Talk:Circumcision/Archive 83

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Psychological effects

Thanks to user Retimuko (06:37, 15 December 2019) and to user Remember the dot (‎Psychological effects: "not being circumcised" → "being intact"), the psychological effects are such an important issue within the topic of circumcision. German professor Dr. Matthias Franz knows f. e. about panic attacks, Angstattacken, and, among 5 or 6 year old boys, about fears of being castrated (soon), Kastrationsandrohung. See here: taz: „Es ist ein genitales Trauma“ https://taz.de/Debatte-um-Beschneidung/!5088276/ - or here: Die Beschneidung von Jungen. Ein trauriges Vermächtnis. 79.219.94.75 (talk) 17:37, 15 December 2019 (UTC)

Are there any decent secondary sources on this? What we have is poorly-sourced. Alexbrn (talk) 17:44, 15 December 2019 (UTC)

Perhaps we should add this: The psychological impact of circumcision (Ronald Goldman (1999)) https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410x.1999.0830s1093.x (In: BJU Int. 83 (1), (1999), S. 93–102) Ronald_Goldman_(psychologist) - and this: A Preliminary Poll of Men Circumcised in Infancy or Childhood (Timm Hammond (1999)). In: British Journal of Urology International (BJUI). Band 83, Nummer S1, Januar 1999, S. 85–92. doi:10.1046/j.1464-410x.1999.0830s1085.x , PMID 10349419. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410x.1999.0830s1085.x 79.219.94.75 (talk) 17:52, 15 December 2019 (UTC)

These are both poor sources: the first is old, the second - a "preliminary poll" - is a weak primary source. Has there been no secondary exploration of this subject in recent years? Alexbrn (talk) 17:56, 15 December 2019 (UTC)

Bingo! A recent systematic review:

• Morris BJ, Moreton S, Krieger JN (November 2019). "Critical evaluation of arguments opposing male circumcision: A systematic review". J Evid Based Med (Systematic review). 12 (4): 263–290. doi:10.1111/jebm.12361. PMID 31496128.

Alexbrn (talk) 05:48, 16 December 2019 (UTC)

The reference I added to the Canadian study that found higher dissatisfaction among circumcised men versus uncircumcised was replaced with a reference to the review you found that didn't mention the Canadian study and only considered two other studies, both in the United States, which came to the opposite conclusion. In fact, all references to whether men like or dislike being circumcised have been removed from the section. I'm fine with talking about the studies in the United States, but if this article is going to be neutral and represent a global perspective, sources representing a broader perspective need to be included as well. —Remember the dot ^(talk) 07:50, 16 December 2019 (UTC)

Since the article I linked is paywalled, perhaps it would be better to link to page 143 of the author's doctoral thesis which discusses the same results. —Remember the dot ^(talk) 08:11, 16 December 2019 (UTC)

To avoid giving WP:UNDUE prominence to novel research, we shouldn't really be using primary sources, especially when we have strong secondary ones. Alexbrn (talk) 08:46, 16 December 2019 (UTC)

I have to say, this article comes off as quite biased, to the extent that I'm a bit pessimistic of getting involved in trying to change the current state of it, because I assume any efforts will be futile. I can sympathize with a preference for reviews, but refusal to include scientific studies that aren't reviews seems too strong, especially when it seems there are selectively removed when they don't support the current dominant authors' point of view. Are there any recent reviews that don't involve Morris, who seems to be extremely biased in favor, as an author? If those are rare, then I think the preference for secondary sources is inappropriate. I agree that we need to represent a broader perspective. Dayshade (talk) 15:27, 20 December 2019 (UTC)

We generally don't use primary sources for WP:Biomedical information anywhere on Wikipedia - see WP:WHYMEDRS for some background to this. There are many secondary sources that do not involve Morris, and we cite many non-Morris sources (134 of the article's 140 sources, to be exact). Morris is of course a bogeyman for anti-circumcision activists, but not using material published in top-tier secondary source would be to pander to that activism – the assumption has to be that the peer-review process gives us good science. As a means of damping down drama in the past, Morris has be de-emphasized when there are equivalent sources saying broadly the same thing. I'm not seeing any policy-based case for doing so with our present text and sourcing. Alexbrn (talk) 15:38, 20 December 2019 (UTC)

Thanks for your quick reply. That makes sense. I'm glad to see that there are a decent number of secondary sources not involving Morris, as he seems to clearly have a conflict of interest to me (although, from looking at several, it seems most of those 134 are not medical studies, do not cover negative effects, or rely on his research to support claims such the nonexistence of harm). Do you disagree with that? Also, it just occurred to me that scientific reviews could become an echo chamber - for example, in the source (by Morris) used on the following quote, other reviews are given high weight, which as noted before, often have cited his publications. Anyway, I think I'm more concerned about the recent addition of this: "Medical disinformation spread by opponents of circumcision may have an adverse psychological effect on vulnerable men who have been circumcised." I don't see the word "disinformation" anywhere in that source, so that claim seems to be uncited. Has there been any scientific study of why circumcised men are frequently unhappy with their status? The old version of that section seems to at least be better than what it was changed to. Additionally, the sexual effects section seems incomplete. It says, "circumcision does not decrease the sensitivity of the penis", but shouldn't that end, "the remainder of the penis"? Additionally, why isn't there a mention of sexual practices that become impaired or impossible with circumcision? Dayshade (talk) 16:31, 20 December 2019 (UTC)

It is simply not our job as Wikipedia editors to attempt amateur peer re-review of scientific sources: we leave that to those who are qualified. So your views about conflict of interest &c. have no bearing because this will have been accounted for in the peer-review process. As a matter of fact, the cited review is not completely "pro" circumcision but in many areas asserts there is debate in the literature, as we say. The prior version of this section was unreliably-sourced using out-of-date sources falling outside WP:MEDRS preferred 5-year window for actively-researched topics. We are meant to paraphrase sources, so your not seeing an exact word quoted in both Wikipedia and the source is quite expected. The relevant sentence in the Morris review for this content is in section 4.20 (I take it you have read the source?):

Men circumcised as adults are able to compare their experience before and after MC, but men circumcised as infants have no experience to draw upon. Arguments used opposing MC can result in psychological problems and their sequelae in vulnerable men. The risk of distress, depression, and the broader psychological impact of arguments opposing MC in vulnerable men, and parents, merit further investigation. [...] Deeper quantitative analysis has revealed that individuals opposing vaccination also tended to post material against other health-related practices such as water fluoridation and MC.

As to your proposed additions, we would need good sources which are – as always – the basis of what we can include. Alexbrn (talk) 16:52, 20 December 2019 (UTC)

With respect to peer re-review, if that is Wikipedia's policy, then very well. To be fair, WP:MEDRS itself says that "Bias caused by conflicts of interest is an important issue in medical research", and so on, though obviously there is no consensus here to apply that. The cited review is as a whole quite pro circumcision, and that is what I was referring to, though yes, it admits more research is needed in some areas. Thanks for the paste of the quote. The "Arguments used opposing..." sentence appears to just be speculation by the author. Do you disagree that it is? Perhaps you would agree that the sentence could at least be removed and the source moved to the earlier paragraph? I don't think an author's offhanded speculation merits the inclusion of such a biased sentence - yes, perhaps there are some men whose unhappiness is purely based on a belief in something like erectile disfunction that are not supported by the accepted literature reviews, but there has been no study on what actually causes men's unhappiness with circumcision, so this assumption is unfair. Even if it were not speculation, it still leaves out many other possible reasons for unhappiness. As for my proposed additions, they are claims inherent to what the procedure does. It does remove sensitive tissue from the penis (I am unaware of any research that disputes this. I am not talking about the sensitivity of the remaining parts.), so I don't see why saying "the remainder of the penis" needs to have an explicit source - it's obvious. The loss of the ability to dock, or masturbate using the foreskin, for example, also is obvious. A study to measure these things would be absurd, which is why they don't exist. And, the same can be said about the disinformation claim - there is no good source that is the basis of what we can include. Dayshade (talk) 17:20, 20 December 2019 (UTC)

It is not "offhand speculation", it is science: a multi-author review article published in a reputable journal – exactly the kind of source Wikipedia favours for the purposes of summarizing "accepted knowledge". In the source the text uses frequent citation (which I have omitted from my copy & paste) – the review has 432 citations. PMID 30905530 is cited in relation to the "misinformation", which may in fact prove useful for this article. Alexbrn (talk) 17:28, 20 December 2019 (UTC)

What? I am not talking about the review as a whole, but that specific sentence that appears to be uncited. The paper you cited in your last sentence does not relate to the sentence added at the bottom of the psychological effects section of this article. I looked at the unquoted text, and see the citations now - but they (citations 419 and 420) are just referencing the motivations and suicide of one person, which is meaningless scientifically. Do you disagree? Also, can you reply to the remainder of my earlier reply? Dayshade (talk) 17:37, 20 December 2019 (UTC)

In the original, the sentence cites two sources (as I said, I did not copy & paste the citations which would just be meaningless superscript numbers in this context). I have nothing more to add with regard to your suggested additions: we would need good sources which are – as always – the basis of what we can include. Alexbrn (talk) 17:42, 20 December 2019 (UTC)

I updated my reply after looking at the actual text. They are references to the motivation of and suicide of one specific person, which is meaningless scientifically. Do you disagree? Why do you think obvious facts that cannot be studied cannot be included? WP:CITE says, "[Wikipedia] requires inline citations for any material challenged or likely to be challenged, and for all quotations, anywhere in article space." Where is it challenged that circumcision removes a sensitive part of the penis and makes sexual activities involving the foreskin impossible? Dayshade (talk) 17:57, 20 December 2019 (UTC)

It is not our job to decide the science, rather we humbly follow good sources. The trouble with including unsourced material is that it risks violating our duty to be WP:NPOV. We reflect material covered in reliable sources to make sure we give only due WP:WEIGHT to things. If something is mentioned nowhere why should Wikipedia (which is meant to be a tertiary source) be saying it alone? Alexbrn (talk) 19:05, 20 December 2019 (UTC)

Well, would you at least agree that the sentence in this article inserted based off of an author's speculative comment based off of an anecdote of one person's life could be removed? I agree in general with your position, but in this case, any study would be absurd, because circumcised men don't have a foreskin that can be used in the practices I am referring to. Because of that, it makes sense that there is no study about them (they aren't mentioned nowhere, just not in studies). To me, this is equivalent to saying "Earth is the third planet from the Sun" in that sourcing it would be absurd. I guess I am sympathetic to a weight argument, but this is specifically a sexual effects section. Why shouldn't the removal of the possibility of an activity that itself is mentioned elsewhere on Wikipedia be mentioned? I also still don't understand what would be wrong about changing "...the sensitivity of the penis" to "...the sensitivity of the remainder of the penis". All that change would do is make the statement less vague. Dayshade (talk) 19:29, 20 December 2019 (UTC)

Because RS doesn't refer to circumcised men's penises as "remainders of penises" - such a wording would be absurd. I have no more to add to what I have already written: we find good sources and faithfully reflect their content. Alexbrn (talk) 19:36, 20 December 2019 (UTC)

What about the remainder of the reply, particularly with regards to removing that sentence? What is "RS"? The current wording suggests the foreskin is not sensitive - sensitive tissue is removed, and the research only suggests that the remaining tissue is unaffected. I don't understand why obvious facts cannot be included. Should the fact that Earth is the third planet from the Sun be sourced? Dayshade (talk) 19:45, 20 December 2019 (UTC)

RS is WP:RS. That the earth is the third planet from the sun is easily sourcable.[1] The sentence you object to also follows relevant, high-quality WP:RS so is WP:DUE; it stays. Alexbrn (talk) 19:49, 20 December 2019 (UTC)

Perhaps it's within a reliable source, but the claim made is unsourced except on a single anecdote. Can you explain explicitly why the sentence within the source follows relevant, high-quality RS? I don't see how DUE applies given that it is unsourced aside from the anecdote. A simple Google search reveals descriptions of practices involving the foreskin. Should the reference of the existence of e.g. docking here (redirected) be removed because it is unsourced? Dayshade (talk) 20:04, 20 December 2019 (UTC)

Once again, it's not our job to re-write the science found in reliable sources. As the saying goes: cite reviews, don't write reviews. We don't use "simple google searches" as sources. Since I have now repeated all these points at least once I shall step back for the moment and see if other editors want to interject. Alexbrn (talk) 20:12, 20 December 2019 (UTC)

An offhanded speculative sentence based on one anecdote is not "science" just because it appears in a research article. Speculation is by no means rare in research articles in an effort to suggest explanations for results, and there's nothing wrong with that, but that doesn't mean that it is research because it occurs next to research. Why do you think it does? I am not referring to using a google search as a source, but results that occur from it, which you can find yourself if you like. These are not disputed claims, either, which I assume is why there is no research on them (doing so would be absurd). If we assume there is no reliable source proving existence, do you then agree that the text at the location I linked to should be deleted? I agree that we are getting nowhere here, but I just do not understand your position at all with regards to the three changes I want to make. Dayshade (talk) 20:26, 20 December 2019 (UTC)

I agree with Alexbrn. Flyer22 Reborn (talk) 22:58, 20 December 2019 (UTC)

Genital mutilation (here: male genital mutilation, MGM), comparable with Female genital mutilation (FGM)

Sorrells et al, 2007, referred to the damage to the frenulum in these words: „In conclusion, 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.“ http://damagefromcircumcision.blogspot.de/p/blog-page.html 79.219.94.75 (talk) 00:49, 30 December 2019 (UTC)

RfC on sexual and psychological effects sections

I'm concerned about bias in reliable sources in the sexual effects section of the article, as well as the use of a speculative comment paraphrased from another reliable source at the end of the psychological effects. While I personally have concerns about the state of research in general on the topic, I am not disputing their use as sources in the article, as convinced by Alexbrn above.

Within the sexual effects section, studies and reviews appear to focus exclusively on self reported satisfaction, problems like erectile dysfunction, the sensitivity of the parts of the penis not removed by circumcision, and penetrative ("insertive") vaginal and anal sex. I believe this is an incomplete comparison, as men can engage in several other forms of sexual activity than those activities, and the foreskin itself is sensitive tissue. I don't believe MEDRS applies as a strong counterargument to these concerns because these would be inappropriately ignored, introducing bias to the article, if MEDRS were applied, because of the impossibility/absurdity of research comparing the foreskins (and use thereof) of circumcised and uncircumcised men. Also, discussing forms of sexual activity made impossible by circumcision would qualify as general information.

With regards to the foreskin's sensitivity, I would like the sexual effects section to include some text that describes the sensitivity of the foreskin in isolation from the remaining parts of the penis. Because there are no secondary sources covering the sensitivity of the foreskin in isolation that I'm aware of, I believe a primary source would be sufficient. I do not believe reviews that claim there is no change in sensitivity are relevant to deciding whether to include the sort of comment I am proposing because it is impossible to compare existing tissue in uncircumcised men to tissue that no longer exists in circumcised men. At the minimum, I'd like to change "...circumcision does not decrease the sensitivity of the penis" to end in something like "...of the remainder of the penis". This has been opposed above because such text does not occur in a reliable source, but I don't believe this is relevant because it is an obvious statement, and from looking at the studies and reviews, they appear to only focus (necessarily) on tissues like the glans and shaft of the penis.

As for sexual activities impaired or made impossible with circumcision, as noted above, studies and reviews appear to focus almost exclusively on penetrative vaginal and anal sex. Masturbation, oral sex, and other activities appear to be ignored in the literature. I would like the sexual effects section to mention the existence of sexual activities (most notably docking and forms of masturbation involving the foreskin) that become impossible with circumcision, potential impairment of other activities such as standard masturbation ("jerking off"), and the dearth of evidence on other activities, such as oral sex. Because there are no secondary sources covering the impairment of sexual activities (I'm mostly referring to standard masturbation here) other than penetrative sex that I'm aware of, I again believe a primary source would be sufficient, as well as with activities made impossible by circumcision. With activities made impossible, I would like to know if such a decision against inclusion would also mean that references to these activities elsewhere on Wikipedia should be removed, and why or why not.

As for the psychological effects section, the sentence "Medical disinformation spread by opponents of circumcision may have an adverse psychological effect on vulnerable men who have been circumcised." appears to stem from a speculative quote (shown in the above section) from a reliable source that is itself sourced based on a single anecdote, and thus is meaningless scientifically. As such, I believe it is inappropriate for inclusion in the article, and at minimum propose that it should be removed. I also would like to propose that the addition of new sentences or restoration of recently deleted sentences regarding the variety of men's opinions on their circumcisions to the article be considered, and get suggestions on how this might be implemented. I again don't think MEDRS applies here because this would qualify as general information.

I would like to know if others agree or disagree with each of what I've proposed above, and why. Additionally, I'd like to get input on what sort of evidence would be sufficient to include comments about the foreskin's sensitivity, the types of sexual practices impaired or made impossible with circumcision, and men's opinions on their circumcisions. Earlier debate can be seen in the section above. Dayshade (talk) 06:52, 23 December 2019 (UTC)

Survey

• Reject RfC as it egregiously ignores WP:RFCBRIEF. Alexbrn (talk) 08:06, 23 December 2019 (UTC)

  Yes, and in ignoring RFCBRIEF, the statement above (from the {{rfc}} tag to the next timestamp) is far too long (being almost 5,000 bytes) for Legobot (talk · contribs) to handle, and so it is not being listed correctly at Wikipedia:Requests for comment/Maths, science, and technology. The RfC will also not be publicised through WP:FRS until a shorter statement is provided. --Redrose64 🌹 (talk) 21:37, 23 December 2019 (UTC)

  User:Redrose64 - what would be a better to alternative to an RfC that can include a longer summary? Never done something like this before so not sure what to do. Dayshade (talk) 06:23, 24 December 2019 (UTC)

  See for example Talk:Hypergiant Industries#RfC about maintenance template stating “Article may have been created or edited for undisclosed payments” where there is a short statement followed by a longer one. Both are signed, notice that the signatures and timestamps are identical. --Redrose64 🌹 (talk) 11:17, 25 December 2019 (UTC)

  I've terminated this RfC early, because two weeks after pointing out the problem there is still no brief and neutral statement, meaning that the RfC has not yet been properly publicised. There is therefore no point continuing. --Redrose64 🌹 (talk) 20:40, 8 January 2020 (UTC)

Semi-protected edit request on 26 January 2020

In the "Adverse Effects" section, subsection "Sexual Effects", the first sentence says "The highest quality evidence...", which I believe is uses the term "highest quality evidence" in a misleading fashion. The 3rd sentence of this subsection then goes on to suggest that the study initial referenced via the term "highest quality evidence" was "not very good."

I suggest removing the phrase "highest quality evidence" from the first sentence of this subsection and replacing it with the following: "Numerous studies have indicated that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction."

Thank you 136.29.20.216 (talk) 04:33, 26 January 2020 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. The "best quality evidence" in the first sentence and the succeeding two sentences are referencing different studies. They do not refer to the same things. Eggishorn (talk) (contrib) 18:50, 28 January 2020 (UTC)

"Adverse effects" section is extremely biased

BJ Morris is not a reputable source of information on circumcision (he owns the patent to a technology used by Roche, which profits from the global harvest of male foreskins). Ditto, American Academy of Pediatrics, a global outlier among paediatric bodies shown to have exhibited an extreme cultural bias. There is an abundant research literature on the known, lifelong psychosexual harms of male circumcision. Please either remove or edit this section. It casts a pall on the good work done elsewhere on Wikipedia. — Preceding unsigned comment added by 220.240.186.39 (talk) 22:33, 7 February 2020 (UTC)

Studies maintaining that male genital cutting prevents HIV are dubious at best.

Complete lack of control for the sources of HIV (Sharing Needles, Potential Blood contact) ending the studies early, and the ultimately small number of actual infections where a single infection could skew data tremendously, on top of no control for the obvious lack of sexual interaction during the healing process where such participants were cut. should allow for room to question the alleged statement that "Male circumcision reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa."

These studies were conducted with an obvious bias and attempt to manipulate data to favor a specific outcome. Ideally they would not be included in the article at all.

Many societies have already conducted similar studies for generations and not one of them have found similar data. The idea that sub-saharan african sexual practices are so glaringly different from the rest of the world that pre-emptively amputating parts of the genitals of men would have some sort of beneficial effect present nowhere else is a tad bizarre.

Convince WHO and Cochrane of this and we will change aswell. Doc James (talk · contribs · email) 01:06, 10 February 2020 (UTC)

Medical uses

Not sure why "Medically it is a treatment option for problematic cases of phimosis and balanoposthitis that do not resolve with other treatments, and chronic urinary tract infections (UTIs)."

Was removed from the lead? Doc James (talk · contribs · email) 01:02, 10 February 2020 (UTC)

Have restored summary of use in HIV with references and side effects to the lead. We need to keep references Doc James (talk · contribs · email) 20:21, 11 February 2020 (UTC)

Request for an Amendment to the 'Adverse Effects' Section

There is evidence according to the National Health Service (NHS) in the UK that male circumcision will result in reduced sexual sensation.

The British Association of Urological Surgeons published an article that confirms male circumcision will result in reduced sexual sensation, and that there is a high risk of this.

Thus, the 'sexual effects' section under the 'adverse effects' section on this wikipedia article should be amended to include and reflect these additional sources of information. Additionally, contradictory or inconclusive studies, regarding the effects of circumcision on sexual sensation, should be omitted from this article. Jas9777 (talk) 16:11, 21 February 2020 (UTC)

References

 Partly done The NHS does not say circumcision "will result" in reduced sexual sensation, but that it is a "possible complication". Alexbrn (talk) 16:36, 21 February 2020 (UTC)

Amendments to 'Adverse Effects' Section

The circumcision wikipedia article should refer to the article by the British Association of Urological Surgeons (BAUS). This article was published in June 2017 and is therefore more up-to-date than a number of sources currently on the wikipedia website.

I believe the first line in the paragraph under “sexual effects” (quoted below in bold) should be removed as it contradicts more recent evidence:

“The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction.[19][76][77]”

The BAUS article, published in 2017, disproves the above statement, which is based on outdated sources from 2010, 2012 and 2016. The BAUS article is a reliable source and based from a number of sources including the Department of Health in England, as mentioned on its article. The NHS also has the BAUS article's link on their website. The BAUS article states:

1. The “penis will feel a little less sensitive than before the operation”. This statement is on page 4 in the "what can I expect when I get home?" section of the article (bullet point 4). Thus, sensitivity will decrease after a circumcision. However the above line in bold states “circumcision does not decrease the sensitivity of the penis”.

2. Almost all patients (men) have reported “permanent altered or reduced sensation” after a circumcision. This statement is on page 3 in the "after-effect" section of the article (3rd risk). However the above line in bold states “circumcision does not… reduce sexual satisfaction”. The term "satisfaction" is a synonym of "pleasure", and "pleasure" is used interchangeably with "sensation".

Additionally, the term “sexual function” is used in the above line in bold, however, according to another wikipedia article regarding sexual function, “the aspects of sexual function defined as being relevant to the assessment include sexual desire, erection, orgasm and ejaculation”, all of which are already mentioned below in the sentence regarding the 2013 review. Thus, there is simply no need for the above line in bold.

The paragraph should be changed to the following:

"A 2013 systematic review found that circumcision did not appear to adversely affect sexual desire, pain with intercourse, premature ejaculation, time until ejaculation, erectile dysfunction or difficulties with orgasm.[78] However, the study found that the existing evidence is not very good.[78] A 2017 review found that circumcision did not affect premature ejaculation.[80] Reduced sexual sensation is a possible complication of male circumcision.[79] Almost all men have reported permanent altered or reduced sexual sensation after a circumcision. The penis will also feel less sensitive than before the circumcision. When it comes to sexual partners' experiences, circumcision has an unclear effect as it has not been well studied.[81]"

Jas9777 (talk) 20:25, 22 February 2020 (UTC)

References

The BAUS source is not great. It is a tertiary (/quaternary) source claiming to cite NHS/Cochrane etc. If we can cite those better sources honestly that would be good. Alexbrn (talk) 20:29, 22 February 2020 (UTC)

AE rates

*Note: there is an inconsistency in this article regarding the incidence of medical complications in circumcision. In the opening section it says: 'A 2010 review found circumcisions performed by medical providers to have a typical complication rate of 1.5% for babies and 6% for older children, with few cases of severe complications.' Yet in the 'adverse effects' section this figure is different by a factor of 10: 'These complications occur in approximately 0.13% of procedures, with bleeding being the most common acute complication in the United States.[71]'

It's not clear whether this is just a mistake or a deliberate inconsistency. In either case, it needs to be corrected. — Preceding unsigned comment added by 71.114.105.225 (talk) 06:06, 27 February 2020 (UTC)

This needs updating. Is there a better source than PMID 24820907 ? — Preceding unsigned comment added by Alexbrn (talk • contribs)

Semi-protected edit request on 5 March 2020

Change"No major medical organization recommends universal neonatal circumcision, and no major medical organization calls for banning it either.[7]" to "No major medical organization recommends universal neonatal circumcision, and no major medical organization calls for banning it either.[Citation needed]". Or remove "no major medical organization calls for banning it either". The original article makes no claim about medical organizations that are in favor of banning it. Also there are medicla organizations in favor of banning it, the question is if they are considered "mayor" or not. However the linked medical article makes no attempt to define what a "mayor medical organization" is, and it makes no statement about medical organizations that are in favor of banning it, and never says that there are none in favor of that. I emailed the original authors and got the article for free. I read it in it's entirety to make sure. If you doubt me I suggest you email them and read it for yourself. Madsenanders (talk) 16:40, 5 March 2020 (UTC)

 Not done Please only use this template once consensus has been established here for the proposed edit, per the template's instructions. This has been discussed before. Alexbrn (talk) 16:43, 5 March 2020 (UTC)

Source 7 does not say what wikipedia claims it says.

Information to be added or removed: no major medical organization calls for banning it either.[7]

Explanation of issue: The source simply doesn't say this. It never mentions there being no major medical organizations in favor of banning it, nor does it make any attempt to define what a "major medical organization" is. I simply cannot understand how you can possibly interpret the article as saying this. The conclusion doesn't say this, nor does anything else in the article. Seeing as there are medical organizations in favor of banning circumcision, what a "major" medical organization is needs to be defined before making this claim, and that isn't done by the source in question.

