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 CDC considering recommending circumcision
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Zebra
Skeptic Friend

USA
354 Posts

Posted - 08/26/2009 :  00:37:46  Show Profile Send Zebra a Private Message  Reply with Quote
...for infant boys, and for adult heterosexual men at increased risk for HIV.

(Oh, that's going to go over well.)

NYT article here. The basis for considering this recommendation comes from clinical trials in Africa, in which heterosexual men who were circumcised had a 50-60% lower risk of becoming infected with HIV. Even after the circumcision healed and they felt like having sex again.

Men who have sex with men do not achieve the same reduction in infection risk from circumcision.

So...any takers?


I think, you know, freedom means freedom for everyone* -Dick Cheney

*some restrictions may apply

Dr. Mabuse
Septic Fiend

Sweden
9677 Posts

Posted - 08/26/2009 :  07:56:50   [Permalink]  Show Profile  Send Dr. Mabuse an ICQ Message Send Dr. Mabuse a Private Message  Reply with Quote
Cutting your willie voluntarity? Not a f**ing chance!


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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 08/26/2009 :  12:49:49   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
Men who have sex with men do not achieve the same reduction in infection risk from circumcision.
Doesn't this alone strongly suggest that the heterosexual correlation is just a correlation and that the whole issues needs to be studied further before any recommendations be made which involve a surgical procedure on men and boy's wangs?

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 08/26/2009 :  12:57:50   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
How about arming boys and men with proper sex education, universal health care including regular checkups and preventative care, free HIV testing and education about the disease and how to prevent it? Sounds a hell of a lot more sensible than cutting their privates. This is such a bizarre issue to me.

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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Simon
SFN Regular

USA
1992 Posts

Posted - 08/26/2009 :  14:22:58   [Permalink]  Show Profile Send Simon a Private Message  Reply with Quote
Originally posted by marfknox

Men who have sex with men do not achieve the same reduction in infection risk from circumcision.
Doesn't this alone strongly suggest that the heterosexual correlation is just a correlation and that the whole issues needs to be studied further before any recommendations be made which involve a surgical procedure on men and boy's wangs?



Not necessarily.
It is known that, hum, for the lack of a better word, 'playing catcher' does increase greatly your risk of being contaminated by any STD.
For the same reason, women are generally more susceptible too.

So, these results would actually be expected. After all, what does the status of your foreskin changes when all the action happens in your butt?
(And yes, I know that gay men's sexual practices are more complicated than that but it's enough to throw the statistics off).


Now, these kind of find have been popping up before and, so far, the evidences seem pretty weak to me. Time will tell if a scientific consensus can be built.



More importantly, I agree with you.
A good sexual education and easy access to condoms are still the only reliable method for epidemiological control of STDs and make this whole point quite moot.

Look again at that dot. That's here. That's home. That's us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives. The aggregate of our joy and suffering, thousands of confident religions, ideologies, and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilization, every king and peasant, every young couple in love, every mother and father, hopeful child, inventor and explorer, every teacher of morals, every corrupt politician, every "superstar," every "supreme leader," every saint and sinner in the history of our species lived there on a mote of dust suspended in a sunbeam.
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Dr. Mabuse
Septic Fiend

Sweden
9677 Posts

Posted - 08/27/2009 :  04:56:55   [Permalink]  Show Profile  Send Dr. Mabuse an ICQ Message Send Dr. Mabuse a Private Message  Reply with Quote
Originally posted by marfknox

How about arming boys and men with proper sex education, universal health care including regular checkups and preventative care, free HIV testing and education about the disease and how to prevent it? Sounds a hell of a lot more sensible than cutting their privates. This is such a bizarre issue to me.

I agree whole-heartedly... Though bizarre can't even begin to describe it.


Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3

"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse

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Simon
SFN Regular

USA
1992 Posts

Posted - 08/27/2009 :  08:42:11   [Permalink]  Show Profile Send Simon a Private Message  Reply with Quote
Originally posted by Dr. Mabuse

Originally posted by marfknox

How about arming boys and men with proper sex education, universal health care including regular checkups and preventative care, free HIV testing and education about the disease and how to prevent it? Sounds a hell of a lot more sensible than cutting their privates. This is such a bizarre issue to me.

