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The Forum > Article Comments > Call to circumcise ignores the evidence > Comments

Call to circumcise ignores the evidence : Comments

By Robert Darby and Hugh Young, published 5/5/2014

The argument for widespread circumcision relies on the proposition that we face a public health crisis to which genital surgery is the only answer.

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The truth about circumcision-Stefan Molyneux
http://www.youtube.com/watch?v=m_zkKciuIpA
And a warning, some viewers may find this video distressing, it contains actual audio and video of circumcisions being performed plus graphic descriptions of the procedure.
The truth: If there was a theoretical basis for surgical procedures to be be performed upon women and female infants which could minimise harm to men the "debate" would not have even reached this point.
Posted by Jay Of Melbourne, Monday, 5 May 2014 7:31:36 AM
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My elder brothers grew up in an era when it was considered normal for one's tonsils to be removed before they gave any trouble, as a 'precautionary measure'. But at least the medical profession didn't have God-botherers insisting that tonsil removal was divinely ordained. There is some good news in this area, too -- some educated Jewish couples are now refusing to have their male babies circumcised. Whatever the dubious 'benefits' of the procedure may be, it's clear that the consent of the adult male concerned should be required for it to go ahead.
Posted by Jon J, Monday, 5 May 2014 8:12:49 AM
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That special circumstances in Africa would benefit from seeing a rise in male circumcisions does not detract from Australians requiring evidence-based practise of medicine before promoting it here.

Certainly, on the available research, it is gynecological testing which needs to be widespread.
Posted by WmTrevor, Monday, 5 May 2014 8:32:19 AM
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I've got a cure for HIV AIDS in Africa, it's an old remedy called Islam.
Go to the WHO or UNAIDS websites and compare the AIDS prevalence rates and distribution in Islamic areas of Africa to the Christian areas, anything stand out?
Sure all male Muslims are circumcised but that can't be the only factor at play, the above named sites list lifestyle factors such as promiscuity and polygyny as the main routes of transmission.
Posted by Jay Of Melbourne, Monday, 5 May 2014 9:24:32 AM
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Jon J,
In high school a friend of mine had to be circumcised at age 16 for medical reasons which I now can't recall, what I do remember is that he had a long recovery and a lot of problems afterwards, especially "performance" issues with his girlfriends when he was a young man.
Posted by Jay Of Melbourne, Monday, 5 May 2014 9:33:04 AM
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If you really want to pay attention to the evidence, then the US medical ass indicates that the health / risk balance weighs slightly in favour of having a circumcision.

However, this does not constitute a recommendation to do so, neither a recommendation that it become taxpayer funded.
Posted by Shadow Minister, Monday, 5 May 2014 9:55:28 AM
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Forced circumcision is a violent crime against humanity and it's time we stopped pussy-footing around and call it what it is - Genital Mutilation for Profit. It is a Human Rights Crime of epic scale for which victims must now be compensated.

All men circumcised as infants should receive just compensation for the loss of their mobile foreskin and its Ridged Band and the subsequent impairment of their sexual capacity which sub-normalized them for life. Victims of forced infant circumcision should at the very least receive free foreskin restoration devices and free Viagra and/or Cialis for life - paid for by the doctor who victimized them as a baby or that doctor's insurer.
Posted by writnow, Monday, 5 May 2014 4:13:50 PM
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'Forced circumcision is a violent crime against humanity ' yep and the mutilation of unborn babies is totally legal and even promoted in some quarters. Great to have such moral outrage over something so trivial.
Posted by runner, Monday, 5 May 2014 5:08:30 PM
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From my experience 'surgical risk' is far greater than the supposed health risks to non-circumcised infant males. As for the long term benefits - I still don't see many. The only one that springs to mind is where personal hygiene assistance is required - usually in elderly disabled or dementia patients.

A male infant whose circumcision is poorly performed or at worse completely botched (albeit rare under Western surgical conditions) has the 'benefit' of a lifetime of issues ranging from poor body image through various levels of dysfunction to complete loss of his penis. Much more prevalent than penile cancer - let me assure you. Not to mention the odd unfortunate who has bleed out or succumbed to infection or complications of anaesthesia.

