American Association of Pediatrics backtracks on circumcision

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American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Wed Jun 29, 2016 8:51 pm

TW: Genital integrity, intersex issues, religious identity

Spoiler:
So... this happened and I'm probably more angry at it than I should be.

http://pediatrics.aappublications.org/content/early/2016/04/04/peds.2016-0594

Basically for the ones who can't pass the paywall, the AAP, staunch supporter of circumcision is finally backtracking after years of international pressure.

They're now claiming they never stated that the medical benefits outweigh the risks, they say they merely claimed the combined medical and cultural benefits outweigh the risks.

That's not something a medical association should concern themselves with though. I shouldn't be surprised since a few years back they were insane enough to actually be in favor of loosening genital integrity laws for girls too: http://www.medscape.com/viewarticle/722840

And of course MRAs are running wild claiming how this proves society is deeply misandrist, and make people shut their ears because of the total idiocy of their claims. A fucking pity that MRAs are actually working against men's rights :/

Here's hoping that doctors will finally follow scientific consensus and advice people not to routinely cut their children. There's now literally no medical organization left that recommends routine infant circumcision.
Maybe we'll finally stop turning ambigious genitalia into vaginas too, simply because they're easier to get to look right.

It would be so much better (IMHO) if we would forbid all infant plastic surgery until they turn 12 and can actually decide what they want for themselves.

More of a rant than a discussion, but feel free to add your own thoughts. Please, please be civil though, and also try to give people the benefit of the doubt.

Mods, feel free to delete the thread if it turns into a flame war. I'm not around that often, so I'm probably not fast enough to do it myself if does ignite.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Werel on Thu Jun 30, 2016 8:52 pm

Izmuth wrote:And of course MRAs are running wild claiming how this proves society is deeply misandrist, and make people shut their ears because of the total idiocy of their claims. A fucking pity that MRAs are actually working against men's rights :/
Wait, I'm confused... how does this prove that the AAP is misandrist, if they're also leaning in favor of female genital mutilation? Or how does it mean they're misandrist if they're moving away from recommending male circumcision? Isn't that... a widely held men's rights position? scratch

Can't get past the paywall, but gotta agree wholeheartedly that "cultural benefits" are not even remotely a thing that a medical organization should be offering opinions about. It's not the American Academy of Pediatric Anthropologists; their job is not to decide what kinds of genitals are most socially acceptable (actually, uh, that should be nobody's job Uh-oh). Their job is to inform people of medical facts. They picked a really dumb path to backtrack down, based on what you've said.
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Re: American Association of Pediatrics backtracks on circumcision

Post by litterature on Thu Jun 30, 2016 9:09 pm

Werel wrote:
Izmuth wrote:And of course MRAs are running wild claiming how this proves society is deeply misandrist, and make people shut their ears because of the total idiocy of their claims. A fucking pity that MRAs are actually working against men's rights :/
Wait, I'm confused... how does this prove that the AAP is misandrist, if they're also leaning in favor of female genital mutilation? Or how does it mean they're misandrist if they're moving away from recommending male circumcision? Isn't that... a widely held men's rights position? scratch

I'm not sure I understood it right, but after 5 minutes of intensely furrowing my brow and striking Rodin poses I think it's because MRAs might be co-opting the idea that intervening the genitalia of people who can't consent is atrocious, so that they can make it about men in particular and claim that misandry is tearing society apart. I'm still not sure, though!

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Re: American Association of Pediatrics backtracks on circumcision

Post by Wondering on Fri Jul 01, 2016 12:25 am

There's now literally no medical organization left that recommends routine infant circumcision.
Doesn't the US CDC recommend it? I thought I read something about that a year or so ago.

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Re: American Association of Pediatrics backtracks on circumcision

Post by Guest on Fri Jul 01, 2016 3:06 pm

litterature wrote:
I'm not sure I understood it right, but after 5 minutes of intensely furrowing my brow and striking Rodin poses I think it's because MRAs might be co-opting the idea that intervening the genitalia of people who can't consent is atrocious, so that they can make it about men in particular and claim that misandry is tearing society apart. I'm still not sure, though!

I hear that a lot when male circumcision is brought up especially among left leaning/liberal guys. It's fucking weird and a load of bologna.

Look, I won't bullshit you guys, personally, I'm pro-circumcision; both my brother and I got it done when we were newborns and never had a problem with it. I had a long winded thing written here, but I decided against posting it, so you're just getting the ultra-condensed version here.

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Re: American Association of Pediatrics backtracks on circumcision

Post by Werel on Fri Jul 01, 2016 4:29 pm

I hear you on not wanting to be discursively cast as a victim when you don't feel like one, Mikey, but I think there's a big difference between being pro-circumcision for yourself--there are certainly plenty of guys who feel neutral-to-positive about having been cut as babies--and being pro-circumcision for other people.

