I absolutely will not...

[mmcnam]

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"if we can reduce the number of infected African truck drivers who pay extra for sex without a condom..."

In sub-Saharan Africa alone there are about 24.7 million people living with HIV. It's not a problem confined to "African truck drivers". It's a problem for everybody living there.


"for all of you nuts out there that don't understand the medical benefits of circumcision"

We understand the medical benefits of circumcision in areas of high risk of infection, but some of us do not believe that our money is best spent on circumcision. Instead, some of us think that there are better ways to stymie the pandemic there, and those efforts also have other far-reaching benefits that circumcision does not.

A simplification on my part, no doubt. This is an internet forum and not an article in Science.

But fighting a world-wide pandemic is not going to work with the unilateral approach you seem to espouse. Your money, I'm sure, pays for very little of an enormous problem. Circumcision halts the spread of infection. End of story.

 

[RPedigo]

A simplification on my part, no doubt. This is an internet forum and not an article in Science.

But fighting a world-wide pandemic is not going to work with the unilateral approach you seem to espouse. Your money, I'm sure, pays for very little of an enormous problem. Circumcision halts the spread of infection. End of story.

You cannot be serious when you say "Circumcision halts the spread of infection. End of story."

Circumcision alone will not halt the spread of infection; it needs to be coupled with counseling to prevent disinhibition and needs to be coupled with safe sex practices. Condom usage is going up, and that is due to educational efforts. Since these efforts are already strapped for cash, implementing circumcision would require removing resources from educational programs. I do not believe that this is the optimal approach to take. I've said this so many times, that the horse that I'm beating is now a bloody pulp: if it weren't for the large up-front capital requirement for routine infant circumcision, I would support it.

My approach isn't unilateral, it just doesn't see the merit in circumcision in the face of scarce resources. Gut Shot is at least providing valid evidence and good points, you're doing neither.

 

[slb]

Your callousness is disturbing. Even if you have not experienced emotional trauma following abortion, it is not very compassionate to belittle someone else's experience. The psychological effect of abortion is widely ignored and it would be foolish to say that it is not detrimental to a great deal of women. I would like to avoid personal attacks, so I'll just say think before you post.

I did think. I am sure that many people do suffer; I certainly never said it wasn't detrimental to anyone. But the above poster certainly implied that it was traumatic and a horrifying experience for everyone. I am very sorry that she felt that way, and I do thank her for sharing her experience. But as future health care providers, you should be aware that not everyone shares her experience. If for no other reason, so that you can be compassionate and empathetic to your patients, whatever your personal views. We may have patients that have felt deep regret and sadness after an abortion. We may have patients that were relieved. I hope we can all accept and empathize with the entire range of experience. I apologize if it seemed that I did not empathize with the prior poster. I find that empathy is much more easily expressed in person than over the internet.

For stories of women who don't share the previous poster's experience, please see:
http://www.imnotsorry.net/

 

[Beau Geste]

I did think. I am sure that many people do suffer; I certainly never said it wasn't detrimental to anyone. But the above poster certainly implied that it was traumatic and a horrifying experience for everyone. I am very sorry that she felt that way, and I do thank her for sharing her experience. But as future health care providers, you should be aware that not everyone shares her experience. If for no other reason, so that you can be compassionate and empathetic to your patients, whatever your personal views. We may have patients that have felt deep regret and sadness after an abortion. We may have patients that were relieved. I hope we can all accept and empathize with the entire range of experience. I apologize if it seemed that I did not empathize with the prior poster. I find that empathy is much more easily expressed in person than over the internet.

For stories of women who don't share the previous poster's experience, please see:
http://www.imnotsorry.net/

I'm willing to make a blanket statement that most women do feel some remorse after having an abortion. Bash me all you want. My point was to counter the flippant nature of abortion being discussed. I'm sure there are some women who consider an embryo/fetus a mass of tissue and not a person and could care less about having one or multiple abortions. However, a good physician should also be aware that there are a LOT of negative ramifications of abortion. I've spoken to hundreds of women about my experience to relate to theirs. Have you?

Have you ever had one? If you haven't, then how do you even know what it's like? If you have, then I'll bet money it's not something you'd celebrate with cake and ice cream.

BTW - your link to imnotsorry.net is a myspace creation. I really don't give much credit to those types of resources.