References supporting change: The source itself is the source, email the authors for access to the full article if you wish: https://link.springer.com/chapter/10.1007%2F978-1-4471-2858-8_1 Also, there are medical organizations in favor of a ban. This article mentions several: https://www.thelocal.no/20120703/minister-says-no-to-circumcision-ban- — Preceding unsigned comment added by Madsenanders (talk • contribs) 16:57, 5 March 2020 (UTC)

The lede is meant to summarize the body, which it seems to be doing okay. Do you think we mention major medical organizations which "ban circumcision". If so, which? Alexbrn (talk) 17:28, 5 March 2020 (UTC)

The lede on wikiepdia or the lede in source [7]? I would disagree with the former but agree with the latter, for reasons mentioned above. Source [7] isn't a bad source at all, but this page is currently using it as a source for something it doesn't say at all. In regards to whether I think major medical organizations in favor of a ban should be mentioned, I believe the page "Ethics of circumcision" (link: https://en.wikipedia.org/wiki/Ethics_of_circumcision ) should be the page that goes more in depth with this. A summary of that page in maybe 10 sentences with a link to it could be good enough in my opinion, though I admit I have not done much editing on wiki and as such I do not know if that would be the best choice. Either way, I believe the statement about major medical organizations should be removed or heavily reworded. Madsenanders (talk) 17:50, 5 March 2020 (UTC)

We have a good & fair summary of the source as-is. Alexbrn (talk) 10:45, 6 March 2020 (UTC)

I'm confused. Are you actually saying that source [7] says that there are no major medical organizations in favor of a ban? If so can you please say where it says this? I can't see how any sentence in source [7] can be interpreted like that.Madsenanders (talk) 13:40, 6 March 2020 (UTC)

We are meant to summarize sources, not copy and pastes bits from them. We have a good & fair summary of the source as-is. Alexbrn (talk) 13:48, 6 March 2020 (UTC)

But nowhere in the source does it say or even imply that "no major medical organization recommends banning the procedure", so how is it a fair summary to use it as a source for that statement? Madsenanders (talk) 13:54, 6 March 2020 (UTC)

"In fact, all policy statements reviewed, regardless of its position on circumcision, have made allowances for parental choice in support of their cultural or religious preference". Page 7. - MrOllie (talk) 14:00, 6 March 2020 (UTC)

"All policy statements reviewed". As far as I can tell they never make the claim that all the policy statements they have reviewed are all major medical organizations in the world. Madsenanders (talk) 15:17, 6 March 2020 (UTC)

@Madsenanders: The point from the source is that major medical organizations like the AAP do not take a polarized for or against view, but adopt varied positions in the middle of the road. We have a good high-level summary of the source to convey that. I've also just noticed your complaint is a re-hash of this. Alexbrn (talk) 14:08, 6 March 2020 (UTC)

Where does it specifically mention that it has reviewed all major medical organizations? It doesn't. Madsenanders (talk) 15:17, 6 March 2020 (UTC)

"Our goal here is [...] to outline the current recommendations from the major medical organizations in western medicine ..." Alexbrn (talk) 15:27, 6 March 2020 (UTC)

The canadian pediatric society has 3400 members which based on this interpretation would make it a major medical organization since it is cited. The norweigan medical assocation has 30000+ members and is in favor of banning circumcision of minors. — Preceding unsigned comment added by Madsenanders (talk • contribs) 15:35, 6 March 2020 (UTC)

This is not a forum. We reflect what reliable sources say. We are doing that. I think we are done here. Alexbrn (talk) 16:01, 6 March 2020 (UTC)

Am I understanding this right? There needs to be a scientific journal/article saying that there is a major health organization in favor of banning circumcision for it to be added to the wiki? And showing a bigger organization than the cited journal in favor of banning circumcision isn't valid because it's not coming from a scientific journal? Doesn't seem very objective to ignore objective information just because it isn't coming from a scientific article. You don't need a scientific article to point out that there are medical organizations in favor of banning it, you just need to point to those organizations. Madsenanders (talk) 16:24, 6 March 2020 (UTC)

It's not up to us to decide what "major" medical organizations are, and nose counting seems a crass way to do it, which is likely why RS does not do that. Alexbrn (talk) 16:33, 6 March 2020 (UTC)

So why use a source that doesn't define what a "major medical organization" is? It's infallible when it doesn't define it.Madsenanders (talk) 17:04, 6 March 2020 (UTC)

The source doesn't have to "show its working" to your personal satisfaction before Wikipedia can use it. We reflect the knowledge found in high-quality sources. Alexbrn (talk) 17:12, 6 March 2020 (UTC)

This all feels like extreme semantics when there is nothing concrete. It feels like the reason this specific source has been used is because it uses the word "major". There are several other articles of high that mention the medical consensus being against among several other things, just for example: https://www.tandfonline.com/doi/full/10.1080/17441692.2016.1184292?scroll=top&needAccess=true& but this doesn't use the word "major". I'm not sure how "high quality" is decided either, and source [7] has only been cited once. Is it really nessecary to find a specific source that uses the word "major" when it comes to organizations in faovr of a ban? This very much feels like it's just arguing semantics in order to keep that sentence there. Madsenanders (talk) 17:45, 6 March 2020 (UTC)

Madsenanders, the issue is Wikipedia must reflect what reliable, secondary sources write on a topic. You must find such a source, one which describes what major medical organizations say on this topic. Jayjg ^(talk) 20:32, 6 March 2020 (UTC)

"highest quality evidence" seems like a value judgement/bias

"highest quality evidence" seems like a value judgement. I feel like it could be worded better to sound less biased. 2601:640:C402:C4A0:D189:1305:6697:EE66 (talk) 14:33, 13 March 2020 (UTC)

It captures the fact that, per the sources, there is some weak evidence out there that is not a reliable indication of anything. To account for that, the current wording is good, rather than simply asserting that "Circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction". Alexbrn (talk) 14:46, 13 March 2020 (UTC)

"weak evidence" according to whom? This is exactly my issue with this. Your value judgement of what constitutes "highest quality" and "weak" evidence seems to be the studies you agree with. 2601:640:C402:C4A0:D189:1305:6697:EE66 (talk) 16:31, 13 March 2020 (UTC)

According to the source (i.e. PMID 27497811). Grading evidence is a mainstay of medical research. Alexbrn (talk) 16:35, 13 March 2020 (UTC)

According to one source. That's still not a justification to use "highest quality"; it's a single source that has determined three clinical trials are of "high quality". That is still loaded language to use in this article. 2601:640:C402:C4A0:D189:1305:6697:EE66 (talk) 16:54, 13 March 2020 (UTC)

It's fine: we are meant to be summarizing what's found in good sources and that's what we have here. There's no reason to dispute it (unless there is some reliable source that has been missed that does so). The alternative is simply to assert "Circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction" - but I think the current nuance is justified. Alexbrn (talk) 17:03, 13 March 2020 (UTC)

Uh no, that's not the only alternative, and would in fact be worse. Circumcision and its effects are still hotly contested and there is no consensus on it. Your bias is showing. 2601:640:C402:C4A0:D189:1305:6697:EE66 (talk) 17:08, 13 March 2020 (UTC)

So how would you summarize this source? Don't just attack what we have now, make a suggestion. - MrOllie (talk) 17:15, 13 March 2020 (UTC)

A new source: I suppose we might use PMID 27399981 which actually says "The highest level of evidence shows no perceived inferior male sexual function following non-medical circumcision"? Alexbrn (talk) 17:18, 13 March 2020 (UTC)

"So how would you summarize this source? Don't just attack what we have now, make a suggestion." Perhaps something like "Multiple reviews indicate that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction." 2601:640:C402:C4A0:D189:1305:6697:EE66 (talk) 18:18, 13 March 2020 (UTC)

Psychological Effects Section

Why is only one source cited? There are several medical studies that have been done about the psychological effects of circumcision, and only citing one several times to claim that there is little consensus is incredibly disingenuous 76.107.1.11 (talk) 06:14, 7 April 2020 (UTC)

We don't cite "studies" but secondary sources (which provide an overview of "studies") to represent current accepted knowledge in this area. Is there a more recent or more comprehensive one we've missed? Alexbrn (talk) 06:22, 7 April 2020 (UTC)

American Bias in This Article

Several claims in this article reflect a distinct American bias, namely the statement that "Circumcision does not appear to have a negative impact on sexual function," which cites the controversial 2012 AAP circumcision taskforce report. Several other medical institutions in the international community have lambasted this report, and the Royal Dutch Medical Association has explicitly stated it carries detrimental sexual effects: https://www.knmg.nl/advies-richtlijnen/dossiers/jongensbesnijdenis.htm

"Op latere leeftijd ontwikkelen besneden mannen veel vaker seksuele problemen." Translated: "Circumcised men are much more likely to develop sexual problems later in life."

The complete rejection of several secondary sources from medical institutions that conclude circumcision is detrimental only further demonstrates the strong bias towards American cultural mores on Wikipedia. 107.77.199.107 (talk) 18:26, 7 April 2020 (UTC)

Sources for this need to be WP:MEDRS. I suppose we might use PMID 27399981 which says "The highest level of evidence shows no perceived inferior male sexual function following non-medical circumcision"? Alexbrn (talk) 19:36, 7 April 2020 (UTC)

You keep copy pasting this exact thing over and over, how does a secondary source from an internationally recognized medical body not count as WP:MEDRS? 76.107.1.11 (talk) 02:00, 8 April 2020 (UTC)

KNMG is a professional organisation for medical practitioners, not a major health organization. We have RS telling us the positions of major health organizations. We not going to use weak sources to undercut strong ones, especially when they have outlier views which are disjoint from accepted science on a topic. PMID 27399981 is relevant because it is a MEDRS source from the journal of the Danish Medical Association, which might more properly give you the European sourcing you want (not that science differs from country to country). The positions of various Dutch organizations is covered at Ethics of circumcision#Netherlands. Alexbrn (talk) 02:26, 8 April 2020 (UTC)

Funny how every organization/study that disagrees with you is considered by you to be "outlier views". Opposing view, sure, but hardly an outlier. How many more organizations and studies have to keep coming out until they stop being "outlier views" and just "opposing views"? This is the exact bias that we're talking about. 2601:640:C402:C4A0:B14B:3E71:2E64:994B (talk) 06:11, 10 April 2020 (UTC)

Saying “science doesn’t differ from country to country” is really bold of you considering outside of America and its sphere of influence neonatal circumcision is not considered to be a justifiable routine medical procedure. In fact it’s very root in America is it’s usage as a sexually damaging procedure to prevent masturbation, which is flat out described in the article. Stop dogmatically assuming you know best and dancing around which sources you choose to accept as right. If you broadened your horizons a bit you’d notice how our partner sites in other languages treat this issue and realize how biased this article is towards an American cultural perspective 76.107.1.11 (talk) 10:39, 10 April 2020 (UTC)

Article should be renamed "Male Genital Mutilation"

Yawn. Alexbrn (talk) 10:28, 30 April 2020 (UTC)
For the sake of equality, this article should be renamed to "Male Genital Mutilation" to mirror the "Female Genital Mutilation" article. 64.43.183.190 (talk) 09:22, 30 April 2020 (UTC) Read the top of this page, particularly the [FAQ]. Alexbrn (talk) 10:28, 30 April 2020 (UTC)

There's 83 archives?

Wow! Even the articles on George W. Bush and Barack Obama aren't nearly as massive archive-wise. Didn't know this was such a volatile topic. MightyArms (talk) 01:12, 12 May 2020 (UTC)

Request for Edits

The World Health Organisation (WHO) stated in an article that postoperative complications of circumcision include loss of penile sensitivity and sexual dysfunction. This is found in Section 6.1 - Introduction (page 35)
Currently in this wikipedia article, the sexual effects section states "The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction." This statement needs to be removed as the WHO has much higher quality evidence from their investigations.
There is also another sentence, that needs to be removed, regarding sexual function in this wikipedia article in the third introductory paragraph - it states "Circumcision does not appear to have a negative impact on sexual function.[19][20]"

References

Jas9777 (talk) 20:47, 30 April 2020 (UTC)

 Not done This source is from 2010, so outdated in comparison to what we cite. We already say "Reduced sexual sensation is a possible complication of male circumcision", which is in no doubt in the sources so far as I can see. Alexbrn (talk) 06:33, 1 May 2020 (UTC)

Based on MEDRS guidance, which states "...public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature", that source is a poor one. The WHO article is higher on the MEDRS totem pole according to the policy. There are other studies besides the WHO one that state the same thing. AuburnMagnolia (talk) 01:04, 7 May 2020 (UTC)

Surely “highest quality” could be changed? How was this source decided to be of “highest quality”? The WHO may well of had the “highest quality” evidence, regardless of whether or not its date of publication is older. I feel “highest quality” is bias. Perhaps re-wording it?

As a separate note, I would also like to ask why in the sourcing of the NHS “circumcision in men” article the date states “22 February 2016” when the NHS article was last reviewed on “5 November 2018”. From where did you get the 2016 date? Jas9777 (talk) 17:23, 11 May 2020 (UTC)

"Highest quality" captures the fact that, per the sources, there is some weak evidence out there that is not a reliable indication of anything. To account for that, the current wording is good. Alexbrn (talk) 17:31, 11 May 2020 (UTC)

Forgive me for not understanding. The NHS article is used to cite the statement "Reduced sexual sensation is a possible complication of male circumcision." According to MEDRS, this is a source of low reliability. It stands to reason, and seems like common sense, that removing erogenous tissue would reduce sexual sensation always. To make a claim that denies common sense stating that the reduction in sensation is only "possible", we must have a reliable citation. AuburnMagnolia (talk) 22:41, 11 May 2020 (UTC)

The NHS is a top-tier source. Especially for medical information we follow sources and the scientific evidence they contain (like PMID 27399981), not "common sense" – that's the Donald Trump approach, remember[2] and risks ending up in all kinds of error. Alexbrn (talk) 05:32, 12 May 2020 (UTC)

The NHS is a top-tier source. That citation is not. Wikipedia policy states that websites, brochures, pamphlets etc. from medical organizations are low tier. The policy says we should be going to the actual studies and research. That website has no citations. It is not reliable according to MEDRS. AuburnMagnolia (talk) 12:15, 12 May 2020 (UTC)

False. Alexbrn (talk) 12:27, 12 May 2020 (UTC)

What is false? Wikipedia's policy states: "public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature". So let's go to the literature. Your link states: "Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D)". That certainly does not back up the claim that "reduced sexual sensation is a possible complication of male circumcision". It's stating something quite different. As you stated, it's about the science, not the Donald Trump approach. I believe that we need to correct the statements we are making so that they align with the sources. AuburnMagnolia (talk) 03:11, 13 May 2020 (UTC)

There is no doubt circumcision has possible complications, and the NHS source is explicitly regarded as WP:MEDRS (even if grade A rather than A+), and is fine. Your statement that it is "not reliable" is false. On a different matter, that of your - wrong - "common sense", the literature tells us the opposite. We don't cherry pick out insignificant findings from sources but must align with their overall conclusions, in this case that the highest level of evidence shows no perceived inferior male sexual function following non-medical circumcision, and that popular narrative that male circumcision results in sexual dysfunction does not seem to be supported by evidence. We are good. Alexbrn (talk) 06:27, 13 May 2020 (UTC)

I am still confused. The policy says one thing that we should go with the underlying medical literature. But you are saying the opposite. Can you resolve that conflict? Can you please point out in the underlying literature where your point-of-view is backed up? AuburnMagnolia (talk) 12:04, 13 May 2020 (UTC)

There is no conflict. On the question of complications we have a strong source say they can happen. On the (slightly different) question of male sexual function we have strong sources saying there's no good evidence of detriment. We follow those sources. So far your discussion has been long on opinion and short on proposals backed by sources. We're not going to change the article because you think your common sense is more authoritative than the NHS. Alexbrn (talk) 12:17, 13 May 2020 (UTC)

Please do not put words in my mouth. I did not say that common sense is more authoritative than the NHS. Please quote where I wrote that. I said the sources need to back up the material. You said "there's no good evidence of detriment". What I quoted above, from the source you provided, stated "problems with obtaining orgasm and erectile disfunction". That's a far cry from "no evidence" unless there is a problem with the source you provided. Additionally, you are making the claim that the sources back up the reduced sensation statement and you want me to take your word for it. Doesn't work that way. The NHS website is low quality according to Wikipedia's policy. That's a fact. If there is a source that does back up the statement, we must switch to that one. The source you linked to doesn't back up the sentence in question -- it talks about sexual function which IS NOT the same as reduced sensation. AuburnMagnolia (talk) 01:08, 14 May 2020 (UTC)

You're making stuff up again. The NHS website is a valuable source and nowhere described as "low quality". A NICE clinical statement would be better, sure, be we don't have one. We can't pick cherries out of sources and we accurately summarize PMID 27399981. You have still produced no source: the only appeal you have made is to your "common sense". I shall not reply further unless specific proposals based on sources are offered. Alexbrn (talk) 05:35, 14 May 2020 (UTC)

AAP policy statement

The 2012 AAP policy statement has expired. Is it proper to continue referencing it? — Preceding unsigned comment added by AuburnMagnolia (talk • contribs) 03:39, 6 May 2020 (UTC)

Expired? Alexbrn (talk) 06:45, 12 May 2020 (UTC)

AAP policy statements expire after five years unless some action is taken. Their policy statement on circumcision has expired and is no longer their position. They actually do not have a position at the moment as they have not reaffirmed or revised their 2012 statement. See here: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Mental-Health/Pages/AAP-Policy-Statements.aspx AuburnMagnolia (talk) 12:18, 12 May 2020 (UTC)

The most recent material from AAP I could find is this. Alexbrn (talk) 12:50, 12 May 2020 (UTC)

Are you implying that this source should now be used instead of their expired policy statement? AuburnMagnolia (talk) 03:09, 13 May 2020 (UTC)

Not sure. Maybe both? Alexbrn (talk) 06:13, 13 May 2020 (UTC)

Should we ask on a noticeboard what the best thing to do is in this situation? AuburnMagnolia (talk) 02:03, 14 May 2020 (UTC)

Looking for citations, are we actually citing their policy? What text in our article do you think needs changing? Alexbrn (talk) 05:39, 14 May 2020 (UTC)

Semi-protected edit request on 30 May 2020

coptic church do not order to be circumcized . 45.110.230.61 (talk) 06:30, 30 May 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. --TheImaCow (talk) 07:31, 30 May 2020 (UTC)

Semi-protected edit request on 14 June 2020

fanatic people of certain religion fabricate health benifits of circumcision and block editing the page 45.106.153.233 (talk) 10:15, 14 June 2020 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. TheImaCow (talk) 10:25, 14 June 2020 (UTC)

Sentence order

In the beginning of the "sexual effects" subsection, the first sentence is about sensitivity, satisfaction and sensation. The NHS sentence in bold, regarding sensation, is currently placed between 2 sentences that are not about sensation. When the paragraph is read, the NHS sentence feels out of place. Thus, the NHS sentence should be moved up to this:

The question of how circumcision affects penile sensitivity and sexual satisfaction is controversial; some research has found a loss of sensation while other research has found enhanced sensation.[76] Reduced sexual sensation is a possible complication of male circumcision.[75] The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction.[19][77][78] A 2013 systematic review found that circumcision did not appear to adversely affect sexual desire, pain with intercourse, premature ejaculation, time until ejaculation, erectile dysfunction or difficulties with orgasm.[79] However, the study found that the existing evidence is not very good.[79] A 2017 review found that circumcision did not affect premature ejaculation.[80] When it comes to sexual partners' experiences, circumcision has an unclear effect as it has not been well studied.[81]

Jas9777 (talk) 13:39, 20 June 2020 (UTC)

If anything it should be moved last, or even made a separate paragraph, because it is about "complications" (outlier outcomes), whereas everything else is about what happens in the normal course. Alexbrn (talk) 13:45, 20 June 2020 (UTC)

Yes, I agree, let’s move it to a new paragraph. Jas9777 (talk) 13:59, 20 June 2020 (UTC)

@Alexbrn: Just wondering if you'd consider moving it last or to a new paragraph then? Jas9777 (talk) 22:28, 1 July 2020 (UTC)

Single, controversial source for 'Psychological effects' section

Though there are four ref tags in the section about possible adverse psychological effects, all four point to the same source, and the source is controversial (with the authors of the study having possible conflicts of interest; this Twitter thread summarizes the issues people have with that study). I don't think that's sufficient to show scientific consensus on this matter. VDZ (talk) 21:37, 4 July 2020 (UTC)

It is completely fair to say there is no scientific consensus on this. I note the concerns of the Royal College of physicians in Australia and the British Medical Association position statements and guidance to doctors on circumcision. Really it should mention both the perceived psychological benefits and harms too. I would recommend a bold edit. PainProf (talk) 23:45, 4 July 2020 (UTC)

I'm afraid I'm not familiar enough with the subject matter to edit it in myself. VDZ (talk) 02:44, 5 July 2020 (UTC)

• The source is reliable per WP:MEDRS; Twitter obviously not. Are additional sources proposed, and if so what? Alexbrn (talk) 06:07, 5 July 2020 (UTC)

Per the guidelines of BAPs, there is a potential for psychological harm in un-anaesthetised procedures. https://www.baps.org.uk/content/uploads/2014/10/circumcision-final-may-2007.pdf that's a tertiary source. As a note the part on medical disinformation is not neutral. It can not be classed as disinformation as it the assertion is supported by the professional guidelines of the British Medical Association, here. Professional guidelines are higher on our evidence chart than this review. https://www.bma.org.uk/advice-and-support/ethics/children-and-young-people/non-therapeutic-male-circumcision-toolkit, that statement is POV pushing. PainProf (talk) 16:42, 5 July 2020 (UTC)

I'm also going to say that last statement on disinformation doesn't verify well, the source in the paper is not likely to be reliable, it appears to be some kind of partisan media outlet? This paper is oddly sourced for a scientific article, there are a lot of blog/news media citations. PainProf (talk) 17:10, 5 July 2020 (UTC)

@PainProf: it is not "POV pushing" to summarize the WP:BESTSOURCES, and it is not our job to perform amateur peer-review on sources. It seems almost obvious that disinformation might have a negative effect, so I'm not sure what source you have in mind that would contradict that. In general, it is fairly typical in medical articles with micro-sections to have a single high-quality source giving us an up-to-date view of the field. A 13 year-old BAPS document would not improve matters, and the BMA is more a trade association than a medical body; if we're to have something from the UK, then the NHS or NICE would be more appropriate sources. Do they have anything on psychological effects? Alexbrn (talk) 17:22, 5 July 2020 (UTC)

@Alexbrn: The BAPs position statement is still in effect and also RACP, https://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-of-infant-males.pdf, to be clear I'm not saying there is a consensus, there is anything but a consensus. The article should simply make clear that there isn't one. I only raise that point because, it is in contrast with certain professional societies, and we are basing that contentious statement solely on this "Arguments used opposing MC can result in psychological problems419 and their sequelae420 in vulnerable men." In the paper this is based on: 419. Conte J. Jonathan Conte: motivations of an intactivist. Intact News. 2011. http://intactnews.org/node/134/1318099689/jonathon-conte-motivations-intactivist (accessed 7 March 2019). [Google Scholar] 420. Bay Area Intactivists. Incredibly sad news: Jonathon Conte has taken his own life. 2016. http://www.bayareaintactivists.org/node/334 (accessed 7 March 2019). Which is marginal. In the paper I note the critiques of "Current policies in other countries are negative and out‐of‐date." which is based off a string of critiques by the first author, it does seem that there is some controversy here in reliable sources and this shouldn't be explained away, the author is also a member of an advocacy organisation as best I can tell so may not be the most reliable source. The arguments about early pain don't sound incorrect or incoherent from a pain perspective. All perceptions (pain, taste, smell even vision) are affected by experience so that doesn't seem particularly controversial, it really reminds me of the debate we had in the pain community about analgesia for heal lances in neonates (which is controversial because early pain may affect perception, but alleviation of pain in neonates may compromise the clinical situation (and to make it even more complicated unalleviated pain may also compromise the clinical situation)). I think in this situation the BMA is providing legal advice to its members which is based on the General Medical Council advice. Including other sources would be ideal because this is a controversial topic, the disinformation part probably should be reworked as there are reliable sources criticising the method (so not typical of disinformation where there are no reliable sources) and the statement in the original paper is brief and potentially tenuous (i.e. this may be undue weight to a part of the paper not emphasised by the original author) as it is based off a single case and not any broader scientific study. PainProf (talk) 17:58, 5 July 2020 (UTC)

@Alexbrn: I'm going to remove that statement for now, but feel free to revert AGF if you want to continue the discussion further. Cheers. PainProf (talk) 18:16, 5 July 2020 (UTC)

We don't say there is a "consensus". We say:

Overall, as of 2019 it is unclear what the psychological outcomes of circumcision are, with some studies showing negative effects, and others showing that the effects are negligible. ...

Per WP:MEDASSESS we shouldn't be second guessing a source because of disagreements with it: cite reviews don't write reviews as we are told.

Morris has been discussed here ad nauseam and in general the community is loathe to exclude high-quality sources because activists have kicked up a fuss about a researcher they dislike having been an author. That would be a dangerous path to tread.

As to disinformation, I am open to alternative wordings but think a brief sentence is due. What wording do you propose? Alexbrn (talk) 18:20, 5 July 2020 (UTC)

Agree, any ad hominem attacks are weak. The sources are lacking and given its a controversial topic it might be better to go unsaid. As a note, the section should also include potential psychological benefits such as fitting in to a religious community, one might legitimately say that could be a potential harm that a doctor should consider. I'm not sure there is enough in Morris's own paper to have a sentence, in the source it is a fairly casual statement and it isn't obviously part of the systematic review part of the paper, but if there are more sources or a paper specifically on that topic it would make sense. I don't think this source should be excluded, however as there as it is recent and by an expert, but should remain temporred PainProf (talk) 18:32, 5 July 2020 (UTC)

Okay, well the BMA document you mentioned seems to cover that "benefit" aspect without making any startling claims, so that seems suitable ... Alexbrn (talk) 18:43, 5 July 2020 (UTC)

Re: https://en.wikipedia.org/w/index.php?title=Circumcision&oldid=966526030

Hi, User:MrOllie - Please respond within 24 hrs, else I will be moving forward with my changes. Others may signal issues with the disputed paragraph, but I would warn against continued reverts without justification.