Among the handful of circumcised dudes I've talked about this with, about half were cool with it, and the other half were pretty unhappy about it and wished it hadn't been done to them. Even for the guys who were fine with it, I can't see what harm would've been done if they'd been allowed to choose for themselves once they were old enough (I know somebody who chose to be circumcised in high school; seems like an okay time to start making informed decisions about your body). I get that you may not feel the same way, but it's really not a load of bologna for people to want a choice in what happens to their genitals.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Fri Jul 01, 2016 6:33 pm

litterature wrote:
I'm not sure I understood it right, but after 5 minutes of intensely furrowing my brow and striking Rodin poses I think it's because MRAs might be co-opting the idea that intervening the genitalia of people who can't consent is atrocious, so that they can make it about men in particular and claim that misandry is tearing society apart. I'm still not sure, though!

^^ Yes, basically this. They're the Boris Johnson of Social Justice: The worst thing that can happen to them is that they actually win.
A sane person would take the fact that every time an American medical society tries to take a pro-circ viewpoint they're called out for it as a victory worthy of celebration, they see the fact that it didn't happen sooner as proof that men are the real victims of society O_o

There was a guy who blamed feminism for ignoring this issue on an intactivist page I frequent. Cue hordes of female intactivists (seriously, of the people involved in the movement >50% is female) mentioning they were feminist. He then began to No True Scotsman the shit out of them, because he just couldn't fathom giving a shit about a problem that didn't concern him personally, so why would anyone else?

Wondering wrote:
There's now literally no medical organization left that recommends routine infant circumcision.
Doesn't the US CDC recommend it? I thought I read something about that a year or so ago.

See, they mentioned the recommendation of the AAP (which they now claim was never a recommendation? O_o) in the draft of their policy, but when they published that draft they got so much backlash from international medical societies who accused them of cultural bias they were very careful to recommend nothing in the final version, no one way or the other. The WHO is also careful to make clear they're recommending circumcision for consenting adults in Africa, not routine infant circumcision.

That's why it's weird (to me) doctors are still very aggressively peddling it to mothers, even just after giving birth.
Hell I heard in some hospitals you weren't allowed to name your baby until you had the chance to recuperate from labour, and yet they consider mothers are perfectly able to consent to an irreversible procedure for their boys before that.

Werel wrote:I hear you on not wanting to be discursively cast as a victim when you don't feel like one, Mikey, but I think there's a big difference between being pro-circumcision for yourself--there are certainly plenty of guys who feel neutral-to-positive about having been cut as babies--and being pro-circumcision for other people.

Among the handful of circumcised dudes I've talked about this with, about half were cool with it, and the other half were pretty unhappy about it and wished it hadn't been done to them. Even for the guys who were fine with it, I can't see what harm would've been done if they'd been allowed to choose for themselves once they were old enough (I know somebody who chose to be circumcised in high school; seems like an okay time to start making informed decisions about your body). I get that you may not feel the same way, but it's really not a load of bologna for people to want a choice in what happens to their genitals.

Yes, in a perfect world (for me) all genital plastic surgery (aka everything that's not medically necessary) would be heavily discouraged until the age of 12-ish. At that age a choice for any religion would also be more meaningful IMHO.

Would also solve the problem of intersex babies given vaginas because they're easier to get to "look right" and "you just can't have people strolling around not conforming to the strict gender binary" :/
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Re: American Association of Pediatrics backtracks on circumcision

Post by Guest on Fri Jul 01, 2016 6:38 pm

Werel wrote:I hear you on not wanting to be discursively cast as a victim when you don't feel like one, Mikey, but I think there's a big difference between being pro-circumcision for yourself--there are certainly plenty of guys who feel neutral-to-positive about having been cut as babies--and being pro-circumcision for other people.

Among the handful of circumcised dudes I've talked about this with, about half were cool with it, and the other half were pretty unhappy about it and wished it hadn't been done to them. Even for the guys who were fine with it, I can't see what harm would've been done if they'd been allowed to choose for themselves once they were old enough (I know somebody who chose to be circumcised in high school; seems like an okay time to start making informed decisions about your body). I get that you may not feel the same way, but it's really not a load of bologna for people to want a choice in what happens to their genitals.

I was referring to the MRA people for the most part. Razz Don't get me wrong, I understand there may certainly be dudes who genuinely aren't happy with them having been circumcised as newborns, I get that. I guess I should have been clearer and said pro-circumcision-choice, it's a choice for either parent or child.

Anyway, I'm gonna scram. But you're right, I don't like being cast as a victim.

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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Fri Jul 01, 2016 6:56 pm

Mickey, if I can ask, what do you personally think would be the drawbacks of a world where people themselves are the only ones that can make choices about their own genitals?

People still can get circumcised if they want as young adults if parents are discouraged from making the choice for them. They can't get un-circumcised if they don't appreciate it and parents were allowed to make the choice for them.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Guest on Fri Jul 01, 2016 8:20 pm

Izmuth wrote:Mickey, if I can ask, what do you personally think would be the drawbacks of a world where people themselves are the only ones that can make choices about their own genitals?

People still can get circumcised if they want as young adults if parents are discouraged from making the choice for them. They can't get un-circumcised if they don't appreciate it and parents were allowed to make the choice for them.

Obviously there aren't any drawbacks to making your own choice. But what I'm trying to understand is why circumcision is so bad, or why it's seen as such. I got it done for medical/sanitary reasons as a newborn and so far... well, there's nothing for me to complain about.

