Talk:Circumcision/Archive 11

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Apology

I'm new here, and made an addition which may have been precipitate (the one concerning Syphilis, Chancroid and Herpes Simplex), which occurred to me after reading the linked article. After reading a little of the debate here, I realise that it would probably have been better to suggest it here first. The section in question goes as follows:

"Syphilis, Chancroid and Herpes Simplex A recent systematic review [41] has suggested that there is strong evidence for a protective effect of circumcision against Syphilis or Chancroid infection, but only weak evidence for a protective effect against Herpes Simplex."

Does anyone have any objections to this addition? —Preceding unsigned comment added by Procrastinator supreme (talk • contribs)

The text is fine - it's sourced and represents the source accurately - but it might be better suited to Medical analysis of circumcision. I'm concerned that we're beginning to duplicate a lot of the content from that article. Incidentally, please could you sign your comments with ~~~~? Thanks. Jakew 11:09, 9 April 2006 (UTC)

OK, thank you. I'll move it over there, and I might also change the heading to "other STIs". Procrastinator supreme 12:12, 9 April 2006 (UTC)

Dubious sections

The following two paragraphs are in dire need of citations. They look very much like original research to me. Can anyone find anything?

Circumcision may be undertaken as a body modification of the genitals to change the looks of the penis to appeal more to certain aesthetics. Where infant or childhood circumcision is the norm, people may consider non-circumcised penises to be less preferable sexually, visually or otherwise. In cultures where circumcision is not the norm, it may be viewed as a mutilation. In a few cultures, circumcision may be one of other modifications of the penis, such as a split penis or a subincision.

If a man wants to be circumcised, he can agree to the procedure as a consenting adult. However, a man who is aggrieved at having been circumcised as an infant or child is unable to replace the removed foreskin, and restoration using extension of the remaining skin will not replace the missing nerve endings of the original foreskin.

Also: "Therefore, debate often focuses" suggests that this is the only possible reason for this aspect of debate, and it is always the reason for it. That looks to me as though the author is explaining the debate in general in terms of his POV. Jakew 12:51, 20 January 2006 (UTC)

1. What exactly do you need citations for? What notion do you not grasp and figure it must be original research?
2. Well, that should probably be changed to "debate currently focuses" because merely 20 years ago, there was much more debate going on about the medical benefits for example. But as this question is mostly answered nowadays by the medical community, only today the debate does more often focus on the ethical aspects of the procedure. Dabljuh 16:06, 20 January 2006 (UTC)

The whole thing is a mass of original research and weasel words. Circumcision "may be" this and "may be" that. People "may consider" this. Or not. Or something else entirely. As for the medical benefits, you're right, there now appears to be general agreement in the medical community that they exist; the questions seem to center on whether or not they outweigh the potential risks involved in the procedure. Jayjg ^(talk) 17:27, 20 January 2006 (UTC)

No, you are mistaken about that: There is, at large, a consensus that the benefits do not outweight the risks, making routine circumcision not recommended. Some individual doctors or you and Jakew may disagree with that notion, but given that no major medical organization disputes this, it would be misleading and very much not NPOV to imply that. The debate does indeed currently focus on the ethical aspects. Dabljuh 17:34, 20 January 2006 (UTC)

It's unclear what part of what you are saying disagrees with what I just said, so I don't see why you assert I am "mistaken". Regarding "consensus", medical consensus on any subject lasts for as long as the consensus lasts, then it changes; it's not written in stone. As for the health aspects themselves, new research is being done all the time, for and against. In any event, your personal opinions on the focus of the debate today is interesting, but not amazingly relevant to verifiable article content. Jayjg ^(talk) 17:39, 20 January 2006 (UTC)

The existence of medical benefits alone is not a sufficiently good justification for surgery on children. The medical benefits of the surgery must significantly outweigh the risks and harms for a surgery to meet the normal standard of care for infants and children. There are medical benefits to cutting off a child's toes. If you cut off a boy's toes, he will never get athletes foot or ingrown toenails. However these medical benefits do not significantly outweigh the risks and harms of cutting off a boy's toes. You are overlooking the fact that there is a broad consensus among professional medical organizations that there is no NET medical benefit of circumcision of healthy boys. (see Medical organization statements)

Only a few pro-circumcision advocates argue that the medical benefits of circumcision of healthy boys outweigh the risks and harms. There is a broad consensus in the international medical community as expressed in the official policy statements of professional medical organizations that the small potential medical benefits of circumcision do not outweigh the risks and harms. For this article to be NPOV it must accurately reflect the broad consensus of professional medical organizations that there is no medical indication for the circumcision of healthy boys. -- DanBlackham 08:51, 21 January 2006 (UTC)

The recommendations of these organisations are clearly stated in the third paragraph, Dan. Jakew 12:49, 21 January 2006 (UTC)

You know, it's funny that the AMA and BMA are telling me that there's a debate in the medical community, with strong views in many directions, and you, Dabljuh, are saying that there's a consensus that the benefits do not outweigh the risks. Hmm. Jakew 17:45, 20 January 2006 (UTC)

Ok, if there is no consensus, how many major medical organizations do recommend circumcision for medical reasons then? Dabljuh 18:04, 20 January 2006 (UTC)

Policies are written by a committee, not the entire organisation. Jakew 19:44, 20 January 2006 (UTC)

The debate is about circumcision for cultural and religious reasons, not about circumcision for medical reasons. There is a broad consensus in the international medical community that the medical benefits of circumcision do not outweigh the risks and harms. (see Medical organization statements) This article and the Medical analysis of circumcision article should accurately reflect that broad consensus. Some doctors argue that there are cultural and religious benefits to circumcision. Therefore the current debate is whether or not the alleged cultural and religious benefits of circumcision of children outweigh the risks and harms. -- DanBlackham 09:28, 21 January 2006 (UTC)

Interesting hypothesis, Dan, but not according to the BMA under the heading 'Health issues': "There is significant disagreement about whether circumcision is overall a beneficial, neutral or harmful procedure. At present, the medical literature on the health, including sexual health, implications of circumcision is contradictory, and often subject to claims of bias in research." Nor the AAP's response to critics: "There is no disagreement between the Task Force and the authors over the fact that there are potential medical benefits to circumcision. There is disagreement over the magnitude of these beneficial effects. The Task Force found the evidence of low incidence, high-morbidity problems not sufficiently compelling to recommend circumcision as a routine procedure for all newborn males." And the AMA tell us: "Debate on the wisdom of routine circumcision centers on the possible benefits offered by circumcision, and whether they medically justify the risks associated with the procedure."

So the medical organisations are quite clear: debate is about medical benefits vs risks. Jakew 12:48, 21 January 2006 (UTC)

Of course, but we cannot judge the prevalence or significance of the pro circumcision arguments by any other way than to count how many of the relevant organizations recommend for circumcision. If there was a significant number of national organizations that would recommend routine infant circumcision, the situation would be wholly different, of course. As I said, within an organization, there is always debate - this is necessary to find a policy, ultimately. Dabljuh 19:48, 20 January 2006 (UTC)

Inevitably, such a policy will represent a compromise - an averaging process - between those responsible for it. Jakew 19:57, 20 January 2006 (UTC)

Terminal Phimosis?

• At that time, deaths attributed to phimosis and circumcision were grouped together, but Gairdner stated that the deaths were probably due to circumcision.

What the hell? Dabljuh 18:35, 20 January 2006 (UTC)

The reasoning is probably like this: patient is diagnoses with phimosis, doctor decides to circumcise, patient dies, cause of death: phimosis. Just like babies do not die or have brain damage due to their circumcision, it's caused by a hemorrhage. --ZimZum 18:55, 20 January 2006 (UTC)

Well, to put it in Jakew's words "MMMH sounds like original research" (Removing it) Dabljuh 19:03, 20 January 2006 (UTC)

No, it's not original research. Gairdner himself explained: "The Registrar-General groups circumcision and phimosis together, but in view of the fact that "phimosis," as the term is commonly applied to infants, is physiological (see below) it is probable that the great majority of these deaths were attributable to operation rather than to any pathological condition necessitating operation." Jakew 19:47, 20 January 2006 (UTC)

Well, the old formulation anyhow is confusing to read, and even misleading. Terminal Phimosis? Seriously... Dabljuh 19:50, 20 January 2006 (UTC)

Gairdner only stated that it was 'probable'. Let's not go any further than that. Jakew 19:54, 20 January 2006 (UTC)

... not go any further? And leave it in the old fashion which implies there is such a thing as terminal phimosis? Are you kidding? Dabljuh 20:36, 20 January 2006 (UTC)

Gairdner evidently felt it necessary to explain this caveat, and also chose to use the word 'probable'. Do you feel, as a result of reading his paper, that you know something he didn't? Jakew 22:23, 20 January 2006 (UTC)

I have never ever heard of actual "deaths by phimosis". Dabljuh 22:41, 20 January 2006 (UTC)

Neither have I, though I can accept it's a possibility (probably very rare though). Acute phimosis can cause dysuria, which in turn can cause kidney damage. Anyway, I'm making the working assumption that, since Gairdner was medically qualified and knew enough about the subject to write about it, he had his reasons for his explanation and choice of words. Jakew 12:18, 21 January 2006 (UTC)

All I'm saying is that it would be confusing and possibly misleading to the casual reader. The source is there, if someone really wants to know it in that level of detail, that's, well, what the source is for. Dabljuh 18:29, 21 January 2006 (UTC)

Well, there's a problem, because if we don't include his caveat, we're effectively misrepresenting the source. Jakew 18:52, 21 January 2006 (UTC)

Not exactly. If we do, we imply there is such a thing as "Terminal phimosis" and tbh, that would be outrageously OR, I'd want a lot more sources than just gairdner's fuzzy statement that explicitely say there is such a thing. Dabljuh 18:58, 21 January 2006 (UTC)

Seconded, don't be unreasonable Jakew. --ZimZum 19:02, 21 January 2006 (UTC)

It's not OR to note that Gairdner made this comment. Jakew 19:14, 21 January 2006 (UTC)

No, but it has no relevance to the article either. You're making the editing of this article a pain in the ass for others by holding on to futilities like this. What are your exact motivations for listing this information? And if you have none please drop it. --ZimZum 19:23, 21 January 2006 (UTC)

It has every relevance. Gairdner clearly states a weakness in his methodology, and you want to exclude that fact from Wikipedia. Gairdner says these are probably due to the operation, while the article implies it's definite. It's a misrepresentation of the source.

Its misleading. We'd then also have to explain, in the same sentence, that infant phimosis is "natural", often misdiagnosed, that its treatment at the time was circumcision, etc etc. That just isn't reasonable. Dabljuh 19:25, 21 January 2006 (UTC)

Solution: quote Gairdner's explanation directly. This includes his position that infant phimosis is physiological, thus addressing both of our concerns. Jakew 19:35, 21 January 2006 (UTC)

Lets not. Alternative: Lets say something like this

• Gairdner's 1949 study reported that 16 children under 5 years per year died in the UK during the 1940s, a rate of 1 in 6,000, for both non-therapeutic infant circumcision and treatment of phimosis combined. Gairder stated that most deaths had occurred suddenly under anaesthesia, and couldn't be explained further, but haemorrhage and infection had also proven fatal.

Dabljuh 19:41, 21 January 2006 (UTC)

No, we can't say that. 1) Gairdner didn't specify non-therapeutic infant circumcision, and 2) he said 'phimosis', not 'treatment of phimosis'. That changes 'circumcision grouped with phimosis' to 'circumcision for one reason grouped with circumcision for another reason'. Jakew 19:45, 21 January 2006 (UTC)

Well then we won't change anything, because we can't quote that sentence out of context either. Dabljuh 19:47, 21 January 2006 (UTC)

Why not? It's relevant (evidently the source we cite thought so, anyway), it addresses your infant phimosis concern, it's obviously not OR to quote a source. What could possibly be the problem? Jakew 19:57, 21 January 2006 (UTC)

Sidenote: How did the QLRC interpret Gairdner's data? Lets read: Gairdner referred to a United Kingdom mortality rate of 1.8 per 10,000 circumcisions. Any questions? Dabljuh 19:53, 21 January 2006 (UTC)

One: Since when was Wikipedia the QLRC? Jakew 19:57, 21 January 2006 (UTC)

Assuming that we are not qualified to properly interpret that data, we need to see how someone else, someone qualified, someone authoritative interprets gairdner's findings. Now... the QLRC doesn't think there should be any mention of the lethality of terminal phimosis, neither should we. Give it up. Dabljuh 20:14, 21 January 2006 (UTC)

Would you care to explain why a law commission report, authored exclusively by non-physicians, is better qualified to interpret medical data? Furthermore, what evidence is there that QLRC actually considered its inclusion, and didn't simply overlook it? Jakew 20:26, 21 January 2006 (UTC)

The number of deaths presumed to be due to these causes is shown in the accompanying Table. The Registrar-General groups circumcision and phimosis together, but in view of the fact that "phimosis," as the term is commonly applied to infants, is physiological (see below) it is probable that the great majority of these deaths were attributable to operation rather than to any pathological condition necessitating operation.