The following text is paraphrased and misconstrues the author's intended meaning:

"There are plausible explanations based on human biology for how circumcision can decrease the likelihood of female-to-male HIV transmission. The superficial skin layers of the penis contain Langerhans cells, which are targeted by HIV; removing the foreskin reduces the number of these cells. When an uncircumcised penis is erect during intercourse, any small tears on the inner surface of the foreskin come into direct contact with the vaginal walls, providing a pathway for transmission. When an uncircumcised penis is flaccid, the pocket between the inside of the foreskin and the head of the penis provides an environment conducive to pathogen survival; circumcision eliminates this pocket. Some experimental evidence has been provided to support these theories."

The original study wording:

"There are several plausible biological mechanisms by which the foreskin may increase a man’s risk of acquiring STIs, including microtears or abrasions in the inner mucosal surface of the foreskin which is retracted over the shaft during intercourse. Further, the environment under the foreskin is thought to favour pathogen survival and replication."

The pertinent parts are highlighted to emphasize why this paragraph is wholly inappropriate and unsupported by the cited study.

References

Hotpass105 (talk) 16:07, 7 July 2020 (UTC)

The source seems to be discussing HIV and STIs together, and our article text looks to be a summary of the entire source, not just the two sentences you quote. The source for example also says "The superficial layers of the penis contain a high density of HIV-1 target cells including Langerhans/dendritic cells and CD4/CD8 T lymphocytes [6-8], and HIV may gain easier access to these through the thin foreskin". Whatever, the content should not simply be deleted and most certainly not edit-warred out. Is there a proposed wording improvement, while representing the source faithfully? Alexbrn (talk) 16:18, 7 July 2020 (UTC)

How about instead of 'likelihood of female-to-male HIV transmission' something like 'likelihood of female-to-male transmission of STIs such as HIV'? - MrOllie (talk) 16:20, 7 July 2020 (UTC)

Thanks for your prompt reply. While the study does discuss both throughout, the primary resource cited in the above paragraph only addresses HIV. You can verify this by reviewing the study (https://www.ncbi.nlm.nih.gov/pubmed/20066050/)

It may be appropriate to leave the text concerning Langerhans cells, but only where the paragraph conforms to the meaning of the study.

Hotpass105 (talk) —Preceding undated comment added 16:35, 7 July 2020 (UTC)

The paragraph as written does conform to the meaning of the source, but if there's some tweak to the wording that would satisfy you (and which does not remove substantive content), lets see it. - MrOllie (talk) 16:38, 7 July 2020 (UTC)

Campbell Walsh Meatal Stenosis

Hi I updated the parts on adverse effects based off a section in this textbook the latest edition just came out and I'm fortunate to have electronic access fr. It is the pre-eminent source amongst urologists. So I hope these editions are okay. I think if anything remotely controversial was said in it the urologists would grab their pitchforks so I wouldn't worry about that. Based off the previous concerns I more wanted to reassure myself that the views on adverse effects reflected the most common urological perspective. I think they now the medicine aspect is a lot tighter hope you agree. PainProf (talk) 21:39, 8 July 2020 (UTC)

Description As "Male Genital Cutting"

Circumcision is the removal of the foreskin from the human penis.

or:

Circumcision, a type of male genital cutting, is the removal of the foreskin 'mfrom the human penis.

~~— Preceding unsigned comment added by ZiplineWhy (talk • contribs) 16:09, 13 July 2020 (UTC)

Not again. We're not going to splice activist language into the opening sentence, as discussed here ad nauseam before. Alexbrn (talk) 16:16, 13 July 2020 (UTC)

Reference Date

@Alexbrn: Reference number 76 has the date 22 February 2016. Where did you get this date from? I can't find it on the source. The source only has the date 5 November 2018 (the date the page was last reviewed) and the 5 November 2021 (the next review date) Jas9777 (talk) 01:33, 15 July 2020 (UTC)

Presumably it was the date given on that page at the time of the edit? Should be checked/updated. I'm not sure what best practice is for using archive-urls for dynamic web pages, but this would give us a fixed text to target. Alexbrn (talk) 04:16, 15 July 2020 (UTC)

But you edited this wikipedia article on 8th April 2020 to include this source. At the time of your edit, the source would have stated the date 5 November 2018, not 22 February 2016. What do you think? Jas9777 (talk) 17:02, 16 July 2020 (UTC)

Your diff is incorrect, it was added on 30 October 2018, before the November 2018 review. - MrOllie (talk) 17:35, 16 July 2020 (UTC)

References

@Jas9777: Huh? I changed no NHS source on 8 April. Is there a point to any of this? Alexbrn (talk) 17:36, 16 July 2020 (UTC)

The point I am trying to make is that the date on reference number 76 should be updated to 5 November 2018, as the source states that date - and no longer the old date. Jas9777 (talk) 08:11, 18 July 2020 (UTC)

Request for Amendments

@Alexbrn: NHS Wales states the following, with regards to circumcision, at the bottom of their webpage:

"The main risk is reduced sensation or a permanent change in the sensitivity of the head of your child's penis."
Because they have used the words "main risk" and not "complication", they have therefore made an association with the foreskin, sensation and sensitivity.
This webpage is reliable and was last updated on 12/02/2020.

References

Jas9777 (talk) 22:15, 21 July 2020 (UTC)

Based off my reading which encompassed authoritative urology textbooks, Meatal stenosis is the main long-term risk occasionally requiring corrective surgical procedures. PainProf (talk) 23:22, 21 July 2020 (UTC)

@Jas9777: Regional NHS is not the greatest source - what precise change are you proposing? Alexbrn (talk) 05:15, 22 July 2020 (UTC)

@Alexbrn: I am proposing the following amendments:

1. To remove the last sentence on the 3rd paragraph ("Circumcision does not appear to have a negative impact on sexual function")
2. In the sexual effects subsection, "The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction." should be replaced with "Circumcision will reduce sexual sensation or permanently change the sensitivity of the penis"
3. Lastly, "The question of how circumcision affects penile sensitivity and sexual satisfaction is controversial; some research has found a loss of sensation while other research has found enhanced sensation" should be removed because research that has found enhanced sensation has been disproven.
   

Jas9777 (talk) 06:05, 22 July 2020 (UTC)

 Not done All those things are very well-sourced. Alexbrn (talk) 06:18, 22 July 2020 (UTC)

You're implying that the source, NHS Wales, is not as good. Why? The NHS is a top-tier source. It states on the bottom of the website that this regional NHS has had original content supplied by the NHS themselves. The NHS is a primary source of information and very reliable. Jas9777 (talk) 06:28, 22 July 2020 (UTC)

Regional NHS is odd to use, and carries less authority than our usual NHS sources. But in any case, the source doesn't say anything different to what we already say, except their assessment that loss of sensitivity is the "main risk" (or complication) is contradicted by better sources. Even if their classification were correct, that is no reason to remove swathes of other, unrelated, content. Alexbrn (talk) 06:34, 22 July 2020 (UTC)

So... if I managed to find information from the usual NHS source, and it made an association with sensation and the foreskin, would you make my proposed amendments? Jas9777 (talk) 07:03, 22 July 2020 (UTC)

Impossible to say without seeing an exact source/proposal. WP:V is policy, and your proposal to remove content was to remove well-sourced content which satisfies WP:V and is due. Alexbrn (talk) 07:15, 22 July 2020 (UTC)

Opinions

What is your opinion on this source?
"Morris BJ and Krieger JN. Does male circumcision affect sexual function, sensitivity, or satisfaction? - A systematic review. J Sex Med 2013;10:2644-2657" Jas9777 (talk) 21:03, 19 July 2020 (UTC)

Why are you asking our opinion of the source..? If there is an alternate source we can use on how circumcision affects sexual function that wasn't written by a fringe pro-circumcision activist, I think we should avoid this source. Correct me if I'm wrong, but isn't the consensus to only use Brian Morris (and other activists such as Morten Frisch) as a last resort..? Prcc27 (talk) 22:28, 19 July 2020 (UTC)

I was wondering whether the source was reliable or not. If it's written by someone biased then I suppose it is not reliable then... Jas9777 (talk) 23:59, 19 July 2020 (UTC)

Whether or not to use Morris was discussed 6 months ago [3]. The consensus was that Morris sources could still be used. However, that doesn't mean we can't use alternate sources when possible. Prcc27 (talk) 00:13, 20 July 2020 (UTC)

I am looking for alternate sources but can't find any reliable ones. I previously provided this source, which is reliable and has been used in this article. However, unfortunately the source has not made an association with the foreskin and sensation, even though there is. It is stated as one of the "possible complications" (outlier). I am waiting for this source to be reviewed and updated on 5 November 2021, so hopefully they make an association then. Jas9777 (talk) 01:30, 20 July 2020 (UTC)

References

• In general the way to use sources is to find the best ones (and, however much anti-circumcision activists might seek to cancel him, Morris is an author of many of these) -- and then summarize them. It is really not a good idea to arrive with a pre-conceived POV and then try to find a source to back it up. This tends to cause POV problems. Alexbrn (talk) 06:24, 20 July 2020 (UTC)
  • @Alexbrn:Please remember that WP:CIVIL is also a Wikipedia policy. Prcc27 (talk) 09:22, 20 July 2020 (UTC)

A correct, but irrelevant observation. Alexbrn (talk) 13:40, 21 July 2020 (UTC)

• @Alexbrn: It is totally relevant. Your comment comes off as snide, condescending, and unprofessional. But I'll give you the benefit of the doubt that it wasn't your intention to come off as condescending. Prcc27 (talk) 17:59, 21 July 2020 (UTC)

• I think you're wrong. Circumcision activists need to know how things work around here, and it's best to be plain about that. Alexbrn (talk) 18:06, 21 July 2020 (UTC)
  • @Alexbrn: Sharing a cheesy meme that could easily be perceived as condescending, is not the same thing as informing Wikipedia users of our rules. It's not that hard to explain Wikipedia policy in a polite and productive manner. Prcc27 (talk) 06:48, 22 July 2020 (UTC)

• There isn't any incivility here, just discuss the sources, Alexbrn always seems perfectly willing to listen IMO. PainProf (talk) 23:26, 21 July 2020 (UTC)
  • @PainProf: I absolutely agree that we should be discussing the sources. But I just think that if Alexbrn had WP:POV concerns, they should have stopped at linking to the relevant Wikipedia policy, rather than share a meme that can be seen as condescending. Prcc27 (talk) 06:48, 22 July 2020 (UTC)
    • It was apposite (as you will see below). In any case, going on about it here is getting disruptive. If you have concerns, please take them to an appropriate venue. Here, we should be focussed on improving the article. Alexbrn (talk) 07:24, 22 July 2020 (UTC)

After looking through these sources my feeling was it is generally reliable although look at the citations to find criticques. On occasion there is some hyperbole in discussion but as it's a systematic review the safest way is to make sure whatever element was in actual fact part of the systematic review section rather than a discussion point. The systematic review section has ethical rules and is harder to insert opinions into. Some of the discussion points aren't well sourced, this applies to many papers. The reality is the research on the topic is full of COI with limited independent research. My feeling was the field looks completely toxic - as a researcher you can't win. Conversely this means noone wants to wade in. My suggestion would in general to be check what medical textbooks say and general urology reviews say. They tend to have fewer opinions than papers as they are normally more medically focused. If Morris is the only source you can't change it but if there are multiple points of view you can. I doubt there'll be much on this topic though. Some or many of the medical sources might mention it in which case just suggest it and then say a systematic review by Morris et Al...... Suggests XYZ. PainProf (talk) 16:28, 21 July 2020 (UTC)

I think if some surprising claim were made then it could be argued a WP:REDFLAG appears which makes us seek corroborating sourcing. But so far as I can see we don't use Morris reviews for anything startling. On its way to WP:GA this article went through some thorough probing of its sourcing. Alexbrn (talk) 16:40, 21 July 2020 (UTC)

"Draft:Willy surgery" listed at Redirects for discussion

A discussion is taking place to address the redirect Draft:Willy surgery. The discussion will occur at Wikipedia:Redirects for discussion/Log/2020 July 25#Draft:Willy surgery until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Hog Farm _Bacon 00:23, 25 July 2020 (UTC)

Circumcision → Male circumcision

The article cannot be moved by traditional means so I place my rationale and how the new revision will look like here. The current version of the article exhibits a non-neutral bent by implying male circumcision to be the "default" circumcision. MeSH and WHO specifically identifies the topic as "male circumcision." This needs to be rectified. — ItsAlwaysLupus (talk) 05:12, 19 August 2020 (UTC)

Here is the new revision:

Circumcision is a surgical removal of an elongated erectile organ (prepuce) present in female and male humans. The word circumcision is from Latin circumcidere, meaning "to cut around."

Further information:

• Circumcision, male

• Circumcision, female

I agree with you that male circumcision shouldn't be considered the default form of circumcision. Furthermore, I also think that circumcision should be defined as the amputation of the prepuce, regardless of gender. However, do you have a reliable source that defines circumcision (male and female) that way? The source you provided seems to have a double standard when it comes to defining circumcision. Male circumcision is only defined as prepuce removal, whereas female circumcision's definition includes prepuce removal and severe genital mutilation. Prcc27 (talk) 07:05, 19 August 2020 (UTC)

• Comment. How many times must we discuss the title of this article? See Talk:Circumcision/FAQ. The term circumcision almost always refers to male circumcision, just like the term condom almost always refers to the male condom. Female genital mutilation is the most common term for what you want to refer to as "female circumcision." Medical experts are clear that calling female genital mutilation "female circumcision" downplays the fact that these are two very different practices and the severity of female genital mutilation. We are not going to move this article to "Male circumcision" as though "female circumcision" is the standard term for female genital mutilation and as though circumcision and female genital mutilation can be easily equated. "Circumcision" would redirect here regardless. We aren't going to turn it into a disambiguation page and list "Male circumcision, female circumcision." The WP:Primary topic for "circumcision" is this article. The title of this article adheres to WP:Common name and WP:NCMED. Flyer22 Frozen (talk) 07:34, 19 August 2020 (UTC)
  • To be fair, the FAQs doesn't mention that users have tried to change the name of the article to "male circumcision". Prcc27 (talk) 07:54, 19 August 2020 (UTC)

I thought about that, but I don't see that it needs to. It has two examples and very clearly states that "circumcision" is the name we use. Obviously, "male circumcision" can be easily added to that FAQ. Flyer22 Frozen (talk) 08:21, 19 August 2020 (UTC)

@ItsAlwaysLupus: as Flyer22 Frozen points out, this article's name conforms to WP:COMMONNAME and WP:NCMED. You'd have to get those policies changed first. Jayjg ^(talk) 14:45, 19 August 2020 (UTC)

Unusual editor in this topic area who I've blocked

See particularly my last few messages at User talk:WriZeo. Graham87 07:21, 14 September 2020 (UTC)

Request for an Amendment

Currently, one of the sentences on this Wikipedia article states “The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction.” However, NHS Wales states the following at the bottom of their circumcision webpage:

"The main risk is reduced sensation or a permanent change in the sensitivity of the head of your child's penis." NHS Wales has made an association with the foreskin, sensation and sensitivity.

Can the sentence in italics above be changed to reflect the NHS Wales source? By removing "highest quality", which is subjective, we could say "Some evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction, while other evidence indicates that circumcision permanently changes the sensitivity of the penis or reduces sexual sensation". Or another sentence?

Jas9777 (talk) 02:53, 15 September 2020 (UTC)

References

The statement in the article is about the expected effects in a successful circumcision. The NHS Wales source is discussing possible complications. You're comparing apples and oranges. - MrOllie (talk) 03:14, 15 September 2020 (UTC)

 Not done It's fine as is, and your proposal misrepresents our sources. We already mention possible complications, and that the risk is small. Alexbrn (talk) 03:19, 15 September 2020 (UTC)

@MrOllie: NHS Wales is not discussing "possible complications" at the bottom of their webpage. NHS Wales discusses the expected effects in a successful circumcision, where the "main risk" is about sensation and sensitivity, and the "small risk" is about bleeding. @Alexbrn: The NHS Wales source should be used. Jas9777 (talk) 11:29, 15 September 2020 (UTC)

It also says the risks are small. It is clearly discussing complications. - MrOllie (talk) 11:40, 15 September 2020 (UTC)

@MrOllie: It says "the risks" in general are small - that sentence does not refer to a specific risk @Alexbrn: My proposal is fair - not to remove any sources, only to change "highest quality". Jas9777 (talk) 12:09, 15 September 2020 (UTC)

Yeah, you keep making the same request, and getting the same answer. Alexbrn (talk) 12:16, 15 September 2020 (UTC)

Medical organization statements

I propose a change to the statement "No major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure". There are in fact medical organizations that do recommend banning this procedure, notably Doctors Opposing Circumcision, and the German Academy of Pediatrics. To say none recommend banning it is misleading in the article, because it implies no medical organizations are opposed to the practice whatsoever. While I understand this suggestion will be shot down on grounds that voluntary -consensual- circumcision is not opposed by any organization, this opinion is not clear in the article, and in fact follows information on infant genital cutting, implying that no medical organization takes a stance against MGM.

The statement is correct and well-sourced. We follow sources. This has been discussed before - please check the archives. Alexbrn (talk) 08:45, 21 September 2020 (UTC)

HIV Lying

Most people with HIV are young African women, not men, and Japan has a very low HIV rate despite low circumcision rate. The article is locked from editing and openly lying. The entire article should be taken down. You should be ashamed of this disgusting anti-scientific lying and this is proof of the inability of this website to conform to science. — Preceding unsigned comment added by 142.162.222.218 (talk) 19:27, 12 November 2020 (UTC)

You're welcome to propose specific changes supported by reliable sources. Adrian J. Hunter^{(talk•contribs)} 23:30, 12 November 2020 (UTC)

Semi-protected edit request on 20 December 2020

The general article is very biased towards an American view on circumcision. It clearly shows a layout that display a positive view on the procedure and has not made thoroughly use of studies more critical of the procedure.

E.g. circumcision has been associated with higher rate of developmental diagnosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530408/

That neonatal circumcision is associated with altered adult socio-affective processing: https://www.sciencedirect.com/science/article/pii/S2405844020324099

Among many others.

On top of that the view that circumcision is safer when the child is younger has also been widely disputed. Here it has been stated by Danish anesthetic doctors that newborns cannot be properly sedated since they cannot be fully sedated and the regular routine of using sugar water for example has no actual effect.

You should be more neutral in the general rhetoric of the article since it shows a false view of the current scientific debate. 212.10.127.175 (talk) 08:41, 20 December 2020 (UTC)

 Not done Suggested sources are not reliable WP:MEDRS. We do carry a reliable Danish source currently. Alexbrn (talk) 08:46, 20 December 2020 (UTC)

Lede edits

recently, I tried to expand on a sentence in the lede, replacing

Male circumcision reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa.[10][11]

with

In 2002, three randomized controlled studies were conducted, finding that male circumcision reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa.[10][11]

only to be reverted. I don't see any valid reason for deleting my addition -- it provides more detail, and it's following the abstracts in the given RS. User:Alexbrn offered complaints via edit summaries. the first: Simplify and respect WP:ASSERT as I said, ASSERT doesn't really apply here, I'm simply giving more details. the statement is that male circumcision reduces risk of hetero HIV transmission in Africa, but how do we know that? the RS say: In 2002, three randomised controlled trials to assess the efficacy of male circumcision for preventing HIV acquisition in men commenced in Africa. This review evaluates the results of these trials, which analysed the effectiveness and safety of male circumcision for preventing acquisition of HIV in heterosexual men. and Three major lines of evidence support this conclusion: biological data suggesting that this concept is plausible, data from observational studies supported by high-quality meta-analyses, and three randomized clinical trials supported by high-quality meta-analyses. thus, the African studies play a key role in supporting the hypothesis, and I think it's appropriate to mention this.

the second complaint: This is bad writing, and begs questions. I beg to differ. it may not be perfect, but I think I did a decent job of linking the two statements together with a natural segue; if you can do better, then feel free to try your hand. as for begging questions, how is this an issue? assuming the African studies are indeed valid, then there's nothing to hide from the reader. I'm not even mentioning the critical minority view here (as that would be UNDUE) so again, I see no valid issue with this. Xcalibur (talk) 03:39, 8 February 2021 (UTC)

Bigdan201, The lead is supposed to summarize, more detail is not better there. The number of studies and the year they were conducted are minor details, best dealt with in the article body if they must be dealt with at all. MrOllie (talk) 03:50, 8 February 2021 (UTC)

that's a valid point. however, we could go into greater detail on this in the relevant section, then it wouldn't be out of place. in the meantime, I can reword it to make it a better fit for the lede. in fact, I'll try that out now. Xcalibur (talk) 04:04, 8 February 2021 (UTC)

That's kind of semi-literate. It's not "according to" studies, but according to science as a whole ... or more specifically the publications which analyze, synthesize and interpret the study evidence. In general in good summaries we try to hide the "working" and just show the results ... and there are many things one could say about the studies. Just surfacing "3", which sounds like a small number, and attributing the result, so it seems like it might just be the studies' view rather than an accepted biomedical fact, is sneaky POV-pushing (it would be like an editor saying of the Pzifer CV-19 vaccine "according to one study the vaccine is safe"). And you're at 4RR. Alexbrn (talk) 08:09, 8 February 2021 (UTC)

semi-literate? that's ironic, given that you refuse to understand my view. just because you disagree doesn't mean it can't have merit. of course, the hypothesis is not derived solely from the studies, but also from analysis/interpretation of data as you said; in fact, this is mentioned in one of the abstract quotations I provided. I assumed this would be tacitly understood. the fact remains, those same few studies, their results, and the analysis thereof is the primary support of the hypothesis (that circumcision reduces HIV transmission); if the methodology/analysis is flawed or not reliable for some reason, that would cast significant doubts on the conclusion. I'm not rejecting the conclusion per se, just pointing out that it's not as secure as it may seem. keep in mind, science can make mistakes and get things wrong at times, not often, but it can happen. science is done by the scientific method, not by consensus or credentials (although these add weight).

in fact, I'm within 3rr. more importantly, I tried out different wordings in pursuit of a compromise, in response to critique; it wasn't the stubborn back-and-forth that characterizes edit-warring. Xcalibur (talk) 09:39, 8 February 2021 (UTC)

"just pointing out that it's not as secure as it may seem" ← so, trying to undermine the best reliable sources by selectively surfacing details. That at least is clear then. Please learn better what a WP:REVERT is, and note that 3RR is not an "allowance" you've got to use up. Alexbrn (talk) 09:43, 8 February 2021 (UTC)

This is a lot like writing 'According to telescopes, Titan is the largest moon of Saturn'. If telescopes were flawed there would be reason to doubt Titan's size, sure. But since there is no good reason to doubt the veracity of telescopes (as there is no good reason to doubt these studies) that is not appropriate wording. - MrOllie (talk) 12:49, 8 February 2021 (UTC)

• I don't think the two are comparable.. There is currently no credible evidence that contradicts the fact that Titan is Saturn's largest moon, and there is nothing contraversial with this assertion. However, unlike Titan's size, the RCTs are not universally accepted. Our article even says "some have challenged the validity of the African randomized controlled trials." That being said, I agree that this issue would need to be dealt with in the body of the article first, before we even think about tweaking the lead. If Bigdan201/Xcalibur's proposed lead wording can accurately summarize what is actually in the body of the article– I could possibly support the change. Otherwise, it may come off as too verbose Prcc27 (talk) 21:05, 8 February 2021 (UTC)

I wouldn't count the first edit, personally. I'm aware that 3rr is not permission to revert 3 times. as I said, I tried out different wordings each time.

indeed, it's not equivalent. our knowledge of the moons of Saturn is highly reliable, and comes from numerous sources and observations, without any doubts. the hypothesis in question (reducing HIV transmission) is largely built on the same 3 studies. it doesn't have the same broad base of support as the moons of Saturn, or the fact that HIV causes AIDS.

admittedly the lede was the wrong place to start, perhaps I should pivot towards the relevant part of the article first. Xcalibur (talk) 21:35, 8 February 2021 (UTC)

• When your edit is reverted, it's usually a better idea to discuss it at the talk, than to keep trying to implement a change to the article. Many users on Wikipedia use WP:BRD as a guide on how to avoid edit warring. Prcc27 (talk) 21:42, 8 February 2021 (UTC)

you're right. even though I tried out different wordings, it's safer to keep it on talk. Xcalibur (talk) 23:52, 8 February 2021 (UTC)

Semi-protected edit request on 9 February 2021

Circumcision violates the Hippocratic Oath to "First, do no harm."

Doctors have an ethical duty to treat the patient by the most conservative means possible, but removing healthy tissue in the absence of any medical need absolutely harms the patient. In the case of routine infant circumcision, nothing was diseased, and thus nothing justifies its removal. Medical personnel who support infant circumcision in any way should reexamine their ethical duties to the child. 85.220.96.173 (talk) 19:00, 9 February 2021 (UTC)

To editor 85.220.96.173:  Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. DigitalChutney (talk) 19:30, 9 February 2021 (UTC)

US-centric bias concerns

This article and most articles related to this topic appear to suffer from a US-centric bias, not considering the perspectives and sources from most of the world's medical organizations and ethicists. While the UN is prominently featured as a source, it must be recognized that the UN reports on circumcision are largely composed of American or US-associated scientists and cite mostly US-funded research. In addition, the Bill and Melinda Gates foundation, with other nonprofits circumcising African men, have a significant financial stake in the matter. Thus, the issue of cultural bias, previously examined and of which the AAP has been accused, comes into focus.

In the spirit of diversifying the viewpoint of this article, I have revised the introduction significantly to incorporate more global sources and perspectives. While much of the article requires further revisions, I hope that this is a good start that can encourage some further updates.

I am open to any and all criticisms of the new introduction and hope to resolve them piece by piece instead of blanket undos. — Preceding unsigned comment added by TomekBotwicz (talk • contribs) 01:01, 14 March 2021 (UTC)

Thank you. — Preceding unsigned comment added by TomekBotwicz (talk • contribs) 00:59, 14 March 2021 (UTC)

Bill Gates? Sounds like a whacky conspiracy theory. Your rewrite was poor and POV-pushing, especially given that ledes must only reflect content that already exists in the body. This is a WP:GA and has undergone much community scrutiny. Although it could do with an update there are no systematic faults such as you claim. Alexbrn (talk) 04:57, 14 March 2021 (UTC)

Following up on recent conflict

@MrOllie

While I understand and respect your removal of that personal attack post on this talk page and do not believe such posts of a personal nature are in line with Wikipedia’s standards, I think the author did raise significant concerns that have been repeatedly surfaced throughout this page’s history.

