Talk:Circumcision/Archive 54

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Controversy about controversy

Relevant discussion at

→ 50. Defining the controversy → 48. Lead

I agree with this edit; the new wording, "interferes with normal sexual function," closely follows the wording of the source, which says "FACT: When normal, healthy, sexually functioning tissue is removed, it interferes with normal sexual functioning." For now, I oppose this edit, which adds "is a practice defended through the use of myths", lengthening the opponents' arguments. Up to now we've had equal weighting of the two sides of the "controversy" in this part of the lead. If the weighting is to be made unequal (in number of words and/or number of arguments), I think it would have to be established that one side or the other has more weight in the reliable sources.^{(15:10, 21 February 2009 (UTC))} I think it would be difficult to come to consensus on this, because the types of sources are different: among web pages (?), grassroots organizations and those who take a very strong stand one way or the other, there may be more anti-circumcision sentiment. Among scientific articles, both risks and benefits may be discussed and the overall trend may be more towards pro-circumcision or acceptance of circumcision (ambivalence). If we look at the types of sources traditionally considered more reliable, perhaps if anything the advocates have more weight, especially after the HIV RCTs.^{(02:29, 16 February 2009 (UTC))} For now, as a compromise, let's stick to equal weighting, until we can reach a consensus as to which side should get more weight.^{(15:10, 21 February 2009 (UTC))} ☺Coppertwig (talk) 16:28, 15 February 2009 (UTC)

Coppertwig, a few points:

The HIV RCTs add weight to one pro-circumcision argument, HIV prevention, which currently has a one-sided paragraph dedicated to it in the lead, referencing three major medical organisations/programmes, two of them international.

When you state "Among scientific articles, both risks and benefits may be discussed and the overall trend may be more towards pro-circumcision or acceptance of circumcision" do you mean to imply that this is not the case among the types of sources mentioned in the previous sentence, "where there may be more anti-circumcision sentiment"? What you seem to be saying is that opponents are more likely not to discuss both risk and benefits, and to lack a scientific basis, and advocates (and the ambivalent) are more likely to discuss both risks and benefits with a scientific basis. Was that your intention and is that what you believe, or have I misinterpreted that part of your contribution? Furthermore, why do you equate acceptance of circumcision with ambivalence? Ambivalence does not equate to acceptance. I think you've perhaps mistakenly chosen the wrong word there, and I would like to understand what you meant exactly, for the purposes of clarity in this discussion.

The paragraph under discussion is about the stances of advocates and opponents. The paper chosen to represent the advocates side of the debate seems to have all its main points summarised in the paragraph in question, but this is not the case with the opponents side of the debate. I do not believe that to be balanced. However, I do concede that the phrase I added, "a practice defended through the use of myths", could be improved. Beejaypii (talk) 18:35, 15 February 2009 (UTC)

It is not necessary to include an exhaustive summary of the points made by each paper; the points are arguments chosen to illustrate the controversy. Also, judging by the various points that have been included over the years, I'm not sure whether there is a single set of "main points" with which everyone would agree. I suspect that it is a matter of perspective.

The fact remains, however, that this paragraph has been discussed (at length) and fine-tuned by a number of editors, and it is consequently very well balanced. Consider:

Sentence	Characters	Words	Points
Advocates	288	43	4
Opponents, without 'myths'	311	46	4
Opponents, with 'myths'	360	55	5

Jakew (talk) 19:45, 15 February 2009 (UTC)

Beejaypi, never mind: I struck out part of my comment because it was based on a small amount of searching I had done a long time ago. Let's just say that I don't know, and that until we have some good reasons to give more weight to one side let's leave the two halves equal. ☺Coppertwig (talk) 02:29, 16 February 2009 (UTC)

Why do you both seem to think that an equal number of arguments equates to equal weight? English is not a programming language. Where in the policies and guidelines does it state that weight is attributed equally to opposing sides of a debate by carefully matching the number of arguments, the number of characters, the numbers of words and sentences, and the numbers or portions of paragraphs? Beejaypii (talk) 21:24, 16 February 2009 (UTC)

