Flawed Circumcision Defense: Barbara Kay

Posted: October 18th, 2016 | Author: | Filed under: Control, Ethics, FCD, FGM, Hygiene, Logic, Media Marketing, Pain, Science | No Comments »

[10/19 Update: Edited for clarity and to reduce speculation since late night posting is imperfect and probably unwise.]

National Post columnist Barbara Kay used Brian Morris’ latest rehash on circumcision to repeat her ignorant thoughts on the subject. She begins by regurgitating claimed benefits, which can all be conceded here for the sake of time because they’re irrelevant to the only issue, ethics. Then:

… Dr. Morris and his American co-authors state, “We found that up to 65% of uncircumcised males might experience at least one of these [medical conditions] over their lifetime.” …

Until May 2015 Morris claimed the number as 33%. Since June 2015 he claims it’s 50% in a brochure on his website. And it’s apparently 65% in this new review. When will he settle on 100%? But more to the point, it’s obvious he likes whichever way he can claim this number because it’s flashy. “Ooooooh, 33/50/65 percent is high. Such danger!” But it’s a meaningless number in the context of non-therapeutic circumcision of boys. I assume Morris knows this. I assume Kay doesn’t, so a review of Morris’ history could help. Instead of those numbers, this is what is worth discussing here, from Morris:

Up to 10% of males reaching adulthood uncircumcised [sic] will later require circumcision for medical reasons.

Not only is the number only 10%, it’s only up to 10%. Medically necessary circumcision is rare, at any age. There is no ethical case for imposing the most radical solution without consent when at least 90% of males will never need it.

She continues:

… Their risk-benefit analysis of the procedure led them to conclude the benefits exceed the risks by about 100 to one. (In another study, published in the Journal of Sexual Medicine, Dr. Morris and colleagues found circumcision produced no adverse affect on sexual function or pleasure, a charge often leveled by anti-circumcision activist groups.)

Much like when Yair Rosenberg accepted Morris’ claim unexamined, Kay doesn’t appear to know the primary source.

But in a study Morris and Krieger rate as [highest quality], Payne et al [12], this:

… It is possible that the uncircumcised penis is more sensitive due to the presence of additional sensory receptors on the prepuce and frenulum, but this cannot be compared with the absence of such structures in the circumcised penis. …

Payne’s study published in 2007. In 2011 Kay wrote:

Set aside the rights-based rhetoric. It’s about sex: Circumcised men have greater pre-orgasmic endurance; non-circumcision permits more frequent ejaculations. …

So, circumcision either delays orgasm, assumed to be positive for all men, or has no effect on sexual pleasure. Like Morris, she appears to play “heads I win, tails you lose”.

Kay goes on to write:

… The AAP states: “The new findings show that infant circumcision should be regarded as equivalent to childhood vaccination and that as such it would be unethical not to routinely offer parents circumcision for their baby boy. Delay puts the child’s health at risk and will usually mean it will never happen.”

That quote is not from the AAP. It’s from Prof. Morris. He wrote it in a press release more than 18 months after the AAP published its revised position statement. Kay doesn’t bother to fact check the most basic statement. [ed. note: Kay asked the online editor to correct her error.] Nor does she pursue how Morris’ quote undermines their case for non-therapeutic neonatal circumcision since he acknowledges that circumcision is rarely necessary.

Thus, while it’s inexcusable, it’s hardly shocking when she continues:

The CPS could not condemn the practice on grounds of increased morbidity. After thousands of years of what is essentially a controlled study with virtually all Jewish men, with a large percentage of Muslim men on one side, and uncircumcised men on the other, it has been unequivocally concluded that circumcision presents no health risks; quite the contrary, as we shall see.

Even Morris doesn’t pretend that circumcision “presents no health risks”. He understates them, and ignores the guaranteed harm from the removal of the foreskin (and possibly frenulum) in 100% of circumcisions. But he’s not so biased that he’ll posit such an obvious untruth. Yet, there’s Kay’s indifference masquerading as hyperbole for all to see.

… Morris’s team estimates the combined frequency of adverse events at 0.4% overall, arguing that “the cumulative frequency of medical conditions attributable to [having an intact foreskin] was approximately 100-fold higher” than the cumulative risk of circumcision.

Even if we accept the numbers, he’s arguing frequency of medical conditions attributable to the foreskin, not the frequency of medically necessary circumcision. It’s fascinating, perhaps, but a transparent obfuscation. The anti-science charge is often leveled at activists here, but soap, water, antibiotics, steroids, condoms, and so on are also science. To start with the most extreme solution at the tiny prospect of a problem sometime in the future is ridiculous.

When she gets to the comparison of male and female genital cutting, she ignores the principle.

The single most irrational argument one often sees is the charge of moral equivalency between circumcision and female genital mutilation. FGM is a phenomenon that is, apart from both affecting the genitals, …

Apart from both affecting the genitals, indeed. Affecting the genitals of a healthy child who does not need or consent to the permanent alteration of said healthy genitals. Non-therapeutic genital cutting on a non-consenting individual is unethical. The individual has inherent rights to bodily integrity and autonomy from birth. Non-therapeutic circumcision violates those rights.

… quite separate from circumcision. Unlike circumcision, which removes an unnecessary piece of skin, …

Unnecessary circumcision removes a piece of skin. It’s the same words, but made objective rather than subjective. It’s the fact-based opposite of “heads I win, tails you lose”.