A cursory comparison of this page to those in a different language reveal that this page is not in line with WIKI:NPOV. Nearly all non-English versions appear to be more balanced and structurally mirror the formatting of the article on Female Genital Mutilation which is in some ways related to male circumcision. For example, most medical articles on Wikipedia display a medical image displaying the procedure in the LEDE. However, the English version of this article shows a historical image of a circumcision that is also used on the History of Circumcision page and really does not seem appropriate for the procedure page. Granted, the citations on this page, however controversial, are medically backed. But the idea of cultural bias CANNOT be swept aside as most of the citations ARE from US publications or scientists (or the WHO, which publishes reports citing these US studies). Given that circumcision is culturally accepted and often favored in the US, that bias is bound to seep into scientific statements.

I think that this should be considered, starting with a change of the image displayed in the LEDE. TomekBotwicz (talk) 22:38, 14 March 2021 (UTC)

TomekBotwicz, The Wikipedias of other languages have their own policies and different content standards. In particular most have much less stringent medical sourcing requirements, so this is an 'apples to oranges' style comparison. Still, I took a look at the Wikipedia which is generally considered the largest and best run (aside from our home here at en, of course!) - de.wikipedia.org, and they're using exactly the same image this article is. MrOllie (talk) 23:06, 14 March 2021 (UTC)

@TomekBotwicz I'm open to changing the lede photo. However, given that circumcision is often carried out for religious/cultural reasons, rather than medical reasons– I fear that replacing the lede photo with something more medical would give the wrong impression that circumcision is usually done for medical reasons. Btw, Wikipedia's Female Genital Mutilation lede does not show an image of the "procedure", so I'm not really sure what you're arguing here. Prcc27 (talk) 03:32, 15 March 2021 (UTC)

Australian circumsision rates

Estimates for individual countries include Taiwan at 9%[88] and Australia 58.7%.[89]

I suggest the reference to Australia be removed as the figure is no longer accurate. The Quoted text is over 15 years old.

I suggest the world map chart be updated too.

• Not sure who wrote this, as there is no signature, but do you have a figure that is more accurate/up-to-date? By the way, isn't there a difference between circumcision prevalence ("how many males are circumcised in their lifetime?") and circumcision rates ("how many males were circumcised in a given year?"). While a majority of Australians may be circumcised, that doesn't necessarily mean a majority of males are being circumcised in recent years. I think we could make this more clear in the article.. Prcc27 (talk) 01:54, 16 March 2021 (UTC)

Psychological Trauma Section does not have reliable sources

I suggest these get removed because of inaccurate, biased sources. Brian Morris is an extreme pro-circumcision advocate who has worked with the Gilgal Society, the Circumcision Foundation of Australia, and has posted circumfetishist websites on his Facebook. I suggest adding more reliable sources, and Wikipedia should caution against troll edits.

Here is what I suggest it should be edited to:

There is evidence that circumcision causes post-traumatic stress disorder (PTSD) and numerous other psychological problems, though to which extent it is unclear and better studies are needed. Dashoopa (talk) 17:57, 5 April 2021 (UTC)

References

See WP:MEDRS for Wikipedia's medical sourcing guidelines. What we have, is compliant. Your sources are primary research and an article that isn't even included in PUBMED, respectively. Neither is usable. Alexbrn (talk) 18:01, 5 April 2021 (UTC)

None of my sources are primary sources. You should check WP:MEDRS to learn what a primary, secondary, and tertiary source is. It also never says there that it is required to use PUBMED as a source. Both are excellent and usable sources. Dashoopa (talk) 18:05, 5 April 2021 (UTC)

The first source is classified by the publisher as a "Research Article". That makes it a primary source. We want reviews or better (like we have already). Non-appearance in PUBMED is pretty much a disqualification, especially when top-tier sources are available. If in doubt, ask at WT:MED for opinion from medical expert editors. Alexbrn (talk) 18:10, 5 April 2021 (UTC)

Nope, a primary source in WP:MEDRS is where authors directly participated in the research and documented their personal experiences. The authors in both studies did not do so, and they were doing literature reviews which would make them secondary sources. Furthermore, it is never stated that non-appearance in PUBMED is a disqualification in any WP article. And either way, my first source was in PUBMED so it is usable. Dashoopa (talk) 18:13, 5 April 2021 (UTC)

Also, it is stated in WP:MEDRS that authors may not have conflicts of interest and it is stated in that article that there are conflicts of interests:

"The first author is a member of the Circumcision Academy of Australia, a not‐for‐profit, government registered, medical association that provides evidence‐based information on male circumcision to parents, practitioners and others, as well as contact details of doctors who perform the procedure. The second author is an editor for http://CircFacts.org. The third author provided advice and supported the legal help to University of Washington for the patenting of a circumcision device. He did not receive any income from this. The authors have no religious or other affiliations that might influence the topic of MC."

Thus, it must be removed. Dashoopa (talk) 18:19, 5 April 2021 (UTC)

You're wrong; we're not going to undercut secondary sources with primary ones, but as I said you can always ask for confirmation at WT:MED. Alexbrn (talk) 18:16, 5 April 2021 (UTC)

These are secondary sources, as I explained. Can you please not troll and do WP:BATTLEGROUND comments? Dashoopa (talk) 18:18, 5 April 2021 (UTC)

I'm not fighting, but inviting you to seek further opinions if you disagree. If the WP:ONUS is satisfied things can move forward. Alexbrn (talk) 18:22, 5 April 2021 (UTC)

Either way, the first source must be removed as they have a Conflict of Interest which violates Bias under WP:MEDRS. Dashoopa (talk) 18:25, 5 April 2021 (UTC)

Dashoopa, Alexbrn is right, absence from PUBMED is usually disqualifying. However, what MEDRS mentions is MEDLINE (which tends to be highly correlated with PUBMED). 'Current Sexual Health Reports' isn't MEDLINE indexed either.

The Boyle source absolutely is a primary source.

Also, it's disingenuous to bring up memberships held by the authors of the source you don't like, while ignoring Goldman's position with the 'Circumcision Resource Center' advocacy group. You also left Svoboda (of 'Attorneys for the Rights of the Child') off the author list of the Boyle source entirely. MrOllie (talk) 18:33, 5 April 2021 (UTC)

How is the Boyle Source primary? It's literally a literature review. Do you guys have any clue what those mean? Or do you just say 'primary sources' when you disagree with them? The first source is in PUBMED and MEDLINE. There are no conflicts of interests declared in the study that I cited whereas there are for the other one. It seems disingenuous to point out one but not the other. Dashoopa (talk) 18:39, 5 April 2021 (UTC)

Dashoopa, Among other things, Goldman quotes and summarizes personal correspondence he received from individuals on the subject. It's not a literature review. MrOllie (talk) 18:44, 5 April 2021 (UTC)

Dude, he is collecting sources on the topic of circumcision and trauma. That's a literature review. This actually hinders reliable sources being put on Wikipedia when you have no clue what these terms mean. Dashoopa (talk) 18:47, 5 April 2021 (UTC)

Dashoopa, No, collecting correspondence is a primary study. At any rate, I'm having trouble finding 'J Health Psychol' in MEDLINE. Since you were able to find it, could you provide the NLM catalog number? MrOllie (talk) 18:48, 5 April 2021 (UTC)

Never mind, I found it! MrOllie (talk) 18:50, 5 April 2021 (UTC)

It says: "A secondary source summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies." The Goldman study was a source that summarized primary and secondary sources, so it qualifies as a literature review. Dashoopa (talk) 18:54, 5 April 2021 (UTC)

If you interview a bunch of people, in person or by mail, and then summarize the results, you have collected data and published a primary source, not a literature review. This is basic stuff. - MrOllie (talk) 18:59, 5 April 2021 (UTC)

He wasn't interviewing a bunch of people, he was collecting the data from several studies. Dashoopa (talk) 19:04, 5 April 2021 (UTC)

Dashoopa: Or do you just say 'primary sources' when you disagree with them?

It certainly seems so. Guarapiranga (talk) 07:46, 21 April 2021 (UTC)

This is indeed basic stuff. Trying to replace a 2019 review with a 2002 (!!) primary source and some marginal advocacy piece is very naughty indeed. It looks like WP:ADVOCACY. Alexbrn (talk) 20:19, 5 April 2021 (UTC)

Adding new section about risk-benefit analyses and cost-benefit analyses

I suggest we add a new section where we document different analyses of circumcision's risks and benefits in aggregated form to determine whether it is medically beneficial based on a range of analyses. I think a good starting point would be Robert Van Howe's paper entitled: "A Cost-Utility Analysis of Neonatal Circumcision" where he analyses the costs/risks and benefits of circumcision through several systematic reviews. He finds: "Neonatal circumcision increased incremental costs by $828.42 per patient and resulted in an incremental 15.30 well-years lost per 1000 males. If neonatal circumcision was cost-free, pain-free, and had no immediate complications, it was still more costly than not circumcising. Using sensitivity analysis, it was impossible to arrange a scenario that made neonatal circumcision cost-effective."

He also finds:

"Neonatal circumcision is not good health policy, and support for it as a medical procedure cannot be justified financially or medically."

This study was published in Pubmed and thus Medline fitting the requirements for WP:MEDRS.

https://pubmed.ncbi.nlm.nih.gov/15534340/

I suggest adding other risk-benefit analyses, systematic reviews and meta-analyses since this is a highly controversial topic and Van Howe arrives at a controversial opinion. Nonetheless it is objective, peer-reviewed research that would be necessary in taking into account in the circumcision debate.

Dashoopa (talk) 02:55, 10 April 2021 (UTC)

We would need WP:MEDRS, and yes - more reliable sources are always useful. PMID 15534340 is primary research from 17 years ago. The phrase "published in Pubmed and thus Medline" does not really make any sense: nothing is "published in" PUBMED, and not everything included by PUBMED is MEDLINE-indexed, and neither determines a source is WP:MEDRS. I suggest looking at WP:WHYMEDRS and WP:MEDFAQ for some guidance.

Searching for articles on cost/benefit turns up PMID 26830283 which is a 2016 review article, though specific to the question of HIV prevention. It says:

Circumcision and condoms are effective, inexpensive interventions that do not require extensive resource allocation in the form of drugs, clinic visits, and health workers. Results consistently demonstrate that these interventions are some of the most cost-effective and affordable interventions available in HIV prevention.

Perhaps we could add this? Alexbrn (talk) 05:35, 10 April 2021 (UTC)

Bro, this is not primary research. This is a systematic review, meta-analysis, and risk-benefit analysis. You really need to learn what. primary source is. With regards to your source about HIV, we could but we need better ones that include not just cost-effectiveness of HIV but every risk and benefit. Dashoopa (talk) 12:45, 10 April 2021 (UTC)

I am not your "bro". Several times, you have mistakenly told multiple experienced editors now that primary research is secondary, in a way which seems very strange. WP:CIR. For a fuller discussion of risk/cost/benefits, the existing source we use, PMID 31496128 which actually is a recent secondary source, is excellent. This could be usefully used to expand the knowledge in the article. Alexbrn (talk) 12:58, 10 April 2021 (UTC)

Dashoopa, cost-utility analysis is not the same thing as a systematic review. Also, since you were concerned about COI issues in the previous section, you may be interested to know that Van Howe is funded by NOCIRC. MrOllie (talk) 13:10, 10 April 2021 (UTC)

This was a cost-utility analysis that also used systematic reviews and meta-analyses. So, it can be a reliable secondary source. Also, Alexbrn is being extremely hostile once again, so I ask you to please warn him or remove him from this beat as if he cannot be a civil editor then he simply cannot edit on a topic that is that controversial for him. Dashoopa (talk) 14:11, 10 April 2021 (UTC)

You are making no sense. An old primary source is not reliable for biomedical content. If you want to confirm this is a primary source, ask at WT:MED, again. Alexbrn (talk) 14:15, 10 April 2021 (UTC)

Systematic reviews, meta-analysis, and cost-utility analyses are secondary source, my guy. This is not up for dispute. The question is whether this could be used as a study, which it can but I will ask for confirmation at WT:MED. Dashoopa (talk) 14:19, 10 April 2021 (UTC)

Dashoopa, You are incorrect. Anything that contains substantially new information, (such as a cost-utility analysis) is not a secondary source. MrOllie (talk) 14:20, 10 April 2021 (UTC)

What do you mean by substantially new information? This was a systematic review of the literature on circumcision's connections to benefits and risks, not primary information. Dashoopa (talk) 14:25, 10 April 2021 (UTC)

Dashoopa, A cost-utility analysis collects information from one set of sources (to derive costs) and associates it from another (to associate costs with outcomes). This relation is substantially new information, and takes a lot of reasoning and work, and can vary from analysis to analysis because of differing assumptions, data selection, or techniques. That is the reason that review articles such as the one Alexbrn is bringing up will work from a whole set of cost-utility analyses. Those actually are secondary sources, and on Wikipedia we use them so we don't accidentally rely on an analysis that turns out to be an outlier. MrOllie (talk) 14:37, 10 April 2021 (UTC)

I don't understand what you mean by substantially new information. This is a review article, a systematic review at that which analyzes information from multiple different sources. That is by definition a secondary source. No ifs, no buts. The analysis that Alexbrn suggested did not include cost-utility or cost-effectiveness analyses either so it is irrelevant to my suggestion. Dashoopa (talk) 14:41, 10 April 2021 (UTC)

Dashoopa, Again, your terminology is plainly incorrect. It is not a review article. MrOllie (talk) 14:46, 10 April 2021 (UTC)

It is a systematic review and meta-analysis. I will read directly from the paper: "Meta-analyses were performed using a random-effects model (DerSimonian and Laird method) by the MantelHaenszel method...Articles addressing the impact of neonatal circumcision on health were collected by searching MEDLINE using circumcision as a search word, reviewing the citations in pertinent articles, and querying experts in the field. Articles published since 1900 were considered. Preference was given to the most current information." This is not up for dispute. Dashoopa (talk) 14:47, 10 April 2021 (UTC)

Yes, and even if it were a secondary source (which it isn't), it's out-of-date (2004) when we have recent sources available. Alexbrn (talk) 14:22, 10 April 2021 (UTC)]

The recent source was not a cost-utility analysis, so it has zero applicability to what I'm talking about. Dashoopa (talk) 14:23, 10 April 2021 (UTC)

PMID 31496128 (2019) has an entire section devoted to reviewing "Cost effectiveness". Alexbrn (talk) 14:26, 10 April 2021 (UTC)

I already explained why that source was bad, but I will explain again. John Krieger sells patented circumcision devices and thus violates Wikipedia policy about Conflicts of Interests and biases. It also doesn't make sense to exclude Van Howe because he is generally anti-circumcision, while including reviews from extreme, pro-circumcision advocates. Dashoopa (talk) 14:32, 10 April 2021 (UTC)

That Morris 'review' is at the very least highly controversial and should not be included, see [4]. RWalen (talk) 12:42, 29 April 2021 (UTC)

No mention of usage in cosmetics?

There's a well documented industry of cosmetic products created from infant foreskins (and they have to be coming from somewhere), but the practice isn't mentioned a single time in the article. I figured it ought to be relevant, but finding RS's is a bit of a challenge. Still something I believe could supplement the article, and I'll include some assorted (mostly non-RS) sources here to offer a starting point for research: [5] [6] [7] Deku link (talk) 02:52, 2 May 2021 (UTC)

[8] - MrOllie (talk) 03:02, 2 May 2021 (UTC)

reference 4 is Scientific American and 5 is The Guardian UK newspaper.

Male Genital Mutilation

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

By definition, circumcision is genital mutilation and should be labeled as such. — Preceding unsigned comment added by 2600:1700:d591:5f10:9423:aaa6:d65e:3995 (talk • contribs) 17 May 2021 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Semi-protected edit request on 25 May 2021

There’s a big case of discrimination with this page, regardless of your views on circoncision.

At the top of the page it’s marked “ This article is about male circumcision. For female circumcision, see Female genital mutilation.”

There’s no mention of genital mutilation in the article.

The title should be: Male genital mutilation (circoncision) 83.37.94.188 (talk) 07:58, 25 May 2021 (UTC)

 Not done. See FAQ at page top. Alexbrn (talk) 07:59, 25 May 2021 (UTC)

The article mentions that the Danish College of General Practitioners views the practice as genital mutilation. And it also notes that the Royal Dutch Medical Association questions why female genital alterations (which Wikipedia recognizes as genital mutilation) should be viewed differently than male genital alterations. Prcc27 (talk) 17:58, 25 May 2021 (UTC)

Inclusion of PTSD claim

User:Alexbrn, you claim that the Morris review supports the finding that there is no evidence of increased likelihood of PTSD in circumsized individuals, I contend that it does not. The section on it, 4.7.7 in [9], first cites the Philippines paper, claiming that it is unpublished (?). It is now published at [10], supporting higher rates of PTSD in non-therapeutic circumsized individuals in the Philippines, although with limitations. Then, it sets out to disprove this finding using the "Alexithymia and circumcision trauma: a preliminary investigation" survey, but that survey talks about alexithymia, not PTSD, with findings that Morris himself counters in his paper. The third citation is of some newspaper article, which then cites an older study finding a potential link with PTSD, which is bizarrely given as support in the Morris claim that there is no other evidence. Taken together, the given review does not support the idea that PTSD is not associated with circumcision, rather, a positive or negative claim should be excluded from this article altogether in the absence of other evidence. I do now contend that the Morris paper sufficiently finds evidence that circumcision has no effect on cognitive ability, although I am wary of including Morris as a reliable source for anything to do with circumcision. I would also like to say that I appreciate your work here on Wikipedia, but your characterization of my edits as edit warring are unfounded. RWalen (talk) 15:46, 29 April 2021 (UTC)

Morris has been discussed ad nauseam and the bottom line is that good sources (such as review articles in reputable journals) cannot be discarded because of the distaste of activists and/or Wikipedia editors: such a route leads to anarchy. Neither should editors being trying to run their own review on the topic, to undercut a peer-reviewed secondary source. As MEDRS says, cite reviews, don't write reviews. Primary sources pretty much always fail WP:MEDRS for biomedical claims in a field for which secondary sources exist, and pmid:31080593 is doubly unreliable from being published in a low-quality, non-MEDLINE-indexed journal. If there are no better sources, the question is how best to summarize the one we have: the claim made (absence of evidence) is a mundane one, being the default assumption in SCI/MED anyway, so it's not as if this should be controversial from a scientific point-of-view. Alexbrn (talk) 15:56, 29 April 2021 (UTC)

This does not really address my concerns about the validity of the source given the claim. You are right that the claim is quite mundane, but my point is simply that the given article does not actually support it. Yes, it is published in an indexed journal and several of its sections are nicely fleshed out and supported by evidence. But the evidence presented in this particular section to this particular claim in the Morris review is simply weak to non-existent. I get that Morris has been discussed before on here, but there are legimitate concerns about his conflicts of interest, not just from 'activists'. RWalen (talk) 16:23, 29 April 2021 (UTC)

Right, so we are sure to use high quality sources with a peer-review process, which are designed to account for any COI. We are bound to reflect reliable sources so, to repeat: the question is how best to summarize the one we have? It is not our job to disagree with sources because we think they've drawn the wrong conclusion from the evidence considered. Alexbrn (talk) 17:15, 29 April 2021 (UTC)

I agree that we should not be doing peer reviews of academic articles here on Wikipedia. But I also think that in a debate as polarized as the circumcision debate, which is also evident in peer-reviewed academia given the constant harsh back-and-forth Morris deals and receives to and from his academic 'opponents', we should aim to be critical ourselves, and to provide a balanced perspective to any claims made. I will try to look for other sources concerning the topic, in the meantime, perhaps another editor wants to give their two cents in this discussion. RWalen (talk) 19:33, 29 April 2021 (UTC)

I agree with you, RWalen. Guarapiranga (talk) 21:11, 29 April 2021 (UTC)

Not all verifiable information needs to be included in an article. We don't have to include Morris's PTSD claim in the article if it is problematic. Prcc27 (talk) 06:29, 30 April 2021 (UTC)

That's true, but material published in recent reputably-published systematic reviews, which for Wikipedia are golden sources, represent exactly the kind of knowledge we are supposed to reflect, far from any kind of WP:NOT. As a POV check, are you saying that if such a systematic review appeared saying there was evidence that MC caused PTSD, Wikipedia should ignore it? I think we may need input from WT:MED or maybe a RfC to get a proper sense of how the WP:PAGs apply here. Alexbrn (talk) 07:11, 30 April 2021 (UTC)

• I didn't say what we should and shouldn't include in the article. I'm only saying that we are not obligated to include something, if there isn't consensus for its inclusion. A source being "golden" does make it more likely to achieve consensus to be included in the article, but it isn't inevitable. Prcc27 (talk) 08:31, 30 April 2021 (UTC)

At face value, any recent systematic review is indeed a gold standard for WP:MEDRS per WP:MEDASSESS, but these policies are not the end-all be-all of determining reliability of sources, especially when the subject is this controversial. This review was written with the explicit purpose of "Critical evaluation of arguments opposing male circumcision" by long-time advocates of therapeutic circmcision each of whom have separate conflicts of interests, and it shows in the writing. Concerns have been raised before about the quality of peer review in another review by the main author of this paper, and authors of a cited paper in this particular review have also raised concerns about misrepresentation of their work in the review. Concerns about Morris sources have been raised on this talk page before, with some editors supporting and some opposing. I don't think there was any real consensus in the past. For the particular claim we are discussing here, the section dealing with it in the original review is in my opinion very weak as I explained before. For these reasons, I think the work cited should be accompanied by other perspectives when possible, and ideally for this particular claim not be included. As for your hypothetical, there certainly are many anti-circumcision authors in academia who may be partaking in much of the same kind of less-than-ideal behavior. If a systematic review of therapeutic circumcision concluded that it does cause PTSD, but was written by authors with a strong conflict of interest in a way set out to explicitly disprove all arguments to the contrary often using low-quality evidence and many many low-quality self-citations, I would absolutely be skeptical of its use. Anyway, I am not sure how to proceed, a WP:3O is possible, or an RfC is other editors are interested. RWalen (talk) 14:37, 30 April 2021 (UTC)

I suggest we get input from WT:MED first. In my understanding, if a topic is controversial (and, is PTSD in circumcision that? especially for an unexceptional claim?) then that's a reason to increase sourcing quality. We cannot use weak sources to debunk solid sources, we can't dismiss a systematic review because of a personal objection to one of its authors, and we can't decide to dismiss a source because we think our personal amateur judgement of the evidence is superior to that which is published by expert scientists following peer review. All this is said, in one way or another, in the WP:PAGs, WP:MEDRS in particular. I'd prefer it if one of the opposers posts at WT:MED, because I'm finding it hard to understand the argument why this source should be considered unusable. Alexbrn (talk) 14:57, 30 April 2021 (UTC)

I agree with RWalen.

1. WT:MED is not a higher instance to this talk page; a Supreme Court of Medicine. Anyone here is free to RfC across WP, otherwise.
2. PTSD is not even solely a medical condition. It's a psychological one too. If you do decide to post the RfC at WT:MED, I suggest you post it at WT:PSYCH too.

  — 𝐆𝐮𝐚𝐫𝐚𝐩𝐢𝐫𝐚𝐧𝐠𝐚 (talk) 00:51, 26 May 2021 (UTC)

Don’t you have the psychological effect section for that? ~ Tisthefirstletter (talk) 22:05, 25 May 2021 (UTC)

Statements falsely categorized as statements of fact

The following text has been categorized as statements of fact:

Overall, as of 2019 it is unclear what the psychological outcomes of circumcision are, with some studies showing negative effects, and others showing that the effects are negligible.[83] There is no good evidence that circumcision adversely affects cognitive abilities.[83] There is debate in the literature over whether the pain of circumcision has lasting psychological impact, with only weak underlying data available.[83]

However the following phrases clearly indicate that opinions - not facts - are stated:

• it is unclear (if something is clear or not lies in the eyes = opinion of the observer)
• effects are negligible (if effects are negligible or not is a matter of opinion)
• There is no good evidence (if the available evidence is good or not is a matter of opinion)
• only weak underlying data (if data are weak or not is a matter of opinion)

Therefore the following rule from WP:ASSERT applies:

When a statement is an opinion (e.g., a matter which is subject to serious dispute or commonly considered to be subjective), it should be attributed in the text to the person or group who holds the opinion.

--Saidmann (talk) 18:24, 25 May 2021 (UTC)

The same user has used WP:ASSERT in the past, including on other articles. And now that you mention it, it does seem like they are misapplying it. WP:ASSERT says "information that is accepted as true and about which there is no serious dispute", and gives examples like "Mars is a planet" or "Plato was a philosopher" when defining what a "fact" is. The examples you listed are more nuanced than indisputable facts such as "Mars is a planet". Regardless, WP:ASSERT is not a Wikipedia guideline or policy. Prcc27 (talk) 22:41, 25 May 2021 (UTC)

Clearly. Agree. — 𝐆𝐮𝐚𝐫𝐚𝐩𝐢𝐫𝐚𝐧𝐠𝐚 (talk) 00:32, 26 May 2021 (UTC)

WP:ASSERT is handy read, but if you want policy then see WP:YESPOV: "Unless a topic specifically deals with a disagreement over otherwise uncontested information, there is no need for specific attribution for the assertion". As well as being just bad writing, adding all the distancing gubbins about "a review said" violates WP:NPOV by making it look like these particular assertions, by virtue of their distinctive treatment in the article, are somehow to be suspected. The prior edit history of Saidmann makes their WP:ADVOCACY purpose in this transparently obvious. Alexbrn (talk) 07:31, 26 May 2021 (UTC)

Of course, the "topic specifically deals with a disagreement". And in WP:YESPOV we read:

"Avoid stating opinions as facts. Usually, articles will contain information about the significant opinions that have been expressed about their subjects. However, these opinions should not be stated in Wikipedia's voice. Rather, they should be attributed in the text to particular sources"

Therefore - in agreement with both WP:ASSERT and WP:YESPOV - it is suggested that the above section is worded as follows:

"In a review from 2019 it was stated as unclear what the psychological outcomes of circumcision were, with some studies showing negative effects, and others showing that the effects were negligible.[83] There was no good evidence that circumcision adversely affected cognitive abilities.[83] There was debate in the literature over whether the pain of circumcision had lasting psychological impact, with only weak underlying data available.[83]"

--Saidmann (talk) 11:55, 26 May 2021 (UTC)

The "disagreement" would need to be in reliable sources, not in the mind of a Wikipedia editor. Alexbrn (talk) 12:02, 26 May 2021 (UTC)

The prior edit history of Saidmann makes their WP:ADVOCACY purpose in this transparently obvious.