The lead controversy paragraph is well balanced. It covers the basic pros and cons of circumcision. It does not have to be a tit for tat pro for every con and vice versa. Garycompugeek (talk) 22:29, 17 February 2009 (UTC)

Beejaypii. Argue is to debate. Both sides of the controversy believe they are correct and are not debating each other. They are stating their claims. You are adding unnecessary length and effecting smooth flow readability. Garycompugeek (talk) 23:53, 17 February 2009 (UTC)

In further response to Beejaypii's first post in this thread, I'm striking out another part of my comment. My position is now neutral on that. The current version of the paragraph seems fine to me. ☺Coppertwig (talk) 15:10, 21 February 2009 (UTC)

TotallyDisputed tag

Relevant discussion at

→ Talk:Circumcision#Straw poll: should tags be removed? → 52. TotallyDisputed tag → 48. Tags → 45. Frenectomy

The disputed content tags on the Topic warns the reader of significant factual omissions listed below, which make the article pro-circ propaganda. Discussion is a sham controlled by a small group. The omissions below were generally created when that cabal removed facts from the Topic:

• Removed from the introduction:

The frenulum may be cut at the same time, in a procedure called a frenectomy[1]

[2]

• Removed from Procedures:

The frenulum is cut frenectomy if frenular chordee is evident.[3]

[4]

• Fact removed from Complications:

Chordee of the glans may be the result of circumcision.[5]

• Facts removed from (or barely mentioned in) Complications:

“Meatal stenosis is a relatively common acquired condition occurring in 9-10% of males who are circumcised. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream and, occasionally, dysuria and urgent, frequent, and prolonged urination. Surgical meatotomy is curative.” [6]

“Meatal stenosis is generally a direct consequence of circumcision that is seldom encountered in uncircumcised men; meatal calibre is know to be greater in uncircumcised individuals. The incidence of meatal ulceration following circumcision is from 8 to 20 per cent14,46,64. The aetiology is thought to be irritation of the external urethral meatus by ammoniacal substances present in wet sodden nappies. Such irritation is unlikely in the presence of a normal prepuce, which serves to protect the glans from these irritant substances46. In a prospective study of 140 consecutive neonatal circumcisions, Mackenzie64 found a 20 per cent incidence of meatal ulceration within the first 2-3 weeks after circumcision. It is thought that meatal ulceration after circumcision is the initiating event in a vicious cycle of stenosis and ulceration, followed by more stenosis64. Meatal stenosis following circumcision has been advanced as a cause of recurrent pyelonephitis and obstructive uropathy, for which meatotomy is curative64,65.”[7]

“Meatal stenosis is an under recognised complication of circumcision done in neonatal and nappy aged boys. Symptomatic presentation from meatal stenosis can be very late (two years).” [8]

“Traumatic meatitis of the unprotected post-circumcision urethral meatus and/or meatal ischaemia following damage to the frenular artery at circumcision are suggested as possible causes of meatal stenosis. CONCLUSION: Preservation of the frenular artery at circumcision, or the use of an alternative procedure (preputial plasty), may be advisable when foreskin surgery is required, to avoid meatal stenosis after circumcision.”[9]

• Gross propaganda:

The Circumcision topic in Wiki leads the reader to believe that the covenant made with Abraham (note the “commandment from God” sentence in the second paragraph) was the current radical practice (in that it removed the covering of the glans). In fact, we find "the circumcision which Abraham performed on himself and other male members of his household was the removal of the tip of the prepuce.” This tip of the prepuce removal circumcision was practiced by Jews and Muslims for thousands of years.[10][11][12] This simple (Milah) procedure resulted in much less pain and erogenous nerve loss than the current Bris and Sunnet practices.

