Nordic countries may finally ban circumcision.

[jdp]

This paper which is pro-circumcision says that despite penile cancer being much higher in the non-circumcised, rates of penile cancer are still sliightly lower in Denmark (with a 2% circumcision rate) than they are in the US. So obviously there are other factors that also have a huge influence - good hygiene and socio-econimic status for example. The HPV vaccine will probably also have an effect on rates.

http://www.hindawi.com/journals/au/2011/812368/

My opinion of the matter is that given even only small risks, routine circumcision is not justified to reduce the incidence of what is a rare cancer in the western world (similar in incidence to male breast cancer, I believe) - the NNT must be huge. I would consider it as a targetted procedure for individuals with a strong family history of the disease, but not recommend it as routine.

I have read that the HPV vaccine is expected to have a very strong impact in that regard, it should deprecate any notion that circumcision has any relavence or usefulness with regard to HPV.

 

[The Big Dog]

There has not been one person in this thread that has argued for the banning of any medical procedures. So I doubt you will get anyone to argue for your strawman.

Looks at title of thread:

"Nordic countries may finally ban circumcision."

Looks back at your post.

Can you explain your statement, Darat?

 

[Rat]

Looks at title of thread:

"Nordic countries may finally ban circumcision."

Looks back at your post.

Can you explain your statement, Darat?

I imagine that he is saying that circumcision is not proposed to be banned where it is deemed medically necessary.

 

[Darat]

As has already been pointed out, circumcision is (or was) common in the US. I asked my mother about it, and she said she never gave it a second thought- it was custom at the time (the 60s/70s).

Religion had little to do with it, if not nothing. I was raised Catholic.

Genital mutilation only became mainstream in the USA thanks to the likes of Kellogg and the anti-masturbation proponents.

Unfortunately their wonky puritan inspired pseudoscience is still influencing many, which means that many males in the USA have to live with having their penis scarred for life.

The only "upside" is that the mutilated penis has been normalised in US culture and society so there is no stigma to having a scarred penis.

 

[Safe-Keeper]

I think Darat has a different definition of "medical procedure" than you do.

 

[Safe-Keeper]

The last thing we need is authoritarians enacting more governmental regulation regarding private medical decisions...

When I hear "private decisions" I think "decisions that affect only you". Circumsicion of an infant doesn't exactly fall in under this definition, in my eyes.

...let alone banning medical procedures.

So, similar operations are okay, too, then? I can give my child a tattoo, or remove her clitoris foreskin, while she is still an infant?

Thought not.

 

[The Big Dog]

I imagine that he is saying that circumcision is not proposed to be banned where it is deemed medically necessary.

I see. Considering that Darat is posting, one would have expected that Darat could have explained that.

Now we reach the next question, who exactly is going to make the decision regarding whether or not it is medically necessary.

You'll forgive me for not wanting someone who characterizes circumcised men as having suffered "genital mutilation" as being involved in the process regarding whether my children should be circumcised.

 

[The Big Dog]

So, similar operations are okay, too, then? I can give my child a tattoo, or remove her clitoris foreskin, while she is still an infant?

Thought not.

Did your doctor recommend that your child be tattooed or her clitoris foreskin be removed?

 

[Rat]

I see. Considering that Darat is posting, one would have expected that Darat could have explained that.

Now we reach the next question, who exactly is going to make the decision regarding whether or not it is medically necessary.

You'll forgive me for not wanting someone who characterizes circumcised men as having suffered "genital mutilation" as being involved in the process regarding whether my children should be circumcised.

Well, you don't need my forgiveness, of course, but circumcision is unquestionably mutilation. Whether one suffers it depends, I suppose, on which definition of 'suffer' you're using.

 

[The Big Dog]

Well, you don't need my forgiveness, of course, but circumcision is unquestionably mutilation. Whether one suffers it depends, I suppose, on which definition of 'suffer' you're using.

"mutilation" has clearly emotional, negative implications.

Lets draw a comparison. I had my tonsils removed, would you think it reasonable to characterize my throat as being "mutilated"?

Of course not.

 

[Rat]

"mutilation" has clearly emotional, negative implications.

Lets draw a comparison. I had my tonsils removed, would you think it reasonable to characterize my throat as being "mutilated"?

Of course not.

It can have those connotations. I don't intend them in this context any more than I infer emotional negative implications when I see instructions not to fold, spindle, or mutilate.

 

[The Big Dog]

It can have those connotations. I don't intend them in this context any more than I infer emotional negative implications when I see instructions not to fold, spindle, or mutilate.

Well this is an odd conversation, because I originally was responding to darat, who I noted using the phrase "genital mutilation" to refer to circumcised men.

But, of course, rather than get bogged down in whether his use of that phrase is insulting or at least grossly insensitive, lets get to the real question:

Who exactly is going to make the decision regarding whether or not it is medically necessary.

 

[Rat]

Well this is an odd conversation, because I originally was responding to darat, who I noted using the phrase "genital mutilation" to refer to circumcised men.

But, of course, rather than get bogged down in whether his use of that phrase is insulting or at least grossly insensitive, lets get to the real question:

Who exactly is going to make the decision regarding whether or not it is medically necessary.

The same people that make those decisions in every other case. I'm not sure (sorry to get semantic again) that anyone sane would consider it medically necessary. Perhaps some might consider the cost/benefit differently, but no one sees it as essential other than for religious or cultural reasons.