As far as I know, most medical procedures require parental consent if the patient is under 18. I don't know why you would discourage circumcision in the first place either. That's what bothers me, personally. Maybe I'm insane, I don't know but I never saw anything wrong with either having a foreskin or not. Other than smegma buildup or phimosis if you kept your foreskin. It's not like someone is causing permanent damage to the glans or the shaft or performing physical castration...

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Re: American Association of Pediatrics backtracks on circumcision

Post by Wondering on Fri Jul 01, 2016 8:46 pm

Izmuth wrote:Hell I heard in some hospitals you weren't allowed to name your baby until you had the chance to recuperate from labour, and yet they consider mothers are perfectly able to consent to an irreversible procedure for their boys before that.

I can't speak for every hospital or the rules in every state/county/city, but...I find that an odd way to parse the situation. I named my baby the moment she was born. But all the placards and hospital wristbands and stuff just said Girl Baby MyLastName. I didn't get the official paperwork for getting her a social security card, which is when her name became legal, until a day later. But it wasn't because I wasn't allowed to. It's just, do I really want to be filling out government forms when they're still stitching me up from my c-section? No. Wink

I get your point, but I think describing the naming thing that way is really inaccurate and implies things going on there that aren't in order to make the comparison.

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Re: American Association of Pediatrics backtracks on circumcision

Post by Werel on Fri Jul 01, 2016 9:31 pm

The Mikey wrote:
Obviously there aren't any drawbacks to making your own choice. But what I'm trying to understand is why circumcision is so bad, or why it's seen as such. I got it done for medical/sanitary reasons as a newborn and so far... well, there's nothing for me to complain about.

As far as I know, most medical procedures require parental consent if the patient is under 18. I don't know why you would discourage circumcision in the first place either. That's what bothers me, personally. Maybe I'm insane, I don't know but I never saw anything wrong with either having a foreskin or not. Other than smegma buildup or phimosis if you kept your foreskin. It's not like someone is causing permanent damage to the glans or the shaft or performing physical castration...

The problem, as far as I understand it (I'm sure Izmuth knows way more), is that the putative medical/"sanitary" benefits of circumcision have been mostly debunked by recent science. It still appears to have some benefit for HIV prevention, but nowhere near comparable to the benefits of condoms. On the other hand, any surgery is an infection risk, especially for infants; it's less of a problem in wealthy countries/hospitals, but in the many many many situations where it's done without sterile tools or antibiotics, it can have some pretty bad or fatal results. There's also some anecdotal evidence that it leads to decreased sexual sensitivity (which makes basic common sense to me, although common sense != medical science), but I have no idea how true that is. The bottom line seems to be that its health benefits are questionable, it poses some real health risks, and it permanently alters a pretty important body part in a way the kid might not like when they grow up. Shrug
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Re: American Association of Pediatrics backtracks on circumcision

Post by Guest on Fri Jul 01, 2016 11:40 pm

Werel wrote:
The problem, as far as I understand it (I'm sure Izmuth knows way more), is that the putative medical/"sanitary" benefits of circumcision have been mostly debunked by recent science. It still appears to have some benefit for HIV prevention, but nowhere near comparable to the benefits of condoms. On the other hand, any surgery is an infection risk, especially for infants; it's less of a problem in wealthy countries/hospitals, but in the many many many situations where it's done without sterile tools or antibiotics, it can have some pretty bad or fatal results. There's also some anecdotal evidence that it leads to decreased sexual sensitivity (which makes basic common sense to me, although common sense != medical science), but I have no idea how true that is. The bottom line seems to be that its health benefits are questionable, it poses some real health risks, and it permanently alters a pretty important body part in a way the kid might not like when they grow up. Shrug

Yeah, those were all subjects I was gonna touch on in my previous post. About infection and sensitivity (which is also bologna in my opinion) and whatnot. Though I forgot the the bit about HIV... Obviously if you can't do it without proper tools, then no, don't do it. You're right, infection may spur and things can go south quickly. Then there's also the whole sensitivity thing, which I've heard a lot of guys complain about with circumcision. They've done studies on this and yeah there's a loss, but the loss is so miniscule that men would barely notice. I can't comment fully on the health risks thing or how a kid will see his genitals as an adult if he doesn't grow up believing "bigger is better" since that i think is a far more dangerous belief than the loss of foreskin.

I dunno. Shrug Maybe I'm biased because I was circumcised and never had any problems with my anatomy. Obviously it's a choice, but I don't think it should be banned/condemned or anything like that. Again, maybe I'm just crazy.

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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Sat Jul 02, 2016 6:40 am

Wondering wrote:
I can't speak for every hospital or the rules in every state/county/city, but...I find that an odd way to parse the situation. I named my baby the moment she was born. But all the placards and hospital wristbands and stuff just said Girl Baby MyLastName. I didn't get the official paperwork for getting her a social security card, which is when her name became legal, until a day later. But it wasn't because I wasn't allowed to. It's just, do I really want to be filling out government forms when they're still stitching me up from my c-section? No. Wink

I get your point, but I think describing the naming thing that way is really inaccurate and implies things going on there that aren't in order to make the comparison.

You're right, I was completely misremembering a conversation I had a few months back. It was about a joke about a dad filling in name of a comic character on the birth certificate while the mother was high on anesthesia, and people mentioned that it could never happen in their hospitals since before you're released you're asked to just review the birth certificate to make sure everything's in order (which is good!).