If I read this correctly the question isn't if the death was caused by phimosis, but if the circumcision itself was necessary. This question however isn't relevant for this particular part of the article. --ZimZum 23:32, 21 January 2006 (UTC)

Well, since we evidently disagree on the interpretation, the obvious choice is to simply quote the passage and let the reader decide. Jakew 15:09, 22 January 2006 (UTC)

Don't be ridiculous. You can't write a NPOV article by quoting vague and confusing information. --ZimZum 19:37, 22 January 2006 (UTC)

Really? I would think that when people disagree about what a source says, the only thing to do would be to actually quote the source. How do you propose determining just what Gairdner meant - a Ouija board? :-) Benami 19:47, 22 January 2006 (UTC)

Lifetime Risk

http://www.medterms.com/script/main/art.asp?articlekey=39200

The lifetime risk definition currently used in the article isn't following medical standards I think. It's also counter intuitive, and I asume a readability improvement is always good. So I'm changing this to 0.17% which is rounded up. --ZimZum 22:49, 20 January 2006 (UTC)

Logically, all other 1:whatever odds should be expressed as percentages, then. Dabljuh 22:56, 20 January 2006 (UTC)

Depends on the formulation, in the other cases the odds are defined clearly. Lifetime risk adds the average life expectancy to the calculation, making it less intuitive. --ZimZum 23:02, 20 January 2006 (UTC)

Some of the probabilities (e.g. for death) are way too low anyways to be reasonably expressed as a percentage. Dabljuh 23:04, 20 January 2006 (UTC)

We should express it in the same way that the cited source expresses it. Jakew 12:10, 21 January 2006 (UTC)

What policy are you refering to? Regardless, it's unclear what 1:600 refers to in the old article. Also, to be in line with the rest of the article we ought to use the 1:200000 yearly incidence ratio some studies show instead. --ZimZum 18:59, 21 January 2006 (UTC)

I find the lifetime risk to be a more useful, intuitive figure though. Dabljuh 19:06, 21 January 2006 (UTC)

Agreed, but it should be listed as 1/600 in that case like other studies do. And when you're going to use 1/600 you might as well use a percentage to enhance readability.

I think that we need to use either percentages or ratios. It's harder to make comparisons between different studies cited if you have to convert their figues. Benami 20:42, 22 January 2006 (UTC)

How about a compromise? We present the figures in a standardised form, but when this differs from how it was originally presented, we are careful to note this. Jakew 20:48, 22 January 2006 (UTC)

I think that makes sense...as long as I don't have to do the math. Benami 20:52, 22 January 2006 (UTC)

I smell a...

I smell a featured article here. Seriously, it's beautiful how this sorry mess has turned into a butterfly. I'm very proud of myself (ha!) and everyone else who helped to contribute. The article is fairly neutral, excellently researched, informative, and probably the highest number of sources in any article ever... Sure, here and there, some thingies can be fixed, I really want to have the section about Masturbation back, and if we really want to turn this into a featured article, we'll have to work on many of the related articles as well, but so far... Great work everyone! Dabljuh 11:11, 22 January 2006 (UTC)

Related vs See also

I think that Jakew's revision makes sense. Using the two categories for other articles is really making a distinction without a difference. Benami 19:59, 22 January 2006 (UTC)

Thanks. It also avoids subtly introducing POV. Jakew 20:15, 22 January 2006 (UTC)

Yes, because in the absence of a real difference, any purported difference is necessarily POV. Benami 20:24, 22 January 2006 (UTC)

Well we can merge them into one category of course, I just figured it was nicer on the eye and more organized. Dabljuh 21:46, 22 January 2006 (UTC)

So we have...

The Medical College of Georgia's description of the Plastibell procedure vs one written by either George Hill or Geoffrey Falk (neither of whom are doctors), and packed with propaganda. And you seriously think the latter one's more useful to readers? Jakew 20:19, 22 January 2006 (UTC)

Jakew's link may have gone to an educational website with English problems, but Zimzum's link to a Cirp page went to a description that was really, really, really POV. Benami 20:20, 22 January 2006 (UTC)

Explain to me what is so POV about the page? Besides that pictures of cosmetic surgery on an infant are disturbing? --ZimZum 21:38, 22 January 2006 (UTC)

Who mentioned the photos as the problem? Not me. Not Jakew, AFAIK. The commentary that goes along with the pictures, on the other hand, is terribly POV. It doesn't even pretend to use clinical language ("torn apart", "raw and bleeding glans"). It's designed to inflame. The U Georgia site is therefore superior. If you can find pictures without the inflammatory language, go for it. Benami 21:58, 22 January 2006 (UTC)

Pictures > No pictures. Simple matter. Dabljuh 21:45, 22 January 2006 (UTC)

Clinical description > inflammatory propoganda. Even simpler. As stated above, if you can find photos without the inflammatory commentary, go for it. Benami 22:00, 22 January 2006 (UTC)

Quite so. It is clearly intended to dissuade rather than to inform. Plugs are included about the foreskin's supposed value whereever possible. A gratuitous photo ("ouch.gif") of what is clearly a different baby is even thrown into the middle, apparently for shock value. Jakew 22:10, 22 January 2006 (UTC)

Is there a medical word for torn apart? Raw and Bleeding are medical terms. I wouldn't call this inflammatory propaganda. These are also the only slightly disputable lines in the article.

Most of the text is informal, and there is no plug about the supposed value of the foreskin. Ouch.gif is clearly intended to give an impression of a circumcision without anaesthetics, if this is shocking so be it.

I don't see any reason to provide a far less informative source, but if you guys can provide a better site I'm all for it. As far as I can see the main motive for this dispute is censorship. --ZimZum 22:28, 22 January 2006 (UTC)

The clinical term for separating the foreskin and glans is 'separate', as used in "Separate the foreskin away from the glans", as the MCG describes it.

More examples: the page begins by offering a sound only video of the procedure. (Explanatory? No. Shock value? Yes.) Yet more propaganda: "(In this illustration, the normal infant penis can be seen, with its foreskin covering.)" (No kidding the foreskin's there at the beginning of the procedure - this is just an excuse to call it 'normal'). And again: "to prevent the entry of foreign matter (eg. fecal matter)." (Completely unnecessary fact, sole purpose is to plug the foreskin's 'value'). "Naturally, this is painful." (But they've just told us above that anaesthetics may be used...) "The slit is separated and the foreskin is laid back, exposing the raw and bleeding glans." (Look closely at the photo. The glans is neither raw nor bleeding.) "Circumcision removes (on average) one third of the penile skin system (sensitive inner and outer preputial layers), including the peripenic dartos muscle, the frenar band, and part of the frenulum." (Yet more plugs, which do nothing to aid our understanding of the plastibell procedure.) "See also: In Memory of the Sexually Mutilated Child by John A. Erickson" (Assuming you hadn't already put up with enough propaganda, let's hint at the M-word and direct you to another propaganda site)

I'm sorry, this is just propaganda. Compare with the other site, which simply explains, using clinical language, what is done, without trying to present it as good or bad, nor trying to persuade or dissuade. Jakew 22:43, 22 January 2006 (UTC)

I wasn't sure about what weight the link to the Erickson site should have, but it's clearly propoganda, too. Benami 22:50, 22 January 2006 (UTC)

The problem is, the other page explains the procedure pretty badly. Circumcision is something that has to be explained with pictures to be understood by laypeople - Most don't know what a glans is or a frenulum. Fuck, most don't even know what a fucking foreskin is! If you find a more "objective" page describing the process of circumcision GOOD and with pictures, go ahead, post it. I could say, the other pages are not NPOV either because they hide or downplay what the procedure entails. Its just one out of four links, the other URLs are already quite "dry" in that sense and lacking pictures. So what's the problem exactly? Dabljuh 22:55, 22 January 2006 (UTC)

If you can find another page with pictures that is more neutral in its portrayal, please feel free to replace the MCG. Jakew 22:59, 22 January 2006 (UTC)

I don't seriously think that anyone with access to the plethora of penis photos on WP is likely to be kept in the dark about what a frenulum, or glans penis, or foreskin are for very long, do you? And yes, descriptions of medical procedure are generally dry, by design. Their intent is to inform, not persuade or appeal to emotion.Benami 23:07, 22 January 2006 (UTC)

Holy shit: From the MCG link:

• Pain control: usually unnecessary for newborn; Acetaminophen for older infant

Sorry but that doesn't cut it as a reliable source. Dabljuh 23:12, 22 January 2006 (UTC)

Really? Says who? Just exactly how much pain control do you usually prescribe for an infant post-circumcision, Dr. Dubljuh? A morphine drip? :-) Seriously, how do you know that this is unacceptable? Benami 23:20, 22 January 2006 (UTC)

Please could you point to the relevant policy that defines 'reliable source' as 'one that Dabljuh agrees with'? Jakew 23:22, 22 January 2006 (UTC)

The page implies newborn infants don't feel pain. Which we know is not true. Dabljuh 23:27, 22 January 2006 (UTC)

No, it doesn't imply that. Jakew 23:41, 22 January 2006 (UTC)

If it implied that infants don't feel pain, it would hardly have the bit about lidocaine.Benami 00:10, 23 January 2006 (UTC)

I found the following alternative: http://www.danheller.com/circumcision.html which isn't tainted by intactivism. More like the opposite, but I don't particularly care. --ZimZum 23:17, 22 January 2006 (UTC)

Looks good to me. Btw jake, that RV you just did was really, really, really dumb. Dabljuh 23:19, 22 January 2006 (UTC)

Does have pictures, but that's a Gomco, and has little description. No objection to its inclusion, but not as a 'description'. And no, it wasn't dumb. The 'related' heading expressed violated NPOV, as explained above. Jakew 23:22, 22 January 2006 (UTC)

That makes it even dumber. A) "Related" = modifications to genitals? Hard to grasp a concept? B) I changed the title of "related" that YOU objected to, to "See also". Dude would you please stop just rv'ing every edit of mine without even looking at it? Dabljuh 23:27, 22 January 2006 (UTC)

You want to include modifications to genitals? Why stop there? Why not list all possible forms of surgery? That's 'related', too, right? Hey, let's broaden the scope further and say that anything that can be done with a knife is related. See the problem here? You may see it as a form of body modification, but lots of people don't. The original article made that clearer than the current version. Hence many would disagree that they're related, and stating or implying that they are imposes your POV on them. Jewish people, for example, see circumcision as a sacred ritual, and it would (I assume) be offensive to them to imply that it's similar to some guy splitting his penis in half. Now before you ask, I'm not arguing for a moment that we shouldn't quote somebody who says the procedures are similar - but let's not subtly endorse a particular POV in the very structure of the article.

I removed those items in an earlier edit (which you effectively revert here). I see you changed the title now. Nevertheless, for the reasons I've just stated, I think it's really inappropriate to include them. Jakew 23:41, 22 January 2006 (UTC)

I think it would be helpful to list other pediatric surgeries that have a similar ratio of benefits to risks and harms as infant circumcision. What other surgeries are there that doctors will perform on children with a similar ratio of benefits to risks and harms as infant circumcision? -- DanBlackham 00:18, 23 January 2006 (UTC)

Thanks for finding those photos. They are educational, but at the same time they are very disturbing. They are disturbing because in all probability there was no medical indication for cutting off a normal, healthy part of that boy's penis. In other words there was no medical condition present that required surgery for treatment. -- DanBlackham 00:48, 23 January 2006 (UTC)

I found a description with pictures here, but it's a circlist page, and I don't think it's very encyclopedic. Benami 23:49, 22 January 2006 (UTC)

Eh, reliable is relative. If it is corroborating the other sources about the exact procedure, and has pictures, and is more readable in layman's terms, it's better. Dabljuh 00:13, 23 January 2006 (UTC)

Subtle POV in article structure

I see that, once again, certain items have been introduced into the 'see also' section. I see, too, that an attempt was made to reintroduce the 'body mod' tag into the article, as discussed below. My comments apply to both, but I'm putting them in one place for the sake of simplicity.