• Removed from complications, and UTI:

"An epidemiological study of UTI during the first year of life involving 169 children born in Israel found that 48% (27/56) of the male infants presented with UTI within 12 days after ritual circumcision.51 The incidence of UTI among male infants was significantly higher just after circumcision (from 9 to 20 days of life) than during the rest of the first month of life and significantly higher in the first month of life than during the rest of the year. After the immediate postcircumcision period, the incidence rate of UTI dropped to a level comparable to that reported among circumcised male infants in the United States."[13]

• Removed from Pain:

Without exception, newborns in this study who did not receive an anesthetic suffered great distress during and following the circumcision, and they were exposed to unnecessary risk. Two of 11 newborns in the study who received no local anesthetic had potentially dangerous episodes within minutes of the procedure. One newborn lost muscle tone, stopped breathing several times and vomited. The other choked and stopped breathing briefly, the researchers said.[14]

• Wiki leds us to believe circumcision is best done during infancy (see Advocates above, and the Topic), but:

“Circumcision at 5 months results in significantly fewer serious complications than circumcision in the neonatal period, irrespective of the method used. Therefore, neonatal circumcision should not be recommended.” [15]

• Obscured from the reader:

Wiki should link to the actual Sorrell’s study. Circumcision currently links to a very short summary. We should also convey the essence of their findings:

“The most sensitive location on the circumcised penis was the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision had lower pressure thresholds than the ventral scar of the circumcised penis.”

…”Circumcision removes the most sensitive parts of the penis and decreases the fine-touch pressure sensitivity of glans penis. The most sensitive regions in the uncircumcised penis are those parts ablated by circumcision. When compared to the most sensitive area of the circumcised penis, several locations on the uncircumcised penis (the rim of the preputial orifice, dorsal and ventral, the frenulum near the ridged band, and the frenulum at the muco-cutaneous junction) that are missing from the circumcised penis were significantly more sensitive.”[16]

• Removed from sexual effects:

“While vaginal dryness is considered an indicator for female sexual arousal disorder,1,2 male circumcision may exacerbate female vaginal dryness during intercourse.3 O’Hara and O’Hara reported that women who had experienced coitus with both intact and circumcised men preferred intact partners by a ratio of 8.6 to one.4 Most women (85.5%) in that survey reported that they were more likely to experience orgasm with a genitally intact partner: ‘They [surveyed women] were also more likely to report that vaginal secretions lessened as coitus progressed with their circumcised partners (16.75, 6.88–40.77).’4”[17]

• Removed from sexual effects:

“Presence of the movable foreskin makes a difference in foreplay, being more arousing to the female.4 Women reported they were about twice as likely to experience orgasm if the male partner had a foreskin.4 The impact of male circumcision on vaginal dryness during coitus required further investigation.”[18]

• Removed from sexual effects:

“These preliminary figures support the claim by Morgan [1 and 2] that vaginal intromission is easier with a (retractable) foreskin in place. The mechanism is simple. The interposed foreskin decreases the friction between the introitus and the glans. The unretracted foreskin consists of a thin dermis that is folded on itself with very little friction between the layers. As the penis advances, the foreskin unrolls so that the portion that makes initial contact with the introitus is 6 cm. Up the shaft before any friction occurs between the device and the skin.”[19]

• Removed from sexual effects:

“Participants reported significantly reduced erectile function, decreased penile sensitivity, no significant change in sexual activity, and significantly improved satisfaction after circumcision. This improved satisfaction represented a more satisfactory appearance of the penis and less pain during sexual activity.” [20]

• Removed from sexual effects:

“Techniques are available to induce ejaculation in men with SCI (spinal cord injury), who are otherwise anejaculatory. The semen can then be used for in vitro fertilization. External vibratory stimulation involves the use of a vibrator over the glans and frenulum to induce an ejaculatory reflex. [21]

• Removed from sexual effects:

Boyle et al. (2002) argued that "structural changes circumcised men may have to live with are surgical complications such as skin tags, penile curvature due to uneven foreskin removal, pitted glans, partial glans ablation, prominent/jagged scarring, amputation neuromas, fistulas, severely damaged frenulum, meatal stenosis, uncomfortably/painfully tight shaft skin when erect, and keratinisation." “The loss of stretch receptors in the prepuce and frenulum and an associated diminution in sexual response" may reduce a "circumcised man’s ability to achieve arousal." …"Due to the neurological injury caused by circumcision, and the resultant reduction of sensory feedback" erectile dysfunction and premature ejaculation may be a complication of male circumcision, potentially making "intercourse is less satisfying for both partners when the man is circumcised.”[22]TipPt (talk) 00:27, 16 February 2009 (UTC)

