circumcised men keep looking for new ways to defend the practice.

When we start talking about banning ear piercing for little girls, then we'll talk about banning circumcision too.

On a only slightly related note: why do anti-circumcisionites get so hot and bothered about this issue. Are there not any more important and germane public health issues to waste consternation over?

 

[Sol Rosenberg]

You know these sources you posted refuse to aknowledge the evidence there is benifit with circumcision, funny how emotions seem to outwiegh good studies and science.

If there is any evidence showing that circumcision provides a significant health benefit to infants/children in the USA, please post some.

(My infants/children qualifier is important, because if circumcision offers health benefits later in life, adult males can just choose for themselves whether or not to be circumcised later.)

 

[Sol Rosenberg]

When we start talking about banning ear piercing for little girls, then we'll talk about banning circumcision too.

Are you serious?

1. I wasn't aware that infant girls routinely had their ears pierced at birth.
2. Ear piercing is reversible.

On a only slightly related note: why do anti-circumcisionites get so hot and bothered about this issue. Are there not any more important and germane public health issues to waste consternation over?

If you have other health issues to debate, please feel free to start another thread.

 

[San_Juan_Sun]

Are you serious?

1. I wasn't aware that infant girls routinely had their ears pierced at birth.

Ear piercing is very common at ages < 2 yo. Sometimes as young as 1-2 mos. Not quite as prevalent circumcision, but the same principles apply, namely an unnecessary procedure inflicted on nonconsenting children. neither (my opinion here) has any significant health benefit. But since we're in the business of banning things here, I propose that we at least be consistent.

2. Ear piercing is reversible.

Really? How exactly do you unpeirce an ear? You can make it so an unncessecary, painful, and potentially complicated procedure (often performed in a mall, no less) can magically disappear?

If you have other health issues to debate, please feel free to start another thread.

You finally make a decent point about debate. I believe in freedom of expression and argument. I believe that others are entitled to their opinion (just as I am entitled to my opinion that they are stupid). I also believe in the rights of parents to act in the best interests of their children, as they see fit.

I do not believe that a society that wears itself out worrying about circumcision has the energy or attention to tackle problems THAT ACTUALLY AMOUNT TO MORE THAN JACK SQUAT.

Anyways, sorry about the all caps. Bottom line, I reject the idea that circumcision is abusive, at least any more so than ear piercing. So when we want to be consistent about our public health policy in this regard, I'm all ears.

 

[Sol Rosenberg]

Ear piercing is very common at ages < 2 yo. Sometimes as young as 1-2 mos. Not quite as prevalent circumcision, but the same principles apply, namely an unnecessary procedure inflicted on nonconsenting children. neither (my opinion here) has any significant health benefit. But since we're in the business of banning things here, I propose that we at least be consistent.

Woah there, big fella. No one is talking about banning anything. I'm actually not sure how you missed the point of this thread. I went back to the OP, and there it was, in bold and large type:

Should circumcision be routine in the USA? Comment, Flame...

To not practice routinely is not the same as to ban. Furthermore, I did a "find on this page" for "ban" (no quotes,) and I didn't find mention of banning circumcision until your first post in this thread.

Really? How exactly do you unpeirce an ear? You can make it so an unncessecary, painful, and potentially complicated procedure (often performed in a mall, no less) can magically disappear?

Holes made by piercing can close. Foreskins can't grow back (to my knowledge.)

You finally make a decent point about debate. I believe in freedom of expression and argument. I believe that others are entitled to their opinion (just as I am entitled to my opinion that they are stupid). I also believe in the rights of parents to act in the best interests of their children, as they see fit.

I do not believe that a society that wears itself out worrying about circumcision has the energy or attention to tackle problems THAT ACTUALLY AMOUNT TO MORE THAN JACK SQUAT.

Anyways, sorry about the all caps. Bottom line, I reject the idea that circumcision is abusive, at least any more so than ear piercing. So when we want to be consistent about our public health policy in this regard, I'm all ears.