Also, don't try to backtrack and feign that you "felt empathy" for me. To feel empathy means you've been in this situation (which you haven't admitted to) and can relate in that matter. Maybe you have sympathy if you're an outside to abortion or have a friend or relative who has had one.

 

[slb]

I'm not going to argue with you.

Do take a look at the site, though. It's not a "myspace creation," whatever that means - it's been around for a while, gathering women's stories.

 

[Beau Geste]

I'm not going to argue with you.

Do take a look at the site, though. It's not a "myspace creation," whatever that means - it's been around for a while, gathering women's stories.

Clicking on the top takes you to a myspace.com account.

If you didn't want to argue, why lash out in the first place? You made assumptions that I referred to "all women" when in fact I never posted "all women". I still hold my blanket statement though about most women feeling something besides elation and joy. You speak with such authority on this topic yet refuse to answer if you've had an abortion or not. Seems like you are trying to be controversial for controversy's sake and not because you care.

I find it rather sad that some of those women on your referred website didn't feel even a twinge of guilt. I can understand why people choose abortion, but to celebrate it as a championing cause for women is just wrong. It's sad to end up in that situation but to make it a militant cause is ridiculous (as the home page suggests with the women in Washington).

P.S. Your remarks were pretty rude and didn't really serve a purpose but to put me down, so I'm putting you on ignore. I won't be responding to your posts in this thread anymore.

 

[apnea]

Clicking on the top takes you to a myspace.com account.

If you didn't want to argue, why lash out in the first place? You made assumptions that I referred to "all women" when in fact I never posted "all women". I still hold my blanket statement though about most women feeling something besides elation and joy. You speak with such authority on this topic yet refuse to answer if you've had an abortion or not. Seems like you are trying to be controversial for controversy's sake and not because you care.

I find it rather sad that some of those women on your referred website didn't feel even a twinge of guilt. I can understand why people choose abortion, but to celebrate it as a championing cause for women is just wrong. It's sad to end up in that situation but to make it a militant cause is ridiculous (as the home page suggests with the women in Washington).

P.S. Your remarks were pretty rude and didn't really serve a purpose but to put me down, so I'm putting you on ignore. I won't be responding to your posts in this thread anymore.

👍👍👍👍👍

 

[Jingalicious]

On a lighter note, I absolutely refuse to have Friday classes this semester. =)

 

[apnea]

On a lighter note, I absolutely refuse to have Friday classes this semester. =)

here here!

 

[Gut Shot]

Well, anyone left intact as an infant has the choice to get cut as an adult; the converse is not true.

Yes, isn't the world just so horribly unfair?

 

[stbxTechie]

Well, anyone left intact as an infant has the choice to get cut as an adult; the converse is not true.

Yes, isn't the world just so horribly unfair?

It is in lots of ways; as they go, this is a very small one.

On the other hand, it's one voluntarily chosen and trivially abandoned by most parents (religious reasons by a few folks aside.) Why would anyone add to the unfairness out there if thay don't have to, and don't receive any personal gain from it?

 

[Gut Shot]

Why would anyone add to the unfairness out there if thay don't have to, and don't receive any personal gain from it?

If there were no health benefits associated with circumcision I would agree, but that appears not to be the case. Transmission of HIV, HPV (which causes about three quarters of all cervical cancer in the world), and squamous cell carcinoma of the penis are all at least partially ameliorated by circumcision. If my reading of the data is correct, circumcision has saved many lives in this country. Unfairness, indeed.

 

[alwaysaangel]

If there were no health benefits associated with circumcision I would agree, but that appears not to be the case. Transmission of HIV, HPV (which causes about three quarters of all cervical cancer in the world), and squamous cell carcinoma of the penis are all at least partially ameliorated by circumcision. If my reading of the data is correct, circumcision has saved many lives in this country. Unfairness, indeed.

This is the most important part of your whole post. Its clearly not correct since as of right now not a single governing body of medicine agrees with you.

If that changes in the next few years than fine - you may have a leg to stand on. But as has been pointed out repeatedly in this thread, WHO and the American Pediatric Association do NOT agree with you.

Thats says a lot...and if you don't understand how much that says about how little your opinion is worth then you must have one of the largest egos known to man.

 

[AnesthesiaMD]

Please stop unnecessarily mutilating young male babies over dubious procedures, especially since it's irreversible (at least without huge expense) and something the child has no choice in.

Children have no choice over MANY things in their early lives...vaccinations, sex, race, etc.

