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653 thoughts on “The case for neonatal circumcision

  1. Draal says:

    “Translation: read stuff that agrees with me and you will see how wrong you are. ”
    Translation: I want you to spoon feed me; I can’t think for myself. :-)

  2. joep says:

    Esquire had a blurb about this issue the other day: http://www.esquire.com/women/sex/getting-circumcised-0210

    “Only 25% of the world circumcises, and not necessarily the good 25%. ” LOL. :)

  3. Zoe237 says:

    “Instead of guessing about Judaism and presenting your guesses as facts, why don’t you do a little research and let us know what you find?”

    Ironic coming from someone in their original post making direct contradictions and outright falsehoods:

    The AAP should revise their current recommendation (oh wait, that’s not what she “meant,” despite the title of the blog and the last sentence).

    The World Health Organization already recommends circumcision for neonates in first world countries (false)

    The AAP flipped on their recommendation (due to pressure from anti-circ advocates) of neonatal circumcision. (false- it was never recommended).

    Developed countries who have high circumcision rates also have low HIV rates (false, according to the WHO).

    It’s rather difficult to get into the science of such a procedure when it’s not a medical issue in this country (that’s why virtually all of the med org in the developed world don’t make a recommendation either way), it’s a religious and cultural issue. Not to mention the reluctance of anyone (besides Alison Cummins, to an extent) to respond to criticisms of the African studies.

  4. Grinch says:

    My 2 cents….if you use ‘wiki’ as a reference, for or against an argument, you are are automatically discredited.

  5. joep says:

    I think one of the big problems here with the OP is that she barely tried to address the large number of substantive issues raised but then came back to rapidly interact on a completely unrelated side point which should have been left to die.

  6. Zoe237,

    Yup, I agree with everything you say. That’s why I don’t think Amy’s posts are up to the standard of SBM.

    Interestingly, I’ve learned a huge amount following this discussion. I think Amy might have been a great classroom teacher (she was a clinical teacher), throwing out obnoxious, vague, un-nuanced and unsupported statements and motivating angry students to write thoroughly documented research papers.

    I do think I could have learned as much from a more disciplined discussion following a more complete, nuanced post, however; and I’m quite sure that I don’t want to have to write a term paper to learn something from a blog post.

  7. Annabel says:

    ““Only 25% of the world circumcises, and not necessarily the good 25%. ” LOL. ”

    I thought that was funny as well, but also something to think about.

    According to Forbes 2009 world’s most dangerous countries, Somalia is number one, followed by Afghanistan and Iraq. While not scientific, I think it is interesting that all three of those countries have male circumcision rates well above 50 percent. Also, of all the western countries, the United States is by far the most dangerous in terms of murders and crime in general, and we also have the highest rate of circumcised adult men. Just thought it was something interesting to ponder.

    (http://www.forbes.com/2009/03/04/most-dangerous-countries-lifestyle-travel_dangerous_countries.html)

  8. galway says:

    Grinch on 09 Jan 2010 at 9:42 am
    “My 2 cents….if you use ‘wiki’ as a reference, for or against an argument, you are are automatically discredited.”

    Discredited from what? Being confused by someone that I went to wiki?? Which, in my opinion is pretty informative.

    I’ve never claimed to have credentials of any kind, or even an argument that I’ve been trying to back up. There’s nothing to discredit.

    Dr. Amy however, has yet to back up her argument, provide relevant studies for her post, or answer anyone’s questions. Yet.. I’m discredited.
    Is there a study out there I should have looked at instead, to answer my question? By all means…

  9. Akheloios says:

    If Dr Tuteur has evidence that neo-natal circumcision is better than adult circumcision, and that any circumcision is better than condoms and safe sex, she should present it. In the absence of such evidence, she’s wrong.

  10. Robert Samson says:

    When they say it is not the money, it is the money.

    “I have some good friends who are obstetricians outside the military, and they look
    at a foreskin and almost see a $125 price tag on it. Each one is that much money.
    Heck, if you do 10 a week, that’s over $1,000 a week, and they don’t take that much
    time.”

    Dr.Thomas Wiswell quoted in the Boston Globe June 22, 1987

    “Profit should never dictate morality, but in the case of nontherapeutic circumcision it does. In 1999 the American Academy of Pediatrics found that neonatal circumcisions in the United States added between $150 and $270 million annually to healthcare costs.” -Respect for Bodily Integrity: A Catholic Perspective on Circumcision in Catholic Hospitals, from AMERICAN JOURNAL OF BIOETHICS, Volume 3, Number 2: Pages 1f-3f. Spring 2003.

  11. Robert Samson says:

    An overview of the profitable industry of MGM:

    http://www.acroposthion.com/acroposthion_018.htm

    The humble foreskin has long been the source of much controversy and continues today particularly in North America to generate even more unbelievable controversy. The most disturbing and alarming is in the unethical trafficking of neonate foreskins. Not only do parents of North American baby boys have to pay between $200 to $300 to obstetricians to circumcise their boys that no sooner are the circumcised foreskins cut off that they are sold on to bio-engineering and cosmetics companies by the hospitals. The numbers of dollars involved are bewilderingly staggering, and this financial force is one which is providing the funds to continue the spread of medical propaganda advocating circumcision. The resale value of neonate foreskins is astronomically dizzying in that from one boy’s foreskin can be grown bio-engineered skin in a lab to the size of a football field. That’s 4 acres of new skin or around 200,000 units of manufactured skin, which is enough skin to cover about 250 people and sells at $3,000 a square foot. Considering that there are 1.25 million neonate foreskins circumcised each year in the U.S alone this translates to one of the most lucrative trades, if not THE most lucrative trade in human body parts ever in the history of humanity.

    The justifiable explanations are that this newly bio-engineered skin is used for burns, persistent leg ulcers, bed sores, reconstructive surgery and other skin problems. Companies such as Advanced Tissue Sciences, BioSurface Technologies, Genzyme, Ortec International, and Organogenisis (and many others) are huge purchasers of infant foreskin tissue. The latest wonder in medical technology, Organogenesis’s Apligraf is the first and only human skin construct with FDA (Food and Drug Administration) approval. Closing wounds is what skin constructs do best thus Bio-engineering researchers want to switch to skin constructs for some of their testing. No one’s sure how these constructs work, but the statistics are incredible. Made of newborn penis-wraps (neonatal foreskin) and cow fat (bovine collagen), Apligraf placed over pernicious wounds magically heals the treated area. Almost 50 percent more wounds heal with Apligraf than with compression alone. The following is a description of what Apligraf is from their website “Apligraf is a unique biological product, containing living cells and structural (rebuilding) proteins and growth factors similar to healthy human skin. Because it is biological, the body can use the elements in Apligraf to help repair itself. As a result, Apligraf is natural and well tolerated, with no major reported side effects.” Not surprisingly, nowhere on this website is it mentioned that neonate foreskins are used for this product, preferring to say that the product contains “living cells” or that it’s a “biological” product.
    Theories abound as to why newborn foreskins work so well. According to the most accepted theory, newborn skin cells can morph into any kind of skin cell, whereas adult skin cells perform a specific function, which is why skin grafting is problematic. Also, neonatal tissue hasn’t yet developed the immunity proteins that cause rejection with adult human skin. Human skin constructs certainly put a spin on the circumcision debate. Previously, parents had only weak evidence of the health benefits of circumcision, such as a lower risk of infection. Now, circumcision really does have health benefits, only it’s not the baby boys who are losing parts of their penises who benefit.

    Other companies also know the value of neonate foreskins and the Cosmetics Industry has been silently taking advantage of newly circumcised babies by using the ‘fresh’ baby boy foreskins to utilise in skin rejuvenating lotions, creams and solutions because of the ability of foreskins cells to regenerate new skin cells. Cosmetics companies, such as Estee Lauder, Helene Curtis, and Mary Kay Cosmetics, use babies’ foreskins in their products. There is a product called TNS Recovery Complex by SkinMedica whose face cream costs over US$100 for a 0.63 oz bottle and is used by many high-profile celebrities (such as Oprah Winfrey and Barbara Walters) as an alternative to cosmetic surgery. It happens to be made from that discarded piece of skin that some parents opt to have removed from their newborn baby boys before they leave the hospital.

    It’s been talked about enthusiastically on ‘The Oprah Show’ where it was announced that this new product which boosts collagen production and can rejuvenate skin contains an ingredient “engineered” from human foreskin cells. TNS contains an ingredient called NouriCel-MD which is the trade name for a combination of Natural Growth Factors, matrix proteins, and soluble collagen. TNS is comprised from six natural human growth factors found in normal healthy skin engineered from human foreskin. Proteins and collagen are not new but Natural Growth Factors are a new category of compounds that act as chemical messengers to turn on and off a variety of cellular activities. Human Growth Factors extracted from cultured cells of foreskin which are then “engineered” into cosmeceuticals is the same as saying the product CONTAINS human foreskin. Oprah Winfrey YOU SHOULD KNOW BETTER than to promote unethical products on your show and your website. Shame on you Oprah for using your influence to promote and advocate circumcision to make your ageing skin look good at the expense of a baby boy’s most sensitive part, his foreskin. Fighting oppression and highlighting human rights abuses have been key Oprah Winfrey themes but here you are promoting male oppression, which is incredibly shocking, disappointing and unacceptable. It makes you look like a heartless, conceited, self serving and vain cow, therefore shame, shame, shame on you Oprah Winfrey.

    Circumcision is a multi billion dollar industry in North America and one doctor alone in the Lower Mainland of British Columbia claims having performed 20,000 circumcisions over the past decade, charging around $250 per procedure, which has earned this doctor an unbelievable $5 million. It is estimated that between the surgery and the foreskin’s resale value, each foreskin is worth approximately $100,000. The number crunchers estimate the developed world’s market for human-skin constructs is somewhere between $1 billion and $2 billion for the treatment of burns alone; for the treatment of chronic wounds (diabetic ulcers, pressure sores, and venous ulcers), the market is roughly $10 billion. Advanced Tissue’s flagship skin-construct, Dermagraft (described on their website as “manufactured from human fibroblast cells derived from newborn foreskin tissue”), sells for $3,000 per square foot, harvesting 250,000 square feet of Dermagraft from one foreskin alone. The math translates theoretically into a $750,000,000 transaction, which is astounding, outrageous and atrociously sickening….Is it not? Foreskin Mafia indeed! This is the sort of information that everyone especially all North Americans MUST know about to curtail and ultimately stop this outrageous scam for once and for all.
    Because most baby foreskins are used in insulin production, breathable bandages, and in the cosmetics industry, one has to wonder why the sale of all other human tissue is considered illegal, or is highly regulated, yet doctors are allowed to remove healthy tissue without the patient’s consent and against all medical recommendations, and then sell it for profit in a for-profit industry. Huge amounts of money are being made in an ethical vacuum, but whose palms are getting greased? Organogenesis, Novartis (the distributors of Apligraf), and Advanced Tissue Sciences were unresponsive to inquiries, and anti-circumcision activists claim the biotech companies won’t talk to reporters about the money. John A. Erickson, owner of sexuallymutilatedchild.org an anti-circumcision web site, received an anonymous email saying the going rate for infant foreskins at a large hospital in the greater San Diego area was $35 each, and that ethical doctors deducted that amount from their circumcision fees.