I have a son and a daughter. My son is uncircumcised and my daughter does not have her ears pierced. Am I "worthy" to debate with you now

I also used "find on this page" to search for "abus" (no quotes,) and I found no instances of anyone calling circumcision abusive until....wait for it.....your post. You are coming out of left field with these accusations.

 

[ml66uk]

I can't believe that cutting off part of a baby boy's penis is being compared with ear piercing. Sure, I'm against ear piercing too, but it's nothing like cutting off the most sensitive part of a boy's penis (it's not just there to protect the glans). Children have died, suffered brain damage, and had to undergo sex changes because of circumcisions gone wrong. I don't think anyone's ever died because of having their ears pierced (though people have had to have their ear reconstructed after piercing the upper ear).

Interestingly, I'm not aware of anyone dying or suffering penile amputation or brain damage because of adult circumcision in a western medical environment, yet the people promoting circumcision are always looking for reasons for it to be done as soon as possible.

I find it very sad that non-religious circumcision only got started because of some seriously bad medical ideas in the 19th century, and yet it's still happening in the 21st.

 

[Pharmavixen]

Foreskins can't grow back (to my knowledge.)

Have a look here:

Beirise has worn a pair of men's tall-size suspenders under his pants for the past four and a half years. The suspenders are attached to various devices - from first-aid tape to a contraption made of halved plastic Easter eggs and copper wire - that gently stretch the skin on his penis.

His goal: to grow back skin that resembles the foreskin he lost when he was circumcised.

 

[Sol Rosenberg]

Beirise has worn a pair of men's tall-size suspenders under his pants for the past four and a half years. The suspenders are attached to various devices - from first-aid tape to a contraption made of halved plastic Easter eggs and copper wire - that gently stretch the skin on his penis.

His goal: to grow back skin that resembles the foreskin he lost when he was circumcised.

Oh my. I guess where there's a will, there's a way.....

 

[ml66uk]

Have a look here:

It is possible to "restore" a foreskin by stretching what's left, but:
1) it's way easier for an intact man to get circumcised than it is for a circumcised man to restore his foreskin.
2) a circumcised man can never recover the nerve endings that were cut off.

The fact that people restore anyway only underlines the fact that they shouldn't have been circumcised in the first place.

 

[Pharmavixen]

The fact that some men feel compelled to restore a foreskin may suggest that they feel sexually inadequate, and they attribute all their problems to a piece of skin removed when they were a baby.

Personally, I'm neutral on circumcision. I wouldn't have gotten my kids circumcised if they'd turned out to be boy children, though there are good arguments on both sides, as this thread has shown.

But in my experience, men who are circumcised have plenty of nerve endings left and do not suffer from any inadequacies in that area. Men who go through all the hassle of re-growing a foreskin might consider that sexuality is centred in the brain rather than the genitalia, and ask themselves why they are so obsessed.

 

[Kai Zhur]

What principles of medical ethics allow a doctor to perform a circumcision without a medical indication? This is a normally functioning, healthy body part that is removed. For historical reasons, a special exception is currently being made for the male foreskin.

There is no consistent ethical standard which permits removal of the male foreskin, but would not permit removing other normal body parts as well.

Any male unhappy with having been circumcised has a legitimate gripe with the physician who performed it, unless there was a medical need and more conservative treatments had failed. Maybe a legal claim, too.

Most physicians (please correct me if I'm wrong) don't actually explain to parents what the functions of the foreskin are, including sexual sensitivity, before querying parents if they want it cut off. In other words, parents haven't even been properly informed.

 

[Dirt]

As far as I am concerned it is a purely aesthetic issue with no appreciable medical benefit or detriment. It should be up to the parents.

 

[Kai Zhur]

As far as I am concerned it is a purely aesthetic issue with no appreciable medical benefit or detriment. It should be up to the parents.