1. The same could be said about you, Mr. Brown.
2. Wikipedia:No personal attacks.

  — 𝐆𝐮𝐚𝐫𝐚𝐩𝐢𝐫𝐚𝐧𝐠𝐚 (talk) 12:36, 26 May 2021 (UTC)

@ Alexbrn: Now come on. The whole paper of the Morris group is mostly a mirror of "disagreements" in the literature. And you want to make it a mirror of statements of fact? Or do you want to say that Morris's sources are no "reliable sources"? --Saidmann (talk) 15:25, 26 May 2021 (UTC)

Just reflect the source and all will be well. Where it says there is disagreement then yes, we can reflect that too (we say "There is debate in the literature over whether ..." e.g.) Alexbrn (talk) 15:30, 26 May 2021 (UTC)

"There is debate in the literature over whether ..." is the only statement in the section that is a statement of fact. There, only the grammar had to be adapted because of the following parts of the sentence. --Saidmann (talk) 19:03, 26 May 2021 (UTC)

Neither "clear" nor "unclear" was used by the authors. Instead they wrote:

"Claims that MC causes psychological harm were contradicted by studies finding no such harm."

Now, this statement definitely is a statement of opinion. Others wrote a very different opinion on the same issue:

"Our findings resonate with the existing literature suggesting links between altered emotional processing in circumcised men and neonatal stress." (PMID 33299934)

Therefore the suggestion "Just reflect the source and all will be well" would be realized by the following altered version:

"In a review from 2019 it was stated that claims MC caused psychological harm were contradicted by studies finding no such harm.[83] There was no good evidence that circumcision adversely affected cognitive abilities.[83] There was debate in the literature over whether the pain of circumcision had lasting psychological impact, with only weak underlying data available.[83]"

I hope this can now settle the issue. --Saidmann (talk) 18:13, 27 May 2021 (UTC)

WP:CLOP is problematic. If there are contradictory findings then the situation is unclear. That's a fair summary without plagiarising. Alexbrn (talk) 18:19, 27 May 2021 (UTC)

WP:CLOP says: "Limited close paraphrasing is appropriate within reason". --Saidmann (talk) 17:03, 28 May 2021 (UTC)

I agree with Alexbrn, that the attribution to a review is wrong. I don't think this is merely the personal opinion of the review authors, but is their findings, like one gets from any study of people. Explicit dating is also wrong, because it suggests this information is date-sensitive, and likely to change (either because the thing being observed is altering, or we strongly anticipate new observations to contradict current uncertainty). I also agree that the wording is too close to the source. -- Colin°^Talk 15:22, 5 June 2021 (UTC)

Oh yes, it definitely was "the personal opinion of the review authors". That's why I had quoted an opposite opinion on the same issue (see above 18:13, 27 May 2021: "Our findings resonate with the existing literature suggesting links between altered emotional processing in circumcised men and neonatal stress." (PMID 33299934)) Also calling what the one side has "claims" and calling what the other side has "studies" is a clear indication of bias (not many authors are so careless as to make their bias that obvious). --Saidmann (talk) 17:49, 5 June 2021 (UTC)

"Contradictory" could easily become "conflicting", without plagiarizing. Maybe we could rework the wording there. Prcc27 (talk) 03:05, 6 June 2021 (UTC)

Avoiding plagiarism takes more than rogeting, which is something I hope no Wikipedia editor would ever do. Alexbrn (talk) 04:00, 6 June 2021 (UTC)

Yeah, so Saidmann's proposal may need to be reworked. Would this work: "Overall, as of 2019, there is conflicting evidence regarding what the psychological outcomes of circumcision are, with some studies showing negative effects, and others showing that the effects are negligible"? Prcc27 (talk) 06:17, 6 June 2021 (UTC)

I am not sure what problem editors think needs fixing. That new proposal puts the two positions on an equal footing, which the source explicitly does not, so would fall afoul of Wikipedia's requirement for WP:V and WP:NPOV, no? How do you think the "compare favorably" wording of section 4.7.8 in the source could be most honestly reflected here? Alexbrn (talk) 06:33, 6 June 2021 (UTC)

I don't see how a subtle change like going from "unclear" to "conflicting evidence" all of the sudden creates WP:V and WP:NPOV issues. But I'm a little confused.. I thought that the wording Saidmann quoted in the very first commment of this section on the talk was what was currently in that section on the article. I guess I should have checked first before commenting. It looks like the section has been heavily condensed by another user..? Why did they do that, when we are still trying to achieve consensus here? Or was that what the consensus was prior to this section at the talk being created? As for section 4.7.8, I'm having trouble comprehending what it means. Prcc27 (talk) 08:20, 6 June 2021 (UTC)

I think having the "unclear" wording was a diplomatic (too diplomatic?) way of conveying that there was a variety in the evidence. If we're just going to say there's two types of evidence (crudely, for and against the idea of psychological harm) we are bound to point out that one lot is of generally higher quality than the other (that is what section 4.7.8 means). Alexbrn (talk) 08:25, 6 June 2021 (UTC)

The current wording only says "There is no evidence that male circumcision causes adverse psychological effects." What happened to all the other information we originally had? I will revert that edit, unless I get a good explanation soon. Prcc27 (talk) 11:47, 6 June 2021 (UTC)

PMID 33299934 is a primary source. It should normally not be used at all, and it definitely should not be used to undermine or contradict the conclusions of a review article, which would violate Wikipedia:Identifying reliable sources (medicine)#Respect secondary sources. WhatamIdoing (talk) 02:04, 7 June 2021 (UTC)

In non-medical sections as this one (psychology) primary sources can of course be used: "primary sources that have been reputably published may be used in Wikipedia" (WP:OR). But this is no issue here. The source was only mentioned to document that other opinions on the matter are extant than that of the Morris group. --Saidmann (talk) 12:19, 7 June 2021 (UTC)

Primary source failing WP:MEDRS, so not usable. Alexbrn (talk) 12:25, 7 June 2021 (UTC)

First: WP:MEDRS is not applicable here. WP:MEDRS stands for "Identifying reliable sources (medicine)". Now, Psychological effects is definitely outside of the realm of medicine - the same as philosophy, sociology, or linguistics.

Second: If a source proves that something is an opinion and not a fact, it is totally irrelevant if the source is a primary or secondary one.

--Saidmann (talk) 19:17, 7 June 2021 (UTC)

All Wikipedia articles must be based on secondary sources. But for all WP:Biomedical information that requirement is even stricter as set out in WP:MEDRS. Specifically included in WP:BMI is "How a treatment works; whether a treatment works, and to what degree; factors that affect whether a treatment works; dosage and timing information; side effects, benefits, and disadvantages." [my bold] Alexbrn (talk) 19:24, 7 June 2021 (UTC)

Now come on. "Must be based" does not mean "must exclusively be based". WP:OR clearly states: "Primary sources that have been reputably published may be used in Wikipedia." Then, "side effects, benefits, and disadvantages" refers to medical matters, not to economic, social, psychological, religious, or what not matters. --Saidmann (talk) 19:45, 7 June 2021 (UTC)

If I had a penny for every POV pusher who quotes that primary sources thing, truncating it at just that point, I'd be rich. The argument that psychological harms are somehow not side-effects or disadvantages is embarrassing, to the point I will now ignore you. You have had your answer now from multiple editors. Alexbrn (talk) 19:50, 7 June 2021 (UTC)

An apparently lost user taking to irrationality and PAs. --Saidmann (talk) 20:15, 7 June 2021 (UTC)

Saidmann, This is a very tortured reading of the policy. The plain language of the policies would clearly indicate that you can't use a primary source to undercut a preferred, secondary source. Also, WP:MEDRS absolutely applies here. Psychological side effects are still side effects. MrOllie (talk) 20:25, 7 June 2021 (UTC)

Again, I did not use this source to "undercut" something, but to document we are dealing with opinions here - not with facts. Well, feeling cheated or feeling honored by a medical or cosmetic treatment is no (!) medical side effect. Therefore WP:MEDRS does not applie here. --Saidmann (talk) 11:58, 8 June 2021 (UTC)

The source used in the article and critiqued by Saidmann is this one:

Morris, B. J., Moreton, S., & Krieger, J. N. (2019). Critical evaluation of arguments opposing male circumcision: A systematic review. Journal of Evidence-Based Medicine, 12(4), 263–290. https://doi.org/10.1111/jebm.12361

This review looked at 398 publications and is close to a meta-analysis in nature. This is exactly the type of source we would want for an overarching claim about a medical procedure. WP:MEDASSESS says:

Respect the levels of evidence: Do not reject a high-level type of source (e.g., a meta-analysis) in favor of a source from lower levels of evidence (e.g., any primary source) because of personal objections to the inclusion criteria, references, funding sources, or conclusions in the higher-level source.

Saidmann pointed to PMID 33299934 which is a primary source and thus would not override (and is not comparable to) Morris et al.

The Morris et al. source is direct in its language:

• Studies listed in Table 4 reporting negligible adverse effect of MC on physical or psychological outcomes compare favorably with those reporting an adverse effect.
• The present systematic review has contrasted evidence used to argue against MC with evidence from RCTs, systematic reviews, and meta‐analyses, in particular, that has demonstrated the multiple medical and health benefits and low risk of MC to males and their female sexual partners. We find that, based on the evidence rated by quality, MC, especially when performed in early infancy, is favored.
• Arguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

All of this is to say that the current language in the article is fine. And Saidmann is incorrect to say that this is "just the opinion" of the authors. A non-peer-reviewed piece (e.g., Responses and Letters to the Editor) are opinion statements. But we treat summary statements by researchers in peer-reviewed articles as more than "just opinion". They are conclusions based on research. It is further incorrect to say that we are stating something as "fact". We state what the review found and provide the link to the source (c.f., WP:TRUTH).

Last, let me add to say that all of what I just wrote is against my own POV on the topic. I think the authors' enthusiastic support of RMIC is rather abhorrent, that reducing body modification to cost-benefit analyses is dehumanizing, and that there is an utter lack of any critical through. But I know that my POV doesn't matter here and that Wikipedia reflects the medical hegemony (as an encyclopedia should). EvergreenFir (talk) 23:41, 7 June 2021 (UTC)

Right. I agree with your "We state what the review found". This implies we should not write

"Overall, as of 2019 it is unclear ...."

but

"A review from 2019 found that it was unclear ...."

Would you agree? --Saidmann (talk) 11:46, 8 June 2021 (UTC)

Service: On WT:MED Talpedia called the above quoted (18:13, 27 May) sentence of the source in the text (Morris group) an "annoying opinion". --Saidmann (talk) 12:13, 9 June 2021 (UTC)

@Talpedia:, is this an accurate assessment of what you said? Or did Saidmann misundertand what you were referring to as an "annoying opinion"? Just want to make sure your views aren't being misconstrued. Prcc27 (talk) 03:27, 10 June 2021 (UTC)

@Prcc27: Sorry, I wasn't very clear. I meant that my opinion that you should be careful about considering individual sentences quoted from reviews as definitive was annoying but true (because it potentially frustrates discussions and make less clear). My opinion is that you need to consider an entire paragraph from a review paper to interpret what a sentence means because researchers can be opinionated - particulary in conclusion sections. Talpedia (talk) 11:04, 10 June 2021 (UTC)

Annoying opinion, but I don't consider the statement in the source necessarily decisive (although it may be depending on the rest of the paragraph it is in). There's often a little spin in papers and I think it's our job to remove the spin (without being too liberal in our interpretations)

< Here is what i said.

Thank you for clarifying. Prcc27 (talk) 16:50, 10 June 2021 (UTC)

Service again: @Talpedia:: The quoted sentence was a stand-alone sentence in the Results section of the Abstract. So it was a deliberate summary of the authors on this issue. --Saidmann (talk) 12:33, 11 June 2021 (UTC)

• I was under the impression we were citing section 4.7. Citing the abstract can be problematic. Prcc27 (talk) 17:56, 11 June 2021 (UTC)

The conclusion in section 4.7 is even worse:

"4.7.8. Conclusion: Studies listed in Table 4 reporting negligible adverse effect of MC on physical or psychological outcomes compare favorably with those reporting an adverse effect."

This is not only poor and unscientific English, it's an even more "annoying opinion" than the summary in the Abstract. --Saidmann (talk) 21:05, 11 June 2021 (UTC)

• Talpedia already explained that they were not referring to the 2019 review as an "annoying opinion". Prcc27 (talk) 21:49, 11 June 2021 (UTC)

I know. No matter if these opinions are regarded as annoying by anyone, can we perhaps agree upon that both the stand-alone sentence in the Abstract and the stand-alone sentence in the Conclusion in 4.7.8 are statments of opinion? --Saidmann (talk) 11:12, 12 June 2021 (UTC)

Don't cite the abstract. As multiple editors have now pointed out, this is a review article and we relay its findings. Probably time to drop the WP:STICK. Alexbrn (talk) 11:17, 12 June 2021 (UTC)

All you seem to be able to do: evading the point. The "findings" must be written down somewhere in the review. Or is it up to you to make up what the authors' findings were? Very funny!! --Saidmann (talk) 14:26, 12 June 2021 (UTC)

Your point seems to be that any finding you disagree with must be an opinion instead, regardless of the underlying facts or the phrasing in the source. - MrOllie (talk) 14:51, 12 June 2021 (UTC)

No Sir. Decisive is what the source says. Just read it. --Saidmann (talk) 16:10, 12 June 2021 (UTC)

@Saidmann, I don't understand your comment about 'poor' English. In simpler language, it says this:

"If you look in Table 4, the average Evidence quality for the studies that conclude 'circumcision is mostly okay' is higher than the evidence quality of the studies that conclude 'circumcision is harmful'." WhatamIdoing (talk) 02:34, 13 June 2021 (UTC)

@WhatamIdoing: "compare favorably" is poor and unscientific English. It was meant to imply that the data "compare" themselves. However, the authors made the gradings and thus the comparisons. It would be an easy game to downgrade the evidence levels of the "mostly-okay-studies". E.g., the Ullmann paper was criticised (in a PubMed paper) as being underpowed und indicating the opposite of what was stated in the paper (PMID 30873485). My point was - and still is - that the Morris group does not report facts but (strongly biased) opinions. --Saidmann (talk) 18:43, 13 June 2021 (UTC)

• I agree it was poor English, which is why I mentioned earlier in this talk page that I didn't really comprehend what they were trying to say.. Prcc27 (talk) 21:03, 13 June 2021 (UTC)

No, "compare favorably" is a standard English idiom, using the intransitive verb form. It may be popular to say "Deutsche Sprache, schwere Sprache", but IMO it's English that people find more difficult to learn. English is not as predictable as German. You can't just glance at the end of a word to discover that it's not the subject. (See also Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo for an extreme version of this problem.) WhatamIdoing (talk) 22:02, 13 June 2021 (UTC)

@WhatamIdoing: You are evading the point. Context is always part of language. In the given context the "standard English idiom" is poor and unscientific language. And I note that you evaded the question of "fact or opinion". --Saidmann (talk) 20:31, 14 June 2021 (UTC)

I don't think that it is poor language, or unscientific language. I think the only "problem" with the source is that you disagree with the results. WhatamIdoing (talk) 04:29, 15 June 2021 (UTC)

Evasion again. Or have you missed what this thread is about? --Saidmann (talk) 10:38, 15 June 2021 (UTC)

The thread is now about an WP:SPA here to advocate for their point of view (who is getting push back from editors in good standing who have a WP:CLUE and the ability to read and understand English) but who won't drop the WP:STICK. We are now well into the area where Saidmann's contributions are disruptive. Alexbrn (talk) 10:45, 15 June 2021 (UTC)

Maybe we can archive this section. Prcc27 (talk) 05:04, 16 June 2021 (UTC)

Conclusions one week after the end of the discussion

• It could be established that the decisive statement of the authors of the source was a statement of opinion (above 18:13, 27 May 2021).
• The suggestion of a slightly altered version of the text of the article (from 18:13, 27 May 2021) was established to be in line with WP:ASSERT, WP:YESPOV, WP:CLOP, and the decisive statement of the authors of the source.

--Saidmann (talk) 12:08, 4 June 2021 (UTC)

No. Alexbrn (talk) 12:15, 4 June 2021 (UTC)

Unqualified and therefore invalid reply. --Saidmann (talk) 17:56, 4 June 2021 (UTC)

See the pertinent points above. I don't propose to keep repeating them. Alexbrn (talk) 18:00, 4 June 2021 (UTC)

None of your points became pertinent. Each of them was refuted. --Saidmann (talk) 18:18, 4 June 2021 (UTC)

You might have replied, but that is rather far off from 'refuted'. Declarative statements about what you believe is or isn't an opinion vs a fact is not a refutation. - MrOllie (talk) 18:26, 4 June 2021 (UTC)

There were no such declarative statements from my side. The refutation refers to this matter: Each point presented by Alexbrn was refuted. --Saidmann (talk) 18:45, 4 June 2021 (UTC)

What MrOllie said. Danth's law also applies. Alexbrn (talk) 09:05, 6 June 2021 (UTC)

What about applying your "law" on your behavior? --Saidmann (talk) 12:04, 6 June 2021 (UTC)

A side note that might make this more intelligible:

In some English variants, "refute" means that the argument was proven wrong by logic. In others, it merely means "disagreed with", including unconvincing disagreements. For example:

• Alice: I don't like this film. The acting is wooden, the pacing is poor, the plot is flimsy, and the camera angles are weird.
• Bob: This is a wonderful film! It has my favorite actress in it.
• Alice: I don't like it. The characters are unrealistic. No wonder the reviewers gave it such low ratings.
• Bob: I have already refuted your argument. This is a wonderful film!

Danth's law doesn't apply to @Alexbrn, because editors who are not Alexbrn (e.g., me) say that Alexbrn has won this argument. WhatamIdoing (talk) 22:11, 13 June 2021 (UTC)

Removal of Source

@ Alexbrn Why has the NHS source been removed from the sexual effects section? Jas9777 (talk) 08:06, 29 May 2021 (UTC)

References

I have some concerns about the original wording, because it doesn't clearly differentiate between unusual complications vs typical experience, and because it provides no information about prevalence. (I also wonder, if we looked into the source, whether that complication has only been reported in older teens and adults.)

Imagine that your doctor has recommended a new medical test, and says to you that the possible complications include a bruise, an infection, or death. Might you not want to know how many people die before signing up for the test? It's one thing to take a one-in-a-ten-million chance with your life (in the US, just driving to and from the doctor's office has approximately that risk of dying), but it's another thing to take a one-in-ten chance. "It's a possible complication" is a clickbait headline. It's not encyclopedic information. WhatamIdoing (talk) 22:21, 13 June 2021 (UTC)

From a quick look, I think our content on complications could probably be usefully updated with PMID 33545206, which looks promising (I haven't read it yet though!) Alexbrn (talk) 05:26, 14 June 2021 (UTC)

Sexual effects

I apologize for making an edit (diff) without first checking the Talk page (which I almost always do!). Mark D Worthen PsyD (talk) [he/his/him] 17:19, 7 June 2021 (UTC)

This is not how WP:CONSENSUS works. The issue raised earlier about MEDRS is important and none of the sources appear to be meta-analyses. EvergreenFir (talk) 20:23, 7 June 2021 (UTC)

@EvergreenFir: Are you referring to the Sexual effects subsection? Mark D Worthen PsyD (talk) [he/his/him] 00:07, 8 June 2021 (UTC)

I reverted the Sexual effects subsection back to the way it was before my edits. I apologize for not checking the Talk page first. // FWIW all of the references that were in my version of the subsection were all systematic reviews, with two of them including meta-analysis. Mark D Worthen PsyD (talk) [he/his/him] 00:14, 8 June 2021 (UTC)

Now that I'm board with the Talk page discussion, I propose the following for the Sexual effects subsection:

The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, lower sexual desire, harm sexual function, or reduce sexual satisfaction for the man or his sexual partners.

- Mark D Worthen PsyD (talk) [he/his/him] 00:21, 8 June 2021 (UTC)

• So you're proposing to condense it..? Condensing a section is okay, when things get too cluttered. But I don't think that's really an issue currently. I feel like the paragraph regarding circumcision and sensitivity being "controversial" is informative and accurately reflects that there is disagreement on the issue. I also think we should be careful about turning the section into a stub section. Prcc27 (talk) 00:38, 8 June 2021 (UTC)

  I don't see evidence that circumcision reduces sensitivity. Which article(s) support that statement and have not been rebutted by more accurate systematic reviews/meta-analysis? Mark D Worthen PsyD (talk) [he/his/him] 00:46, 8 June 2021 (UTC)

  • Someone removed all of the sources in that section. So you may need to go to an older version of the article to see which source was cited for that claim. BTW, those sources should probably be readded.. Prcc27 (talk) 01:04, 8 June 2021 (UTC)

    I restored the Sexual effects section to the way it was before my edits. Mark D Worthen PsyD (talk) [he/his/him] 01:57, 8 June 2021 (UTC)

    @Markworthen, I support your proposed sentence. I wonder if it really needs six citations piled up at the end, however. WhatamIdoing (talk) 02:36, 13 June 2021 (UTC)

    Oppose. Prcc27 (talk) 20:54, 13 June 2021 (UTC)

    I agree that 6 citations is a lot, but given the opposition to updating the section to correspond with the scientific literature, I wanted to leave no stone unturned. If we can agree to the sentence (or similar) we can trim a couple of references. Mark D Worthen PsyD (talk) [he/his/him] 21:02, 14 June 2021 (UTC)

    Disagree with your assessment. We give due weight to the controversy surrounding circumcision and sensitivity. Prcc27 (talk) 22:19, 14 June 2021 (UTC)

    I'm sure that everyone here wants to give due weight to everything in all of Wikipedia, including this particular point. What we shouldn't be doing is treating all views equally and letting the reader make up his own mind, when the highest-quality scientific evidence shows that one of these views is more likely to reflect biological reality than the other (on average. Any given person could have a terrible outcome, without affecting a statement about the average or typical outcome). WhatamIdoing (talk) 05:16, 17 June 2021 (UTC)

Except the article doesn't treat both views as equal, and it already notes what the highest quality evidence says: ("The highest quality evidence indicates that circumcision does not decrease the sensitivity of the penis, harm sexual function or reduce sexual satisfaction"). Ignoring the sensitivity controversy would be undue. Prcc27 (talk) 05:30, 17 June 2021 (UTC)

References

Semi-protected edit request on 6 July 2021

Wikipedia has show that they are willing to call FGM exactly what it is, mutilation. Continuing to call the male procedure by the medical term circumcision gives the idea that there are medical benefits to said male mutilation. 2600:1008:B00C:1C10:3DEF:5AD1:2B34:E1F0 (talk) 15:50, 6 July 2021 (UTC)

 Not done FAQ's linked at top of page. Alexbrn (talk) 15:55, 6 July 2021 (UTC)

2020 WHO Policy Brief and Informed Consent

Greetings,

We are currently using the WHO August 2020 Policy Brief in paragraph three of the lede and throughout the article body.

This revised document, under the section titled "ISSUES AND KEY CONSIDERATIONS REGARDING VMMC FOR YOUNGER ADOLESCENT BOYS" states "[a]s a general principle, health care providers should seek to postpone non-emergency invasive and irreversible interventions until the child is sufficiently mature to provide informed consent" and "[s]everal factors should be considered in deciding whether to offer VMMC to younger adolescent boys, including their capacity to give informed consent, thus respecting their human rights, and safety, thus reducing risk of rare serious adverse events".

Thus, the WHO, which is considered an ideal source according to WP:MEDRS, takes a clear stance on the deferral of surgery considered "non-emergency," "invasive," and "irreversible." Newborn non-medical circumcision undeniably falls under both "non-emergency" and "irreversible." Whether it is "invasive" is a subjective judgement, but bears little relevance given the other two points.

Given that this Policy Brief states that "the child" ought to provide "informed consent," parental consent is superseded in favor of delaying the procedure until the child is able to provide that consent.

I propose that the following sentence be added to paragraph two of the lede: "The World Health Organization currently takes the position that non-medical circumcision of babies and children be delayed until there is sufficient maturity to provide informed consent."

TomekBotwicz (talk) 20:54, 6 July 2021 (UTC)

Could you quote the bit in the source about "babies" ? Isn't all this scoped to young adolescents, within the context of HIV prevention? Alexbrn (talk) 21:15, 6 July 2021 (UTC)

Re-reading the document, it does not appear that the source directly addresses babies. I apologize, I misread. Regarding your point on context, while the brief is concerned primarily with HIV prevention, it does address other key points: "Circumcised men and their female partners experience lower rates of several sexually transmitted infections, including human papillomavirus, herpes simplex virus-2, bacterial vaginosis and Trichomonas vaginalis, than uncircumcised men and their female partners."

It appears to be the latest WHO publication on this topic and thus could conceivably be considered the most up-to-date guidance. Note that the 2007 report makes reference to "informed consent" twice without fleshing out what that means (does parental consent count?). This 2020 brief seems to indicate a new stance.

Taking all this into consideration, I would propose adding one of the following:

"The World Health Organization currently takes the position that preventative circumcision of adolescents be delayed until there is sufficient maturity to provide informed consent."

"The World Health Organization currently takes the position that circumcision of adolescents as an HIV preventative be delayed until there is sufficient maturity to provide informed consent."

I favor the first sentence given that the brief makes reference to other preventative effects.

TomekBotwicz (talk) 21:34, 6 July 2021 (UTC)

It's a good source alright, but for Circumcision and HIV not here, since I don't think its content is generalizable without running into WP:V issues. Alexbrn (talk) 21:38, 6 July 2021 (UTC)

Point taken on applicability to Circumcision and HIV.

If the second choice ("The World Health Organization currently takes the position that circumcision of adolescents as an HIV preventative...") is inserted into the third paragraph of the lede, how do we run into generalizability issues according to WP:V?

