Can we hope to eliminate Female Genital Mutilation while we still allow Male GM (circumcision)

[CarnalK]

It’s so much easier to concentrate on the people who called you nazi. You can make huffy noises and flounce in such a noble fashion.

[x-ray_vision]

@Malthus

Cosmetic orthodontia usually involves braces, but can also involve surgery - for example, as in my case, the removal of teeth, where tooth crowding was causing protrusion of the bite.

That doesn’t sound purely cosmetic to me.

[CarnalK]

@x-ray_vision

That doesn’t sound cosmetic to me.

It is. People can eat, breath and talk just fine with a little buck toothedness or overbite. But if you know different, I’m perfectly open to correction.

[clairobscur]

@Malthus

In light of such evidence, I see no medical ethics problems with allowing parents to choose one way or the other, since the risks are trivial and the benefits, while also minor, outweigh the risks.

Sorry, I didn’t in fact address this argument (although I did link to a meta study showing that circumcision in fact increase, not decrease, the risk of penile cancer).

Here an abstract of the German pediatric association position on the subject :

[QUOTE=German Pediatrician Association]
The male foreskin is a part of the skin of the organ and fulfils important functions that protect the very sensitive glans. It normally covers the glans and protects it from harmful substances, friction, drying out and injuries. It has apocrine sweat glands, which produce cathepsin B, lysozyme, chymotrypsin, neutrophile elastase, cytokine, and pheromone such as androsterone. Indian scientists have shown that the subpreputial wetness contains lytic material, which has an antibacterial and antiviral function. The natural oils lubricate, moisten and protect the mucous membrane covering of the glans and the inner foreskin. The tip of the foreskin is richly supplied with blood by important blood vessel structures. The foreskin serves as a connective channel for Berufsverband der Kinder- und Jugendärzte (BVKJ. e.V.) many important veins. Circumcision can lead to erectile dysfunction as it destroys these blood vessels. Their removal can, as described by many of those who have been affected, lead to considerable limitations to sex life and cause psychological stresses.

The statement from AAP (DOI: 10.1542/peds.2012-1989 Pediatrics; originally published online August 27, 2012) cited over and over again, contradicts earlier statements from the same organisation, without the necessity of referring to new research results. Since then, this AAP statement as been graded by almost all other paediatric societies and associations worldwide as being scientifically untenable.
[/QUOTE]

I left the first part for the reasons why circumcision is damaging. And I bolded the last part because a quick search will show you that indeed the AAP is pretty much alone in the western world in stating that circumcision is beneficial. Overwhelmingly, medical associations believe it’s detrimental.

I would add, even though I already mentioned it, that the fact that a number of people choose to have skin removed from their ballsack to reconstruct a very imperfect foreskin should show you that at least a number of people who have been circumcised feel that this surgery had a seriously detrimental effect on them.

At the very best, you could say that the medical benefits of circumcision are disputed. And I don’t believe that in case of doubt, we should err on the side of cutting pieces of genitals on babies.

[x-ray_vision]

@CarnalK

It is. People can eat, breath and talk just fine with a little buck toothedness or overbite. But if you know different, I’m perfectly open to correction.

What Problems Come With Crooked Teeth and Misaligned Bites?

Crooked teeth and misaligned bites can:

Interfere with proper chewing.
Make keeping teeth clean more of a challenge, increasing the risk of tooth decay, cavities, and gingivitis.
Strain the teeth, jaws, and muscles, increasing the risk of breaking a tooth.
Make people feel self-conscious about their appearance and affect their self-esteem.

Crooked Teeth and Misaligned Bites

Regarding your tooth crowding, which you say was the cause of your protrusion:

Individuals who don’t fix their crowded teeth can suffer from anxiety, depression and other similar mental issues.

…

In some moderate to severe cases, crowded teeth can also create long-term problems with speech. It may become difficult to properly pronounce certain sounds as the tongue can’t freely move in the mouth. Extensive speech therapy might be needed to correct the habits of improper pronunciation of sounds due to malocclusion. Crowded teeth can essentially block the tongue from natural motions that lead to normal speech patterns.

…

Similarly, misaligned teeth can interfere with the proper chewing of food. It’s also possible that crowded teeth that are angled can cause some abrasions and other trauma to the gums and inner cheeks.