Granting your medical assessment for the moment, there is a double-standard at work. Can doctors remove a child's earlobe(s) on parental whim? Can doctors cut out a patch of skin on a child's thigh, then stitch it back together, on parental whim? Can doctors perform any parentally desired cosmetic surgery on a child, ethically?

That said, in determining medical benefit or detriment, have you considered loss of the normal functions of the foreskin such as touch sensitivity, gliding action, and glans protection in the equation? If not, why not? Loss of normal function is detrimental, isn't it?

 

[Dirt]

Granting your medical assessment for the moment, there is a double-standard at work. Can doctors remove a child's earlobe(s) on parental whim? Can doctors cut out a patch of skin on a child's thigh, then stitch it back together, on parental whim? Can doctors perform any parentally desired cosmetic surgery on a child, ethically?

That said, in determining medical benefit or detriment, have you considered loss of the normal functions of the foreskin such as touch sensitivity, gliding action, and glans protection in the equation? If not, why not? Loss of normal function is detrimental, isn't it?

There are numerous aesthetic traditions that are granted exclusionary status from the "unnecessary procedure" argument (many of which lead to a much greater loss of function than circumcision). As I see it, if you want to call circumcision unethical, you have to then lump that with any sort of religious or cultural phenomena that can in any way lead to discomfort either for the individual or for society as a whole.

Furthermore, I am cut, and I can tell you that my d*ck works just fine.

 

[Kai Zhur]

There are numerous aesthetic traditions that are granted exclusionary status from the "unnecessary procedure" argument (many of which lead to a much greater loss of function than circumcision). As I see it, if you want to call circumcision unethical, you have to then lump that with any sort of religious or cultural phenomena that can in any way lead to discomfort either for the individual or for society as a whole.

Furthermore, I am cut, and I can tell you that my d*ck works just fine.

Aesthetic traditions? Sure, people split tongues, stretch earlobes to their knees, do all sorts of body modifications: But unless American doctors are participating in it under the auspices of their medical license, that's not what I'm talking about.

I am not aware of any other cosmetic surgeries which doctors perform on normal, healthy newborns. Are you? Any such example would certainly be very unusual, and not involve significant excision of tissue.

Religious and cultural phenomena have no place in the doctor-newborn relationship. The doctor has an ethical duty to provide the medical care needed by the newborn. Physically modifying children based on the non-medical whim's of parents breaches the doctor-patient relationship.

Like you, I was circumcised, and I can sexually function. However, like you, I have lost all sensation from my foreskin and have scars. Causing that kind of loss and scarring to a child is not something doctors should be party to unless there is medical justification.

I wonder why American doctors are dragging their feet on this.

 

[skee lo]

Circumcision is an archaic religious tradition that amounts to genital mutilation. The end.

 

[Tired]

I wonder why American doctors are dragging their feet on this.

You really wonder why? Well let me explain it to you:

99% of the population doesn't care about this issue, that's why. Some people want their children circumcised, some people don't. Those who do are adequately informed of the risks and accept them. Those who don't accept the risks don't have the procedure performed. But regardless of their choice, very few people are particularly worked up over it one way or the other.

Yes, there are complications. I will be happy to accept the 1:1000 quoted here, although honestly that seems a bit low for a surgical procedure. What you are ignoring, however, is that the majority of complications from circumcision (like any other surgical procedure) are relatively minor. Excessive bleeding and most superficial infections are easily treated, even the dreaded MRSA. Long-term sequelae are rare.

The fact that the AAP says that long-term effects are "unknown" ought to trigger a fair degree of skepticism. The procedure has been done for literally thousands of years. How could long-term sequelae be "unknown"? Likely because if there are any, they are relatively minor and do no interefere with peoples' lives.

It is a medical truism that when you have large numbers of studies with different conclusions, there is likely a minimal effect being observed. This seems to be what happens with circumcision. Some studies show decreased sensation and sexual functioning, others do not. Some show decreased rates of infection and cancer, others do not. Sum total: it probably has minimal positive or negative effects.

