The Sensitive Issue of Circumcision

[devnull]

Earlier this week my wife and I found out that we are going to have a boy this October. As we shared the good news, we unknowingly ran smack dab into a debate with very passionate advocates on either side: Were we going to circumcise our son?

Firstly, congrats!

Secondly, I think it's unnecessary.

I myself have a boy due in about a month, he's our third child (after 2 girls).

I myself am circumcised, but I wouldnt ever consider doing it to my child. It is unnecessary, plain and simple. My father was railroaded into having me circumcised by my mother and her jewish doctor (who espoused the non-existent health benefits to the point of making my mother believe that if she didnt have me circumcised it was as good as killing me), and he still regrets it to this day.

Then again, Im kinda biased against unnecessary surgery and body alteration. I suffer from a disease that means I have and will continue to undergo major surgery periodically throughout my life. I even feel the same about ear-piercing, which to me is just some odd leftover tribal thing.

Anyhoo, the answer is: no.

 

[Fiona]

How common are measles mumps and rubella again?

They were very common and very serious before vaccines were developed. They emerge quite quickly when vaccination falls below a critical mass of the population. What is your point?

Are we only talking in western countries, or the whole world here anyway? Circumcision has shown to decrease the transmission of HIV...that seems like a pretty serious and wide spead disease.

It is serious but it is not particularly widespread in the herterosexual population except in Africa. That does not have much relevance for Mr and Mrs Upchurch

It is also suggested through scientific findings that smegma may actually be a carcinogen contributing to cervical cancer.

Yes, I mentioned this in my first post in this thread, I believe. Cleanliness is effective and less drastic in dealing with it: and I note the last sentence of the text you quoted.

Epidermoid cancer of the cervix has been noted in women exposed only to circumcised males and in virgins. Other etiological factors than those involving coitus and lack of circumcision must therefore exist.

There is also the information that has already been supplied in this thread, such as the prevention of prostate cancer,

Prostate cancer rates vary greatly. They are lowest in South and East Asia, higher in Europe - though the rates vary widely between countries - and highest in the United States [44].

Since circumcision is rare in Europe compared to the US this does not make an argument in favour of circumcision. I note also

.some statistically significant associations were found, although these can only be viewed as hypothesis generating in this context."

Not very compelling

uninary tract infections,

Newborn circumcision during the first year of life is, thus, a valuable preventive health measure, particularly in the first 3 months of life, when uncircumcised males are most likely to be hospitalized with severe UTI

Better. But note also from skeptigirls's post

Although the relative risk of UTI in uncircumcised male infants compared with circumcised male infants is increased from 4- to as much as 10-fold during the first year of life, the absolute risk of developing a UTI in an uncircumcised male infant is low (at most, ~1%).

This risk is low: the seriousness is not demonstrated. I do not find this compelling either.

and HPV.

That study was criticized on methodological grounds.[53] [54] but Baldwin et al (2004) [55] also found less HPV infection in circumcised men in their sample.

Some genital HPV strains some can cause genital warts, cervical or penile cancer [56]. One study found no statistically significant difference in HPV infection between circumcised and uncircumcised men,

Again, not very compelling

 

[rocketdodger]

As I say in every thread on this topic, I have been regrowing my foreskin little by little.

I will refrain from details, but anyone who raises the question will be interested to know that there is a positive difference to having an amount of extra loose skin even if it lacks the tactile receptors of the natural foreskin.

That should put to rest any arguments regarding the pleasure side of the issue.

 

[Skeptic Ginger]

...

Better. But note also from skeptigirls's post

This risk is low: the seriousness is not demonstrated. I do not find this compelling either. ...

So hospitalization, permanent kidney damage and death are not serious?

I am not arguing the low rate of occurrence, mind you so no need to address any straw, but the idea the risk is not serious is simply naive. Urinary tract infections in infants are never minor. Maybe they are typically a minor infection in an adult, but not in an infant!

 

[logical muse]

...snip... (pardon the pun!)
So if you hetero and interested in sexual satisfaction perhaps this is something to consider...

Yeah, because in Europe (and in fact pretty much the rest of the world), with its abundance of foreskins, no one is having sex.
And those that do, aren't enjoying it. And those that are enjoying it, aren't indulging spontaneously. And those that are spontaneous, are catching diseases. And those that aren't catching, aren't aesthetic. And those that... well... yeah.

 

[MRC_Hans]

Earlier this week my wife and I found out that we are going to have a boy this October. As we shared the good news, we unknowingly ran smack dab into a debate with very passionate advocates on either side: Were we going to circumcise our son?

My wife and I had half-discussed it in the past, but it was still sort of a maybe-we-don't-have-to-deal-with-it issue so we didn't really invest any energy into it. My wife is taking the cowards way out* by saying that it has to do with penises, so it's my responsibility to decide.

So, I'm bringing the question to the board. I'm starting from a default position that the kid should not be circumcised. Does anyone have medical reasons why this is a good idea? Can anyone persuade me that this would be a mistake based on medical reasons?