By 'structure' I mean the choice of title, the division of the article into sections and their corresponding headings, categories, 'see also' and other ways of directing readers to other topics, infoboxes, and so on. Broadly speaking, I'm referring to the context in which the body text is presented.

I'm sure that everybody would agree that the structure of an article can explicitly introduce POV. Consider, for a rather silly (not to mention extreme) example, an article entitled "why brussels sprouts are disgusting". My concern here is more with implicit POV.

Whether presented as 'related material', 'see also', or a series of articles, a substantial number of articles are presented, explicitly or implicitly, as related (think about it: if you saw 'Jet engine' in there, you'd immediately think 'what does that have to do with circumcision', wouldn't you?).

What one considers related depends upon one's point of view. Off the top of my head, I can think of a number of points of view on circumcision. Anti-circumcision/genital integrity activists often compare it to FGC and so on, and often compare adult circumcision to body modifications such as piercings, tattoos, etc. A prospective parent might think of choices such as breastfeeding, home birthing, etc. A community surgeon might think of other minor surgeries. A paediatrician might think of procedures commonly performed in infancy, such as vaccinations, etc. A pro-circumcision doctor might immediately think of preventative medicine, etc. That's five points of view already, and there are obviously countless others - I haven't even touched the religious points of view, for example.

There simply isn't room in the article's structure to list every conceivable issue that might be related from someone's point of view. The 'see also' section has more than twenty items already - far too many. As for related article ('part of the X series') boxes, if we included one for every point of view there would be no space for the article! And clearly, choosing one POV for determining what's related violates NPOV.

Obviously, there is quite a lot of common ground. 'Penis' and 'foreskin', for example, and those with 'circumcision' in the title. I propose that we stick to those, and include at most a small number of others that represent other points of view without one dominating the others. Jakew 12:43, 23 January 2006 (UTC)

Well, NPOV commands us to be objective and neutral. Circumcision, objectively and neutral, is a irreversible modification to the genitals for aesthetic, cultural, medicinal (if therapeutic), or religious reasons.

Let's think about what different people would be looking for if they looked up Circumcision. What do you recommend? Vaccines? Breastfeeding? Preventive medicine? Home birthing? Are you high or what? I mean seriously, are you completely losing it? On the other hand, let's see what you did remove originally [1] and ultimately: [2]

• Castration
• Female genital cutting
• Genital_bisection
• Meatotomy
• Penectomy / Penis_removal
• Subincision

And because you perceive these links to be POV, you argue rather than adding "Vaccination" and "Breastfeeding", they should be removed.... I fail to find the words!

Again, lets be super duper objective and neutral here: All of these things are, objectively and neutral, irreversible modifications done to the genitals for aesthetic, cultural, medicinal (if therapeutic) or religious reasons. How exactly does Breastfeeding match into that picture? Have you finally and absolutely LOST it? Dabljuh 09:54, 27 January 2006 (UTC)

Yes, I agree, they do unquestionably alter the genitals. They are also unquestionably things that are done with knives. The complete list of things that unquestionably have something in common with circumcision is doubtless enormous, and we have to keep the length of the list reasonable in size. That means that we must exclude some items. The only question is which ones.

As for breastfeeding, you need to try to think from the perspective of a prospective parent here. You're expecting in, say, 2 months. You're making parenting decisions. Whether to circumcise? Whether to breastfeed? See the connection? Jakew 10:11, 27 January 2006 (UTC)

I suspect that the idea of cutting off a normal, healthy part of their son's penis without a medical indication never enters the mind of most European parents or most South American parent or most Japanese parents. For most people in the world male circumcision has no more relationship with childbirth than female circumcision has with childbirth. -- DanBlackham 11:19, 27 January 2006 (UTC)

Thank you, Dan. Since my point is that what is seen to be 'relevant' varies from person to person, it is nice that we seem to be in agreement. Jakew 11:36, 27 January 2006 (UTC)

Body Modification Series?

Well, in the first place, as Jakew has pointed out, I don't think that circumcision is necessarily body modification. Can be, for some people, but that'isn't how the phrase is usually employed. Secondly, circumcision is the only article I found with this label. Benami 00:44, 23 January 2006 (UTC) Besides, it made the article look cluttered and narrow. Benami 00:50, 23 January 2006 (UTC)

Unless there is a diagnosis of a medical condition that requires surgery for treatment, circumcision is a form of body modification. -- DanBlackham 00:52, 23 January 2006 (UTC)

It made me laugh while it lasted. I added the body modification category to the article. On second thought it's probably already properly sub categoried elsewhere. --ZimZum 00:56, 23 January 2006 (UTC)

My word, you people are easily amused. I don't have any problem with the categorization. I didn't like the way that the tag made the article look (including its prominence) and its selective use on this article. Benami

Body modification clearly includes circumcision. First line of the body modification article: "Body modification (or body alteration) is the permanent or semi-permanent deliberate altering of the human body for non-medical reasons..." Also, circumcision is explicitly mentioned in the first paragraph. Circumcision is only NOT body modification when it is being done for a legitimate medical purpose, such as phimosis. -Kasreyn 02:33, 23 January 2006 (UTC)

I think it should be rather added to the other relevant articles than removed from here. But as I said, there still needs to be work done on many related articles to make this article really awesome. Dabljuh 01:09, 23 January 2006 (UTC)

As a sidenote, should we create a category or series "Religious initiation rites"? I am totally not into the religious aspect of circumcision so I wouldn't know. Dabljuh 01:12, 23 January 2006 (UTC)

I once read that some Jewish mohels suck up the blood from the fresh circumcision wound as some sort of additional rite. You're missing out on a lot of interesting stuff. --ZimZum 01:28, 23 January 2006 (UTC)

You mean like that? Just check out brit milah. But there's certainly a lot of other crazy initiation rites, especially in tribal traditions that could go into the same direction. Dabljuh 01:39, 23 January 2006 (UTC)

A microscopic minority of haredi and hasidic mohalim do this. It is, as you might imagine, very dangerous. Benami 01:52, 23 January 2006 (UTC)

Well... They say it isnt dangerous! So, who's right, you or them? Isn't that mouth-sucking thing also some jewish commandment? Why follow one and not the other? Also, the islamic faith demands both female and male circumcision, so, why is only female circumcision outlawed?

I don't know, man, as I am not religious in that sense, I really can't understand it when people try to legitimize harming others by saying their faith commands them to. Of course the world isn't happy candytree land, but why harm someone if it can be avoided? Dabljuh 02:10, 23 January 2006 (UTC)

No, the "mouth sucking thing", called metzitzah b'peh, is not considered "some jewish (sic) commandment" by mainstream Judaism. A very few authorities within in the haredi and hassidic communities do consider it mandatory, and it used to be the only way that metzitzah was done. Nowadays most mohalim either use a glass tube to avoid mouth-to-wound contact, or simply swab. Most authorities agree that what's needed is for the blood to be drawn from the wound, not that it be done orally. By the way, you are mistaken about Islam - read the article for information about male circumcision in Islam. And female circumcision is a cultural practice, not a religious requirement. Benami 02:28, 23 January 2006 (UTC)

Dabljuh, you're forgetting that our friends Jakew and Benami don't consider cutting someone without their consent and causing them to bleed, to be "harm". I agree with you, fwiw, but I've already tried this argument and they don't buy it. -Kasreyn 02:33, 23 January 2006 (UTC)

Not quite. I don't consider the decision to circumcise one's children after taking "into account cultural, religious, and ethnic traditions, in addition to medical factors, when making this choice" [3] to be harm. Neither do most people in the United States. Neither do most Jews worldwide. Neither do most Muslims worldwide.Benami 02:51, 23 January 2006 (UTC)

Oh, I was aware that you consider cultural, religious, and ethnic traditions to be justifications for the procedure, but Dabljuh (I believe) and I don't, so that's irrelevant to the discussion we were having. You believe in custodial consent without medical indication for this procedure, and I don't; therefore in my eyes, whenever it is performed without medical indication, then it is also performed without consent, and is clearly harm. Unless the infant is such a prodigy that he can already speak and make his wishes known, that is.  ;) -Kasreyn 03:33, 23 January 2006 (UTC)

You are quite wrong there, I think, Benami, about Islam. Female genital mutilation and male genital mutilation, are both mentioned in the Hadith and are considered part of the sunnah. Dabljuh 04:19, 23 January 2006 (UTC) You've probably fallen prey to the anti-female-circumcision propaganda that pretends FGM isn't really part of islam and could be abandoned therefore... Dabljuh 04:25, 23 January 2006 (UTC) I can assure you, the part of scholars of Islam that believe the practice should or could be abandoned is a microscopically small part. Dabljuh 04:30, 23 January 2006 (UTC)

Dabljuh, you're sounding as if you haven't read "your" own article on circumcision, as far as male circumcision is concerned. Please take a look at the section on Islam. And if FGM is part of Islam, and not a cultural practice, then why don't all Muslims practice it? Benami 11:47, 23 January 2006 (UTC)

As a matter of fact, what you've written here about FGM doesn't square with the information at the article you linked to, either. Seems as if you have your work cut out for you, as it were. Good luck. Benami 11:55, 23 January 2006 (UTC)

The female genital mutilation article doesn't correspond, er, "square" to that because it is written by evil intactivist anti-female-circumcision-POV pushers, obviously. And the muslim folks that don't practice female circumcision are INFIDELS in breach of the PROPHET's words... PBUH, If you catch my drift Dabljuh 13:40, 23 January 2006 (UTC)

It's not entirely clear what you mean here, Dabljuh. The FGC article has been written by a number of contributors, including intactivists, and also those trying to ensure NPOV. The section discussing FGC in Islam is referenced (though it could certainly be improved in that respect). Jakew 13:55, 23 January 2006 (UTC)

When it comes to FGM there is a difference of opinion amongst Muslim scholars about whether female genital cutting is allowed, or mandated or not mentioned in reliable traditions. While the article as it stands does not go into this debate in the Islamic world it does point out that world opinion and also Islamic opinion, is becoming increasingly hostile to this practice. Michael Glass 23:39, 23 January 2006 (UTC)

Meaning, some would argue that FGM is very clearly mandated by islam. Much like some would argue that MGC is mandated by judaism or any other religion. It's all just a matter of your point of view :) Dabljuh 19:44, 29 January 2006 (UTC)

How cultures view circumcision

A busy but anonymous editor changed a passage in the section about cultures to read, "Where infant or childhood circumcision is the norm, people may consider non-circumcised penises to be less preferable sexually, visually or otherwise. In the remaining majority of cultures where circumcision is not the norm, it is considered mutilation." (emphasis mine) First of all, just how are we defining "culture" here? Under that definition, how many circumcise? How many don't? Is Yemeni culture considered different from Saudi or Iranian culture? Or are all Muslim societies lumped together as "Islamic culture"? Please note that circumcisions per capita do not necessarily relate to the practice's prevalence among cultures. Secondly, how do we know that in all non-circumcising cultures the practice is definitely viewed as mutilation? All cultures have only a two-position switch when it comes to circumcision - "beloved tradition" or "mutilation"? Benami 02:19, 24 January 2006 (UTC)

You make a good point. Here in the U.S., it's looked on by most (at least by most non-Jews) as neither "beloved tradition" nor "mutilation", but "fact of nature". It's considered natural and normal and most Americans would be flabbergasted by the level of debate going on on this talk page, because it's simply something they don't think about. Their father was circumcised, their husband was circumcised, and so by default will their son. It's a non-issue (which incidentally provides a heavy inertia to budge for those of us interested in calling the procedure into question). So I agree that it's not appropriate to try to paint the issue as a black-or-white thing. Perhaps words like "some" or "many" could be used to indicate which cultures have which viewpoints, rather than making sweeping statements. -Kasreyn 05:48, 24 January 2006 (UTC)

That's replacing a sweeping and unverifiable claim with unverifiable weasel words. I really don't think it helps. I suspect that this is original research (I sincerely doubt that any international surveys have been performed).

