Circumcision, again

July 6, 2005 11:28 AM

I'm so glad we got that circumcision debate over with since there is no evidence of a benefit from circumcision, except maybe that 70% reduction in the risk of HIV infection....
posted by dwivian (151 comments total)

... hoo boy...
posted by idest at 11:37 AM on July 6, 2005

Seeing as the test is on men who were circumcised as adults perhaps they just don't feel like having any nookie with their wounded willies.
posted by zeoslap at 11:38 AM on July 6, 2005

zeoslap: presumably, the study controlled for factors like that.

there are two other studies underway that are needed to confirm or question these results, which is part of the scientific process.

without multiple studies, you can't do certain mathematical analysis of error margins or probabilities across studies (the so called meta-study).

this could be great news, indeed, if it turned out to be valid, but i wish people just understood the scientific process better, rather than reflexively falling for the usual journalistic hype.
posted by reality at 11:47 AM on July 6, 2005

Zeoslap.... HEHEHEHEHE ... okay, that one got me good....
posted by dwivian at 11:47 AM on July 6, 2005

All three trials were designed to compare the HIV infection rates of two groups of HIV-negative men, one-half of whom would agree to be circumcised, the other to be offered only counseling on AIDS prevention.

Odd that it doesn't say whether the men used condoms or not.
posted by orange swan at 11:48 AM on July 6, 2005

The MSNBC article specifies that the participants in the South African study were 18-24.

Zeo are you seriously suggesting that for a *full 21 months* a statistically significant number of 18-24 year old men avoided sex because of an operation that leaves one sore for a couple months at worst?

I have a very very hard time swallowing that. I think what's going on here is pretty obvious - fluids from sex are getting trapped under the skin of the uncircumcised males thus providing them with more prolonged exposure.

What I'd be curious to hear is the statistical breakdown of opinions from the 1500 circumcised participants as to whether they perceived a decrease in sexual pleasure, and if after learning the results of the test they felt the tradeoff was worthwhile.
posted by Ryvar at 11:53 AM on July 6, 2005

Castration has even more dramatic effects.
posted by srboisvert at 11:55 AM on July 6, 2005

Turtle neck or crew neck? You decide.
posted by ZenMasterThis at 11:56 AM on July 6, 2005

Ryvar - actually the most supported theory is that foreskin, being rich in white blood cells, is a richer "attack surface" for the virus because WBC's are their favorite targets.

But if you do some hard thinking about the numbers (always remembering this needs to be replicated and meta-studied), then the facts are quite strange: 70% putative reduction in likelihood of infection over the time period.

But then how come it makes no difference for the other 30%? And the numbers also show circumcised men also get infected, at some sort of "base probability". So it's not an absolute guarantee of protection, all else being equal.

There is a good chance there is something else at play here, or there's a subtlety the study did not capture.

It would be quite impressive to be able to combine both a vaccine (say 40% protection) and this procedure (another 70% max), and get the product of the two! Huge.
posted by reality at 12:03 PM on July 6, 2005

More white blood cells in the foreskin = more possible targets for the virus to attack. That's the proposed mechanism according to the article.

What puzzles me is the last line of the MSNBC article Ryvar links above:

Previous studies have linked circumcision with increased HIV infection.

Really? That's wierd, considering the dramatic results of this study.
posted by selfmedicating at 12:04 PM on July 6, 2005

The best way to encourage circumcision would be to advertise some sort of "Half Off Sale"
posted by Robot Johnny at 12:08 PM on July 6, 2005

Wouldn't it be even easier, and more effective, to just wear a damned condom?
posted by mosch at 12:08 PM on July 6, 2005

how do you forcibly circumcise a few dozen million African men?
posted by matteo at 12:12 PM on July 6, 2005

Oh man. This again?
posted by redteam at 12:15 PM on July 6, 2005

It was deemed unethical to continue the trial after an early peek at data showed that the uncircumcised men were so much more likely to become infected.

Ok. Science running afoul of ethics is now magically a cause for concern? What gives? Why not continue the study? they aren't people anyway.

The white substance that forms between the uncircumcised foreskin and the head of the penis is considered by some to be antibiotic (not sure about antiviral).

Considering that articles abound describing a direct link between circumcision and non-HIV STD's, and the fact that stringent HIV testing standards do not currently exist in much of africa (e.g. false positive cross reactive antibody detection), wouldn't it be a bad idea to encourage this type of practice?

I call shenanigans.
posted by Milliken at 12:17 PM on July 6, 2005

I'll be interested to watch the results of further study into this. It seems there could be some confounding variables: like - as mentioned in the article - perhaps the cultural differences between circumsized males and uncircumsized males lead to differences in behaviour (say.. fewer sexual partners or less risky types of sexual contact, or fewer total sexual encounters). There is obviously an effort to remove this confound from the data by having the circumsicion performed on adults - but it isn't clear from the article if the control group also would have agreed to the circumsicions. Perhaps there is a difference between the sexual behaviours of men that would agree to circumsicion, and men who would refuse.

On Preview:presumably, the study controlled for factors like that. - reality

Well, hopefully. But the linked articles don't say, and without access to the study (which is not yet even published) there is no way to know. I don't think it's correct to assume that a particular study controlled for a particular variable without any indication that they did. The information we have right now doesn't say if they controlled for (or even monitored) frequency of sexual contact, other protective measures the subjects might have used, etc. It's possible that they did, but it's jumping to conclusions to assume that they did or did not control for those variables. The answer to that question could potentially have a significant impact on the importance of this research.

It would be so exciting to find a solution that could be so simple towards slowing the spread of HIV - though it will only benefit those who are currently HIV negative. but I would hate to see a bunch of people run out and get cut only to discover that it might not help them as much as this study suggests. And they'll still be far safer to abstain (duh) or have protected safer sex.

My friend that had a medically neccessary circumcision at 24 can tell you that while it is a simple procedure, it isn't very fun to have done. He hurt for weeks after and it took him a while to walk normally & comfortably.

I'll be interested to see if this study is enough to start to sway the North American debate on circumsicion. Where I live, at least, the majority of 20-somethings were circumsized, but the majority of them are not circumsizing their sons. I wonder if that tide might shift again.

Wild speculation about possible contributing factor as to why uncircumsized males might be at higher risk for contracting the disease: perhaps it's easier for a man with a foreskin to have the skin of his penis damaged (slight tears or abrasions) and therefore open for the direct contact from foreign bodily fluids.
posted by raedyn at 12:20 PM on July 6, 2005

It's certainly an interesting result. But what does it say about the efficiency of counseling? And I'd like to know the numbers. Ah - here we are - from another study :

• A two-year cohort study of male partners of HIV-positive women in Rakai, Uganda, in which 40 of 137 uncircumcised men became infected, compared with 0 of 50 circumcised men.

This is from a usaid site.
posted by TimothyMason at 12:22 PM on July 6, 2005

This is idiotic. Why not just start chopping the penis right off? That'll lower the number as well. If you circumcise a man, you remove thinner more membranous tissue and replace it with thicker, calloused skin. Of course it will lower transmission rates, but how far do you want to take it?
posted by glider at 12:26 PM on July 6, 2005

Ok. Science running afoul of ethics is now magically a cause for concern? What gives? Why not continue the study? they aren't people anyway.

I can't tell if you're being sarcastic or not. I think you are, but just in case: It is an accepted practice during medical trials that you stop the study if your preliminary results are very dramatic, because at that point you're essentially letting the placebo group die for no reason. They did this for the aspirin -> reduced risk of heart attack study.
posted by breath at 12:30 PM on July 6, 2005

As a previously linked article on the topic says: "The fact remains that the circumcised male can be infected." and "Researchers are ... afraid that too many people will put faith in the procedure as a weapon against Aids [sic]."

Of course it will lower transmission rates, but how far do you want to take it? - glider

I think that choice would have to be up to the individual man. You may not find it to be worth your while, and I think it's your right to make that choice. But if you are a man in a relationship with an infected partner, you may decide it's worth it to have the surgery to add to the other precautions you're already taking.

The point you raise reminds me of a phenomenon in North Amercia. There are some women here who have never had breast (or any other kind of) cancer, yet have chosen to get elective masectomies as a preventative measure. Of course cutting your breasts off will lower transmission, but how far do you want to take it? Most of these women are at high risk due to carrying a particular gene and having lost multiple family members to the disease. This seems like a drastic and extreme measure to me, and I am not getting my breasts removed in order to prevent the disease, but to those women - they've decided it is the right choice for them and helps them sleep at night. Who am I to tell them that they're wrong?
posted by raedyn at 12:38 PM on July 6, 2005

"This is idiotic. Why not just start chopping the penis right off? That'll lower the number as well."

No, what's idiotic is for some doofus living in a country in which AIDS has been almost abolished through combination therapy ranting about the evils of circumcision in a subcontinent in which tens of millions are dying prematurely in the most agonizing fashion. Hey, why should we give a shit about preventing a whole generation from growing up as AIDS orphans if it means having to endorse a superficial cosmetic procedure?

Talk about fucked up priorities ...
posted by Goedel at 12:38 PM on July 6, 2005

Lessee... anything here to justify a particular bugbear of mine - infant circumcision? Nope. Good.

If adult males wish to take this one study as terribly convincing evidence that circumcision will make them less likely to get AIDS than wearing a condom would, hey, that's up to them. I do hope no one is going to suggest anything more than that should happen.
posted by Decani at 12:47 PM on July 6, 2005

So, it would seem that circumcision and just a good daily washing of your cock might have something in common.
Although the apparent protective effect of circumcision has been noted for more than 20 years, doubts linger as to whether circumcision itself is protective, or whether the lower risk may be the result of cultural practices among those who circumcise. HIV rates are low in Muslim communities, for example, which practice male circumcision but also engage in ritual washing before sex and frown on promiscuity.

Decani, please do me a favor and go to Africa and try to convince the men there to spend the money to buy condoms and then to use those condoms. Its one helluva lot harder than you think it is.
posted by fenriq at 1:02 PM on July 6, 2005

Goedel, how far will you take your mutilation argument? Seriously, why not just cut the penis off altogether? That'll cut down on it even more, and reduce over population as well. Maybe you could infibulate the women while you're at it.

Or we could get over our Christianity and just donate education and birth control assistance. But no, God wants us to cut little boys' cocks, not wear a rubber, right? Or we could be less draconian in our capitalism and offer AIDS drugs at a fair price to these countries. But no again, God wants us to get rich on the backs of the coloured folk not help our neighbors, right?
posted by glider at 1:39 PM on July 6, 2005

fenriq:
...but convincing them to have a piece of their dick chopped off will be easy?

Even if it is true that circumcision drastically reduces HIV transmission (and it seems entirely plausible), does it matter? The same cultural/educational factors that stop condom use from being universal in sub-saharan Africa will still make it difficult to put it into large-scale practice.
If it's difficult to convince men to use condoms, it's going to be even harder to convince them that they should be circumcised. I mean, the idea of circumcision seems bizarre and medieval to *me*, how will it sound to people who are already bombarded by messages that anti-retrovirals are a plot to kill Africans(S. Africa), or that Polio vaccines will deprive them of their manhood(Nigeria)?
posted by atrazine at 1:47 PM on July 6, 2005

Well, I'll be damned. ... So the Jews had it right all along after all.
posted by Possum at 1:48 PM on July 6, 2005

If adult males wish to take this one study as terribly convincing evidence that circumcision will make them less likely to get AIDS than wearing a condom would, hey, that's up to them. I do hope no one is going to suggest anything more than that should happen.

I think this is a very good argument for infant circumcision in places with a high AIDS rate.