… in no way prevents natural and satisfying sexual function, …

In addition to calling back to the Payne study and Kay’s earlier comments about delayed orgasm, circumcision removes the foreskin, a natural part of the body. That is “natural”. Its mechanism is gone, so circumcision certainly prevents that function. And “satisfying” is subjective. Would all men prefer delayed orgasm and the loss of the foreskin? (I don’t.)

… FGM is a misogynistic practice created as a means for men to control women, …

Circumcision controls men. Its imposition is another’s assessment that the male’s body should be the way someone else prefers. It is then made that way (hopefully, except when complications occur, including possible death). The male is never asked. He is to say “thank you”, praise the imposition, and impose it on his sons as soon as they’re born.

Kay’s argument rests on control as intent rather than action. I doubt she would accept that parents cutting their daughter’s genitals for the reasons we allow them to cut their son’s genitals. She assumes their intent is always evil, but is it the intent or the act that matters here? If she believes intent with FGC is only what she writes, as she appears to believe, she should read more¹ on the topic. And then extrapolate back to the disparity in the intent and the violence of male circumcision.

… meant to prevent sexual desire and gratification in women to ensure their fidelity, and which removes a portion of the genitals absolutely vital to gratification. It is the very epitome of patriarchy, whereas circumcision is a rite of passage conceived by males for other males, and for thousands of years rooted solely in spiritually contractual language and meaning. Women who have been subjected to FGM invariably come from countries in which extreme misogyny is the norm. Circumcision carries no moral or gender-injustice baggage of this kind whatsoever.

I agree that FGM is awful. But it’s silly to repeatedly claim a definitive knowledge that male circumcision does not remove of portion of the genitals absolutely vital to gratification. She ignorantly cites bad summaries of studies and only uses groups of males circumcised at birth or as young children as reference points for this opinion. She doesn’t appear interested in males as individuals with rights and preferences of their own for their foreskins. (“Conceived by males for other males”.) Preference for the foreskin or circumcision is an individual decision. What other males prefer is only valid for themselves.

She closes by misunderstanding the ethics involved one last time, in a disgusting manner:

Parents deserve to be informed of all the evidence, pro and con, when the issue of circumcision arises. It is not necessary for the CPS to actively recommend circumcision to keep to the path of ethics and professional responsibility, but given the accumulation of evidence demonstrating the positive effects of circumcision, it would be unethical of the CPS – or any pediatricians individually – not to present the science available, or worse, to recommend against the procedure.

She’s dancing close to the silly proposition that boys have a right to grow up circumcised. The only ethical position is absolute opposition to (and prohibition of) all non-therapeutic genital cutting without the patient’s consent. It’s the right she recognizes for females. Her source (inadvertently?) recognizes that circumcision is rarely needed ever and can be (but likely won’t be) chosen later. She cites evidence of males who are dissatisfied with circumcision and being circumcised. But she ignores these in favor of her own biases. Cognitive dissonance (and a non-sequitur) is the best she can offer. She is ignorant. She should aim to be less ignorant.

¹ Consider Fuambai Sia Aahmadu, and from 2008.


The “Hacking Away at Perfectly Healthy Genitals is Bad” Principle

Posted: February 5th, 2016 | Author: | Filed under: Ethics, FGM, Logic, Parenting | No Comments »

How many times have we seen a quote like this?

In Jacksonville, Dominic Morris, a 30-year-old father of two, said he did not understand what all the fuss was about. He said he was not mutilated during his circumcision, didn’t bleed at all and felt nearly no pain during or after the procedure. “Mutilation is horrible, but it’s not true that it happens here” in America, Mr. Morris said. “They cannot stop us. It’s our tradition.”

That’s said every time an activist discusses circumcision for what it is rather than what people think it is. It’s accepted thought. We’re told we owe complete deference to it. Who are we to tell people their dismissal of inconvenient facts is wrong? We’ll assume they’re informed, whatever they’ve been told or choose to believe. Parents have this absolute right to have their healthy children cut for whatever reason they desire. Sons only. Obviously.

Except, wait. I just noticed an error. I transcribed that quote wrong. Here’s the real quote from that story:

In Jakarta, Fitri Yanti, a pregnant 30-year-old mother of two, said she did not understand what all the fuss was about. She said she was not mutilated during her circumcision, didn’t bleed at all and felt nearly no pain during or after the procedure. “Mutilation is horrible, but it’s not true that it happens here” in Indonesia, Ms. Fitri said. “They cannot stop us. It’s our tradition.”

We will never accept that defense in the context of female genital cutting. Rightly so, of course. But I choose not to be a hypocrite, so I don’t accept it for male genital cutting, either. The basic fact is the same. It’s non-therapeutic genital cutting on a non-consenting individual. Therefore, the principle is the same. They are both unethical. Opposition to one necessitates¹ opposition to the other².

We should also be clear on what Ms. Fitri may be arguing.

Experts in Indonesia said the practice there had largely involved a less drastic version of cutting, usually a surface scratch or nick, as compared with more severe disfiguring. The Indonesian government’s survey asked parents if their young daughters had undergone circumcision. Ms. Cappa said it was possible that there were some more severe cases in Indonesia, but she said the official Indonesian government definition of female circumcision was “an act of scratching the skin that covers the front of clitoris without injuring the clitoris.”