  12. Robert Samson says:

    “It’s rather difficult to get into the science of such a procedure when it’s not a medical issue in this country (that’s why virtually all of the med org in the developed world don’t make a recommendation either way), it’s a religious and cultural issue.”

    Ah, and even more revealing is that while the AAP cannot recommend infant circumcision, it excuses it for “religious and cultural” reasons.

    The bottom line is that infant circumcision has no scientific or even medical justification! Hence, no RATIONAL justification.

  13. rwinkel says:

    It seems that the obvious fact that most adults would not consent to genital amputation, especially without pain control (more than 50% of american physicians who circumcise don’t use any pain relief at all) is not enough to sway the true believers in the religion of medical infallibility. Even the long trail of the devastated victims of the admitted history of medical disasters ranging from lobotomy to thalidomide doesn’t seem to be enough to give them pause. Even now handwashing must be actively promoted in the obstetrical literature to overcome the inertia and culture of narcisissm prevalent in the medical community. It doesn’t take a medical degree to be deluded as to one’s own infallibility, but it definitely increases the damage which can result.

    A fellow activist for the human rights of babies believes that the best way to change the situation is to educate fathers on what to expect and guard against in the obstetrical wards, since the mother is frequently incapable of protecting her baby. I think she’s right on.

    “Frenar band”. Google it, Amy. And then consider the impact that its amputation has had on family cohesiveness in america, land of the divorcees. Then you could investigate the impact MGM has on male->female HIV transmission. (DOH!) Or do you require a double-blind study to sow some doubt? That will be coming I’m sure, but why wait when common decency demands that even the most helpless among us have human rights?

    Medicine will soon be trying to disown this monster which haunts the nightmares of children.

  14. Annabel says:

    “Thank you, untitled. You have asked almost every question that I want the pro-circumcision camp to address.
    Why neonatal circumcision?
    Why the double standard when dealing with male vs female genitals?
    Why the double standard when it comes to religious practices? If jewish parents can perform bodily modification in the name of religion, shouldn’t parents from a minority religion be allowed to do the same?
    “It certainly seems plausible that there are negative psychological consequences. Does the “pro-circ” camp have sufficient evidence to show that it is psychologically safe? Have they done rigorous testing on the psychological and emotional well-being of males who are circumcised as infants? If not, then why?”
    “While merely anectdotal, I do know several circumcised men who lament their lack of choice. What would you say to these men, who had a part of their body taken from them for no good reason and can never get it back? I would say that they’ve been violated. Would you disagree? If so, then why?”
    “And why do people keep pretending that the only possible biases are monetary?”
    “Why continue to condone and even promote a violation of an individual’s “physical integrity” (to borrow a phrase from the WHO) that is neither ethically nor medically justified?” adding to this, why is it only a females right to physical integrity that is violated, when there are several forms of FGM that are less severe than male circumcision? Do boys not have the same basic human rights as girls?
    ( all quotes are from a previous post written by “untitled”.)
    I would really like these questions addressed by the pro-circumcision camp. Especially Amy, since she has remained mostly silent on these issues when brought up, or has cherry picked a sentence out of an entire post three paragraphs long to respond to, avoiding these fundamental questions.”

    I would still like to hear a response to these questions from someone from the pro-circumcision camp, especially from Amy Tuteur, who has yet to provide any substantial answers to these issues, although they have been brought up and asked multiple times in this thread.

  15. Pnakotus says:

    I find that I may have to revise my stance on the benefits of circumcision, but the one thing I am concerned about is whether it is necessary to perform this on babies rather than at a time closer to when the benefits would be reaped (nearer the beginning of sexual activity). The only other benefit to performing the circumcision neonatally is reduction of UTIs. Is that enough to justify this procedure?

    I could see that if boys were given a choice then they’d likely say “Hell, no!” I know I would have. Is that a consideration for suggesting that this be done neonatally as well?

    I still don’t buy the “reduction of sexual pleasure” angle. I never used that as a reason to support not circumcising. I enjoy sex just fine as I am. I would have no way to comparing, either, so it is pointless to use this “what might have been” as an argument.

    Thanks for the article, Dr. Tuteur.

  16. Nick says:

    “I still don’t buy the “reduction of sexual pleasure” angle. I never used that as a reason to support not circumcising. I enjoy sex just fine as I am. I would have no way to comparing, either, so it is pointless to use this “what might have been” as an argument.”

    Persons who have lost body parts must grieve their loss.The first stage of grief is denial of the loss. Fitzgerald and Parkes state that “Anything that seriously impairs sensory or cognitive function is bound to have profound psychological effects, not only on the person who is affected but also on family, friends, workmates, and caregivers.” The thought of permanent loss of sensory function is so painful that persons deny their loss in order to avoid facing the painful feelings. Denial of loss causes a flight from reality. Parkes et al. state that persons in denial may minimize their loss. Circumcision causes the loss of a body part and all of its functions including a drastic loss of erogenous sensory function, so denial of loss is not uncommon in circumcised males

  17. Robert Samson says:

    “I still don’t buy the “reduction of sexual pleasure” angle. I never used that as a reason to support not circumcising. I enjoy sex just fine as I am. I would have no way to comparing, either, so it is pointless to use this “what might have been” as an argument.”

    So you prefer to ignore the scientific evidence?

    You might wish to look up the evidence for this loss..

    Taylor’s study on penile anatomy, and the Sorrel’s study on sensation and sensitivity loss.

    Here is a summation..

    http://www.urotoday.com/42/browse_categories/erectile_dysfunction_ed/finetouch_pressure_thresholds_in_the_adult_penis.html

    Fine-Touch Pressure Thresholds in the Adult Penis l

    http://www.nocirc.org/touch-test/bju_6685.pdf

    “Analysis of results showed the glans of the uncircumcised men had significantly lower thresholds than that of circumcised men (P = 0.040). There were also significant differences in pressure thresholds by location on the penis (p < 0.0001). The most sensitive location on the circumcised penis was the circumcision scar on the ventral surface. It was remarkable that five locations on the uncircumcised penis that are routinely removed at circumcision had lower pressure thresholds that the ventral scar of the circumcised penis.

    This study suggests that the transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. It appears that circumcision ablates the most sensitive parts of the penis."

    http://www.prweb.com/releases/2007/3/prweb512999.htm

    "A new study in the British Journal of Urology International shows that men with normal, intact penises enjoy more sexual sensitivity — as much as four times more — than those who have been circumcised. Circumcising slices off more of a male's sensitivity than is normally present in all ten fingertips. "

    Ignorance of, or denial of loss hardly negates that loss.

  18. Annabel says:

    “I could see that if boys were given a choice then they’d likely say “Hell, no!” I know I would have. Is that a consideration for suggesting that this be done neonatally as well?”

    If anything, that is a reason it should not be done during the neonatal period in my opinion.

    How is it ethical to perform a surgery that, by your own admission, you ( and most every man, statistically speaking ) would not perform on themselves when given the free will to do so as an adult? I think that this is an extremely over looked point.

    Is it ethical to perform a surgery on a baby who would most likely not choose the surgery for himself just because he is incapable of fighting back as an infant? I don’t think it is.

    Removing the breast from females offers a 97-99 percent risk reduction in getting breast cancer( I linked to this statistic in a previous post if you are interested ), which affects thousands of more people than HIV does in the United States. So is it ethical to perform this surgery on infants, even when their family history puts them at an elevated risk? No, because the girl may not want the intervention. I would much prefer to be responsible and get annual screenings once I am at an age where that is beneficial than to have my breasts removed ” just in case.” Non essential breast tissue is no different than non essential foreskin. Neither is required to survive, and formula is readily available for infants.

    If people believe that circumcision reduces the risk of HIV, by all means present your case to competent adults at high risk for HIV. As others have already states, babies are not having sex and there is no evidence that circumcision offers an additional benefit when done on neonates.

  19. Zoe237 says:

    joep

    “I think one of the big problems here with the OP is that she barely tried to address the large number of substantive issues raised but then came back to rapidly interact on a completely unrelated side point which should have been left to die.”

    Exactly!

    The anti-circumcision side (with whom I sympathize to an extent), might do well to avoid the following arguments (at least with a audience more interested in evidence rather than emotion):

    1. There is a vast financial conspiracy for circ or baby foreskins.

    2. The female genital mutilation angle (while I can see the point/analogy here to an extent, for type 1a, it just angers rather than persuades).

    3. Saying anything about it being a Jewish conpiracy. While I personally agree that religion is a bias, looking at the medical history of grasping at straws to find medical justifications over the past 100 years, there is too much history of persecution of Jews and the culture/religion (and yes, it’s both). It is impossible to make this argument in a vacuum.

    4. Calling it mutilation. Possibly technically true, but a word designed to invoke emotion rather than persuade.

    5. Sexual feeling with or without a foreskin. I have seen studies both ways. It’s probably impossible to prove, even with adults before and after.

    6. Foreskin restoration, or that circumcised men should forever be in mourning. This should go without saying.

  20. Nick says:

    “If anything, that is a reason it should not be done during the neonatal period in my opinion.

    How is it ethical to perform a surgery that, by your own admission, you ( and most every man, statistically speaking ) would not perform on themselves when given the free will to do so as an adult? I think that this is an extremely over looked point. ”

    I easily imagine that the pro circumcision lobby perfectly knows that, that’s why Amy (despite her claims in the comment section) is making the case for NEONATAL circumcision.
    Circumcision only exists because it is performed on unconsenting infants or children. That’s why I’m against routine infant circumcision. If an adult male wants to be cut he can go for it, I’ve nothing agaisnt that. And it’s notable that Amy makes no mention of ethics at any point.

  21. Robert Samson says:

    Well, Zoe,

    since all of the points you have mentioned should not be discussed, have been discussed and been shown to be accurate, WHY do you believe they should be avoided?

    All you seem to be saying is don’t confront people with the truth, they might feel offended–well, I say, if you can’t take the heat-get out of the kitchen.

