The Circumcision Discussion - page 10

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My... Read More

  1. by   ZASHAGALKA
    If this data regarding circumcision proves to be true, AND if the Catholic church, as it is considering, relaxes its stance on condom use (not for birth control purposes, but for infection control purposes) then maybe some real tools can be brought to bear to stem this epidemic in Africa and Asia.

    At issue is neither how circs are viewed in the West, nor birth control in the Church. Neither position is threatened by arming people with the tools to save their lives in affected areas.

    And THAT is the issue that matters most: the real and desperate need for tools to save the lives of countless victims in epidemic nations.

    Indeed, this study was SO promising, that NIH ended the study early in order to offer circumcisions to its control population.

    ~faith,
    Timothy.
  2. by   Jelli_Belli
    Circumcision is a barbaric, cruel, and unneccesary procedure inflicted on baby boys by an undereducated public. The foreskin is not a vestigial organ. It is an important part of the male reproductive system and provides several important services:
    1. It contains tens of thousands of nerve endings and plays a large role in the sensation of reaching climax for males. Removal of the foreskin not only lessens sexual pleasure, it can lead to ejaculatory problems (esp. for males that are circumcised late in life.)
    2. The penis is NOT an external organ. It was designed to be housed inside the foreskin. This helps prevent injury and keeps the penis lubricated.
    3. The foreskin also helps prevent UTI in males by keeping the head of the urethra covered and away from bacteria covered foreign bodies (ie. pants and undershorts).
    There is no credible evidence that circumcison prevents any disease that proper hygiene and safe sexual practices can not prevent 10 times better.
    So why do people continue to want to torture (and make no mistake, circumcising a baby is torture) their newborn child? Circumcision is a traditional Jewish procedure linked to a passage in the old testament. Circumcison here in the US was instituted during the Victorian era by religious heads that felt that by removing the sensitive area on the penis, they could prevent little boys from touching themselves and masturbating (sounds kind of familiar to female genital mutilation, doesn't it?). I think that most every sensible person out there would agree that this is rubbish, so why does circumcision remain so prevalant?
    Aesthetics and conformity. Parents are so concerned with what their children will look like and how they will be perceived by the public that they are willing to strap a baby to a board and let someone slice a part of their body off with a razor. I find it shamful that this society has such a disdain for the natural state of the body. We dye our hair, fake tan, fake boobs, botox, a thousand types of plastic surgery, and mutiliate the genitals of our young all in some quest of what society finds "desirable" for a body to look like.
    Lets not forget the financial side of things too. Circumcision is a 400 million dollar business. Common sense tells us that a MD is going to advocate for any procedure that they will be paid for. Circumcision is a fast and profitable way for 0B's and Pediatricians everywhere to make a buck.
    We live in a time when most people are enlightened enough to realize that female genital mutilation is a human rights violation and find it a repulsive practice, but in the same breath can advocate for the same thing on a male child. Where is the logic in that?
  3. by   ZASHAGALKA
    Quote from Jelli_Belli
    Circumcision is a barbaric, cruel, and unneccesary procedure inflicted on baby boys by an undereducated public. The foreskin is not a vestigial organ. It is an important part of the male reproductive system and provides several important services:
    1. It contains tens of thousands of nerve endings and plays a large role in the sensation of reaching climax for males. Removal of the foreskin not only lessens sexual pleasure, it can lead to ejaculatory problems (esp. for males that are circumcised late in life.)
    2. The penis is NOT an external organ. It was designed to be housed inside the foreskin. This helps prevent injury and keeps the penis lubricated.
    3. The foreskin also helps prevent UTI in males by keeping the head of the urethra covered and away from bacteria covered foreign bodies (ie. pants and undershorts).
    There is no credible evidence that circumcison prevents any disease that proper hygiene and safe sexual practices can not prevent 10 times better.
    So why do people continue to want to torture (and make no mistake, circumcising a baby is torture) their newborn child? Circumcision is a traditional Jewish procedure linked to a passage in the old testament. Circumcison here in the US was instituted during the Victorian era by religious heads that felt that by removing the sensitive area on the penis, they could prevent little boys from touching themselves and masturbating (sounds kind of familiar to female genital mutilation, doesn't it?). I think that most every sensible person out there would agree that this is rubbish, so why does circumcision remain so prevalant?
    Aesthetics and conformity. Parents are so concerned with what their children will look like and how they will be perceived by the public that they are willing to strap a baby to a board and let someone slice a part of their body off with a razor. I find it shamful that this society has such a disdain for the natural state of the body. We dye our hair, fake tan, fake boobs, botox, a thousand types of plastic surgery, and mutiliate the genitals of our young all in some quest of what society finds "desirable" for a body to look like.
    Lets not forget the financial side of things too. Circumcision is a 400 million dollar business. Common sense tells us that a MD is going to advocate for any procedure that they will be paid for. Circumcision is a fast and profitable way for 0B's and Pediatricians everywhere to make a buck.
    We live in a time when most people are enlightened enough to realize that female genital mutilation is a human rights violation and find it a repulsive practice, but in the same breath can advocate for the same thing on a male child. Where is the logic in that?
    A perfectly catched argument by those that oppose circumcision for asthetic/hygienic reasons. I could debate some of the points, but, since it is obviously, by your choice of words, a very personal matter to you, there is no point.