But at the same time, I was just a bit shocked about the stories I heard from other women about how they were constantly badgered about if they wanted a circumcision (one was asked five times, the first time while she was in actual labour, and the others were also asked multiple times because those fickle women are sure to change their mind if only you ask enough, AMIRITE?), and how little was needed to make the doctors perform surgery on infants (you didn't even have to sign an information sheet that you were aware of the risks, they didn't need both parents explicit permission, one says the word and the foreskin gets amputated).

But you're right, lack of actual informed consent is a seperate issue, and I shouldn't have linked those two, it only muddies my point.

@Mickey, @Werel, ohh boy massive wall of text incoming, let me get on my soapbox Grin Fair warning, in text tone is reaaallly hard to convey correctly for me. If I overstep any line, I assure you it's not intended, but please notify me of it so I can hopefully change my ways for the future.

So first off, I'm pretty much against any procedure that doesn't have clear benefits for the person itself.
Like, tattooing your baby, or giving it piercings, or any permanent modification should be heavily discouraged in my opinion. If the person wants those on a later age, they're always free to get it, and yet if they don't want those modification, they're really hard to reverse. Parents should be made aware of the fact that their children may not necessarily thank them for it, before they're allowed to make those permanent modifications on their children.

Secondly, there are obvious exceptions: Medical decisions for your child. Let me give an example of vaccinations just to be able to explain why in my personal opinion routine circumcision is nót a valid medical decision to make for your child (obviously, if people want to get circumcised at a later age for medical reasons, all the power to them!)

1) We've got medical studies that are pretty clear vaccines prevent diseases extremely well. This "benefits" were also never disproven, we've been steadfast in our claims that *this* vaccine prevents *this* disease. Medical consensus is that the benefits of routine vaccination outweigh the risks extremely.

2) We've also demonstrated this in populo. If you give societies access to vaccines, the amount of deaths decreases significantly. If you take away societies access to vaccines, the amount of deaths increases significantly.

3) There are no less invasive ways to get the same effects (because vaccines are already extremely uninvasive).

4) Children have immediate benefits from vaccines, so it doesn't make sense to wait.

Now let's examine the case of circumcision (do note I will be talking about risks of things happening, not saying they will definitely happen. Not every uncircumcized guy will have issues with foreskin, and not every circumcized guy will have issues with circumcision.)

1+2) The medical consensus is that the medical benefits do not outweigh the risks (and that's the risks of the procedure itself, they often don't take the function of the foreskin into account, which I find... odd. You'd think the first thing anyone would consider before cutting off part of someones body is its function.).

Most medical organizations list common risks in their analysis such as: Removing too much skin, leading to painful erections; Narrowing of the urethra, requiring additional surgery; Infection, which circumcision is ironically supposed to prevent; And lastly, bleeding (which is dangerous in infants, see point 4).

That's the hard science part. If you compare the incidence of those complications to the reduced risks of other diseases that is claimed as a health benefit, the equation already doesn't tilt in favor of circumcision.

Now for my soft science opinion (which is very much not fact!): I seriously doubt the claimed health benefits to be honest.

From a historical perspective, circumcision was claimed to help against gout, syphilis, epilepsy, headaches, arthrosis, alcoholism, groin hernias, asthma, poor digestion, eczema and excessive masturbation. Which we all now agree isn't the case and circumcision doesn't help against any of those things. So it already has a track record for dubious health benefits.

The health benefits are also not backed up with population wide data. America and Europe have about the same UTI rates for boys, while their circumcision status differs widely.

If I can demonstrate one issue with research that "proves" uncircumsized boys in America are more at risk of UTIs than circumsized boys, I'd like to ask you how often per week should you wash under the foreskin of your baby to make sure he stays healthy?

Don't look it up! Just think of the frequency you think is right, and then check under the spoiler.
Spoiler:

0 times per week. You shouldn't wash under the foreskin of babies at all, you only clean what can be seen. The foreskin is fused to the glans until the age of 10, to protect it from infection, exactly in the same way a fingernail is fused to your finger (same membrane).
But American doctors, having no experience with uncircumcized boys, advice parents to regularly "clean" under there with soap. It's as if you want to clean under your nails by ripping them off, washing them with soap and putting them back on and then being surprised you actually increased the likelyhood of infection.

People claim circumcision helps against HIV, and they always quote the same three studies. We've spend millions on campaigns to circumcise people in Africa, and yet we don't see major benefits back. The only follow up I could find was in South Africa where they couldn't find any significant benefits from the campaigns there, but that was a relatively old study so YMMV (http://www.ncbi.nlm.nih.gov/pubmed/19115756).

The problem with the original three studies was that they were set up in the same way:
People were asked to volunteer for circumcision to check if it prevented HIV infection. This already gives selection bias: Only people who fear HIV volunteer to get anything cut off, so they might already be more careful than the control group.

People were asked to have no sex for three months while they healed from circumcision, while the control group already had all the sex they wanted. Coupled with the fact that the HIV test used could only detect HIV infection three months after infection and the study was already cut short, these three months of having no sex (and therefore no HIV risk) could have a very significant influence.