* to be fair, I was planning on doing the same thing if we had a girl when it came to menstruation.

Coming in late, but in this case I feel it is alright to answer the OP without reading the thread. After all, you ask for opinions, and the below is mine.

First of all: Congratulations, and good luck with your new son!

As for circumcision, my question is: Why?
Since you ask at all, I assume that you have no religious reasons.
Since you son has not yet been born, there can be no known medical reasons.
So you are left with cultural reasons. I understand that circumcision is more or less SOP, where you are.

My opinion, in medical as well as other matters, is: If it ain't broken, don't fix it. Small as it is, any surgical intervention involves some risk. If you son, later in life, encounters problems that indicate circumcision, he can always get one. To be sure, it is probably more painful later, but...

Where I am, circumcision is only done if there is an indication (usually narrow foreskin), and only about 10% have it done.

Hans

 

[Fiona]

http://www.healthandage.com/html/well_connected/pdf/doc36.pdf

Urinary tract infections are a major cause of hospitalization in children. Untreated, they can be very serious, particularly
in children under four years old. Fortunately, with prompt treatment childhood cases of upper urinary tract infections
rarely cause any serious consequences.

http://healthguide.howstuffworks.com/urinary-tract-infection-in-depth4.htm

Scarring in young growing kidneys is much more serious than in the mature kidney. Over the years, it increases the risk for hypertension and kidney failure. In one study, evidence of scarring developed in 6% of children who had been hospitalized for a urinary tract infection. Children most at risk for this complication include:

* Children with vesicoureteral reflux (VUR). (Carefully managed vesicoureteral reflux without scarring is not associated with serious complications.)
* Abnormally structured urinary tracts
* Recurrent kidney infections
* A delay in treating an acute UTI

One encouraging study followed children with evidence of kidney scarring for 16 to 26 years. On average, their total kidney function was well preserved, although the scarred kidney had signs of lower function and patients with scarring in both kidneys were at higher risk for future problems. Earlier studies have shown poorer results, which suggests that outcomes are now improving with early detection and better follow-up.

Couldn't find the mortality rate but serious risk? I don't think so

 

[Ivor the Engineer]

The medical literature supports a medical benefit from circumcision.

<snip>

That's incorrect. The medical literature supports a potential medical benefit from circumcision.

 

[Ivor the Engineer]

<snip>

Quit imposing your fundamentalist mentality on people who don't see it your way.

I had to laugh when I read that, SG. That is exactly what parents who have their child circumcised do, even those who sincerely believe they are basing their decisions on evidence.

I believe Zimbardo, Milgram and Asch explain the (non-)thinking that goes on in people who circumcise infants, even down to how circumcised men often internalise their parents' behaviour, thinking if they were not circumcised, they would elect to have it done as an adult.

 

[Professor Yaffle]

I just wonder, if circumcision were not traditionally practiced, and a study was published showing the extent of the health benefits (in the US and Europe, say), would anyone be rushing to bring it in as a routine procedure? Obviously, the issues are different in Africa, but that's not really what we are talking about.

Personally, I am against circumcision, but it comes on a scale somewhere between FGM and piercing a baby's ears. I'm against all of them, but some more strongly than others.

 

[Darat]

I just wonder, if circumcision were not traditionally practiced, and a study was published showing the extent of the health benefits (in the US and Europe, say), would anyone be rushing to bring it in as a routine procedure?

...snip...

The answer has to be no - and this is why I said it's a classic example of cultural relativism.

I'd go even further and say we can conclude that any actual benefit is insignificant in the real-world else we'd have seen it show up in different health outcomes in the populations of comparable cultures that do and do not circumcise regularly. (Given the focus on finding ways to justify male circumcision over the decades and the converse is obviously true - in that it is equally unlikely that it causes any significant negative effect to health outcomes.)

 

[Ivor the Engineer]

The answer has to be no - and this is why I said it's a classic example of cultural relativism.

I'd go even further and say we can conclude that any actual benefit is insignificant in the real-world else we'd have seen it show up in different health outcomes in the populations of comparable cultures that do and do not circumcise regularly. (Given the focus on finding ways to justify male circumcision over the decades and the converse is obviously true - in that it is equally unlikely that it causes any significant negative effect to health outcomes.)

Yeah, but Americans are obsessed with tips, particularly in New York. I can't help but think there's a connection somewhere...

 

[Skeptic Ginger]

http://www.healthandage.com/html/well_connected/pdf/doc36.pdf

http://healthguide.howstuffworks.com/urinary-tract-infection-in-depth4.htm

Couldn't find the mortality rate but serious risk? I don't think so

Fiona you posted "major cause of hospitalizations" then went on to take the reassuring sentence, "Fortunately, with prompt treatment childhood cases of upper urinary tract infections rarely cause any serious consequences," as if that meant nothing bad ever happens.

Bad things do happen from urinary tract infections in young children. I said I was not arguing they were common. They are rare. But the idea a UTI in an infant isn't serious because the link you posted has some words of reassurance for its readers is preposterous.