I agree whole-heartedly... Though bizarre can't even begin to describe it.




It is fairly common in the U.S and, hence, not bizarre over here.

Look again at that dot. That's here. That's home. That's us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives. The aggregate of our joy and suffering, thousands of confident religions, ideologies, and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilization, every king and peasant, every young couple in love, every mother and father, hopeful child, inventor and explorer, every teacher of morals, every corrupt politician, every "superstar," every "supreme leader," every saint and sinner in the history of our species lived there on a mote of dust suspended in a sunbeam.
Carl Sagan - 1996
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 08/27/2009 :  21:49:07   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Personally, I think that thinking of males circumcision as something in the same ballpark with the true mutilation of female circumcision is way off the mark. As practiced in the West, it's a trivial surgical procedure, with a fairly trivial lasting effect. I think that anyone with a very strong opinion of (male) circumcision is probably wrong-headed.

There are just two factors that should, in my opinion, be considered: Does the procedure have health implications? The answer seems to be yes, circumcision slightly reduces the spread of STD's. But that effect is quite minor compared to knowledge of hygienic sex, especially the use of condoms.

Second, does having or not having a circumcision create a social stigma? In the US, there is probably a greater chance of some kid being made fun of in a school locker room for having a foreskin, than for not having one. In other cultures, that may be reversed.

So I, as an American, think that having had a circumcision is probably a little better than not having one. But, like the little flap of skin involved, it's really no big deal.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 08/27/2009 21:52:05
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H. Humbert
SFN Die Hard

USA
4574 Posts

Posted - 08/27/2009 :  21:56:45   [Permalink]  Show Profile Send H. Humbert a Private Message  Reply with Quote
Originally posted by HalfMooner
Second, does having or not having a circumcision create a social stigma? In the US, there is probably a greater chance of some kid being made fun of in a school locker room for having a foreskin, than for not having one. In other cultures, that may be reversed.
Actually, in my high school, the taboo was looking at other guys' dicks. So I don't see any social stigma resulting from other men. The first time it's likely to be an issue is with a woman who isn't accustomed to seeing an uncircumcised penis. Some women think natural is better, while others find them "weird looking" and can be slightly skeeved out.


"A man is his own easiest dupe, for what he wishes to be true he generally believes to be true." --Demosthenes

"The first principle is that you must not fool yourself - and you are the easiest person to fool." --Richard P. Feynman

"Face facts with dignity." --found inside a fortune cookie
Edited by - H. Humbert on 08/27/2009 21:57:19
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astropin
SFN Regular

USA
970 Posts

Posted - 08/27/2009 :  22:22:25   [Permalink]  Show Profile Send astropin a Private Message  Reply with Quote
Originally posted by H. Humbert

Originally posted by HalfMooner
Second, does having or not having a circumcision create a social stigma? In the US, there is probably a greater chance of some kid being made fun of in a school locker room for having a foreskin, than for not having one. In other cultures, that may be reversed.
Actually, in my high school, the taboo was looking at other guys' dicks. So I don't see any social stigma resulting from other men. The first time it's likely to be an issue is with a woman who isn't accustomed to seeing an uncircumcised penis. Some women think natural is better, while others find them "weird looking" and can be slightly skeeved out.




Yeah....but in junior high everyone does it so Halfmooner's argument stands.

Not too many women in the U.S. think "natural" is better. I'd have to side with Mooner on this issue....if you live in the U.S. you'd probably be more comfortable having the circumcision; especially if your young and not already married....IMHO. I'm sure that if you live in some other parts of the world the opposite would be true.

I would rather face a cold reality than delude myself with comforting fantasies.

You are free to believe what you want to believe and I am free to ridicule you for it.

Atheism:
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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 08/28/2009 :  02:14:46   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
Mooner wrote:
Personally, I think that thinking of males circumcision as something in the same ballpark with the true mutilation of female circumcision is way off the mark. As practiced in the West, it's a trivial surgical procedure, with a fairly trivial lasting effect. I think that anyone with a very strong opinion of (male) circumcision is probably wrong-headed.