That is objectively less harmful than male circumcision. Still, the official government definition could be irrelevant to the reasons parents are answering “yes”. The parents could be openly admitting something much more severe. This possible difference matters for prevention and response. In principle, it’s irrelevant. We recognize even “a surface scratch or nick” on a female minor’s genitals, which will likely heal without permanent injury or scarring, as unethical and worthy of prohibition. The WHO’s definition of FGM is effectively “any genital injury for non-medical reasons”. The universal principle is obvious and applies without regard to sex. We must all reject the silly, biased distinction the WHO and others demand. Possible health benefits are not a “medical” reason for non-therapeutic male genital cutting. (“Medicalized” is not the same as “medical”.)

What happened to Ms. Fitri is unethical. What will/did happen to Ms. Fitri’s children is unethical. For every male who was/is the hypothetical Dominic Morris as a child, what happened to them as a child is unethical.

(Title reference here.)

¹ Opposition to both does not necessitate equal activist efforts from everyone. Care more about FGC/M? Agitate for change. Care more about MGC/M? Activate for change. The cumulative effort will work itself out. Just don’t dump on those agitating more for one than the other, or for making the logical comparison of the two.

² Or it necessitates support for both, but I assume no one reading this wishes to be horribly wrong and unethical.


The Trauma of Small Numbers

Posted: May 26th, 2015 | Author: | Filed under: Ethics, Logic, Regret | No Comments »

At The Washington Post’s Wonkblog, Christopher Ingraham crunches through a few statistics about circumcision, with the headline writer concluding that “Americans truly are exceptional — at least when it comes to circumcision”. In the implied context of outlier for exceptional, yes, we are exceptional in our ability to ignore ethics and logic. Let’s not celebrate.

Most of the post is working through numbers. While relevant and informative, virtually everyone reading this will not be surprised by any of it. The encouraging aspect is in the access young people have to information.

Survey data indicate that we may see these declines continue. A YouGov survey conducted earlier this year found that young people were more skeptical about the practice than their elders: only 33 percent of 18-to-29 year-olds said that male children should be routinely circumcised, compared to 43 percent of 30-to-44 year-olds, 52 percent of 45-to-64 year-olds, and nearly two thirds of seniors.

This is why it’s critical to continue highlighting and objecting to garbage initiatives like the CDC’s recent draft proposal that focuses on infants. We’re convincing people that it’s time to stop circumcising.

The end of the post provides the information necessary to grasp the ethics.

… Overall, men who have been circumcised don’t appear to have many regrets about it: only 10 percent of circumcised men said they wished they hadn’t been circumcised, according to YouGov.

Since the number-crunching doesn’t quite get there, I want to open the perspective to what the numbers mean. At the time I’m writing this post, the U.S. Population Clock stands at 320,952,250 Americans. That means there are approximately 160,476,125 American males. Given that infant circumcision rate spent decades in the 90% range but is now lower, I’ll estimate that 75% of American males were¹ circumcised. That estimate results in 120,357,093 circumcised American males. Applying the survey’s 10%, I wish to restate Mr. Ingraham’s conclusion to consider whether his analysis should survive further number-crunching.

Overall, men who have been circumcised don’t appear to have many regrets about it: only 12,035,709 circumcised men said they wished they hadn’t been circumcised.

We mistakenly think about circumcision in terms of statistics and probabilities. That hides the violation involved, and allows society to believe we’re doing something good. But there is an individual at the tip of every scalpel. I think one is an exceptional, too-large number in the context of a male regretting non-therapeutic circumcision without his consent. However, it’s easy to imagine that ten percent is a small, inconsequential number. It is neither small nor inconsequential. We must realize that twelve million males² is a large, inexcusable number.

¹ Some might argue I should say are circumcised. I criticize the act of circumcising healthy males without their consent, not the state of being circumcised, however the male got to that point. It’s the ethics against circumcision, which includes the ethics against body shaming. I support any male’s decision to be content being circumcised.

² It’s worth remembering that some number of the content 90% would be content with their foreskin. It’s a mistake in the ethical evaluation to conclude that contentment by itself is a justification. That is dealing only with what is seen. Do not ignore what is unseen.


Revising Tactics

Posted: May 15th, 2015 | Author: | Filed under: Ethics, Logic, Mission | No Comments »

This excellent post on activism by Freddie deBoer captures what I’ve been thinking lately. The context is different, and I largely disagree with his politics, but the larger theme remains activism and convincing people of ideas. If you only have time to read Mr. deBoer’s post or what’s below, click that link.

I’ve been frustrated about the direction of activism for genital integrity rights for a longer time than I’m willing to accept. I’m not going anywhere. I haven’t changed my mind. But it’s difficult to expend the effort when so many are fighting those who agree on the goal and demonizing those who we need to convince. Maybe there’s a cause where a punch in the nose is the right activism. This isn’t it. Doing so only makes the process harder and further pushes out the day we achieve full protection for all children, male, female, or intersex.

I remember many political fights over the last decade-plus that I was sure would turn out a specific way. The most recent example is the general election in the United Kingdom last week. I was convinced Labour were going to win. “Go Labour” was all I saw on Twitter. The Rise of Ed Milliband was everywhere in my news feeds. And then the election happened. David Cameron remains Prime Minister, but with an actual majority instead of a coalition government. The exact opposite of the expected result occurred.

British Politics Twitter melted down from the moment the first exit poll leaked. “How could this be? Impossible! We’re doomed!” And so on. I reacted this way in years past, and I felt justified in doing so. I’m right, after all. Except when this happens enough times, it’s wise to step back to figure out why expectation and result don’t match. We need to examine that chasm for genital integrity rights.