The first sentence that Benami quoted is almost as bad. Jakew 12:31, 24 January 2006 (UTC)

It was quite blatant POV. rv'ing it was the right thing to do. Dabljuh 09:23, 27 January 2006 (UTC)

Pictures again

Heys again. First of all, hooray for penis pictures.

But what I am currently missing is a *good* set of uncirc'd wangs, especially a pic of an erect wang without the foreskin pulled back. Some uncirc'd guys look almost like circ'd guys when erect, with others the foreskin covers the glans completely even when erect. I have argued before that it is important to have pictures of uncircumcised genitalia for the quite realistic number of people who have never seen such a thing before.

Its kinda funny, I remember a time when we had no circ'd penises and had to sell an uncirc'd penis with the foreskin pulled back as a circumcised penis... Dabljuh 11:51, 31 January 2006 (UTC)

Sorting by Topic vs Sorting lexicographically

Jake, I'm not really sure what you are doing there. Sorting by topic? How do you sort the external links by topic? I mean... they're all sort of circumcision related... thats enough sorting for me... Dabljuh 12:58, 31 January 2006 (UTC)

Simple really, Dabljuh. With such a huge number of links, it's a good idea to help the reader quickly identify links by theme. Thus, we have:

• The more academic aspects, going from medical, through sexual, and then historical views.
• Procedures: retraction, frenulectomy, and restoration.
• Anatomical details: foreskin, circumcision scar.
• Religious: biblical view, holy prepuce, brit milah + shalom, zeved habat, fgc.
• Views and advocacy: fgc (shared with previous topic), genital mod/mutilation, circ advocacy, genital integrity, bioethics.
• Legal: bioethics (shared with previous topic), circ and the law.

As noted, some fall into more than one topic, but I believe the system is more useful than a simple alphabetical order. Those interested in the scientific aspects will find the beginning of the list helpful. Those with a political/legal/ethical interest will find the end helpful. Those with a religious interest will find the middle helpful. Make sense? Jakew 13:18, 31 January 2006 (UTC)

Listing Medical analysis of circumcision first and Circumcision and law last reflects a pro-circumcision POV. In my opinion alphabetical order is the most neutral POV. -- DanBlackham 13:56, 31 January 2006 (UTC)

Trying not to somehow put my own POV into things is why I usually resort to lexicographical ordering. Of course it's still possible to put some POV in by simply naming the links accordingly (like, er, ZZZUltra bad aspects of Circumcision) Dabljuh 21:25, 31 January 2006 (UTC)

FGM vs FGC

Ok, so the WHO, Amnesty international, the ICGI, just about anyone calls the practice of female circumcision "Female Genital Mutilation". None of them calls it "Female Genital Cutting" from what I can see. There is even an "FGM network". Google's topmost url that contains "FGC" is a .gov site 4women.

I would say, the correct term is FGM, with FGC being merely an alternative spelling. I have no idea why the FGM article is named FGC rather than FGM, that is their problem. I don't know the history of that but given the data, it is quite clear to me that the correct term is FGM.

So I have no idea why the FGM article is now named FGC, but I would say, that shouldn't bother us here at the MGM *cough* circumcision article. I prefer to do things the right way, rather than the wrong way to comply with someone who is wrong. If Wikipedia works, they will rename their article to FGM anywhere near soon and then we can dance the TOLD YOU SO dance. Naming their article the wrong way is THEIR beef.

So I suggest we link to the FGM article by the term of FGM, and not by any alternative spellings the crazy fuckers at the FGM article came up with. Alright? Dabljuh 11:12, 1 February 2006 (UTC)

No. The article is named FGC, not FGM. There is a very good reason for that, documented on that article's talk page (see the UNFPA's explanation of why it is a more neutral term here). Jakew 11:22, 1 February 2006 (UTC)

No dice, friend. I've tried to make the same point about "STD" versus "STI" (ie., one term enjoys widespread, almost universal comprehension and usage while having a high degree of sensibility and information content; the other, while marginally more informational, is highly obscure). Such matters as readability and comprehensibility are apparently far less important to most than ensuring maximal euphemism. They seem to think that in a world where harm and cruelty definitely do occur, it is somehow appropriate to strip all allusion to harm and cruelty from language. As if it were not the purpose of language to describe the world as it is! I've never understood it myself, so I really don't know what to tell you. It's a pity. -Kasreyn 11:30, 1 February 2006 (UTC)

You seem to take a position opposed to WP:NPOV, Kasreyn. Is that your intent? Jakew 11:56, 1 February 2006 (UTC)

My opposition is to eviscerated, meaningless language, not to neutrality. I firmly believe it's possible to make a neutral statement while still using words that have firm meanings. -Kasreyn 17:50, 1 February 2006 (UTC)

I don't understand, Kasreyn. How is it possible to have a neutral article on something that the very title declares is a mutilation? I would have said that when you use emotionally loaded, POV terminology, it's impossible to write a neutral statement. Jakew 18:00, 1 February 2006 (UTC)

Well, in that specific instance I was making reference to "STI" vs "STD", not to "FGC" vs "FGM". I suppose I could have been more clear about that. I would personally prefer "female circumcision". FGC to me is a clear example of language that has been so expunged of possible offense that it has also been expunged of all useful information content. "Cutting"? What kind of cutting? Paper cuts? It's ridiculous. -Kasreyn 06:34, 2 February 2006 (UTC)

Thanks for finally admitting what everybody knew all along: That you personally are unable to be neutral on this topic. You find it impossible, while others find it quite easy. So you should move on to other, more possible topics for you, while those of us who know and understand neutrality on this issue can remain to fix the article. Matt Gies 19:25, 1 February 2006 (UTC)

Why do you feel the need to twist my words like that, Matt? Do you think it is constructive? Come on, I'm addressing people's points here, without feeling the need to try to turn it around on them personally. It seems a far more decent way to behave. Can't you do the same? Jakew 22:19, 1 February 2006 (UTC)

I'd say the same about you, Jakew. Is it indeed your own intent to be so biased? Matt Gies 16:08, 1 February 2006 (UTC)

Can you give an example where I have argued in favour of emotionally loaded terminology, Matt? Jakew 17:17, 1 February 2006 (UTC)

Link it by name. There's a reason it's called that just as it's a reason this article isn't called MGM. // Liftarn

Wrong. This article is called circumcision because most people that look up the procedure do it under the name of "Circumcision", rather than as "Male Genital Humpty Dumpty". The FGM article is named FGC because its editors are mongoloid. At least that is my theory, I dare you to find a better one. Dabljuh 03:54, 2 February 2006 (UTC)

Hey! Let's keep it civil. Calling people "mongoloid" is not compatible with Wikipedia:No personal attacks. // Liftarn

Dubious Canadian claim

Two individuals have attempted to insert the following text:

In very marked contrast to the United States, circumcision rates have been and remain very low in Canada.[4] A survey ov seven provinces and one territory, representing approximately 75% of the Canadian population, found that only 11.46% of males were circumcised.

There are several problems here:

1. The source cited (CIRP.org) does not meet the standards of WP:RS. It is a personal website belonging to an anti-circumcision activist, and does not even cite a source for this 'unofficial survey'.
2. Who says Canadian rates are in 'very marked contrast'? This looks like original research.
3. Also, who says that these rates are 'very low'?
4. Having cited an unreliable source, the text then contradicts it, claiming that rates 'have been and remain very low', while the CIRP page repeatedly claims that they are falling.

Reverting. Jakew 14:46, 5 February 2006 (UTC)

Hi Jake. I was able to find mention of the study on a non-CIRP site through Google: [5]. Apparently the lead researcher was a Dr. John R. Taylor. Would this link suffice as a citation? I can't seem to find a webpage with the actual paper itself, though I'll keep looking.

Agreed on "very low" being POV, but "very marked" I'm not so sure about. Is it really such a value judgement to say that 12 percent is in very marked contrast to the 60 - 80 percent rate (varying by state) in the U.S.?

Agreed on the self-contradiction, and any reinserted version would need to agree more closely with its source.

Thoughts? -Kasreyn 22:13, 5 February 2006 (UTC)

Thanks, Hasreyn. The article refers to this paper. Since it's republished from the BJU, I've no objection to citing it, but it doesn't even mention Canadian rates. I don't know where they got that figure (20%) from. I guess we could cite that article, but having spent the last few minutes Googling for 'canadian circumcision rates', I've found dozens of equally confident, yet wildly different rates.

As for 'very marked', why not just say 'lower'? Simple, clear, indisputable. Jakew 22:36, 5 February 2006 (UTC)

bias

I think BIAS is a huge factor in this. I would only trust this article if it was written by an equal amount of both uncircumcised and circumcised males, from all over the geo-political-economic-social spectrum. Maybe we should just have women write the entire article. jokes aside, i'm interested in hearing what % of the contributions come from uncircumcised versus circumcised males... -129.133.139.113

• new section moved to bottom to preserve chronology -Kasreyn 09:55, 11 February 2006 (UTC)

First off, please give us a name to call you by if you're going to join the discussion! It's so much more civilized than "hey you". As for getting equal amounts of circ'd and uncirc'd editors - nice joke. How exactly would wikipedia verify that?  ;) As far as I know no one has conducted any sort of poll on the current status of the penises of the male editors of this page, and it wouldn't be appropriate if they tried. I'll leave the research to you, but there are comments scattered here and there that indicate pretty clearly that at least three of us (that I know of) have claimed to be circumcised. I don't know of any who have claimed to be currently uncircumcised.

You may think that you're only joking, but the concept of innate bias has been raised by more than one editor in this discussion (ie., that anatomy to an extent influences opinion on the matter). This is definitely a hotly disputed idea, with few adherents.

The majority of editors of this page, however, seem to feel strongly that the condition of an editor's genitals do not influence his opinions on the subject, so it would appear the majority opinion is that you are raising a non-issue. Sorry if this disappoints. -Kasreyn 10:05, 11 February 2006 (UTC)

Circumcision of Jesus image

I have several problems with the inclusion of this image. Firstly, it's uninformative. It's impossible to see the procedure, just a bunch of figures gathered around an infant. Secondly, it would seem to blur the lines between artistic and factual representation: Is there any proof that Jesus was circumcised, aside from his being Jewish? Wikipedia shouldn't misrepresent how little is known about him. And thirdly and most importantly, I think the picture was added in order to provide an argument from authority to legitimize the procedure, ie "circumcision is fine because Jesus was circumcised". I am strongly in favor of the image's removal. Comments? -Kasreyn 05:42, 13 February 2006 (UTC)

I think it should be removed as well. It adds nothing to the article. At the least it belongs somewhere other than the very top of the article.Christopher 04:38, 14 February 2006 (UTC)

Well, that's two of us. Are there any objections before I remove the image? I'm trying to avoid reverts and hurt feelings here. I'm sure the statuary in question is very artistic and whatever, but this is an article about a surgical procedure. I'd say what we need are NPOV images that aid in understanding, which this one is not. -Kasreyn 17:40, 15 February 2006 (UTC)

I'm proceeding with the removal of the image. I'd say a week is enough time for anyone who cared to have commented. -Kasreyn 00:04, 20 February 2006 (UTC)

I agree the image is of little relevance to this article specifically. It's probably much more appropriate in the Christianity section of Circumcision in the Bible. Tomer^talk 02:42, 20 February 2006 (UTC)

I guess so, if you feel it would be appropriate. I searched that article and found no reference to circumcision, so apparently wikipedia does not currently make a statement on whether Jesus was circumcised or not. I suppose many assume he was because he was Jewish. -Kasreyn 04:34, 20 February 2006 (UTC)

Eh...I don't think there's any doubt among Christians that Jesus was circumcised...Luke 2:21 says so pretty clearly—there is even a Holy Prepuce among the relics (that article is, as it happens, a FA presently)... That said, I don't know how you could possibly read through Circumcision in the Bible#In Christianity and not find a reference to circumcision, but regardless, WP isn't in the business of making statements on whether or not Jesus was anything: WP:NOR requires that we report only what others have said. Tomer^talk 09:42, 20 February 2006 (UTC)

I think the image has merit. Although circumcision remains common, it is increasingly rare to see it depicting as an event worthy of artistic capture, and especially so for a religious figure. The picture invites the reader to consider circumcision from an earlier viewpoint. 20:34, 2 March 2006 (UTC)

Increasingly rare? Was it ever commonly depicted artistically? I'm curious. I'm also not sure of how valid it is to push "earlier" viewpoints. My specific objections still hold, that the image is uninformative and could be considered a POV push. I suppose I won't object if it's restored in an appropriate section (such as the Cultures and Traditions). It certainly shouldn't be above the table of contents. -Kasreyn 06:39, 3 March 2006 (UTC)

I think I've seen two or three medieval versions of the circumcision of Jesus; I don't know what picture was formerly on this site. I don't think I've ever seen any graphic depiction of circumcision from the lst 500 years. So, yeah, increasingly rare. 20:13, 6 March 2006 (UTC)

Mention of arguments re: Preventative Surgeries?