So we don't care. The real questions is why you do.

 

[ml66uk]

So we don't care. The real questions is why you do.

No, the real question is why male circumcision has been so quick to fall out of favor in the UK, Canada, Australia, and New Zealand, but the rate has been dropping so much slower in the USA.

The rate in New Zealand has dropped from about 95% to about 3% (mostly Samoans and Tongans). Over 90% of Australian male babies were circumcised in 1950, but "routine" circumcision is now *banned* in Australian public hospitals in all states except one.

Check out what various national medical organisations have to say in post 11 in this thread.

I think the fact that there so many studies show different conclusions is in part due to bias on the part of the researchers. It's hard to imagine otherwise when I see studies measuring penile sensitivity that don't measure the sensitivity of the foreskin itself.

You seem to be suggesting that Kai has "issues". Do you think the same about the Canadian Children's Rights Council:

Canadian Children's Rights Council policy on circumcision

It is the position of the Canadian Children's Rights Council that "circumcision" of male or female children is genital mutilation of children.

 

[Llenroc]

America has definitely been behind the curve on this issue. Routine circumcision needs to go.

 

[Pharmavixen]

So we don't care. The real question is why you do.

Good post I've wondered how many of those "recap" men were circumcised guys who didn't give a crap until they were told that being cut affects sexual functioning. And maybe they had problems that were psychological in origin, but now there's this organization telling them that all sexual problems stem from missing their foreskin. So instead of addressing problems in their relationships, or maybe leftover issues from being abused as children, or whatever, they dedicate themselves to regrowing their foreskins and spreading the word that circumcision is child abuse and mutilation, and whatever other exaggerated rhetoric they can think of.

Personally, I wouldn't have circumcised boy children if I'd had 'em. But some of the anti-circumcision rhetoric strikes me as a bit racist, and even irresponsible, if you consider the role circumcision may play in helping reduce the transmission of HIV in sub-Saharan Africa.

 

[Sol Rosenberg]

Personally, I wouldn't have circumcised boy children if I'd had 'em. But some of the anti-circumcision rhetoric strikes me as a bit racist, and even irresponsible, if you consider the role circumcision may play in helping reduce the transmission of HIV in sub-Saharan Africa.

Please show me ANY study that links the rate of circumcision of children in the USA (read the thread title again if you missed it....) to the rate of transmission of HIV in sub-Saharan Africa.

Alternatively, you can save yourself a long, fruitless search and just concede that the two have nothing to do with one another and that you're just blowing smoke.

 

[Tired]

You seem to be suggesting that Kai has "issues". Do you think the same about the Canadian Children's Rights Council:

Canadian Children's Rights Council policy on circumcision

It is the position of the Canadian Children's Rights Council that "circumcision" of male or female children is genital mutilation of children.

Seriously, big yawn.

The Europeans and Canadians can get all worked up over this if they want. Hell, it's their countries.

But for me, don't care. In fact, for most Americans, don't care.

It's like listening to someone freak out over the health effect of eating eggs. "Oh my God, it's got cholesterol!" vs "Oh my God, it has good protein!"

It's not a big deal. No one cares. Do whatever you want. It really makes no difference in the end.

 

[Pharmavixen]

Please show me ANY study that links the rate of circumcision of children in the USA (read the thread title again if you missed it....) to the rate of transmission of HIV in sub-Saharan Africa.

Alternatively, you can save yourself a long, fruitless search and just concede that the two have nothing to do with one another and that you're just blowing smoke.

It wasn't a long and fruitless search, just five seconds of googling. From the CDC:

A systematic review and meta-analysis that focused on male circumcision and heterosexual transmission of HIV in Africa was published in 2000 [5]. It included 19 cross-sectional studies, 5 case-control studies, 3 cohort studies, and 1 partner study. A substantial protective effect of male circumcision on risk for HIV infection was noted, along with a reduced risk for genital ulcer disease. After adjustment for confounding factors in the population-based studies, the relative risk for HIV infection was 44% lower in circumcised men. The strongest association was seen in men at high risk, such as patients at sexually transmitted disease (STD) clinics, for whom the adjusted relative risk was 71% lower for circumcised men.