I believe the explanation for this experience is the same for politics and genital integrity. The Internet is not society. The Internet is a specific, motivated subset of society. It will change the world, probably. But this change will occur only if we realize that most of the people we need to convince don’t care about our obvious intellectual win in a long-running feud with oppositional trolls.

It isn’t that a large percentage of society is being obstinate, refusing to change. For most people the issues important to activists aren’t merely unimportant. They aren’t real. How many times have we heard, “I don’t know any men who miss their foreskins/regret being circumcised”? The answer is always, accurately, “Yes, you do. You don’t know who they are because it isn’t safe to say such a thing in most company.” Consider the immediate reaction in the UK election: “Why were Tories so afraid to tell pre-election pollsters that they’re conservatives?” It’s more reasonable to recognize that some people will not tell another their truth if they believe it will be dismissed or ridiculed.

That’s the crux. People aren’t evil. They’re unaware. It’s ignorance in the purest definitional reality. Perhaps there is a better way for them. We can show them. Will we show them?

With politics, we all believe that our views are correct. Maybe. With genital integrity, the truth is clear rather than subjective. Society should already be where we are on this issue. Of course. But it would be foolish to use that to inform our activism. We must educate. Antagonizing only keeps us out of the experience of those we need to convince. As I’m sure I’ve written before, would we rather be right or victorious?

It would be wonderful if we could explain ourselves to a sufficient number of judges and legislators. Boom, everything changes. That isn’t how change happens. Courts and legislatures lag society. Justice derives from those who refuse to participate in injustice any longer, not those who would command us not to participate. This is true even though providing legal protection for the inherent right to genital integrity to all citizens is the only ethical stance. The burden of proof shouldn’t be on us. The burden of proof is on us.

Where do we go from here? I wish I had the magic words that would fix this. However, if you read Mr. deBoer’s post, magic words are the opposite of what we need. We have too many magic words now. Cutter. Circumfetishist. Rape. Sexual crime. And so on, even to mutilation in many contexts. Using these words signals to a preferred segment of activists that only we understand how truly awful circumcision is. Perhaps. And it feels so good, right, so it doesn’t matter what the cutters and circumfetishists think, except what the people called cutters and circumfetishits think is all that matters. They have all the power to stop circumcision. We need to stop aiming to convince those who are already convinced.

How do we educate the people who need to be convinced?


Not every male would have foreskin anxiety

Posted: January 31st, 2015 | Author: | Filed under: Ethics, FCD, Hygiene, Locker Room, Logic, Parenting, Regret | No Comments »

It’s rare that I read something providing both confirmation and frustration. Such is the case with this interview with Aaron Calloway, a man who chose circumcision for himself as an adult. Some of Mr. Calloway’s thinking precedes the Q&A in the interview:

“I have been in a couple of social circles where people would be talking and say, ‘Ugh, yeah. He was uncut,’ and I, like, didn’t want that,’” Calloway told me, when we spoke a second time about his circumcision. “And I’m sitting there with an uncut penis. People don’t really assume you may not be [cut]. They just assume that you’re cut and if you’re not, it’s kind of like this abomination.”

I’ll assume everyone is familiar with this because it certainly matches my experience. Americans generally assume every male is – and should be – circumcised. It’s what we do. It’s “good”. I take a different view on what to do with society’s perception. Of course I don’t have the same experience Mr. Calloway does. Mine is people assuming I’m happy with being circumcised, because why wouldn’t I be? It’s strange, and annoying because I don’t care what other people think about my preference. I’d rather have my normal body, which I had until my parents made my choice.

Early in the interview, Jenny Kutner, asks a question that expands on this:

How would you say it’s perceived to be uncircumcised [sic]?

It’s strange because it really depends on being asked. If you are someone who prefers a cut penis, or to be circumcised, it’s weird because the preference — they automatically associate it with cleanliness. It’s considered a more proper penis and uncircumcised is like, weird. But it makes me think, it’s weird to actually be born and have your penis hacked at. I am glad that I made the decision on my own to do it. There’s something empowering about that.

I’m glad Mr. Calloway had his choice, even though I don’t (emotionally) understand – and wouldn’t make – the choice he made. He’s correct that it’s weird to be born and have your (healthy) penis hacked at. That weirdness is why I dreaded this excellent, necessary question:

Since you found it empowering to decide yourself, what do you think you would do for your son if you had one?

I would probably get him circumcised, only because I wouldn’t want him to deal with the social embarrassment of [not being circumcised], because it can come off that way. I’ve been in situations where if I let myself, I could’ve felt embarrassed, but I chose to own it. I think I had enough resilience where it didn’t get to me, but I think that some people in that situation, it does get to them.

I wanted to turn off my monitor, unplug it, and throw it in the garbage when I read this, just so I’d never be able to read that answer again. Because the obvious question is obvious: What if that hypothetical son wouldn’t be embarrassed by social pressure to be circumcised? Or, what if the social pressure is no longer the same 15+ years after that hypothetical son is born in the future? And, I still remember, “I am glad that I made the decision on my own to do it” from the previous question. Is there a reason to assume a hypothetical son wouldn’t want his choice, too?

My frustration with Mr. Calloway’s answer grew later in the interview when the question turned to Mr. Calloway’s results:

Aside from not being able to ejaculate for a while, were there any other negative side effects?

Besides the desensitization –

So you do have less sensation now?