Shit, I'd rather be circumcised at birth then get AIDS. I think most people would as well (it's really not a big deal). I'd rather be circumcised at birth then have a 70% greater chance of catching AIDS.

Hell, I'm going to go out and bang some sluts today!
posted by delmoi at 1:48 PM on July 6, 2005

It would be quite impressive to be able to combine both a vaccine (say 40% protection) and this procedure (another 70% max), and get the product of the two! Huge.

Um... Actually the product of 70% (0.70) and 40% (0.40) is only 28% (0.28). Not quite as huge as you might think.
posted by Snowflake at 1:50 PM on July 6, 2005

Goedel, how far will you take your mutilation argument? Seriously, why not just cut the penis off altogether? That'll cut down on it even more, and reduce over population as well. Maybe you could infibulate the women while you're at it.

Because there is a huge diffrence between cutting of a penis and cutting off the foreskin. Would you rather lose your pinky's fingernail or your whole arm?
posted by delmoi at 1:50 PM on July 6, 2005

Or we could be less draconian in our capitalism and offer AIDS drugs at a fair price to these countries.

Umm, that meme ran out of steam a couple of years ago. See, current distribution efforts, right to produce generics all the way back to 2000.
posted by thedevildancedlightly at 1:50 PM on July 6, 2005

If it's difficult to convince men to use condoms, it's going to be even harder to convince them that they should be circumcised. I mean, the idea of circumcision seems bizarre and medieval to *me*, how will it sound to people who are already bombarded by messages that anti-retrovirals are a plot to kill Africans(S. Africa), or that Polio vaccines will deprive them of their manhood(Nigeria)?

Do you really think that's what most Africans think? I think it would be easy to convince them to circumcise their children, since it's been so common throughout history and people know exactly what it is, unlike antiretroviral agents and the like.

Circumcising most children in Africa could drastically reduce AIDS in a generation if current sexual practices are kept up.

The AIDS rate in Nigeria is 5.4%, by the way, compared to 21% in south africa.
posted by delmoi at 1:56 PM on July 6, 2005

atrazine, yeah, it actually is easier to convince them to undergo a ritual that turns them from boy into man. At least in the Xhosa (South Africa) men I spoke with, many of them looked forward eagerly to the day they became men by being circumsized.

The cultural triggers are already in place to make circumcision more widespread, much, much more so than condom use which has had a campaign of lies and misinformation to discourage use (thanks religious numbnuts!). That and they cost money which is in pretty short supply.
posted by fenriq at 1:59 PM on July 6, 2005

Um... Actually the product of 70% (0.70) and 40% (0.40) is only 28% (0.28). Not quite as huge as you might think.

Well, if circumcision makes it 30% as likely for someone to get HIV as before, and a vaccine makes it 60% as likely, then the combination would make it 18% as likely (82% reduction) assuming independence.
posted by transona5 at 2:00 PM on July 6, 2005

Why do I get the impression that all of the doubters of this study are already against circumcision and those finding credible results either are in favor of or have no opinion as to whether circumcision is a good or bad thing? Given the limited information already released about the study parameters and controls we will have to wait until it is published to get a better idea as to whether it is good science or not. Of course we can always opine on the study based upon our prejudices about circumcision.
posted by caddis at 2:04 PM on July 6, 2005

how do you forcibly circumcise a few dozen million African men?

Tell them that the ladies like it. They'll line up.
posted by jonmc at 2:06 PM on July 6, 2005

My bet is that when you keep the foreskin, it increases the likelihood of love juice (or death juice in this context) getting trapped for an extended period of time, increasing the chances of those juices finding their way into nicks and scratches. Also keeps it warm.

I'm also guessing frequency of sexual activity is factored into the study.
posted by furtive at 2:06 PM on July 6, 2005

What is glaringly ommitted from these media commentaries on circumcision and AIDS (btw in a clinical trial involving circumcision, it is very difficult to eliminate confounding factors) is a discussion on all the risks and losses due to circumcision.

Here is a quote from the physicians manual of the College of Physicians and Surgeons of British Columbia:

Medical Perspectives
Circumcision removes the prepuce that covers and protects the head or the glans of the penis. The prepuce is composed of an outer skin and an inner mucosa that is rich in specialized sensory nerve endings and erogenous tissue. Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death. The benefits of infant male circumcision that have been promoted over time include the prevention of urinary tract infections and sexually transmitted diseases, and the reduction in risk of penile and cervical cancer. Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended.

https://www.cpsbc.ca/cps/physician_resources/publications/resource_manual/malecircum

For an excellent review of the modern history of male circumcision, see Gollaher's paper from the Journal of Social History:

http://www.cirp.org/library/history/gollaher/
posted by spacediver at 2:07 PM on July 6, 2005

Given the limited information already released about the study parameters and controls we will have to wait until it is published to get a better idea as to whether it is good science or not.

Ever heard of PubMed? Try doing a literature search on circumcision on there: you'll find that this is far from being the first study indicating that circumcision dramatically reduces the risk of HIV infection. Frankly, the extent of the literature in support of this assertion is overwhelming, and most people would be screaming blue murder about "greedy pharmaceutical companies" if it were a drug we were talking about with so much research evidence behind it.

As for spacediver's screen-dump of carefully selected anti-circumcision lobbyist fodder, I suggest that others interested in a balanced assessment of the risks also do a PubMed study, to see which way the whole of the literature trends, not just cherry-picked quotes meant to inspire alarmism.

Circumcision is one of the single safest medical procedures known to man, and anyone who thinks the miniscule risks not worth taking on in Southern Africa is either indifferent to the AIDS crisis unfolding there, positively malicious and wishing to see it spread, or just plain out of his or her mind with ideological lunacy.
posted by Goedel at 2:17 PM on July 6, 2005

I can't belive there are people implying that this is a bad thing. Condoms are only 80% effective against stopping AIDS.

It seems like a no-brainer, but maybe I just don't understand the sacredness of the foreskin, having only had any for a short time, myself.
posted by 4easypayments at 2:20 PM on July 6, 2005

bad link above, sorry: here
posted by 4easypayments at 2:21 PM on July 6, 2005

Of course most Africans don't think that, note that I said they were exposed to these messages, not that they outright believed them.

I agree that this could save many lives, I'm just not sure that it'll ever happen.

I am aware that Nigeria has a much lower AIDS rate, (and in fact the Polio issues took place in a region where it is even lower), I'm simply observing that if it seems a bit odd at first to me, then it *may* seem even more so to people who have very little education. It also seems obvious to me that the uneducated are the demographic where the "condoms & retrovirals" strategy is having the least effect.
It's all very well saying that not many people believe the conspiracy theory bullshit about antiretrovirals, but those beliefs are more prevalent among those most at risk (the poor and uneducated in the SA townships) than among the population at large.

Of course none of this matters if male circumcision is a traditionally accepted practice in the worst affected areas.
Does anyone know if this is traditional in South African and Botswana?

on preview:
ah! fenriq, exactly the info I was looking for. How widespread is this belief among South Africans of different tribal origins? According to wikipedia, Xhosa are about 15% of SA's population, which is certainly a good start.
posted by atrazine at 2:22 PM on July 6, 2005

Ever heard of PubMed?

Ever hear of the word "condescending?"
posted by caddis at 2:28 PM on July 6, 2005

4easypayments: The usual reason for opposition is the decreased sensation. What causes the most anger is the fact that it's done to infants without their consent (obviously).
That's also my reason for being opposed to it in general, but if I was living in South Africa, the risk/reward assesment would be different and I would certainly consider it for any children of my own.
posted by atrazine at 2:29 PM on July 6, 2005

Just out of curiosity, is there any study that shows your chances of contracting AIDS by having unprotected sex with an infected person?

1 in 5 South Africans has HIV/AIDS. If I lived there, I would sooooooo be into self love.
posted by b_thinky at 2:42 PM on July 6, 2005

glider writes "This is idiotic. Why not just start chopping the penis right off? That'll lower the number as well. If you circumcise a man, you remove thinner more membranous tissue and replace it with thicker, calloused skin. Of course it will lower transmission rates, but how far do you want to take it?"

Glider-What, exactly, are you on about? Comparing circumcision and removal of the penis is inane, and doesn't do your anti-circumcision stance any credit. It may or may not be better for, say, sex, to be uncircumcised (I'm cut, and I have a great time), but reducing the function of the penis to its level of sensation is an ill-considered move. Not only is it rife with philosophical problems, it also plays right into the hands of people who argue that having sex with a condom is no good because condoms reduce sensation. In other words, if you insist on penile sensation being the most important thing in the world, there is no where to "take it" except to abstinence or the morgue. There are no other prevention messages left for you to advocate.

Presumably this study advocates for infant circumcision, I agree that it would be incredible to think that men would rather get cut than use a condom. However, I guess that some men were willing to for this study.

I wonder if the study controlled for the men who got circumcised being more willing to use condoms than the control group. There's nothing that says they were more willing, but they did choose an intervention when they could have chosen none, so perhaps they were.
posted by OmieWise at 2:44 PM on July 6, 2005

originally posted by Goedel

As for spacediver's screen-dump of carefully selected anti-circumcision lobbyist fodder, I suggest that others interested in a balanced assessment of the risks also do a PubMed study, to see which way the whole of the literature trends, not just cherry-picked quotes meant to inspire alarmism.

I've actually immersed myself for a few years in this issue - and it would be more fruitful if you tried to deal with specific issues regarding circumcision, rather than categorizing my posts as derived from anti-circumcision fodder.

Circumcision is one of the single safest medical procedures known to man, and anyone who thinks the miniscule risks not worth taking on in Southern Africa is either indifferent to the AIDS crisis unfolding there, positively malicious and wishing to see it spread, or just plain out of his or her mind with ideological lunacy.

It is relatively safe given today's current medical technology, however it is not without risks. Furthermore, the loss of erogenous tissue/functioning is guaranteed.

There is more to be said on this issue, however I'm late for volleyball. Will be back in a few hours.
posted by spacediver at 2:53 PM on July 6, 2005

atrazine, I should note that my information is based on a very, very small sample of the population, namely those Xhosa men I got to know well enough to discuss their genitalia with. And that was only a couple and only one of those described the ritual he underwent to become a man. It was not for the faint of heart (which is how he said it should be!).
posted by fenriq at 2:55 PM on July 6, 2005

Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death.

Christ what a load. Wiping your ass carries a risk of sepsis, minor bleeding, paronychia, laceration, foreign body entrapment, inadvertant autoerotic instability, and stink-finger.
posted by docpops at 3:03 PM on July 6, 2005

b_thinky: If I lived there, I would sooooooo be into self love.

Your capacity for self love is location dependent?
posted by pmbuko at 3:04 PM on July 6, 2005

This could be a good wakeup call for people at risk of AIDS.

However, if any of you are telling me, an uncircumcised American in a monogamous marriage, to get circumcised, I'll tell you one thing:

You can take my foreskin from my cold, dead ......
posted by whoshotwho at 3:21 PM on July 6, 2005

penis?
posted by InfidelZombie at 3:28 PM on July 6, 2005

matteo: how do you forcibly circumcise a few dozen million African men?

Very carefully.
posted by hipnerd at 3:32 PM on July 6, 2005

My bet is that when you keep the foreskin, it increases the likelihood of love juice (or death juice in this context) getting trapped for an extended period of time, increasing the chances of those juices finding their way into nicks and scratches. Also keeps it warm.

Actually it is because the foreskin contains a higher concentration of Langerhan cells than the rest of the penis. Langerhan cells are the much more susceptible to infection than normal skin cells. here
posted by 517 at 3:38 PM on July 6, 2005

I assume that, here in the developed world, its smegma lovers that aren't getting their sons circumcised.
posted by joedharma at 3:58 PM on July 6, 2005

Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death.