    It is also not at issue here.

    Circumcision to protect against life depriving and society wrecking disease processes is NOT about asthetics. This is not about a newfound Western athetics debate, but about saving lives in areas of the world that don't have the luxuries at their disposals that would lead to cultures that can afford to spend their time arguing asthetics. The SAME luxuries that allow us to spend our time arguing these asthetics also afford us the medications and treatments to NOT have to consider the costs of such positions, if our morality is enforced on other parts of the world.

    For the record: I'm HIGHLY educated and all 3 of my boys are circ'd, but again, that's not the point; saving lives is the point. Just because someone disagrees with you does not mean that they are ignorant and just need more education. That rationale only supports positions where there is a need, within the argument, to deny a valid, if opposite, point of view. In this case, the need comes directly from the position being a minority position. Ultimately, it becomes a circular argument: I'm right because those that disagree with me are wrong.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Dec 14, '06
  4. by   GardenDove
    I didn't circumcize my sons, but I think the above post detailing the barbarity of circumcision is highly exaggerated.

    Circumcision was popularized in the United States in the 1920's as a preventative for masturbation. Masturbation was feared in those days and it was thought that circumcision reduced the need for a boy to touch his genitals, and that was how it got started.

    The best preventative for HIV is monogamy. Regarding the Catholic Church, I doubt if those men who are fornicating without condoms are paying much attention to Catholic doctrines on sexual morality. I don't know how people manage to blame the Catholic Church for AIDS in Africa, it's a really shaky connection.
  5. by   ZASHAGALKA
    Quote from GardenDove
    I didn't circumcize my sons, but I think the above post detailing the barbarity of circumcision is highly exaggerated.

    Circumcision was popularized in the United States in the 1920's as a preventative for masturbation. Masturbation was feared in those days and it was thought that circumcision reduced the need for a boy to touch his genitals, and that was how it got started.

    The best preventative for HIV is monogamy. Regarding the Catholic Church, I doubt if those men who are fornicating without condoms are paying much attention to Catholic doctrines on sexual morality. I don't know how people manage to blame the Catholic Church for AIDS in Africa, it's a really shaky connection.
    I haven't blamed the Catholic Church for anything. Even if I disagree with it, I consider the Church's stance on birth control to be a principled decision. But, with ANY such decision lies the constant vigilance to continually evaluate the costs of that decision.

    The Church it seems, is doing JUST that. Far from placing blame, I applaud the fact that they take their positions seriously enough to evaluate the costs of those decisions. Whatever decision they finally reach, I'm glad they are having the debate, amongst themselves.

    IF the Catholic Church relaxes its position on condoms as infection control (without giving ground on its position of condoms as birth control) it could go far towards abetting some of the problems in Africa/Asia. Stigmas are powerful things, purposely designed TO BE powerful, to attain the desired effect. As such, the Church has vast power to effect the treatment/prevention of HIV in its role of being the arbiter of this particular stigma.