The circumcised guys had to visit the clinic multiple times to make sure everything went well, and while they visited the clinic they were counseled on correct condom use and were provided condoms. Again something the control group didn't get.

So... not sold on the validity of the studies.

And lastly the old time favourite health benefit claim: Penile cancer. Something that 1 in 300 000 men get. Yeah, I'm going to take those odds thank you very much Razz

To get back to the comparison of circumcision vs vaccines:

3) For UTIs there is antibiotics. Girls get more UTIs and we're able to treat them effectively without cutting pieces off. For HIV there are condoms (which you will need even if you get circumsized, since they even in the best case scenario only protect you 60%). For penile cancer there is the HPV vaccine. For every claimed health benefit there's a less invasive option.

4) Infant circumcision just plain doesn't make sense, procedure wise. It's hard to give them effective anesthesia, they can't communicate pain well so if they don't show discomfort that doesn't actually mean they're fine (see all the old timey literature about whether or not they feel pain at all, luckily we moved past that O_o), they don't contain a whole lot of blood so minimal losses can already be dangerous and they wear a diaper with fecal matter all day around their open wound. Of course there's the argument "But at least they won't remember it!", but that seems to imply circumcision is such a horrible procedure that grown men can't face it, and yet at the same time people who give this argument want to perform it on babies since it's only a tiny snip. They can't both be true at the same time.

Any major benefits they claim like HIV prevention will also only come into play when they start being sexually active anyway, or in the case of phimosis: When they're actually diagnosed with phimosis.


Last edited by Izmuth on Sat Jul 02, 2016 6:53 pm; edited 1 time in total
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Re: American Association of Pediatrics backtracks on circumcision

Post by Wondering on Sat Jul 02, 2016 6:29 pm

Can I ask that we not use the terms "intact" and "cut." I find them offensive and insulting. They are not neutral terms like "uncircumcised" and "circumcised." And the both imply negative characteristics about the circumcised, who generally -- as many people who use these terms say -- were not involved in the decision to be circumcised.

Intact = whole. Which necessitates the association of the opposite: Not whole, not a whole human being. I can only imagine the outcry if this were common terminology to refer to women who had mastectomies, that they are cut vs women who hadn't who are intact and whole.

I understand the use of words to give power to a position that has traditionally been the disregarded minority. And I understand that these are the words used in the anti-circumcision community. But I hate them so much. And generally, they turn me away from listening because of the implication of superiority: "I/my child is intact and whole. You/your child is not whole." It degrades the humanity of the circumcised.

/rant,soapbox

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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Sat Jul 02, 2016 7:04 pm

Sorry! That's what you get when you spend your time in specialized groups, your vocabulary shifts and you don't even realize it happens. Changed it!

Although to be honest, I would love a truly neutral word instead of "uncircumcised". Because for me personally, "uncircumcised" seems to imply circumcision is the norm.

Maybe I have heard that word being used too much in connection with the "eww gross" and "I wouldn't date an anteater" kneejerk reactions, and I've started to associate it with that *shrugs*.

But until a more neutral word is invented, you're right that uncircumcised is the probably the most neutral you can get, and I'll make sure to use it in the future. Thanks for pointing it out!
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Re: American Association of Pediatrics backtracks on circumcision

Post by Werel on Sat Jul 02, 2016 11:59 pm

Izmuth wrote:"I wouldn't date an anteater" kneejerk reactions
I know this is a serious medical and personal issue worthy of gravitas and I acknowledge that and don't agree with the sentiment, but... I still laughed at this phrasing Uh-oh

For neutral terms, uh... "crew-neck" vs. "turtleneck"? "Aerodynamic" vs. "cloaking device"? "Bagel dog" vs. "hot dog" is also disarmingly funny and seems to be pretty value-neutral, unless you have really strong feelings about bagels. Or maybe some people also have strong feelings about using humorous terms to talk about circumcision? This is all pretty alien discourse to me (never thought much about it before this thread), so I don't have a good sense of how serious the tone tends to be.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Sun Jul 03, 2016 4:22 pm

Werel wrote:
Izmuth wrote:"I wouldn't date an anteater" kneejerk reactions
I know this is a serious medical and personal issue worthy of gravitas and I acknowledge that and don't agree with the sentiment, but... I still laughed at this phrasing Uh-oh

For neutral terms, uh... "crew-neck" vs. "turtleneck"? "Aerodynamic" vs. "cloaking device"? "Bagel dog" vs. "hot dog" is also disarmingly funny and seems to be pretty value-neutral, unless you have really strong feelings about bagels. Or maybe some people also have strong feelings about using humorous terms to talk about circumcision? This is all pretty alien discourse to me (never thought much about it before this thread), so I don't have a good sense of how serious the tone tends to be.

...to be honest, I'm actually kind of endeared with calling it an anteater now in private, because it's just so silly Razz

But you wouldn't believe how toxic the discourse normally is. My request to the mods to delete the thread as soon as it turned into a flame war was sadly inspired by experience.

Every thread basically turns into people shouting at each other how circumcision is, like, literal castration designed by Zionist Big Pharmacists to restore the Matriarchy, and on the other side people screaming how foreskins are gross, how foreskins will actively conspire to kill you and your family and how it's the worst kind of child abuse only short of murder someone can perform by not getting their child circumcised.