It's the frequency of problems that matters, not the number of different ones. From a numbers perspective, catching HIV can cause many, many more problems then circumcision.


I am aware that Nigeria has a much lower AIDS rate, (and in fact the Polio issues took place in a region where it is even lower), I'm simply observing that if it seems a bit odd at first to me, then it *may* seem even more so to people who have very little education. It also seems obvious to me that the uneducated are the demographic where the "condoms & retroviral" strategy is having the least effect.

Well, it seems like less educated people are more likely to accept a circumcision, especially given how common they are. Pretty much all Muslims get circumcised. People know what circumcision is, and they can understand it fully. It's not like getting injected with an unknown substance or eating unknown pills.

It seems like it would be as easy to convince a guy to get a circumcision as it would be to convince a girl to get her ears pierced. Just tell them it makes their dicks look bigger and that women like it and they'll line right up.

Anyone claming that there are other major benefits to having an uncircumcised penis besides enhanced sensation are crackpots, IMO.

I don't know how you would test this, but I bet a circumcision would cause less of a sensation reduction then a condom.

And actualy I doubt theres that much of a diffrence between cut and uncut sensations when wearing a condom.
posted by delmoi at 4:08 PM on July 6, 2005

Know what reduces the risk of HIV/AIDS infection by up to 100%?

NOT fucking around!
posted by ackeber at 4:13 PM on July 6, 2005

Regarding the conclusions of the study specifically: As far as I can remember, the center of the AIDS epidemic in South Africa is around the single-sex hostels in the Witwatersrand, which house migrant mine workers. They tend to be mainly Zulu, Swazi and, I think, Venda. None of these are groups which traditionally practise circumcision, so there may be an element of selection bias in here.
Partially related, most of the ruling ANC people are (or at least were when I last knew about things) Xhosa, specifically from the Eastern Cape, which is a particular power-base of theirs. It's one of the areas that was worst-treated under Apartheid, and this has left it very rural.Traditional initiation rituals are still important: the initiation school is a central part of becoming an adult in Xhosa culture. The government have to please their power-base and also I'd imagine that individual party members will have strong views on the importance of these sorts of traditions. Given the government's history of medical activism in the AIDS debate, I doubt they'd hesitate to make their views known to a state-employed research team - particularly now, when the traditional initiation schools are under attack. There's pretty strong support for measures to rein in or regulate the initiation ceremonies, principally due to the horror stories of disfigurement and death that come out of the schools each year. One one hand, the circumcision is supposed to be carried out using a friggin' spear and on the other, anyone can set themselves up as an ingcibi (tradional surgeon), and its a pretty lucrative trade. Each year variously unqualified, drunk or otherwise unsuitable surgeons kill or mutilate dozens of kids out in the bush: a quick google for the term 'ingcibi' will show up a litany of news reports.
posted by muppetfiend at 4:16 PM on July 6, 2005

Yet another topic to piss off the liberals =)
posted by shockingbluamp at 4:17 PM on July 6, 2005

You can take my foreskin from my cold, dead ......

THAT'S funny.
posted by joedharma at 4:23 PM on July 6, 2005

An uncut member is more sensitive?
How do you goyim even walk around? Do you only wear silk boxers filled with vaseline or something?
To be honest, I'm still plenty sensitive.

I'm not buying that sensation loss nonsense for a second.
posted by Jon-o at 4:24 PM on July 6, 2005

How do you goyim even walk around?

Most of us goyim are circumsised as well these days, at least in the US. To be quite frank, I don't miss my foreskin, but the anti-snip contingent has convinced me, it's all a conspiracy of the handbag industry.
posted by jonmc at 4:30 PM on July 6, 2005

it's all a conspiracy of the handbag industry.

To you, maybe. To a few of us, it's a 5,000+ year old tradition and religious practice.
posted by Jon-o at 4:35 PM on July 6, 2005

An uncut member is more sensitive?
How do you goyim even walk around? Do you only wear silk boxers filled with vaseline or something?

I think the point is that the foreskin does the protecting...

To be honest, I'm still plenty sensitive.

I'm not buying that sensation loss nonsense for a second.

'kay, well, do the test and let us know...
posted by senor biggles at 4:36 PM on July 6, 2005

OmieWise, the foreskin is the nerve-laden end of the penis. Circumcision is by definition the partial amputation of the penis. It's not just some useless vestigial bit of skin!

The quesiton is, if one can say "cutting off part of the penis lowers AIDS rates", why not draw that line a little farther?

Of course, I'm opposed to involuntary genital mutilation of babies, but for those that are into mutilating baby penises, I'm interested in knowing how they draw the line (other than "my parents cut off this much of my penis, so I will cut off about the same from my kid")... Certainly the "science" behind the whole thing is highly debatable.
posted by glider at 4:40 PM on July 6, 2005

Circumcision helps prevent HIV infection? Thus explaining why the USA, the last "western" nation still routinely circumcising most of it's infant boys, has such a low rate of HIV infection compared to other first world countries. Har.

The idea of amputation of body parts at birth in order to prevent disease is a most curious one. On the other hand, I really have no problem if an adult wishes to be circumcised on the slim chance that this study applies to his activities. But, that person should also remember that a very large majority of the US males who have died of AIDS were circumcised.
posted by telstar at 4:42 PM on July 6, 2005

I had a friend who had to be snipped when he was 18. Not a pretty event (painful). I bet he wished his parent's would have taken care of it 18 years ago.
posted by tomplus2 at 4:44 PM on July 6, 2005

senor biggles writes "'kay, well, do the test and let us know..."

Yes, because a look at the last paragraph of the article reveals that the author is completely neutral in the circumcision debate...

"Loss of sensation" seems like a red herring to me. It may exist for someone who undergoes circumcision as an adult, but how much of that is directly related to having the procedure done as an adult? I don't think anyone can honestly claim to know. It's a bit like a white guy talking to a black guy and asking if the black guy feels "warmer" than him when going out into the sun. There's no real shared, objective point of reference that would help clear up the issue.
posted by clevershark at 4:46 PM on July 6, 2005

AIDS Read. 2005 Mar;15(3):130-1, 135, 138.

Male circumcision and the risk of HIV infection.

Inungu J, MaloneBeach E, Betts J.
School of Health Sciences, Central Michigan University, Mt. Pleasant, Michigan, USA.

Epidemiologic data have suggested that male circumcision is a major protective factor against male heterosexual HIV transmission and may explain the significant geographic differences in the prevalence of HIV observed within sub-Saharan Africa. To assess the evidence of the protective effect of male circumcision, African studies on its association with HIV infection were reviewed. These studies' systematic lack of control of important confounding factors makes the assessment of the association between male circumcision and HIV transmission very difficult and raises doubt about the validity of the current findings. Randomized trials are needed to determine the true strength of the association. Until then, a decision to recommend mass male circumcision to prevent HIV transmission in sub-Saharan Africa is premature and risky.

I call bullshit on the 80% protection number against HIV afford by condoms?

This protection is most evident from studies of couples in which one member is infected with HIV and the other is not, i.e., "discordant couples." In a 2-year study of discordant couples in Europe, among 124 couples who reported consistent use of latex condoms, none of the uninfected partners became infected. In contrast, among the 121 couples who used condoms inconsistently, 12 (10%) of the uninfected partners became infected.
posted by PurplePorpoise at 4:48 PM on July 6, 2005

Actually, I agree about the website, clevershark, and there are probably plenty out there that can claim to prove the opposite. Just a quick reaction to the peculiarly insistent assertion that there was no, nada, zippo loss of sensation in Jon-o's mighty organ.
posted by senor biggles at 4:52 PM on July 6, 2005

Personally I find the idea of "knowingly discordant couples who use condoms inconsistently" to be more than a little weird.
posted by clevershark at 4:53 PM on July 6, 2005

I want my foreskin back. :-(
posted by ddf at 5:04 PM on July 6, 2005

Circumcision images copyright 1994 Corel Corporation.

Too bad i only feel 20% of the pleasure as I ROTFLMOL!!!
posted by furtive at 5:07 PM on July 6, 2005

clevershark writes "Personally I find the idea of 'knowingly discordant couples who use condoms inconsistently' to be more than a little weird."

Happens all the time, I can't explain it very well, but it's a well-known phenomenon for anyone who does Aids work.
posted by OmieWise at 5:17 PM on July 6, 2005

tomplus2 writes "I bet he wished his parent's would have taken care of it 18 years ago."

Heck if they'd tossed his head in a jar he'd never have any medical problems below the neck.

Even assuming that 80% figure for condoms above was right (sounds awefully low to me), if it came down to an either/or I know which method of risk reduction I'd rather use. And on preview I'm with PurplePorpoise
posted by Mitheral at 5:26 PM on July 6, 2005

glider writes "OmieWise, the foreskin is the nerve-laden end of the penis. Circumcision is by definition the partial amputation of the penis. It's not just some useless vestigial bit of skin!

"The quesiton is, if one can say 'cutting off part of the penis lowers AIDS rates', why not draw that line a little farther?"

Yes, I understand, you think circumcision is a bad idea. Alright. Your still not making sense and not helping your case by engaging in this kind of hyperbole. The reason one does not draw the line further is because there is no evidence to suggest that it would be helpful. You seem to have decided that the reason there is lower HIV transmission in the test group is because they have sex less frequently because they're cut. I think that's bullshit.

I also, and this is ancillary to this debate, think that the reduction of the penis to its level of sensation is a dubious philosphical move plagued by exactly the same limitations that all appeal to purity and authenticity are: namely, unexamined assumptions about worth grounded in an unrigorous equivalence between 'nature' and 'the unspoiled (or unmediated).' The problem is, nature is always mediated, and purity can always be rolled back a little bit further. Authenticity and purity become simply the language of exclusion and the currency of value; but both always protect the assumptions of the arbiter precisely because those assumptions are always present when what counts as pure as authentic is determined in the first place. In other words, why do we remove the cowl from in front of a baby's face, remove the umbilical, wash a child, teach a child to talk? These things seems like self-evident actions, natural; and to many, so does circumcision.
posted by OmieWise at 5:29 PM on July 6, 2005

I don't think Matt will delete this, so I'd just like to mention that I flagged this as "breaking the guidelines" (and I don't flag very often). The content is okay, but the tone of the post was intentionally provocative and I really think this should be discouraged.
posted by Ethereal Bligh at 5:42 PM on July 6, 2005

Can you elucidate Ethereal? (that's a pretty good alliteration!)

I took it as being a little ironic, not intentionally offensive. More like, "gee, my parents skipped having me circumcised, and I skipped having my son circumcised because the public health authorities told me there was little or no benefit. Now I find out this.....
posted by joedharma at 5:57 PM on July 6, 2005

'kay, well, do the test and let us know...

Um, my dick worked fine.
posted by delmoi at 5:57 PM on July 6, 2005

This is good news for Africa if it pans out, of course - I don't understand well the AIDS problem there but virtually anything productive that's available should be done at this point.

This argument for circumcision shouldn't have to apply in the Western world where condoms and education are prevelent (or whatever else it is that keeps the AIDS situation much less dire here): to circumcize your kid at birth (removing a part of their body and reducing their subsequent pleasure) is kind of imposing an assumption that they'll be unable to consistently use condoms - better left to them, as they'll be competent to make the decision (hopefully) before they become sexually active. It's an imposition by the parents.
posted by abcde at 5:59 PM on July 6, 2005

Let the record show that Ethereal Bligh is a stodgey and not afraid to let it be known.
posted by furtive at 6:03 PM on July 6, 2005

"I took it as being a little ironic, not intentionally offensive."