There are just two factors that should, in my opinion, be considered: Does the procedure have health implications? The answer seems to be yes, circumcision slightly reduces the spread of STD's. But that effect is quite minor compared to knowledge of hygienic sex, especially the use of condoms.


First of all, I hear this "social stigma" argument all the time, but nobody ever points to any evidence that men in the USA who are not circumcised suffer in any measurable way from this stigma in terms of their life success, relationship success, or sense of self esteem. Until I see some evidence of that, I will remain skeptical.

If a woman is already to the point of having sex with a man and takes issue with the aesthetics of his penis, should he really be romantically involved with this woman in the first place? I mean, what, they've been going at it and he pulls it out and all the sudden she's recoiling and saying, "Ew, what's wrong with it?" I don't think so. Especially considering that most uncircumcised men's penis heads comes out from the hood during erection, so it is possible that if the guy doesn't mention it outright, the woman wouldn't even notice until after sex. Also, given that penises come in all shapes, sizes, and levels of curvature (which, unlike circumcision, actually do slightly vary the physical feel of intercourse for the woman) I'm not sure why the hooded or unhooded look would be a point of any special concern.

And finally, on the matter of social stigma, circumcision is in decline in the USA because it is not recommended by the American Medical Association. According to current stats, if I have a son, he'll be among 35% of American males of his generation - hardly a tiny minority.

Mooner, I agree with your basic argument that male circumcision, at least in the USA when done by professional medical experts, is really no big deal (if my husband insisted on us doing it for our baby, I'd consent)and shouldn't be compared to female circumcision. However, in other parts of the world complications leading to bleeding and infections is a statistically significant issue.

When speaking about circumcision as it is practiced in some parts of Africa, it might be fair to compare male and female circumcision since there are several different types of female circumcision, and in the most mild type, the exact same tissue which anatomically corresponds to the male foreskin is removed from the female, and there are far less health issues for women associated with circumcision in comparison to the more extreme forms of female genital mutilation. Also, there are heavy cultural pressures for women to be circumcised to the point where some young women whose parents didn't get them circumcised will opt to get the procedure done as adults. If social stigma is to be an argument in favor of a procedure, there is definitely some serious social stigma in certain part of the world against women who aren't circumcised.

Finally, you left one factor out of your assessment in deciding whether circumcision or not is superior. Being a medical procedure there is always a risk of complications. They are pretty minor in the first world, however, they do and probably always will exist and I think they balance out slightly lesser risk of catching HIV.

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 08/28/2009 :  04:09:11   [Permalink]  Show Profile Send HalfMooner a Private Message  Reply with Quote
Yeah, Marf, I qualified/weasel-worded my remarks when I made it clear I was writing about the relative merits of circumcision vs. non-circumcision assuming modern medical conditions. In non-hygienic situations such as primitive or impoverished African villages or urban slums, I would be against any kind of circumcision at all. I'd say damn any stigma, and the hell with any minor reduction in STD transmission in later years -- keep your dirty witch doctor mitts off those babies!

In fact, I'd also be set against male circumcision in the US (or another country with modern medicine) if it were only a matter of possible embarrassment in school locker rooms.

Is that kind of limited female circumcision (I presume you mean the cutting away of the labia minora?) actually done by MD's in Africa? If not, I'm agin' it. Even where it might be performed in a clean surgical theater, I'd be against it if there weren't some actual (even if minor) medical benefit.

I can't say much about the risk factors of the circumcision procedure in First World countries vs. possible STD benefits. It'd be good to have those quantified.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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Simon
SFN Regular

USA
1992 Posts

Posted - 08/28/2009 :  09:29:49   [Permalink]  Show Profile Send Simon a Private Message  Reply with Quote
Well; as I said elsewhere, the rate of HIV/AIDS in Israel is the same than in most countries of Western Europe, where circumcision is the exception.
So, it does not seem to have a big impact on the population level.