 

[The Big Dog]

The same people that make those decisions in every other case. I'm not sure (sorry to get semantic again) that anyone sane would consider it medically necessary. Perhaps some might consider the cost/benefit differently, but no one sees it as essential other than for religious or cultural reasons.

Well then who judges the cost/benefits then?

 

[TheGoldcountry]

Removing tonsils would reduce the chance of infection by 100%.
Removing the appendix would reduce the chance of appendicitis by 100%.
Removing the spleen would reduce the chance of a hemorrhage by 100%
Removing the gall bladder would reduce gall stones and infection by 100%

Doctors don't prescribe these at the age of 6 days- ask yourself why.

 

[jdp]

Removing tonsils would reduce the chance of infection by 100%.
Removing the appendix would reduce the chance of appendicitis by 100%.
Removing the spleen would reduce the chance of a hemorrhage by 100%
Removing the gall bladder would reduce gall stones and infection by 100%

Doctors don't prescribe these at the age of 6 days- ask yourself why.

In fact they don't prescribe these for anyone unless there is a clear individual therapeutic need, and only then is the option to proceed given to those who need to make a decision.

 

[Professor Yaffle]

In fact they don't prescribe these for anyone unless there is a clear individual therapeutic need, and only then is the option to proceed given to those who need to make a decision.

Exactly the same as circumcision in countries that aren't still in thrall to tradition. In fact, where used only therapeutically, circumcision is seen as a treatment of last resort, when all other measures have failed.

The NHS mainly funds circumcision that is used to treat a small number of medical conditions (see below). In such cases, circumcision is usually regarded as a "treatment of last resort", when all other treatment options have failed.

http://www.nhs.uk/conditions/Circumcision/pages/introduction.aspx

 

[Wildy]

Who, in Nordic countries, performs circumcision as a rite of passage?

And here I was thinking you were speaking in general terms in response to sadhatter who as far as I can tell was speaking in general terms. Thus I asked my question in a general sense as well.

In answer to your question: no idea. I don't know enough about the demographics of the Nordic countries to say.

 

[jdp]

Exactly the same as circumcision in countries that aren't still in thrall to tradition. In fact, where used only therapeutically, circumcision is seen as a treatment of last resort, when all other measures have failed.

http://www.nhs.uk/conditions/Circumcision/pages/introduction.aspx

As it should be. I find it interesting that in most of medicine, at least as far as I am aware, there is an emphasis on conservative treatments first. In countries where circumcision has strong cultural roots though that idea, where it relates to the male genitalia, is typically dismissed. Especially if there is any hint of a problem but surprisingly enough even when no clear theraputic need exists. It's the classic, I think I only have a hammer problem.

 

[spin0]

BTW, do countries that do not perform routine infant circumcision (eg, most of Europe) have higher rates of AIDS or penile cancer than those that do (eg. the US)? Has anyone done this comparison?

I happen to have done such comparison between the US and my country.

Male population
US: 151.4 million (of 316.8) with about 79% circumcised
Finland: 2.666 million (of 5.442) with less than 5% circumcised

Infant death rate
US: 6.8
Finland: 2.4


HPV
The US estimates of HPV prevalence vary from 14% to more than 90%, so I'm not gonna bother with that. Besides, there's a vaccine against the most harmful types of HPV including 6, 11, 16 and 18.


Penile cancer
US: 1 570 cases/year, rate: 1.04 per 100 000 males
Finland: 13 cases/year, rate: 0.49 per 100 000 males

Penile cancer is a rare condition in both countries. But the US has over double the rate despite having for generations circumcised most of the male infants. Doesn't seem like it has helped them much though.

If we for the sake of the argument suppose the health benefit exists and go by the estimated efficancy of 1 prevented cancer per 322 000 circumcisions per year (Learman,1999) then the US male population would need to get circumcised multiple times to get their cancer rate halved.

I guess it goes without saying that the relevant medical associations and experts in Finland do not condone infant circumcision as a medically justified preventive measure against penile cancer. Sometimes it's good to have rational people in charge. No wait, not just sometimes.


Cervical cancer
US: 2004 estimate 7 per 100,000 women
Finland: 5,4 per 100,000 women
Again the US prevalence is apparently higher, but not by as much.


HIV (did not find the number of HIV infected males in the US)
US: 1.148 million infected, 362 per 100 000
Finland: 2072 infected, 38 per 100 000

The US has almost ten times the rate of HIV infections despite having most of the male infants circumcised for generations.


UTI

Some infants do get UTI and it's generally one of the most common bacterial infections among infants. I haven't found an authorative estimate about the prevalence of UTI among infants and children in the US. One study I found put it at 1.8% in infants which sounds surprisingly high IMO. Yet the estimate I've most often seen quoted is that roughly about 1% of boys and about 3% of girls get it at least once during their childhood. Incidently happens to be the same as estimated in Finland.

So, apparently neither country suffers from an epidemic of UTI among children despite having very different rates of and attitudes towards infant genital mutilation. Over here it is not used as a treatment for UTI because it is not a treatment for it, and it's treatable with antibiotics anyway. Recurring infant and childhood UTIs are much rarer cases and by far most of them are caused by developmental abnormalities in the urinary tract. Those are checked and diagnosed before any possible surgical intervention is planned. For such cases there exists also medication for keeping the UTIs from reoccurring.

No, over here we don't tend to mutilate childrens' genitals after they have born. They receive a gift package instead: Finland’s State-Issued Baby Care Packages Give All Children an Equal Start in Life