This is a minor point, but I think it's worthwhile to discuss. I looked up and down this talk page and couldn't find anything related to it (but then again, this is an extremely long talk page....)

In my experience of talking about the circumcision debate, one of the common arguments that I hear from a anti-circumcision POV is a corollary (correct usage?) to the arguments about elective surgery. Those who are pro-circumcision often argue that there is a preventative medical benefit from circumcision (that circumcision prevents infections and/or penile cancers.) A response to that argument that I have heard many times is that there are many surgical procedures that may prevent future illness, but these procedures are not considered necessary for everyone. Specifically, I've heard (pretty much every time I've talked about circumcision) that, although removing a person's appendix prior to illness would prevent that illness from occuring, we don't remove the appendix of the average person prior to illness (because of the risks and drawbacks of surgery.) In a more extreme version, I've heard it suggested that "we don't cut off a finger because that finger might some day become broken."

Now, a quick disclaimer and then my question.

First, I am not advocating this position or making that argument here. It would be inappropriate for me to advocate a position here on a talk page. I am also not suggesting that the article itself contain this argument in a way which violates neutral point of view.

What I am suggesting (and asking for feedback) is that, from my personal experience, this position (that circumcision is at odds with a general resistance to preventative surgery) is a significant enough anti-circumcision argument that it merits mentioning in the controversey section of the article. I'm asking for feedback on whether or not other editors find this argument to be common, relevant, and notable enough to warrant inclusion in the article.

It is certainly possible that this is not a mainstream argument, or that it is too closely related to the general elective surgery argument to warrant a specific mention, so I invite feedback. Again, I am neither advocating or disputing this argument, I am just suggesting that it might be appropriate for inclusion. Freddie deBoer 07:22, 13 February 2006 (UTC)

Welcome to the discussion, Freddie. For what it's worth, I don't think it's inappropriate to identify yourself as supporting one position or another on a talk page - it's the article that falls under the NPOV policy, not the talk page. On the talk page, as long as you respect WP:civil and remain on-topic, you can say pretty much what you want and people usually won't mind too much.

The argument that you mention is indeed common, I think it's relevant and noble also, but others here might disagree. It's a good thing you decided to get feedback before making that kind of change. One possible reason the argument might not be stated is because, as you mentioned, it may have been found to be already covered by the elective surgery argument, or maybe because no reliable sources could be found to cite it from. After all, wikipedia can't include original research. This is the first time since I've been monitoring this page that anyone has voiced concerns about the coverage of the elective surgery argument (that I know of), so I don't know whether this has been discussed in the past or not. You might want to check the archives. -Kasreyn 04:21, 14 February 2006 (UTC)

Thanks. I've been looking for appropriate citations re: this argument, and I haven't found anything that would be quite appropriate for inclusion. I'll keep an eye out, and if I find something that is relevent and appropriate for an encyclopedia, I'll include it. Freddie deBoer 19:16, 15 February 2006 (UTC)

The Circlist homoerotic fantasy website=

I have followed the link to the Circlist site and I am puzzled that the description of it as “gay fantasy” or “gay discussion focussing on circumcision” or whatever — these are clearly accurate descriptions — keeps getting deleted. That is clearly what this site is; it is most certainly only informational insofar as discussion of the subject gives pleasure to the participants. I really think that a disinterested description of what that site really is would be the minimum fair warning for the unsuspecting. And this article is surely not taking the POV that homoerotic fetishism is the norm? I am restoring the objective description of that homoerotic fetishism site. If Jackew or others want to revert it perhaps they could explain why and enter into a discussion. Sam Bne 16:44, 18 February 2006 (UTC)

It is a highly POV description. Unless the site describes itself in such terms, it is inappropriate to label it as such because you happen to interpret the site in such a way. Jakew 17:01, 18 February 2006 (UTC)

“It is a highly POV description. Unless the site describes itself in such terms, it is inappropriate to label it as such because you happen to interpret the site in such a way.” Excuse me??? (I take some pains to forbear to capitalise by way of indicating my utter astonishment here.) An encyclopædia is required to take its primary research sources on their own terms? No no no. An encyclopædia could not properly describe the laws of the Medes and the Persians or the Code of Hammurabi or the Nuremburg Laws for a disinterested audience seeking only information if that were the rule. An objective viewpoint is required. Otherwise this is only a conduit for propoganda. And you wish to advertise that website on its own terms? Please! Take a look with an objective eye—it is doubtless a useful source of information but the information must be filtered through an obvious point of view which is clearly not appropriate for an encyclopædia. “Extreme POV” indeed! Sam Bne 17:32, 18 February 2006 (UTC)

It is clearly labelled as an 'external link', not a research source.

As for the content, I agree (this being my POV) that the site contains gay fantasy material, as well as heterosexual fantasy, reality, republished articles and papers, etc. For example, one could not call this page 'gay homoerotic fantasy'. With such a range of content, it is inappropriate to focus on one aspect, ignoring the rest. Jakew 18:12, 18 February 2006 (UTC)

• No Jakew, this really just won't do at all. The integrity of the Wikipedia circumcision article is seriously compromised by its referring readers to a website which as you readily agree "contains gay fantasy material, as well as heterosexual fantasy" focusing on circumcision in such a context. The link needs to be properly identified or it needs to be deleted. 58.104.210.198 02:15, 19 February 2006 (UTC)

Nonsense. Frankly, most sites contain something that meets that criteria to some extent. Wikipedia is in no way compromised by the fact that you and I share the POV that there is some fantasy material on that site. Jakew 11:10, 19 February 2006 (UTC)

I'd like to hear how the site is considered important to the article. It looks like a bunch of biased/fantasy nonsense to me, but I don't know about the subject. Is it important enough to argue over, or can it just be removed? --Fuzzie (talk) 09:16, 10 March 2006 (UTC)

As I just pointed out on 58.104.210.198's talk page, if the site is to be left, then it does seem to need to be more accurately described - however, "gay erotic fantasy" isn't appropriate since that's not all there is to the site. Anyone disagree with the removal and have a better description suggestion? --Fuzzie (talk) 09:47, 10 March 2006 (UTC)

I'd say go ahead and remove the link, as there are too many external links in this article anyway. dbtfz^talk 09:51, 10 March 2006 (UTC)

I most certainly agree. It is indeed "a bunch of biased/fantasy nonsense" and whether it's homoerotic (actually it self-evidently mostly is) or heteroerotic (granted, there is a little of that as well) it doesn't belong here. The pictures on the main page of that site are self-explanatory as to its essentially erotic nature and the extensive erotic fantasy totally compromises it as an objective source of information. Take it out. Sam Bne 10:11, 10 March 2006 (UTC)

Okay, removed the link, everyone seems in agreement. No-one should add it again without further talk page discussion. --Fuzzie (talk) 10:28, 10 March 2006 (UTC)

Sexual preferences section

Removed:

Potential partners not used to foreskins may consider them unclean or otherwise less preferrable than circumcised penises. A 1988 study of randomly selected young mothers in Iowa, where most men are circumcised, found that 76% found the circumcised penis more visually arousing. [6] Although 88% of the women surveyed had only had experiences with circumcised penises, the pattern was repeated among the 24 women with dual experience.

Moved the Bensley and Boyle study, but this might be worth deleting also - have not read through it yet.

Reason: The Iowa study is probably the worst piece of published literature I have ever read. It does not take into account circumcision state of current partners, it includes the preferences of women who have no experience of both circumcised and uncircumcised penises, with only 24 having experienced both - a very small number for such a study. It makes sweeping generalisations about the suitability of un-anaesthatised circumcisions, not even neccesary in such an article.

This kind of paper has no place in a NPOV discussion of circumcision. 163.1.130.142 13:06, 20 February 2006 (UTC)

If it's that bad of a paper, it should be fairly easy to find verifiable scholarly sources critiquing it. I'd prefer to include those rather than to apply our own (original research) determination that it's not a good study. Nandesuka 14:38, 20 February 2006 (UTC)

What that paper essentially says is that women prefer what they are used to. Without a comparison study in a population with no majority circumcision, it is worthless as a measure of preference. Guy 15:29, 20 February 2006 (UTC)

No, it says no such thing. You may interpret it that way, but that's your own opinion. Jakew 15:42, 20 February 2006 (UTC)

A summary of information from here. See references 30-34 for comment on the effect on circumcision on sexual function. Unfortunately ref. 30, which apparently shows the Williamson study to not be statistically significant, is a personal correspondance which doesn't seem to be copied elsewhere. Ref. 31 has this to say on it, apart from the main point of the paper to show that women who have experienced both prefer intercourse with an anatomically complete penis.

A study from Iowa in the late 1980s [15] found that young mothers (who had recently given birth to sons) preferred intercourse with a circumcised man; however, the importance of this study is compromised, as only 16.5% of the women surveyed had sexual experience with both circumcised and intact men. The study results may reflect the tendency of people to choose the familiar and shun the unfamiliar.

I think there is too little evidence in support of the original claim, too little acceptance of this papers by others, and more reliable primary evidence that opposes the views in the Williamson paper. Apart from the poor experimental design. 163.1.130.142 16:56, 20 February 2006 (UTC)

Fine, feel free to cite O'Hara's criticism. I have included some criticism of O'Hara's research (which - my opinion - is frankly a joke). But don't delete cited material simply because you disagree with it. Jakew 17:45, 20 February 2006 (UTC)

I'd not seen that criticism of O'Hara's work, I would agree that in this case that is probably innapropriate for this article, as is the Williamson paper and definitely the Georgia College one you have just added. That isn't really a paper - it has no description of methodology, they make no allowance for experience or lack thereof. I would settle for a removal of all of these sources - they add little to the article save a POV, which this article has to try hard to avoid. Would you support a removal of these 3 sources? 163.1.130.142 18:01, 20 February 2006 (UTC)

Thought I'd pick out some classic quotes from a supposedly unbiased scientific paper (from the conclusions section):

While the foreskin of an uncircumcised penis can be retracted, the circumcised penis exists in exposed beauty whether flaccid or erect.

Furthermore, in some uncircumcised men the foreskin can actually detract from the visual appeal of the penis.

I would argue, on top of the points I've already made, that you don't need to undertake primary research to see this source is biased and a good example of an 'academic' study poorly done. Anyway, enough of a rant, but was fun reading. 163.1.130.142 17:49, 20 February 2006 (UTC)

What you omit to say is that these two statements were clearly intended as possible answers to the question posed: "What is sexier about a circumcised penis?". Additionally, the statement that neonatal circumcision should not be performed without anaesthesia is now recommended by numerous medical associations, and hardly evidence of bias.

Still, it is clear that you don't like the paper, for whatever reasons. Fine, you're entitled to your views, but please don't try to censor the article. Jakew 17:58, 20 February 2006 (UTC)

I fail to see how "While the foreskin of an uncircumcised penis can be retracted, the circumcised penis exists in exposed beauty whether flaccid or erect." can ever be construed as NPOV. They have done no research to find the reasons why people responded as they did, so have no place speculating as such.

You are correct on the 3rd quote, I misread the double negative.

I do not like the paper, because it is poorly conducted and tries to force conclusions that do not follow from the data. As for trying to censor WP I think you'll find it is better off without such tripe, as with the other papers I have removed from both sides of the argument that are poor. I have presented my reasons for my edits and opened them for discussion on the talk page, I fail to see how I am acting innapropriately. 163.1.130.142 23:35, 20 February 2006 (UTC)

I also removed this:

On the other hand, at least one man circumcised at the age of 22 reports that, without having the foreskin to roll over the head, sex is more pleasurable: "During the 'in' stroke, the foreskin would slide back and away from the glans, leaving it open for full contact. During the 'out' stroke however, the foreskin would roll back over the glans and cover it, thus muting half the sensation. Now that doesn't happen. The head stays exposed on the 'out' stroke and the sensation is amazing." (Page 45, SEXlife Magazine, premiere issue, 1996: Zygote, Inc.)

