The Sensitive Issue of Circumcision

You all can frame a circumcision as an amputation, that doesn't make it one. It is not referred to amputation in any medical literature I have seen.
 
I'm still waiting for that evidence of harm, Ivor. You didn't post any in the last 40+ page thread either if I recall.
 
I'm still waiting for that evidence of harm, Ivor. You didn't post any in the last 40+ page thread either if I recall.
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You and I both know there will never be any evidence of infant circumcision causing harm because there is no way of creating a control group for such a subjective measure (unless you know of a way to access parallel worlds).

What does exist is reports of adult circumcision making masturbation more difficult and loss of pleasure. It is reasonable to assume this is also true for infant circumcision.

http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1464-410X.2006.06646.x
 
skeptigirl said:
You have a short memory since we discussed this in the other thread.

All first UTIs in infants necessitate an IVP. All IVPs do not find anatomical defects. So if the infant's UTI is caused by any risk factors that not circumcising results in rather than an anatomical defect, that infant will be one of ones who gets a needless IVP.
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You seem to be a bit out of date with this.

Scarring is best detected using a nuclear medicine kidney scan (DMSA scan). (The old test for scarring, an "IVP" (intravenous pyelogram) generally should notbe used.)

.....

An IVP should not be done to evaluate children with a UTI unless there are very unusual circumstances, such as a suspicion that the ureters are in the wrong place. If your doctor recommends an IVP for other reasons, you might want to get a second opinion before proceeding.
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Ivor the Engineer said:
Here's the NICE guidelines for treatment of UTI in children.

http://www.nice.org.uk/nicemedia/pdf/CG54NICEguideline.pdf

Interestingly the standard treatment in the UK uses ultrasound or injected radioactive chemicals, not X-rays.

ETA: X-ray examination is recommended for atypical and recurrent UTI.
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AAP Policy
Recommendation 11

Infants and young children 2 months to 2 years of age with UTI who do not demonstrate the expected clinical response within 2 days of antimicrobial therapy should undergo ultrasonography promptly, and either voiding cystourethrography (VCUG) or radionuclide cystography (RNC) should be performed at the earliest convenient time. Infants and young children who have the expected response to antimicrobials should have a sonogram and either VCUG or RNC performed at the earliest convenient time (strength of evidence: fair).
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I think I recall that the IVP and the RNC were equally acceptable. I don't know which exposes the infant to less radiation. If someone is interested I'm sure they'll look it up for us.

Is there a breakdown of how frequent the "atypical" infections referred to are compared to the low risk infections? From your source
Atypical UTI includes:

* seriously ill (for more information refer to ‘Feverish illness in children’ [NICE clinical guideline 47])
* poor urine flow
* abdominal or bladder mass
* raised creatinine
* septicaemia
* failure to respond to treatment with suitable antibiotics within 48 hours
* infection with non-E. coli organisms.
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Atypical does not necessarily mean rare.
 
Professor Yaffle said:
You seem to be a bit out of date with this.

...
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It was a general term. I do not practice pediatric urology. Is it relevant in comparing the risks of the procedure that I referred to a slightly different version?


From the AAP Policy I cited above:
VCUG with fluoroscopy characterizes reflux better than does RNC.
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VCUG exposes the infant to a fluoroscopic X-ray just the same.
 
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These discussions always end up in the same place - what we have is a cultural practise that some people have recently sought to find "scientific evidence" to support its continued practise and at best the evidence for any benefit can be described as slight.

One thing I really can't get out of my head in regards to this discussion is how the common rationales defenders of genital mutilation use are always the same - "hygiene", "what others prefer", "tradition" and so on, - whether they are defending female or male genital mutilation. Yet (at the risk of an over simplification) the defenders of male genital circumcision have no problems with condemning all female circumcision.
 
There are many differences Darat, but the biggest one besides the complete lack of medical benefit with female circumcision is the reason behind the tradition. Female procedures originate in male dominated societies and are associated with abuse of women. They aren't done as a right of passage, they are done as a means of controlling women's sexuality.
 
skeptigirl said:
There are many differences Darat, but the biggest one besides the complete lack of medical benefit with female circumcision is the reason behind the tradition. Female procedures originate in male dominated societies and are associated with abuse of women. They aren't done as a right of passage, they are done as a means of controlling women's sexuality.
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Really?

http://www.ias-2005.org/planner/Abstracts.aspx?AID=3138

Introduction: It has been postulated that female circumcision might increase the risk of HIV infection either directly, through the use of unsterile equipment, or indirectly, through an increase in genital lacerations or the substitution of anal intercourse. The authors sought to explain an unanticipated significant crude association of lower HIV risk among circumcised women [RR=0.51; 95% CI 0.38,0.70] in a recent survey by examining other factors which might confound this crude association.

Methods: Capillary blood was collected onto filter paper cards from a nationally representative sample of women age 15 to 49 during the 2004 Tanzania Health Information Survey. Eighty-four percent of eligible women gave consent for their blood to be anonymously tested for HIV antibody. Interview data was linked via barcodes to final test results for 5753 women. The chi-square test of association was used to examine the bivariate relationships between potential HIV risk factors with both circumcision and HIV status. Restricting further analyses to the 5297 women who had ever had sexual intercourse, logistic regression models were then used to adjust circumcision status for other factors found to be significant.

Results: By self-report, 17.7 percent of women were circumcised. Circumcision status varied significantly by region, household wealth, age, education, years resident, religion, years sexually active, union status, polygamy, number of recent and lifetime sex partners, recent injection or abnormal discharge, use of alcohol and ability to say no to sex. In the final logistic model, circumcision remained highly significant [OR=0.60; 95% CI 0.41,0.88] while adjusted for region, household wealth, age, lifetime partners, union status, and recent ulcer.