Get over it.

 

[alwaysaangel]

Children have no choice over MANY things in their early lives...vaccinations, sex, race, etc.

Get over it.

Sex and race the parents can't change either. Vaccinations are required to get into schools because the reigning medical bodies recognized the benefits outweighed the costs (which are few to none) years ago. The same cannot be said for circumcision. Most circumcisions occur simply because its just whats always been done - not for any actual health benefits.

Again, yes some health benefits have been shown but they have not been sufficient for anyone to recommend automatic circumcision of infant males.

 

[Gut Shot]

This is the most important part of your whole post. Its clearly not correct since as of right now not a single governing body of medicine agrees with you.

My only statement was that circumcision has probably saved lives. I didn't realize that any "governing bodies of medicine" had issued opinions on that particular conclusion. If you can point to some please do.

If that changes in the next few years than fine - you may have a leg to stand on. But as has been pointed out repeatedly in this thread, WHO and the American Pediatric Association do NOT agree with you.

The 1999 APA statement was actually quite neutral, and I'm not in disagreement with it. They don't recommend routine circumcision, and neither do I. I do, however, recognize the potential medical benefits and feel it's best left as an informed parental decision. Their summary:

"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision. Analgesia is safe and effective in reducing the procedural pain associated with circumcision; therefore, if a decision for circumcision is made, procedural analgesia should be provided. If circumcision is performed in the newborn period, it should only be done on infants who are stable and healthy."

According to the Fresno Bee, the APA is currently reviewing their recommendation based on the recent HIV transmission data from Africa.

The WHO's March 2007 recommendation, in part:

"Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men."

Thats says a lot...and if you don't understand how much that says about how little your opinion is worth then you must have one of the largest egos known to man.

My ego is actually quite small. As they say, the more you learn the less you know.

 

[Gut Shot]

Again, yes some health benefits have been shown but they have not been sufficient for anyone to recommend automatic circumcision of infant males.

Can you point to a single person on this thread who has recommended automatic circumcision of male infants?

 

[alwaysaangel]

Can you point to a single person on this thread who has recommended automatic circumcision of male infants?

Its basically what you were doing in this thread - arguing the health benefits with no regard to the fact that with the low rates of HIV in the US and high availability of condoms that benefit is negligible.

Right now a lot of parents still automatically circumcise male infants because of the misunderstanding of these health benefits. By pushing them you are basically encouraging that.

I agree - informed decisions by parents is best, but thats not what we have and those of us pointing out the loss of sensation, and negligible health benefits are trying to get to a point where parents are actually doing that.

If thats what you were pushing for then we agree - but thats not what you made it sound like in your posts.

 

[Gut Shot]

Its basically what you were doing in this thread - arguing the health benefits with no regard to the fact that with the low rates of HIV in the US and high availability of condoms that benefit is negligible.

Translation: No, I can't.

I've been discussing Africa for the last few pages of this thread, where HIV prevalence is much higher and acceptance of circumcision would likely be very beneficial to public health. My only recent statement regarding this nation is that our already high circumcision rate has probably helped us avert a larger domestic HIV epidemic. I know it's speculation, and if you have a different take I'd like to hear it.

Right now a lot of parents still automatically circumcise male infants because of the misunderstanding of these health benefits. By pushing them you are basically encouraging that.

Hey, I haven't delivered a baby since 2004, and I've never had a conversation about circumcision with a new parent. My opinions as expressed on this anonymous forum aren't encouraging anyone to do anything.

If thats what you were pushing for then we agree - but thats not what you made it sound like in your posts.

Oh, just admit it. You overreached, I called you on it, and now you're handwaving.

 

[alwaysaangel]

Translation: No, I can't.

I've been discussing Africa for the last few pages of this thread, where HIV prevalence is much higher and acceptance of circumcision would likely be very beneficial to public health. My only recent statement regarding this nation is that our already high circumcision rate has probably helped us avert a larger domestic HIV epidemic. I know it's speculation, and if you have a different take I'd like to hear it.



Hey, I haven't delivered a baby since 2004, and I've never had a conversation about circumcision with a new parent. My opinions as expressed on this anonymous forum aren't encouraging anyone to do anything.



Oh, just admit it. You overreached, I called you on it, and now you're handwaving.

