I think one of the things that we far too often overlook in this country is that fact that genital mutilation of newborn boys is common practice, if not standard. Why isn't there more of a cry against this? Do the benefits of circumcision (if any, and I don't see any valid argument that there are any) outweigh the cost and mutilation of a boy?

Of course circumcision isn't the only genital mutilation in the world, but it's the only type in practice in the United States. Female genital mutilation is just as barbaric, if not more so. Americans, and Europeans in general, ban female genital mutilation of babies, but why the hypocrisy in not doing the same for males?

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This brief reply is entered here because of Daniel's question which is on page 2 of this thread, but it seems that any further reply has to go here because NING is not allowing another inserted reply at that location.
I had asked Daniel to read the following which I wrote on May 23 (it is page 30 of this thread). It suggests that we cannot believe the advices given by American physicians on the subject of male circumcision because it is possible that as many as 8 out every 10 such physicians had been circumcised as babies and could therefore have been very biased themselves. My response had been initiated by the claim of Mark Luther on the previous page 29 which should also be read.

Reply by Terence Meaden on May 23, 2010 at 12:54am

In the course of this thread it seems that those supporting circumcision for non-medical reasons (i.e. religious, ethnic, cultural, cosmetic) or claiming neutrality were themselves circumcised, and those who were not circumcised were not supportive.

From the AAFM short document of 2007 [referred to by Mark Luther] we find that
“An estimated 1 million circumcisions are performed each year in the United States. . .
In 1960, over 80% of men in the United States were circumcised. However, the percentage is now decreasing, and in 1992 the prevalence of circumcised men was estimated to be 77%. One study found that between 1987 and 1996, 37% of newborn males were circumcised during newborn hospitalization.”

This allows us to judge that for the years 1960-1992 approximately 77 to 80% of the American male population were circumcised men.
This further hints that perhaps around 77 to 80% of family physicians were themselves circumcised.

“The AAFP Commission on Science has reviewed the literature regarding neonatal circumcision”.
The authors of this review are not named.
Who were they? Were the men on this commission circumcised or not?
Their circumcision status should, even now, be made clear.
It may be that 8 out of every 10 men on this commission had themselves been circumcised.
This is enough to suggest that there could be unintended, unacceptable, bias in the review.

Moreover, the report ends with
“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.”

But if 77-80% of these family physicians are circumcised men, then the advice given would probably not be sincerely neutral.
Imagine how the general advice from physicians to parents and guardians could differ greatly if every single American male physician had never been circumcised.
As far as I'm concerned any non-medical reasons for circumcision are indefensible.

But my concern is that Africa has an all out epidemic on their hands and every organization I've seen weigh in on the topic recommends circumcision. The idea that the WHO, CDC, NIH, B&M Gates Foundation, AIDS Map, Avert, Doctors Without Boarders and the African nations themselves are spending millions of dollars circumcising the population despite the evidence, that just sounds like a conspiracy. The NIH was quoted to have even cut their own study short because of overwhelming evidence.

Circumcision is not a long term answer like condoms, education, cultural changes, and an improved quality of life but it is effective right now. The Catholic church certainly doesn't care to help the culture by changing their stance on condoms, so what do you recommend? Also, all these secular organizations are recommending circumcision and spending millions on it because of some possible religious and personal bias in a few unconvincing studies? If so are you saying these organizations are not qualified or able to make informed medical decisions?
^^ The NIH was quoted to have even cut their own study short because of overwhelming evidence. ^^

All three of the trials cited to defend the massive roll-out were cut about 75% short of their agreed-to protocol periods. This magnified the distorting effect of the cut mens' post-surgical period of abstinence. Further compounding that issue is the assay used to detect HIV can miss infections acquired within a few months.

The cut men had repeated visits to the medical tent during healing with additional safe-sex counseling each time. None of this was double-blinded or placebo controlled of course, and the subjects weren't even really randomized. ALL the subjects SOUGHT circumcision for cultural reasons. All the subjects were paid and all knew that researchers' aim was to prove the value of circumcising.

You know which other study was cut short? The one by the same research team (Gray et al) that showed the HIV+ cut men were 50% MORE likely to infect their partners (18% vs 12%). But that one was cut short due to "futility" with a recommendation to circumcise anyway, while the trials trending toward comparable effect but in favor of male circumcision were cut short and declared resounding successes.

These are facts. I'm not at all a conspiracy theorist. I just don't believe researchers from cut cultures can be rational about this.

To say mass-circumcision might make sense if only in Africa is nonsense. That's already been tried. In Cameroon, Ghana, Lesotho, Malawi, Rwanda, Swaziland, and Tanzania it is the CIRCUMCISED who have markedly higher HIV incidence.

This protective effect of circumcision is NOT seen in the real world, only when pro-cut researchers are running the show. Most of the US men who have died of AIDS were cut at birth. The US with general health and education comparable to Europe has three times the HIV incidence, even though American adults are mostly cut and cutting is rare in Europe.