Conclusions: A lowered risk of HIV infection among circumcised women was not attributable to confounding with another risk factor in these data. Anthropological insights on female circumcision as practiced in Tanzania may shed light on this conundrum.
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skeptigirl said:
There are many differences Darat, but the biggest one besides the complete lack of medical benefit with female circumcision ...snip...
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Can you show me the studies that show there is a complete lack of medical benefits?

skeptigirl said:
...snip... Female procedures originate in male dominated societies and are associated with abuse of women. They aren't done as a right of passage, they are done as a means of controlling women's sexuality.
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Sorry but you are just wrong. In many cultures female genital mutilation is a rite of passage just like a male genital mutilation may be. Indeed it is very rare that males have anything to do with female genital mutilation, it is something that originates with and is carried out by women.
 
In addition, there are serious medical risks from female circumcision.

New study shows female genital mutilation exposes women and babies to significant risk at childbirth
Serious complications during childbirth include the need to have a caesarean section, dangerously heavy bleeding after the birth of the baby and prolonged hospitalization following the birth. The study showed that the degree of complications increased according to the extent and severity of the FGM...

...on average 30 per cent more caesarean sections compared with those who have not had any FGM. Similarly there is a 70 per cent increase in numbers of women who suffer from postpartum haemorrhage in those with FGM III compared to those women without FGM..
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Those are some pretty serious complications.
 
Darat said:
These discussions always end up in the same place - what we have is a cultural practise that some people have recently sought to find "scientific evidence" to support its continued practise and at best the evidence for any benefit can be described as slight.

One thing I really can't get out of my head in regards to this discussion is how the common rationales defenders of genital mutilation use are always the same - "hygiene", "what others prefer", "tradition" and so on, - whether they are defending female or male genital mutilation. Yet (at the risk of an over simplification) the defenders of male genital circumcision have no problems with condemning all female circumcision.
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"Mutilation" is an overly loaded word, I think.

We've heard in this thread from both circumcised and uncircumcised men in this thread, and sexual function is normal in both cases. And, I wouldn't condemn ALL "female circumcision." Some women have hoodectomies done to improve sexual function. What we condemn is the partial or complete removal of the clitoris, which IS mutilation and equivalent to chopping off the end of the penis. Conflating all of these various and sundry events under the heading "mutilation" seems both dishonest and... what's the technical term I'm looking for? ◊◊◊◊◊◊* crazy! :)

That's like saying this:
t_l9gv4q5l.jpg


Is the same as this:
68995748_5c3a5b6b02.jpg
 
Darat said:
Can you show me the studies that show there is a complete lack of medical benefits?
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I can't find any studies with medical benefits after an extensive look. Are you just arguing semantics?

Darat said:
Sorry but you are just wrong. In many cultures female genital mutilation is a rite of passage just like a male genital mutilation may be. Indeed it is very rare that males have anything to do with female genital mutilation, it is something that originates with and is carried out by women.
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Women who live in strict Islamic cultures claim they are being taken care of and protected, yadda yadda.

This is a complex issue I have spent a lot of time on. I've been raised on the idea of respecting cultural differences. That comes into conflict with opposing the cultures in which men oppress women. But after significant 'soul searching' so to speak, I have personally come to the position that the treatment of women in these cultures is intolerable. It's akin to saying slavery or child abuse is OK because it's their culture. Many women do report a preference for their circumstances. I think that is to be expected considering the fact they have been indoctrinated into the culture.

This is not something one can really address without an in depth discussion and that would be a thread hijack anyway. So I can only say that I personally have given this a lot of thought and am convinced the female circumcision is indeed part of the pattern of oppressing women and serves no other purpose.
 
skeptigirl said:
In addition, there are serious medical risks from female circumcision.

New study shows female genital mutilation exposes women and babies to significant risk at childbirthThose are some pretty serious complications.
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Not read the full report as I stopped when I saw the headline referred to the minority of female genital mutilations i.e Type III. Anything about the most common types of female genital mutilation (which just involves the removal or a bit of flesh) carried out by appropriately trained people?
 
JoeEllison said:
... Some women have hoodectomies done to improve sexual function. What we condemn is the partial or complete removal of the clitoris,...
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I think if the practice has become merely a reflection of past practices and this minor procedure is continued as a holdover from the past, I wouldn't waste a lot of time trying to snuff it out. Still without any medical benefit, it would be harder to support.

My original position in this matter is one of advocacy. If a parent choses to circumcise their child, then attacking that position with claims of mutilation, amputation, and harming the child's future sex life cannot be justified. There is no evidence which would support this attitude. I will not condemn a parent who choses to circumcise their child because there are a group of moral police out there with strong personal views on the matter.

If there was a form of female circumcision that truly did more good than harm on any level, I would consider reconsidering it. I have not seen any evidence there is such a form of female circumcision. With male circumcision there is that evidence with which you can make a case for more good than harm.
 
JoeEllison said:
...snip... What we condemn is the partial or complete removal of the clitoris, which IS mutilation and equivalent to chopping off the end of the penis. Conflating all of these various and sundry events under the heading "mutilation" seems both dishonest and... what's the technical term I'm looking for? ◊◊◊◊◊◊* crazy! :)
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Why is removing nerve rich tissue from genitals so different when it is male then when it female?

Of course I am not saying that they are exactly comparable however the differences are not as large as most people who defend males being chopped but don't defend women being chopped sem to want to make it out to be.



That's like saying this:
[qimg]http://media.collegepublisher.com/media/paper601/thumbs/t_l9gv4q5l.jpg[/qimg]

Is the same as this:
[qimg]http://farm1.static.flickr.com/18/68995748_5c3a5b6b02.jpg[/qimg][/QUOTE]

Outside our own cultural norms how are they different?
 
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