Yes, and that is something that I’m a little bit sour about. I used to have very intense orgasms–my legs would curl and my head would go back. It was cool. I was very into it. Now, I’ll cum or whatever, and it’s just more calm. It’ll feel good, but it’s not as dramatic as before, which was nice, because it felt sexual and passionate, and now it’s just like, get out.

Is it worth it?

Is it worth it? I would say, in my situation, and my experiences, yes, it is to me, because I just personally feel better about it. I was with some friends who were talking about the word “smegma” and making jokes about it, and now I don’t have to feel uncomfortable in that situation, and that’s really nice. I think for me and my personal psyche, it is worth it. I’m not saying that when I cum I don’t feel anything. No. That’s not the situation either. I still get horny. I want to have sex. It still feels great and I still have an orgasm. Is it to a lesser degree? Yes. Is it an orgasm nonetheless? Definitely.

It’s consistent to say “I’m a little bit sour about” it and “in my situation, and my experiences, yes, it is [worth it] to me.” All preferences are unique to the individual. Mr. Calloway values the aesthetic and social benefits more than the healing process and diminished sensitivity. Given that I only advocate for each person to make his own choice, not that no one be circumcised, I’d be a hypocrite to criticize his conclusion. I criticize his current thinking that he would circumcise a future son. There’s also time for him to see the error in his thinking there.

To the possible objection with this interview, of course Mr. Calloway’s claim is subjective and anecdotal. This does not prove that adult or infant circumcision leads to desensitization. I think the inference is logical, given how circumcision changes the normal penis. Still. No, this isn’t proof.

It does support my focus on individuals rather than groups. We must remember how critical this is when reading generalized garbage such as what the CDC offers on page 26 of a detailed supporting document for its proposed recommendations to teens, adults, and parents of newborns.

… However, in one survey of 123 men following medical circumcision in the United States, men reported no change in sexual activity and improved sexual satisfaction, despite decreased erectile function and penile sensation. [Abstract and study]…

From the results section of the study’s abstract:

A total of 123 men were circumcised as adults. Indications for circumcision included phimosis in 64% of cases, balanitis in 17%, condyloma in 10%, redundant foreskin in 9% and elective in 7%. The response rate was 44% among potential responders. Mean age of responders was 42 years at circumcision and 46 years at survey. Adult circumcision appears to result in worsened erectile function (p = 0.01), decreased penile sensitivity (p = 0.08), no change in sexual activity (p = 0.22) and improved satisfaction (p = 0.04). Of the men 50% reported benefits and 38% reported harm. Overall, 62% of men were satisfied with having been circumcised.

As the study concluded, and the CDC’s use failed to understand, “adult circumcision appears to result in worsened erectile function, decreased penile sensitivity and improved satisfaction.” Again, those don’t have to be inconsistent for an individual. But it’s indefensible to assume infant circumcision results in a different outcome, or that results one and two ethically coexist with result three for healthy children.

Even in this study supposedly supporting the CDC’s recommendation, only 62% of men were satisfied. The other 38% matter, too. In the absence of need, the only relevant issue is always individual choice. And looking at the math, the results show that far fewer than 100% of men circumcised for (probable) need were satisfied. Remember this every time someone implies every male should¹ be satisfied with non-therapeutic circumcision because some males are satisfied with therapeutic circumcision.

I appreciate what Mr. Calloway has done with his interview. His honesty is informative in both its insights and its flaw. We need more honest, focused discussion like that. I don’t assume all men circumcised as adults would report reduced sensitivity. I know there are enough that it might help break through the societal barriers we maintain against ethical protections for the normal bodies of male children.

¹ Consider Mr. Calloway’s results in the context of a recent silly lifestyle trend piece. It concludes with a man from Staten Island named Boris who had himself circumcised at 33. Okay, fine, good for him. Even though he said that “[t]he next six months weren’t normal,” everything is apparently okay with circumcision because now “[w]e’re expecting a baby next month — everything works just fine!” Clap, clap, except no one is making the argument that circumcision prevents ejaculation or climax (Except in those rare cases of death where it prevents that). “Sex still feels good” is the most persistent and most pernicious straw man in the circumcision debate.

Read this response instead.


“well, perhaps to you, but this is MY body!”

Posted: November 16th, 2014 | Author: | Filed under: "Voluntary", Logic, Regret | 1 Comment »

Musician and YouTuber Emma Blackery posted an excellent response to a question on Tumblr, Why are you getting rid of your tattoos? 🙁. Her reasoning is perfect and word-for-word applicable to circumcision, except for the obvious point that she chose her tattoos, whereas most circumcised males didn’t choose it.

Gonna answer this publicly – not for any malicious reason (as I’m not mad at anyone!) but simply because I’ve had SO many people phrase this question in a way to make me feel guilty.

I got many of my tattoos when I was quite young. The one on my leg is (in my opinion) very obnoxious, as well as being a mess as it was a coverup. The ones I can see in the mirror just don’t make me happy anymore. I’m a different person to the one that got all of these tattoos and they just don’t reflect me anymore.

My problem isn’t the people asking – it’s the way people are putting it, with unhappy emoticons and saying ‘why? they’re great!’ well, perhaps to you, but this is MY body! i’m the one that has to look at them every day, and i no longer want them. that’s honestly it.

“‘Why don’t you want circumcision? Circumcision is great!’ Well, perhaps to you, but this is MY body! I’m the one who has to live with it every day, and I don’t want it.”