In a perfect world with only reasonable people this kind of discussions would be so much easier to have :/

Personally, I would like a system where circumcisions weren't offered anymore, only provided when asked and only after the parents read a booklet on the actual risks & benefits of circumcision, that includes the relative percentages of those risks and benefits, so they make an easier, more informed choice.

I find it highly disturbing that doctors are still trying to upsell a procedure that no medical organization is in favor of.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Wondering on Sun Jul 03, 2016 5:22 pm

Izmuth wrote:Although to be honest, I would love a truly neutral word instead of "uncircumcised". Because for me personally, "uncircumcised" seems to imply circumcision is the norm.

Yeah, I get that. It's become a somewhat loaded word because of cultural norms and context. And your personal experience. My problem with "intact" and "cut" is that the words themselves, even divorced from signifying context, are degrading to the circumcised.

"Circumcised" and some new word other than "intact" would be nice.

Izmuth wrote:Every thread basically turns into people shouting at each other how circumcision is, like, literal castration designed by Zionist Big Pharmacists to restore the Matriarchy, and on the other side people screaming how foreskins are gross, how foreskins will actively conspire to kill you and your family and how it's the worst kind of child abuse only short of murder someone can perform by not getting their child circumcised.

Yeah...that was kind of my experience trying to learn about this back when I was pregnant and didn't know what I was having yet. I dipped my toe in to try to educate myself, saw this sort of discourse, saw the terms "intact" and "cut" and said, "Yikes! Those are some vitiriolic, anti-vaxxer style arguments. Why would I listen?"

Werel wrote:For neutral terms, uh... "crew-neck" vs. "turtleneck"? "Aerodynamic" vs. "cloaking device"? "Bagel dog" vs. "hot dog" is also disarmingly funny and seems to be pretty value-neutral, unless you have really strong feelings about bagels.

You know, this is sad, but I've been exposed to so much anti-Semitic rhetoric this election year because that's who so many of Trump's Twitter supporters are, and so, I would say, it's not a good idea to combine circumcision and bagels in the terminology. Sad


By coincidence, in church today, one of the readings had a line about circumcision and non-circumcision, so I thought of this thread! Smile

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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Tue Jul 05, 2016 7:39 pm

To be honest, part of why the discourse is so heated is because there's a lot of pain. It's easy for me to come across calmly and explain my arguments in an organized matter because my parents never removed anything from my body against my will, but a large part of the group has to live with their circumcision every day. Worst part is that they can't even blame their parents, because they did it because they thought it was best for them.

And then they see some people arguing with them who know there's no valid medical reason to do it, because medical science is finally moving on, and yet still feel justified for altering their children's genitals for no better reason than the way it looks.

The parents who don't circumcise also get a lot of hate of their families. One father in law said he already bought flowers for the funeral of his grandson, after he heard they weren't going to perform an unnecessary procedure on their newborn(!).

And they see people defending the practice with the argument that *they* are fine and didn't have side effects, and thus everyone must be fine with it.

It's so weird to me that people honestly think there are no risks involved at all. Hell, you even see it in masturbation habits: Circumcised guys use lube significantly more often (well, according to the internet polls I've found on the subject, so YMMV on the scientific validity, but there ís a trope of lotion + kleenex on American tv that's curiously absent from tv from other countries), and yet people think there are no risks they might miss the mechanical lubrication of the foreskin when having PiV sex.

Circumcised men use less condoms, and yet people seem to think there are no risks of reduced sensitivity *at all* or again uncomfortablebless caused by not having enough lubrication.

All mammals have foreskin? Probably useless then Razz

That article about the death grip on DNL prime? I tried his masturbation tips but holy fuck that hurt like Hell.

Hell, even in this article http://www.doctornerdlove.com/2015/10/what-men-should-have-learned-in-sex-ed/ where DNL describes how to deal with the clitoris ("Attacking it head-on can often be uncomfortable, especially if you’re just slapping at it with your fingers or tongue") I was like, "is this new for people? If I just run a finger over my glans it's also extremely uncomfortable... ooohhh"

Hell, even the numbers he quotes 8000 nerve endings for the clitoris vs. 4000 for the penis he conveniently forgets to include the foreskin as part of the penis (20 000 nerve endings)

I'm definitely not saying every circumcised guy has problems. If they say they're fine, who am I to not believe them? I don't have their penis, I don't know what they feel.

But it's incredible odd to know so many circumcised guys with issues that are being told their issues can't possibly stem from circumcision, because there are also circumcised guys who are fine. That's not how risk works Razz

More people, most of all doctors, should follow primum non nocere, IMHO.
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Re: American Association of Pediatrics backtracks on circumcision

Post by reboot on Tue Jul 05, 2016 10:51 pm

What I find interesting is that circumcision of baby boys who are not Jewish seems to be an American, Canadian, and (maybe) Australian thing, as far as I know (which is not far). Southern, Central and Eastern Europe do not circumcise non-Jewish babies and have no adverse effects., so there is a good chunk of a continent out there demonstrating that being uncircumcised is fine.

