Alex_Dubinsky And The Fatal Foreskin

[Malthus]

@CalMeacham

Yup. See saoirse’s post above.Plus, in my day, it was believed that circumcision was proof against cancer . Nowadays they say that you just have to keep it clean. I’m geberally against cutting anything that doesn’t need to be.

I’m not familiar with the arguments for snipping in Africa, but I suspect this is much more than a simple open-and-shut case. You could as easily have said in the 1950s “even if it prevents cancer?”, and been just as wrong.

I’m assuming, merely for the purposes of the question, it was proved to be a prophylactic.

What I’m beginning to suspect is that for some this is an issue beyond proof, almost a matter of faith. Which strikes me as more than a trifle bizzare.

[CalMeacham]

No, I would have been just as right, if the assumption (that circumcision prevents cancer) had been right. It wasn’t, as it turns out. But if it had, I think many men would have decided it was a worthy trade-off.

Most men don’t make the decision – it’s made for babies who don’t get a vote.

My understanmding is that the incidence for penile cancer, even among the uncircumcized, isd pretty low. I seriously doubt if it makes much impact on the decisions of fully grown and uncircumcized men on whether they want to stay that way or not. Kind of like I don;t weigh the chances of getting struck by lightning or meteors when I go out during the day.

How major a difference in HIV incidence does circumcision make relative to uncircumcised with clean habits?

[saoirse]

@CalMeacham

How major a difference in HIV incidence does circumcision make relative to uncircumcised with clean habits?

I believe that an uncircumcised male has CD4 (?) receptors where circumcised males don’t. The study has a mechanism by which it occurs, and some dramatic statistics. But the reduction is ONLY among men who are not using condoms. The best way to keep your CD4 cells away from the HIV virus is to separate them with latex. I would say it definitely merits further study, but that’s not the same as inviting 5000 people to make fun of someone who opposes circumcision.

[Excalibre]

@saoirse

I believe that an uncircumcised male has CD4 (?) receptors where circumcised males don’t. The study has a mechanism by which it occurs, and some dramatic statistics. But the reduction is ONLY among men who are not using condoms. The best way to keep your CD4 cells away from the HIV virus is to separate them with latex. I would say it definitely merits further study, but that’s not the same as inviting 5000 people to make fun of someone who opposes circumcision.

The thing that merits being made fun of is the bizarre analogy to removal of the labia majora and minora and the attempts to reference Mexican cinema as proof.

The boy is not a clear thinker.

[The_Flying_Dutchman]

As an uncircumcised male in his 50’s, let me tell you that when it comes to an erection, there is no difference between whether you’ve been cut or not. An independant obsever would be hard pressed to distinguish a circunmcised erection from the natural erection.

[saoirse]

@Excalibre

The thing that merits being made fun of is …the attempts to reference Mexican cinema as proof.

Which was not offered as proof, but as an illustration of how greater sensation might not lead to premature ejaculation. I know of no study that links premature ejaculation with circumcision. On the other hand, the assertion that circumcision affects sensation is itself speculative, so we can forgive our scientists for not following up on this.

[levdrakon]

@Malthus

Even if it is proven as a propylactic against AIDS?

It hasn’t been proven to be a prophylactic against AIDS. Actually, circumcised men may be at greater risk of HIV infection.

@Tuckerfan

After having a couple of posters question his beliefs and suggest that the thread isn’t the most appropriate place for such a discussion AD responds with

And to anyone who suggests that discussing the ethics of circumcision is inappropriate in a thread about circumcision being a treatment for HIV… anyway, you’re probably only saying it because you’d rather not talk about the ethics of circumcision.

Apparently, this is an ethical issue, and not a medical one.

First, in the other threads about this the idea was proposed that quarantine might be a perfectly reasonable & acceptable way of dealing with HIV. Other posters felt quite free to enter the thread and call that “barbaric.” I see no reason why AD shouldn’t be able to call circumcision “barbaric” in a thread about circumcision.

Second, it certainly is a medical issue, not just an ethical one.

So, let’s discuss the ethics of a few centimeters of skin versus the lives of millions of people.

Yes, let’s discuss it. From my cite above,

The recommendation to routinely circumcise boys in Africa is unfounded and even dangerous. In some parts of Africa, circumcision is a leading cause of tetanus (59.4% of cases). The use of dirty instruments and mass ritual events, including group circumcision, may increase the number of young boys developing HIV infections. The risk of spreading tuberculosis through circumcision in developing countries is also a valid concern. Severe complications and death are not uncommon following ritual circumcision.

On the one hand you, and many others here constantly decry the dearth of adequate, or even the existence of any available medical care in Africa, and in the same breath you want universal circumcisions performed. By whom, pray tell? The same witch doctors who tell their people to have sex with virgins to cure AIDS?

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.