TipPt, your message repeats what you said earlier and fails to address what I already said in reply. You have still not stated any arguments as to why you believe that material ought to be included in this article. Although in your earlier reply you quoted parts of the sources you mentioned, I see nothing in what you quoted that says only the tip of the foreskin was removed. While you may be right that some of the material may have been deleted before the shortening of the article, that in no way constitutes an argument as to why it should be present in the article. A reason not to include it, as I've already stated, is that this is a summary article and adding any material may make it too long. There is also a careful balancing of amount of material on different topics and viewpoints in this article, which would be overbalanced by any lengthy additions. I would appreciate it if you would try to keep your article talk page posts shorter. One easy way to do this would be to give diff links to where you've presented the same material before, rather than repeating it. Re the disputed template: see deletion discussions [23] and [24]. ☺Coppertwig (talk) 01:51, 16 February 2009 (UTC)

Coppertwig You seek to waste our time with repeat silly questions. I have provided reasons for inclusion, and have provided valid sources. Current text is often not accurate. Jakew, in my opinion is a Wikipedia:Troll#Misuse_of_process. He is great at detail and wasting time, while ignoring relevance.

Some new editors may be interested in this: Jakew

Read the sources above, or simply remember prior discussion.

Here is one example of silly: I provide two published surveys (one that cites a third survey) that find circumcisions need include frenectomy in 20%, 25%, and 33% of procedures. But the cabal removes and blocks any mention of frenectomy in the Topic! It's not in the intro, or procedures, or complications, or sexual harm ... though all well sourced for each of those sections, this factual information is denied the reader for pro-circ gain. Coppertwig ... You are silly to ask "state why" something like frenectomy should be included! Remove the male G-spot, but don't mention it in Circumcision! The fact that it is not included is proof of silly, gross bias in the Topic.

The length problem is cause by detailing medical "benefits" at length, twice, though they are minor, generally dismissed by the medical community, and cost/benefit studies find medical reasons invalid for all neonatal circs (the vast majority of circs).

Wiki is deeply flawed in letting biased editors, and especially admins, form a cabal and dominate a topic. My purpose is to keep significant missing facts ... at least in discussion ... available to the reader. If you are serious about making the Topic honest, I will again try to provide suggested text.TipPt (talk) 16:10, 16 February 2009 (UTC)

TipPt, please respect consensus, and please desist from defacing articles and violating WP:NPA: Comment on content, not on the contributor.. Jayjg ^(talk) 16:34, 16 February 2009 (UTC)

I expect admins to respect verifiable relevant fact.TipPt (talk) 16:45, 16 February 2009 (UTC)

They do; but your view on what is "relevant" and appropriate for this article, given the constraints of WP:PRIMARY, WP:NPOV and WP:LENGTH, differs remarkably from both Wikipedia preferred practice and the views of other editors here. Jayjg ^(talk) 16:57, 16 February 2009 (UTC)

For all to see, here's Jayjg implicitly stating that issues of frenectomy are not relevant to (violates Wiki???) circumcision. Silly gross propaganda by the Cabal (concensus?).TipPt (talk) 17:11, 16 February 2009 (UTC)

Tip I know it can be hard to assume good faith but you must try harder. I agree with much of what you say but my time is usually limited. Follow the dispute resolution process to resolve these issues. Garycompugeek (talk) 23:11, 17 February 2009 (UTC)

TipPt has been blocked. ☺Coppertwig (talk) 00:40, 18 February 2009 (UTC)

Problematic addition to lead

A problematic addition has been made to the lead. A similar edit was made previously; I edited it at the time to correct some of the most severe problems.

Let's consider the two versions:

• "Most circumcisions occur during adolescence for cultural reasons."
• "Most circumcisions occur without anesthesia during adolescence for cultural reasons, and in these circumstances there is an increased chance of adverse effects."