Science is more than intervention

Posted: November 11th, 2014 | Author: | Filed under: Ethics, Logic, Science | No Comments »

This thread fascinates me. I read as much as I could stand and was repeatedly amazed at the logic and tactics, especially those from self-professed “skeptics”. It’s also a useful insight into why I don’t use Facebook for activism. (To those who agree with me that non-therapeutic child circumcision is unethical, please don’t engage in the vitriol and name-calling in this thread. It’s wrong and hurts our efforts.)

In response to a picture (used without permission) of a man holding a sign¹ explaining his opposition to circumcision, the moderator for a group called “I fucking love vaccines” posted this:

Those evil “doctors”!!111! Performing minor operations on infants in sanitary conditions with proper pain relief, giving the lifelong benefits of prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. A procedure that would be significantly more complex and painful for an adult male.

If that’s a skeptic’s analysis, skepticism means nothing. Discussion of non-therapeutic child circumcision needs a thorough cost-benefit analysis because that is appropriate for proxy consent and demonstrates the ethical failing, not just the question begging of the benefit recitation provided above.

In response, a pediatrician² responded with a deeper analysis:

So I have to disagree with the sentiment here. I am a Board-Certified Pediatrician. When we look at the benefits of a procedure, we need to consider the Number Needed to Treat (NNT). In other words, how many boys do we need to circumcise to prevent one case of…something?

For HIV in the highest-prevalence regions of Africa, the answer is 72. 72 circumcisions must be done to prevent one case of HIV. That number hasn’t been calculated in the US, but with our much lower HIV prevalence and the fact that HIV in the US is primarily transmitted by anal intercourse, the number would be orders of magnitude higher. Even for unprotected anal intercourse, the NNT is over a thousand. For UTI in the United States, the answer is 200-300. For penile cancer the number ranges into the millions.

I can show that routine appendectomy reduces the risk of acute appendicitis by 100% and that routine tonsillectomy reduces the risk of tonsillitis by 100% and yet we don’t routinely perform either. So why are we performing a mutilating procedure on infant boys on a routine basis? It’s the only such elective operation we do. It flies in the face of medical ethics that we perform routine circumcisions on infant boys. And for that reason, I refuse to do them.

And yes, it’s mutilating. That isn’t a judgmental or emotionally-charged term in my usage. Any procedure that changes the appearance of the body is mutilating. That includes a medically necessary appendectomy. Now, I would never argue against a medically necessary appendectomy, but the key words are: “medically necessary.” Circumcision isn’t. And the proof is Europe, Asia, Australia, and New Zealand where these things aren’t done and yet their overall epidemiology for related conditions stay the same.

I do agree, however, that equating circumcision with female “circumcision” or “rape” is insulting to people who have been subjected to these things. I find that absolutely disgusting that any man would equate his circumcision to rape and complete excision of the clitoris.

I disagree that equating male and female genital cutting is insulting. The comparison is more complex than and focused on principle than “removal of the male prepuce is the same as removing the clitoris.” Non-therapeutic genital cutting on a non-consenting individual is unethical. That’s the principle. Everything else in the doctor’s comment is spot-on.

The moderator replied to the last paragraph:

Yeah, that is my issue with this actually and the whole reason I posted it. This does nothing but trivialize male violence against women.

Then why not post about that relevant issue instead of providing the one-sided, non-skeptical benefit recitation? But that isn’t the curious response. This is:

I also remain skeptical of your claims of being a pediatrician when you come into a socially charged thread never having commented on my page before and going against official recommendations in the US, but no biggie.

This is embarrassingly free of skepticism. It’s skepticism as a label rather than a process. I’m supposed to trust someone offering only the benefits of a non-therapeutic surgery on a child when that person can’t be bothered to do even a minimal amount of research to confirm a commenter’s identity? It took me about 60 seconds to find evidence that the Facebook profile matches a real person who is a pediatrician. This does not prove that the Facebook profile isn’t an elaborate scam to post biased, misleading comments on a random Facebook community’s rant. It could be, but that seems to require a few too many (convenient) assumptions.

Anyway, his job title is interesting, but there’s more than just an appeal to authority. Google exists for more than just verifying a random doctor’s identity. Does what he wrote hold up? Number Needed to Treat is a topic anyone can research. Is he explaining it correctly? Are his numbers accurate? What are the implications to the question of non-therapeutic child circumcision? But maybe I’m wrong and a skeptic doesn’t need all the information.

Of course, the moderator seems to value the appeal to authority fallacy. Better still would be to read the AAP’s technical report to see what it omits instead of merely regurgitating the inadequate abstract. I read the technical report. It is lacking.

Also, the “official” recommendation is that parents should decide, not that circumcised males are incorrect if they’re unhappy.

Next is a string of comments from people who don’t seem to understand that words have meaning and should be applied in a way consistent with their definitions. For example:

Consent is given by the parents. It is not forced when the parents give consent on their son’s behalf.

And:

Because the surgery is for the benefit of the child not to create harm. The use of the term “mutilation” is hyperbole to generate a negative emotional response. This dishonest technique is used by intactivists because the facts do not support their position.

Parents consent. The surgery is forced on children who do not consent. This is not complicated. It’s the essence of proxy consent. The question is whether that consent is valid on this topic. And the surgery is not harmless and cost-free merely because the parents don’t intend to do harm. I agree they don’t intend harm. But harm is inevitable, despite their intentions.