The scientific relevance of a sample of one is, I think, obvious. Plus, once erect, the foreskin pretty much stays out of the way. Guy 15:32, 20 February 2006 (UTC)

Better remove the preceding paragraph, too, since the scientific value of speculation is even less than a sample of one. Jakew 15:42, 20 February 2006 (UTC)

Just OOI...

Does anyone have some rough idea of the number of people circumcised in Japan?

-James

POV yes, but not the way you think

Surveys however indicate that the majority of circumcised males are satisfied with their state

Could this possibly BE any more POV? I'm not certain, but I've got a pretty good guess that if surveys were done on whether most people were satisfied with having five fingers, as opposed to four or six, they would rate their status as "highly satisfied". Would this be considered justification for surgical "correction" of functional polydactyly? Just because people who have no basis for comparison, such as myself, are "satisfied" with their state, doesn't mean they're qualified to comment. This isn't a matter of POV or ad hominem attacks, this is a matter of basic semantics: you cannot make a rational judgement between two conditions if you only have experience of one of them. -Kasreyn 10:44, 10 March 2006 (UTC)

I don't think this survey is meant to show whether one is better than the other. It shows what percentage of men are satisfiesd with their current status. This makes sense - a man need not have experienced both to have feelings. The survey means very little however, because studies have shown that a suprisingly small percentage of men(in the US) actually know their status. Furthermore, I expect that if the same survey was done among women who had been mutilated, the results would be similar, even though FGM is viewed as much worse than the male homologue. If couse, take this with a grain of salt as I am speculating about which study the quote is referring to. Christopher 16:04, 10 March 2006 (UTC)

If you don't think the survey is meant to show whether one state is better than the other, then it boggles the mind as to why it deserves inclusion in this article!! "This makes sense - a man need not have experienced both to have feelings" It makes sense, yes, but it proves nothing, because since that man doesn't have experience of the other situation, he can't know how he would feel if he knew. I agree with your sentence about women who were mutilated, and it works for the same reason, assuming the women were harmed before they were old enough to gain meaningful experience with their whole genitalia.

The point is, it's a matter of logic: you cannot compare something to itself, the very nature of the concept of comparison means that you must compare something to something ELSE. People who have experience of only one physical state of being, whether it's being circumcised or uncircumcised, have nothing to compare it with. A certain percentage of circumcised men might be horribly unsatisfied if they knew what it was like to be uncircumcised, and no doubt a certain percentage (my guess: a far smaller one) would be even MORE satisfied and glad they were rid of it. Therefore they can be as "satisfied" as their particular level of ignorance or cognitive dissonance allows, and it doesn't make a damned bit of difference. Now, a person who had experienced both states and reported he was "satisfied", that person's statement would actually mean something. For that, you would need a survey of only people who had the procedure done as adults. Until such a survey is done, I'll keep opposing the inclusion of less meaningful surveys. -Kasreyn 10:16, 19 March 2006 (UTC)

External Link Balance

I don't think it's necessary to have the same exact number of external links in favor of or opposed to circumcision. The balance between the two should rather reflect the actual ratio of sites out there. Any thoughts? MamaGeek Joy 20:34, 10 March 2006 (UTC)

Thanks for your views, MamaGeek. Wikipedia policy, on the other hand, states: "On articles with multiple Points of View, a link to sites dedicated to each, with a detailed explanation of each link. The number of links dedicated to one POV should not overwhelm the number dedicated to any other." WP:EL Jakew 20:48, 10 March 2006 (UTC)

The exact wording here is important. 'should not overwhelm' is not the same as 'must be equal' I would interpret 'overwhelm' as being off by more than 50%. Also, the choice of which pages to remove should be a group effort. I personally feel that having links to both NOHARMM and NOCIRC is unnecessary because they kinda stand for the same thing. I think that Jews against circumcision should be left in because it is a unique perspective. Discuss. Christopher 16:32, 11 March 2006 (UTC)

It's neither a question of perfect balance nor of ratio of sites - it should just be a question of providing useful links which don't duplicate one another, without overwhelming numbers on either side (which really means *overwhelming* numbers, not balance - 50% sounds reasonable, if you have more than a few sites involved). Removing sites purely due to numbers should only be done in that overwhelming case, you should be justifying by content in any other case. Note that I haven't examined the links in question, so this shouldn't be interpreted as an argument for or against removal of them. --Fuzzie (talk) 16:43, 11 March 2006 (UTC)

The trouble is that there are a fair few anti-circumcision sites out there, many of which are more or less equivalent, as ChristopherK has noted. Unfortunately, people keep adding these to the article, so every so often it's a good idea to prune the list, as if it's not already overwhelming, it'll become that way soon enough.

My feeling is that sites should either contain useful, encyclopaedic information, or should be sites of at least vaguely notable organisations. CIRP is probably the most useful of the lot (despite its faults), due to the republished papers they have. NOHARMM and NOCIRC aren't terribly informative, but have at least gained a mention in certain books on the subject, suggesting notability. These three are thus worthy of inclusion. Moving on, circumcision.org and historyofcircumcision.net at least try to be academic. Infocirc doesn't seem to offer anything more than the first three, and jewsagainstcircumcision is an incredibly small organisation with a view accepted only by a tiny minority of Jewish readers (and Wikipedia already links to them on brit milah, which is our article on circumcision in a Jewish context). Jakew 20:58, 11 March 2006 (UTC)

Re: Nonexistent Move Request

"It has been proposed below that Circumcision be renamed and moved to Male circumcision. The proposed move should have been noted at Wikipedia:Requested moves."

This "request" is nowhere to be found either on this page (search for "move" has no hits) or on the requested moves page (search for "circ" has no hits). FlareNuke, from what I've been able to see in the past, has a history of moving pages without gathering consent from the contributors to those pages, and of occasionally failing to move and maintain talk pages. He seems to feel that, rather than making the article agree with its title, the title should be made to agree with the article's contents. This Procrustean approach is entirely inappropriate for Wikipedia, in my opinion.

Since the stated "request below" is nowhere to be found on this page or the Requested Moves page, I'm removing the move request tag. -Kasreyn 12:37, 19 March 2006 (UTC)

HIV Section

I would like to edit the reference to the Cochrane Review to more closely reflect the conclusion of the article. The conclusion of the article cited reads "The possibility exists that the observed results included in this review could be explained by confounding. Although the positive results of these observational studies suggest that circumcision is an intervention worth evaluating in randomised controlled trials, the current quality of evidence is insufficient to consider implementation of circumcision as a public-health intervention." Accordingly, I don't think it's entirely accurate to say that the article cited "concluded that...there are clear indicators that circumcision can significantly reduce the rate of female-to-male HIV infection in an African population." To my understanding, a "suggestion" is not a "clear indication". As such, I would edit that sentence to read "The March 2005 Cochrane review of the medical evidence concluded that, despite widely observed correlation between circumcision and low rates of HIV infection, a causal relationship between circumcision and reduced risk of HIV transmission had not been established." Given the contentiousness of this topic, and my newbie status here, I am suggesting this change here before carrying out the edit, and would appreciate any opinions. In the interest of full disclosure, I am a medical anthropologist and am very familiar with the literature on and debate over both male and female genital modifications in a variety of contexts. (I've been silently observing this page and the fascinating conflicts herein for some time). My own research does not address circumcision as an HIV intervention per se, but I am familiar with the Cochrane Reviews on the topic, and that's why this sentence caught my eye.Zandrous 08:48, 12 April 2006 (UTC)

This is my first post to wikipedia (and what a topic to pick;), so please be gentle... I have taken the liberty of making a few structural changes under the HIV heading, which I found impossible to follow. I hope these have not compromised NPOV, which I can see has been hard to establish. I have left in two parts which I think need correction: 1. Could someone offer citations for the sentences starting "However, others have postulated..." I have not found in the medical commentary anyone who suggested that the control group (ie those who were not circumcised) in the randomised trial received less sex education/condom education than the intervention (circumcised) group. 2. Similarly, the argument regarding Muslim sexual practices may be valid at a population level or as criticism of observational data, but in the context of the trial it is not relevant: the men were all uncircumcised/intact at entry (hence unlikely to be Muslim as they were all adults) and there is no evidence that any of the religious groups were randomised disproportionately to the intervention or control arm (see Table 1 of the citation) In contrast to this section as it now stands, the major responses that I have seen in the medical literature have focussed more on mechanisms, and on the acceptability and practicality (or otherwise) of circumcision as a means of HIV control at a population level in Africa. I think the section would be stronger and more coherent if the discussion was presented in this light, but am very open to comments Marknp 13:19, 21 March 2006 (UTC)

Links

Alienus, please stop adding personal websites and other non-encyclopedic links and non-reliable sources to this page. The only way to "balance" them is by removing them. Wikipedia is not a link repository, and we should only link to reliable, encyclopedic external sources that actually provide information not in the article. None of the links you provided apply. Please read WP:EL. Jayjg ^(talk) 22:18, 22 March 2006 (UTC)

Pro and con links.

Today, I decided to test the cabal that owns this article by adding a few anti-circumcision sites to see what the reaction would be. If this were a normal, fair article, then a comparable number of pro-circumcision links would have been added, for parity. But, of course, this article is nothing if not abnormal.

All of the links were removed with dishonest reasons. Then, as an after-thought, a particularly unassailable one was allowed, so as to avoid making it obvious that nothing anti-circumcision will ever be allowed here. At no point, of course, was there any prior discussion about this matter here. Nor, for that matter, is there any point to having one, since the standard technique is to make arbitrarily high demands on all anti-circumcision additions.

Thank you so much for proving my point, Jayjg. Your overwhelming bias is now on the record, permanently. One more step accomplished. Alienus 22:54, 22 March 2006 (UTC)

Please review WP:OWN and WP:NPA. Kind regards, Nandesuka 23:47, 22 March 2006 (UTC)

In addition to Nandesuka's highly relevant comment, please review the comments I made in the section above, which was exactly on this topic. Wikipedia is not a link repository (see WP:NOT), and the article already has plenty of good anti-Circumcision website links, it doesn't need 1/2 dozen personal websites added. In addition, when linking to POV sites, there should be some balance in the links in an article; that is, one should not have twice as many "pro" as "anti", or vice versa; quoting from WP:EL "The number of links dedicated to one POV should not overwhelm the number dedicated to any other." Finally, I didn't remove all the links you added, but left the best one in. Jayjg ^(talk) 00:05, 23 March 2006 (UTC)

There was no personal attack here, so WP:NPA is irrelevant. If I attacked anything, it was an impersonal, faceless cabal. As for WP:OWN, it applies directly to this informal cabal of yours. You do not own this article. You do not exclusively decide what stays and what goes. It is not your article and not your Wikipedia, and your manipulation of policies to suit your goals is not in keeping with the letter or spirit of the rules.

When I added those links, I encouraged matching "pro" links in my comment, as per WP:EL. You chose to delete my additions instead of matching them. The only links you've kept are dry, boring medical stuff that you hope nobody will bother reading. The links I added were WP:NOT "personal websites", although they were certainly POV. I chose them for quality and readability, but the only one you kept, as an afterthought, was the least assailable yet dullest of the bunch. In short, nothing you've said has actually refuted my arguments. If anything, you've supported them. Thank you for going on the record in showing your bias. Alienus 03:55, 23 March 2006 (UTC)

I certainly view your comments about Jayjg as personal attacks, as I think would most reasonable people. You and he are having a disagreement over content. Your response to that disagreement is to disparage the person you are disagreeing with. That is a personal attack. I encourage you to realize that reasonable people can and do disagree all the time, on Wikipedia and elsewhere. While it is possible that the Secret Brotherhood of Anti-Alienus Editors has taken residence here, an equally likely explanation might be that the links you added were removed because they were poor. Wikipedia is not here for you to "test" the "cabal" with. It is an encyclopedia. If you add unencyclopedic links to an encyclopedia, you should not be surprised when they are quickly removed. Nandesuka 04:20, 23 March 2006 (UTC)

Well, I'm a reasonable person, and I'm not certain I agree. Is it a personal attack to warn a vandal on their talk page, or accuse them of such in an edit summary? Jayjg certainly isn't a vandal, but being "overwhelming(ly) bias(ed)" is certainly an equivalent accusation. Hypothetical situation: what if Alienus were right and Jayjg really was extremely biased? Wouldn't it be Alienus's proper duty to point this out to try to limit Jayjg's infractions of NPOV? Of course, the question of whether Alienus has satisfactorily proven Jayjg's bias is completely up for grabs, and until that's settled I won't know whether Alienus acted appropriately or not. I'd say it's a little unrealistic to try to shut him up with WP:NPA; what happened to assuming good faith on Alienus's part? Or is this a gray area that's already been covered by a policy?