…
Individuals who have crowded teeth are also vulnerable to mouth injuries, especially when playing contact sports or doing other physical activities.

http://packortho.com/dangers-leaving-crowded-teeth-untreated/

[CarnalK]

Those sure seem like minor health benefits to me. What was that other thing we were talking about that had reported minor health benefits? Rhymes with circumcision? No wait, it WAS circumcision.

[Thing_Fish]

@tomndebb

ENOUGH!

Everyone back away from the sort of question that is a (not so) veiled accusation of anything. Let’s leave the words “you” and “your” out of the discussion from this point on.

Stick to discussing the topic in neutral terms.

Further, I see no serious point to the discussion of punishment for crimes, or even references to crimes. It is possible to discuss whether an action may be permitted or prohibited without jumping to the sentencing phase of a crime that has not yet been committed or even legislated.

[ /Moderating ]

Sorry I got upset just because someone is advocating the genocide of my people. I guess I’m just a little sensitive on that particular topic.

[x-ray_vision]

@CarnalK

Those sure seem like minor health benefits to me.

Okay. :eek:

[CarnalK]

Circumcision might have various health benefits, including:

**Easier hygiene**. Circumcision makes it simpler to wash the penis. Washing beneath the foreskin of an uncircumcised penis is generally easy, however.
**Decreased risk of urinary tract infections**. The overall risk of urinary tract infections in males is low, but these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later on.
**Decreased risk of sexually transmitted infections**. Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV. Still, safe sexual practices remain essential.

** Prevention of penile problems**. Occasionally, the foreskin on an uncircumcised penis can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the penis.
Decreased risk of penile cancer. Although cancer of the penis is rare, it’s less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.

Circumcision (male) - Mayo Clinic

Don’t our lists look similar, x-ray vision?

[clairobscur]

And here an article criticizing the methods and conclusions of this AAP report (and listing some of the medical associations that took position against circumcision).
I expect that you will read it with as much interest as you did with the AAP conclusions, and will integrate these opposed conclusions in your analysis of the value (or lack thereof) of circumcision.
ETA : I was addressing Malthus, here.

[Thing_Fish]

Some may think “genocide” is a loaded term. It has been proposed that Jews should not be allowed to raise children, and that any children they happen to bear should be taken from them to be raised in some other religion. After a couple generations, there would be no Jews. Genocide is the correct term for what is being advocated here.

[Dr.Crap]

I think kids should be taken away from their parents after their third circumcision.

[x-ray_vision]

@CarnalK

Circumcision (male) - Mayo Clinic

Don’t our lists look similar, x-ray vision?

Yes. I don’t see how you could possibly look at the list of issues I gave you and conclude that fixing those things add up to “minor health benefits.” I don’t believe you actually think that.

But I have found that the things you just listed are exaggerated or can be taken care of if there’s ever a problem, such as phimosis. Mistakes during circumcision aren’t as easily fixed. Men wash their uncircumcised penises as easily as women wash their labia. Seems silly to even mention it.

[Malthus]

@clairobscur

Sorry, I didn’t in fact address this argument (although I did link to a meta study showing that circumcision in fact increase, not decrease, the risk of penile cancer).

Here an abstract of the German pediatric association position on the subject :

I left the first part for the reasons why circumcision is damaging. And I bolded the last part because a quick search will show you that indeed the AAP is pretty much alone in the western world in stating that circumcision is beneficial. Overwhelmingly, medical associations believe it’s detrimental.

I would add, even though I already mentioned it, that the fact that a number of people choose to have skin removed from their ballsack to reconstruct a very imperfect foreskin should show you that at least a number of people who have been circumcised feel that this surgery had a seriously detrimental effect on them.

At the very best, you could say that the medical benefits of circumcision are disputed. And I don’t believe that in case of doubt, we should err on the side of cutting pieces of genitals on babies.

Well, firstly, your statement is not accurate. The Canadian association has likewise modified its statement:

Canadian paediatricians modify position on circumcision

So it is not the case that the US position is universally graded as “scientifically untenable”. Rather, it is a divide between North Americans and Europeans.

Secondly, a google search has demonstrated that your statement is, in fact, an expert’s report made in opposition to a particular German law - it is not analogous to the AMA statement (which is for practicing physicians), it is a piece of legislative advocacy.