For comparison, it may help to examine the source. It states:

• "Globally, 30–34% of men are circumcised.3 Most of these circumcisions are performed for cultural or religious reasons during adolescence, outside formal health-care settings, without anaesthesia and in challenging traditional settings."

If we examine the first of these, we can see that it fits well in the context of the paragraph. If we examine the second version, we see that there are some serious problems:

1. The edits involve the second paragraph of the lead. The subject of this paragraph is the prevalence of and reasons for circumcision: in short, "how many?" and "why?". The relevance of the particular method of circumcision (ie whether anaesthesia is or isn't used) and the consequences (if any) in terms of adverse effects is unclear. I don't mean to suggest that these issues don't matter, but it is unclear why they belong in this paragraph. Their only apparent function seems to be to say "look how awful most circumcisions are." And because it is unclear why they belong, the effect is that the paragraph seems to act as a soapbox.
2. There are verifiability problems. On the plus side, the source does suggest that most circumcisions are performed without anaesthesia, and it does suggest that they occur during adolescence. However, from there it is downhill. It does suggest that most circumcisions are performed for cultural or religious reasons, but this is different from saying (as in both versions) that they're performed for cultural reasons. Worryingly, it doesn't directly support the claim that the items mentioned (adolescence, lack of anaesthesia, and cultural reasons) increase the probability of adverse effects.

For these reasons, I'm reverting to the shorter version. I am also changing "cultural reasons" to "cultural or religious reasons". Jakew (talk) 10:27, 4 March 2009 (UTC)

I disagree with your edit. I believe the fact that most circumcisions are committed without anaesthesia to be extremely relevant, and much more relevant than much other information in the lead, especially the WP:SOAP paragraph that emphasizes its antiquity and the religions that encourage the act, while omitting mention of religions that discourage it or have discouraged it. We should at the very least cite this source in "circumcision procedures," and specifically mention that most circumcisions are done in adolescence, without anaesthesia. Blackworm (talk) 16:11, 4 March 2009 (UTC)

Sorry, Blackworm. When I said "I don't mean to suggest that these issues don't matter, but it is unclear why they belong in this paragraph", I was trying to stress that I was discussing relevance to that particular paragraph rather than, say, relevance to circumcision. I guess that wasn't as clear as I intended.

I think it would be reasonable to include something in "Modern circumcision procedures". Jakew (talk) 19:46, 4 March 2009 (UTC)

If you think so, why don't you add it? Removing something wholesale, rather than moving it, is discouraged on Wikipedia. If you think it doesn't belong in that particular paragraph, move it to another (in the lead). Don't remove it. The third paragraph, which discusses pros and cons, is so focused on neonatal circumcision that I feel it would be misleading to put it there, although if nothing else I will put it there. I don't understand how cultural cannot be used to summarize "cultural and religious" -- a religious reason is a cultural reason. Please restore the language or at least move it elsewhere. As far as adverse effects, I guess you didn't see this sentence:

That the adverse event rate of 35.2% in traditional settings was twice the rate of 17.7% in medical settings is scarcely comforting.1

Or can adverse event not be summarized as adverse effects? Also, why is there no mention of possible complications of the lead, when there is a good summary in the body? The lead looks pretty soapboxy to me, in the positive vein -- coming from someone who really doesn't have a strong opinion about neonatal circumcision. II | (t - c) 20:26, 4 March 2009 (UTC)

Regarding "cultural and religious", if you examine the previous sentence ("The prevalence of circumcision varies mostly with religious affiliation, and sometimes culture"), you'll see that it makes a distinction between religion and culture. Having made such a distinction, we cannot reasonably use "culture" in a very broad sense, and expect that the reader will understand that this more inclusive sense is intended. In another context it might be more acceptable to use less precise language, though personally I would prefer to be precise.

Regarding adverse effects, the sentence you quote compares the adverse event rate in traditional settings with that in medical settings. It might support a statement such as: "circumcisions performed in traditional settings are associated with a greater risk of adverse effects than those in medical settings." However, the claim attributed to the source was that circumcisions performed a) without anesthesia, b) during adolescence, and c) for cultural reasons were associated with increased risk of adverse events. That claim is not made by the source, and should not be attributed to it.