Personally, I have nothing against Jayjg or Alienus, and no wish to get sucked into this conflict. I'd say if Alienus made a mistake it was in failing to assume good faith, rather than personal attacks - but does this mean he sacrificed his right to be assumed to be acting in good faith? An interesting dilemma.  :) -Kasreyn 13:16, 25 March 2006 (UTC)

Thanks for jumping in. First, I just want to say that if you have a strong feeling warning you not to get involved any deeper in this mess, that's just your common sense talking to you and you should listen. This is pretty ugly, and it does involve some admins violating the rules. So the main reason I'm responding is to warn you off from here so that you don't get harmed. This is one of those areas where justice will not come quickly, and anyone expecting it today will get the punishment they deserve.

Second, I want to freely admit that I feel Jayjg and a few others are acting in bad faith. However, the rule is to assume good faith — which I did — not to continue believing it in the face of all evidence. In contrast, Jayjg and the others who feel they WP:OWN this article immediately assumed bad faith on my part, reverting each and every attempt to edit this article without once trying to correct instead of remove.

Third, you are entirely correct in thinking that certain common-sense Wikipedia rules are being abused. Even if I'm completely mistaken about Jayjg's bias, I honestly believe that it exists and have at least enough basis for this belief to be understandable. Therefore, calling him biased is not an attempt to attack him, but to point out that his behavior has been unacceptable. I may not be as polite as some might like, but I'm acting in good faith. Unfortunately, this group is all about twisting (or simply ignoring) the rules to get their way. Wheels are in motion to combat this problem, and others like it, but the wheels of justice are not known for their speed, just their finality. Alienus 16:15, 25 March 2006 (UTC)

I can't see that it is ever necessary to declare that an editor is biased, Kasreyn. It does little or nothing for NPOV. What may sometimes be needed, however, is a declaration that an edit is biased. That isn't a personal attack. The former is. Jakew 17:30, 25 March 2006 (UTC)

Thank you contributing absolutely nothing of value to this discussion. Perhaps you should stick to baseless reverts, instead of trying to talk. Alienus 04:39, 23 March 2006 (UTC)

Your continued lack of civility is disturbing, and no doubt explains a lot. Nandesuka 05:27, 23 March 2006 (UTC)

Content is far more important than form. Looking only at form, one might imagine that some guy inserted some bad links that got removed. Looking at the content, it becomes clear that the links were fine and the excuses for removing them were dishonest. Looking at form, one might imagine that I am uncivil. Looking at content, it becomes clear that I am being incredibly civil given the level of bad faith that exists here. Alienus 07:05, 23 March 2006 (UTC)

This is quite extraordinary. You began this discussion by saying: "Today, I decided to test the cabal that owns this article by adding a few anti-circumcision sites to see what the reaction would be." Implicit in this is the assumption of bad faith. Not only that, but it is a bad faith edit on your own part. By your own admission, you did it not to improve the article, but to test the reaction of the 'cabal'.

It is true that you (very graciously) gave permission for other editors to add other links, but why on earth did you feel that these links added anything to the article? One was already included, and what information did the others add that wasn't already provided? Nothing, as far as I can tell. Jakew 13:10, 23 March 2006 (UTC)

I would be an ogre to assume bad faith, but an idiot not to conclude it after the behavior of this cabal. Alienus 04:30, 24 March 2006 (UTC)

Yes, content is important, which is why those links were removed, but behaviour is also important. Your admitted WP:POINT was bad enough, and it was compounded by your violations of WP:CIVIL and continued denial of same, it already looks even worse. Moreover, your revisions of your Talk: comments, with the claim "A lame explanation after the fact doesn't qualify" is exactly wrong; each removal was accompanied with an explanation, and then the entire edit was explained immediately afterwards on the Talk: page - exactly what good Wikipedia ettiquette demands. Wikipedia etiquette does not insist that explanations of edits must occur before the edit. As for the links themselves, it's rather absurd that you would suggest that the links containing "dry boring medical stuff" are inappropriate, whereas the POV ones (i.e. ones containing personal opinion) are appropriate. And I emphasize "personal", since they were indeed personal websites: for example,

• this one is a single page by "Heather", based on an essay she wrote,
• this bizarre one is written entirely from a personal perspective (e.g. "Many people ask me how this site got started and comment on how big it is. I started it in June, 1998","I encourage you to not only review my site etc."), is filled with alleged anonymous message board quotations, and specifically says in red This site is not meant as medical advice.
• this one is the personal website of Robert Darby, some guy with a literature degree (admittedly a PhD in literature). He even has a page saying "About me". Oh, and it was already on the page anyway.

etc.

Your behaviour in relation to these topics, these pages, and other Wikipedia editors, is becoming increasingly disruptive; please rethink your actions. Jayjg ^(talk) 21:07, 23 March 2006 (UTC)

I love implied threats. Read my implied response. Alienus 04:30, 24 March 2006 (UTC)

I'm not sure what you mean by an "implied threat"; I've made no threats, implied or otherwise. Whether or not you love "implied threats", it's quite clear you love empty threats; for example, "This will include following up on why Jay has been allowed to violate Wikipedia rules while I've been punished despite not violating them. I bet you can guess what will come of this." "I'm not going to drop this issue until a few admins have lost their badges" "I'm not stopping until Jayjg, Nandesuka, Jakew and anyone else who supports them is blocked from Wikipedia indefinitely...He needs to explain precisley how many reverts I did and when they occurred, or I'll have his badge." (the last with the edit summary "this means war, duh"). I would recommend focussing your efforts on actually improving the encyclopedia, rather than trying to "war" with various editors, or making WP:POINT edits in attempts to set "traps" for them; the latter is exactly the kind of thing that is seen as disruptive. Jayjg ^(talk) 18:04, 24 March 2006 (UTC)

I'm told that holding your breath can make you dizzy. Alienus 01:37, 25 March 2006 (UTC)

Radical Circumcision

Jakew ... You were circumcised as an adult. The prepuce of adults is fully developed less likely to be damaged during circumcision (relative to infant circs). I also assume that an adult would specify to the surgeon the precise amounts and location of skin and mucosa to be removed.

My point is that circumcisions in the US are frequently radical. I'm the guy that tried to edit in essentially the following:

"The primary zones of erogenous sensitivity are the frenulum, frenular delta, ridged mucosa, the preputial orifice, and the external fold of the foreskin. All of these zones are orgasmic triggers. Continuous and gentle stimulation of any one of these areas can elicit pleasure, orgasm, and ejaculation. All, save a portion of the frenulum and possibly the frenular delta, is removed during routine infant circumcision (in the US). The innervation of the remaining mucosa may be damaged by the procedure."

It is my opinion that if your circumcision had been similarly radical, you would feel differently about infant circumcision.

Completely missing from the Circumcision articles are facts about the erogenous functions of normal mucosa and anatomy, and how results of a circumcision will depend on exactly what was excised or damaged.

Given large differences in individual anatomy, the tools used, and the small size of the infant penis, a surgeon will not predict the extent of a proposed circumcision.

Jakew ... would you have taken that risk?

In the US, infant circs are frequently radical and thus mutilate. For example, infants left with only a remnant of the frenulum and a 1/2 inch of mucosa below the corona will have less capacity to enjoy voluptuous feelings. I know this is original research, but in a ramdom sample of 500 US circumcised guys, 185 were missing their frenular delta and frenulum.

I have several friends that report they can only reach orgasm (masturbating) by using lube and vigorously jacking their penis. They put lots of rubbing pressure on the heads of their penis. They report no special erogenous place on the front of their penis below their corona. They take longer to reach orgasm (than most men, they notice). They all had radical circumcisions.

I'd hate to be involved in keeping that information from new parents. (unsigned by 172.193.189.204)

Hi. I seem to remember that Jakew, not Jayjg, is the one who put his penis under the knife as an adult. Frankly, I got the two of them confused when I first ran into them, so I wouldn't be surprised if you did. Then again, perhaps you know more than I do, and both of them did it.

I wish you the best of luck in getting your point across. Also, you may want to create an account, because your dynamic IP makes it hard to ever leave you messages. it's not required, of course, but it's a good idea, and it's free and easy.

Alienus 00:04, 27 March 2006 (UTC)

The text that you tried to include was dubious and cited no sources. If you can find reliable sources supporting these claims, go ahead and include them. If you can't, and it is merely your opinion that this is correct, then it doesn't belong in an encyclopaedia. Jakew 20:45, 27 March 2006 (UTC)

Thank you, I corrected my error above. The message should be addressed to all those who have made the circumcision topic a simplistic joke.

I'm just learning, will create an account, and participate. It's discouraging to see a topic hijacked to narrow scoped prejudiced information. This is really serious business when so many people rely on wikipedia.

The trouble with the studies about orgasm rates for circumcised men is that I've seen studies calling it both ways: some say circumcised men suffer more from premature ejaculation, others say circumcised men have a hard time ejaculating at all. To me, all this is moot. The earlobe is a part of the body that serves no purpose whatsoever other than to serve as an erogenous zone (Desmond Morris, "The Naked Ape"), and children must be taught to clean behind them, just like a foreskin. Parents would shriek in horror if a doctor offered to excise their child's earlobes at birth for "sanitary" reasons, but see no problem in the foreskin being removed. A trivial example, I know, but it goes to demonstrate how the issue is one of cultural acceptance and taboos, rather than medical knowledge. Medical knowledge only enters into the debate when circumcision proponents use it as a rationalization for a procedure which is actually being carried out for the purpose of satisfying ancient tribal/cultural taboos, and for "normalization" in cultures where it is the dominant mode. To quibble over medical details, in my opinion, completely misses the point that circumcision is a cultural phenomenon, largely detached from medical realities. -Kasreyn 02:52, 27 March 2006 (UTC)

Common Ground

Jakew: That information was from the deposition of an expert witness … a UCLA professor and medical doctor … the plaintiffs won (the parents weren’t properly informed). Regardless, I can’t legally cite the passage. I also personally find the passage to be true, and considered it common knowledge.

I would like to negotiate common ground for changes to the topic. It is common knowledge that the penis is primarily a sexual organ, and distinct parts of the penis are erogenous zones. Labeling these zones primary or secondary is irrelevant. The topic fails if it doesn’t communicate that infant circumcisions routinely excise sensitive mucosal tissue, and that the frenulum, frenular delta, and surrounding tissue is highly erogenous and is reduced or excised during neonatal circumcisions.

I suggest the following:

The prepuce (foreskin) is comprised of two distinct surfaces, the external penile skin and the inner mucosa. Prepuce mucosa is innervated with specialized nerve endings, including Golgi-Mazzoni corpuscles, Merkel's disks, Vater-Pacinian corpuscles, estrogen receptors, Meissner's corpuscles, Pacinian corpuscles, Krause end bulbs, Ruffini corpuscles, genital end bulbs, and genital bodies. These nerve receptors provide voluptuous sensation to motion, touch, temperature, and change in pressure. Neonatal circumcisions routinely excise sensitive mucosal tissue, and often reduce or excise the frenulum and frenular delta, which are commonly considered the primary male erogenous pleasure zones.

—Preceding unsigned comment added by TipPt (talk • contribs)

With a subject as controversial as this, the testimony of an 'expert' witness is of dubious value.

Your proposed pararaph is still unsourced. You need to cite sources for each claim. For example:

The prepuce (foreskin) is comprised of two distinct surfaces, the external penile skin and the inner mucosa. Taylor reports that the preputial mucosa is innervated with end bulbs resembling Meissner's corpuscles and Krause end bulbs.[7] Other authors have reported, however...