Muslim boys do it when they are 10-15, so technically they could opt out, although I am not sure how much real choice they have. It is a huge manhood ceremony and a big celebration of the boy, so between religion and wanting to "be a man", saying no is probably not a real option.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Fri Jul 08, 2016 6:29 pm

reboot wrote:What I find interesting is that circumcision of baby boys who are not Jewish seems to be an American, Canadian, and (maybe) Australian thing, as far as I know (which is not far). Southern, Central and Eastern Europe do not circumcise non-Jewish babies and have no adverse effects., so there is a good chunk of a continent out there demonstrating that being uncircumcised is fine.

Muslim boys do it when they are 10-15, so technically they could opt out, although I am not sure how much real choice they have. It is a huge manhood ceremony and a big celebration of the boy, so between religion and wanting to "be a man", saying no is probably not a real option.

I find it difficult, but at this moment I'm close to 100% okay with Muslim circumcision (although to be fair, the parents should again be informed of the current medical consensus on the risks involved with the procedure). Even if they don't have the most real choice one can have, I think that at least symbolically having a choice already spares them from psychological pain at a later age. Most circumcised intactivists I speak are mostly hurt that their parents without a second thought altered their body out of a deep sense of ownership of them, no matter what the risks were.

I've got to admit I'm even on the hedge about the recommendation of the AAP to allow symbolic circumcisions (where only a small nick in the labia is made that'll heal without complications)... if people accept it as an alternative, and it spares girls from having worse done to them, I may not like it but maybe we should be pragmatic.

But then I remember I'm agreeing with the AAP. And it makes me feel dirty beyond belief.

To understand the recommendations, one has to acknowledge that when parents decide on circumcision, the
health issues are only one small piece of the puzzle. In much of the world, newborn circumcision is not primarily a medical decision. Most circumcisions are done due to religious and cultural tradition. In the West, although parents may use the conflicting medical literature to buttress their own beliefs and desires, for the most part parents choose what they want for a wide variety of nonmedical reasons.
There can be no doubt that religion, culture, aesthetic preference, familial identity, and personal experience all factor into their decision. Few parents when really questioned are doing it solely to lower the risk of urinary tract infections or ulcerative sexually transmitted infections. Given the role of the phallus in our culture, it is not illegitimate to consider these realms of a person’s life in making this nontherapeutic, only partially medical decision. The task force was sensitive to the fact that as physicians, although we claim authority in the medical realm, we have no standing to judge on these other elements.
The ethical standard used was “the best interest of the child, ” and in this setting the well-informed parent was felt to be the best proxy to pass this judgment. Protecting this option was not an idle concern at a time when there are serious efforts in both the United States and Europe to ban the procedure outright.

I truly shudder at the thought what would've happened if people had actually listened to the Kellogg lobby and started to remove clitori with carbolic acid too as well as amputating foreskins. I can only assume we would've found myriad "benefits" of female circumcisions too, and would have "questionable evidence of its harms" because we would have relied on self-reporting (TW: Anthropologist talking with tribal women who're "glad they were cut" http://www.theatlantic.com/international/archive/2015/04/female-genital-mutilation-cutting-anthropologist/389640/).

And the AAP could have written the same piece how mean it is that international medical societies are up in our business about the potential harms of the "deeply culturally significant procedure" and how "the well-informed parent was felt to be the best proxy to pass this judgment" (even though we fail at informing them and even though they admit that for the "most part parents choose what they want for a wide variety of nonmedical reasons").

So, in that sense we lucked out I guess. The world could always be an even shittier place than it already is Razz
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Re: American Association of Pediatrics backtracks on circumcision

Post by Werel on Fri Jul 08, 2016 9:51 pm

I truly shudder at the thought what would've happened if people had actually listened to the Kellogg lobby and started to remove clitori with carbolic acid too as well as amputating foreskins. I can only assume we would've found myriad "benefits" of female circumcisions too, and would have "questionable evidence of its harms" because we would have relied on self-reporting (TW: Anthropologist talking with tribal women who're "glad they were cut" http://www.theatlantic.com/international/archive/2015/04/female-genital-mutilation-cutting-anthropologist/389640/).
I uh... I'm not sure I quite understand how you're coming at that article, but I can't agree that the self-reported benefits of female circumcision as reported by Rendille women in Kenya are comparable to any purported benefits that might have been advanced by the Kellogg lobby. There's a big difference between something ubiquitous and largely opt-in within a self-regulating culture (which the Rendille women's statements sound like), and something imposed on the majority by an outlier faction within a culture (Kellogg and his ilk).

I also have to sort of agree that it is... not "mean," but "serious imperialism-scented overreach" for international medical societies to be all up in people's business about adult genital cutting. There's no need to put patronizing scare quotes around "glad they were cut" (not that you necessarily intended it that way!); that Atlantic article covers plenty of totally legitimate reasons that Rendille women choose to be circumcised. The text you quoted (from the AAP?) points out quite correctly that most of the parental choice about circumcision has very little to do with health outcomes, and way more to do with culture; it's not a stretch to say that the international medical community's concern with female genital cutting is also largely cultural. I figure if we were discussing a commune in Berkeley where a bunch of white youth participated in recreational scarification for art or counterculture purposes, there'd be no problem. It's only once the people in question are Others that voluntary body damage seems widely perceived as A Problem.