    If people need to be emotionally coddled to act rationally, then perhaps they might instead consider the effect on those infants they are harming rather than THEIR emotions?

  22. Nick says:

    Ending Circumcision:

    Where Sex and Violence First Meet

    by Jeannine Parvati Baker

    http://www.mothersagainstcirc.org/feature.htm

  23. Nick says:

    Where Sex and Violence First Meet

    There is another psychological benefit to keeping our sons intact. The workof Dr. Rima Laibow (1991) concludes that a man carries unconscious rage againsthis own mother for betrayal, abandonment, and the assault itself. In otherwords, the unconscious mind of the son blames his mother for his circumcision,not “the tradition,” the circumcisor, or the father who wanted the son tolook like himself–only the mother. It’s just like some bad Jewish-motherjoke.

    Indeed for a newborn, his world is mother. If she cannot protect him fromviolation at the beginning, a baby loses trust. And isn’t lack of trust anissue in relationships between the genders nowadays? Can circumcision be a symptom of profound resentment between the genders? Can sexuality be healedon a very deep, unconscious level during the perinatal period?

    A connection exists between crimes of sexual violence, rape for example,and circumcision. The first heterosexual encounter–with a female nurse preppingthe infant male–as well as betrayal by the mother, is revenged in sexual assaults against women. As Marilyn Milos, Founder and Director of NOCIRCsays, “Circumcision is where sex and violence meet for the first time.”

  24. Nick says:

    Another great review of Amy Tuteur’s article :

    http://layscience.net/node/878

  25. Nick says:

    A great comment by Marilyn Milos (founder of NOCIRC) :

    Circumcision is a primal wound and it interferes with the maternal/infant bond, disrupts breastfeeding and normal sleep patterns, and undermines the baby’s first developmental task of establishing trust. It leaves a scar on the body and the psyche of the non-consenting minor and it is an assault on the baby’s body. Circumcision is where sex and violence meet for the first time.

    The Number One complaint of circumcised males in America is premature ejaculation, which occurs because the specialized, erogenous nerve endings in the foreskin that let a man know what his penis is feeling and allow him to ride the wave to orgasm are missing. Without them, a man goes “Ooh, ooh, oops! Sorry, honey, it’s because I’m so sensitive.” Nope, it’s because he lost what was rightfully his, a normal penis, with the 20,000-70,000 nerve endings that encircle the opening of the foreskin.

    At the other end of life, the exposed, calloused, desensitized, glans becomes more and more difficult to stimulate. It’s no surprise that males in the US have a high rate of erectile dysfunction, and the USA has the highest sales of Viagra in the world.

    You cannot alter form without altering function. When a male’s foreskin is amputated, it affects him for life and his partner’s sex life is affected as well. The mechanics of sex must be altered to compensate for what was lost. As CJ Fallier wrote in JAMA in 1970, “…the fundamental biological sexual act becomes, for the circumcised male, the satisfaction of an urge and not the refined sensory experience it was meant to be.”

    Circumcision is not a medical issue, it is a human rights issue. We protect females from genital cutting in the USA and it’s time we protect our males as well.

  26. Plonit says:

    To return to the FGM/double-standard issue for one moment (sorry Zoe!), Annabel misunderstood my point upthread.

    Firstly, there clearly IS a “double standard” with regard to Type Ia FGM and male circumcision, insofar as they involve the removal of morphologically, developmentally equivalent biological structures, and are done for similar reasons (control of sexuality, group marking, initiation/lifecycle ritual). Legistlative efforts to limit the rights of parents to make irreversible decisions for their children, should be restricted to those issues where there is clear evidence of harm. No such evidence exists for Type Ia FGM specifically, as distinct from FGM in general, even if Type Ia FGM can be shown to originate in sexist precepts. Much parenting practice is sexist, without being criminal. Indeed, it could be argued, that the symbolic/literal inclusion of male infants in a convenant by marking on the body, with not equivalent for female infants is also sexist. It follows that there is a strong case that the law has no business in regulating Type Ia FGM.

    However (and this was my point that Annabel missed), you don’t need a conspiracy theory to explain why the double standard exists. You merely need to look at the pragmatic law-making issues involved in FGM and male circumcision.

    In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe 99%+ of male genital modification is Type Ia equivalent. If that had been the case for female genital modification, I doubt that concerted international pressure to end the practice would exist.

  27. Zoe237 says:

    “Well, Zoe,

    since all of the points you have mentioned should not be discussed, have been discussed and been shown to be accurate, WHY do you believe they should be avoided?

    All you seem to be saying is don’t confront people with the truth, they might feel offended–well, I say, if you can’t take the heat-get out of the kitchen.

    If people need to be emotionally coddled to act rationally, then perhaps they might instead consider the effect on those infants they are harming rather than THEIR emotions?”

    LOL… rational you are not.

    Sorry, but you guys sound almost as loony as the “cut every American newborn male” people. It enables people to completely disregard any real point that you manage to make among the insane rants.

  28. Plonit says:

    oops, scrub that last paragraph. It should have read:

    In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe 99%+ of male genital modification is Type Ia equivalent. If that had been the case for female genital modification, I doubt that concerted international pressure to end the practice would exist.

  29. Plonit says:

    oops, scrub the last paragraph of my last comment. It should have read:

    In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe 99%+ of male genital modification is Type Ia equivalent. If that had been the case for female genital modification, I doubt that concerted international pressure to end the practice would exist.

  30. Nick says:

    About the “evidence” circumcision prevents HIV by 57% :

    http://www.doctorsopposingcircumcision.org/info/HIVStatement.html

  31. Plonit says:

    WordPress is treating my comments very strangely.

  32. Plonit says:

    One last try..

    oops, scrub that last paragraph. It should have read:

    In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe less 1%). In practice, removal of the foreskin constitutes close to 100% of all male genital modification. In the case of FGM, the existence of a ‘loophole’ permitting Type Ia might hinder the erradictation of Types Ib, II & III – which constitute the overwhelming majority of FGM. In the case of male circumcision, none is equivalent to Type Ib, II & III, therefore similar pragmatics (banning Type Ia to assist in the eradication of Types Ib, II & III) do not apply. The references to “Yemeni circumcision” etc in an attempt to demonstrate that male genital modification goes beyond removal of the foreskin refer to a single case report from the 1920s, and not to current widespread practices. I think anyone would accept that more than 99% of male genital modification is Type Ia equivalent. If that had been the case for female genital modification, I doubt that concerted international pressure to end the practice would exist.

    Aha! Don’t use “more than” “less than” signs in your comments, folks.

  33. Robert Samson says:

    “LOL… rational you are not.
    Sorry, but you guys sound almost as loony as the “cut every American newborn male” people. It enables people to completely disregard any real point that you manage to make among the insane rants.”

    So this is how you handle reality?–name-calling and this provides you with an excuse to dismiss the evidence and facts.

    Speaking of being rational, can YOU provide a rational justification for infant circumcision, or is name-calling and dismissal all you can conjure up?

  34. Nick says:

    “In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe less 1%)”

    Do you have any evidence to support this claim ?

    Where did you that type Ia is very marginal (<1%) ?

    Did you know, that in Indonesian female circumcision, the mutilation is minimal? It's true. The NY times released this article a couple of years ago:

    http://www.nytimes.com/2008/01/20/ma…mcision-t.html

    A more extreme version of the practice, known as Pharaonic circumcision or infibulation, accounts for 15 percent of cases globally and involves the removal of all external genitalia and a stitching up of the vaginal opening.

    Studies have shown that in some parts of Indonesia, female circumcision is more ritualistic — a rite of passage meant to purify the genitals and bestow gender identity on a female child — with a practitioner rubbing turmeric on the genitals or pricking the clitoris once with a needle to draw a symbolic drop of blood. In other instances, the procedure is more invasive, involving what WHO classifies as “Type I” female genital mutilation, defined as excision of the clitoral hood, called the prepuce, with or without incision of the clitoris itself.

    The amount of flesh removed, if any, was alternately described by circumcisers as being the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle.

  35. Annabel says:

    “In the case of FGM, law-makers confronted a continuum of practice, in which the least damaging type (type Ia) was very marginal (maybe 99%+ of male genital modification is Type Ia equivalent. If that had been the case for female genital modification, I doubt that concerted international pressure to end the practice would exist.”

    Even so, the media and public outrage when the Somalian parents wanted doctors to perform just a ceremonial pin prick on their daughter is clearly a bias. It was deemed illegal and doctors would not perform it. People claimed it violated a child’s right to physical integrity. Imagine if they wanted the clitoral hood removed from their daughter, which is analogous to removal of the male foreskin, for religious reasons? It would never be legally allowed in the United States, even though Jewish parents can circumcise their son for religious reasons. I am not convinced that even if the only type of FGM was removal of the clitoral hood that it would be legal. It is not the social norm in the United States so we view it is a heinous crime, even though it is analogous to male circumcision.

  36. Plonit says:

    Recommendations of routine infant circumcision require clear evidence of benefit. The onus is on proponents to provide the evidence.

    Calls to prohibit infant circumcision require clear evidence of harm. The onus is on proponents of prohibition to provide the evidence.

    It seems to me that Zoe was merely trying to define the terrain of rational debate which focusses on these issues.

  37. Nick says:

    Circumcision (male or female) is an obvious form of violence and it hurts like hall. The fact one procedure is worse than another one doesn’t make the latter OK.

    There’s an obvious double standart :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=317371456

    Both male and female traumatize young children, do you see any difference ? :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=350337158&Mytoken=626220D0-2193-48A4-A4D2B818991698EF160410465

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendId=1000579069&blogId=422594729

  38. Plonit says:

    It is not the social norm in the United States so we view it is a heinous crime, even though it is analogous to male circumcision.

    ++++++++++

    And I agree with you, that is an irrational and mistaken response.

    This was my second comment upthread (some several 100s comments ago).

    “One can see why from a legal perspective: if you allow Type Ia, then you can going to see a lot of intentionally ‘botched’ procedures to get around the law, especially given that Type Ia has always accounted for a small percentage of procedures amongst a much more damaging continuum. However, from a scientific standpoint, Type Ia in women is a exact analogue of the removal of the male foreskin, so it is worth asking ourselves (especially those of us who have circumcised our sons!) why we are content for this procedure (Type Ia) to be criminalised.”

    I think we are content (beyond the pragmatics of law-making) for exactly the reasons you suggest, i.e. cultural familiarity/prejudice/ethnocentrism.

  39. Nick says:

    Circumcision (male or female) is an obvious form of violence and it hurts like hall. The fact one procedure is worse than another one doesn’t make the latter OK.