    It's not the Catholic Church's 'fault' that HIV is rampant in Africa/Asia, but the Church has within its power to mitigate the effects. Cure in the vehicle of prevention is not cause. I applaud them for reconsidering their role in the cure; I have not blamed them as the cause.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Dec 14, '06
  6. by   RN mom of 2
    Quote from Jelli_Belli
    Circumcision is a barbaric, cruel, and unneccesary procedure inflicted on baby boys by an undereducated public. The foreskin is not a vestigial organ. It is an important part of the male reproductive system and provides several important services:
    1. It contains tens of thousands of nerve endings and plays a large role in the sensation of reaching climax for males. Removal of the foreskin not only lessens sexual pleasure, it can lead to ejaculatory problems (esp. for males that are circumcised late in life.)
    2. The penis is NOT an external organ. It was designed to be housed inside the foreskin. This helps prevent injury and keeps the penis lubricated.
    3. The foreskin also helps prevent UTI in males by keeping the head of the urethra covered and away from bacteria covered foreign bodies (ie. pants and undershorts).
    There is no credible evidence that circumcison prevents any disease that proper hygiene and safe sexual practices can not prevent 10 times better.
    So why do people continue to want to torture (and make no mistake, circumcising a baby is torture) their newborn child? Circumcision is a traditional Jewish procedure linked to a passage in the old testament. Circumcison here in the US was instituted during the Victorian era by religious heads that felt that by removing the sensitive area on the penis, they could prevent little boys from touching themselves and masturbating (sounds kind of familiar to female genital mutilation, doesn't it?). I think that most every sensible person out there would agree that this is rubbish, so why does circumcision remain so prevalant?
    Aesthetics and conformity. Parents are so concerned with what their children will look like and how they will be perceived by the public that they are willing to strap a baby to a board and let someone slice a part of their body off with a razor. I find it shamful that this society has such a disdain for the natural state of the body. We dye our hair, fake tan, fake boobs, botox, a thousand types of plastic surgery, and mutiliate the genitals of our young all in some quest of what society finds "desirable" for a body to look like.
    Lets not forget the financial side of things too. Circumcision is a 400 million dollar business. Common sense tells us that a MD is going to advocate for any procedure that they will be paid for. Circumcision is a fast and profitable way for 0B's and Pediatricians everywhere to make a buck.
    We live in a time when most people are enlightened enough to realize that female genital mutilation is a human rights violation and find it a repulsive practice, but in the same breath can advocate for the same thing on a male child. Where is the logic in that?
    HALLELUJAH!!!

    I am SO with you on this. I witnessed a circ in nursing school that shook me to my core. Ever see a tiny baby pass out from the intensity of the pain? I did...and it was mortifying!

    When I got pg with my first son I researched high and low to find one good reason to circ my son. After the torture I witnessed I desperately needed one. I could not find any reason good enough to circ either one of my boys, including, because my husband is circumcised. To me, it's the least convincing argument of all. A person's genitalia is their business and no one else's. Who cares what another person's penis looks like? Women don't run around checking out each other's labias! My 4 yo has had zero problems being intact, because I follow the golden rule...leave it alone! The 8 mo is also fine.

    A far as the study goes, it's good to know in order to inform intact boys of the possible added risk, in the hopes that they will be extra careful when they become sexually active. I'm glad to know this information for that reason. It's something they should be doing anyway, because there is a lot to protect themselves from, including, unwanted pregnancies. I think that education and taking measures to control the transmission are the best ways to change what's happening in these countries. I do not believe that cutting off an integral part of a boy's penis is the way to go about it.

    Unfortunately, it's important for circ advocates to find ways to perpetuate the myth that circ's are a necessary medical procedure. This is the kind of thing they will grab on to and use to try and scare new parents into circumcising their sons. This kind of thing really bothers me. So many circ myths are being debunked and the circ rate has been dropping, but this sort of thing may drive them back up.

    Mainly, I find the practice completely barbaric, and all these boys will never know what has been taken from them. Also, they still aren't sure how the pain of the circ may permanently affect their developing brains. The newborn brain is a blank slate, and some believe intense pain may cause permanent negative pathways to form in their brains. Who knows how this may affect boys throughout their lives? Maybe it's one of the reasons some men are so angry and violent? Just a thought.