I agree it would be inappropriate to include this material in the third paragraph. It doesn't seem to belong in any paragraph in the lead. Jakew (talk) 21:50, 4 March 2009 (UTC)

Ah, yes. Circumcisions performed in adolescence without anesthesia for cultural reasons is not equivalent to circumcisions performed in traditional. I apologize for not picking that up. Since you seem to be heavily-invested in this article, why not summarize the medical effects in the lead? II | (t - c) 00:33, 5 March 2009 (UTC)

Because we don't want to acknowledge any negative effects associated with circumcision. This is the purpose of the article, didn't you know? Tremello22 (talk) 12:20, 11 March 2009 (UTC)

Navbox discussion

Readers of this page may be interested in an ongoing discussion about the navigation box that was recently added. Jakew (talk) 10:21, 26 March 2009 (UTC)

Effect of circumcision on HIV infection & other STD's

There's a large new randomized prospective trial that was published in the latest New England Journal of Medicine on male circumcision and its effects on prevention of HSV-2, HPV and syphilis in Uganda. I'll post the link as soon as the site posts what's already been printed on paper.

Also, I was looking at the intro paragraph to the HIV:

"The origin of the theory that circumcision can lower the risk of a man contracting HIV is disputed.[117][118][119] Since the idea was first mooted, over 40 epidemiological studies have been conducted to investigate the relationship between circumcision and HIV infection.[120] Reviews of these studies have reached differing conclusions about whether circumcision could be used as a prevention method against HIV.[121][122][123][124]"

At this point, with several well-designed experimental studies published, the epidemiologic data seem less relevant. Any objections to condensing the paragraph to the following?

"Over 40 epidemiological studies, with contradictory conclusions, have been conducted to investigate the relationship between circumcision and HIV infection[120]." Wawot1 (talk) 19:44, 24 March 2009 (UTC)

I agree with the basic idea, Wawot1, but not with the proposed edit. I think it would be misleading to say that these studies have had "contradictory conclusions", which might be interpreted as meaning that the results of these studies were highly inconsistent. Observational studies generally find a negative association between circumcision and HIV infection. With the exception of Van Howe, authors of meta-analyses were generally in agreement on this, but disagreed about whether observational data alone were sufficient to support a recommendation of circumcision as intervention.

How about this instead: "Over 40 epidemiological studies have been conducted to investigate the relationship between circumcision and HIV infection;[120] reviews have reached differing conclusions about whether circumcision could be used as a prevention method against HIV.[121][122][123][124]" Jakew (talk) 19:57, 24 March 2009 (UTC)

Fair enough. Wawot1 (talk) 20:04, 24 March 2009 (UTC)

In at least 7 African countries circumcised males have higher AIDS rates than uncircumcised males. The U.S. has the highest AIDS rate and highest STD rates of any indutrailized country in the world, although in most industrailized countries near 0% of males are circumcised. Dozens of studies show that circumcisions do not reduce the risk of males getting AIDS. So especially outside of the U.S. many medical organizations state that there are conflicting evidences if circumcisions help protect against AIDS and STD's or not. I think it is very misleading to cherry-pick evidences and claim that circumcisions help protect against AIDS and STD's when there are so many conflicting evidences. You guys are doing a good jobJew1000x (talk) 14:04, 26 March 2009 (UTC)

Can you please cite some reliable sources for your claims?Wawot1 (talk) 21:14, 26 March 2009 (UTC)

Gladly, Rwandan men are more likely to have HIV if they've been circumcised: 3.5% of intact Rwandan men have HIV 2.1% of circumcised Rwandan men have HIV (figures from http://www.measuredhs.com/hivdata/reports/start.cfm) Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, Swaziland, and Tanzania. That's at least seven African countries where men are more likely to be HIV+ if they've been circumcised, and yet we see health organizations promoting circumcision to prevent HIV. What will it take to stop this madness? I'm mot an epidemiologist, but I am a doctor and incomplete justifications are nothing more than guessing and often lead to misdiagnoses. I don't know why this bias exists, but for once there are a lot of those of the Judaic faith in medicine, especially in the U.S. As a member of the Judaic faith myself, I can attest bias may be at hand. Ambiguity is the only safe argument Jew1000x (talk) 00:11, 27 March 2009 (UTC)