Let me illustrate the African trial numbers:

{Let each * equal 0.5% of sample.}

***** 137 men left intact got HIV (2.5%)

*************** 376 intact men were lost to the study, status unknown (6.8%)

************************************************************************************************************************************************************************************* 4984 intact men didn't get HIV (90.7%)

** 64 cut men got HIV despite 6 weeks of abstinence and safe-sex counseling (1.2%)

************ 327 men were cut but lost to the study, status unknown (6.0%)

*************************************************************************************************************************************************************************************** 5020 cut men didn't get HIV (91.3%)

Do you see how large the chunk of men lost to the study is? The assumption by the researchers is that the men lost did not have significantly differing outcomes from the men studied until the end. Is that valid? Maybe not. If you were in a trial and got butchered would you go back to the butcher for more treatment? If you were in a trial and got sick despite a pleasure-robbing surgery would you go back or would you head to the city for proper treatment? I would suggest a man who would have surgery and then not show up for follow-up treatment could be a less-responsible type person who might have accounted for a case of HIV in the cut group.

Another assumption about these men who ALL chose to be circumcised (some just agreed to wait until the end) is that their behavior was not significantly different whether cut or left intact. Is that valid? If you were in a culture where getting cut was an important coming-of-age ritual yet you had somehow not had it yet, would you act the same after being initiated as a real man? Would potential partners view you the same? I would suggest you might be inclined to act more like responsible adult. I would suggest you might be in line for a higher class of female partner if you can boast you've had this cut that the man in the white coat says protects you from HIV. I would suggest you might be less likely to give or get a bareback BJ from a dude on the down-low (remember ZERO percent of these subjects self-reported ANY gay activities or inclinations, which is just absurd). Who knows? The issue is that the researchers DON'T know.

What they do know is that their recommendations definitely don't apply outside high-prevalence areas like the places in Africa they studied.
Where do you get the raw numbers, please provide references on points of fact. I'm happy to go read the article and interpret the raw data myself. Your position would be well served with references and data but I feel like I just keep getting "that's not true everyone knows that's fake and/or discredited".

If so much of this data is so well known and widely discredited then why have none of the big name international organizations become aware of it and updated their official recommendations? It would be better to divert funds to different activities that were found to be more effective if the medical efficacy didn't add up.

I didn't cherry pick any data, all of these groups are quoted as supporting this position. I just searched for any group with an opinion on the topic and every reference I found was in favor of the practice.

The most telling was the B&M Gates Foundation, known for having highly economical practices headed by Bill Gates a widely known atheist. I can't imagine a group that would shun ineffective religious based practices more.
^^ If so much of this data is so well known and widely discredited then why have none of the big name international organizations become aware of it and updated their official recommendations? ^^

HELLO! As I told you earlier, the seminal work on this is the recent update to the Dutch Medical Association's policy on male genital cutting. They updated their official recommendation. Read their bibliography.

The raw numbers from the South Africa, Kenya, and Uganda trials are all over. One place where they've been compiled is http://Circumstitions.com. Just use the Google search box at that site for Africa HIV.

While I've got your ear, where did you see anything by MSF on male circumcision? I can only find tweets with no links.
I read the the DMA's policy (that is also quoted on the circumstitions.com website you just linked). It most definitely supports your position although further details into the recommendation were in Dutch...so I kinda left it at that.

The article linked above has Eric Goemaere suggesting male circumcision as a means to look into due to the severity of the epidemic. MSF does not appear to have an official stance on male circumcision (that I could find), so I take back the MSF reference, sorry...

Honestly, I'm mostly just playing devils advocate to develop a stronger argument for myself but my main point still stands. Why do so many international health organizations support circumcision? It seems as though everyone here should be protesting these stances and asking for a re-evaluation of this issue rather than just debating amongst ourselves.

Note: I hate researching this topic, I keep running along gems like this:
Also in North Sudan, MSF runs a project in Port Sudan, in Red Sea State (RSS), providing reproductive healthcare with a particular focus on pregnant women who have been circumcised. In RSS, an estimated 97.6 percent of women are circumcised, causing serious medical complications for many throughout their lives.
Daniel asked Why do so many international health organizations support circumcision?

Part of the reason may be that many of the physicians involved in such decision-making had received that 'unkindest cut' themselves when they were defenceless babies.
I would like to see such policy-making set by decision-makers none of whom had themselves been circumcised.
True, if any circumcised person were to accept that routine infant circumcision is indeed a unnecessary procedure which is an infringement upon the rights of the infant they would have to accept that they were in fact mutilated by their parents in a very private part of their body.

It's weird to me, some supporters of RIC seem to think of the foreskin as a burden, while other (intact) males think of it as a pleasure.
Then the decisions would still be biased, they just would happen to be biased to your bias.

I hope uncircumcised is the scientifically backed course of action for obvious reasons but if male circumcision was supported as being highly effective with overwhelming evidence then would you consider it or does that not matter?

I think it matters if and how effective such a treatment could be but I can understand arguments that it doesn't matter.
Even if every word published by Bailey, Gray, et al were true,.. for me personally, no I would not trust circumcision to protect me, and since condoms are needed anyway, I wouldn't bother to amputate the most exquisitely pleasure-receptive part of my body.

And if Bailey, Gray, et al are not lying then my circumcision would endanger my female partner if I was HIV+ and have no effect if I was HIV-.

And if I was a social planner I would not recommend circumcision for anyone. Condoms are far more effective and cost-effective.

I certainly wouldn't stand for anyone making the circumcision decision for minors or coercing service men to be cut.
Take the money it would cost to circumcise your kids and use it to create a condom fund.

You know... help em get off their feet.

Even if there were huge advantages of circumcision I would still argue that it's a decision that should be made by the person himself when of age of consent.

It's a ridiculous practice that should be abolished. Religion or culture is no excuse for mutilation.



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