Nor is the use of the term “mutilation” hyperbole. The doctor made the case, but here it is in the context of another post from the moderator:

There were of course the inevitable hysterical people saying circumcision of infant males is equal to FGM, most of which occurs in the developing world in unsanitary conditions, and which offers ZERO health benefit, serious long term health complications and is considered a violation of the human rights of girls and women. There is no comparison between circumcision and FGM.

I am seriously skeptical of the skepticism of a lot of these commenters on what is supposed to be an anti-woo page are caricaturing medical doctors as being “savage” and “barbarians”… this is no better than what people against “Big Pharma” and the “Medical Establishment/”Western” medicine/Allopathy caricaturize doctors as.

I am offended by it and I do not even have any family members in the healthcare professions. Here is a link to some fact these hysterical/testerical dimwits should know about or stop ignoring.

http://www.who.int/mediacentre/factsheets/fs241/en/

*The procedure has no health benefits for girls and women.*
*The procedure has no health benefits for girls and women.*
*The procedure has no health benefits for girls and women.*

Not only do you show your lack of scientific understanding but you also engage in vile misogyny when you compare to FGM, a HUMAN RIGHTS VIOLATION to basically harmless infant circumcision.

That link is full of gender-neutral principles arbitrarily assigned a gendered difference. When the WHO states that “[i]t involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies”, we can ask ourselves if we’d dismiss that if its preceding sentence stated “FGM has health benefits…” I believe the overwhelming response would be “no”, as it should be. Change the pronouns. The principles remain the same. Genital cutting without need or consent is mutilation.

I also invite anyone to read through my archives to see if I’m a dimwit who doesn’t know about or who ignores the facts about FGM.

More on mutilation:

Except that circumcision is not an act of physical injury that degrades appearance or function, so once again, your own definition does not support calling circumcision mutilation.

Assuming the perfect form comes at birth is rather ridiculous when you consider evolution does not select for perfect. If the foreskin was perfect there would have not been the need to make surgical improvements starting several millennia ago.

“Degrades appearance” is subjective to the individual circumcised. That it degrades function is not up for debate, or at least not that it alters function. If you change the form, you change function.

The evolution bit is mere question begging. There is no “need” to alter healthy genitals. Evolution didn’t screw up. Most males (and females) live normal, healthy lives with their prepuce. And notice how circumcision becomes a “surgical improvement”. It’s always “heads I win, tails you lose” on every subjective question.

Next comes the tired false dilemma fallacy about how only one side loves science:

You would advocate against a procedure with medical benefits? OK. I admire your honesty in admitting that even though it makes you look like a callous jerk.

“Why do you want babies to get UTI-laden HIV Cancer, you monster?” Except, that’s not the only choice or the only (or likely) outcome from leaving a child with all of his (or her) normal, healthy genitals.

Finally:

the big mean doctor touched my wee-wee!

“[T]he big mean doctor touched my wee-wee with a scalpel without medical need” is the scenario. If you must offer unfunny ridicule, at least attempt to ridicule what’s happening. That’s if this community’s form of skepticism involves facts, which I’m unconvinced it does.

¹ I’ve made my opinion clear on the accuracy and value in calling circumcision “rape”. I stand by that here.

² I’m not using names here because they’re irrelevant for my purpose here. Click through the links, if you wish.


Circumcision Is

Posted: September 8th, 2014 | Author: | Filed under: Ethics, Logic, Parenting | 4 Comments »

In a comment on a post last month, paper0airplane wrote:

Sorry this comment had a typo, and now apparently my blog is being screen capped and line by line minutia is being debated so I want to make sure there’s no confusion or conspiracy theory because I delete or edit the comment lol.

Act shocked when I note that paper0airplane has used screen caps five times in posts in the last month. Some of that appeared to be in direct response to my criticism of unsupported claims. And I’m not actually criticizing the use of screen caps. I think they can be useful, as some of those links show, even if their point is incorrectly generalized. If it helps make the point, and they’re presented as fairly as possible, why not? For example, they can demonstrate when someone deleted a post, as this screenshot shows that paper0airplane deleted a post without comment.

That’s merely an intro for my “line by line minutia” response to this post.

Medical Circumcision and Brit Milah is not…

Circumcision is not rape

On the obvious intent of that statement, I agree. This has been the biggest frustration for me recently. It’s offensive. It isn’t effective. There’s more nuance involved, which I addressed in Truth and Loaded Words, but that isn’t how “circumcision is rape” is used. So, here, the core point remains. I agree with paper0airplane.

Circumcision is not violence

To the extent that paper0airplane probably means “intent” to injure or harm, sure. But that’s a pedantic way to address it. Circumcision is violence. There is a foreskin. Then there isn’t a foreskin. The foreskin doesn’t just fall off without specific action. That action is violence.

Circumcision is not dangerous

Again, I suspect paper0airplane means “intent”. Again, that’s a pedantic way to address it. Or the claim is that complications are usually minor. Either way, it’s wrong. Circumcision is objectively dangerous. There is always risk involved. How dangerous it is and whether that danger is worth the trade-offs are subjective. The problem here is that in paper0airplane’s view, the subjective preference of a (male only) child’s parents is enough to ignore the objective danger involved without concern for the child’s preference (or – obviously – need, as the circumcision we’re discussing is non-therapeutic). If circumcision weren’t dangerous, the death rate would be zero. The complication rate would be zero. Neither rate is zero. And there is objective harm in every instance. Circumcision is dangerous. When circumcision isn’t therapeutic, proxy consent is unethical.