    There’s an obvious double standart :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=317371456

    Both male and female traumatize young children, do you see any difference ? :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=350337158&Mytoken=626220D0-2193-48A4-A4D2B818991698EF160410465

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendId=1000579069&blogId=422594729

  40. Nick says:

    “especially given that Type Ia has always accounted for a small percentage of procedures amongst a much more damaging continuum. ”

    Where did you see that ?

    I would like some proof to support your claims

    I’ve already shown an article from NYtimes which goes against your claims.

  41. Nick says:

    Male or female circumcision is an obvious form of violence and it hurts like hall. The fact one procedure is worse than another one doesn’t make the latter OK.

    There’s an obvious double standart :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=317371456

    Both male and female traumatize young children, do you see any difference ? :

    http://blogs.myspace.com/index.cfm?fuseaction=blog.view&friendID=1000579069&blogID=350337158&Mytoken=626220D0-2193-48A4-A4D2B818991698EF160410465

  42. untitled says:

    Zoe237: “LOL… rational you are not.”

    You’ve made a rather arbitrary list of things we’re not allowed to talk about without justifying why we’re not allowed to talk about them. Simply calling us irrational for not agreeing with you does not get us anywhere. Please explain in more detail why you think those particular lines of reasoning are not valid.

    Regarding the FGM and MGM comparisons: It has already been demonstrated that both are umbrella terms covering a wide variety of practices. Circumcision is only one type of MGM, while arguably less extreme forms of FGM have been discussed above, which are notably illegal. Insisting that we reserve the term “genital mutilation” for all forms of FGM but not for circumcision seems to me both flippant and sexist.

  43. Fifi says:

    Nick – Rima Laibow is insane/sociopathic and probably the worst source you could use to support your argument. As is her husband, General Stubblebine (who is responsible for some of the torture techniques used in various American wars, was a key player in the military/woo insanity book/film The Men Who Stare At Goats is based upon and is behind all kinds of weird new agey astroturf activism and other assorted weirdness and atrocities). Incidentally, there were also key Scientologists involved in the military/woo insanity and Rima Laibow’s main agenda is totally aligned with Scientology’s anti-science agenda). Sometimes truth really is stranger than fiction. Nick, by using her as your chosen expert, you’ve pretty much aligned yourself with the quackiest of quacks. Not only are they sketchy on the new age and Scientology tip but they’re military torture, disinfo, mind control sketchy. Oh, and of course she pushes vitamin cures just like Scientology, which her and Stubblebine sell on their site.

    http://forums.whyweprotest.net/8-education-research-inside-reports/conspiracy-lady-dr-rima-laibow-scilon-43230/

  44. Plonit says:

    For some reason your link doesn’t give me access to the NY Times article, but I would refer you to the WHO on this subject. But do remember that Type I FGM includes both Type Ia and Ib, they are not the same thing, and only Type Ia is equivalent to male circumcision. The WHO changed their typology in 2007 to reflect a better understanding of practice.

    Type I: Excision of the prepuce, with or without excision of part or the entire clitoris. (WHO typology 1995)

    Type I: Type I: Partial or total removal of the clitoris and/or
    the prepuce (clitoridectomy). (WHO typology 2007)

    I refer you to the rationale for the change in typology.

    “Comments on the modifications to the 1995 definition of Type I
    The reference to the clitoral prepuce is moved to the end of the sentence. The reason for this change is the common tendency to describe Type I as removal of the prepuce, whereas *this has not been documented as a traditional form of female genital mutilation.* However, in some countries, medicalized female genital mutilation can include removal of the prepuce only (Type Ia) (Thabet and Thabet, 2003), but this form appears to be relatively rare (Satti et al., 2006). *Almost all known forms of female genital mutilation that remove tissue from the clitoris also cut all or part of the clitoral glans itself.*” WHO, 2008

  45. Plonit says:

    Circumcision is only one type of MGM

    ++++++++++++

    Please describe the other types which are currently widespread. What is their prevalence vis-a-vis circumcision?

  46. Nick says:

    Plonit,

    Here’s the link (it should work now) :

    http://www.nytimes.com/2008/01/20/magazine/20circumcision-t.html

    “A more extreme version of the practice, known as Pharaonic circumcision or infibulation, accounts for 15 percent of cases globally and involves the removal of all external genitalia and a stitching up of the vaginal opening.”

    “Studies have shown that in some parts of Indonesia, female circumcision is more ritualistic — a rite of passage meant to purify the genitals and bestow gender identity on a female child — with a practitioner rubbing turmeric on the genitals or pricking the clitoris once with a needle to draw a symbolic drop of blood. In other instances, the procedure is more invasive, involving what WHO classifies as “Type I” female genital mutilation, defined as excision of the clitoral hood, called the prepuce, with or without incision of the clitoris itself.”

    “The amount of flesh removed, if any, was alternately described by circumcisers as being the size of a quarter-grain of rice, a guava seed, a bean, the tip of a leaf, the head of a needle.”

  47. Robert Samson says:

    Thanks for the OPINION of WHO, but until and unless people can PROVE that somehow MGM is COMPLETELY harmless, all the terminology does not justify the banning of FGM and allowing MGM.

    THAT is the ethical foundation that all must address, and so far, none have done so.

  48. Nick says:

    Nick – Rima Laibow is insane/sociopathic and probably the worst source you could use to support your argument.

    I can give you other sources :

    http://www.circumstitions.com/Nursing.html

    And I don’t think Rima Laibow is more sociopathic than all these American circumcision evangelists. These individuals seem to have a fixation with promoting and performing circumcisions. Perhaps the next study should be of these researchers’ brains, to discover why they have such an unhealthy fascination with cutting off healthy foreskins from others. It almost borders on pathological!

  49. Robert Samson says:

    “Calls to prohibit infant circumcision require clear evidence of harm. The onus is on proponents of prohibition to provide the evidence.”

    This part has been satisfied–Taylor and Sorrels.

    Now we are still waiting for this..

    “Recommendations of routine infant circumcision require clear evidence of benefit. The onus is on proponents to provide the evidence.

  50. Nick says:

    “Calls to prohibit infant circumcision require clear evidence of harm. The onus is on proponents of prohibition to provide the evidence.”

    http://www.nospank.net/fleiss1.htm

  51. Plonit says:

    Studies have shown that in some parts of Indonesia, female circumcision is more ritualistic

    ++++++++++

    Firstly, there is no citation to those studies in the NY Times report. Secondly, they do not distinguish between Type Ia and Type Ib. Thirdly, the significance of the removal of a “rice grain/bean/guava pip etc…” of the clitoral glans tissue would vary according to the age of the child on which the procedure was performed. I refer you to the WHO report cited above, and ask whether your NY Times article refutes it.

    Finally, the fact that “in some part of Indonesia” female circumcision is more ritualistic doesn’t undermine the assertion that Type Ia is totally marginal and hardly practised, since “some parts of Indonesia” constitute only a small part of the population in which FGM of some type is practised.

  52. Plonit says:

    unless people can PROVE that somehow MGM is COMPLETELY harmless

    +++++++++

    Impossible. NOTHING can be PROVED to be completely harmless. Even participating in a web-based comment thread can be harmful.

  53. Robert Samson says:

    “Circumcision is only one type of MGM

    ++++++++++++

    Please describe the other types which are currently widespread. What is their prevalence vis-a-vis circumcision?”

    Gee, who now is trying to limit the evidence?

    The mere existence of different forms of MGM is sufficient to discredit the double standard–magnitude or prevalence is irrelevant..and using the word”circumcision” in no way alters the basic concept. All one needs to do is call all forms of FGM “circumcision, and this vanishes in a puff of smoke.

  54. Zoe237 says:

    “I still don’t buy the “reduction of sexual pleasure” angle. I never used that as a reason to support not circumcising. I enjoy sex just fine as I am. I would have no way to comparing, either, so it is pointless to use this “what might have been” as an argument.”

    Nick:
    “Persons who have lost body parts must grieve their loss.The first stage of grief is denial of the loss. ”

    You honestly expect people to take you seriously when you claim that the vast majority of American men *should* be mourning their lost foreskin? This is exactly the kind of insanity I’m talking about.

    I never said that people couldn’t talk about arguments like this or that they weren’t valid (necessarily). Just don’t expect any people (particularly circumcised males who are investigating the issue for their sons) to believe you. My husband and I chose not to circumcise our sons, but not because of hysterical arguments about the lost primal foreskin.

    I will not respond again. Obviously, mine was a subjective list. I only believe that there are more effective, reasonable arguments against infant circumcision.

  55. Robert Samson says:

    “unless people can PROVE that somehow MGM is COMPLETELY harmless

    +++++++++

    Impossible. NOTHING can be PROVED to be completely harmless. Even participating in a web-based comment thread can be harmful.”

    EXACTLY my point..hence the double standard that FGM is not acceptable and MGM is.

  56. Plonit says:

    magnitude or prevalence is irrelevant

    ++++++++

    It is not irrelevant to the legislative approach (see comments upthread).

  57. Plonit says:

    The vast majority of FGM can be shown to be harmful, and, on balance FGM has been shown to be harmful.

    If some sub-types that have not been shown to be harmful, then there is a pragmatic legal question as to whether permitting the practice of this sub-type of FGM undermines efforts to erradicate demonstrably harmful types. I’m willing to be persuaded in either direction on this question, according to the evidence.

  58. Robert Samson says:

    “You honestly expect people to take you seriously when you claim that the vast majority of American men *should* be mourning their lost foreskin? This is exactly the kind of insanity I’m talking about.

    Zoe, where have you been spending your time?

    perhaps you are not aware of this?

    http://www.noharmm.org/synopsis.htm

    http://www.noharmm.org/bodyimage.htm

    http://www.noharmm.org/bju.htm

    This survey indicated there are 52 million men in the US that are dissatisfied with their circumcision. This number almost exactly duplicates a study in Journeyman in 1992. It must be fairly accurate.

    192 respondents (average age 44 years,85% circumcised

    circumcised intact
    Satisfied 38% 78%
    Dissatisfied 20% 3%
    Ambivalent 41% 17%

    “I will not respond again. Obviously, mine was a subjective list. I only believe that there are more effective, reasonable arguments against infant circumcision.”

    There sure are, and they have been presented, but some irrational people refuse to accept the evidence for them. Some need a clue by four upside their heads.

  59. Nick says:

    Finally, the fact that “in some part of Indonesia” female circumcision is more ritualistic doesn’t undermine the assertion that Type Ia is totally marginal and hardly practised, since “some parts of Indonesia” constitute only a small part of the population in which FGM of some type is practised.