There is a study out there, however, that found a 50% increase in resistance, I am doubtful and will wait a few years and see if the results are repeated.
At any rate, considering that people have sex (are exposed) multiple times, even this decrease does not mean much in the long run.

Look again at that dot. That's here. That's home. That's us. On it everyone you love, everyone you know, everyone you ever heard of, every human being who ever was, lived out their lives. The aggregate of our joy and suffering, thousands of confident religions, ideologies, and economic doctrines, every hunter and forager, every hero and coward, every creator and destroyer of civilization, every king and peasant, every young couple in love, every mother and father, hopeful child, inventor and explorer, every teacher of morals, every corrupt politician, every "superstar," every "supreme leader," every saint and sinner in the history of our species lived there on a mote of dust suspended in a sunbeam.
Carl Sagan - 1996
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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 08/28/2009 :  10:20:36   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
Mooner wrote:
Is that kind of limited female circumcision (I presume you mean the cutting away of the labia minora?) actually done by MD's in Africa? If not, I'm agin' it. Even where it might be performed in a clean surgical theater, I'd be against it if there weren't some actual (even if minor) medical benefit.
When I was in undergrad my freethought group hosted a talk by a professor in Women's Studies on female circumcision. To my surprise, the speaker's main point was her frustration over peoples' total ignorance about how complex the issue is, both with regards to the cultures involved and what the actual medical procedure is. She first emphasized that there are several different types of female circumcision, some of which when they are done by a doctor are relatively harmless, and on the other extreme types which are just, plain torture and not excusable by any kind of cultural relativism. The majority of female circumcisions done are at neither extreme. The speaker's second emphasis was that as a custom, in many populations the desire for it among women is great. Just like men in America often want their sons circumcised because they were, women in Africa typically want their daughter's circumcised. The women drive the custom as much as the men do. In some places where a generation of women changed their minds about the practice and didn't get their daughter's circumcised, the sentiment of "returning to our traditions" became trendy and teen girls and young women were opting to get the procedure done later in life. That really says something about how strong the custom is driven into peoples' ideas of normalcy. I can't imagine that in 15-20 years we're going to have a bunch of teen boys and young men in America opting to get circumcised late in life.

Contrary to what a lot of people assume about it, women who are circumcised do still tend to enjoy sex and are capable of lots of sexual stimulation and gratification. The real health risks are connected to complications, especially during childbirth. Lots of babies in Africa needlessly die because their moms were circumcised.

It is actually a pretty fascinating topic and wikipedia has a great article on it: http://en.wikipedia.org/wiki/Female_circumcision

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 08/28/2009 :  10:28:00   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message  Reply with Quote
Simon wrote:
Well; as I said elsewhere, the rate of HIV/AIDS in Israel is the same than in most countries of Western Europe, where circumcision is the exception.
So, it does not seem to have a big impact on the population level.

There is a study out there, however, that found a 50% increase in resistance, I am doubtful and will wait a few years and see if the results are repeated.
At any rate, considering that people have sex (are exposed) multiple times, even this decrease does not mean much in the long run.
Given how extreme the problem of HIV is in parts of Africa, I can see why they are promoting circumcision as just one of many measures to try to control the disease.

However, I worry that a man who gets the procedure done will have a false sense of security which makes him more likely to be reckless. If a man is discriminating about his sexual partners, always uses barrier methods, and gets regularly tested for STDs including HIV, he is much more likely to be protected.

"Too much certainty and clarity could lead to cruel intolerance" -Karen Armstrong

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astropin
SFN Regular

USA
970 Posts

Posted - 08/28/2009 :  11:22:51   [Permalink]  Show Profile Send astropin a Private Message  Reply with Quote
Originally posted by marfknox


However, I worry that a man who gets the procedure done will have a false sense of security which makes him more likely to be reckless. If a man is discriminating about his sexual partners, always uses barrier methods, and gets regularly tested for STDs including HIV, he is much more likely to be protected.


Good point.

I would rather face a cold reality than delude myself with comforting fantasies.

You are free to believe what you want to believe and I am free to ridicule you for it.

Atheism:
The result of an unbiased and rational search for the truth.

Infinitus est numerus stultorum
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