Circumcision does not ruin your sex life

Probably, although I hope we can agree that a boy who loses his penis or his life probably has a ruined sex life. Policy from the margins is usually bad. Ignoring the margins for policy is usually bad. This does the latter, which is unacceptable here because there are individual human rights involved. It’s foolish and cruel to treat individuals as mere statistics within the group. We can’t know which boys will actually have their sex life ruined. We can know that some will. For a non-therapeutic intervention, that is indefensible.

Circumcision does not mean your parents didn’t love you

Circumcision is almost never the reason you’re not enjoying sex

Almost certainly, although the same caveat about the margins applies.

Circumcision does not increase sales of Viagra or increase ED

I wouldn’t make the opposite claim because I can’t prove it. A citation for the negative claim would be appropriate for such a definitive stance.

Circumcision does not make someone a pervert

I read this as “circumcising”, not “being circumcised”. Both are obvious. To the former, support for bodily integrity rights for all people (i.e. opposition to non-therapeutic male child circumcision) does not make someone a pervert, either, despite the ease with which some propagandists casually lob that smear. To the latter, being circumcised does not guarantee a preference for being circumcised, regardless of how many times someone like Brian Morris¹ trots out the irrelevant “regarded by most men and women as being more attractive”.

Circumcision does not make someone a cripple

In the generalized context, this is true. How much can we debate the crippling effect of rare-but-serious complications from (non-therapeutic) circumcision? This is about individual rights, so individual outcomes matter.

Circumcision is not replaceable with a made up ceremony for Jewish boys

It seems like there are Jewish individuals who disagree with that point. Even if that false claim were true, individual rights in a civil society must trump the religious rights of another individual over that person when the rite inflicts objective harm. Circumcision inflicts objective harm, regardless of the obvious-but-irrelevant implication above that parents do not intend harm. Of course they don’t, usually. But circumcision always inflicts harm. So, even if I grant paper0airplane’s point here, it’s irrelevant. Religions must adapt, not human rights.

Circumcision is not to blame for everything wrong in the world

Agreed.

Circumcision is not on the decline

Please provide a citation. Even Brian Morris recognizes that circumcision among newborns has declined. That paper claims an increase to 81%, but I hope we can agree that an increase from 79% to 81% among 14 to 59 year old males is hardly the demographic in this debate. Where those 14 to 18 who don’t consent matter here, the remaining males in that group are irrelevant to this part of the debate. (Note, too, that he states, “Delay puts the child’s health at risk and will usually mean it will never happen.” A delay that means circumcision will usually never happen means that circumcision will never be necessary or needed. That’s damning.)

Circumcision is not used to routinely acquire foreskins for cosmetic or medical uses and never without parent’s informed consent

This asks used and routinely to do too much work, to the point of question begging. Are neonatal foreskins routinely used for cosmetic or medical purposes? No, I don’t think so. Does it happen? Yes. Whatever happens to the foreskin matters, whether it’s used for another purpose or is tossed in an incinerator. It matters because the foreskin belongs/belonged to the individual, not his parents. Their informed (or uninformed, which is also permitted) consent to this non-therapeutic surgery isn’t sufficient to negate his right to self-ownership. A male’s foreskin is part of his self. He owns it.

And until things change with presentation…

Intactivism will not succeed at changing minds.

That’s a weirdly broad statement. But I agree with the implication that making unsupported claims, tossing around hyperbole, and generally being an ass are unhelpful, at best. In the sense that people who nominally share a goal with me believe those are acceptable, there is work to do. And I’ll state it as many times as it takes for the point to be internalized into others’ activism, circumcision is not rape. This claim is offensive and unhelpful.

May I trust that the same expectation to improve one’s activism applies to those who (mistakenly) believe that parents have a right to choose genital cutting (for their sons only – of course, somehow)?

¹ I never provide hyperlinks to Brian Morris’ site. Throw a dart at any paper he’s authored and you’ll probably find this claim. Regardless, the specific quote is from the summary page of his site.


Facts about circumcision

Posted: August 30th, 2014 | Author: | Filed under: Ethics, Logic, Mission, Pain, Parenting | No Comments »

Here is another good video about circumcision from Dr. Lindsey Doe, a clinical sexologist.My only caveat: I’m not a fan of the book Dr. Doe recommends at the end. I’ll post a review here eventually to explain why.


“Enough. No. I will protect my son.”

Posted: August 1st, 2014 | Author: | Filed under: Ethics, Logic, Parenting | No Comments »

There is so much to praise in this post from a mother who researched and rejected circumcision for her son. I like this the most:

So if you’re still reading, you are probably thinking, “Damn, okay you didn’t circumcise your little boy. He didn’t feel the pain, and his penis is just fine. So why are you still talking about it?”

I’d answer you with this: If everyone just stopped talking about it, where would mothers like me who were wavering in their decision find the information and the courage to say, “Enough. No. I will protect my son.” I was so lucky to know a woman who was passionate and outspoken, and at times even aggressive, about educating parents and protecting baby boys. She was such an invaluable resource for my entire pregnancy and labor/delivery and continues to be a good friend. She truly gave me strength. There were times when I may have given in to my husband and others pressuring me, but this woman gave me strength. She made me realize that it IS a BIG DEAL. No baby deserves to suffer through a needless surgery like circumcision. Thank God for her. She sparked something in me, and now here I am trying to pass it on to you.

The full post has a lot to offer. I recommend it.