Friday, November 13, 2009

To Circumcise, or Not to Circumcise



Studies show that male circumcision causes the loss of sensation: http://www.forward.com/articles/2704/

Related to: Penn & Teller: Bullshit! - Circumcision

Also watch: Moolaadé - Protection

6 comments:

Charles said...

The article you referenced does not mention any studies that show that circumcision causes a loss of sensation.

The article claims that some book that seems to me, by the language used in reference to it, to demonise circumcision, brings together the "scientific consensus" that circumcision diminishes sexual pleasure!

What a joke...

If I ever have a son I will get him circumcised as a favour for his health (there are good studies that suggest it reduces transmission of aids) and future sexual activity.

I'm an ex Muslim who converted to Islam when 18 and got circumcised.

The reason I wanted to leave this comment is that there is a serious amount of harm caused by forms of female circumcision and medical malpractice when carrying out circumcision. I think these issues would be better not being confused with something like properly done male circumcision.

BlindW@cher said...

It's just a reference. Did you search for the studies? Did you read the book? No?

Just unsupported comments...

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Here is the some studies (look at the link for more):

Some recent researchers have asserted that the foreskin may be sexually responsive.[14][15][16][17] Opponents of circumcision have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations.

Circumcision removes the ridged band at the end of the foreskin.[16] Taylor (1996) observed that the ridged band had more Meissner's corpuscles — a kind of nerve ending that is concentrated in areas of greatest sensitivity[citation needed] — than the areas of the foreskin with smooth mucus membranes. Taylor postulated that the ridged band is sexually sensitive and plays a role in normal sexual function. He also suggested that the gliding action, possible only when there was enough loose skin on the shaft of the penis, serves to stimulate the ridged band through contact with the corona of the glans penis during vaginal intercourse.[18] This gliding action was also described by Lakshmanan (1980).[19]

Boyle et al. (2002) argued that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision."[20] They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."

http://en.wikipedia.org/wiki/Sexual_effects_of_circumcision

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Yeah, female circumcision is more brutal but that does not justify the circumcision producure on males.

But male circumcision is risky too:

* Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.48 These complications include uncontrollable bleeding and fatal infections.49 There are many published case reports of gangrene following circumcision.50 Pathogenic bacteria such as staphylococcus, Proteus, Pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death.51, 52 These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.

Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.53, 54, 55 Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.56, 57, 58 The September 1989 Journal of Urology published an account of four such cases.59 The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicine described one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.60 Many other similar cases have been documented.61, 62 Infant circumcision has a reported death rate of one in 500,000.63, 64

http://www.mothersagainstcirc.org/fleiss.html

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The studies about preventing AIDS are suspicious and disputatious.

To circumcise a kid to protect him from HIV is an irrational approach in this case.

According to that argument, then we can say that women surgically remove their breasts to protect them from breast cancer.

Is that less logical than circumcision?

That is the real big joke!

Charles said...

Well I'll have to get back to you when I have time to go through some of this stuff.

Just some thoughts though.

The references you are giving, except for the Wikipedia one, are not giving both sides of the issue. Articles by "Mothers against circumcision" and the other called "Marked in your flesh" (think that was it), come across as having an ideological bias.

I do not doubt that the foreskin does produce sensation. But you are mixing things up if you are to conclude that that leads to a loss of sexual pleasure or even loss of sensation during sex. They are different things altogether. There are many more variables to sex than the sensation that the foreskin produces.

The penis head is constantly exposed and rubbing against the inside of their partner during sex for a circumcised man.

I don't think that it is a good analogy comparing removal of breasts to avoid breast cancer and the removal of the male foreskin so that HIV cannot be transmitted through it (I'll have to check but I think that is the case).

Breasts are different than foreskin in terms of their importance to people. If you cut a women's breasts off she will probably appear disfigured and perhaps unattractive to most men. Also, do you see heaps of people wanting to cut their breasts off for the sake of pleasure?

Good science takes into account both sides of an argument.

BlindW@cher said...

This is an example of using science to justify an ancient tradition due to health issues. Circumcision wasn't discovered to protect people from HIV. So you approve circumcision just in this matter? (Even there are more simple and bloodless methods like using condom!) If there was a total cure for HIV, you would do this operation again? While you are blaming the studies against circumcision, you suppose they may not be objective, but how do you so sure on supporting studies?

The analogy is not wrong. All my body parts are important for me and anybody even my family has no right what will I remove from it!

Why do I choose decreased pleasure?