 

[Sol Rosenberg]

It wasn't a long and fruitless search, just five seconds of googling. From the CDC:

Perhaps you misunderstood my point. The link that you posted summarizes studies of HIV transmission in Africa among circumcised males in Africa. Please show me a study linking circumcision of males in the USA with HIV transmission rates in Africa (your original point = circumsicion in the USA lowers HIV transmission rates in Africa.) Hell, I'll even settle for a study linking circumcision rates of males in the USA with HIV transmission rates in the USA.

 

[badasshairday]

No, the real question is why male circumcision has been so quick to fall out of favor in the UK, Canada, Australia, and New Zealand, but the rate has been dropping so much slower in the USA.

Socialized medicine thats why.

 

[Sol Rosenberg]

Socialized medicine thats why.

Can you not pay out of pocket for cosmetic procedures in the UK, Canada, NZ, etc? (This is not meant to be a rhetorical question -- I'm honestly not familiar with those healthcare systems to that level of detail.)

I don't believe that many insurance companies pay for circumcision (despite its obvious medical benefit ) contending that it is a purely cosmetic procedure. Therefore, I don't believe that socialized medicine has anything to do with it (unless it is impossible to pay out of pocket for cosmetic procedures in those other countries)

 

[Pharmavixen]

Perhaps you misunderstood my point. The link that you posted summarizes studies of HIV transmission in Africa among circumcised males in Africa. Please show me a study linking circumcision of males in the USA with HIV transmission rates in Africa (your original point = circumsicion in the USA lowers HIV transmission rates in Africa.) Hell, I'll even settle for a study linking circumcision rates of males in the USA with HIV transmission rates in the USA.

If enough of these "recap" organizations in wealthy countries such as yours and mine spread the "truth" about circumcision; ie, the notion that it seriously impairs a man's sexual functioning, this notion could spread to Africa, where men there might be prone to hesitate before taking this potentially life-saving step.

I don't think circumcision rates in the US have anything to do with health issues elsewhere in the world; I was speaking critically about the anti-circumcision people and the lies they spread (even though personally, I'm not pro-circumcision per se; like you said, I haven't heard of evidence for health benefits outside of sub-Saharan Africa).

Oh, and yes; you can pay out of pocket for circumcision in Canada; it was delisted by our health care system more than ten years ago, but it's still available for people who want it and will pay. So most people don't do it anymore, except for religious reasons.

 

[NO2Noctors]

i'm glad i'm circumcised. really glad.

it just looks better, doesn't it? no offense to the anteaters out there, i'm just sayin. and i plan to circumcise my male children. you can leave yours intact if you wish, but if you call it genital mutilation, you're just plain stoopid.

 

[ml66uk]

Good post I've wondered how many of those "recap" men were circumcised guys who didn't give a crap until they were told that being cut affects sexual functioning. And maybe they had problems that were psychological in origin, but now there's this organization telling them that all sexual problems stem from missing their foreskin. So instead of addressing problems in their relationships, or maybe leftover issues from being abused as children, or whatever, they dedicate themselves to regrowing their foreskins and spreading the word that circumcision is child abuse and mutilation, and whatever other exaggerated rhetoric they can think of.

Personally, I wouldn't have circumcised boy children if I'd had 'em. But some of the anti-circumcision rhetoric strikes me as a bit racist, and even irresponsible, if you consider the role circumcision may play in helping reduce the transmission of HIV in sub-Saharan Africa.

I'm an intact man for what it's worth, but there seem to be plenty of women and intact men who are against circumcision. The Canadian Children's Rights Council have a very strong policy against male circumcision, but they're probably mostly women. There are also three anti-circumcision sites run by Jewish men.