"As a member of the Judaic faith myself"? LOL! Nice try. Jayjg ^(talk) 02:22, 27 March 2009 (UTC)

Great website. I couldn't find your statistics about circumcision on it though. Regardless, all of the data there are from sample surveys and are observational. Those kind of data can only demonstrate correlation, but not causality. The three randomized studies showing that circumcision reduces HIV incidence were randomized prospective trials and this type of study can say something about causality. Wawot1 (talk) 21:34, 27 March 2009 (UTC)

Catholic Church view on circumcision

Reading the section on the Catholic's view on circumcision, I checked the source material for the cited sentence. However, from what I can understand from the source, what is said on the Wiki page is not the same as what is said in the source. The page currently states that anyone who observes the act of circumcision commits mortal sin, yet the source says that anyone who observes it as necessary for salvation and as if faith in Christ without them could not save, sins mortally.. I believe the two sentences are worded differently and should be changed to reflect the intent in the source. Big Samus (talk) 04:58, 31 March 2009 (UTC)

No this is not a correct reading of the cited text, "Therefore it strictly orders all who glory in the name of Christian, not to practise circumcision either before or after baptism, since whether or not they place their hope in it, it cannot possibly be observed without loss of eternal salvation.". This is a clear prohibition on circumcision for those who hope for (Catholic) salvation.

However a source more recent than the fifteeth century would be desirable! Circumcision is currently requested by many Catholics for their children for the secular reasons of health, tradition and culture and it would be desirable to include this point with a reference. I will see if I can find one. Dr-zt (talk) 09:25, 6 April 2009 (UTC)

As is so often the case, multiple interpretations exist; for a couple of sources see History of circumcision#Male circumcision in the Renaissance. Jakew (talk) 09:34, 6 April 2009 (UTC)

Circumcision is also currently rejected by many Catholics on the grounds that it is an unnecessary infliction of great pain and mutilation upon a helpless infant. It would be desirable to include this point with a reference. I will see if I can find one. Blackworm (talk) 19:35, 6 April 2009 (UTC)

New African study conclusive, unless we turn against science itself

The new African study is so conclusive that people who questioned circumcision can take pride in having demanded scientific data in support of circumcision's health benefits. That data has been supplied. At this point, the only way to deny circumcision's health benefits is to deny the scientific method, or to impute deceit by our most respected news organizations. "When reason is against a man, a man will soon be against reason." Well, let's hope not.Profhum (talk) 02:58, 27 March 2009 (UTC)

"March 25, 2009 — Male circumcision significantly reduced the incidence of HIV and herpes simplex virus type 2 (HSV-2) infection and the prevalence of human papillomavirus (HPV) infection, suggesting potential public health benefits, according to the results of a randomized controlled trial reported in the March 26 issue of the New England Journal of Medicine."

"Male circumcision significantly reduced the incidence of...HIV infection among men in three clinical trials," write Aaron A.R. Tobian, MD, PhD, from Bloomberg School of Public Health, Johns Hopkins University in Baltimore, Maryland, and colleagues. "We assessed the efficacy of male circumcision for the prevention of...HSV-2 and...HPV infections and syphilis in HIV-negative adolescent boys and men." ...

"Male circumcision has now been shown to decrease the rates of HIV, HSV-2, and HPV infections in men and of trichomoniasis and bacterial vaginosis in their female partners," the study authors conclude. "Circumcision also reduces symptomatic ulceration in HIV-negative men and women and HIV-positive men. Thus, male circumcision reduces the risk of several sexually transmitted infections in both sexes, and these benefits should guide public health policies for neonatal, adolescent, and adult male circumcision programs."