IMO - to circumcise is a decision which should be based on need and in the absence of disease or defect - there's no valid reason.
Posted by divine_msn, Tuesday, 6 May 2014 12:11:34 AM
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The issue of infant circumcision is not as trivial as some might think. The medical community has never investigated the long-term harm to boys and the men they become. In 2012 more than 1,000 men responded to the Global Survey of Circumcision Harm - www.CircumcisionHarm.org - to document the long-term adverse physical, sexual and psychological consequences of infant circumcision. They completed an extensive questionnaire and uploaded photographic evidence and video testimony of the harm they live with on a daily basis.
Posted by Survey Programmer, Tuesday, 6 May 2014 2:00:29 PM
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Divine,

"in your experience" really, how many botched circumcisions have you personally seen? Is dying of cancer minor compared to a poor body image?

The number of botched circumcisions in Western societies is so low that you probably have more chance of dying from a tooth pick.

As the medical experts have determined, the risks on both sides slightly favour circumcision. And the choice is entirely that of the parents.
Posted by Shadow Minister, Tuesday, 6 May 2014 3:52:15 PM
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Shadow - Over a 12 yr span in Qld public Hospitals, I saw several poorly performed circumcisions in infants - one of which was done on a child with undiagnosed hypospadias which caused severe trauma to the penis. This child required several follow up surgeries and would almost certainly have encountered functional problems in adulthood.

I saw a number of men - not many, perhaps 4 or 5 with problems related to their infant circumcision. These are possibly more common than thought but many men are embarrassed and their penis 'works' so it's not a huge deal. The main complaint was an erection which pulled to one side or bent like a banana. One man had had an excessive amount of skin removed from the shaft and as a result his pubic hair was a third of the way up the penis during erection.

Personally, I know a man, now in his early 60s, who lost approx two thirds of his glans during a botched infant circumcision. He was a reserved, rather withdrawn individual who never married - despite being a handsome fellow who attracted female attention. Whether this was because his penis was not functional, I don't know.

In that same 12 years I encountered 2 cases of Penile Cancer, one in a man in his 60s, the other an octogenarian. The 60 something gentleman smoked and drank heavily and had very poor hygiene - all greater risk factors than a foreskin. In my private life, I've never known anyone who has contracted this rare form of cancer.

It is these observations and experiences along with the lack of convincing research data that brings me to my logical conclusion - if it's not diseased or defective it doesn't need treating. Simple
Posted by divine_msn, Tuesday, 6 May 2014 10:20:19 PM
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D,

Sorry for the delay.

Reading your post, while I respect your time working in a hospital, but your experience over 12 years shows a handful of cases, the majority of which caused mild embarrassment, one that was significantly embarrassing but could be corrected with surgery, and one that significantly affected the man's life, compared to two cases of penile cancer (which may or may not be related).

The logical gaps in this argument against future circumcisions are:
1) Circumcision measurably reduces the transmission of most STDs with lives lost and changed far more significantly than penile cancer.
2) The worst botched circumcision example you gave are from nearly half a century ago when essentially unqualified religious instructors were responsible for many procedures. The statistics for qualified medical practitioners is far, far better.
Posted by Shadow Minister, Thursday, 8 May 2014 10:02:56 AM
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As Robert Darby points out on his own web site: "The evidence in medical journals as to whether the presence or absence of the foreskin makes any difference to [STD's] is contradictory and inconclusive; every study which claims to find a correlation has been criticised as flawed or countered by other studies that find no connection at all. Some studies find that circumcised men are more vulnerable to some STIs."

If you have a strong stomach, Hugh Young also has a section on his web site regarding botched circumcisions.

Circumcised men are not immune from penile cancer, if that's what you are implying.

And the American Academy of Pediatrics policy on circumcision has been criticised by medical authorities in other countries.
Posted by Felix Garfield, Thursday, 8 May 2014 8:54:44 PM
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Not quite Shadow Minister. 2 cases of botched circumcision done by Medical Practitioners - one over 60 yrs ago, the more recent in 1994 - both certainly resulted in severe - if not total sexual dysfunction due to penile mutilation and irreparable damage. Other cases involved infection and one severe bleeding requiring transfusion - near fatal but for an anxious mother. Do not trivialise the extent of damage done or current risk. If you believe Doctors nowadays don't occasionally make cock-ups (pardon my very bad pun) you probably think Santa and Tooth Fairy are real. As for 'mild embarrassment' - there are some men with circumcision related problems suffering psychological impotence - usually related to fear of how a sexual partner will react to their penis. "Mild" I guess if you are not one of them.