Until you have watched someone die of AIDS (as I have), and until you’ve spent time in Africa and seen how bad AIDS is there, and how nonexistant medical care can be, you have no right, none whatsoever, to declare that a potential method for reducing the chances of even one person from becoming infected is verboten and wrong. Can you grasp that? Can you understand that there are things more important in life that a few lousy centimeters of skin that 99.99999% of the population will never miss? Wrap your mind around that, would you? If you can’t, then think of this: If someone you love (assuming you’re capable of feeling that emotion) were in danger of dying and the only way you could save them would involve the amputation of all your limbs, would you do it? If you even have to stop and think about it for a second, if your answer is not an automatic, “Yes, of course!” then your problems are greater than you can even imagine. Losing your foreskin is nothing compared to losing your life. Not even close.

Calm down. I’ve seen people die from AIDS. I feel really bad for some older friends I have who’ve seen dozens of friends die from AIDS. Quit correlating “a few lousy centimeters of skin” with saving millions of lives. It doesn’t work that way. You’re going to lose hundreds of lives, for every one life you save by cutting those “few lousy centimeters of skin.” Oh, but that’s hokey-dokey. As long as you SAVE ONE LIFE FROM AIDS.

Based on the studies published in the scientific literature, it is incorrect to assert that circumcision prevents HIV infection. Even if studies showing circumcision to be beneficial are accurate, the risk from circumcision outweighs any small benefit it may have. To depend on circumcision to protect against HIV infection in lieu of condoms, which have been shown to be efficacious, is dangerous. Promoting circumcision as protection against HIV could also promote, intended or not, the inference, that a circumcised penis is adequate protection from contracting HIV, resulting in an increase in HIV infections. The circumcision experiment in the United States, which has failed to prevent the spread of this pandemic, should serve as a lesson to other countries.

How do you explain the high percentages of cut males in the US and our high infection rates?

American men are reluctant to use condoms. Studies indicate a considerably higher acceptance and usage rate for condoms in Europe and Japan, where circumcision is almost never practised. Some have suggested that American men are resisting a layer of latex that would further decrease sensation from a glans already desensitized from the keritinization following circumcision. Moreover, condoms are more likely to fall off the circumcised penis. This low acceptance of condoms may be responsible for the high rate of STD and teenage pregnancy rates in the United States–the only industrialized country that has failed to control bacterial STDs during the AIDS era.

[Helen_s_Eidolon]

@levdrakon

It hasn’t been proven to be a prophylactic against AIDS. Actually, circumcised men may be at greater risk of HIV infection.

You realize that that meta study was done in 1999, and is therefore seven years old? The study cited in the other thread was done in 2003, and the results should be coming out next year - this is NEW proof.

[levdrakon]

@Helen's Eidolon

You realize that that meta study was done in 1999, and is therefore seven years old? The study cited in the other thread was done in 2003, and the results should be coming out next year - this is NEW proof.

It’s a new STUDY, not new proof. Is there any evidence that universal circumcision has gotten any safer in Africa? You know, that continent which doesn’t have adequate medical care? I’m a little tired of people treating circumcision as if it’s as safe & routine as getting your ear pierced.

[Malthus]

@levdrakon

It hasn’t been proven to be a prophylactic against AIDS. Actually, circumcised men may be at greater risk of HIV infection.

For the second time, I’m assuming, merely for the purposes of the question, it was proved to be a prophylactic.

Answering that in your opinion it has not been so proved is not responsive to the question.

[levdrakon]

@Malthus

For the second time, I’m assuming, merely for the purposes of the question, it was proved to be a prophylactic.

Answering that in your opinion it has not been so proved is not responsive to the question.

I’m assuming, merely for the purposes of the question, it was proved to be a prophylactic.

What I’m beginning to suspect is that for some this is an issue beyond proof, almost a matter of faith. Which strikes me as more than a trifle bizzare.

You seem to like to play “pretend.” I don’t feel like playing on this topic. Sorry.

One South African study fills me with absolutely zero confidence. Until more studies are finished, leave African boys’ & mens’ dicks alone.

[Weirddave]

Levdrakon, anyone that backs up their argument by linking Cirp.org has not provided a cite at all. Cirp is so biased that they make Anne Coulter look like a fair and balanced political commentator in comparison.
And in case anyone is wondering why we haven’t heard from Alex_Dubinsky in a while, I think he’s been busy posting on Craig’s list.

[levdrakon]

@Weirddave

Levdrakon, anyone that backs up their argument by linking Cirp.org has not provided a cite at all…

I’d say it’s a hellofalot better than citing a news article with no references other than, “a small South African study says circumcision will save millions of lives! Let’s circumcise Africans!” :rolleyes:

This just in:* "Double mastectomies save millions of women’s lives from breast cancer! Let’s make them all have double mastectomies!