Oh, really? Hmm. It seemed to me to be a very aggressive "I told you so" sort of post. Sarcastic and ridiculing of the anti-circumcision point of view. That's why I think it was pretty out-of-line. But maybe I misread it.
posted by Ethereal Bligh at 6:07 PM on July 6, 2005

whoshotwho writes "You can take my foreskin from my cold, dead ......"

wife's . . .
Too much?
posted by jenovus at 6:07 PM on July 6, 2005

OmieWise, the foreskin is the nerve-laden end of the penis. Circumcision is by definition the partial amputation of the penis. It's not just some useless vestigial bit of skin!

Circumcision helps prevent HIV infection? Thus explaining why the USA, the last "western" nation still routinely circumcising most of it's infant boys, has such a low rate of HIV infection compared to other first world countries. Har.

Well, we're better off then Brazil, Spain, the Ukrane. Not to great, but I think it has more to do with our lack of universal healthcare and poor social equity (i.e. we still have a lot of poor people)

The idea of amputation of body parts at birth in order to prevent disease is a most curious one.

People have no problem getting their appendix taken out, I mean, a slight reduction in sensation is certanly worth the reduction in risk.

Yes, I understand, you think circumcision is a bad idea. Alright. Your still not making sense and not helping your case by engaging in this kind of hyperbole. The reason one does not draw the line further is because there is no evidence to suggest that it would be helpful. You seem to have decided that the reason there is lower HIV transmission in the test group is because they have sex less frequently because they're cut. I think that's bullshit.

Well, to be fair cutting off the entire penis would preclude them from sleeping with women. They might start with the buttsex out of boredom, in which case their infection rates would skyrocket. But that's not the point.

Assuming that they don't turn gay, then they won't catch AIDS without a penis. That's obvious.

Whats not obvious, is why that is in any way not crazy. A circumsized man can still enjoy sex, masterbation, etc. The amount of sensation loss isn't that great, or important really. If there's no reason to remove it, then why bother. But if there is, then there's no reason to keep it.

Its like the diffrence between getting your ears peirced and getting your head cut off.

One is harmless, the other, not.
posted by delmoi at 6:15 PM on July 6, 2005

Ethereal: we have this thing called metatalk. Might want to look into it. (If you'd posted that comment in the first few, you could have totaly derailed the thread)
posted by delmoi at 6:17 PM on July 6, 2005

You'd never accept genital mutilation of a woman, regardless of any medical 'benefit', so cut the righteous bs and admit you're a misandrist.
posted by HTuttle at 11:25 PM on July 6, 2005

The people who consider that "loss of sensation" to be "no big deal" are speaking having never known the difference.
I know a few people who have been circumcised as adults. Every single one of them regrets it and says sex is nowhere near the same.
posted by nightchrome at 11:47 PM on July 6, 2005

I posted this in the other circ thread, but unfortunately I posted way late.

It started off with a reply to Goedel:

Originally posted by Goedel:

"Hmm, it doesn't take much work to turn up studies supporting the claim that circumcision does have health benefits. Furthermore, the claim that circumcision damages sensation doesn't appear to hold up to scientific scrutiny."

Goedel, the study you posted is similar to the 1966 Masters & Johnson study, which was similarly flawed. For a couple of critical dissection of this study, see:
this and this.

Notice that the 2005 study by Bleustein et al., assesses the sensitivity of the dorsal glans, which is one of the least sensitive areas of the penis. The dorsal glans is the region of the "mushroom head" that would be facing the sky, if your penis were to be extended outward, "viagra style", perpendicular to your body.

That circumcision may affect the sexual experience for the male is not a radically underground idea, but it is veiled with the mild notion that it may merely reduce sensitivity of the glans. What is not acknowledged, or even brought to attention, is the notion that reduced sensitivity is the least important and significant way in which functioning is changed. In addition to the mechanical aspect of sexual functioning of the foreskin, there is the fact that the quality of the sensations, in addition to quantity, is reduced. Circumcision permanently removes erogenous tissue that contain a dense array of highly organized nerve endings. Embryologically, this tissue is equivalent to that of the female labia (minora and majora). (See Taylor's study: - abstract here full text here (this is a peer reviewed study in the British Journal of Urology, btw). Also, see an interview with the author of the study here

The College of Physicians and Surgeons of British Columbia recently issued a statement on male circumcision:

Of note:

"Medical Perspectives

Circumcision removes the prepuce that covers and protects the head or the glans of the penis. The prepuce is composed of an outer skin and an inner mucosa that is rich in specialized sensory nerve endings and erogenous tissue. Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death. The benefits of infant male circumcision that have been promoted over time include the prevention of urinary tract infections and sexually transmitted diseases, and the reduction in risk of penile and cervical cancer. Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended."

These missing nerve endings mean that the brain receives signals from only a fraction of what it is designed for. Because of this discrepancy, neural plasticity probably allows each nerve to stimulate more brain regions, but despite this possible adaptation, the richness and complexity of the sexual sensation is diminished, since sexual pleasure, including orgasm, is derived from fewer modulators (which is the essential function of a neural signal). It is like chopping off a few fingers, wearing a plastic glove, and claiming that sensitivity of the hand is reduced. It is conceivable that the remaining fingers would be able to stimulate all brain regions that were once stimulated by the original intact hand, but to claim that the experience of running this hand across silk, or through water, is essentially unchanged after amputation, is to hold a very naive view of sensuality.

Many religions can be fruitfully understood as a transmission of wisdom. Some are focused more explicitly and directly on spiritual development, whereby dogma recedes in favour of prayer/meditation; but the ones that are more dogmatically embodied serve an important purpose in the development of people and their societies. Many lessons from scriptural and prophetic sources do indeed serve good purposes, though the reasons for these purposes are anointed spiritual import. Sometimes things serve purposes within a certain context, but not others. In these other cases, we can appreciate the lesson but should not feel bound by it. Many kosher laws were likely lifesavers in certain circumstances. However they are not all as necessary in others.

If one examines the literature carefully, one can find statements that support the idea that circumcision's primary function is to weaken the male's sexual experience.

Advocating Circumcision Today, a Jewish pro-circumcision group, states:

"When the foreskin is properly removed on the eighth day, all negative energy is annihilated and will never be able to have control over the person. On a metaphysical level, we cut off the ability for the potential of negative energy to become actualized in the child, thus giving him the extra strength necessary to overcome any problems he will experience throughout his life.

Kabbalah explains, that in this world there are many obstacles which conceal G-dliness. It is our job to remove these blocks, thus revealing the G-dly light. Circumcision is an act of removing unholiness. By physically removing the foreskin, we are spiritually removing and eliminating undesirable character traits, depressive tendencies and so on. We eliminate from the body of the child, forces which might try to cultivate overindulgence in physical pleasures, etc. In short, we give the child a boost and head start in fighting life’s battles; it can be compared to the concept of immunization.”
(emphases added)

Here are some historical examples:

Philo Judaeus, 1st Century:

“To these [reasons for circumcision] I would add that I consider circumcision to be a symbol of two things necessary to our well being. One is the excision of pleasures which bewitch the mind. For since among the love-lures of pleasure the palm is held by the mating of man and woman, the legislators thought good to dock the organ which ministers to such intercourse, thus making circumcision the figure of the excision of excessive and superfluous pleasure, not only of one pleasure, but of all the other pleasures signified by one, and that the most imperious.”

Moses ben Maimon (Maimonides), 12th Century:

“With regard to circumcision, one of the reasons for it is, in my opinion, the wish to bring about a decrease in sexual intercourse and a weakening of the organ in question, so that this activity be diminished and the organ be in as quiet a state as possible.

The bodily pain caused to that member is the real purpose of circumcision. None of the activities necessary for the preservation of the individual is harmed thereby, nor is procreation rendered impossible, but violent concupiscence and lust that goes beyond what is needed are diminished. The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened.

The sages, may their memory be blessed, have explicitly stated: "It is hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him." In my opinion this is the strongest of the reasons for circumcision.”

Some may interpret this as making sex less addictive, thus having a prophylactic effect on promiscuity, however it is also possible that the reduced experience has other effects, such as reducing allegiance to woman, and allowing the allegiance to males to thrive. There is anthropological evidence that may be relevant here (see tables in http://montagunocircpetition.org/genitalpain.pg ). There seems to a deep seated fear of women that some cultures have had on a culturally subconscious level. Surely reducing attachment to women, be it sexual or other, favours patriarchal functioning (this does not mean that attachment to women cannot be fulfilled through other more spiritual means). Perhaps if females were running the planet, female genital mutilation wouldn't be such an internationally recognized evil. Of course it wouldn't be a pharaonic affair, with full labial and clitoral excision and infibulation, but done in sterile conditions by trained physicians. Perhaps only the labia majora would be removed, a relatively useless flap of skin to those who don't know any better.

An example of such wisdom may be found in this 13th century statement by Isaac ben Yediah:

“With the circumcised man it is different. He will find himself performing his task quickly, emitting his seed as soon as he inserts the crown. … As soon as he begins intercourse, he immediately comes to a climax. The woman has no pleasure from him. She leaves the marriage bed frustrated. She does not have an orgasm once a year, except on rare occasions.

[This is good for her husband: freed from lascivious desires] he will not empty his brain because of his wife [and] his heart will be strong to seek out God."




The historical references are extensive, but it is interesting to note that explicit mention of the sexual rationale has withered almost completely in current discourse among medical professionals. This is reflected in the training that doctors undergo for circumcision, as well as a dearth of preputial education in medical textbooks, as well as a lack of histological and sexological research on the prepuce.

Now oppressing male sexuality may indeed be useful wisdom - i personally feel it's not a very enlightened idea - but what I can assert unequivocally is that this wisdom is not being transmitted honestly. There is something of a noble lie at play here, where palatable lies (i.e. extent of medical prophylaxis), or obscure spiritual references (the foreskin is a source of spiritual evil), are employed in favour of hard truths (circumcision reduces sexual pleasure, which is important for a healthy and godly society). There has been a radical break from the tradition of circumcision: where it was once understood by scholars, religious authorities, and physicians to be a form of control over male sexuality, we are now in an era of hypocrisy.

I do not believe in noble lies, as I believe they ultimately stunt intellectual and spiritual growth, if not overcome. It is spiritually dishonest, not to mention immoral, to use religious duty, or faith, as a justification for a procedure that is proved to be harmful, without any reflection on the wisdom. Reflection on the "command to circumcise" would involve the same sort of reflection on why recreational drug use is considered spiritually dangerous. Reflection does not stop at the thought that drugs are simply spiritually evil. Reflection requires the question of the mechanism of this evil. A deeper understanding is thus acquired. We have no problem reflecting on issues such as drugs, sex, murder, etc., but with circumcision very few are willing to take that step.

For a lucid and engaging account of the modern history of circumcision, particularly in North America, see David Gollaher's:

From Ritual to Science: The Medical Transformation of Circumcision in America

Journal of Social History
Volume 28 Number 1, p. 5 - 36,
Fall 1994.


Remember, circumcision was explicitly recommended by leading medical authorities as a cure for masturbation, which in turn was supposed to be a terrible thing thing.

The link between FGM and MGM (male genital mutilation) is not as absurd as many would prefer to think. For a disturbing view of the similarities, see
this chart

(by Hanny Lightfoot-Klein, a pioneer in the fight against FGM)

Originally posted by Three Blind Mice:
"male circumcision isn't done to make sure boys aren't driven to promiscuity and infidelity by sexual passion. cutting off the clitoris and labia are done for no other reason."

