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Thursday, August 20, 2009

Bigger, longer, uncut

I was sent this news story today, and was asked to comment on it.


My response was:

I don't support the idea that a parent has the right to mutilate their children's bodies without a solid reason for doing so.

From what I have heard and read (podcasts, books etc) the health claims made about circumcision are all either false, or negligable when compared to the possible defecits.

If a person chooses to get a circumcision for cosmetic or cultural reasons, I believe that they should be able to choose when they are capable of doing so, with all the relevant information at their disposal.

At the heart of it, circumcision is a cultural/religious practice which may have come from many ancient sources, including health, identifying races, and spiritual beliefs. The modern medical claims seem to be an attempt to justify the practice post hoc, and to me, that's not good enough.

I believe that laws protecting male children from circumcision are a good move, and may help to break down an outdated, irrational practice.

You can read a much better response to the circumcision debate by Harriet Hall, the Skepdoc here: http://www.sciencebasedmedicine.org/?p=269

8 comments:

  1. I completely agree with you. Circumcision should only be performed for medical reasons while the child cannot make an informed decision by himself. The recommendation that circumcisions should be performed because of the apparent link between non-circumcision and a higher risk of STI's is dubious to me. It would be like recommending we all cut off our lips because of the high risk of gingivitis in un-lipped people. Proper hygiene is all that is necessary, not mutilation.

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  2. Before you use a loaded term like 'mutilation' please read this ethics paper on the topic. It's a bit long, but it covers all the arguments, and don't forget the responses to letters on the second page.

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  3. "It would be like recommending we all cut off our lips because of the high risk of gingivitis in un-lipped people."

    Sorry I meant to say "It would be like recommending we all cut off our lips because of the high risk of gingivitis in lipped people"

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  4. Jonny_eh,

    The study on your link is self contradictory.
    "Mutilation = Disfigurement or injury by removal or destruction of any conspicuous or essential part of the body."

    Circumcision always removes a large sexually significant portion of the penis
    and the glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis (PDF).

    So circumcision removes the essential part of the body to have best possible sex life and is mutilation. You study nicely omitted it.

    The researchers wonders "one can only wonder what possessed ancient people to first think of removing the foreskin" but we have a reasonably idea why.

    Their relativistic cultural cost-benefit analysis would also support abortion of female babies, voluntary wife burning and slavery I guess. They claim cultural bias, but don't explain why my bias is wrong (Bias does not equal wrong). They say that "We are not endorsing or condemning cultural views in favor of or against circumcision" but also say that it is OK for Jews to do it. Logically they should have then not said anything to support it. This article gave me a headache. Their "How not to argue about circumcision" is even worse.

    Now explain me again if circumcision is needed why can they wait until kids are legally old enough to make their own decision?

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  5. "So circumcision removes the essential part of the body to have best possible sex life and is mutilation. You study nicely omitted it."

    It is not a shut case on whether or not circumcision negatively impacts the enjoyment of sex. The enjoyment of sex is more than 'the number of nerve endings' in a penis. In fact, many men have the problem of too much sensitivity, causing premature ejaculation, which I would think is undesirable.

    The study did address this though. See the section "Other Considerations"

    "The researchers wonders "one can only wonder what possessed ancient people to first think of removing the foreskin" but we have a reasonably idea why."

    First of all, the study you linked to is just a suggestion of a possible reason. It's untestable, and to me not very convincing. We will never know for sure why this practice became so popular in so many different cultures. I suspect there were different reasons in the different cultures, and those reasons could have changed over time too. Regardless, it's not very relevant why the practice came about. The question at stake here is if it should be done now.

    "Their relativistic cultural cost-benefit analysis would also support abortion of female babies, voluntary wife burning and slavery I guess."

    That's just plain poisoning the well. We're talking about a harmless procedure that imparts some pros and some cons. No babies are being aborted, and no wives are being burned. You missed the point. The point was that since there were nothing overtly troubling about circumcision (it's medical benefit/risk is neutral, etc) there's no need to interfere with people's cultural traditions. I could argue back that preventing circumcision would be like preventing dragon boat races. Of course I wouldn't since it's a silly analogy, like yours.

    "Now explain me again if circumcision is needed why can they wait until kids are legally old enough to make their own decision?"

    They explained it multiple times in the paper and response section.

    Simply speaking, it's like vaccinations. For it to have its maximum benefit, it needs to be given when the child is young. Less painful, recovers faster, etc. Reread the section on the second page titled "Informed Consent"

    I'd also like to argue that the idea that the foreskin should remain in place, all things being equal (risk/benefit being neutral for circumcision) is an example of the naturalistic fallacy. Just because "that's how god made us", it does not mean that it's "better" or "preferrable". The risks and benefits need to be judged on their own merits.

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  6. Oh, and apparently the CDC is considering mass circumcision due to the massive benefit of reducing HIV transmission rates.

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  7. Jonny_eh said...
    "The enjoyment of sex is more than 'the number of nerve endings' in a penis. In fact, many men have the problem of too much sensitivity, causing premature ejaculation, which I would think is undesirable."

    Sure sex is more that the number or nerve endings but you can only reduce the number not add. This is why your suggestions fail. If you have premature ejaculation problem then consider circumcision not other way around as you suggest. You might circumcise someone with ejaculation problem later in life and cause more harm. (BTW foreskin is not "a piece of useless skin" as you wrote in sciencebasedmedicine.org)

    Jonny_eh said...
    "[comparing circumcision to abortion of female babies is] just plain poisoning the well...it's a silly analogy"

    I disagree. There is no medical need for the abortion of female fetuses, people don't see that they don't hurt anyone in the process and use cultural cost-benefit analysis to decide if to do it. Same arguments can be used for both practices.

    Jonny_eh said...
    "We're talking about a harmless procedure that imparts some pros and some cons"

    So a harmless procedure has cons?

    Jonny_eh said...
    "The point was that since there were nothing overtly troubling about circumcision"

    If you don't see it, it does not mean it is not troubling. I tried to explain that many people like me think it is troubling, so let's not do it to babies who do not understand the procedure. When they get older we can ask them if the procedure troubles them. I don't see many adults doing non-medically needed circumcision, so people don't see any real value in it...

    Jonny_eh said...
    "Simply speaking, [circumcision] is like vaccinations."

    Sorry this is false analogy and nonsense. Vaccination prevent diseases with very high probability. According to your study circumcision has only cultural benefits.

    Jonny_eh said...
    "The risks and benefits need to be judged on their own merits."

    I agree and let the person do the judging himself, just like you like to make your own decisions.

    Jonny_eh said...
    "CDC is considering mass circumcision due to the massive benefit of reducing HIV transmission rates."

    Sorry I did not see the word "massive" in the article. I believe CDC recommends that you use a condom to prevent HIV and is clear that circumcision is not a solution to HIV. People need to be educated about HIV; circumcision is not the solution, condom is (partly). Unfortunately the story does not tell how many CDC people or African health officials decided to circumcise themselves based on their own recommendation (?). People seem to be so eager to cut the genitals of other people who are defenseless, but not their own...

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  8. As I read this I couldn't help but think that I'm glad I'm circumcised, if for no other reason than every woman I've had any kind of intimate relationship with doesn't like (or wouldn't like) an uncircumcised penis. I also couldn't help but think that I'm glad it happened when I was a baby because I don't remember it at all. When I stand naked in front of a mirror, I don't consider myself "mutilated" at all. If my parents had waited till I was old enough to decide for myself, I'd have been angry at them.

    This isn't really an argument for anything, just my initial reaction after reading.

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