I didn't over react about anything. People keep claiming that we are overreacting by arguing that circumcision is not the best thing. As if to even suggest that perhaps someone should consider not doing it to their child is completely ridiculous. THAT is pushing automatic circumcision. The post that my reply was actually to did that - and I could find many other examples in this thread but I have better things to do.

I'm not handwaving or overreacting. I am pointing out that in the US circumcision has few to no health benefits. Yes you were talking about Africa, but you kept jumping back and forth and others were talking about the US. Parents should take all points into account and make their own opinions.

My post about automatic circumcision wasn't even to you so I don't know why you're freaking out about it - unless you just feel really insecure about your stance. Beyond that I don't know why you would care about a comment not made to your OR your particular points.

 

[ertepnf]

No, it's not any kind of psych thing. Men that I've known who had the proceedure done later in life, for silly reasons like wanting to be like everyone else, regreted having a circ done afterwards and either had expensive reconstructive cosmetic surgery done to have it "replaced" or just couldn't afford it and had to live with the damage. They found a marked decrease in sensitivity and enjoyment regarding sex after having their prepuce removed.

As for doing what the parent want, I would highly discourage them from the practice. A better arguement would be: why do a medical proceedure that isn't necessary. Why do something just because everyone else does it?

I'm not sure whats wrong with having your son look like his father (the reason I'd have it done on my kids..and I intend to do so). Its a human tradition with some cultures (and a requirement in some religions...are you going to discourage Jews and Muslims and basically insult their religious practices?).

I have no problem with being circumsized. On the other hand..I wouldn't want to perform one because they kinda freak me out 😛

 

[alwaysaangel]

I'm not sure whats wrong with having your son look like his father (the reason I'd have it done on my kids..and I intend to do so). =

A better question is...whats with having your kid NOT looking like his father? He's not going to look exactly like you anyway - no pubic hair when young etc. etc. etc. So whats the big deal if he has extra skin - it won't freak him out just cuz daddy doesn't have it.

I'm sorry, I'm trying to understand your point of view (I know its one a lot of people hold), but frankly as of now it sounds like a really stupid reason to cut off a piece of your son's penis.

 

[Gut Shot]

I didn't over react about anything. People keep claiming that we are overreacting by arguing that circumcision is not the best thing.

I didn't say overreact, I said overreach. You falsely implied that people on this thread have taken a position that, in fact, no one has. Namely, that male circumcision should be automatic. It shouldn't, and nobody says otherwise. That stance is an imaginary one you have formulated in the heat of argument.

- and I could find many other examples in this thread but I have better things to do.

Oh, now it's just getting sad.

I'm not handwaving or overreacting. I am pointing out that in the US circumcision has few to no health benefits.

And you could have done that without telling me that the APA doesn't agree with me (which the do), or that the WHO doesn't agree with me (which they do). You could have stated your opinion without commenting on the perceived size of my ego or value of my opinion, but you didn't. You decided to express yourself in an accusatory fashion more appropriate for online pissing contests.

Yes you were talking about Africa, but you kept jumping back and forth and others were talking about the US.

Oh no, I kept jumping back and forth! Help me, I'm getting dizzy!

My post about automatic circumcision wasn't even to you so I don't know why you're freaking out about it -

Wasn't even to me? So when you wrote this in post #713:

This is the most important part of your whole post. Its clearly not correct since as of right now not a single governing body of medicine agrees with you.

If that changes in the next few years than fine - you may have a leg to stand on. But as has been pointed out repeatedly in this thread, WHO and the American Pediatric Association do NOT agree with you.

Thats says a lot...and if you don't understand how much that says about how little your opinion is worth then you must have one of the largest egos known to man.

...that wasn't directed to me? Either you're making things up in desperation or I need to lay off the mescaline.

unless you just feel really insecure about your stance. Beyond that I don't know why you would care about a comment not made to your OR your particular points.

Word to the wise: stop digging.

 

[alwaysaangel]

I didn't say overreact, I said overreach. You falsely implied that people on this thread have taken a position that, in fact, no one has. Namely, that male circumcision should be automatic. It shouldn't, and nobody says otherwise. That stance is an imaginary one that you have formulated in the heat of argument.



Oh, now it's just getting sad.



And you could have done that without telling me that the APA doesn't agree with me (which the do), or that the WHO doesn't agree with me (which they do). You could have stated your opinion without commenting on the perceived size of my ego or value of my opinion, but you didn't. You decided to express yourself in an accusatory fashion more appropriate for online pissing contests.