    I could go on and on about this subject...but I'll put a cork in it for now. :wink2:
  7. by   bookwormom
    I will accept that circumcized males have lower incidences of HIV, for whatever reason. And I think in some African countries, circumcision of adult males is being promoted for that reason. Here are two questions:

    1) Could the male circumcized as an adult have a false sense of security and use condoms even less?

    2) What are the risk factors for complications in adult circumcisions?
  8. by   ZASHAGALKA
    Quote from bookwormom
    I will accept that circumcized males have lower incidences of HIV, for whatever reason. And I think in some African countries, circumcision of adult males is being promoted for that reason. Here are two questions:

    1) Could the male circumcized as an adult have a false sense of security and use condoms even less?

    2) What are the risk factors for complications in adult circumcisions?
    The South African study in 2004 did indeed site that a false sense of security lead to greater numbers of sexual encounters for the circumcised group. EVEN SO, the risks were cut in half. Taking that into account leads to protection rates approaching 60-70%.

    The study also looked at risk. It determined that circumcision is a well known procedure in all parts of the world, even parts where it is not primarily practiced. It could serve to offer rates of protection equal to a vaccine with less side effects (or less fatal side effects) then a vaccine. Since it is a one time treatment, it would be considered more effective then condoms and abstinence, both subject to periodic 'failures'.

    Another factor that the study discussed is that, while the protection to women is incidental to their partners, it is a real protection that could lead to preferential choices that would serve to encourage the cultural advantage of circumcision.

    Of note, there are two studies here: the S. African study in 2004 and the Sub-Saharan studies in 2 locales that ended this year. All 3 locales showed 50% or greater improvement.

    It has been known for years that in areas of Africa that routinely practice male circumcision (and several areas do, be it for tribal, cultural or religious (Muslim) reasons), that the incidence of HIV is lower. These studies sought to recreate the effect of circumcision in cultures and areas that have a higher incidence of HIV. The goal was to isolate circumcision as the causitive factor in the decrease.

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Dec 14, '06
  9. by   ZASHAGALKA
    Are We Ready For Circumcision: The Role of Circumcision as a Potential Preventive Measure to Stop the Spread of HIV Infection

    "A systematic meta-analysis of 38 studies, mostly in Africa, found that circumcised men appear to have a 50% or more reduction in HIV infection than did uncircumcised men. A sub-analysis of 16 of these studies found a 70% reduction in HIV infection among higher-risk men. Mapping of the HIV epidemic has demonstrated a strong correlation between regions with higher rates of HIV infection and those with lower circumcision rates. A 2-year cohort study of male partners of HIV-positive women in Rakai, Uganda, found that 40 of 137 uncircumcised men became infected compared with 0 of 50 circumcised men over 2.1 years (p = 0.0004).

    Biological explanations include greater ability of the internal foreskin to absorb HIV more efficiently due to the greater presence of Langerhans and other HIV target cells and its greater susceptibility to tears, abrasions, and consequently infection by sexually transmitted diseases and HIV. One randomized controlled trial in South Africa demonstrated that circumcision afforded a 61% (95%CI 34 to 77%) reduction in HIV incidence even after controlling for behavioral factors; and 2 similar trials in Uganda and Kenya are in progress."


    ~faith,
    Timothy.
  10. by   Josh L.Ac.
    Quote from ZASHAGALKA
    The above is not only a 7 yr old article, it is one from an anti-circumcision site. It's expressed purpose seems to be to rebut evidence, even then, that circumcision was noted to decrease HIV transmission.

    At first glance, the article (it can't really be called a study) mentions its specific biases against circumcision. It tries to overfit direct and simplistic correlations into its analysis: for example, that the U.S. has higher HIV rates than Europe because circumcision leads to less sensation and so, less use of condoms. But, that simplistic correlation ignores that fact that Israel, with even HIGHER circumcision rates, have far less percentages of HIV rates - so, the direct comparison the article tries to force with the U.S. doesn't hold. Obviously, there are other cultural issues at play in the use of condoms. For example, one could be religious: the Catholic church has a principled stance against the use of condoms and Israel doesn't have nearly as large Catholic populations.