The only source I have found in English is from the website “Intact America” (which sort of speaks for itself), and it is here:

http://www.intactamerica.org/german_pediatrics_statement

The title:

Expert Statement: Dr med. Wolfram Hartmann, President of “Berufsverband der Kinder- und Jugendärzte” (professional association of paediatricians) for the Hearing on the 26th of November 2012 Concerning the Drafting of a Federal Government Bill:
“Drafting of a law regarding the scope of child care and custody in the case of male circumcision”
and
concerning the draft billing by members of parliament: Marlene Rupprecht, Katja Dörner,
Diana Golze, Caren Marks, Rolf Schwanitz, additional members of parliament:
“Drafting of a law regarding the scope of care, custody and rights of a child in the case of
male circumcision”.

In short, it is a polemical piece of political advocacy. It is filled with over-the-top arguments which would be scorned here at the Dope, such as:

The debate over ritual circumcision shows fundamentalist characteristics. The proponents of circumcision trivialise this form of bodily harm, which can also lead to lifelong physical and emotional injuries and repeatedly accuse the advocates of child welfare with anti-Semitism.

This is not acceptable and I expect the Central Council of Jews in Germany to distance themselves from such accusations. Especially paediatricians many years ago, long before the existence of the German Medical Association, subsequently dealt with injustices done to Jewish colleagues during the Nazi regime, publically apologised and asked the survivors for forgiveness. This is laid down in detailed documentation and corresponds to the current position of all paediatric associations in Germany.

Seriously? Talk about poisoning the well!

…
I think you are misstating the nature of the onus here.

It isn’t a case of ‘if it proven to have a tiny bit of benefit over risk, everyone should do it. On the other hand, if it proven to have a tiny bit of risk over benefit, doing it ought to be subject to criminal sanctions’.

That’s an absurd position.

Rather, the onus is ‘if reasonable people can disagree over the risks and benefits, it ought to be a matter of parental choice, untrammeled by the state. If, on the other hand, there is an overwhelming consensus that it is significantly harmful, then (and only then!) the state ought to intervene’.

By stating ’ … you could say that the medical benefits of circumcision are disputed …", you have effectively ended the argument - as far as state intervention goes.

Of course you go on to say " And I don’t believe that in case of doubt, we should err on the side of cutting pieces of genitals on babies". That’s a perfectly reasonable position … for you to take. Not so, in enforcing that view as a general proposition.

[clairobscur]

nm

[CarnalK]

@x-ray_vision

Yes. I don’t see how you could possibly look at the list of issues I gave you and conclude that fixing those things add up to “minor health benefits.” I don’t believe you actually think that.

But I have found that the things you just listed are exaggerated or can be taken care of if there’s ever a problem, such as phimosis. Mistakes during circumcision aren’t as easily fixed. Men wash their uncircumcised penises as easily as women wash their labia. Seems silly to even mention it.

ok, you think “might get a mouth injury playing contact sports” is comparable to an increased risk of having penile cancer? My goodness, what might befall my child with a chance of an abrasion or other gum trauma?

And of course, the cites you gave couldn’t possibly be exaggerated. What could Pack Orthodontics possibly have to gain from exaggerating the impacts of crowded teeth? Not like my cite, the Mayo Clinic, with all their lucrative circumcision clinics.

[begbert2]

Well, I see things have been lively during my overnight absence. Also I see that there are still a plethora of attempts to compare and/or equate male circumcision with any number of other procedures. I’ll just reiterate my fixed opinion that each and every last one of these types of comparisons is a false equivalence and should cheerfully be disregarded. About the closest you should get to even admitting the existence of other procedures is to note that there are a heck of a lot of medical procedures, cosmetic or otherwise, which are decided upon by parents on behalf of their children. The “parents can’t make medical decisions for their children” argument is thus a non-starter, unless you want to completely overthrow lots of things, up to and including parents deciding upon their children’s diet by doing the shopping and telling them to eat their vegetables.

Regarding the relative merits and downsides of infant male circumcision, I’d say that it’s pretty clear that there is not a wide medical consensus in favor the idea that we should stop doing them.

[clairobscur]

@Malthus

Seriously? Talk about poisoning the well!

Because after reading this thread, you’re under the impression that proponents of circumcision don’t trivialize the issues resulting from it (you have yourself used the very word “trivial”) and don’t throw around accusations of antisemitism?

It seems to me that it’s pretty much exactly what they have been doing here, so it’s a pretty accurate description of reality.