The third paragraph currently states "Consequently, the World Health Organization (WHO) recommends consideration of circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV." The proposed sentence seems relevant given that "comprehensive HIV prevention program[s]" are usually carried out on adolescents and young adults.

TomekBotwicz (talk) 21:46, 6 July 2021 (UTC)

The text the WHO have in their pull quote is "Several factors should be considered in deciding whether to offer VMMC to younger adolescent boys ...", so their recommendation is not just about consent. Once some text is in the Circumcision and HIV article, then possibly it might get summarized in the "Human immunodeficiency virus" section here. It unlikely it's weighty enough to then be worth further summarizing in this article's lede, but not impossible. Alexbrn (talk) 21:56, 6 July 2021 (UTC)

I agree, since the brief prefaces all their statements with 'Several factors should be considered' they are leaving open the possibility that other factors may outweigh this one, so these suggestions overstate what the WHO has communicated here. More generally, I think that if the WHO wants to update their guidance on circumcision they'll issue some sort of statement specifically doing that, we should not have to infer it from Africa/HIV policy briefs. MrOllie (talk) 22:00, 6 July 2021 (UTC)

I don't read that as indicating one factor may "outweigh" another, especially because the most-conflicting factor, Burden and effectiveness, clearly states that "[t]he reduction in HIV risk is expected to be the same for all circumcised men regardless of the age at which the procedure is performed." Thus, the Burden and effectiveness is being considered in conjunction with the Consent factor, not somehow overriding it given that effectiveness is the same even with a delay until informed consent is given.

Additionally, there is no "infer[ring]" being done here. This is an official WHO document on the matter and the most up-to-date one. This is de facto an updated statement.

TomekBotwicz (talk) 22:20, 6 July 2021 (UTC)

Agreed that it is not just about consent but other factors as well. Once the Circumcision and HIV article has been updated, we can revisit updating the "Human immunodeficiency virus" section here and possibly see about rewording the HIV section of the lede based on that.

TomekBotwicz (talk) 22:11, 6 July 2021 (UTC)

Heal Time in Newborn Babies

In the section on newborn baby circumcision, healing time is needed, and a statement “Healing time is 7 to 10 days (ref 1) to several weeks (ref 3). Pain may last up to 2 weeks (ref 2).”

Ref 1 Dayton Children’s Hospital, Dayton, Ohio - “Most of the time it takes between 7 to 10 days for a penis to heal.“

Ref 2 Alberta, Canada Govt - “Your baby may seem fussy while the area heals. It may hurt for your baby to urinate. This pain often gets better in 3 or 4 days. But it may last for up to 2 weeks. Even though your baby's penis will likely start to feel better after 3 or 4 days, it may look worse. The penis often starts to look like it's getting better after about 7 to 10 days.”

Ref 3 Texas Children’s Hospital - “ It could take a few weeks to heal completely. Bruising at the base of the penis and scrotum is not unusual and should disappear shortly. His penis will have several areas of green/yellow scabbing, which is a normal sign of healing.”

References

I added something sourced to a WHO document, which also covers adult healing times. See what you think. Alexbrn (talk) 07:51, 8 July 2021 (UTC)

Cite error

The ref CDC_2008 is no longer in use, but is still part of the reflist. It should be commented out, or deleted. Thanks 89.241.33.89 (talk) 23:31, 6 October 2021 (UTC)

•  Done. Prcc27 (talk) 23:37, 6 October 2021 (UTC)

Thank you 89.241.33.89 (talk) 00:24, 7 October 2021 (UTC)

Lede change

I see the topic of changing the title to MGM has been discussed, and I agree that circumcision is the common name and should be used. However, the lede should be changed to read something like: "Circumcision is a form of male genital mutilation in which the foreskin is removed from the human penis." 172.72.188.8 (talk) 21:19, 29 October 2021 (UTC)

The predonderance of sources do not describe it that way, so neither should the article lead. - MrOllie (talk) 21:24, 29 October 2021 (UTC)

Include Medical Associations Finding No Benefit from or Harmful Effects

Multiple national medical associations find no benefit, harmful effects, ethical questions or autonomy with circumcision and should be included here.

https://en.wikipedia.org/wiki/Circumcision_and_law has them with citations — Preceding unsigned comment added by 2600:1700:D591:5F10:E16B:8F99:2E98:D408 (talk) 06:54, 30 November 2021 (UTC)

Add to the elective section after the Dutch paragraph. This is from the circumcision and law page with references.

The Royal Australasian College of Physicians (RACP) finds that routine infant circumcision is not warranted in Australia and New Zealand and that, since circumcision involves physical injury, physicians ought to raise and consider with parents and considered the option of leaving circumcision until later, when the boy is old enough to make a decision for himself:

After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. … Since circumcision involves physical risks which are undertaken for the sake of psychosocial benefits or debatable medical benefit to the child, … The option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered.

—  Royal Australasian College of Physicians

Semi-protected edit request on 1 December 2021

Please add the following sentence (within Ethical and Legal Issues, end of 4th paragraph)- "Parental preference is typically solidified well before the birth of the newborn boy. Even when presented with the risks and benefits during pregnancy, parents still mostly maintain their prior desires to circumcise or not." [citation here DOI: 10.1177/0009922809346569 ] Nobarney98 (talk) 02:04, 1 December 2021 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. That's a pretty strong statement for a survey with 340 responses. ScottishFinnishRadish (talk) 18:32, 1 December 2021 (UTC)

Circumcision equated with genital mutilation

@KlayCax: I mentioned that circumcision has been described as genital mutilation and provided two sources, and created a new paragraph in the lead on the ethical controversies concerning circumcision (as opposed to the controversies on its alleged health benefits). You reverted my changes since you deem that "This article is about circumcision in general: not the routine imposition of it for cultural, religious, or alleged prophylactic health benefits." I can't follow your logic:

• Since the article is about circumcision in general, the lead section, of course, should summarize all aspects of the subject: given the debates raised by this practice, I see no reason to omit the controversy about its status as mutilation.
• Your statement that circumcision is distinct from "the routine imposition of it for cultural, religious, or alleged prophylactic health benefits." is a fallacy, since, as the article states, "The procedure plays a central role in many cultures and religions."; "The procedure is usually an elective surgery performed on babies and children as a religious duty or cultural tradition, as in Israel and Islamic world; or as a prophylactic health intervention". Seemingly, these two motivations (hygienic and religious) are practically the only reasons for the existence of circumcision and its routine imposition.--Nacho del ruiz (talk) 23:12, 17 December 2021 (UTC)

The mutilation thing has been brought up and rejected many times, please consult the talk page archives. Your edits also have the false impression that circumcision curbs masturbation - some people used to think that, but that is a discredited position now. MrOllie (talk) 16:41, 19 December 2021 (UTC)

Thanks for responding.

• Concerning mutilation : Wikipedia is based on sources, not personal views or feelings. Several scholarly sources describe circumcision as a form of mutilation. I can provide more if you want. There is nothing to say about this fact.
  "Circumcision has been described by its opponents as a form of male genital mutilation" : I would find it difficult to find a more neutral wording than that.
• Concerning curbing of masturbation : As I said in my revert comment : Whether it does or not is irrelevant. What matters is the intended historical purpose of circumcision, whether achieved or not (since the whole paragraph is about epidemiology, history and culture). There is nothing to say about the validity of the sentence, I almost copy-pasted the quoted source, without distortion.
  Source (p 39) : "Nevertheless, circumcision was used as a social tool to control male sexuality throughout history (...) Similarly, Victorian British doctors introduced male and female circumcision to the medical practice in the nineteenth century to “prevent” and “treat” masturbation (Wallerstein, 1980)."
  My edit : "Throughout history, circumcision has been used as a means of curbing masturbation and controlling male sexuality." --Nacho del ruiz (talk) 16:58, 19 December 2021 (UTC)

If you want to include the mutilation bit you're going to need a strong consensus, as this has been rejected by a variety of editors on many occasions. Maybe run an RFC. As to it being 'irrelevant' - giving readers a false impression by quoting without context can never be irrelevant, we're supposed to be educating here. Also, this is a minor point for this overview article and should not be in the lead section. Your arguments would be more applicable if you were trying to add this on History of circumcision. - MrOllie (talk) 17:08, 19 December 2021 (UTC)

Nacho del ruiz, please review WP:LEDE and WP:MEDRS. The article's lead should summarize the actual article (not introduce new materials or sources), and all sources should comply with the requirements of WP:MEDRS, which are quite stringent. Jayjg ^(talk) 23:17, 22 December 2021 (UTC)

This article's about circumcision in *general* - not *specifically* routine circumcision in developed countries. No reliable source calls circumcision *in general* (in all cases) genital mutilation. That's why I reverted your edits. KlayCax (talk)

@KlayCax your explanation for reverting the edit explains that it was based on “in general” being the equivalent of “in all cases”. But “in general” does not mean “in all cases”. Your reversion of the edits was thus predicated on a *verifiable* falsehood. I trust, having now been made aware of your misdefining of terms to justify your actions, you will now take appropriate action to reverse them, in line with accuracy and neutrality. SolsticeStormlands (talk) 04:35, 31 December 2021 (UTC)

What changes do you suggest be made to this article, based on which WP:MEDRS-compliant resources? Please review WP:MEDRS, WP:WEIGHT and WP:TALKNO carefully before commenting again. Jayjg ^(talk) 18:27, 31 December 2021 (UTC)

Polarised nature of discussion around circumcision being blocked in bad faith by a tiny minority of emotionally invested users

Despite the clear numerical consensus on this page for, at the very least, flagging widespread criticisms of circumcision at minimum, with a possible majority in favour of acknowledging criticism of it as a form of genital mutilation, MrOllie and KlayCax are standing in the way with emotionally-driven, bad faith arguments. The latter, in particular, has erroneously conflated the "generalities" of circumcision with "all" cases under the discussion relating to circumcision as a form of mutilation, and has used this false conflation as a means to block the clear numerical consensus with bad faith editing.

I understand that some users who have undergone circumcision may feel particularly strongly on a validation driven emotional level to obfuscate against widespread criticism and promote a specific agenda, but as things stand the neutrality of the article is being grossly held back by this behaviour. The article should be fair and even-handed, and present the proposed benefits *as well as* the argued criticisms, without users allowing entirely emotional and subjective positions to skew the editorial stance towards their own agenda. SolsticeStormlands (talk) 04:28, 31 December 2021 (UTC)

What changes do you suggest be made to this article, based on which WP:MEDRS-compliant resources? Please review WP:MEDRS, WP:WEIGHT and WP:TALKNO carefully before commenting again. Jayjg ^(talk) 18:27, 31 December 2021 (UTC)

Edits over multiple sections

There is nothing that prohibits making an edit that touches multiple sections of the article - the mere fact that an edit was done that way isn't a good reason to revert improvements to the article. MrOllie (talk) 13:47, 16 January 2022 (UTC)

MrOllie You're ignoring the crux of my argument. He was making substantial changes to the article without justifying his change. Also you unreverted a revert, which is edit warring. Please follow bold revert and discuss by discussing reverted edits and not unreverting them.Stix1776 (talk) 14:10, 16 January 2022 (UTC)

He doesn't need to "justify his change" in advance. WP:BRD is an essay and not a way to lock in your preferred version of the article. - MrOllie (talk) 14:14, 16 January 2022 (UTC)

If you want go on record saying that he doesn't need to justify his edits and that WP:BRD doesn't matter, then you're not making a great case for yourself if this ever gets escalated. Stix1776 (talk) 14:59, 16 January 2022 (UTC)

I'm not particularly moved by threats of escalation, especially based on misrepresentations of my comments. - MrOllie (talk) 15:09, 16 January 2022 (UTC)

Canvassing

I'm sorry, I'm not familiar with making edits on Wikipedia. I would like to make you aware of some bad actors that are brigading this page. Please refer to this Reddit post: https://www.reddit.com/r/Intactivism/comments/si9z1k/need_help_with_wikipedia_circumcision_talk_page/Cblackbu1 (talk) 22:59, 2 February 2022 (UTC)

That's too bad. Thank you for bringing this to our attention. I think it's fair to say, we should start to be skeptical of new editors coming to this page for a while. In the meantime, I have a reddit account, so I'll report the post. Stix1776 (talk) 00:03, 3 February 2022 (UTC)

Many of the edits to this page are by drive-by POV warriors (usually the "intactivist" ones). One of the purposes of getting it to WP:GA some years ago was to try to guard against this. Alexbrn (talk) 05:58, 3 February 2022 (UTC)

Organized brigading campaign and meatpuppetry (et al.)

I just wanted to give everyone a notice that User:Cblackbu1 posted a statement showing that this article and talk page has been undergoing an organized editing brigade by meatpuppets to push a POV. After clicking the link, and searching through the discussion boards involved, it seems abundantly clear that this page has been intentionally brigaded for a period of at least nine months.

It is being organized on anti-circumcision forums such as /r/Intactivism and /r/Intactivists. Posts (particularly by a user with the name of /u/Jews_v_Circumcision) track which circumcision-related articles are being edited; others routinely congratulate active "intactivists" [e.g. anti-circumcision advocates] who "put up a good fight" to modify articles in a way that "helps to advance the cause". Yesterday, a post was published on /r/intactivism by a user known as /u/The_Uncut_Truth stated that "our people" are "presently in an editing dispute" and that they "need help" in making sure that the article is "modified to make clear that circumcision has NO medical benefits and is (religious mental illness and coping delusions aside) de facto genital mutilation that is no different from FGM."

Here is the full text. Comments or explanations by me personally are marked like [this].

(Note: DO NOT MENTION that you came from here.) Hey, everyone. Our people are presently in an editing dispute with other Wikipedia editors on the talk page. And we need help in making sure the article accurately reflects the fact that circumcision has NO medical benefits and is (religious mental illness and coping delusions aside) de facto genital mutilation that is no different from FGM. Recently, editors called User:MrOllie and User:KlayCax have attempted to modify the article to represent mainstream American medical opinions. (Which of course reflect the mainstream medical community in GM'ing [e.g. I'm not entirely sure what this is suppose to mean. But I'm pretty sure it's supposed to mean "genital mutilation".] cultures such as the United States... But are also inaccurate, wrong, and bias; Wikipedia somewhat reflexively reflects an pro-American bias by default.) Some of our guys are helping push the article in the ethically correct direction. But Brian freaking' Morris is considered a reliable source in the article. 

Wikipedia works through editorial consensus. So a display of support amongst [a majority of] users should push the article to be more in line with what we want. Make sure to not just say that circumcision is mutilation and damages and diminishes the penis  — although, to anyone with knowledge, it obviously does — but rather the fact that these edits don't belong on Wikipedia, are contradicted by high quality studies showing that the foreskin is the BEST PART of the penis, and that the edits break the rules. Don't state the truth about it directly. You have to be smart. 

Keep challenging the article under NPOV and bias. I know a lot of people want to be "neutral" and "non-biased" - but it's important we use every trick in the book to make sure this forum of religious abuse and medical fraud is called out. Additionally, make sure to include sources criticizing the religious and "WHO in Africa" aspects of MGM as well. Prcc27 and User:Stix1776 are pro-intactivism and on our side. While User:Alexbrn is an administrator who seems somewhat inbetween. (Although leaning against the intactivist cause somewhat.)

It's important because Wikipedia has a role in molding people's opinions. Parents don't read forums like this. [e.g. I'm assuming he means Reddit; /r/intactivism, specifically.] What they do read are things like Wikipedia, major medical organizations, major academic papers, et al. So if we could get the article to reflect and predominately promote/display intactivist opinions we could indirectly benefit our movement as well. This might be unpopular. But bs [e.g. bullshit] as well along the way. Say the entire article is biased in order to slow down anti-intactivist edits, et al. If pro-circers can play with numbers, stats, studies, and rules, there's no reason we can't either.

Thanks.

The post appears to have stayed up for around a day without any significant modification or change. (Archive of the post here. Original post here.) However, this immediately changed when User:Cblackbu1 posted a link to the above post on the talk page. Shortly after, a moderator on /r/intactivists went through and blanketly deleted any recent link (see here and here) by /u/Jews_v_Circumcision going back to September 26, 2021. The original post by /u/The_Uncut_Truth was similarly deleted by a /r/intactivism moderator immediately after.

Similar posts to those made above additionally exist. But I've felt that this is presently too long as is.

I made an archive of all of these posts in case anything is further deleted. KlayCax (talk) 11:07, 3 February 2022 (UTC)

Note: all links below are very unsafe for work

Since accusations are already being tossed around, may I point out that (Redacted). The account is only two months old, isn't very active, and started as KlayCax's arguments with circumcision started to heat up.

Obviously it's very far from certain that KlayCax made this account just to start this. But then again, this should be decided by the Sockpuppet investigations, not normal users like you and me.

Note: I already mentioned that I reported the comments on Reddit. Stix1776 (talk) 11:33, 3 February 2022 (UTC)

What accusations am I "tossing around"? That users on there were brigading? I don't think you are a sock or meatpuppet. I'm talking about how the page has undergone brigading in general for months. Of course editors who care about the ethics of circumcision are disproportionately more likely to comment on the "ridged band" (a part of the foreskin) and politics. That seems kind of an obvious sequitur. No? Additionally, I also posted below about suitable wording for the lead. Can you check it out and see if it's acceptable to you? KlayCax (talk) 12:15, 3 February 2022 (UTC)

Note again: all links below are super NSFW

Additional evidence that KlayCax owns that reddit account. That user posted (Redacted). Again, 11 days apart.

@KlayCax:, regardless you shouldn't be reverting because of a sockpuppetry or brigading issue. What users do you think are brigading? We all have old accounts and we've been editing circumcision related pages for months or years.Stix1776 (talk) 12:39, 3 February 2022 (UTC)

If this weren't so silly I might be inclined to report this post for attempted WP:OUTING. - MrOllie (talk) 12:45, 3 February 2022 (UTC)

• I could believe there have been organizing attempts to edit this page, but equally a lot of this kind of drama has been happening lately which is nothing more than attempts by LTAs to stir up trouble off-wiki. After all, for a secret coordinated campaign to edit a page, making a public reddit post would be a pretty stupid thing to do. Alexbrn (talk) 13:08, 3 February 2022 (UTC)

And you really have nothing to say about using this event to remove sourced content from this page??Stix1776 (talk) 13:22, 3 February 2022 (UTC)

I am suspicious about what's going on. Rather than try to second guess it, I say stick to decent sources faithfully summarized -- it's the only sane way through. I'm not an administrator BTW. Alexbrn (talk) 13:25, 3 February 2022 (UTC)

Acceptable compromise?

Hey, User:Stix1776. I modified the lead paragraph from...

Discussions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up over these cases.

to become:

In these situations [e.g. routine circumcision in developed countries], questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure.

Is this acceptable to you? KlayCax (talk) 12:28, 3 February 2022 (UTC)

No. The sources don't mention group rights, religious freedoms, or prophylactics. I've been asking for your quotes from the source to back this up, and I'm not getting it. Stix1776 (talk) 12:40, 3 February 2022 (UTC)

Earp et al., 2021 (full link) is an example of a source that mentions all of these things. (e.g.: "these organizations have at times appealed to potential health benefits") In addition, Brian Earp, could be considered a good source for several anti-routine circumcision arguments in developed countries. KlayCax (talk) 12:56, 3 February 2022 (UTC)

The full quote:

The American College of Nurse-Midwives, American Society for Pain Management Nursing, American Academy of Pediatrics, and other largely US-based medical organizations have argued that at least some forms of non-therapeutic child genital cutting, including routine penile circumcision, are ethically permissible even when performed on non-consenting minors. In support of this view, these organizations have at times appealed to potential health benefits that may follow from removing sexually sensitive, non-diseased tissue from the genitals of such minors. We argue that these appeals to “health benefits” as a way of justifying medically unnecessary child genital cutting practices may have unintended consequences.

This study is clearly advocating for informed consent and the rights of the child, something which your edit removed. No, I'm not OK with your compromise. Bring an RfC if you need to.Stix1776 (talk)

Correct. I'm not disagreeing with you. But I'm not sure how my edit in anyway "removes" that or why Earp et al., 2021 is in anyway an invalid citation there. The edit states that there are "ethical discussions" surrounding the procedure, principally over the topics of prophylactic efficacy, religious and group rights, and consent. That's exactly what Earp et al. (2021) is talking about in the paper. What's an example of an alternative wording that is acceptable to you? KlayCax (talk) 13:43, 3 February 2022 (UTC)

The source doesn't talk about prophylactic efficacy at all, nor does it discuss religious and group rights. It does, however, discuss informed consent and the lack of health benefits of circumcision. Just because you aggressively revert everything, doesn't make you right. I'll take this to an RfC if I have to, and I'd certainly prevail because that's what the source states. Honestly I really wish we could do arbitration, because all this reverting of good sources and intentionally misinterpreting source text goes no where. I do really believe that KlayCax is destined for a block someday. Sorry to bother you both again @MrOllie: and @Alexbrn:, would arbitration mediation interest you? Or would you all prefer a slow and arduous RfC process?Stix1776 (talk) 13:51, 3 February 2022 (UTC)

Both (Earp, 2021) and (Cohen-Almagor, 2020) certainly discusses how questions of prophylactic efficacy, religious/group/ethnic rights, et al. directly relate to ethical questions surrounding RIC in developed countries. I don't think Wikipedia covering that is problematic. That's certainly what the disagreement amongst medical organizations is about. Isn't it? (e.g. Whether the (alleged and real) health benefits are worthwhile and outweigh risks, where is the line drawn between the community and individual, et al.) KlayCax (talk) 03:24, 4 February 2022 (UTC)

Arbitration is for behavioral problems - it is a venue people use to try to get people blocked or topic banned. They don't issue rulings on content disputes. I don't see anything worthy of that here. You've been asked to write some alternative wording, why not do that? That is how disputes are normally resolved. MrOllie (talk) 13:53, 3 February 2022 (UTC)

Ah sorry, I meant mediation. I've never actually done either.Stix1776 (talk) 13:56, 3 February 2022 (UTC)

My alternative wording: "Ethical and legal questions regarding informed consent and human rights have been raised over the circumcision of babies and children for non-medical reasons; for these reasons, the procedure is controversial".Stix1776 (talk) 13:59, 3 February 2022 (UTC)

Organizations such as the American Academy of Pediatrics see those instances as an example of medical reasons, because they claim that RIC-type circumcision reduces the risk of STD transmission — particularly HIV and HPV — and reduces the risk of penile cancer and urinary tract infections. Since there is no consensus over the matter amongst major medical organizations, Wikipedia can't take a stance on the matter, but rather has to showcase the differing perspectives. KlayCax (talk) 03:24, 4 February 2022 (UTC)

"Since there is no consensus over the matter amongst major medical organizations, Wikipedia can't take a stance on the matter". Yes! And we shouldn't be deleting sources text saying that circumcision is controversial, like the BMA statement [11]. We should be stating all viewpoints. Regarding the AAP statement and Cohen-Almagor (2020), Wikipedia policy is very clear that you can't "combine material from multiple sources to reach or imply a conclusion not explicitly stated by any source". You should be summarizing them all differently. You can't use one article about a proposed law in Denmark to delete regular mentions about informed consent and the rights of the child. The funny thing is that Cohen-Almagor even mentions "male circumcision is a controversial practice" and "rights of the child" is mentioned 11 times. But, you know, I can quote Wiki policy and discuss sources all day, and it won't change your opinion because you're not here to build an encyclopedia. At some point, you'll be blocked from Wikipedia for these behaviors.Stix1776 (talk) 02:51, 5 February 2022 (UTC)

Edits warring and WP:BOLD

MrOllie is engaging in edit warring by unreverting bold edits. User:KlayCax made massive changes over many sections of the article without a proper explanation, which pretty clearly goes against WP:Reckless. Wikipedia policy expects editors to properly explain their edits in the summary and be cautious about major changes to controversial subjects.

In [12], KlayCax deletes huge chunks of the article over multiple sections and the explanation is "1.) Trimmed reductant/excessive language in the lead. 2.) Minor other changes" (my emphasis). In [13], he reordered an entire section and didn't explain his reasoning. In [14] he KlayCax removed text from the header, saying it was in the body when it wasn't.

I'm the future, we need to explain our edits and justify them with other editors. Doing an edit that isn't explained in the edit summary is borderline disruptive editing. Stix1776 (talk) 15:52, 16 January 2022 (UTC)

Policy does not say what you seem to think it says. 'Unreverting' once, is not edit warring. Making well sourced changes, even multiple ones is not reckless. By no stretch of the imagination are KlayCax's edits disruptive, but reverting them for misunderstood procedural reasons very well could be. MrOllie (talk) 16:51, 16 January 2022 (UTC)

Hey, Stix1776! I'd be happy to discuss the changes I made with you. What specific part of these edits do you object to? KlayCax (talk) — Preceding undated comment added 05:52, 17 January 2022 (UTC)

As I've posted, articles with "controversial subjects with long histories or active sanctions... should be done with extra care". Also "explain your changes. When you edit an article, the more radical or controversial the change, the greater the need to explain it". Lastly were told to "be cautious about making a major change to an article. prevent edit warring by discussing such edits first on the article's talk page".

This edit [15] deleted multiple sections and added text that changed the meaning of sentences. Here [16] you again deleted large sections and reordered sections without explanation. Lastly here [17] you removed sourced content, saying it was covered in the body when it wasn't.

Possibly some of these edits would be acceptable if each edit was explained well and each change was a single edit. But please justify them and don't make massive changes. And please make your justifications more meaningful than "minor other changes" or "trimmed unnecessary detail". Like why is it unnecessary? Other editors can't read your mind. And to be honest "other minor change" should never be in an edit summary for a controversial topic.

Do report me if you think I'm in the wrong, but I'm the one here citing wikipolicy and discussing what's in the edits. The onus to defend and explain edits falls on the editor making the changes, not on the reviewing editors.Stix1776 (talk) 10:26, 17 January 2022 (UTC)

• I reverted your claim that circumcision is "most common" in the US because it is incorrect; it contradicts the article's sources and what is already stated in the body paragraphs of the article. As seen in the World Health Organization graphic given in the article, there are many countries with a higher rate of incidence/prevalence.