    But you didn’t show any real evidence either. And the male foreskin is much bigger and has far more nerve endings (about 20,000) than the clitoral hood.

  60. untitled says:

    Plonit, I was referring to an earlier post by Robert Samson. I don’t know the prevalence, but I don’t see why that matters.

    My point is this: I don’t see any way to construct a clear and consistent definition of the term “genital mutilation” that admits all currently recognized forms of FGM while omitting circumcision, without making explicit mention of gender.

  61. Robert Samson says:

    “The vast majority of FGM can be shown to be harmful, and, on balance FGM has been shown to be harmful.

    If some sub-types that have not been shown to be harmful, then there is a pragmatic legal question as to whether permitting the practice of this sub-type of FGM undermines efforts to erradicate demonstrably harmful types. I’m willing to be persuaded in either direction on this question, according to the evidence.”

    It has? Where is there any scientific study proving this, so far all I have seen is a facile ASSUMPTION of harm? I know of no study confirming harm, but I know of some studies showing harm from MGM.

    Where is the harm in a pinprick?

    And again, none of these attempted qualifications justifies the double standard.

  62. David Gorski says:

    Rima Laibow is insane/sociopathic and probably the worst source you could use to support your argument. As is her husband, General Stubblebine (who is responsible for some of the torture techniques used in various American wars, was a key player in the military/woo insanity book/film The Men Who Stare At Goats is based upon and is behind all kinds of weird new agey astroturf activism and other assorted weirdness and atrocities). … Nick, by using her as your chosen expert, you’ve pretty much aligned yourself with the quackiest of quacks. Not only are they sketchy on the new age and Scientology tip but they’re military torture, disinfo, mind control sketchy. Oh, and of course she pushes vitamin cures just like Scientology, which her and Stubblebine sell on their site.

    Yup. Stubblebine is about as far into the woo as it’s possible to get, and so is Rima Laibow–proof positive that right wingers can be just as woo-prone as the left-wing New Agey types. He heads up an entire organization dedicated to “health freedom,” or, as I like to call it, the freedom of quacks from any pesky interference from the government. You know, come to think of it, one of us here ought to do a post about Stubblebine and Raibow.

  63. Nick says:

    And about tattoos ?

    http://www.bvblackspin.com/2010/01/05/parents-face-charges-for-tattooing-six-of-their-young-children

    Why parents are facing child cruelty for tattooing a child when neonatal circumcision doesn’t seem to disturb most people ?

    Tattoos are less invasive and painful than circumcision. It doesn’t remove any erogenous and healthy tissues. Why parents are allowed to cut off part of their male children’s genitals when tattooing is child cruelty ? Not to mention, children gave their consent.

    Instead of finding new excuses to legitimize circumcision, parents should recognize it for what it is: a violation of the
    human rights of their son, a violation of their genital integrity, a
    violation of every person’s sovereignty of his own body. It should be a decision each male is allowed to decide as an adult (like tattoo).

  64. windriven says:

    Nick, you’ve wandered so far into the weeds I’m not sure you’d know what the path looked like even if you were on it. Do you have some kind of weird head thing going on because mommy took your foreskin away?

    “Circumcision is a primal wound and it interferes with the maternal/infant bond, disrupts breastfeeding and normal sleep patterns, and undermines the baby’s first developmental task of establishing trust. It leaves a scar on the body and the psyche of the non-consenting minor and it is an assault on the baby’s body. Circumcision is where sex and violence meet for the first time.”

    Yeah, and all penetration is rape, too.

    A strong ethical case can be made for delaying circumcision until the informed consent of the foreskin’s life support entity is obtained. But you sure aren’t making it.

  65. Fifi says:

    Nick – “And I don’t think Rima Laibow is more sociopathic than all these American circumcision evangelists. These individuals seem to have a fixation with promoting and performing circumcisions.”

    Hmmm, well one person’s crazy doesn’t negate another person’s crazy. (And quite honestly both the “procirc” and “anticirc” sides seem to be ideologues and need each other, as extremists that avoid reality based thinking in favor of ideologies generally do.) The fact that you think one extreme of crazy negates the other pretty much discredits your argument again, as well as showing that you actually have no interest in good science and medicine and are happy to align yourself with Scientologists, people who invent ways to torture other people, seriously sketchy military types and dangerous pseudomedical quacks as long as you think what they’re saying supports your ideological position. Your polarized and clearly anti-science stance does absolutely nothing to further rational discussion about the ethical implications of circumcision, the cost/benefit analysis of it as a medical procedure or to actually discount the people you’re arguing against.

    Besides, Stubblebine and Laibow aren’t activists, they’re propagandists /marketers and disinfo agents (I’d assume mainly for personal profit and because they’ve heavily invested in tin foil, alongside selling Big sCAM quackery on their site). They actively and directly profit off the disinfo they promote and fearmongering.

  66. Plonit says:

    It has? Where is there any scientific study proving this, so far all I have seen is a facile ASSUMPTION of harm?

    ++++++++++++

    For harm of FGM, see the WHO 2008 report already linked to. Annex 5 is a summary of the health complications, with citations to research studies. I think these research studies need to be discussed dispassionately and impartially, and if you think they are wrong – then let’s discuss that. In particular, I think the difference in chronic health complications and increased risk in childbearing arising from FGM need to be considered.

    What are the chronic health consequences that arise from male circumcision/MGM? Are there increased risks reproductive risks to men arising from being circumcised?

  67. Fifi says:

    David Gorski – “Stubblebine is about as far into the woo as it’s possible to get, and so is Rima Laibow–proof positive that right wingers can be just as woo-prone as the left-wing New Agey types. He heads up an entire organization dedicated to “health freedom,” or, as I like to call it, the freedom of quacks from any pesky interference from the government. You know, come to think of it, one of us here ought to do a post about Stubblebine and Raibow.”

    I’d love it if one of you did, they seem to be behind a lot of disinfo and it’s such a weird story – particularly the covert Scientology connection. My (subjective, of course) observation is that Left/Right is a false dichotomy at this point, it’s really about reality-based thinking versus fantasy-based thinking. After all, Senators Kennedy and Orrin Hatch often worked together to promote woo (and there’s similar bipartisan support of Big Pharma and the insurance industry). It’s a bit like how the Big Pharma vs Big sCAM dichotomy is a false dichotomy that serves both well in that it obscures what’s really going on, which is industry promoted pseudoscience vs good science. It makes it a battle of ideologies and polarizes people around emotional ideologies instead of asking what the reality is and who or what our governments are serving if it’s not “we the people”.

  68. geskoi says:

    Kudos to “untitled” who posted on 08 Jan 2010 at 11:56 pm, saying, “Your defenses are beginning to cast serious doubt on your objectivity.” and much more.

    I know that took a long time to put together, especially as it’s taking me a long time to study it, and appreciate your effort.

    There are a few things you suggest that we don’t know at all, and yet for specific individuals, we can and do know more than that. Plus, circumcision has been forced on males of all ages, and we have reports from these victims, which can be tied together by the age of the victim at the time of circumcision. We also have men who learned what was done to them at various ages, and have trauma that they can articulate based on that discovery alone.

    There really is a lot more we could know if we just open our eyes.

    We also need to educate men as to exactly what the foreskin is, and what was done to them. Most do not know, and indeed, too many think they were not cut. The ignorance is part of what keeps circumcision in place, so it has not been in the interest of physicians in doing this. Call it monetary, Stockholm, or whatever, it’s what happens. Fortunately, now we have the internet, and that is changing. My web pages on circumcision and foreskin restoration were the first ones to be found on the WWW.

    Listen to the victims, and that includes more than just those that get cut.

  69. Nick says:

    “The fact that you think one extreme of crazy negates the other pretty much discredits your argument again, as well as showing that you actually have no interest in good science and medicine and are happy to align yourself with Scientologists, people who invent ways to torture other people”

    @fiffy :

    I didn’t know about personal conviction of Rima Laibow, is that OK?
    I also put other studies showing how circumcision is disturbing for a newborn and consequently for the future adult.

    You are talking about torture ?
    Please explain me how neonatal isn’t torture ?

    Despite AAP recommandations, it’s usually not even done with anesthetics, and if you do a respiratory response analysis of a baby boy during a circumcision his heart rate reaches 180 beats per minute and his cortisol levels rise to around 300 nanmoles per liter, which are levels you would expect from a torture victim.

    And circumcision has nothing to do with medecine (unless there’s a valid medical reason). It’s a bloody ritual that has become medicalized for the last 150 years. Please read hostory of circumcision in US, it’s almost comical. You may find different studies showing “health” benefits but so far empirical evidence shows that none of the alleged benefits for circumcision manifest in the real world. One telling example : US has both the highest rates of HIV and circumcision among industrialized world.

  70. untitled says:

    Nick: “Why parents are allowed to cut off part of their male children’s genitals when tattooing is child cruelty?”

    I can tell you in one word: Tradition!

    (Sorry, I couldn’t resist.)

  71. Xero says:

    This article is not up the standards of Science Based Medicine. As mentioned earlier, it appears newborn circumcision is this author’s Sacred Cow. The ad hominem arguments in the text are actually tame compared those made earlier and competently responded to here:

    http://www.rollingdoughnut.com/2009/04/if_you_cant_beat_them_resort_t_1.html

    I would like the author to address the arguments made recently by major medical associations in Canada and Australia. They have seen the same data, they reject newborn circumcision on medical grounds, and they extensively question the ethics of irreversibly removing body parts from a healthy, normal child who cannot consent.

    The Dr. has still not explained why a surgery with risks and potential benefits to sexually active adults should be performed on newborns who cannot consent.

  72. Charon says:

    “A visitor from outer space might be forgiven for concluding that the most important part of the human body is the foreskin. It is, after all, the only part of the body that has multiple organizations devoted to its preservation in the natural state.”

    What else is routinely amputated for no reason? (Even if you are correct that there are now valid medical reasons for this admittedly minor amputation, those are quite recent results. We’ve been doing this for no valid reasons for a long, long time.)

  73. Charon says:

    “If you don’t want to circumcise your sons, don’t do it. If you don’t think the benefits outweigh the risks, don’t do it. Just don’t claim that there are no medical benefits when there are real benefits.”

    But there aren’t any medical benefits for children. All the benefits you cite are about STIs. You did not address why this is even a question for the parents at all. Seriously, WTF?

  74. Fifi says:

    Nick – “I didn’t know about personal conviction of Rima Laibow, is that OK?”

    That’s exactly what discredits you, you have no idea about the sources you’re presenting and claiming are scientific evidence that support your argument. It makes it obvious you’re an ideologue and not interested in reality but promoting a particular viewpoint your emotionally attached to.