Penile cancer is rare. When it does occur it's usually, but not always, found in elderly men who usually, but not always, have intact foreskins. To liberate the world from the deadly scourge of penile cancer the best solution would be to amputate the organ once every male reached a certain age - say 50. That would do it!

Sexually transmitted infections aren't contracted or spread because a man has a foreskin. They are due to unwise sexual behaviour - period! So - circumcise every single male shortly after birth and wipe out STIs? I don't think so! Santa and Tooth Fairy are likewise sceptical ...

If a male old enough to give informed consent wishes to be circumcised - I'm fine by that. If a child requires the procedure - as some do, albeit rarely - parental consent is valid in such cases. Otherwise I stand by evidence of my eyes and experience when examining the arguments put forward by both pro and anti camps. Most research outcomes not obviously skewed one way or the other seem to suggest if there are benefits - they are insignificant.

That brings me to the logical conclusion as with all things medical - if it's not diseased or defective, it doesn't need treating
Posted by divine_msn, Thursday, 8 May 2014 11:57:43 PM
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D,

With all due respect, in the hospital you see what goes wrong, in a hospital you are unlikely to see the benefits of circumcision. While some on this site try to rubbish the evidence that this procedure reduces (not prevents) the chance of catching STIs, I would prefer to take the considered opinion of the American medical association, who has reviewed many research articles and concluded that the benefits exist and at least outweigh the risks of the very occasional botched procedure in the modern world.
Posted by Shadow Minister, Friday, 9 May 2014 11:34:31 AM
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It's what I call the Mushroom-Turtleneck Law: for every study or statement on circumcision, a contradictory study or statement exists. I assume you're referring to the American Academy of Pediatrics policy on circumcision, which has been criticised by medical authorities in Europe, Australia, and Canada:
http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896

As PZ Myers said: "It’s certainly not that the benefits [of circumcision] are as solidly established as they are for vaccination; reading the literature, the most striking observation is the murkiness and insignificance of the evidence. If you’ve got lots of studies, and they vary up and down in their conclusions, and are constantly skirting the margins of likelihood, what’s the best explanation: that there is a strong effect that can only be detected by true believers, or that we’re dealing with no effect at all and people are cherry-picking peaks and troughs from statistical noise?"
Posted by Felix Garfield, Friday, 9 May 2014 12:13:54 PM
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Felix,

There are those that make up their minds based on the evidence, or those that have made up their minds already and cherry pick the evidence they want to support their pre conception. The moment I hear stupid comments such as "If a male old enough to give informed consent wishes to be circumcised - I'm fine by that." then I know that the fall into the latter category. (circumcision at 18 is far more painful and risky than at a few weeks, and follows the same logic of making women wait for an abortion.)

The reality is that the risk or a botched procedure by a medical professional is miniscule, and the benefits are also small but supported by reliable studies by independent organisations.

All in all while there is no medical justification to have the procedure, there is similarly no justification not to. The decision is that of the parents.
Posted by Shadow Minister, Friday, 9 May 2014 1:18:46 PM
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With Mothers' Day upon us it is time for all boys and men to demand an answer to THAT question that has been bugging us all and particularly feminists,

"How is it that mothers can produce such beautiful, perfect offspring as girls, yet cruel Nature dooms mums to make a complete cock-up where boys are concerned?"

If there is one thing that feminists and religious fundamentalists agree on it is that the little teapot spout possessed by boy infants is a PROBLEM that needs to be dealt with. That wee spout needs to be CUT. The only difference is how much either side might lop off.

Now as a man I have been confronted by all manner of women's p*ss flaps. Some are of such dangling abundance that they rival John Wayne's saddlebags and are more wrinkled than a Savoy cabbage. What small boy's, or even a man's, foreskin could compete with those?

Women are lucky though because no bacteria could ever lurk in a voluptuous box and even if any did it must by definition be GOOD. Anyhow it would be unthinkable and a horrendous crime to tamper with the tackle of an Earth Goddess.

On the other hand, boys are made of puppy dogs' tails, snails and awful stuff, so of course they should be cut. It just so happens that it is a jolly good earner for some doctors too. That is never a consideration of course.

Just wondering though, what penile health differences are there between US men who are often lopped and men from Scandinavian countries where the ritual is uncommon? I think I have seen the answer before and no, it doesn't favour the chopped American men.
Posted by onthebeach, Friday, 9 May 2014 5:09:51 PM
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