Absolutely false - not only has MGM historically functioned to reduce the male sexual experience, but FGM is done, in many cases willingly by the "victims", for reasons equally bizarre as those employed in the advocacy of MGM, such as hygiene, conformity, spiritual cleanliness, attractiveness, etc.

Girls who aren't circumcised in communities that practice the ritual experience shunning not only by the males, but by their female sisters, who will refuse to play with them since they're dirty and spiritually unclean.
posted by spacediver at 12:50 AM on July 7, 2005

Aw, now no one will see my joke.
posted by jenovus at 2:00 AM on July 7, 2005

Quick! Someone send in the St. Bernards... there's been an avalanche of text!

(insert muffled cries for help)
posted by Davenhill at 2:12 AM on July 7, 2005

This is one of those arguments where people just don't listen to each other. It's similar to the abortion debate in that each side takes it as axiomatic something the other side doesn't accept, and in doing so they are actually arguing about different things.

The anti side thinks the argument is only about whether the procedure is "mutilation" or not. The anti side recognizes that the pro side is concerned about tradition, but they think it is an insignificant concern relative to the mutilation concern. Similarly, the pro side thinks the argument is only about respect for (and the rights to practice) tradition. They recognize that there may be some valid argument related to the mutilation claim, but they think it is an insignificant concern relative to the tradition concern. See how each side takes it as axiomatic that the other side's concerns are relatively unimportant? So there can't be a successful discussion about the matter.

There's a few ways this could be resolved. One is that one or both sides allow for the other side's concern to be weighed much more heavily than they have previously. This would allow room for some kind of compromise. Another resolution would simply be a recognition that if no one is willing to compromise, then it is zero-sum and work toward some winner-take-all resolution. A third is to just continue to argue about it for a long time until one position becomes unpopular and it's resolved by default.

Basically, there's not an easy solution. However, this is a version of a conflict that all societies have, all the time. If you are a traditionalist on one issue, there's probably another issue on which you see traditionalist concerns as unimportant. If you think something is self-evidently wrong and must be changed, there's probably something that you think is self-evidently "okay" and where traditionalism is very important. My point here is that this being the case, surely there is room for each side to respect the other side's point of view as being valid (not necessarily correct). We can be respectful of people with opposing viewpoints.

Here's a rather odd contention, but I think it's true: considering that there is practically an infinity of practices that are traditional which we could question (and don't), the mere fact that we are arguing about a particular one proves the basic validity (not correctness, but validity) of both points of view. The majority of things we do are traditional. So not questioning a practice is inherently valid because, for example, it's not practical to question every practice. Similarly, if a practice is being questioned by any significant number of people, then it is inherently valid to question it because for whatever reason it's being discussed when a billion other things aren't. That isn't a solid logical argument, but it's a fairly solid practical argument. There's a good basis on which to assume that someone with the opposing viewpoint isn't batshit crazy. Respect their point of view.
posted by Ethereal Bligh at 2:16 AM on July 7, 2005

Ethereal, there are millions of somali, sudanese, egyptian, men and women who believe strongly in female circumcision. It is an ancient tradition for them, with values (which are, incidentally, disturbingly similar to the values of male circumcision).

Within those societies, there are a few unpopular critics of female circumcision who experience enormous resistance to their ideas.

Would you be willing to apply your above analysis to their social situation, and draw the same conclusions?
posted by spacediver at 2:34 AM on July 7, 2005

spacediver writes "What is not acknowledged, or even brought to attention, is the notion that reduced sensitivity is the least important and significant way in which functioning is changed."

I was all set to see what you brought after this statement, but it turns out that, in fact, all you are concerned about is the loss of sensation. You may also be concerned about the ramifications of that loss of sensation, but that isn't a different thing, it is the same thing writ large.

The comparison of male circumcision to female circumcision is odious. They may both be called the same thing, their results are radically different and cannot be compared without a disingenuous inflation of the results of male circumcision. Contrary to the charge of my being anti-man, I think anyone who compares the two must be misogynist: claiming that male circumcision is a horror reduces the true horror of FGM, thereby making it more difficult for people to take seriously and respond to appropriately.
posted by OmieWise at 4:27 AM on July 7, 2005

What caddis said. A long way back.
posted by dreamsign at 6:32 AM on July 7, 2005

FWIW, I was circumcised as an adult because my foreskin had scarred and shrunk to the extent that I couldn't retract it even slightly.

The only reason I had let it get so bad was, essentially, denial; I didn't want to admit to myself or anybody else that there was anything wrong with my knob, even though I had started needing to use cotton buds (that's Q-tips, for those of you divided by our common language) in the shower to clean it. Penises are just one of those things most cultures end up neurotic about to some degree, I think.

I do miss the foreskin I had before it shrank, but it wasn't doing me much good once it had, and sex is certainly much more fun with no foreskin than it was with a scarred and useless one. I'm also pretty sure it's more fun than it would be with a scarred and re-stretched foreskin.

Seems to me that the only ways a bloke is going to miss his foreskin are if (a) he'd had it for long enough to get used to it being there before losing it, or (b) he gets told by people whose opinion he respects that he *should* miss it.

The arguments about loss of sensitivity are, I think, more of a way to score debating points than anything else. It seems to me that if those who make those arguments cared as much about minimizing the world's knob-related distress as they did about Being Right, they'd just shut the hell up.

The foreskin is not actually cognate with the labia minora at all; it's roughly the equivalent of the clitoral hood. The labia minora pretty much correspond to the underside of the penis and part of the scrotal sac: that faint brown line underneath the penis, and the raised seam down the centre of the scrotum, are where the embryonic labia have fused.

FGM generally involves removing much more tissue and destroying far more nerve connections than male circumcision. Perhaps those of you who argue that they are equivalent might care to consider the effects of having your whole glans cut off, the underside of your penis flayed and most of your scrotum cut away, and then having the whole wounded area folded in half and roughly stitched back together. I can't imagine too many men lining up for that, even if it did make them more attractive to the chicks.
posted by flabdablet at 6:42 AM on July 7, 2005

thanks spacediver, interesting stuff.
posted by asok at 7:02 AM on July 7, 2005

thanks spacediver and flabdablet, interesting stuff.
posted by asok at 7:03 AM on July 7, 2005

spacediver, I'm strongly opposed to what I call MGM. Surprised? But, yes, I would make the same argument with regard to FGM. Which I've long opposed, even during the period when leftist thought took the cultural relativism position on this matter and refused to disapprove of it. I am not, in practice, a relativist. But I am, in theory and practice, respectful of opinions that differ from my own, as long as I think they are "valid". You and I think that MGM is prima facie unacceptable; but there are no doubt some practices which you and I don't question that people who come after us will likewise consider prima facie unacceptable. If we claim that the pro-circumcision folks are making an egregious mistake, then we should consider that we, too, are likely to be making an "egregious" mistake on some issue. In short, the argument that something is simply obviously true and that anyone who takes the opposite position on the issue is willfully self-deluded, or even malaevolent, is just way, way too easy and self-serving.
posted by Ethereal Bligh at 7:36 AM on July 7, 2005

Anyone claming that there are other major benefits to having an uncircumcised penis besides enhanced sensation are crackpots, IMO.

Major benefit: body parts are intact and the way momma nature made them.
posted by glenwood at 9:20 AM on July 7, 2005

I vote we remove tongues to reduce the transmission of kissing diseases.

Also perhaps some fingers to reduce the spread of stupidity on the internet.
posted by ewkpates at 9:28 AM on July 7, 2005

WHOA WHOA WHOA. How about this: I like all the nerve endings in my foreskin, and I'm willing to clean and protect myself in order to keep them around. Easy enough?
posted by kevspace at 9:29 AM on July 7, 2005

My gf and I have actually argued a lot about the circumcision issue. If we ever have a son, she wants to leave him looking like a barbarian; I want to have him circumcised so he can enter civilized society without shame. We still haven't settled the issue. This research might help, though.

The anti-circumcision crowd has always infuriated me, but now they want people to die to further their agenda. I hope they can sleep well at night now.
posted by Captain_Tenille at 9:32 AM on July 7, 2005

they won't catch AIDS without a penis. That's obvious. - delmoi

Umm.... you DO know that sex isn't the only way to transmit the disease, right? Perhaps the most common way, but certainly not the only way.

/pedant
posted by raedyn at 9:48 AM on July 7, 2005

glenwood writes "Major benefit: body parts are intact and the way momma nature made them."

Why is this a benefit? Seriously.
posted by OmieWise at 10:12 AM on July 7, 2005

Originally posted by OmieWise

I was all set to see what you brought after this statement, but it turns out that, in fact, all you are concerned about is the loss of sensation. You may also be concerned about the ramifications of that loss of sensation, but that isn't a different thing, it is the same thing writ large.

I'm not sure if you read my subsequent post in this thread, but loss of sexual sensation (quality & quantity) is not the sole factor that underlies my view on male circumcision. My basic concern is that this ritual deprives the child of his right to bodily integrity.

The comparison of male circumcision to female circumcision is odious. They may both be called the same thing, their results are radically different and cannot be compared without a disingenuous inflation of the results of male circumcision. Contrary to the charge of my being anti-man, I think anyone who compares the two must be misogynist: claiming that male circumcision is a horror reduces the true horror of FGM, thereby making it more difficult for people to take seriously and respond to appropriately.

They are both superstitious rituals involving the cutting of genitals. Furthermore, they are both rationalized for medical, aesthetic, and cultural reasons (it's cleaner, more beautiful, and more civilized to have our sons and daughters mutilated). Additionally, there is a history of both as being used to curb the female, and male, sexual responses, respectively.

Again, as in my previous post, I refer you to this chart

(by Hanny Lightfoot-Klein, a pioneer in the fight against FGM)
posted by spacediver at 10:14 AM on July 7, 2005

Captain: "I want to have him circumcised so he can enter civilized society without shame."

Oh, puhleeeeeze.

I'm not a member of an "anti-circumcision crowd", but that has to be the dumbest reason to inflict pain that I ever heard. And I can assure you, it *does* hurt.

Civilized society is not going to give a crap what shape your hypothetical son's knob is, and as long as he's healthy, neither should you. Leave this one up to your gf and go worry about something important.
posted by flabdablet at 10:20 AM on July 7, 2005

originally posted by Captain_Tenille

My gf and I have actually argued a lot about the circumcision issue. If we ever have a son, she wants to leave him looking like a barbarian; I want to have him circumcised so he can enter civilized society without shame. We still haven't settled the issue. This research might help, though.

I hope you realize that advocates of FGM feel exactly the same way about their daughters, with respect to being shameful, etc.

There is massive prejudice against the foreskin in certain parts of this world, including North America, Africa, Mid-East. We seem to have developed a fetish for the circumcised penis. It is a symbol of purity, cleanliness, goodness, etc. Symbols have a powerful effect over our judgement.

It never occurs to many people to reflect upon the origins and meaning of this practice. It is so fundamental to their cultural consciousness, that by default, it occupies a privileged place of normativity, relatively immune from critical insight.

The anti-circumcision crowd has always infuriated me, but now they want people to die to further their agenda. I hope they can sleep well at night now.

Would you feel similarly about people who are against neonatal masectomies at childbirth?

Margaret Sommervile - a world renowned figure in medical ethics, has written a book called "The Ethical Canary"

Here are some excerpts (from here) :


"If someone asked you what our reactions to human cloning could teach us about the ethics of infant male circumcision, you might think it was a trick question. I was working on speeches on both these topics at more or less the same time and, with some surprise, recognized there was at least one important lesson that cloning would provide in relation to circumcision. When they first hear of human cloning, most people's reaction is "Yuck!" But as familiarity increases, and dread decreases, they move from this rejection and horror to neutrality to acceptance, usually with safeguards, and finally even to positive approval. In contrast, many people's view of infant male circumcision has gone in the opposite direction: from positive approval to rejection and sometimes horror. This is certainly true of my attitude."