    Btw, your credibility isn’t enhanced by making up new names for people. I recognize it’s a common internet trolling tactic – as well as being a popular arguing strategy amongst five year olds – but all it does is make you look silly and juvenile and at a loss to make a real argument. I mean, go ahead if that’s the best you’ve got but I’d hardly have called myself something as silly as Fifi if my ego was all wrapped up in my internet pseudonym. Apparently your ego IS very tied up with the ideology you’re promoting and the idea of yourself as some grandiose victim.

    You promote torturers and quacks and then wail about how others don’t see how circumcision is torture. It may well be cruel and painful – the evidence really isn’t in on that yet – it’s not torture. Once again you’re coming off as irrational and as someone who is really just using this as an excuse to claim victimhood. How many failures in your life do you blame on the lack of a foreskin? One of the things I greatly admire about women who have been subjected to female circumcision (often held down by female relatives) and who speak publicly about it is that they are empowered survivors who are most definitely getting on with their lives. They’re brave women who aren’t looking for pity or making false comparisons vis a vis other people’s suffering but are rather doing practical things to help other girls.

  75. Charon says:

    (The only other vaguely comparable preventative procedure that comes to mind is the HPV vaccine… but that causes no physical damage, and 12 != infant.)

  76. SunkenShip says:

    This has been a very interesting discussion in the comments. The original post, however, was a complete and utter waste and a slap in the face to the mission of this blog. While there is undoubtedly some scientific evidence that circumcision may provide POTENTIAL benefits, there are also studies that contradict circumcision’s benefits. The book is not closed on any circumcision’s supposed benefits, so to slam those who are skeptical of the hype of circumcision’s protective benefits from HIV as “foreskin fetishists” belies a closed mind and an ideologue.

    Dr. Amy Tuteur has an axe to grind on the subject of neonatal circumcision and this post is just another of her self-admitted campaign to provoke and stir controversy.

    http://open.salon.com/blog/amytuteurmd/2009/10/17/dr_amy_was_mean_to_me

    She aims to emulate the incendiary styles of Ann Coulter and Rush Limbaugh, and by her own admission, she conjures up provocative headlines to elicit exactly the type of response this post has gotten. Which makes her seemingly innocent claim that she merely borrowed the headline from the paper she cited a flat out joke. She knew what she was doing and she has gotten exactly the response she wanted.

    Those expecting an answer to the reasoned challenges put forth to Dr. Tuteur to explain exactly HOW the AAP recommendation should be changed and why the HIV studies make neonatal circumcision an imperative, will likely not get an answer. That would put her out of her “online persona.”

  77. Nick says:

    “Hmmm, well one person’s crazy doesn’t negate another person’s crazy. (And quite honestly both the “procirc” and “anticirc” sides seem to be ideologues and need each other, as extremists that avoid reality based thinking in favor of ideologies generally do.)”

    Intactivists have no need to justify their position. Opponents of circumcision have no axe to grind. They have no reputations or careers to protect. They do not reap huge profits by engaging in unethical practices. Those who promote ethical and legal practices have no need to be accountable for their words and actions. Their aim is to protect the rights and interests of those who are unable to defend themselves. They are to be commended and supported for their actions and should not be subjects of ridicule, which appears to be the norm today. It is those who advocate or perform circumcisions who need to justify their perverted activities.

  78. Nick says:

    “That’s exactly what discredits you, you have no idea about the sources you’re presenting and claiming are scientific evidence that support your argument. It makes it obvious you’re an ideologue and not interested in reality but promoting a particular viewpoint your emotionally attached to.

    Btw, your credibility isn’t enhanced by making up new names for people. I recognize it’s a common internet trolling tactic – as well as being a popular arguing strategy amongst five year olds – but all it does is make you look silly and juvenile and at a loss to make a real argument. I mean, go ahead if that’s the best you’ve got but I’d hardly have called myself something as silly as Fifi if my ego was all wrapped up in my internet pseudonym. Apparently your ego IS very tied up with the ideology you’re promoting and the idea of yourself as some grandiose victim. ”

    Do you know what projection means in psychology ?
    It is the unconscious act of denial of a person’s own attributes, thoughts, and emotions, which are then ascribed to the outside world, such as to the weather, the government, a tool, or to other people (like me in this particular case). Thus, it involves imagining or projecting that others have the same feelings or motives, rather than what they really think.
    It applies perfectly for you.

    Do you have any idea of the sources coming from pro circ lobby? I have shown you that these “studies” are of questionable value for many reasons.The first being that the authors, especially Robert Bailey, are known circumcision evangelists. It doesn’t take a great genius to see the obvious conflict of interest.

    Also just google “circumcision”. There are millions of results. Do you know ALL the authors of different studies ?

    “You promote torturers and quacks and then wail about how others don’t see how circumcision is torture. It may well be cruel and painful – the evidence really isn’t in on that yet – it’s not torture. Once again you’re coming off as irrational and as someone who is really just using this as an excuse to claim victimhood. How many failures in your life do you blame on the lack of a foreskin?”

    What is your obsession about claiming I promote torture (except the fact I show a study coming from a debatable source that I wasn’t aware of) ? I already responded to you about that and show you other studies proving the exact same results.
    Sorry but neonatal circumcision is torture. It is exaclty what it is.
    Have you ever seen a video of circumcision ?
    Please watch this and tell me how it isn’t torture ?

    http://video.google.co.uk/videoplay?docid=5933355699286047639&ei=7A1JS8nbKsSp-AbTjuysCg&q=circumcision&hl=fr&view=3#

    You claim I’m coming off as irrational ? How is it irrational to defend a man’s right to choose for himself what he wants to do with his penis ?
    How is it rational to remove healthy and erogenous tissues from a baby without his consent ?

    “I greatly admire about women who have been subjected to female circumcision (often held down by female relatives) and who speak publicly about it is that they are empowered survivors who are most definitely getting on with their lives. They’re brave women who aren’t looking for pity or making false comparisons vis a vis other people’s suffering but are rather doing practical things to help other girls.”

    Good for you.
    90% of the world’s population already lives under laws banning FGM with no religious exemption. A male is more than 5 times as likely as a female to be missing sexual parts due to non-therapeutic genital cutting.
    Cutting women is bad but cutting men is good? You should have your heads examined. The American idea that there is something congenitally wrong with the human penis is madness.
    Keep reading pseudo scientific articles promoting male genital mutilation and tell yourself that what you’re doing is sane and ethical. Maybe some day you’ll grow up and join the rest of the civilized world. Well, shamble on in your blissful ignorance.

    It’s obvious that you make the deliberate choice to be in denial. There’s nothing I can do about that but maybe your doctor can help you (and don’t take it personally, I would be very happy if you could find some psychological help because judging by your posts it’s obvious you need some).

  79. Fifi says:

    Sunkenship – Well said. As a woman, I find it particularly disappointing to see this coming from another woman when there are so many brilliant and ethical women working in science and medicine who are very much defenders of science-based medicine.

    Nick – “Intactivists have no need to justify their position. Opponents of circumcision have no axe to grind. They have no reputations or careers to protect. They do not reap huge profits by engaging in unethical practices.”

    Ah, jargon and making a position into an identity, once again you’re revealing your an ideologue and not actually interested in science. Clearly you’ve constructed an identity for yourself around being an “intactivist” and a “victim of torture”, you’re gaining an identity as an “ist” rather than just being another person. You’ve been grinding axes here from the start, it’s pretty much all you’ve done.

    All those links you posted as “evidence” – particularly the one to Rima Laibow – are people who profit professionally and monetarily from promoting a certain ideological perspective and selling things. They reap huge profits from engaging in unethical practices and promoting pseudoscience. In fact, you’re personally so unethical and out to gain (narcissistic gain is still gain) – and anti-science – that you don’t even recognize when people are making sane arguments against circumcising infants and you’re damaging the case for what you claim to care so deeply about. Why? Because it’s not actually about protecting anyone else for you or having a rational discussion based on evidence, it’s all about positioning yourself as a victim and your self interest.

    Nick – “Those who promote ethical and legal practices have no need to be accountable for their words and actions.”

    Wow…. The very essence of being ethical is being accountable for one’s words and actions. Something you’re clearly not willing to be. As someone who has engaged in much real activism for human rights, I can tell you that being accountable and ethical is essential if we’re calling upon others to be accountable and ethical.

    You’re making yourself appear ridiculous, partly by refusing to be accountable for your words and actions. And you’re not fooling anyone into believing you’re being heroic when it’s obvious you’re all about your own drama and identity as a victim.

  80. Fifi says:

    Nick – You really are stupendously dense aren’t you? I’ve been consistently arguing that unnecessary surgery on infants isn’t ethical and that circumcision (and all body modification) should be an adult choice. As are other people here who you’ve gotten all in a lather about. Clearly you’re just here seeking attention (that would be your narcissistic gain at work again) and to make grandiose claims about your personal victimhood. You do a great disservice to people who actually are championing the rights of children, something you’re clearly not actually doing. It’s a bit pointless continuing to converse with you since it clearly just fills your me-me-me agenda for being here.

  81. Nick says:

    “Ah, jargon and making a position into an identity, once again you’re revealing your an ideologue and not actually interested in science. Clearly you’ve constructed an identity for yourself around being an “intactivist” and a “victim of torture”, you’re gaining an identity as an “ist” rather than just being another person. You’ve been grinding axes here from the start, it’s pretty much all you’ve done.”

    Woaaa you are really a hard nut to crack or you don’t get my point. I’ve already told you that I strongly believe that circumcision has nothing to do with science for 4 major reasons :

    FIRST (I agree this is just MY opinion) : we are talking about NEONATAL circumcision and not adult circumcision. How ethical would it be to perform circumcision on adults without their informed consent because it might prevent HIV by about 50% ? How is it more ethical to perform this surgery on babies ?

    SECOND : You want me talk about science ? So far, there’s NO evidence or proof that circumcision prevent HIV by X%. Studies aren’t scientific proof. The entire set of studies are based on the hunch that somehow HIV transmission is facilitated through Langerhans cells found in the foreskin. However this is a very debatable hypothesis. I’ve already posted a scientific study showing that these Langerhans cells fight against HIV :
    http://www.circumcisionandhiv.com/files/de_Witte_2007.pdf
    There’s nothing conclusive so far.

    THIRD : There’s ac ompulsive obsession and fixation by certain researchers to try to discredit the existence of a normal part of the male anatomy for almost 170 years in US. Have you studied the history of circumcision in US ?
    http://www.youtube.com/watch?v=srGTtm56R2A
    When you look at the backgrounds of the doctors who are conducting these studies, it’s a very testable hypothesis to say that there’s an obvious conflict of interest.