I'm not saying female circumcision is great, I'm saying... it's a lot better than curtailing people's rights to do what they will with their bodies, unhindered by imposed foreign norms. Shrug
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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Sat Jul 09, 2016 5:14 am

Ah, sorry Werel!

I'm not that great at making my point it seems. Let me try again before anyone thinks I'm saying that getting rid of clitori and foreskins are even remotely equivalent in their effects.

I was just trying to point out that in an alternate universe where Kellogg had found supporters for his carbolic acid ideas a few things would have happened:

1) We would have found myriad "benefits" of it. Starting with that uncircumcised girls would have been considered icky, and doctors would strongly advice parents of those to use vaginal douches "for improved hygiene". Then, since vaginal douches are the worst thing you can do to your vagina, they could report a difference in UTI rates between circumcised and noncircumcised girls. Success!
For the rest, if you look at enough diseases, you can always find some that seem to have a significant correlation between the circumcision status and the amount of people having that disease, and presto: Instant health benefit! (Fun fact: In quite a few African countries there's more HIV in circumcised males, indicating that's there's probably a correlation between circumcision status and belonging to a certain tribal group, and a correlation belonging to a certain tribal group and HIV status, instead of a direct relation between circumcision status and HIV. This was conveniently ignored by the medical groups involved in setting up the clinical trials.). Oh, and every time a health benefit is disproven, we look for new ones.

2) We would obviously want to chart the ill-effects on sexual satisfaction. We would mainly do some self-reporting studies, which are notoriously inaccurate (as you can see from the article, you'd have quite a good chance the majority would still claim to be pretty happy with their genitals.). Other studies would indicate adverse effects (because you're getting rid of the frigging external clitoris, no shit) and of course anatomical knowledge makes it pretty self-explanatory why there *should* be adverse effects. And yet, because the studies disagree, people would just pick whatever scientific articles they agree with.

3) When there's finally backlash from the international community, the AAP would set up an ambigious recommendation, because they're afraid this culturally sensitive procedure is going to be banned outright, where they don't support it but claim the benefits outweight the risks (which everyone reads as an endorsement, because it is Razz). And then finally, when the international pressure becomes too great, the AAP would privately release an article behind a paywall, admitting that they basically lied about the health benefits outweighing the risks, but still keep the endorsement unedited on their website. That quote is indeed from their article by the way.

People just sometimes seem to think male circumcision can't be that bad because we've been doing it for generations and I just wanted to show how something as objectively bad as cliterodectomies would also persist for generations, through the same shit science.

To discuss adult female circumcision (which you thought I was discussing but I wasn't but it's still interesting Razz) you have a valid point about "serious imperialism-scented overreach". My only problem with it is the same point that Reboot made about Muslim boys: They may seem like they have a choice, but they don't truly got a choice. If they don't get circumcised, they don't get married and get shunned by the whole community.

But yeah, just forcing our opinion on them is not going to work even in the case of infant FGC, and is problematic in its own right. I dislike it that from the WHO that the recommended term is "Female Genital Mutiliation" exactly for that reason. It makes us feel superior, but if you truly wanted to help people "Female Genital Cutting" will work better IMHO, because it doesn't instantly antagonize the very people you want to educate (and personally I find it hilarious that getting rid of the clitoral hood (female foreskin) as they do in the Philippines is considered mutilation, while we get rid of 55% of our male foreskins and that's considered completely okay. Cultural blindness for the win!).

I also personally think it's not the smartest ideas to perpetuate the myth that a cliterodectomy destroys all sexual satisfaction, instead of "merely" the largest part. We still don't seem to have it in our collective heads the clitoris is also a large internal structure. So chances are, you tell women in Egypt or Somalia that they shouldn't circumcise their daughters because it destroys all sexual satisfaction, they know from experience that that isn't right, and ignore the rest of your arguments because you already "lied" to them.

I wonder if it would help to ask emigrated Somali women who didn't infibulated their daughters to write personal accounts how their daughters are completely okay without circumcision, and just spread those around when you're trying to educate people back in Somalia. I'm afraid that some battles we're not going to win by facts, and it's more important to show people evidence how people who were just like them who made a different choice are completely okay.

But I'm sure we have more knowledgeable people than me working the fields there, so hopefully in a generation or two they'll have managed to convince people to stop the practice, or change the practice to something less damaging.
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Re: American Association of Pediatrics backtracks on circumcision

Post by Izmuth on Mon Aug 15, 2016 6:59 pm

It hasn't got anything to do with the AAP as such anymore, but I just wanted to share this because it's good news for body integrity:

http://news.xinhuanet.com/english/2016-07/30/c_135551541.htm

TL;DR: Pan African Parliament is taking real steps to tackle the problem of female genital cutting and child brides. They're educating help workers to deal with specific issues of circumcised women and engaging religious leaders and town elders to stop the practice!

I hope (but really also expect) that this will be more effective than the bans that were already in place. Egypt has nice laws and all against it, but still 90% of women undergoes some form of genital cutting. Hopefully educating and having respected members of society disavow it will reduce this percentage drastically.
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