• Voluntarily adult circumcision as a partial prophylaxis against HIV transmission in Sub-Saharan Africa is uncontroversial amongst mainstream sources. They're endorsed by the World Health Organization, UNAIDS, and a large variety of other international medical association. The type you're referring to that is controversial is routine circumcision in developed countries, and bioethical, moral, and religious conversations over that are already discussed in extensive detail in the third paragraph of the lead, the "elective" section of the body, and the "culture" parts of the article. This is a general article about circumcision: not an article that specifically focuses on routine circumcision in developed countries.

• It's also problematic to tie the reasons for circumcision to specific areas. Readers could get the wrong impression that only one justification for the practice in a given area — and the fourth paragraph of the lead already explains it much better. It's verbose and reductant to have a semi-repeated, clunky statement of something that already exists in the first couple of paragraphs.

• You're confusing incidence (current rate) with prevalence (total amount in the population that is circumcised). You're right that the incidence of circumcision has fallen dramatically in Australia. But because these policy changes happened relatively recently, the prevalence of the procedure within the population won't "drastically fall" for awhile — a majority of men in Australia are still circumcised. It would be a overly detailed for the lead to go into detail about which way incidence is going in each specific country.

• The quote I specifically deleted was: "no medical organization recommends banning the procedure" because the next part of the sentence already said "there was a consensus across all major medical associations... that it be legal." It's reductant wording. I'd be open to discussing moving "Debates over prophylactic efficacy, bioethics, culture, consent, group rights, and religious freedom have been discussed over these cases" back to the lead. But that's simply because it's only supposed to give a quick summary of the body. I'd be perfectly okay if you added that sentence back.

• As MrOllie mentioned, a lot of the rules you're quoting don't specifically apply to this case. KlayCax (talk) — Preceding undated comment added 15:20, 17 January 2022 (UTC)

It seems that User:Alexbrn has already informed you here that WP:BOLD and WP:BRD are not justifications that may be enforced to obstruct progress, but here you are doing it again - in the same topic area, no less. They're certainly not a justification to remove edits when they are supported by multiple other editors. MrOllie (talk) 15:41, 17 January 2022 (UTC)

• I haven't looked closely in the past few weeks, but it seems since the start of the year there has been a deterioration in quality, with the introduction of several non-WP:MEDRS sources: I see e.g. at least a blog and the Cleveland Clinic being cited. Alexbrn (talk) 17:06, 17 January 2022 (UTC)

I'm open to removing the Cleveland Clinic and Council of Foreign Relations sources, if you'd like. They're not critical to the lead or body of the article. KlayCax (talk) 17:53, 17 January 2022 (UTC)

Literally no one is reading my quotations from WP:RECKLESS, WP:UNRESPONSIVE, and WP:CAUTIOUS. KlayCax keeps talking about factual questions that no one is arguing, yet ignoring the obvious and glaring procedural issues.

It seems almost a moot point, as MrOllie's rollback [18] was done as a content dispute and this inappropriately. See WP:ROLLBACKUSE.

I already made KlayCax aware of this problem in his talk page a month ago, so this isn't out of the blue. I'm sorry to point this out, but much of KlayCax's edits are massive, no summary changes to controversial topics. Most of them are regarding circumcision. We shouldn't feed into a problematic editor. OMG look at this edit [19]. He used the term "illibearl".Stix1776 (talk) 08:25, 18 January 2022 (UTC)

Stix1776 (talk) 07:28, 18 January 2022 (UTC)

That's not a rollback. The important thing is to get the article good, and if that involves reverting then that's fine. Alexbrn (talk) 07:31, 18 January 2022 (UTC)

My apologies. I've never seen a multiple edit revert before. I didn't think it was possible.Stix1776 (talk) 08:03, 18 January 2022 (UTC)

To end this, @KlayCax: can you please just make the edits you want to make, but do them individually and explain them in the summaries per WP:FIES and the other policies I've cited. Can't you see that making huge edits with little or no explanation is a lot of work for other editors to parse out???Stix1776 (talk) 09:03, 18 January 2022 (UTC)

@Alexbrn: Would you mind giving a summary of what you find troubling in this article, and I'll make an effort to fix it over the next few days. Thanks. Stix1776 (talk) 12:54, 18 January 2022 (UTC)

I have read and I understand your objections about reckless, cautious, and so on, and I just disagree. Wikipedia policies and guidelines and essays sometimes contain advice rather than hard 'rules'. That someone failed to heed this advice in your opinion is not a reason for you to attempt to enforce it through edit warring. - MrOllie (talk) 12:58, 18 January 2022 (UTC)

@MrOllie: Ya but you're not giving any reasoning, and your explanations are overly vague.

"I see no good reason to blanket revert all these changes, which strike me as improvements to the article"

"restoring changes reverted due to nonsense 'procedural' issues"

"I have read and I understand your objections about reckless, cautious, and so on, and I just disagree"

Is there no alternative than reverting back and forth? Can we find a dispute resolution. May I do an RfC over this process? Or do you have another dispute method you prefer? Because I find this super tedious.Stix1776 (talk) 15:10, 18 January 2022 (UTC)

My reasoning is: reverting because edits are too big or touch too many sections is nonsensical. You are not objecting to the content, you're just reverting because of 'procedure' - and your understanding of 'procedure' is fundamentally flawed. It is difficult to be more substantive than that because you are reverting without any substantive objection yourself. Take this to whatever noticeboard you like, or if you can come up with a neutral RFC question that makes sense, have at it. I look forward to finding out what your issues with the content actually are. - MrOllie (talk) 15:15, 18 January 2022 (UTC)

@Stix1776: An RfC seems like an unsuitable and heavyweight approach, and would need to be a tight & focussed question (not "are all these changes better?") I for one find it practically impossible to follow these huge composite edits. Perhaps an editor seeking a change could do one thing at a time and/or post focussed questions on a proposed change here, to facilitate consensus building. Alexbrn (talk) 15:17, 18 January 2022 (UTC)

I generally agree that smaller edits are better and easier to understand, but per WP:NOTBURO such minor flaws of procedure aren't grounds for reverts. - MrOllie (talk) 15:21, 18 January 2022 (UTC)

The revision [20] found 2 unarguable WP:MEDRS failures and 1 failure of WP:RS/AC (thanks to @Alexbrn: for finding these issues which I didn't spot). I find it very unlikely that outside editors would agree to the revision that "I see no good reason to blanket revert all these changes". I think it's obvious why smaller edits are better, and it's not my job to parse over a very rough count of 38 edits (please don't hold me to this count). I already informed User:KlayCax about the problem on his talk page, so it's not like it's out of the blue. It's unfair to other editors to deal with these destructive edits, and the policies I kept repeating back me up.

A dispute resolution is required, as reverting and reverting isn't solving anything. I'm happy to write an RfC in my sandbox and not post it until others agree. Otherwise I'm open to suggestions, but they aren't forthcoming. The last option would be to post to a dispute noticeboard and request that an uninvolved editor suggest a way forward.

I agree with Alexbrn that there are some serious problems with this article, and I'm happy to work on fixing them. Keeping bad edits is not the solution.Stix1776 (talk) 14:43, 19 January 2022 (UTC)

Those sources had already been removed before your most recent revert, so clearly that isn't your actual issue. What is? - MrOllie (talk) 14:54, 19 January 2022 (UTC)

I'm just going to ask you to suggest a dispute resolution, as this clearly isn't going forward. Stix1776 (talk) 14:59, 19 January 2022 (UTC)

If you'd like to outline your content-based objections in the form of an RFC, that'd be fine, so long as you outline them somewhere. MrOllie (talk) 15:03, 19 January 2022 (UTC)

Your comment

@Stix1776: Before doing that, could you propose some changes as single atomic items, so it's actually possible to see what the issues are?. I don't believe this has been properly discussed here yet, so WP:DR is likely to be a bad move. Alexbrn (talk) 15:03, 19 January 2022 (UTC)

I should mention that I do agree with Alexbrn about the problems in article and I do pledge to work to fix any problems you guys see. Stix1776 (talk) 15:10, 19 January 2022 (UTC)

I spent literal hours going over these three KlayCax edits, and I found multiple issues of him removing sourced content, removing good sources, and him stating what's not in the source. When I have a free moment, I'll put them all down. These are objectively bad edits. Stix1776 (talk) 04:35, 22 January 2022 (UTC)

Specific Problems with KlayCax's Edits Explained

Very bad

- As mentioned by Alexbrn, the addition of the Council of Foreign Relations fails WP:MEDRS [21]

- "has described the procedure as being 'stunningly successful'" [22], this is quoting a source that fails WP:MEDRS

- Addition as Cleveland Clinic as a source [23], as Alexburn pointed out, fails WP:MEDRS

- Health.com [24] fails WP:MEDRS

- "The scientific consensus and highest quality evidence" [25] fails WP:RS/AC

- "American, and some other Anglospheric medical organizations" [26], the addition of "American and some other Anglospheric" is unsupported by any source, and in fact is directly contradicted by Jacobs et al, which is the 3rd source for that sentence.

Pretty Bad

- The removal of a high quality sourced material (Canadian Urological Association guideline) on the Sexual Effects heading [27].

- In this diff [28], he removes the word "controversial" and the text "while formerly common in many English speaking nations during the first half of the 20th century, rates have declined significantly in the UK and Australia". This is supported by Calcagno and the WHO document titled Male circumcision: Global trends.

- "Male circumcision significantly reduces the risk" [29], the addition of "significantly" with "reducing risk" is not supported in any of the 4 sources listed.

- "Discussions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up over these cases" [30] despite 3 sources, I can't find this in either source. This just strikes me as original research. It's not like he explained his edit, so I have nothing to go on.

Not ideal and looking quite POV pushing

- Removal of "Circumcision does not appear to impact sexual function" [31], which is the AAP language. Although granted this way my original edit.

- "The procedure is usually an elective surgery performed as a prophylactic health intervention, religious rite, or cultural practice" [32]. He didn't explain why he choose to change the order, but this is contrary to the order that his source, Calcagno, uses.

- "circumcision is a treatment option for problematic cases of phimosis" [33]. It seems odd to remove this as so many sources here state that other treatments for phimosis should be sought before circumcision, such as [34].

- "European medical organizations generally hold the belief that its medical benefits are not counterbalanced by risk" [35], it just seems odd to swap the order when Jacobs et al has it the other way around. What's the reasoning? It's not like this was explained.

- The reordering around the Elective section [36]. I don't know his reasoning, and it's just overly confusing.

@KlayCax:, after I have read through your edits in detail, this is pretty bad behaviour that will get you a block on Wikipedia if you're not careful. @Alexbrn:, I honestly used to admire you as an editor, and your defense of some questionable edits isn't a good look. @MrOllie:, do you finally see a good reason to revert these edits? I ask everyone for the last time, is there a way you're willing to hold a dispute resolution? Because holding on to these edits is just tendentious editing. Stix1776 (talk) 15:18, 22 January 2022 (UTC)

Taking objections in order:

• The Council of Foreign Relations is redundant with other sources, and easily removed without affecting content. I have just done so. I left in where it mentions Fauci's attributed viewpoint.
• 'has described the procedure as being 'stunningly successful' This is a viewpoint attributed to Anthony Fauci a well-known (to put it mildly) public health official. I see no problem with including his attributed view.
• Cleveland clinic has already been removed from the article, so I'm not sure why this is being brought up again.
• Health.com is another source for Fauci's views and doesn't need to pass WP:MEDRS.
• This article doesn't currently contain the phrase 'scientific consensus', so I'm not sure why this is being brought up. There is a statement about consensus of major medical organizations, which is a fair summary of the Bolnick source.
• I don't have access to all the sources attached to this statement. 'American' seems well sourced, but I don't know where 'some other Anglospheric' is supported. KlayCax, can you specify where you got that from?
• The Canadian Urological Association guideline stuff was moved and rephrased, not removed. It remains in the current version of the article.
• The 'controversial' and rate stuff removal is a matter of editorial judgment, I don't personally have a problem with it.
• 'significantly reduces the risk' - this is a paraphrased summary of the statistics presented in the WHO source.
• 'Discussions surrounding...' seems well supported by the sources cited. We don't need to mirror wording exactly.
• 'Circumcision does not appear to impact sexual function' there's still sexual function language in the article body. I don't mind something being in the lead, so I copied the opening sentence of the sexual effects section up there.
• Changing the order of text - I don't see what the problem is at all. We don't have to mirror sources exactly.
• 'seems odd' - the sentence is accurate either way.
• more order swapping - again, we don't have to mirror sources exactly
• yet more reordering - see above.

These strike me as (as most) minor problems or differences of style preference, and I continue to think there was no good reason to blanket revert these edits. - MrOllie (talk) 19:50, 23 January 2022 (UTC)

@MrOllie:, just an FYI, "Ignoring or refusing to answer good faith questions from other editors" is in WP:TENDENTIOUS. And I keep asking you how we can dispute this without edit warring, and you keep refusing to answer. Also isn't breaking WP:MEDRS 3 times and WP:RS/AC at least once is not a "minor problems or differences of style preference"? Shall we have an RfC if "edits that break WP:MEDRS and WP:RS/AC are just minor problems or style differences"? Can we solve this without reverting back and forth?

I'll make a numbered list to make it easier

1. But an edit with 3 sources failing WP:MEDRS is clearly problematic and worth reverting, no?
2. 'stunningly successful', I can't believe that you're considering keeping text in a medical article that fails WP:MEDRS. @Alexbrn:, you really have nothing to say about keeping text from an article that fails WP:MEDRS
3. Cleveland clinic - because it shows that these edits are heavily problematic and that a revert was just and reasonable.
4. "Health.com is another source for Fauci's views and doesn't need to pass [[WP::MEDRS]]". Um, yes it does need to pass WP:MEDRS, per WP:MEDPOP.
5. The original edit did. Therefore my revert was reasonable.
6. "American, and some other Anglospheric medical organizations" - I literally demonstrated the source that contradicted it.
7. "The Canadian Urological Association guideline stuff was moved and rephrased" - no it's not there. The text "sexual satisfaction is controversial" is not there. Also the study was changed to an older study, which is bad. Because WP:AGEMATTERS
8. "The 'controversial' and rate stuff removal is a matter of editorial judgment, I don't personally have a problem with it." But it's sourced content. It doesn't matter how you feel. This is why we need to have a dispute resolution over this.
9. "'significantly reduces the risk' - this is a paraphrased summary of the statistics presented in the WHO source." - You need to show me the page, because I've read that document up and down and it's not there.
10. "'Discussions surrounding...' seems well supported by the sources cited. We don't need to mirror wording exactly." - Well you need to find the quote then, because I'm not seeing it in the source.
11. 'Circumcision does not appear to impact sexual function' Ya but there's newer and better articles, per WP:MEDASSESS. We shouldn't be removing the language for older articles.
12. Ya but this wasn't defended, it's different to the source, and it's striking on POV pushing
13. See above
14. See above

I'm also seeing your name pop up in the 3RR noticeboard frequently. So edit warring seems to be your thing.Stix1776 (talk) 06:18, 24 January 2022 (UTC)

Lastly there are multiple texts statements that you're unable to find the quotes in the source. Per WP:Burden, "the burden to demonstrate verifiability lies with the editor who adds or restores material", ie you.Stix1776 (talk) 11:51, 24 January 2022 (UTC)

This still seems like a big shopping list of complaints without any concrete proposals. In the one thing I was pinged about, the "stunningly successful" wording, that's no longer in the page. Where it did occur in previous versions the markup was broken but the source did indeed support that Fauci said this. Whether or not to include it, is a matter for debate (we don't need MEDRS for relaying Fauci's words), but Fauci is kind of a big deal when it comes to health policy. I wouldn't say this was some kind of huge obvious PROBLEM which merits edit-warring. Alexbrn (talk) 12:08, 24 January 2022 (UTC)

I have answered your question a few times already. Since you are so concerned about forms of tendentious editing, you might be interested in reading WP:IDIDNTHEARTHAT. - MrOllie (talk) 12:24, 24 January 2022 (UTC)

I'm shocked that edits with "big shopping list of complaints" wouldn't be a prime candidate for revert and redo. I find out glaringly obvious that I'm only the one quoting wikipolicy, like where's the exception to WP:MEDRS? Stix1776 (talk) 12:14, 24 January 2022 (UTC)

Fauci's view is Fauci's view, and the fact he expressed it is a matter of record. It cannot be asserted as WP:BMI but may be relevant in the context of what the WP:BMI is (which would need WP:MEDRS sourcing). Whether or not to include it, is a matter for debate. Alexbrn (talk) 12:24, 24 January 2022 (UTC)

Fauci's views have been written about in basically every major news outlet: NBC News, Reuters, NY Times, CBS, LA Times (I could go on), as well as the Health Magazine and Council of Foreign Relations that were used in the article. The wording of the quotes used differs, but it is a very notable view that we really should represent in our article. MrOllie (talk) 15:15, 24 January 2022 (UTC)

Sorry for the slow reply, I was busy with work. You are aware that including CBS, NYTimes, Reuters etc is goes against Wp:MEDRS, as this is a medical article, right? WP:MEDPOP pretty clearly says "no" to adding text from the popular press to a medical article.Stix1776 (talk) 06:11, 29 January 2022 (UTC)

This is a cultural and public health article as well, not everything in it needs a WP:MEDRS. A public health official's attributed view of a public health intervention doesn't need a WP:MEDRS, any more than we need MEDRS to discuss vaccine mandates - it is a political issue. - MrOllie (talk) 12:58, 29 January 2022 (UTC)

A public health official's attributed view of a public health intervention doesn't need a WP:MEDRS - I'm not certain this is true. In the past editors have argued that beliefs about medical claims should be subject to MEDRS and that not doing this would completely undermine MEDRS. See for example [37]. Sizeofint (talk) 00:58, 30 January 2022 (UTC)

Regardless of whether circumcision is also cultural issue, the effectiveness of of the procedure for preventing HIV is definitely a medical issue and should require MEDRS. Anyhow, this seems to be a settled issue as 3 other editors are coming against it.Stix1776 (talk) 05:28, 31 January 2022 (UTC)

Dispute Tag (old)

I do appreciate the removal of WP:MEDRS failing sources. However I have some specific issues that I've talked to death over, for which I've asked for the source and I'm not getting it. If any editor can show me with source text or wiki policy that contradicts my reasoning, I'll be happy to remove these concerns.

1. "American, and some other Anglospheric medical organizations " in this diff [38]. I'm not seeing this "some other Anglospheric" anywhere in any source. Jacobs (2012), the third source for that sentence, states " Canadian health organizations have largely opposed routine NC over the last 30 years", " In 2010, the Royal Australasian College of Physicians published an updated policy reaffirming their position against routine infant circumcision", and "In England, the consensus of medical bodies has been similar to that in Canada. Both the British Medical Association (BMA) and the British Association of Pediatric Surgeons (BAPS) have expressed that there is “rarely a clinical indication for circumcision”". (this seems solved)
2. "There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice". I'm not seeing this in the source, which again is Jacobs et al (2012), or Bolnick (the textbook author). Feel free to correct me with the quote.
3. Sexual effect in this diff [39]. the Removal of newer clinical practice guidelines (from the Canadian Urological Association) with an text from an older, 2013, study that states "the highest quality evidence indicates that circumcision has no impact on sexual function, sensation, or pleasure". WP:MEDDATE is pretty clear that research from over 5 years ago shouldn't be considered over newer research. As I've stated previously WP:AGE MATTERS. There is newer and more nuanced research here [40], [41] as well as a plethora of older policy statements with more nuance.
4. The removal of the word "controversial" here [42], even though it's listed in multiple high quality sources, including Calcagno (2007), World Health Organization (2007), the BMA advice to doctors [43], and likely other sources.
5. "Male circumcision significantly reduces the risk of HIV infection" (this diff [44]). Someone needs to find the text that supports this, as I'm not seeing it. I'll be happy to remove this when someone shows me the source. Edit: I forgot the mention that "significantly" came with the MEDRS failing Council of Foreign Relations source.
6. "In these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure" is just a hodgepodge of WP:SYNTHESIS with different articles combined to create a novel conclusion not written in any source. It's clear intent was to block wording of "informed consent" and "rights of the child" that are well sourced. SN Social Sciences is not medline indexed, or even a medical journal, and really shouldn't be in a medical article per WP:MEDRS. @KlayCax:, have some standards for this article.Stix1776 (talk) 14:40, 3 February 2022 (UTC)
7. (amendment, I missed one) - "while formerly common in many English speaking nations during the first half of the 20th century, rates have declined significantly in the UK and Australia" [45] removing well sourced material, without explanation, because the editor doesn't like it clearly goes against WP-NPOV and WP:PRESERVE. Editors can't just remove sourced content that they don't like.
8. "Public health advocates of circumcision consider it to have a net benefit". Morris is the only author of this source, and he didn't state there's more than one person advocating. I tried to fix this, but it was returned in this revert [46]. Also there's multiple medical bodies and researchers that disagree [47] [48] [49], yet these get removed while only keeping the pro infant circumcision mentions. (see this dif [50]) Stix1776 (talk) 07:46, 5 February 2022 (UTC)

I'm not going to add the unexplained rewording of whole sections, because they're not really something I'd succeed in an RfC with.Stix1776 (talk) 07:27, 29 January 2022 (UTC)

1. Let us give KlayCax a chance to respond, but removing 'some other Anglospheric' isn't a big deal.
2. Bolnick writes "all policy statements reviewed, regardless of its position on circumcision, have made allowances for parental choice in support of their cultural or religious preference.'
3. As I mentioned above, the Canadian Urological Association's 2018 guidelines are still cited. You can find it on the second sentence of the sexual effects section.
4. 'Controversial' is, again, a matter of editorial preference.
5. The WHO source specifies a 59% reduction of risk of HIV infection. 'Significant' is underselling it a bit but is an accurate summary.
6. It is those sources. It is the topic of those three citations. Did you read them? MrOllie (talk) 13:17, 29 January 2022 (UTC)

The Royal Dutch Medical Association, a major medical organization, doesn’t support “parental choice”, and seems to think arguments for a ban are meritorious (although they worry about unintended consequences of a ban). We should not be pretending that there is a consensus across “all” major medical organizations on parental choice and legality of circumcision. Prcc27 (talk) 20:49, 29 January 2022 (UTC)

It is extremely debatable that they're a major medical organization, but after consulting the talk page archives it seems that you know this. MrOllie (talk) 21:07, 29 January 2022 (UTC)

• What does the source define “major medical organization” as (I wouldn’t know because I can’t access the full article)? The source does cite the Royal Dutch Medical Association, so if KNMG is included among organizations that are “major” according to that source, that article misrepresented KNMG’s viewpoint. Prcc27 (talk) 09:16, 30 January 2022 (UTC)

The HIV infection reduction as a percentage can't be well interpreted without knowing the prior rate in the population. For instance, a medication that reduces the incidence of a disease from two in a million to one in a million technically reduces the risk by 50%, but few would probably call that significant. The number needed to treat is probably more informative. The WHO source says 23 million VMMCs have probably prevented 250,000 HIV infections so by their estimates 100 VMMCs prevents one HIV infection. Sizeofint (talk) 20:11, 30 January 2022 (UTC)

It's a reduction of risk, not a reduction of incidence. Number needed to treat is just the inverse, if you know one you know the other. If reduction of risk is 50% number needed to treat is 1/0.50 = 2.MrOllie (talk) 20:32, 30 January 2022 (UTC)

I don't know why we, as Wikipedia editors, are getting in debates about medical research data. We should be writing what's in the source. Adding our own interpretation, which isn't supported by the source, is clearly original research. I also neglected to mention that the word "significantly" was added with a MEDRS failed source (the Council of Foreign Relations). It seems especially tedious to force other editors to debate this, since it was clearly a bad edit.Stix1776 (talk) 05:32, 31 January 2022 (UTC)

• Reply

1. I'm not insisting that @KlayCax: answers soon, but it's telling that he's not bothering to respond to sourcing problems with his edits. I've checked a few of his edits recently, and he adds and changes the text quite contrary to what the source is saying.
2. The text that MrOllie is quoting doesn't state anything about legality. And of course stating "consensus" without an actual source saying "consensus" is very directly against WP:RS/AC.
3. The issue is that the article is citing a 9 year-old study, when much newer research and clinical guidelines have come out. Again, WP:MEDDATE is very clear about this.
4. Removing the sourced text "controversial" without reason is not up to editor preference. WP-NPOV and WP:PRESERVE are clear that sourced text shouldn't be removed just because an editor doesn't like it.
5. As mentioned, the word "significantly" was added with a failed MEDRS source. Also editor interpretations of source material as "significantly" is clearly original research. It seems that 2 other editors are against the addition.
6. I literally did read them. I noticed what KlayCax did between a few edits. Originally [51] the text read "Ethical and legal questions regarding informed consent and human rights have been raised over routine circumcision" and this was changed to "discussions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up over these cases". KlayCax clearly didn't read those sources, as "group rights", "prophylactics", and "religious freedom" weren't mentioned. "Informed consent" and "human rights" were central to the text in the source. Also I've requested the source text for this change 3 times and I haven't gotten an answer.
7. As I amended above, we can't removed sourced text that we don't like, per WP-NPOV and WP:PRESERVE.Stix1776 (talk) 08:40, 31 January 2022 (UTC)

Number 2: If nobody has a rebuttal or suggestion for how to reword the sentence, I will remove it. Prcc27 (talk) 01:13, 1 February 2022 (UTC)

Some version of this is fairly long standing (it used to be phrased "No major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure."), reflects the sources used, and should not be removed. Policy statements that say parents should have a choice obviously indicate that it should be legal. MrOllie (talk) 01:55, 1 February 2022 (UTC)

• Where do the sources say “no major medical organization”? I agree with Stix1776 that WP:RS/AC applies. I’d be open to saying something like “many medical organizations” instead. Especially since the source cites the Royal Dutch Medical Association, which is not “pro-parent choice”. Prcc27 (talk) 02:31, 1 February 2022 (UTC)

  Again, they're a professional association, not a major medical organization, and even they don't support banning it outright because they don't want to send religious parents to non-medical practitioners. MrOllie (talk) 02:36, 1 February 2022 (UTC)

• Again, what does the *source* define as “major medical organization”? What does the source specifically say about *legality*? Seems like Wikipedia editor(s) have been doing their own original research. Prcc27 (talk) 04:18, 1 February 2022 (UTC)

• I'm very in favor of deleting until a good sentence can be reached, but I'm also in favor of Prcc27's alternative. But putting the source next to MrOllie, his interpretation makes no sense. The source says "all policy statements reviewed, regardless of its position on circumcision, have made allowances for parental choice in support of their cultural or religious preference" yet he summarizes this as "no major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure". Those are not the same things. An honest, WP:WIKIVOICE summary of the source would read something like "one literature review found that all the medical bodies it reviewed agreed to be flexible for the decision of parents". Perhaps the best thing is the remove the sentence until we find consensus on this.Stix1776 (talk) 11:52, 1 February 2022 (UTC)

  Hey, I didn't write it, that was @Zad68: around 10 years ago: diff. I'm surprised you have a problem with this, 'no major medical organization recommends...' was wording you were recently repeatedly putting back in the article, for example here. Since there is some confusion about interpretation of this source, I'll ask for input at WT:MED unless there are any objections? - MrOllie (talk) 12:57, 1 February 2022 (UTC)

• Feel free to consult other editors, and please ask them how they would phrase it.Stix1776 (talk) 13:26, 1 February 2022 (UTC)

• @MrOllie:, I'm a bit shocked that you're reverting without bothering to explain how WP:RS/AC doesn't apply here. It's a pretty cut and dry case, and frankly you holding onto the word "consensus" isn't great for your reputation. Also there's a 2-1 editor count. It just seems like you're holding onto edits and avoiding clear Wikipedia policy. @Alexbrn:, don't feel compelled to join as I know you find this article stressful. But if you care to look, you must see that this sentence fails WP:RS/AC.Stix1776 (talk) 04:36, 3 February 2022 (UTC)

  I'm a bit shocked that you didn't read the discussion above where such concerns were addressed. It is not a statement about 'academic consensus' of 'scientists or scholars' as discussed by WP:RS/AC, but a statement about public policy by medical orgs. In any case, I could -maybe- support going back to the most recent wording, but this 'most' stuff based on a misunderstanding of the KNMGs position is not going to fly. MrOllie (talk) 12:38, 3 February 2022 (UTC)

I want to again advise @KlayCax: to get involved with the discussion on his edits. Much of your edits seems to be contrary to what the actual source is stating. If you're going to revert, please explain to us your reasoning.Stix1776 (talk) 02:50, 2 February 2022 (UTC)

@KlayCax: is reverting sourced edits against multiple editors, and is not discussing his edits in the talk page. I'm not seeing anyone supporting his removal of the word "controversial". I'll bring this to an RfC if I need to. I can't see the community siding against the inclusion of "controversial" with so many high quality sources stating explicitly that it is controversial.Stix1776 (talk) 03:30, 2 February 2022 (UTC)

No one is disputing that RIC in developed countries is controversial; the third paragraph of the lead and the "elective" section already extensively discuss that fact. The problem is that you are trying to change the article to make it state that "prophylactic circumcision" is universally controversial. I've already explained why I reverted a similar edit to the one you just made here two weeks ago.