    The article specifically leaves out areas where HIV is rampant. While it might be nice to compare Western nations and HIV rates, that says NOTHING about HIV rates and Africa and Asia. Indeed, the argument the poster makes is why not study it in the West? Increased access to condoms, privacy concerns, and aggressive treatment regimens make it more difficult to study in the West. In any case, the BEST place to study any epidemic is in epidemic areas.

    Finally, I'll take an unbiased, contemporary, controlled study over a 7 yr old analysis by a vested party, any day.

    From the FAQ on the site quoted above's main webpage: "Although there is an apparent geographical correlation between male non-circumcision and HIV infection on the African continent, this is not true globally, and the pattern seen in Africa could easily be due to other factors."

    Fine, I'll accept the above reasoning. I'm not on a campaign to increase the number of circumcisions performed in the U.S. IF the above statement from CIRP is correct then, lacking evidence of the 'other factors' that reduce HIV transmission, circumcision in those nations seems like a prudent method to facilitate those 'other factors'.

    This finding is not at issues or odds with the 'circ or not circ' debate in the States. Whatever the reasons for not circ'ing a child, those reasons do not compare with saving the lives of children (and adults) in nations where HIV remains epidemic and where the resources (ARVs) to treat it simply aren't available.

    ~faith,
    Timothy.
    Even if your statement is true, the article does bring up a great point: even if circumcision is effective at reducing HIV/AIDS, does the cost of it + the risk of complications from the surgery make it a viable option?

    If one assumes that circumcision does not prevent some cases of HIV infection, what impact would universal circumcision have? Using the data provided by Seed et al.43, the relative risk of developing HIV infection is 1.37 times greater in the male with a foreskin, and 27% of HIV cases might be attributed to this factor. With an AIDS prevalence in the United States of 16 per 100,0005 and an attributable risk of 27%, it would take 23,148 circumcisions to prevent one case of AIDS. In Australia and the UK, it would take 82,304 and 154,320 circumcisions respectively to prevent one case of AIDS. One could expect 46, 165, and 308 life-threatening complications in the US, Australia, and UK respectively, for each case of AIDS prevented72. In a developing country, the risks of tetanus, tuberculosis, infection, exsanguination, amputation, and death from circumcision would outweigh the benefit of preventing a small number of HIV infections.
  11. by   ZASHAGALKA
    Quote from Josh L.Ac.
    Even if your statement is true, the article does bring up a great point: even if circumcision is effective at reducing HIV/AIDS, does the cost of it + the risk of complications from the surgery make it a viable option?
    The risk might not be worth saving a 'few' HIV infections in the West. In fact, I haven't advocated or seen this advocated as a treatment in the West. WE have the luxury of antiretrovirals and similar treatments. So, the risk/benefit in the West is simply not at issue.

    Africa/Asia is a different story altogether. The potential there is to save thousands and thousands of HIV infections. The cost/benefit ratio THERE would be astronomically in favor of circumcision. Some of these studies point to upwards of a 70% reduction in HIV transmission. When 2/3rd of the 40 million world wide HIV cases exist in that region, you are are talking about demographic risk reduction in the millions.

    What would YOU advocate for if it would save millions of lives? Would you hold our relative morality regarding our cultural norms and values regarding circumcision as more important a concept then those lives? (those are general questions not directly pointed towards the OP above.)

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Dec 14, '06
  12. by   CHATSDALE
    the idea that circumcision was begun to prevent masturbation is completely out of the loop..cleanliness was believe to easier and is probably the primary reason that this study showed the results that it did
    the longer the virus remained in contact with penis the more likely it would be to enter host body
    and i thinkthat men have a sexual drive regardless of foreskin or no
    i am not for or against circumcision but sometimes facts get mixed with passion
  13. by   ZASHAGALKA
    Quote from CHATSDALE
    the idea that circumcision was begun to prevent masturbation is completely out of the loop.
    In any case, it doesn't work, and I doubt we need double blind studies to prove THAT. Speaking of being 'blind' . . . I wonder if circumcision leads to decreased incidents of sudden onset adolescent blindness?

    ~faith,
    Timothy.
    Last edit by ZASHAGALKA on Dec 14, '06

close