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There were no significant differences in sexual drive, erection, ejaculation, and ejaculation latency time between circumcised and uncircumcised men. Masturbatory pleasure decreased after circumcision in 48% of the respondents, while 8% reported increased pleasure. Masturbatory difficulty increased after circumcision in 63% of the respondents but was easier in 37%. About 6% answered that their sex lives improved, while 20% reported a worse sex life after circumcision.

http://www.cirp.org/library/sex_function/kim2006/



The supporting studies mostly arguable.

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Evidence that sexual exposures were responsible for only 27% of HIV incidence appears inconsistent with the observed 60% lower incidence in circumcised than in uncircumcised men. Some of the observed lower incidence in circumcised men may be due to less non-sexual HIV acquisition during their less frequent health care for genital complaints[1,2]. Some men many have misreported their sexual behavior; however, insofar as assumed misreporting is relied on to explain what happened, any conclusion that circumcision protects would not be based on evidence, but rather on assumptions that overcome evidence.

Other puzzles in the study include much higher HIV incidence for men aged more vs. less than 21 years, for men recruited before vs. after 30 December 2002, and for men during the 13th to 21st months of follow-up vs. the 4th to 12th months. Does this evidence provide any clues to blood exposures and non-sexual acquisition?

It may be that non-sexual HIV acquisition in this study cannot be identified and delimited. If so, it's not clear how convincing this research will be, or should be, in promoting circumcision for HIV prevention. Evidence from other studies suggesting a protective effect from circumcision may already be sufficient to persuade uncircumcised men in long-term partnerships with HIV-positive women to seek circumcision. However, without good evidence that circumcision prevents not less than some specified number of HIV infections per 1,000 coital acts with HIV-positive women, is it responsible to recommend circumcision to men who are anticipating possible coitus with unknown non-spousal partners? Data reported from this study do not (yet) provide that evidence.

http://www.plosmedicine.org/annotation/listThread.action;jsessionid=B026CF48CE1870B5A3C7B2BC8563171D?inReplyTo=info%3Adoi%2F10.1371%2Fannotation%2F9832218a-b129-4484-8d4d-66b6754c0850&root=info%3Adoi%2F10.1371%2Fannotation%2F9832218a-b129-4484-8d4d-66b6754c0850

BlindW@cher said...

The study by Auvert et al (1) will certainly go into the history of HIV prevention as a landmark. The study is important because the results are the first blinded randomized study demonstrating that HIV can be prevented by male circumcision (MC). Although double-blinded studies are considered a panacea, the nature of the intervention, however, necessitated that double blinding was impracticable - i.e. it was impossible for the men to be circumcised without them knowing that they had been circumcised.


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The other challenge is that medical practice is conservative - i.e. it is unlikely that any country will immediately include MC in its policy for the prevention of HIV. The reasons include: these studies may not be corroborated in forthcoming studies, the potential harms still need to be considered in order to assess the cost-benefit ratio. Even in South Africa where the study was carried out, it will be a while before MC is incorporated into the national HIV prevention policy. Interestingly, however, the institutional review board stopped the study prematurely, as is always deemed ethical, before the completion of the study, suggesting implicitly perhaps their endorsement that MC works and ought to be standard practice and no one needed to be further exposed to not being circumcised.

(And there are different issues too)


Researchers in the HIV field face the dilemma of not subjecting their study subjects to undue harm through stigmatization and discrimination. In several Southern African countries, providing HIV test results to clients of health services and research subjects is at the discretion of the client. That there is no requirement for people who test positive to inform others who may benefit from the disclosure is, in my opinion, an important omission in the prevention of HIV in the region. It may be useful, to include at the time of obtaining informed consent that "should you test HIV positive, we will encourage you to inform your sexual partners about the test results.

http://www.plosmedicine.org/annotation/listThread.action;jsessionid=B026CF48CE1870B5A3C7B2BC8563171D?inReplyTo=info%3Adoi%2F10.1371%2Fannotation%2F72688c82-327c-4246-9624-1ce0d17224bf&root=info%3Adoi%2F10.1371%2Fannotation%2F72688c82-327c-4246-9624-1ce0d17224bf

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In a nutshell, there is no any logical base to be circumcised.

ernest said...

there are different methods for circumcision... certain procedures that do severe the foreskin containing the nerves could do just that -- lead to some loss of sensation. However, I think most(?) doctors who do the procedure avoid this now... but anyway, I don't think it's always justified even with the supposed medical benefits. If I were in Africa, or say, plan to have sex with a lot of different people... maybe circumcision is best. There is no single right answer here it depends on the context, risks and benefits have to be weighed.

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