Oh no, I kept jumping back and forth! Help me, I'm getting dizzy!



Wasn't even to me? So when you wrote this in post #713:



...that wasn't directed to me? Either you're making things up in desperation or I need to lay off the mescaline.



Word to the wise: stop digging.

Eek! Posts over a page. Thats where I stop reading. Sorry. But I'm sure it was very constructive and interesting. 🙄

 

[Gut Shot]

Eek! Posts over a page. Thats where I stop reading. Sorry. But I'm sure it was very constructive and interesting. 🙄

The last refuge for the pwned.

 

[alwaysaangel]

The last refuge for the pwned.

The best part is that you honestly believe that and it makes you feel good about yourself. 😆

This is why I <3 the internet. Especially SDN. Its always:

 

[Gut Shot]

The best part is that you honestly believe that and it makes you feel good about yourself. 😆

Uh huh.

P.S. For the record, you pwned yourself. I was just the cheerleader.

 

[alwaysaangel]

I'm not sure whats wrong with having your son look like his father (the reason I'd have it done on my kids..and I intend to do so).

A better question is...whats with having your kid NOT looking like his father? He's not going to look exactly like you anyway - no pubic hair when young etc. etc. etc. So whats the big deal if he has extra skin - it won't freak him out just cuz daddy doesn't have it.

I'm sorry, I'm trying to understand your point of view (I know its one a lot of people hold), but frankly as of now it sounds like a really stupid reason to cut off a piece of your son's penis.

Bumpity bump - because I really want to know why this view is so important to some people. And my question got buried in the crap.

 

[stbxTechie]

If there were no health benefits associated with circumcision I would agree, but that appears not to be the case. Transmission of HIV, HPV (which causes about three quarters of all cervical cancer in the world), and squamous cell carcinoma of the penis are all at least partially ameliorated by circumcision. If my reading of the data is correct, circumcision has saved many lives in this country. Unfairness, indeed.

The first two are addressed more effectively by condom use, as has been noted elsewhere in this thread.

Squamous cell carcinoma might be a fair cop; do you have any numbers on the actual rates with and without circumcision you can point me to? If you've posted them earlier in the thread, just say so and I'll dig.

That said, you could virtually eliminate breast cancer (much more common) by taking the breast buds out of baby girls. And yet, we're not even routinely screening babies for the BRCA genes. A few adult women do get screened, and do choose prophylactic mastectomy, but it's deservedly rare.

Children have no choice over MANY things in their early lives...vaccinations, sex, race, etc.

Get over it.

The last one is never a matter of choice for a given pair of parents, and the ability to accurately aim for a given sex is dubious. So only the example of vaccination holds up.

Further, none of those involve permanently removing a functional bit of tissue. Or even a non-functional one... we don't routinely remove babies' appendixes, after all.

I'm not sure whats wrong with having your son look like his father (the reason I'd have it done on my kids..and I intend to do so).

Well, that's your choice. I'd say you'd be doing something wrong and harmful to the child, but that's between you and your conscience.

Its a human tradition with some cultures (and a requirement in some religions...are you going to discourage Jews and Muslims and basically insult their religious practices?).

Discourage, yes. Forbid (or attempt to get the law to forbid), no. If they take it as an insult, tough for them.

If I do make it to becoming a doctor, I would, however, refuse to perform one (assuming I was qualified, etc.) While I would not refuse to refer to another doctor who had no such compunctions, I'd make an effort to talk any parents (regardless of religious affiliation) out of it.

I have no problem with being circumsized. On the other hand..I wouldn't want to perform one because they kinda freak me out 😛

Gee, how about having the courage of your convictions? (Ignoring any issues of medical qualification to do so.)

A better question is...whats with having your kid NOT looking like his father? He's not going to look exactly like you anyway - no pubic hair when young etc. etc. etc. So whats the big deal if he has extra skin - it won't freak him out just cuz daddy doesn't have it.

I'm sorry, I'm trying to understand your point of view (I know its one a lot of people hold), but frankly as of now it sounds like a really stupid reason to cut off a piece of your son's penis.

I wonder if it's just laziness about not wanting to explain about circumcision or adequate hygiene as a teen/pre-teen.

If it were really about LOOKING like the kid, are they going to have issues if the hair color/type doesn't match? If the kid is a lot taller than them?