Castrating men reduces rape! Let’s castrate all men!"*

According to this Kaisernetwork.org article, (which I’m sure you’ll immediately dismiss as biased as Anne Coulter),

Bill Gates, who co-founded the Gates Foundation, and former President Clinton spoke favorably about the procedure at the conference, but they also highlighted its challenges. Gates said that male circumcision as an HIV prevention strategy “depends on a man,” adding, “We need to put the power to prevent HIV in the hands of women.” Opponents of male circumcision in their petition said promoting the practice as an “HIV/AIDS panacea” in developing countries is “deeply flawed” and “even cruel” and would violate human rights. John Geisheker, an attorney and executive director of Doctors Opposing Circumcision, said routine male circumcision in Africa would mean “[v]illage or bush surgery in septic conditions on millions of Africans against their will or with coerced or bogus consent … with the payoff 18 years from now.” Opponents have begun circulating a study questioning the results of the South Africa research.

I’m going to wait until I see some studies questioning the results of the SA research. But you go ahead and jump on that circumcision band-wagon. Hey, I heard wine was good for you. No wait. That was last week. This week it’s bad for you. No wait. Maybe that was the week before last. I think it’s good for you. But maybe bad for you. Same thing with coffee. And eggs. Criminy’s sake, you really want to rush out and circumcise Africa based on one study?

[Miller]

@levdrakon

I’d say it’s a hellofalot better than citing a news article with no references other than, “a small South African study says circumcision will save millions of lives! Let’s circumcise Africans!” :rolleyes:

This just in:* "Double mastectomies save millions of women’s lives from breast cancer! Let’s make them all have double mastectomies!

Castrating men reduces rape! Let’s castrate all men!"*

Your reasoned and accurate analogies go a great distance towards proving you are not an raving fanatic on this issue.

[Boyo_Jim]

Let me start by saying, “I WANT MY THIRD OF A DICK BACK!”

Here’s a thought to consider:

Some men don’t want to put a bag over their dick. Some men don’t want to slice off part of their dick, or their sons’ dicks. Which attitude is going to be easier to change?

Here’s another thought. If YOU are not circumcised, and someone told you AND you believed it, that getting circumcised would reduce your chance of STDs, would YOU go under the knife? Even a nice sterile one with some local anaesthetic? Me – no way on earth! Especially if I also knew that a condom worked MUCH better.

I’d have to agree that, until decent medical care in Africa is as accessible as it is in America and Europe, “routine male circumcision” would mean, for most practical purposes, “routine slashing with an unsterile razor blade”.

Is there a door number 3, Monty?

Though I will say for the record, ** Alex_Dubinsky**'s arguments don’t strike me as being models of enlightened rationality.

[Helen_s_Eidolon]

Okay.

J Acquir Immune Defic Syndr. 2006 Jul 31 - Epidemiology of HIV-1 Infection in Agricultural Plantation Residents in Kericho, Kenya: Preparation for Vaccine Feasibility Studies.Sateren WB, Foglia G, Renzullo PO, Elson L, Wasunna M, Bautista CT, Birx DL

Exerpt from the abstract: "Among men, elevated HIV-1 prevalence was seen with increasing age, peaking in those older than 30 years (10.3%), marriage (10.4%), Luo tribe affiliation (23.5%), employment (8.9%), travel (11.0%), and being uncircumcised (29.2%). "

PLoS Med. 2006 Jul 11;3(7):e262 [Epub ahead of print] The Potential Impact of Male Circumcision on HIV in Sub-Saharan Africa.Williams BG, Lloyd-Smith JO, Gouws E, Hankins C, Getz WM, Hargrove J, de Zoysa I, Dye C, Auvert B.

Exerpt from abstract: "A randomized controlled trial (RCT) has shown that male circumcision (MC) reduces sexual transmission of HIV from women to men by 60% (32%-76%; 95% CI) offering an intervention of proven efficacy for reducing the sexual spread of HIV. "

These cites satisfy you?

I think it’s important to note that no one is suggesting we start circumcising everyone in Africa right this second. Two more studies are currently taking place and everyone hopes that these do confirm that circumcision will have a significant impact on the rate of new infections. If/when that is show, THEN new procedures will be put in place.

[Excalibre]

@Miller

Your reasoned and accurate analogies go a great distance towards proving you are not an raving fanatic on this issue.

[levdrakon]

@Helen's Eidolon

Two more studies are currently taking place and everyone hopes that these do confirm that circumcision will have a significant impact on the rate of new infections.

Why does everyone hope that?

@Miller

Your reasoned and accurate analogies go a great distance towards proving you are not an raving fanatic on this issue.

Thank you!

[Helen_s_Eidolon]

@levdrakon

Why does everyone hope that?

… because most of us are looking for ANYTHING that will help stop the spread of AIDS?

Do you hope that circumcision isn’t proven to help?

[Excalibre]

@levdrakon

Why does everyone hope that?

Well, those who believe life can be worth living without a foreskin would love to see something that can reduce the prevalence of AIDS in Subsaharan Africa.

Personally, as I mentioned in the original thread, I wonder if modeling has actually been done to see if a substantially lowered rate of transmission from a single exposure would make any significant difference in overall infection rates. I have to wonder how that math would turn out, since it’s not obvious to me that it would.