HIV in Africa is a completely different subject given the high rates of HIV there, but I think it's a huge mistake to be promoting circumcision rather than ABC. Some things you may not be aware of:
1) there are six African countries where circumcised men are more likely to be HIV+ than intact men.
2) in Rwanda, circumcised men are 65% more likely to be HIV+ than intact men, but they've just launched a campaign to promote circumcision. A little strange for a country with just 1 doctor for every 50,000 people, and one nurse for every 3,900 people.
3) circumcised men who are HIV+ seem to be more likely to infect women than intact men who are HIV+
4) female circumcision seems to protect against HIV (but there's no way we'd investigate cutting off women's labia).

People seem to be forgetting that HIV doesn't strike people at random - circumcision can't make any difference unless someone is having unsafe sex with an HIV+ partner. There seem to be people who are keen to promote circumcision for its own sake, and they're joined by the fundies who want to promote anything-but-condoms, and even try to stop aid workers from talking to prostitutes. Lots of men seem to be believe that circumcision makes them immune to HIV, despite being told the opposite. It doesn't help that one of the studies described circumcision as being "comparable to a vaccine of high efficacy", which is quite ludicrous given the results, and the fact that it wasn't finished (none of them were finished). I honestly think that diverting resources to circumcision rather than focusing on ABC is almost certain to make the problem worse.

No, the real question is why male circumcision has been so quick to fall out of favor in the UK, Canada, Australia, and New Zealand, but the rate has been dropping so much slower in the USA.

Socialized medicine thats why.

"Socialized medicine" - I can almost hear Ronald Reagan's voice on that old tape warning of how evil it was. If you think it's really that bad, try falling ill in Europe - you'll be peasantly surprised. Even Canada spends about 1/3 per person on healthcare as the USA, but Canadians are healthier and live longer. This is another topic that could generate many threads of its own, but if circumcision was believe to promote long-term health benefits, then you'd expect countries with national health care to promote it. Australia and New Zealand had circumcision rates of over 90% under "socialized medicine", but the (circumcised) physicians there turned against it. It's not quite clear why that hasn't happened to anything like the same extent in the USA.

It is possible to pay for circumcision in all the countries mentioned btw. It's actually banned in public hospitals in all Australian states except one, but you can still get it done at a private hospital.

i'm glad i'm circumcised. really glad.

it just looks better, doesn't it? no offense to the anteaters out there, i'm just sayin. and i plan to circumcise my male children. you can leave yours intact if you wish, but if you call it genital mutilation, you're just plain stoopid.

So you admit you're planning to have genital surgery on your male children for cosmetic reasons. At least you're honest - I think that a lot of people that cite medical reasons are really doing it for cosmetic reasons. Even if you're 100% happy with your equipment, I honestly think you should find out more about the function of what gets cut off before you have it done to your children. They may not be happy that someone else took the decision to have part of their penis removed, and if they ever live on the west coast or outside the USA, they're likely to be living in an environment where circumcised males are in the minority.

It's worth noting that most men, circumcised or intact, are happy with their equipment. Intact men who are unhappy however can choose to get circumcised.

There are plenty of circumcised women who think their parts "look better", and guess what - they mostly plan on circumcising their daughters, and they mostly seem to think that anyone against that is "plain stoopid". Try debating with some of the bloggers that have done it or are about to do it.

It was the Canadian Children's Rights Council that called it "mutilation" btw. Are you really prepared to dismiss them as "plain stoopid"? Do you not want to find out why they think it's such a big deal?

 

[NO2Noctors]

i'm just saying that my penis is far from mutilated. i've been told it is quite nice, as a matter of fact.

i could care less if a person decides to circumcise or not, and i'm sure intact males are as happy with their tools as we are. what i'm calling stoopid is the calling of our penises mutilated. it's just untrue.

i don't know much about female circumcision, so i can't really comment about that.