Immediate cause of death from a UTI in an infant will almost always occur as sepsis.

Septicemia is the 5th leading cause of postneonate male infant death in the US, causing 3% of the total deaths in 2004 in that group or 167 deaths per 100,000 male postneonates. (1 mo to 1 yr of age). [pg 83] While I cannot find a breakdown of the site of initial infection of infant septicemia (not to be confused with neonatal septicemia) I can tell you UTI is one of the major causes. Meningitis is probably the most common cause of septicemia with UTI second but I base that on my medical knowledge and cannot find a source at the moment.

You might also consider how much risk one takes just being in a hospital from both nosocomial infections and medical mistakes.

 

[Skeptic Ginger]

That's incorrect. The medical literature supports a potential medical benefit from circumcision.

Yeah and the same goes for all the vaccinations we give our kids, seatbelts, smoke alarms, and a gazillion other things.

Sorry, Ivor, I'm not buying into your choice of using special 'framing' for this medical intervention unless such framing is the norm for all medical interventions we discuss.

 

[Skeptic Ginger]

I had to laugh when I read that, SG. That is exactly what parents who have their child circumcised do, even those who sincerely believe they are basing their decisions on evidence.
....

So the evidence is equivocal and you claim the people who have only opinion and no evidence are not the fundies?

Where's your evidence Ivor? All you have are fundie anti-circ'ers' opinions. The research does not show the harm you claim. Where is your evidence?

 

[Ivor the Engineer]

Fiona you posted "major cause of hospitalizations" then went on to take the reassuring sentence, "Fortunately, with prompt treatment childhood cases of upper urinary tract infections rarely cause any serious consequences," as if that meant nothing bad ever happens.

Bad things do happen from urinary tract infections in young children. I said I was not arguing they were common. They are rare. But the idea a UTI in an infant isn't serious because the link you posted has some words of reassurance for its readers is preposterous.

Immediate cause of death from a UTI in an infant will almost always occur as sepsis.

Septicemia is the 5th leading cause of postneonate male infant death in the US, causing 3% of the total deaths in 2004 in that group or 167 deaths per 100,000 male postneonates. (1 mo to 1 yr of age). [pg 83] While I cannot find a breakdown of the site of initial infection of infant septicemia (not to be confused with neonatal septicemia) I can tell you UTI is one of the major causes. Meningitis is probably the most common cause of septicemia with UTI second but I base that on my medical knowledge and cannot find a source at the moment.

You might also consider how much risk one takes just being in a hospital from both nosocomial infections and medical mistakes.

Yet doctors in Europe, China and Japan have missed this significant cause of infant septicemia and abandoned (or never started) male circumcision as a preventative measure.

 

[Skeptic Ginger]

I just wonder, if circumcision were not traditionally practiced, and a study was published showing the extent of the health benefits (in the US and Europe, say), would anyone be rushing to bring it in as a routine procedure? Obviously, the issues are different in Africa, but that's not really what we are talking about.

Personally, I am against circumcision, but it comes on a scale somewhere between FGM and piercing a baby's ears. I'm against all of them, but some more strongly than others.

There may not be a "rush" but as long as it wasn't seen as leaving the boy with an abnormal appearance which today it is not, then there would still be people opting to do it.

And no one is advocating this be a "routine" procedure. I and others of like mind are arguing for parental personal preference and less condemnation by the fundies for the parents who chose to have their child circumcised.

 

[Skeptic Ginger]

Yet doctors in Europe, China and Japan have missed this significant cause of infant septicemia and abandoned (or never started) male circumcision as a preventative measure.

Not relevant. The evidence is not changed by who choses to consider it.

 

[Skeptic Ginger]

The answer has to be no - and this is why I said it's a classic example of cultural relativism.

I'd go even further and say we can conclude that any actual benefit is insignificant in the real-world else we'd have seen it show up in different health outcomes in the populations of comparable cultures that do and do not circumcise regularly. (Given the focus on finding ways to justify male circumcision over the decades and the converse is obviously true - in that it is equally unlikely that it causes any significant negative effect to health outcomes.)

The research has shown a difference in circumcised and uncircumcised infants. What makes you think the difference would not show up in comparison of larger groups?

And, if you take the reverse of what you are saying, there is also no evidence the culture circumcising their infants are clearly suffering negative outcomes either.

 

[Ivor the Engineer]

So the evidence is equivocal and you claim the people who have only opinion and no evidence are not the fundies?

Where's your evidence Ivor? All you have are fundie anti-circ'ers' opinions. The research does not show the harm you claim. Where is your evidence?

Well you could look at the tiny fraction of uncircumcised men who elect to be circumcised as adults when weighing up what the child will most likely want in the future.

But let's not fool ourselves that parents have their boys circumcised to reduce theoretical risks based on evidence. It's a decision based on a feeling and a world view of what is acceptable treatment of the weak and those without a voice in society.