    FOURTH : There are many other factors to take into account in the equation especially as regards complications of circumcision, infant pain, potential trauma for a newborn, the role of foreskin…these are interesting points that should be studied more carrefully in order to provide good scientific results. However this is something that Amy Tuteur completly completely neglects.

    So if you think I’m saying someting wrong (point 1,2,3 or 4), please explain me why and show your arguments. I’m ready to listen to them. However if you have nothing interesting to say, then just say nothing.

    And please claiming it’s obvious I’m about my own drama and identity as a victim is just retarded, so far I haven’t talked about my personal experience.

  82. Nick says:

    “Clearly you’re just here seeking attention (that would be your narcissistic gain at work again) and to make grandiose claims about your personal victimhood.”

    Where did you see that ?

  83. Nick says:

    Fiffy,
    If an adult was strapped down to a plastic board and circumcised without his informed consent and without anesthesia (like neonatal circumcision), wouldn’t you consider this act as a form of obvious torture ?
    Please explain me the difference with a baby who is much more vulnerable than adult.

  84. joep says:

    @Zoe237

    Zoe237 said: “The anti-circumcision side (with whom I sympathize to an extent), might do well to avoid the following arguments (at least with a audience more interested in evidence rather than emotion):”…

    Yes, I know and completely agree. Actually most of those arguments are best avoided altogether but they always crop up. The case against infant circumcision, especially in the west, is strong enough on its own.

    What I really regret is that those arguments are the only ones that Amy has really chosen to answer. Despite there being a significant number of good counter points to the original post made by most contributers. I’ll have to dig through and see if there is anything worth discussing today.

  85. misterxroboto says:

    # Amy Tuteur, MDon 07 Jan 2010 at 8:15 am

    “There are many variations of female genital modification”

    And none have any medical benefit at all.

    1.
    # Amy Tuteur, MDon 07 Jan 2010 at 9:18 am

    “the possible medical benefits of those forms of female genital modification analogous to male circumcision have not been studied.”

    And therefore you cannot make claims about their existence.

    Is this meant to be ironic?

    obviously you know it’s a principle of empiricism that you can’t claim there’s a link nor claim there isn’t one without testing. you can assume all you like, but without testing it, it’s pulling things out of thin air.

  86. Zoe237 says:

    “admitted campaign to provoke and stir controversy.

    http://open.salon.com/blog/amytuteurmd/2009/10/17/dr_amy_was_mean_to_me

    She aims to emulate the incendiary styles of Ann Coulter and Rush Limbaugh, and by her own admission, she conjures up provocative headlines to elicit exactly the type of response this post has gotten.”

    Thanks for posting that; it was enlightening, particularly the comments. It also explains why she’s not publishing in journals or debating with actual scientists about her apparent mission/obsession in life (mothers who birth at home are babykillers). So the best thing to do for naysayers is to ignore her.

    Rush Limbaugh doesn’t usually have his facts straight either. Particularly his recent defense of “Muslims should be in concentration camps” bs. Dr. Tuteur’s missing the humor, entertainment, cult personality part of the Limbaugh success equation though- she just ends up sounding arrogant. Not to mention this is some random blog, not tv or radio.

    People are attracted to extremist ideologues because it practically gives them permission to not have to think critically.

  87. Fifi says:

    Why is she even writing at Sciencebasedmedicine? This seems entirely contrary to the stated aims of most of the main bloggers here and to simply be dragging science even further down to the level decried so often here. It would be a different matter if Dr Tuteur was actually entertaining, intellectually provocative, clever, witty, eloquent or a good or even fairly good writer. You do need at least a bit of talent to get away with being an ass unless you are intending to pander and compete for Fox’s core audience. I don’t expect Christopher Hitchens level provocation, intelligence or eloquence but, really, SBM is stooping to Fox News levels here. The insult to the reader is not provocative, it’s just corrosive to SBM’s credibility, as is Tuteur’s obvious disregard for science as anything but an ideological tool. I may not always agree with the other bloggers here but at least I can generally respect them as medical professionals and writers.

  88. Robert Samson says:

    “For harm of FGM, see the WHO 2008 report already linked to. Annex 5 is a summary of the health complications, with citations to research studies.”

    Could you provide the link to this please?

    “What are the chronic health consequences that arise from male circumcision/MGM? Are there increased risks reproductive risks to men arising from being circumcised?”

    Besides documented deaths, there are these:

    There are literally hundreds of medical journal articles documenting the complications of circumcision. Some published from 1940 to 1998 are listed below.

    Bleeding after circumcision. Gold S. Canadian Medical Association Journal 1940;43:473.

    Wound diphtheria in the newborn infant following circumcision. Rosenstein JL. Journal of Pediatrics 1941;18:657-658.

    Osteomyelitis of femur (probably due to circumcision) in infant. Altman H. Bulletin of the Hospital for Joint Diseases 1946;7:109-113.

    Tuberculosis of the penis: a report of 5 new cases, and a complete review of the literature. Lewis EL. Journal of Urology 1946;56:737-745.

    Total denudation of the penis. Editor/ Banham. Urologic and Cutaneous Review 1949;53:309.

    Gangrene of penis following circumcision with high frequency current; plastic reconstruction of penis. Hamm WG, Kanthak FF. Southern Medical Journal 1949;42:657-659.

    Reconstruction of penis with split-thickness skin graft; case of gangrene following circumcision for acute balanitis. Thorek P, Paul E. Plastic and Reconstructive Surgery 1949;4:469-472.

    Amputation of the penis as a complication of circumcision. Lerner, BL. Medical Record and Annals 1952;46:229-231.

    Surgical reconstruction of the penis. Brown JB, Fryer MP. GP 1958;17:104-107.

    Plastic repair of the denuded penis. Wilson CL, Wilson MC. Southern Medical Journal 1959;52:288-290.

    Excessive penile skin loss from circumcision. Van Duyn J, Warr WS. Journal of the Medical Association of Georgia 1962;51:394-396.

    Meatal ulceration following neonatal circumcision. MacKenzie AR. Obstetrics and Gynecology 1967;28:221-223.

    Hazards of circumcision. Editor. Practitioner 1967;198:611.

    Glans necrosis as a complication of circumcision. Rosefsky JB. Pediatrics 1967:39:774-776.

    Penile urethral fistula as a complication of circumcision. Limaye RD, Hancock RA. Journal of Pediatrics 1968;72:105-106.

    Hazards of plastic bell circumcisions. Malo T, Bonforte RJ. Obstetrics and Gynecology 1969;33:869.

    Thirty years of ritual circumcisions: appraisal of personal experiences, after-care and postcircumcision complications. Schlosberg C. Clinical Pediatrics 1971;10:205-209.

    Circumcision complicated by pulmonary embolism. Curtis JEA. Nursing Mirror 1971;132:28-30.

    Concealed penis: another complication of circumcision. Trier WC, Drach GW. American Journal of Diseases of Children 1973;125:276-277.

    Impotence and adult circumcision. Stinson JM. Journal of the National Medical Association 1973;65:161,179.

    Preputial skin-bridging: complication of circumcision. Klauber GT, Boyle J. Urology 1974;3:722-723.

    Neonatal septicemia after circumcision. Kirkpatrick BV, Eitzman DV. Clinical Pediatrics 1974;13:767-768.

    Complication of ritual circumcision in Israel. Frand M, Berant N, Brand N, Rotem Y. Pediatrics 1974;54:521.

    Ablatio penis: normal male infant sex-reassigned as a girl. Money J. Archives of Sexual Behavior 1975;4:65-71.

    Urinary retention due to ritual circumcision. Berman W. Pediatrics 1975;56:621.

    Reconstruction following iatrogenic burn of the penis. Pearlman CK. Journal of Pediatric Surgery 1976;11:121-122.

    Abdominal distension following ritual circumcision. Horwitz J, Schussheim A, Schalettar HW. Pediatrics 1976;57:579.

    Iatrogenic microphallus secondary to circumcision. Levitt SB, Smith RB, Ship AG. Urology 1976;8:472-474.

    Neonatal meningitis and circumcision. Scurlock JM, Pemberton TJ. Medical Journal of Australia 1977;1:332-334.

    Circumcision and obstructive renal disease. Linshaw MA. Pediatrics 1977;59:790.

    Staphylococcal scalded skin syndrome: a complication of circumcision. Annunziato D, Goldblum LM. American Journal of Diseases of Children 1978;132:1187-1188.

    Impotence following anesthesia for elective circumcision. Palmer JM, Link D. Journal of the American Medical Association 1979;241:2635-2636.

    Gangrene of the penis after circumcision. Du Toit DF, Villet WT. South African Medical Journal 1979;55:521-522.

    Overwhelming infection with Group B Beta-Hemolytic streptococcus associated with circumcision. Cleary TG, Kohl S. Pediatrics 1979;64:301-303.

    The case against neonatal circumcision. Fleiss PM, Douglass J. British Medical Journal 1979;2:554.

    Necrotizing fasciitis after neonatal circumcision. Woodside JR. American Journal of Diseases of Children 1980;134:301-302.

    Circumcision disasters. Cleary TG, Kohl S. Pediatrics 1980;65:1053-1054.

    Successful replantation of a traumatically amputated penis in a neonate. Izzidien AY. Journal of Pediatrics 1981;16:202-203.

    Necrosis of the glans penis following neonatal circumcision. Sterenberg N, Golan J, Ben-Hur N. Plastic and Reconstructive Surgery 1981;68:237-236.

    Plastic reconstruction of partially amputated penis at circumcision. Hanash KA. Urology 1981;18:291-293.

    Staphylococcal scalded skin syndrome: a complication of circumcision. Anday EK, Kobori J. Clinical Pediatrics 1982;21:420.

    Myocardial injury following immediate postnatal circumcision. Ruff ML, Clarke TA, Harris JP, Bartels EK, Rosenzweig M. American Journal of Obstetrics and Gynecology 1982;144:850-851.

    Penile adhesion: the hidden complication of circumcision. Gracely-Kilgore KA. Nurse Practitioner 1984;9:22-24.

    Acute gangrene of the scrotum in a one month old child. Evbuamwan I, Aliu AS. Tropical and Geographical Medicine 1984;36:299-300.

    Penoplasty for buried penis secondary to radical circumcision. Radhakrishnan J, Reyes HM. Journal of Pediatrics 1984;19:629-631

    Penile denudation injuries after circumcision. Sotolongo JR Jr, Hoffman S, Gribetz ME. Journal of Urology 1985;133:102-103.