...


"As I have noted elsewhere, good ethics depend on good facts, and good law depends on good ethics. The medical facts about infant male circumcision have changed as a result of medical research. We now know that infant male circumcision is harmful in itself and has harmful consequences. Circumcision removes healthy, functioning, erogenous tissue that serves important protective, sensory and sexual purposes. The surgery also involves risks of further damage-ranging from minor to serious damage to the penis or even its loss or death. In one recent American case a baby died from the general anesthetic he was given in order to deal with the complications that had resulted from his circumcision. Some physicians who continue to support routine-that is, non-therapeutic-circumcision argue that its potential medical benefits-which research shows do exist-justify carrying it out on infants. But these potential benefits do not outweigh its harms when the procedure is not medically necessary, which in the vast majority of cases it is not. Moreover, when we look to the nature of the medical benefits cited as a justification for infant circumcision, such as a reduced rate of urinary infections, we can see that medical problems can be avoided or, if they occur, treated in far less traumatic and invasive ways than circumcision.

The most recent claim of a medical benefit from circumcision is a reduction in the risk of contracting HIV infection or other sexually transmitted diseases. The research on which this claim is based is being challenged, but even if it is correct, it would not justify circumcising infant boys. Even assuming that circumcision gave men additional protection from becoming infected with HIV, baby boys do not immediately need such protection and can choose for themselves, at a later stage, if they want it. To carry out circumcision for such a future health protection reason (assuming for the moment that circumcision is protective) would be analogous to testing a baby girl for the gene for breast cancer and, if it is present, trying to remove all her immature breast tissue in order to eliminate the risk of her developing breast cancer as an adult woman. I believe that most of us would be shocked at undertaking such a procedure on a baby girl, but some of us might not have the same reaction to infant male circumcision. Why is this? Quite simply we value breasts-we see it as a serious harm to a woman to lose them-and we do not value foreskins, in fact they are often devalued-spoken of as ugly, unaesthetic and unclean. Yet both are part of the intact human body and both have sexual and other functions. Consequently, to summarize, routine infant male circumcision cannot be ethically and legally justified on the grounds that it is medically required.

A common error made by those who want to justify infant male circumcision on the basis of medical benefits is that they believe that as long as some such benefits are present, circumcision can be justified as therapeutic, in the sense of preventive health care. This is not correct. A medical-benefits or "therapeutic" justification requires that overall the medical benefits should outweigh the risks and harms of the procedure required to obtain them, that this procedure is the only reasonable way to obtain these benefits, and that these benefits are necessary to the well-being of the child. None of these conditions is fulfilled for routine infant male circumcision. If we view a child's foreskin as having a valid function, we are no more justified in amputating it than any other part of the child's body unless the operation is medically required treatment and the least harmful way to provide that treatment"
posted by spacediver at 10:27 AM on July 7, 2005

Leanord Glick, professor emeritus at Hampshire College, has just had a book published by Oxford University Press, detailing the history of this practice. It is nothing new, and I suspect much of this information can be found in Gollaher's paper, which I posted earlier.

It is, however, instructive to note that this information passes society's highest standards of scholarship (hence the oxford university press "approval").

Here is the press release on the book.
posted by spacediver at 10:35 AM on July 7, 2005

Originally posted by Ethereal Bligh

You and I think that MGM is prima facie unacceptable; but there are no doubt some practices which you and I don't question that people who come after us will likewise consider prima facie unacceptable. If we claim that the pro-circumcision folks are making an egregious mistake, then we should consider that we, too, are likely to be making an "egregious" mistake on some issue. In short, the argument that something is simply obviously true and that anyone who takes the opposite position on the issue is willfully self-deluded, or even malaevolent, is just way, way too easy and self-serving.

I agree completely with the spirit of your post, except that I content it doesn't apply to any of the arguments I've made.

I believe that as society evolves, it looks back upon its past, and cannot believe the things that we did in the past. We used to publicly torture innocent women to death. We used to bring our whole families to these events. It probably never occured to many that this was a horrendous affair. Such shifts in consciousness are not the norm. We were blinded by superstition and prejudice against certain behaviours, and appearances (talking about witch trials here).

I would be very surprised if there are absolutely no things that I do personally, that people will look back upon and shake their heads in disgust. I am not immune from these forces and imperfections, and I do not claim to be.
posted by spacediver at 10:44 AM on July 7, 2005

Originally posted by Flabdalet

The foreskin is not actually cognate with the labia minora at all; it's roughly the equivalent of the clitoral hood. The labia minora pretty much correspond to the underside of the penis and part of the scrotal sac: that faint brown line underneath the penis, and the raised seam down the centre of the scrotum, are where the embryonic labia have fused.

Here is some correspondance I had with Dr. John Taylor through email, regarding the embryology of the scrotum, labia, etc:

(email is from him)

Foreskin is serious taboo. As well guys may be expert in one field eg embryology but not anatomy and function, so they have difficulty shaking off rumours. .These ideas are difficult to reconcile with newer concepts and this is reflected in their replies. Still, they can be trained!
You are right about the uro(endo)-genital fold Basically it is mucocutaneous junctional tissue with potential to respond to testosterone. In male fetuses it contributes to the urethra, which is enfolded by cutaneous tissue of the rest of the mc junctional zone In the mature fetus/adult it probably contributes the ridged band.and adjacent tissues. In females it gives rise to labium minus, which as you know is continuous with and probably forms the prepuce, just as in males. But the F prepuce - as far as I know - has no ridged band as such. This is not to say it is unspecialized tissue.All it means is that it may not be designed and positioned to be stretched and to develop a powerful sexual reflex. Adjacent skin tissue forms labium major or scrotum and it may be a mistake to see it as unrelated to events forming labium minus They are all integral to a very large mc junctional zone which includes all the penis and probably as much of the F equipment. . The best way to see genital tissues is the way we look at the relationship between the lips (the precise junction between skin and mucosa of the lower face) and surrounding cutaneous and muscular tissues of the face necessary for lip function.
You have room for compromise with your friend but remember that the labium minora are the genital equivalent of .lip vermilion while the labium majus (not minus) is equivalent to surrounding whether lower face or scrotume. The main thing is to view M and F genitls as mc junctional zones with very wide and indistinct borders: what we really need to know is how each individual tissue contributes to the function of its zone . .
I hope this helps.
posted by spacediver at 10:48 AM on July 7, 2005

Ethereal -- yah, the tone was somewhat provocative, but the study itself is going to be provocative, and I wanted to get the right people on each side to go pick it apart to show the strengths and weaknesses and thus add to the ongoing debate. The fact that the medical community had written off circumcision up until this study makes it quite interesting to me -- science should always keep an open mind, but not so open that its brain falls out, and not so closed that we miss that the world is round. This is yet another case of science having to step back and re-evaluate, and I like that.

If I insulted anyone or caused grief, I do apologize.
posted by dwivian at 10:54 AM on July 7, 2005

Spacediver: "My basic concern is that this ritual deprives the child of his right to bodily integrity."

High-minded piffle.

If you're going to butt heads with pro-circumcision parents on those grounds, you'll prevent no circumcisions; you'll only encourage them to retreat more securely into their own "principled" positions.

I see no difference in kind between your talk of "rights to bodily integrity" and the Captain's idiot line about "entering civilized society without shame".

The decision to circumcise or not ought to be made on the basis of the best information available about effects on health (both acute and longterm), not a peergroup-normal set of fine-sounding but ultimately empty principles.

ISTM that if you're living somewhere where AIDS is rife, and the study linked in the OP is fair dinkum, there's a good argument to be made for male circumcision. If you're not, there probably isn't.

It further STM that if you're going to circumcise a male, the best time to do that is while he's very very young so he (a) heals as quickly as possible and (b) never gets a chance to miss what you're slicing off.

As a formerly uncut man, I can distinctly recall times in my childhood where I thought it would have been much cooler to have been cut than not; as an adult I would not, if given a healthy foreskin, remove it. But - in total contrast to FGM - it's really not that big a deal!
posted by flabdablet at 10:57 AM on July 7, 2005

There is massive prejudice against the foreskin in certain parts of this world, including North America, - spacediver

It is inaccurate to characterize Canadians and Americans as being agreed on this. Point of fact: In Canada in 2003 the infant circumcision rate was approximately 11.5%, and our provincial health plans (with the exception of Manitobia) do not fund to procedure. In the US in the same year, the rate was 55.9%. That's a dramatic difference.
posted by raedyn at 11:22 AM on July 7, 2005

spacediver-Enough with the fucking bold-face type. You're giving me a headache. It sounds like you're shouting.

Your bodily integrity thing is unconvincing. First, there is no such right. Secondly, there are procedures that are preformed for the sake of health and welfare all the time that challenge this suppossed right. Thirdly, children's welfare and health are the reposibility of their parents, as they should be. How many children have you asked about whether they wanted any operation? I can actually buy the argument that there is no benefit to circumcision, or I could before this study, but you are bent on convincing everyone that there is harm, without actually presenting any evidence to that effect. Rhetoric is not evidence, and your own admonisions about how touchy a subject foreskins are applies to you as much as to anyone.

Your unwillingness to acknowledge the serious differences between FGM and circumcision indicate your intellectual dishonesty.
posted by OmieWise at 11:35 AM on July 7, 2005

...between FGM and circumcision indicates...
posted by OmieWise at 11:42 AM on July 7, 2005

See? If you argue Principle at people, they just arc up and accuse you of intellectual dishonesty. You're better off sticking to factual arguments you can back up with sources and/or personal experience.

Preferably concisely.
posted by flabdablet at 11:45 AM on July 7, 2005

Circumcision helps prevent HIV infection? Thus explaining why the USA, the last "western" nation still routinely circumcising most of it's infant boys, has such a low rate of HIV infection compared to other first world countries. Har.

That's kind of comparing apples with oranges. Being circumcised will not prevent against infection contracted by being the "receptive" partner in anal or oral sex. (Or, obviously, from tainted blood transfusions or needles.)

Gay men, drug addicts and hemophiliacs were the most common victims of AIDS in the early days of the epidemic in the west, while AIDS in Africa seems to spread largely (though not only) through heterosexual contact. That seems to be where being circumcised may make a difference -- by preventing infection to men not using condoms who are the "active" partners in oral, anal or vaginal sex with an infected partner.
posted by whitearrow at 12:13 PM on July 7, 2005

flabdablet writes "If you argue Principle at people, they just arc up and accuse you of intellectual dishonesty."

My point is that there is no Principle being argued here. Asserting that FGM and male circumcision are comparable is unprincipled.
posted by OmieWise at 12:37 PM on July 7, 2005

I fear that some on this board have not analyzed my arguments, or the references I have provided.

Many of you lack a historical understanding of the practice.

Searching for abstracts on pubmed, or browsing contemporary media blurbs does not suffice for a deeper insight into the practice.

OmnieWise, you accuse me of not providing evidence of harm of the practice. I have provided ample evidence. Go back and read my posts carefully, and read the links provided. I assure you the evidence is not rhetorical or anecdotal.

If you read the current literature within bioethics journals, the idea that circumcision harms is becoming acknowledged.


You accuse me of not have not provided any serious distinctions between FGM and MGM.

I have provided ideas on their common denomination. To examine their differences would require an understanding that not all female circumcisions are equal.