Prophylactic circumcision simply refers to any form of circumcision done for reasons of prophylaxis. (i.e. Prevention of disease transmission) In other words, it's a form of the procedure whose context, application, and background varies widely. The citations that you quoted refer exclusively to routine circumcisions in developed countries such as the United States. But "prophylactic circumcision" can also refer to the widespread practice (in the tens of millions) of voluntary adult circumcision by organizations such as UNAIDS as a preventative against HIV transmission in Sub-Saharan Africa. That is something much less controversial, receiving widespread support from European medical organizations as well. Or, as Chikutsa and Maharaj (2015) state: "it is now generally accepted in public health spheres that medical male circumcision is efficacious in the prevention of HIV infection [within the context of sub-Saharan Africa]". KlayCax (talk) 04:06, 2 February 2022 (UTC)

Assuming what you're saying is true, why would you not edit the text to make it more correct? Why would you remove it? I keep quoting WP-NPOV. If you disagree with sourced text, you should fix it and not remove it. That you choose to remove it shows that you're POV pushing. Also are we to specify on HIV reduction quote that it's for adult men, as the WHO specifies.

You could easy argue that the adult HIV circumcision in Africa is controversial, as there have been critical discussions about it [52] [53] [54] [55]. But then again, you aren't talking about this on the talk page. I wish you would discuss edits instead of removing the edits or multiple editors.Stix1776 (talk) 04:33, 2 February 2022 (UTC)

Also please answer where "we've already reached a consensus over that exact wording in the talk page" is located. There's heaps of questions that we're asking you on this talk page.Stix1776 (talk) 08:50, 2 February 2022 (UTC)

Community reassessment

Circumcision

The table below represents my individual assessment of the article against the Good article criteria. However, I requested a community reassessment given the lack of consensus and high level of disagreement on the article's talk page. Thus, the assessment below represents only one person's opinion; it is neither the complete nor the final good article reassessment. Mark D Worthen PsyD (talk) [he/him] 19:30, 20 February 2022 (UTC)

Article (edit | visual edit | history) · Article talk (edit | history) · Watch • Watch article reassessment page • Most recent review

Result: delisted, has active cleanup banner (t · c) buidhe 09:16, 14 March 2022 (UTC)

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	Recent contentious editing has degraded the quality of the prose.
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	The lead is too long, containing text better suited for the article body.
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).	Whether or not a reference constitutes a reliable source per WP:MEDRS has been hotly debated. In my estimation, some of the references do not comply with both standard and medical reliable sources criteria, e.g., theoretical articles and primary source citations.
	2c. it contains no original research.	There appears to be instances of WP:SYNTH.
	2d. it contains no copyright violations or plagiarism.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	Not a major problem but excess detail occurs in some places.
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.	Some agendas are being pushed, IMHO of course.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.	Frequent back-and-forth edits with tendentious arguments common on the talk page.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.
	6b. media are relevant to the topic, and have suitable captions.
	7. Overall assessment.	Regrettably, the article no longer meets GA criteria.

Mark D Worthen PsyD (talk) [he/him] 19:19, 20 February 2022 (UTC) Mark D Worthen PsyD (talk) [he/him] 19:20, 20 February 2022 (UTC)

Suggest one-word change, to clarify the WHO's position

"Consequently, the World Health Organization (WHO) recommends consideration of circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV"

I don't think this communicates the WHO's position effectively, because it could easily be understood to mean circumcision of babies/children without their consent. As the link given there shows, the WHO only recommends "voluntary medical male circumcision" and I think this should be reflected in the article's introduction. I suggest simply adding the word "voluntary":

"Consequently, the World Health Organization (WHO) recommends consideration of voluntary circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV"

But because this is a sensitive article, I will leave the edit to seasoned editors.

By the way, regarding the recommended age of consent, in the presentation "24 August 2020 Session 2", slide 22 says "Usually, adolescents ages 15 years and older are able to give informed consent, while younger adolescents’ ability to consent should be assessed case-by-case", and elsewhere "younger adolescents" are indicated to be aged 10 to 14. I'm not sure that can be easily worked into the sentence above, but I found it interesting enough to note here.

182.19.163.2 (talk) 11:18, 25 March 2022 (UTC)

References

This seems to me a reasonable suggestion on how to better represent the WHO recommendation, I agree that without it the reader may believe the WHO is recommending universal or infantile circumcision. I have made the change, happy to discuss if any other views on this. |→ Spaully ^~talk~  13:54, 25 March 2022 (UTC)

Way too many circumcision articles

It's come to my attention that much of the articles surrounding this subject are split and schism'ed for no apparent reason. Many haven't been edited for years, have almost no daily viewership, and simply repeat information from better-quality articles.

• Does Marilyn Milos, Genital Autonomy America, and Intact America need three seperate articles? Arguably, I'd say that it could be deleted all together under WP: Notability. Similarly, does Intaction meet WP: Notability?

• Why is there seperate articles for foreskin restoration and restoration device? Do we need them for articles at all? A brief mention at foreskin seems enough.

• Are people such as Leonard Glick important enough for their own articles?

I could keep going on and on with examples. But it seems absurd that there's literally 25+ articles related to circumcision on here. Almost all of them could be merged into the existing articles, made into a brief mention, or deleted all together. OntologicalTree (talk) 09:59, 31 March 2022 (UTC)

Frankly I haven't noticed, but it is a thing that happens with many contentious topics like this. There is a method for deleting, although honestly I've never done it. You may want to propose merging some of those similar articles. Stix1776 (talk) 10:32, 31 March 2022 (UTC)

Unexplained Reversal by Stix1776

My edit, which was an attempt to trim down and summarize the current run-on state of the leading paragraphs, been reverted by Stix1776 for unexplained "reasons of consensus".

Do we really need to say it has "no impact on sensation/function" in the lead? It's not a major aspect of the article in any respect. Do we really need to give an entire paragraph to what the WHO, AAP, CDC, European, UNAIDS, medical organizations et al. all say in the lead when it's already covered sufficiently in the body? It doesn't seem objectionable to simply state what WHO says (like we do on HIV/AIDS transmission already) and then briefly state that smaller national organizations such as AAP, CDC, UNAIDS, DMA, et al. disagreeing with themselves on the matter. It's simplier, more precise, and less verbose, which seems to me an improvement in every way. The other changes were simply related to grammar. The changes that have been made have been entirely in line with the talk page consensus. It's clear that the previous lead was verbose, excessively detailed, and needed revised. The leading paragraphs are only meant to summarize the topic. To state that they "go against or lack consensus" (?) is perplexing. Since there doesn't even seem to be anything that could be possibly objectionable. OntologicalTree (talk) 03:11, 30 March 2022 (UTC)

I realize the lead needs to be trimmed, but it is common practice to not restore your BOLD edit when reverted. Let’s try to achieve a Consensus on how to proceed with the lead. Prcc27 (talk) 03:44, 30 March 2022 (UTC)

Sure, I'm open to discussing. Is there anything specific that you'd suggest that could be improved? Or anything that seems problematic? OntologicalTree (talk) 03:49, 30 March 2022 (UTC)

While BRD is important, it’s not a valid revert if you don’t articulate specific objections. As you’ve linked, bold editing is encouraged as a matter of policy, engaging in communication is required as a matter of policy, and reverting good faith edits without providing specific objections, or reverting a change simply because it is a large change is a form of disruptive editing. I definitely think Styx has created the edit war here and he should not be reverting without articulating specific objections, period. As long as this is the case, no blame can be placed on OT. ~Swarm~ ^{sting} 05:37, 30 March 2022 (UTC)

I agree that communication in the edit summary is important, but the talk page, not the edit summary, is where most of the discussion should take place. You’re absolutely wrong about putting the blame 100% on Stix1776. OntologicalTree was 1 edit away from a 3RR violation, and lack of edit summary explanation is not an exemption for edit warring. You are the one being disruptive. Instead of discussing what to do with the lead, you are pointing fingers at someone and taking sides. My comment above tried to 1) end the edit war and 2) redirect the dispute to the consensus building process; not point fingers or take sides.

That being said.. I do not necessarily oppose OntologicalTree’s edit, but I really wanted to hear from other users to see if anyone had any other ideas for how we could make the lead more concise. Given we all seem to agree that the lead should be trimmed, it is a matter of what stays and what goes. Prcc27 (talk) 16:27, 30 March 2022 (UTC)

I strongly dispute that my revert was "unexplained". I clearly wrote in my edit summary that the Royal Dutch Medical Association was not a "small Danish organization" as your wrote in your last edit, and that Morris passes WP:MEDRS. I'll be more specific and say that he was removing sourced content from the article.

It would seem that OntologicalTree has rereverted edits elsewhere, as he's done so here [56]. This isn't a good habit for editors.

Your edit removed sourced material from outside the lead, such as the Royal Dutch Medical Association and sexual function. I see some positive additions, which I will attempt to keep. I do see a concerted effort from some editors to remove any mention of a national medical body that isn't American, as they generally recommend against infant circumcision. "Electively administered" makes more sense than just "elective" by itself. Please keep discussion in the talk page instead of re-reverting.Stix1776 (talk) 06:41, 31 March 2022 (UTC)

Nothing from Morris et al. or the Dutch Medical Organization was removed in the edit. So I'm unsure what you're talking about. Are you referring to how the Dutch Medical Association's words were moved up into the previous paragraph? Everything they stated was preserved in the edit. The only thing that was removed in relation to "sexual function"' was lower-quality evidence. If you want to keep the main gist of the edit, and just revert that part, would you be okay with a reversion for now? As for the lower-quality evidence thing: almost any published subject in academia (even things such as tobacco use and health problems, climate change, et al.) has contradictory information published about them. The World Health Organization, other major medical organizations, and multiple gold-tier metanalysises and studies have near-universally stated it has no impact on sexual sensation, function, or pleasure. This includes the Danish Medical Journal's Düring, Shabanzadeh, and Frimodt-Møller (2016) in the article. OntologicalTree (talk) 09:08, 31 March 2022 (UTC)

And what's your specific objection to simply stating elective? Rather than electively administered? OntologicalTree (talk) 09:23, 31 March 2022 (UTC)

Yes you did remove Morris. You removed "lower quality evidence has found conflicting results".

Fair enough (edit: and I'm sorry) about the comment on the Royal Dutch Medical Association. I'll try to return your edit. In regards to "elective", it's a small matter, but "elective" in this sense is typically an adjective, which requires a noun after it. In regards to to sexual effects, see [57] part #2. There's newer medical guidance with that points to some nuance on the sexual effects debate, so it is literally citable controversy from gold-standard medical bodies. This is why I'm hesitant to remove "lower quality evidence has found conflicting results". Also why did you remove the link to "ethics of circumcision"?Stix1776 (talk) 10:24, 31 March 2022 (UTC)

You don't have to apologize for anything. Would it be alright if I revert back and preserve rest of the edit: while we can discuss the "lower quality evidence" dispute on talk in a separate section here? Since it wasn't a main focus of the edit, and I believe we both agree that the vast majority of the changes are an improvement upon the predecessor.

The "ethics of circumcision" link wasn't removed. I just removed the part that repeated itself: "prophylactics, bioethics, group rights, and religious freedom have been brought up over these cases, leading to discussions over the procedure's ethics" was changed to "In these situations, questions surrounding prophylactics, group rights, and religious freedom have been brought up, leading to bioethical discussions surrounding the procedure". The discussion surrounding bioethics in those cases has not been effected at all; it simply improved reductant wording. Would it be alright for me to start a "lower-quality evidence discussion" in another talk page section so others here can discuss it: while the main contents of the revision could be preserved? Thanks. OntologicalTree (talk) 11:01, 31 March 2022 (UTC)

Please don't do a revert again as there's a lot I'm uncomfortable with. It completely erases non-US medical body disapproval from the lead, as well as to any mention of controversy. Also the text "the WHO holds the belief that the elective circumcision of minors in developed countries carries prophylactic health benefits that outweigh small risks" is absolutely not supported by the source, although that's not your fault. In terms of reducing the lead, could we not cut out much of the religious stuff, as well as condense much of the medical benefits. They take much much more of the space in the lead. Feel free to mention specific issues, but let's not edit war again,

The bioethics part was completely moved from the lead. Again, there's been a concerted effort to remove any well sourced critical content from this article. It looks like you're a new editor. Why are you focused solely on the lead and only on circumcision for some reason?

Please do start another section. To be honest, this was something I was planning on doing a RfC (see dispute tag issue #2 again). Would you like to collaborate on this?Stix1776 (talk) 13:11, 31 March 2022 (UTC)

The revised lead also completely excludes the UNAIDS, American, (generally favoring the notion that it benefits health) et al. as well. Both pro-circumcision and anti-circumcision viewpoints have simply been moved into the body. It's not an instance of bias. It still maintains the main point - with it saying that major medical organizations disagree upon the matter - and then expounds upon what that means in more detail in the body. Why is that objectionable?

The Canadian Paediatric Society policy statement explicitly backs up the current phrasing in the article: saying that "| medical studies do not support circumcision as having a negative impact on sexual function or satisfaction in males or their partners". Similar statements have been made by the World Health Organization, the Danish Medical Journal, et al. I'm not sure how anything they published contradicts the present wording of the article.

I wasn't planning on cutting down the cultural, religious, or ethnic justifications part of the lead, at least to any great extent. So I don't disagree with you there. OntologicalTree (talk) 13:40, 31 March 2022 (UTC)

As I wrote in the dispute tag above, UNAIDS isn't part of that statement anyways, so removing UNAIDS just brings the article closer to accuracy. I tried to remove it, but it was kept after an aggressive edit war. I'll ask again, why are the remaining critical comments moved to the body when the bulk of the lead discusses benefits, despite UTIs and penile cancer being quite treatable or rare? If we genuinely want to cut the lead, we'd start with topics that are taking up most of the lead.

The Canadian Pediatric Society is more nuanced that the current text, so I'd be supportive of that. It probably is worth adding newer publications like | there is debate about the role of the foreskin, with possible functions including keeping the glans moist, protecting the developing penis in utero, or enhancing sexual pleasure due to the presence of nerve receptors or | there is ongoing controversy regarding the impact of circumcision on penile sensitivity and sexual satisfaction. I think the only way to solve this issue to to have an RfC. Doing so would make the result mostly permanent, so editors wouldn't be needing to argue this point again and again. Again, I invite you to do this with me. Clearly this article is not going to say "circumcision definitely makes sex bad" but ideally it would make a mention of the actual controversy that is explicitly stated by newer medical body guidance. Stix1776 (talk) 14:39, 31 March 2022 (UTC)

First of all, the question of sexual function/sensation wasn't the main point of the edit. If you want to keep the "lower quality evidence" sentence in the sexual effects section while we work this out: it's perfectly fine by me. This shouldn't cause the vast majority of the edit to be blanketly reverted.

What newer medical body guidance has been stated? Both of the papers you linked explicitly back up what is present in the article. (Dave et al., 2018) explicitly concludes that "is lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood". The Canadian Pediatric Society similarly states that "studies do not support circumcision as having a negative impact on sexual function or satisfaction in males or their partners". I'm failing to see how either of these add a layer of nuance. (The Canadian Urological Association is additionally a different organization than the Canadian Pediatric Society) Within context, they appear to be talking about the popular conception that circumcision heightens (most commonly believed in Africa, et al.) or lowers (Most commonly believed in North America, Europe, et al.) a man's sexual pleasure. Then, both the Canadian Pediatric Society and Canadian Urologist Association come out against that viewpoint, in line with the World Health Organization and other major world medical organizations.

The World Health Organization does say that in WHO, 2007. But (in reference to various hypothesises related to the foreskin) they immediately go to state that: "Although it has been argued that sexual function may diminish following circumcision [because of this]... there is little evidence for this". As for BMA, 2010: I'm failing to see how they address the sexual function, sensation, or pleasure question at all the paper. It's talking about the ethics. Which, of course, is still preserved in the body, and I support keeping in the article.

As for a RFC, I'd be happy to start one - in relation to whether the "lower-quality evidence" sentence should be in the sexual effects section. OntologicalTree (talk) 15:30, 31 March 2022 (UTC)

Edit: | The Danish Medical Association probably doesn't say what you're insisting.Stix1776 (talk) 14:52, 31 March 2022 (UTC)

I'm not fluent in Danish. But nothing in that (through translate) appears to reference sexual function, sensation, or pleasure at all; it's criticizing the ethics of routine circumcision. Discussion surrounding the ethics of the procedure is still present in the article. OntologicalTree (talk) 15:33, 31 March 2022 (UTC)

It's perfectly logically consistent to hold that 1.) Routine circumcision is unethical and should not be performed 2.) High quality evidence has suggested it has an adverse negative effect on sexual sensation, function, or pleasure. #1 appears frequently in the academic literature and amongst mainstream medical organizations; #2 is much less supported. OntologicalTree (talk) 15:38, 31 March 2022 (UTC)

@OntologicalTree: please stop removing sourced material without consensus. I'm sorry that I was unable to write the RfC that second, but WP:THEREISNORUSH.

I'm going to come out and say it. You're editing and language style is too similar to KlayCax, and I'm officially reporting this as a sockpuppet account. Your editing history is incredible suspicious. You made 10 quick edits to non-protected pages in a short amount of time, just to edit a semi-protected page. And your edits are almost entirely around circumcision. Unlike KlayCax, I'm actually going to send this to Sockpuppet Investigations.

How would you like the RfC question to start? Stix1776 (talk) 01:47, 5 April 2022 (UTC)

Needs RS on economics

The article needs a RS on the economic cost of paying for the millions of circumcision procedures in ths USA each year. The medical field has an economic interest in performing circumcision which should be called out with a RS.

A trade group advocating for more medical procedures which its member doctors profit from should be included. They would hardly push for less revenue. American Association of Pediatrics is a trade group lobbying for what benefits doctors and the medical industry. It should not be portrayed as an unbiased source.

For example https://www.discovermagazine.com/the-sciences/why-human-foreskin-is-a-hot-commodity-in-science has tens of ways circumcision is used to further medical research, commercial drug research anf for profit businesses.

Ask: - how much money does a circumcision cost in 2022 whether on a baby newborn boy or adult? - how much total money is paid to doctors and hospitals for the procedure per year? https://www.nytimes.com/2011/08/23/health/23consumer.html New York Times 2011 has $300 per circumcision - is there a RS where the AAP trade group adresses the for profit conflict of interest in recommending circumcision? — Preceding unsigned comment added by 2600:1700:D591:5F10:7CBF:736C:AC12:95E6 (talk) 05:51, 9 April 2022 (UTC)

The very last subsection is "Economic considerations". Would you want to add it there. Stix1776 (talk) 07:25, 12 April 2022 (UTC)

Lead Trimming

I realize that the lead is a bit too long. There does seem to be an intentional effort by POV editors (editors who edit circumcision almost exclusively) to remove sourced material from the lead that they don't like. I did a quick analysis with MS-Word, and this is how much each topic takes in the lead, per character:

• Definition – 7%
• How the medical procedure is performed – 2%
• Medical benefits – 25%
• Complications – 11%
• Disagreement on benefit and ethics – 4%
• Religion – 33%
• Other (contradiction, prophylactics, religious freedom, prevalence, word history) = 18%

With such a massive chunk taken by medical benefits and religion, does it really help the article to trim the 4% from disagreements and ethics?

I propose removing some of the rarer benefits to circumcision, like "balanitis, balanoposthitis, balanitis xerotica obliterans". They're not even recommended reasons for circumcision by the WHO. Also religion needs a bit hack. Complications doesn't seem to need to be that long. Stix1776 (talk) 04:47, 12 April 2022 (UTC)

@KlayCax:: according to MOS:LEAD, "It should identify the topic, establish context, explain why the topic is notable, and summarize the most important points, including any prominent controversies". I disagree with your arguments that we can remove controversy text and put it into the body. Anyhow, please use the talking page and don't just revert.Stix1776 (talk) 07:37, 12 April 2022 (UTC)

While I agree that covering controversies is necessary, the complications section is stating the obvious. Do we really need to spell out in detail that "an inexperienced operator" is more likely to (unwittingly) cause "complications" than a trained professional, or that a lack of sterile conditions increases the likelihood of infection? Dimadick (talk) 12:41, 12 April 2022 (UTC)

No sourced content was removed, either. It was just moved into the body. There was no need for him to blanketly revert the edit. Tagging @Alexbrn:, @MrOllie:, @OntologicalTree:, and @Jayjg: on this, as this has been essentially the same conversation that has been going on for last four months. (Look at the top of talk page for context.) KlayCax (talk) 15:06, 12 April 2022 (UTC)

I support including controversies in the lead, and removing “balanitis, balanoposthitis, balanitis xerotica obliterans” as well as the complications section Dimadick mentioned. If the religion section of the lead is WP:UNDUE, I support trimming some stuff from that also. Prcc27 (talk) 04:55, 13 April 2022 (UTC)

I don't have an issue with including controversies in the lead. But something amongst the lines of: "Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness of circumcision in developed countries" is more fitting than "The WHO, UNAIDS, and American medical organizations generally hold the belief that the elective circumcision of minors in developed countries carries prophylactic health benefits that outweigh small risks, while European medical organizations generally hold the belief that its medical benefits are not counterbalanced by risk. In these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure. There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice." The vast majority of that clearly belongs in the body. KlayCax (talk) 13:16, 13 April 2022 (UTC)

I think pointing out that certain international and American organizations have one view while certain European organizations have another view is an important distinction to make in the lead. I do agree that we should trim this sentence from the lead: “There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice.” The accuracy of this sentence is currently disputed, so it should not be included in the lead. Prcc27 (talk) 16:06, 13 April 2022 (UTC)

Disputed by whom, on what grounds? Last time this was brought up it seems it was dropped after noting that even the Royal Dutch Medical Association (giving the benefit of the doubt that they are 'major', which is questionable) doesn't want it made illegal. MrOllie (talk) 16:11, 13 April 2022 (UTC)

• Stix1776 brought up WP:OR concerns irrespective of what KNMG said. Their concerns still have not been fully addressed, which is part of the reason why the dispute tag remains and should remain. Please re-read that section for further clarification. Also, KNMG never said that they do not want it made illegal: “There are good reasons for a legal prohibition of non-therapeutic circumcision of male minors, as exists for female genital mutilation. However, the KNMG fears that a legal prohibition would result in the intervention being performed by non-medically qualified individuals in circumstances in which the quality of the intervention could not be sufficiently guaranteed. This could lead to more serious complications than is currently the case.” The sentence in question should not be in the lead, or at the very least, should have its own independent dispute tag attached to it. Prcc27 (talk) 20:07, 13 April 2022 (UTC)

  Consensus doesn't mean unanimity on Wikipedia. We're not going to maintain a dispute tag indefinitely because of one person, nor does one person have veto power over every sentence in the article. MrOllie (talk) 22:12, 13 April 2022 (UTC)

  • I know what consensus is.. You should already know that sometimes there is no consensus one way or the other. I do not think the dispute was resolved on the talk page or the noticeboard. Stix1776 created a whole list of concerns, and while everything else on that list may have only 1 user expressing concerns (and thus a dispute tag may not be needed); this particular sentence has at least 2 users, not 1 user, with concerns. Unless of course, Stix1776 no longer has WP:OR concerns? If that’s the case, I would yield. Otherwise, I think an RfC might be needed.. Prcc27 (talk) 22:52, 13 April 2022 (UTC)

    I did mean to do RfC's for my points in the dispute. I apologize for not doing it, as work keeps me busy. I'd really appreciate it if anyone were to do any for me, although I'm not insisting. Stix1776 (talk) 15:01, 14 April 2022 (UTC)