    Complications de la circoncision rituelle [Complications of ritual circumcision]. Gross PH[?], Pages R, Bourdelat D. Chirurgie Pédiatrique 1986;27:224-2265.

    Impetigo in newborn infants associated with a plastic bell clamp circumcision. Stranko J, Ryan ME, Bowman AM. Pediatric Infectious Disease Journal 1986;5:597-599.

    Tachycardia and heart failure after ritual circumcision. Mor A, Eshel G, Aladjem M, Mundel G. Archives of Disease in Childhood 1987;62:80-81.

    Circumcision complications and indications for ritual recircumcision – clinical experience and review of the literature. Breuer GS, Walfisch S. Israel Journal of Medical Sciences 1987;23:252-256.

    Mechanical complications of circumcision with a Gomco clamp. Feinberg AN, Blazek MA. American Journal of Diseases of Children 1988;142:813-814.

    Methemoglobinemia following neonatal circumcision. Mandel S. Journal of the American Medical Association 1989;261:702.

    Total ablation of the penis after circumcision with electrocautery: a method of management and long-term followup.Gearhart JP, Rock JA. Journal of Urology 1989;142:799-801.

    Scrotal abscess with bacteremia caused by salmonella Group D after ritual circumcision. Uwyyed K, Korman SH, Bar-Oz B, Vromen A. Pediatric Infectious Disease Journal 1990;9:65-66.

    Ruptured bladder following circumcision using the Plastibell device. Jee LD, Millar AJW. British Journal of Urology 1990;65:216-217.

    Skin bridge – a complication of paediatric circumcision. Sathaye UV, Goswami AK, Sharma SK. British Journal of Urology, 1990;66:214.

    Gastric rupture associated with prolonged crying in a newborn undergoing circumcision. Connelly KP, Shropshire LC, Salzberg A. Clinical Pediatrics 1992;31:560-561.

    Toxic methaemoglobinaemia after circumcision. Ozbek N, Sarikayalar F. European Journal of Pediatrics 1993;152:80.

    Keloid of the penis after circumcision. Warwick DJ, Dickson WA. Postgraduate Medical Journal 1993;69:236-237.

    Phallic construction in prepubertal and adolescent boys. Gilbert DA, Jordan GH, Devine CJ Jr, Winslow BH, Schlossberg SM. Journal of Urology 1993;149:1521-1526.

    Pathogenesis of post-circumcision adhesions. Attalla MF, Taweela NM. Pediatric Surgery International 1994;9:103-105.

    Botched circumcisions. Miya PA. American Journal of Nursing 1994;94:56.

    Penile reconstruction following post-circumcision penile gangrene. Ahmed S, Shetty SD, Anandan N, Patil KP, Ibrahim A.I.A. Pediatric Surgery International 1994;9:295-296.

    Buried penis as a contraindication for circumcision. Alter GJ, Horton CE Jr; Horton CE. Journal of the American College of Surgeons 1994;178:487-490.

    Male ritual circumcision resulting in acute renal failure. Eason JD, McDonnell M, Clark G. British Medical Journal 1994;309:660-661.

    Iatrogenic penile gangrene: 10-year follow-up. Kural S. Plastic and Reconstructive Surgery 1995;95:210-211.

    Clinical presentation and pathophysiology of meatal stenosis following circumcision. Persad R, Sharma S, McTavish J, Imber C, Mouriquand PD. British Journal of Urology 1995;75:91-93.

    Newborn penile glans amputation during circumcision and successful reattachment. Gluckman GR, Stoller ML, Jacobs MM, Kogan BA. Journal of Urology 1995153:778-779.

    Serious complications of routine ritual circumcision in a neonate: hydro-ureteroephrosis, amputation of glans penis, and hyponatraemia. Kanukoglu A, Danielli L, Katzir Z, Gorenstein A, Fried D. European Journal of Pediatrics 1995;154:314-315.

    Bipolar diathermy haemostasis during circumcision. Marsh SK, Archer TJ. British Journal of Surgery 1995;82:533.

    Amputations with use of adult-size scissors-type circumcision clamps on infants. Editor. Health Devices 1995;24:286-287.

    Amputation of distal penile glans during neonatal ritual circumcision – a rare complication. Neulander E, Walfisch S, Kaneti J. British Journal of Urology 1995;77:924-925.

    Partial amputation of glans penis during Mogen clamp circumcision. Strimling BS. Pediatrics 1996;97:906-907.

    Circumcision: successful glanular reconstruction and survival following traumatic amputation. Sherman J, Borer JG, Horowitz M, Glassberg KI. Journal of Urology 1996;156:842-844.

    Sex reassignment at birth: long-term review and clinical implications. Diamond M, Sigmundson K. Archives of Pediatrics and Adolescent Medicine 1997;151:298-304.

    Amputation of the penis during traditional circumcision. Ameh EA, Sabo SY, Muhammad I. Tropical Doctor 1997;27:117.

    Necrotizing fasciitis after plastibell circumcision. Bliss DP Jr, Healey PJ, John HT Waldhausen. Journal of Pediatrics 1997;131:459-462.

    Surgical repair of urethral circumcision injuries. Baskin LS, Canning DA, Snyder III HM, Duckett Jr JW. Journal of Urology 1997;158:2269-2271.

    Reconstruction of the penis after necrosis due to circumcision. Belkacem R, Amrani A, Benabdellah F, Outarahout O. Ann-Urol-Paris 1997;31(5):322-5.

  89. Robert Samson says:

    ““If you don’t want to circumcise your sons, don’t do it. If you don’t think the benefits outweigh the risks, don’t do it. Just don’t claim that there are no medical benefits when there are real benefits.”

    Gee, how many times have we heard this claim of real benefits?–MANY,

    and how many times have circumcision advocates supported the claim with scientifically credible evidence of even one benefit?–NONE.

  90. Robert Samson says:

    “What are the chronic health consequences that arise from male circumcision/MGM? Are there increased risks reproductive risks to men arising from being circumcised?”

    Again, here is an attempt to limit the consequences from circumcision..

    Reproduction is not the only parameter we need to consider–we need to consider sexual fulfillment–and that is impeded with the loss of sensation and sensitivity.

    And what about erectile impairment? Should we not also consider this?

  91. Fifi says:

    nick – Nick – “Those who promote ethical and legal practices have no need to be accountable for their words and actions.”

    zoe – “People are attracted to extremist ideologues because it practically gives them permission to not have to think critically.”

    Well said zoe and it appears to be as true of Dr Tuteur as the rabid anti-circ posters here (who give themselves away by using the usual tactics of those ideologically opposed to the practice of good science and reality-based thinking and discussion). Apparently neither is willing to take responsibility for their words or actions! Nor do either really want a rational discussion based upon science.

  92. Robert Samson says:

    I just happened to notice that Amy is an obygyn? Perhaps the fact that most circumcisions are done by them might be a motive in her promotion of circumcision?

    When they say it is not the money–it is the money.

  93. Robert Samson says:

    “Link for WHO 2008″

    Thanks, interestingly ALL of these factors also occur in MGM–and there are extensive studies documenting prevalence.

    So again, rationally, why should FGM be illegal and not MGM?

  94. Fifi says:

    Nick – “Those who promote ethical and legal practices have no need to be accountable for their words and actions.”

    zoe – “People are attracted to extremist ideologues because it practically gives them permission to not have to think critically.”

    Well said zoe and obviously equally true of Dr Tuteur and the extremist ideologues who are anti-circ. Both seem proud of the fact that they don’t think critically, while they’re both busy abusing science and pretending to be critical thinkers promoting a science-based position.

    It looks like the extremist on the anti-circumcision side are using the usual tactics employed by anti-vaxers of trying to flood the forum so discussion is now futile. It’s pretty obvious that neither side actually cares about people or anyone’s suffering, particularly if it intrudes upon their narcissistic promotion of their ideological position (and attention seeking, both Tuteur and the evangelical/ideological trolls seem to have that as their primary agenda and then are pretending that they’re doing this for others and have the moral high ground…I say moral because the taint of evangelicism lingers over both as they try to abuse science to support their ideological position).

  95. Fifi says:

    And to repeat what should be obvious but apparently isn’t to some, the very essence of being ethical is being accountable for one’s words and actions.

  96. Plonit says:

    Sorry, that should have read reproductive *health* risks. I was referring to the increased risks of childbirth for women who have had FGM. AFAIK, male circumcision does not result in long-lasting and ongoing health risks for men who decide to reproduce.

    What is the evidence that circumcision makes a difference either to sexual function or sexual pleasure?

    Pleasure is subjective. It makes sense to say “You haven’t lost as much blood as you think you have” – because we can measure that objectively. It doesn’t make sense to say “You haven’t had as much pleasure as you you think/feel you’ve had” – because pleasure is defined by the person experiencing it. Therefore, the fact that the skin removed contains a lot of nerve endings may be suggestive of reduced pleasure, but whether it actually reduced pleasure for men in the real world (as opposed to looking at cells under a microscope) would be the research question. Where is the evidence that it does?

    Similarly, where is the evidence that circumcision causes erectile impairment?

    You list a large number of commentaries and some studies. But an equally large number could be listed to show the benefits of circumcision.

    When I look at studies showing benefits of circumcision, I find them deficient in various ways (in particular, the lack of attention to absolute risk reduction and whether the benefits are clinically significant, rather than merely statisitcally significant, the failure to compare circumcision with conservative treatments rather than ‘no action’, and so forth). The huge *quantity* of studies showing benefits of circumcision do not, in my view, provide a basis for recommending routine infant circumcision.

    Similarly, when I look at the totality of studies showing harms of circumcision, I find them dificient in various ways. The huge *quantity* of studies showing harms of circumcision do not, in my view, provide a basis for prohibiting routine infant circumcision.

    The point is not to list the studies, but to evaluate their quality. This is what I invited you to do in relation to WHO 2008 (“I think these research studies need to be discussed dispassionately and impartially, and if you think they are wrong – then let’s discuss that.”) Similarly, we can discuss the research strengths and weaknesses on male circumcision harms.

    I am surprised to see an activist for prohibition of male circumcision seek to undermine claims of harm of FGM, given the way the the harms of FGM are usually used rhetorically by campaigners for prohibiting male circumcision/MGM. Frankly, if you successfully persuade me that the harms of FGM are no greater than the harms of male circumcision/MGM, I would have to conclude that the former should not be prohibited.

  97. Plonit says:

    Perhaps the fact that most circumcisions are done by them might be a motive in her promotion of circumcision?

    +++++++++++

    Amy Tuteur hasn’t been an Obgyn since 1994.

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