 

[AwesomO]

"Socialized medicine" - I can almost hear Ronald Reagan's voice on that old tape warning of how evil it was. If you think it's really that bad, try falling ill in Europe - you'll be peasantly surprised. Even Canada spends about 1/3 per person on healthcare as the USA, but Canadians are healthier and live longer. This is another topic that could generate many threads of its own, but if circumcision was believe to promote long-term health benefits, then you'd expect countries with national health care to promote it. Australia and New Zealand had circumcision rates of over 90% under "socialized medicine", but the (circumcised) physicians there turned against it. It's not quite clear why that hasn't happened to anything like the same extent in the USA.

When you adjust the life span for those killed by violent crimes Americans actually live longer than Canadians.

 

[cpants]

i'm just saying that my penis is far from mutilated. i've been told it is quite nice, as a matter of fact.

i could care less if a person decides to circumcise or not, and i'm sure intact males are as happy with their tools as we are. what i'm calling stoopid is the calling of our penises mutilated. it's just untrue.

i don't know much about female circumcision, so i can't really comment about that.

The problem is you have absolutely no basis of comparison. You have no way of knowing what function was lost. I have no problem with circumcision for aesthetic or any other reason, as long as the patient is able to make an informed consent. Therefore I think circumcision should be banned until the patient is 18, or at least old enough to understand and approve of the procedure.

Circumcision reduces sensation for men. Foreskins have nerves, and you are removing them. End of story. Men should be able to decide for themselves it's worth reducing the amount of skin on their penises for appearance's sake.

 

[NO2Noctors]

The problem is you have absolutely no basis of comparison...

Circumcision reduces sensation for men. Foreskins have nerves, and you are removing them. End of story.

this is ridiculous. YOU have no basis of comparison, unless you got circumcised after you were able to quantify the sensation in your penis and then compared afterward. YOU have no freaking idea what my penis feels, and to say what you said is so dumb, it is actually kinda funny.

maybe you have repressed anger toward your foreskin and are venting on this forum.

end of story.

 

[cpants]

this is ridiculous. YOU have no basis of comparison, unless you got circumcised after you were able to quantify the sensation in your penis and then compared afterward. YOU have no freaking idea what my penis feels, and to say what you said is so dumb, it is actually kinda funny.

maybe you have repressed anger toward your foreskin and are venting on this forum.

end of story.

Do you deny that foreskins are innervated? Actually, I am circumcised, and I don't plan on doing it to my sons. While my penis functions, I suspect it would have added functionality if part of it's surface area hadn't been removed shortly after my birth. There is no medical reason for it.

 

[Tired]

HIV in Africa is a completely different subject given the high rates of HIV there, but I think it's a huge mistake to be promoting circumcision rather than ABC. Some things you may not be aware of:
1) there are six African countries where circumcised men are more likely to be HIV+ than intact men.
2) in Rwanda, circumcised men are 65% more likely to be HIV+ than intact men, but they've just launched a campaign to promote circumcision. A little strange for a country with just 1 doctor for every 50,000 people, and one nurse for every 3,900 people.
3) circumcised men who are HIV+ seem to be more likely to infect women than intact men who are HIV+
4) female circumcision seems to protect against HIV (but there's no way we'd investigate cutting off women's labia).

Citation please.

 

[Sol Rosenberg]

this is ridiculous. YOU have no basis of comparison, unless you got circumcised after you were able to quantify the sensation in your penis and then compared afterward. YOU have no freaking idea what my penis feels, and to say what you said is so dumb, it is actually kinda funny.

maybe you have repressed anger toward your foreskin and are venting on this forum.

end of story.

While not overly common, there are uncircumcised men that need to be circumcised as adults (sports injury that ends up tearing the foreskin, etc.) While it is necessarily anecdotal, the consensus amongst adult circumcisees is that the circumcision results in reduced sensation.

 

[NO2Noctors]

well, since you put it that way, now i feel gypped. how do i go about fixing my pecker?