There are at least four different degrees of female circumcision, with pharaonic being the most harmful, and prepucial amputation the least.

It would be ludicrous to purport that pharaonic circumcision is as harmful as male circumcision, but prepucial amputation in the female is less harmful than that of male circumcision, with respect to considerations around erogeneity and complications.

What I am trying to bring forth, in this discussion, is the idea that both female and male circumcision are rituals based on superstitious ideas. They involve the cutting of genitals, usually of unconsenting minors/infants. The rationales that advocates of each are similar, throughout modern and ancient history.

How does pointing this out amount to intellectual dishonesty?


The bold face is not meant to denote yelling - its function is to delineate quoted text (whether from a previous poster or an external source), from my own writings.
posted by spacediver at 1:15 PM on July 7, 2005

This is one of those arguments where people just don't listen to each other. It's similar to the abortion debate in that each side takes it as axiomatic something the other side doesn't accept, and in doing so they are actually arguing about different things.

this makes sense.

The anti side thinks the argument is only about whether the procedure is "mutilation" or not....Similarly, the pro side thinks the argument is only about respect for (and the rights to practice) tradition.

mm, but - no, I don't think so. Tradition may be one reason for the pro side to circumcise, but it is not the only reason. There are aesthetic and hygenic reasons, and there are some medical reasons. There's a small but still significant portion of men whose foreskins don't grow properly with the rest of the penis, and who experience serious pain and eventual circumcision as adults - it's only a couple percent of the population, but it's more difficult to go through as a teenager than a baby, so pre-emptive circumcision isn't completely crazy, if you believe a circumcised penis is no big deal.

That's really where the difference is - circumcision has perhaps a few small benefits, but also has negative consequences in the loss of sensation. If you believe the latter is significant, cutting pre-emptively makes no sense. If you believe the latter is insignificant, cutting pre-emptively is just simpler.

This is completely different from FGM; no females need to get their genitals chopped up as adults due to medical conditions, and the loss of sexual pleasure is far more radical.

its function is to delineate quoted text

normally we use italics or indents around here for that purpose.
posted by mdn at 1:42 PM on July 7, 2005

btw here's a little experiment we can all do on this thread.

One of the things that is invariably lost due to circumcision are the erotogenic stretch receptors on the ridged band of the foreskin.

Males with intact penises can elicit sexual feelings by pulling down their foreskin, and stretching it. Some can even induce orgasm this way simply by stretching the foreskin down.

This is due to the receptors' responsiveness to physical deformation.

Males who are circumcised do not experience this.

Would be nice if intact males who are posting in this thread could confirm this.
posted by spacediver at 1:43 PM on July 7, 2005

spacediver-I have read your evidence, but I remain unconvinced. The talk about complications, for instance, is about potential harm from circumcisions, but is presented as if it were actual harm. Not agreeing with you does not mean I don't understand the history here. I would point out, once again, that the same motivations having to do with taboo and myth surrounding the penis are as applicable to you as to anyone advocating circumcision. You are not beyond that in any way, and given the stridency of your position, seem to be more affected than most people I know.

You most current comment on FGM and male circumcision is better, which is to say, less dishonest. Your earlier comments failed to distinguish between various different female circumcisions and instead relied on the shorthand FGM which, to most people in the West, equates with the most severe forms of genital rearrangement. It was this rhetorical move that I considered dishonest, especially when followed by an enumeration of all the similarities between FGM and the considerably more benign male circumcision without any acknowlegement (again) of the differences in severity among various forms of female circumcision.

Thanks for stopping with the bold-face. I didn't think you were shouting, just that it seemed like that, especially in such big blocks. Usually italics are used here for quotations, and you can also use the [blockquote] tag for long quotes such as you added. If you use firefox, and intend to stick around, consider using Metafilthy in order to quote others' comments.
posted by OmieWise at 1:45 PM on July 7, 2005

thanks for the tip mdn (re italics). New to these waters... :)

btw loss of sensation is only one of the harms of circumcision.

There are quite a few more functional features that are lost (the mechanical aspects of the foreskin, the acute sensory (non erogenous) on the outer wall of the foreskin, the frenulum, the physical protection that it offers the glans, the increased thickness of the penis, due to the foreskin. There are also benefits for females in terms of sexual pleasure, although I have not researched these very fully.

The idea is that, within a snug vaginal environment, the penis can slide within its own foreskin (which itself clings to the interior vaginal walls), thus reducing abrasive forces in the woman.

Furthermore, there are complications of circumcision that are not insignificant in either frequency or seriousness. A brief literature search will confirm this, however here is a review of some.

It is also a fundamentally painful procedure. Modern anaesthetics may help, but remember we are advocating for a procedure that through the larger portion of its history, was done without current surgical/anaeshthetic technology.
posted by spacediver at 1:54 PM on July 7, 2005

OmnieWise:

The talk about complications, for instance, is about potential harm from circumcisions, but is presented as if it were actual harm.

There are many dimensions of the harm of circumcision, and the risk of complications is only one. A fundamentally painful surgical procedure against an unconsenting creature, which permanently deprives that creature of healthy sexual tissue is, by my definition, harmful.

Again, I refer you to Somerville's discussion of the procedure:


Not agreeing with you does not mean I don't understand the history here. I would point out, once again, that the same motivations having to do with taboo and myth surrounding the penis are as applicable to you as to anyone advocating circumcision. You are not beyond that in any way, and given the stridency of your position, seem to be more affected than most people I know.

I'm not sure I completely follow. While I agree that I am not immune from social forces that shape my consciousness around certain issues, I am not driven toward eschewing circumcision for cultural/superstious/aesthetic reasons.

btw, an interesting introspective exercise that demonstrates our schizophrenia around this issue is to examine our reactions to those who use, as an argument for female circumcision, the aesthetic issue.

When confronted with those who say:

"The intact female genitilia is ugly, and the husbands prefer the look of the female genitals without the labia, and this is a good reason for female circumcision"

we tend to think:

"how dare those people impose their attitudes around what is beautiful to them, upon unconsenting infants. What right do they have to do this?"


Yet how many times have we heard the exact same rationale given for male circumcision? One of the touted "benefits" of the procedure, given by even medical professionals, is that "most women think it looks better". Yet we have quite a different reaction. We actually consider it a valid rationale. It is disturbingly revealing to explore the nature of this double standard. It is not enough that we explain it away by supposing that FGM and MGM are different. The issue is that the very standards we apply in our judgement differ.
posted by spacediver at 2:06 PM on July 7, 2005

Just saw the classic Itchy and Scratchy episode: A Bris Before Dying. As far as I'm concerned, it's definitive. Mousel Tov.

spacediver writes "I am not driven toward eschewing circumcision for cultural/superstious/aesthetic reasons. "

Really? How do you know? What makes you so concerned about this, then?
posted by OmieWise at 3:20 PM on July 7, 2005

From Essential Judaism: A complete Guide to Beliefs, Customs, and Rituals. By George Robinson:

Although it is common practice today for Jews and non-Jews alike, there is little evidence that circumcision serves any medical purpose. Nor are the arguments of Philo (for hygene) and Maimonides (curbing lust) particularly convincing. What makes circumcision important is its larger symbolic resonance, as a brit/covenant, a linking of a newly born Jew to a four-thousand-year-long history, a sign of the relationship between Jews and God. Like many other mitzvot, circumcision can be explained by a variety of not very convincing rationales, but ultimately it is a mitzvah one performs for its own sake as a subordination of oneself to a larger entity. (page 146) Perenthesis added.

posted by Jon-o at 5:13 PM on July 7, 2005

OmieWise:

Really? How do you know? What makes you so concerned about this, then?

Bit of an odd question. How do I know what my judgements are based on? Well let me ask you this:

are your judgements on FGM based on superstition?

My beef with male circumcision derives from a respect for sexuality, and a basic understanding of human rights.

I don't understand why you consider this high minded piffle, yet apparently do not think the same when similar arguments are made against FGM.
posted by spacediver at 6:23 PM on July 7, 2005

Because female genital mutilation is an important part of wider systems of oppression and subjugation. This is not true of penile circumcision, unless you want to adopt the ludicrous claim that the US, Israel, and Saudi Arabia of all places are characterized by the widespread oppression of men and by commonplace subjugation of men to women.

The difference between penile circumcision and female genital mutilation is like the difference between a tribal or cultural tattoo, where such things are done, and the tattoo on the arm of an Auschwitz survivor.
posted by ROU_Xenophobe at 6:59 PM on July 7, 2005

Xenophobe:

That doesn't answer my question.

Why are my arguments against MGM, which use sound ethical principles, high minded piffle?

And fyi, "penile circumcision" was used as a system of sexual oppression. That's how it was introduced into North America. This is not a debated fact within the literature.

I urge you to educate yourself on this practice. For the third or fourth time:

From Ritual to Science: The Medical Transformation of Circumcision in America

and your analogy highly understates the damage due to male circumcision. It also fails to distinguish the many forms of female circumcision.

The absurdity of male circumcsion, as it exists today, is that there is a break with tradition. It used to be understood to serve a sexual-curbing function, whereas today it is usually carried out just for the "sake of culture".

This is the very definition of an irrational practice.
posted by spacediver at 7:08 PM on July 7, 2005

You didn't ask that. You asked, right there in blue and white, why someone did "not think the same when similar arguments are made against FGM."

Because they're not the same thing, that's why. One is a simple cultural marker, not terribly different from ritualized tattooing, decorative scarification, or tooth modification. The other is part of a system intended to terrorize women into meek obedience, into being relatively content with life as near-property.

I have no issue with your opinion of penile circumcision. Arguing that it is similar to female genital mutilation, and the webs of oppression of which is it a part, is just silly.
posted by ROU_Xenophobe at 8:15 PM on July 7, 2005

Xenophobe:

penile circumcision is not simply a cultural marker. You may wish to believe it to be, but it is a lot more serious than a tattoo.

believe it or not, the reason FGM continues is not primarily due to male subjugation. It is the same reason that MGM continues.

Women in these societies consider it barbaric not to be circumcised. Many of them willingly undergo the procedure. In fact, it is an institution largely comprised of women. The women are the ones that forcibly restrain the girls and cut them (when it's non-consensual).

I have pointed toward's Hanny Lightfoot-Klein's work - she is a pioneer who spent a decade in africa trying to understand FGM.

She is the one who made the comparisons between FGM and MGM.

see her chart here

Male circumcision is also forcibly imposed upon adolescent males in parts of this world.

You have to understand that our species has had an ancient obsession with mutilating itself. These rituals are based on superstition. They serve no decent function, and are largely harmful.

They are practices borne out of ignorance and fear.

Male circumcision is no different. Many people do not understand this...they have a blindspot about reflecting upon the meaning and origins of this bizarre custom.


Many males who are cut are unwilling to undertake this shift in consciousness around the issue. It is the exact same reason that FGM continues - the women are in denial about their own victimhood.

In order for a cut male to understand these arguments, he must come to terms with the nature of what was done to him. This involves suffering, and as we all know, the mind goes to great lengths to avoid suffering.

In this thread, I have provided ample material to introduce people into the literature and thought surrounding male circumcision. If there are specific details that you wish to challenge, or discuss, then please do so, but educate yourself to a degree beforehand.
posted by spacediver at 8:39 PM on July 7, 2005

but it is a lot more serious than a tattoo

You must have never been tattoo-ed or circumcised.
posted by Jon-o at 9:00 PM on July 7, 2005

here is a video of what a circumcision looks like.