[Malthus]

@clairobscur

And here an article criticizing the methods and conclusions of this AAP report (and listing some of the medical associations that took position against circumcision).
I expect that you will read it with as much interest as you did with the AAP conclusions, and will integrate these opposed conclusions in your analysis of the value (or lack thereof) of circumcision.
ETA : I was addressing Malthus, here.

I was very interested to read it.

So much so, I actually took the trouble of reviewing the very first source they cite - because I cited it too!

From your link:

Canadian Paediatric Society (CPS) (2015)
The CPS does not recommend the routine circumcision of every newborn male. It further states that when “medical necessity is not established, …interventions should be deferred until the individual concerned is able to make their own choices.”

From the actual source:

Neonatal circumcision is a contentious issue in Canada. The procedure often raises ethical and legal considerations, in part because it has lifelong consequences and is performed on a child who cannot give consent. Infants need a substitute decision maker – usually their parents – to act in their best interests. Yet the authority of substitute decision makers is not absolute. In most jurisdictions, authority is limited only to interventions deemed to be medically necessary. In cases in which medical necessity is not established or a proposed treatment is based on personal preference, interventions should be deferred until the individual concerned is able to make their own choices.[46]

With newborn circumcision, medical necessity has not been clearly established. However, there are some health benefits, especially in certain populations. Furthermore, performing circumcision in older boys, who are able to provide consent, can also increase risk and costs to the individual.[39] Therefore, some parents view circumcision as being in their child’s best interest. A complete discussion of ethical and legal issues associated with newborn male circumcision is beyond the scope of this statement. Readers are referred to the July 2013 issue of the Journal of Medical Ethics, which is devoted to the topic.[47] Both parents and health care providers should be familiar with the legal issues related to consent.

Summary

Current evidence indicates that there are potential health benefits associated with male circumcision, particularly in high-risk populations. Infant circumcision reduces the incidence of UTI in young boys and eliminates the need for medical circumcision in later childhood to treat recurrent balanoposthitis, paraphimosis and phimosis. Circumcised men have a lower risk of developing penile cancer, while the incidence of trichomonas, bacterial vaginosis and cervical cancer in the female partners of circumcised men is also reduced. Circumcision in adult men can reduce the risk of acquiring an STI (specifically HIV, HSV and HPV). Minor complications of circumcision can occur, although severe complications are rare. The risk of complications is lower in infants than in older children. The complication rate decreases significantly when the procedure is performed by experienced health care professionals, with close follow-up in the days postprocedure to ensure that bleeding does not increase. It is important to remember that most data regarding the benefits and outcomes following circumcision come from countries other than Canada, which can make application to our population difficult.

Because the medical risk:benefit ratio of routine newborn male circumcision is closely balanced when current research is reviewed (Table 1), it is challenging to make definitive recommendations for the entire male newborn population in Canada. For some boys, the likelihood of benefit is higher and circumcision could be considered for disease reduction or treatment. Health care professionals should provide parents with the most up-to-date, unbiased and personalized medical information available so that they can weigh the specific risks and benefits of circumcising their son in the context of familial, religious and cultural beliefs. Having the right information will enable them to make the best decision for their boys. Decision aids based on current medical information can be helpful.

[Emphasis added]

I ask you this - does the summary in your link represent a fair and factual summary of the actual position?

Think carefully!

[Bone]

Given this:

@tomndebb

ENOUGH!

Everyone back away from the sort of question that is a (not so) veiled accusation of anything. Let’s leave the words “you” and “your” out of the discussion from this point on.

Stick to discussing the topic in neutral terms.
[ /Moderating ]

@Thing_Fish

Sorry I got upset just because someone is advocating the genocide of my people. I guess I’m just a little sensitive on that particular topic.

This is a warning for failure to follow moderator instructions. For one, this is not even a veiled accusation. For two, it’s an absurd cartoonish interpretation which is pretty jerky. For three, it’s passive aggressive bullshit to try and get in another dig after **tom’s **note. One can agree or disagree with the proposition of banning or allowing circumcision without resorting to accusing those who disagree of being advocates for genocide.

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@CarnalK

It’s so much easier to concentrate on the people who called you nazi. You can make huffy noises and flounce in such a noble fashion.

This gets a pass because it’s trivially minor snark, but do note **tom’s **note above.

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Everyone else, cool it.