Circumcision May Reduce Incidence of HIV, HSV-2, HPV Infection CME

News Author: Laurie Barclay, MD

CME Author: Charles Vega, MD, FAAFP

Disclosures

Release Date: March 25, 2009; Valid for credit through March 25, 2010

http://cme.medscape.com/viewarticle/590110?src=cmemp

-- Fyslee (talk) 06:44, 7 April 2009 (UTC)

Who's the one turning against science?

Your claims regarding the scientific method and reason are classically mistaken. First, the countries with the lowest HIV rates in the world do not practice circumcision. This alone is scientific proof (a la scientific method) that circumcision is entirely unnecessary to achieve the lowest rates of HIV infection. It would thus be completely folly to suggest that men in countries with low HIV rates (European countries, for example) should cut the tips off their penises based on the evidence you've presented. Further, the studies you cite could actually lead young people towards the FALSE belief that they could avoid HIV infection by circumcision with the result being that young circumcised males might not use condoms. Or perhaps an HIV positive man who is circumcised would be less likely to tell a partner with the FALSE hope that there is a low(er) risk of spreading infection. This could lead to an increase in HIV. Again, the lowest HIV rates in the world are in countries that do not circumcise.

Having said that, I'm curious why the issue of cleanliness and access to fresh water is not discussed in this article. The nations that circumcise all arise from relatively arid cultures (israel and Palestine, arab countries, and sub-saharan africa) where regular bathing was not always possible in ancient times. This may explain the historic practice. After all, the scientific consensus appears to be that circumcision is unnecessary and thus not recommended so long as you practice good basic hygiene (and have access to the fresh water that is necessary).

Cochrane Review updated

The Cochrane Review on circumcision and HIV has now been updated. See this news report. I think that this is the updated report. However, it is slightly unclear whether this version reflects today's update, as it states "Last assessed as up-to-date: September 10. 2008". This will affect circumcision and HIV, medical analysis of circumcision, and possibly this article. Jakew (talk) 14:34, 15 April 2009 (UTC)

Perhaps we should create a Male Circumcision in South Africa article. Here might be some other useful sources: [25] [26] [27]. Blackworm (talk) 00:45, 17 April 2009 (UTC)

I think perhaps you may have misunderstood, Blackworm. Although the authors of the Review are (I believe) from South Africa, the Review is in no way limited to that country. Cochrane Reviews are systematic reviews and meta-analyses of the evidence that are well-respected in evidence based medicine. Consequently, it is a reliable secondary source. We therefore need to ensure that a) it is cited where appropriate, and b) where earlier versions of the Review are cited, these are updated to reflect the current version. Jakew (talk) 09:54, 17 April 2009 (UTC)

The Mucous membrane Issue & Circumcision

Why is there no discussion or references in this article about the glans (head) of the penis being a natural mucous membrane? This is one of the main medical arguments against circumcision, because when the foreskin is sliced away the glans ceases to be a mucous membrane like it is in its natural uncircumcised state. Circumcision is quite simply the process of turning the glans from a (mostly) internal part of the body (a natural mucous membrane) in to a totally external part of the body (non-mucous membrane). This is bad because mucous membranes like the glans are supposed to be naturally moist, while a circumcised glans loses its ability to be moist because the foreskin has been sliced away and thus the retention of smegma and other natural secretions is lost, leading to gradual toughening [keratinization] of the skin of the glans. There are plenty of sources and references regarding this issue - so why is it not mentioned in this article? —Preceding unsigned comment added by 172.163.80.90 (talk • contribs)

REPLY: not to tech savy, so i wasn't sure how to properly add responses, but this is also an argument FOR circumcision, as a new study has pointed out that transmision of STIs, including HIV has a higher possiblility of occuring in uncircumcised men. Im not sure of the source of this, but i do remember hearing it on the news. They said that the findings were concerning heterosexual males, and only Female to Male transmission. They were saying it may be a way of decreasing the growing rate of HIV in africa, as most transmissions are in heterosexual situations, and most men are uncircumcised. —Preceding unsigned comment added by 24.201.209.7 (talk • contribs)

Again, please see Talk:Sexual effects of circumcision#The Mucous membrane Issue .26 Circumcision. Jakew (talk) 09:43, 17 April 2009 (UTC)