More stuff here (though i haven't seen the other vids)
posted by spacediver at 9:12 PM on July 7, 2005

Are we sure that the axioms in conflict here aren't individual rights vs. parental rights?
posted by Skwirl at 1:25 AM on July 8, 2005

Spacediver - FWIW, and bordering on TMI: stretching what I'm left with after circ feels just as good as stretching the whole lot ever did. Different, because there's less there to stretch and backward is now a lot easier than forward, but absolutely as good.

I get the distinct impression you're circumcised and resentful about it. Really, you don't have to be; being an uncut male isn't different enough from being a cut one to warrant the kind of concern you so clearly communicate.

Of course I grieved for a while after losing a little piece of me. Of course I was sad to see it go. But I've got used to the way my body is now, and I can honestly report that it works every bit as well without as it ever did with.
posted by flabdablet at 4:29 AM on July 8, 2005

btw loss of sensation is only one of the harms of circumcision...There are quite a few more functional features that are lost (the mechanical aspects of the foreskin, the acute sensory (non erogenous) on the outer wall of the foreskin, the frenulum, the physical protection that it offers the glans, the increased thickness of the penis, due to the foreskin.

you say there are functional features, but what you list are only sensory (or size) related issues. What do you mean by "mechanical aspects of the foreskin"?

The idea is that, within a snug vaginal environment, the penis can slide within its own foreskin (which itself clings to the interior vaginal walls), thus reducing abrasive forces in the woman.

yeah, I don't really see how that would be considered a benefit to the woman - isn't it "the motion of the ocean"...?

I'm not particularly committed to either side of this debate, but I do think the comparison to genital mutilation is unfair for the reason that this is in some cases a completely sensible medical procedure (eg, as it was for flabdablet in this thread, and likewise for the son of a friend of my father's - they had opposed circumcision at the boy's birth, but around puberty it became medically necessary -).

The context of this argument is that circumcision significantly reduces the spread of AIDS - that seems more important than the extent of pleasure the foreskin can provide. It does not seem as if circumcized men lack the experience of sexual pleasure.
posted by mdn at 8:53 AM on July 8, 2005

spacediver writes "I don't understand why you consider this high minded piffle, yet apparently do not think the same when similar arguments are made against FGM."

I don't consider it high minded piffle. I think that your insistence that other people are reacting from deep cultural taboos and issues is something that could equally be said about you. Why is the obsessive level of detail indicated in your posts not evidence that your own investment in this exceeds the rational?
posted by OmieWise at 9:32 AM on July 8, 2005

spacediver writes "here is a video of what a circumcision looks like.

"More stuff here (though i haven't seen the other vids)"

This is just inane. You keep wanting to be taken seriously, but it's pretty hard when your arguments reduce time and again to emotional reactions to the idea of a knife around a penis. Your "functional" problems with circumcision are all, ultimately, in the realm of sensation (by which I mean both definitions of the word), and now this video. I've got news for you, you of the overvalued idea, any surgery looks like butchery, which has absolutely no bearing on the reasons, justifications or results of said surgery. Have you ever seen open heart surgery? It looks barbaric. Plus, mother nature wants people to die of heart attacks and arterial blockage, that's clear, they wouldn't have heart disease otherwise.
posted by OmieWise at 9:39 AM on July 8, 2005

Spacediver: Your link on Ritual to Practice does not say what you think it says. It describes the rise as based on Dr. Sayre, who believed there were significant medical benefits (from renal health to the curing of paralisis) from the proceedure, and the next doctor to move the proceedure toward the mainstream (Chapman) thought that doing so would prevent men from seeking snake-oil remedies to a "loss of manhood." It was only later, with J.M. McGee that the link between paralysis and circumcision became less sure and he endorsed it to prevent excessive masturbation (the chances that it cured that are slight as well). But perhaps you meant to cite The Rape of the Phallus where Dr. Morgan posits that it's the matriarchal society of America that encourages the proceedure?
And note again that your linked article concludes with a note that even the most skeptical doctors to have reviewed the Kenyan AIDS/circumcision data have admitted that there is some link.
posted by klangklangston at 10:46 AM on July 8, 2005

Spacediver: Your link on Ritual to Practice does not say what you think it says.

I'm not sure what you think I think it says. I've read Gollaher's article very carefully from start to end, and I posted it here to allow others to examine the modern history of male circumcision's introduction into north america.

Furthermore, the paper gives valuable insight into the nature of medical institutionlization.

Where did I say that Gollaher's paper discussed the matriarchal dimension?

I've mentioned gollaher's paper many times in this thread - perhaps you missed the original context?
posted by spacediver at 11:03 AM on July 8, 2005

This is just inane. You keep wanting to be taken seriously, but it's pretty hard when your arguments reduce time and again to emotional reactions to the idea of a knife around a penis.

I posted that video to illustrate what a circumcision looks like.

Many people who discuss circumcision have never witnessed a circumcision operation.

There were some interesting things to note in that video.

*it is quite a serious surgical intervention, with respect to the amount of tissue that is removed.

*it is very painful, and caused the child to suffer

*it is obviously done against the child's will.


Sometimes seeing something occur can give insight. As creatures who have evolved to assimilate information through many modes, I think it is enriching to watch a video of the procedure.

Or do you think that videos as an educational aid are useles, and that we should all study from text?

Seeing a genocide occur in person may rivet you to make a judgement that you might not have made had you not seen it. Does that mean that the judgement upon witnessing is not as sound?

I'd argue that in a very important way, it gives phenomenological insight into the object in question, and can render our judgements more appropriate.
posted by spacediver at 11:11 AM on July 8, 2005

Spacediver - FWIW, and bordering on TMI: stretching what I'm left with after circ feels just as good as stretching the whole lot ever did. Different, because there's less there to stretch and backward is now a lot easier than forward, but absolutely as good.

It could be the case that you weren't circumcised tightly. I'm fortunate myself in that regard (although when i was a baby, the ridged band was so thin that it was completely removed - I was, however, left with a fair amount of tissue compared to others).

There are people who are circumcised so tightly that they or their partners cannot manually stimulate the penis using its own skin to rub up and down. Instead, they must use some lubricative aid.

I have friends who, due to their circumcision, cannot get off on oral sex, and have a hard time reaching orgasm during normal sex. One has told me that while this is great for lasting power (good for his girlfriend), he wishes the experience was more sensous for him.

However, these are just anecdotes - take them for what they're worth.
posted by spacediver at 11:16 AM on July 8, 2005

mdn:


you say there are functional features, but what you list are only sensory (or size) related issues. What do you mean by "mechanical aspects of the foreskin"?

This is a small page that answers your question
posted by spacediver at 11:19 AM on July 8, 2005

I'm not particularly committed to either side of this debate, but I do think the comparison to genital mutilation is unfair for the reason that this is in some cases a completely sensible medical procedure (eg, as it was for flabdablet in this thread, and likewise for the son of a friend of my father's - they had opposed circumcision at the boy's birth, but around puberty it became medically necessary -).

I'm not talking about cases where circumcision has valid medical indications. There are valid medical indications for removal of just about any tissue of the human body, including breasts.
posted by spacediver at 11:22 AM on July 8, 2005

OmieWise:

I don't consider it high minded piffle. I think that your insistence that other people are reacting from deep cultural taboos and issues is something that could equally be said about you. Why is the obsessive level of detail indicated in your posts not evidence that your own investment in this exceeds the rational?

exceeds the rational...obsessive...

interesting choice of words. Would you say that all experts on male circumcision who are against it, likewise exceed the rational? If so, then there are many world renowned scholars who are guilty.

here is just one example
posted by spacediver at 11:28 AM on July 8, 2005

For those who consider male circumcision not a big deal, what would they say about the milder forms of female circumcision?

For many years, I lived in a country that practiced female circumcision (amptuation of prepuce). It was done under safe conditions, and had cultural importance.

People who spoke out against them were met with the same sort of reactions that people who speak out against male circumcision experience.

So are they obsessive and irrational?
posted by spacediver at 11:31 AM on July 8, 2005

mdn quoted: The idea is that, within a snug vaginal environment, the penis can slide within its own foreskin (which itself clings to the interior vaginal walls), thus reducing abrasive forces in the woman.
--and added:
yeah, I don't really see how that would be considered a benefit to the woman - isn't it "the motion of the ocean"...?

Seems to me that a foreskin would be of great use in rape, as it requires less lubrication for the male to enjoy the sex despite the woman's arousal level..... So, does this translate to you like it does me, that is, that a foreskin for sex is a means to promote the patriarchy and subjugate women? Or, should I have never sat in on that Women's Studies class in college.... ::grin::
posted by dwivian at 11:38 AM on July 8, 2005

spacediver writes "exceeds the rational...obsessive...

"interesting choice of words. Would you say that all experts on male circumcision who are against it, likewise exceed the rational? If so, then there are many world renowned scholars who are guilty. "

No, let me be clear. I think you're a crank with an overvalued idea of the damage done by male circumcision. I think your evidence is almost non-existent; that what there is of it can be reduced to the debatable contention that circumcision irreparably limits male penile sensation and the appearance of the penis; that you misread history in order to insist that there was and is some sinister motive to the introduction of circumcision to cultures which previously did not practice it; and that you confuse an operation being painful and a child being unable to make medical decisions with human rights violations. Your comparison of male circumcision to FGM is odious, your allusion to genocide as a reasonable comparison deplorable. Your failure to address the content of the post, while insisting that others wade through an avalanche of quotation, is an unfortunate hypocrisy. I not only consider you obsessive, I consider you irrational and almost singularly lacking in insight.

The irony is that I had been unconvinced of the utility of circumcision and had been meaning for the past several years to do some research into its history and use in North America. You've pretty much assured me that that would be a waste of time, and that the increasing evidence of its utility is disputed mostly by wingnuts. Thanks for saving me some trouble.
posted by OmieWise at 11:48 AM on July 8, 2005 [1 favorite]

I have to leave now, so I'll briefly respond to a couple points.

You're continuing to misconstrue my posts.

I used the genocide example to illustrate that a more immanent experience with an object can give insight beyond just reading about it.

This was to defend the idea that watching a circumcision ritual can lend insight beyond that gleaned from merely reading about it.

How is this deplorable?

I thought we had clarified the FGM issue.

Again, I will repeat my most recent comment on it:

For those who consider male circumcision not a big deal, what would they say about the milder forms of female circumcision?

For many years, I lived in a country that practiced female circumcision (amptuation of prepuce). It was done under safe conditions, and had cultural importance.

People who spoke out against them were met with the same sort of reactions that people who speak out against male circumcision experience.

So are they obsessive and irrational?

What exactly is odious about this line of thought?

You continue to accuse me of all these things (odiousness, depolorability, etc) yet you do not back up your assertions.

So what exactly is it about my quoted post that you find troubling? Be specific. We will get nowhere if you continue to paint me with broad strokes.

I have not done this to you - it would be helpful if you reciprocated in kind.
posted by spacediver at 11:54 AM on July 8, 2005

"You've pretty much assured me that that would be a waste of time, and that the increasing evidence of its utility is disputed mostly by wingnuts. Thanks for saving me some trouble."

You're really being a jerk. And it's too bad those Europeans and Asians are so medically backwards.
posted by Ethereal Bligh at 2:06 PM on July 8, 2005

EB-Give me a break, I think you know full well that that was not what I was implying, any other jerkiness aside.

spacediver-Sorry, that last was over the top. I should have been more measured. The bottom line is that I think the conversation cannot proceed because I think you have an over-valued idea about the dangers represented by male circumcision. You may well feel the same way about my ideas of its relative safety. Cheers.
posted by OmieWise at 9:17 PM on July 8, 2005

Thanks for the post OmieWise
posted by spacediver at 2:13 PM on July 9, 2005