See? It's verifiable.

Next, we cannot include anything about 'voluptuous sensation'. It's extremely POV language that doesn't belong in an encyclopaedia. If you can find examples of measured response to various types of stimulation (I'm not aware of any such studies), I've no objection to their inclusion, but I'm not aware of any.

Next, the final sentence is based upon no sources. What evidence is there that the mucosal tissue is sensitive (as I remarked, there don't seem to be any studies that have investigated this)? Also, what evidence is there that these are commonly considered the primary male erogenous zones? Have surveys been performed? Or is this merely your opinion? Jakew 11:38, 29 March 2006 (UTC)

Jakew... I’m looking for common knowledge that forms the basis of a common ground. Again, that’s how my penis performs. I can masturbate to orgasm by twisting the very tip of the prepuce. When I’m excited, I can proceed to orgasm by gently touching (only) my “ridged bands.” In that circumcision video (I’m sure you’ve seen) the surgeon stimulates an erection by almost exclusively touching the orifice and mostly the back side of the end of the prepuce. The surgeon is not stimulating the frenulum area of the prepuce. That indicates that erogenous tissue will be excised. You can see why I think "common knowledge."

How about: Neonatal circumcisions may reduce or excise the frenulum and frenular delta which are commonly considered the primary male erogenous pleasure zones.TipPt 15:50, 29 March 2006 (UTC)

Most men would call some parts of their penis voluptuous, but I guess you’ll accept erogenous. How would you distinguish between erogenous kiss to the lips, versus a highly erogenous stroke to your “G-spot (s)”?TipPt 15:52, 29 March 2006 (UTC)

Wikipedia needs to be verifiable. If we can't find sources, it's best to say nothing. Jakew 16:00, 29 March 2006 (UTC)

I'll find the cite for "Neonatal circumcisions may reduce or excise the frenulum and frenular delta." Will you permit the rest of the sentence ... "which are commonly considered the primary male erogenous pleasure zones."?TipPt

Can you find a source for it (the rest)? Jakew 11:29, 30 March 2006 (UTC)

I found the journal cite for the first, but the second is common knowledge.172.185.45.163 16:38, 30 March 2006 (UTC)

What people who edit this page typically refer to as "common knowledge" is almost invariably uncited, unverifiable POV and original research, all of which are forbidden by Wikipedia policy. Jayjg ^(talk) 17:42, 30 March 2006 (UTC)

We are not talking generally here, we are addressing a specific issue. What parts of the penis are commonly known to be highly erogenous. No male with normal anatomy would not include the frenulum and frenular delta in that category. No normal uncircumcised man would not say rolling down their prepuce is not erogenous.TipPt 06:05, 1 April 2006 (UTC)

Thanks for your opinion. Would you like to present evidence, so that others can verify it? Jakew 11:07, 1 April 2006 (UTC)

Thank you for providing a fine example of unreasonable demands. Noted. Alienus 17:50, 30 March 2006 (UTC)

If you feel Wikipedia policy makes "unreasonable demands" on you, perhaps you should edit a project that has lower standards. Jayjg ^(talk) 18:04, 30 March 2006 (UTC)

I can't find many topics that are more poorly written (regardless of content).TipPt 06:51, 1 April 2006 (UTC)

The only one here with low standards is you, and then only selectively. If it's a source that's in support of medically unecessary gential surgery, you're all for it. If it's something obvious and uncontroversial, yet contrary to your not-so-hidden agenda, you bring up the unreasonable demands. The problem isn't Wikipedia, it's you. You think you WP:OWN this article, which is your error. You're just one more rogue admin. Alienus 18:46, 30 March 2006 (UTC)

If it were something "obvious", then there would be lots of reliable sources for it, and if it were "uncontroversial", then people wouldn't oppose it. This is just simple logic. And rather than feeling I WP:OWN this article, I actually feel I have a responsibility to ensure that Wikipedia policy is followed on this, and all other articles. Finally, it appears that Wikipedia's civility and no personal attacks policies make "unreasonable demands" on you as well. Jayjg ^(talk) 20:06, 30 March 2006 (UTC)

What's obvious is that you are biased beyond all reason. If stating this simple fact is a "personal attack", then so be it. Alienus 05:49, 1 April 2006 (UTC)

Jakew...This is so strange. In another topic I see you calling the most (and only by exclusion) erogenous part of the penis the glans. You don't mention the frenulum or frenular delta. Rediculous. It's not cited.

My glans is a relative dead zone. What planet are you on?

My only solution is to check on how biased editors can be curbed, and if that looks fair head to the UCLA library ... this stuff is easy in the right environment.TipPt 23:47, 1 April 2006 (UTC)

I don't see a problem with describing the glans as erogenous. Studies have been conducted in which erection and ejaculation have been induced through stimulation of the glans. I'm not aware of any that have tested the frenulum, however. Jakew 11:07, 1 April 2006 (UTC)

Could you please provide that glans/orgasm study cite?

All I've found is speculation about innervation, but they also included the prepuce. My glans is erogenous. But the prime real estate is the frenular delta (which includes the frenulum).

I've enlisted a research scientist...can I cite respected French, Italian, and German journals?TipPt 23:43, 1 April 2006 (UTC)

Yes, one glans/orgasm study that springs to mind is Shafik A. Sensory evoked potential and effect of SS-cream in premature ejaculation. Yonsei Med J 1995; 36(5): 397-401. There are a couple of others, but I will have to look through my files.

As for foreign-language journals, I don't see that as a problem, as long as the original text can be found online or you can quote relevant passages and/or data (or, even better, if PubMed have an English translation of the abstract, as they often do). Jakew 10:26, 2 April 2006 (UTC)

Medical association controversy?

Jakew... I would like to correct the topics opening third paragraph, because I find no controversy in the medical community regarding infant circumcision as being therapeutic. In fact, all neonatal circumcisions are by definition non-therapeutic because no disease state exists. From the CDC: “What controversy that exists pertains to the existence or relevance of potential preventive care benefits.”

I would like to replace your third paragraph with the following quote:

Routine, non-therapeutic circumcision is not recommended for newborn infants.1 2 The Council on Scientific Affairs of the American Medical Association classifies neonatal male circumcision as a non-therapeutic procedure.3 The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, in a joint publication, Guidelines for Perinatal Care, have reclassified neonatal circumcision as an “elective procedure.”4 5 Medical societies worldwide find that the potential benefits do not exceed the known risks.10 11 They counsel that circumcision should not be routinely performed, meaning that circumcision should not be performed without a specific medical indication.10 11

The genital integrity movement condemns non-therapeutic infant circumcision as a human rights violation that they consider comparable to female genital cutting,[6] while circumcision advocates stress the medical benefits of the procedure.[7]

Jakew … I have esteemed citations for each of those quotes … will you permit its inclusion?

—Preceding unsigned comment added by TipPt (talk • contribs)

You're misreading the paragraph. The controversy is not over whether it is therapeutic, but whether it should be performed.

When you read the whole article, the summary "controversy" refers to the potential benefits and risks (the topic), not to recommend (or not) circumcision. Regardless, where there is a strong consensus on the issue of neonatal circumcision among all the global primary medical associations (and the CDC) it should not be portrayed as a controversy if one lesser body disagrees. You show bias using that one citation to claim "controversy."

"Controversy" is a dangerous word, because it invites lazy (stick to your prejudices) thinking.TipPt 16:24, 29 March 2006 (UTC)

The controversy is acknowledged by two major medical associations. To quote the AMA: "Debate on the wisdom of routine circumcision centers on the possible benefits offered by circumcision, and whether they medically justify the risks associated with the procedure." Or the BMA: "Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA’s membership. ... There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself." (Incidentally, please don't insert comments in the middle of comments by others. It makes it difficult to respond tidily.) Jakew 20:42, 29 March 2006 (UTC)

Your proposed paragraph is unacceptable. Firstly, while you've included reference numbers, you haven't indicated to what they refer.

1 Foetus and Newborn Committee. FN 75-01 Circumcision in the Newborn Period. Canadian Paediatric Society News Bulletin Supplement 1975;8(2):1-2. 2 Committee on Fetus and Newborn: Standards and Recommendations for Hospital Care of Newborn Infants. Sixth Edition. American Academy of Pediatrics; Evanston, IL, 1977: 66-7. 3 Council on Scientific Affairs, American Medical Association. Report 10: Neonatal circumcision. Chicago: American Medical Association, 1999. Available at URL: http://www.ama-assn.org/ama/pub/article/2036-2511.html 4 American Academy of Pediatrics & American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care, Fourth Edition, 1997. 5 American Academy of Pediatrics & American College of Obstetricians and Gynecologists. Guidelines for Perinatal Care, Fifth Edition, 2002. 6 American Academy of Pediatrics Task Force on Circumcision. Circumcision Policy Statement, Pediatrics 1999;103(3):686-93. URL: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686 7 Council on Scientific Affairs, American Medical Association. Report 10: Neonatal circumcision. Chicago: American Medical Association, 1999. Available at URL: http://www.ama-assn.org/ama/pub/article/2036- 2511.html 8 Commission on Clinical Policies and Research. Position Paper on Neonatal Circumcision. Leawood, KS. American Academy of Family Physicians, 2002. URL: http://www.aafp.org/policy/camp/4.html 9 ACOG Committee Opinion Number 260: Circumcision. Obstetrics & Gynecology 2001; 98(4):707-8. 10 Fetus and Newborn Committee, Canadian Paediatric Society. Neonatal circumcision revisited. (CPS) Can Med Assoc J 1996; 154(6): 769-780. URL: http://www.cps.ca/english/statements/FN/fn96-01.htm 11 Beasley S, Darlow B, Craig J, et al. Position statement on circumcision. Sydney: Royal Australasian College of Physicians, 2002. URL: http://www.racp.edu.au/hpu/paed/circumcision/TipPt 16:24, 29 March 2006 (UTC)

Next, the first sentence is POV. Since some people do recommend it, it should say not recommended by X (as the current version says). I'll comment further on the other sentences once you've specified what your sources are. Jakew 11:46, 29 March 2006 (UTC)

The paragraph refers to medical associations, and NONE (please provide the cite otherwise) recommend non-therapeutic neonatal circumcision. You cite one junior association, and conclude that there is a controversy; they did not recommend. You are biased. TipPt 16:23, 29 March 2006 (UTC)

Ok, your first proposed sentence cites recommendations from the 1970s. It is better to cite modern, verifiable information as the present article does. The second and third are peculiar, as this language is just what these organisations have decided to use. There's no grand declaration, nor any reason to suppose that they intended that language to be a big deal. Why make a fuss about it? The fourth is inaccurate - one Canadian organisation and one Australian is not 'organisations worldwide' - it is two medical organisations. Finally, the fifth imposes an interpretation ("meaning that...") that is not stated by these organisations. In fact it is contradicted by the only organisation to explain what is meant by 'routine circumcision' - the AAP - who stated that it meant that they did not recommend the circumcision of all newborn boys, but instead that parents should make an informed decision. Jakew 20:42, 29 March 2006 (UTC)

You know this subject well. But "controversy" was settled in the governing body policy statements. None recommend non-therapeutic neonatal circumcision. That paragraph should not convey otherwise.TipPt

It doesn't. The controversy is acknowledged by at least two policy statements, so there is no reason to doubt its existence. Nor did these statements 'settle' the controversy; they simply stated a position which was doubtless a compromise between their members (or, more precisely, the committee writing the statement). Jakew 11:34, 30 March 2006 (UTC)

I only see the use of "controversy" in your cites from one junior association (aafp), not "at least" two policy statements.

The controversy is NOT over the policy statements. You can always find a minority faction to claim discord. Again, the sentence in the paragraph invites controversy and lazy thinking.172.185.45.163 15:40, 30 March 2006 (UTC)

I'm sure that's your opinion, but it's better to simply cite what they say, rather than interpret it. Jayjg ^(talk) 17:41, 30 March 2006 (UTC)

When you cite a minority, you mislead.TipPt 05:56, 1 April 2006 (UTC))

We cite the assessment of the American Medical Association. If you can find an equally reliable source which states that a larger number of organisations agree, please present it. Jakew 11:09, 1 April 2006 (UTC)

The picture is too dark

Can you make the natural penis pictures the same brightness as the circumcised penis pictures? You can barely see the uncircumcised penis, and it unfairly looks bad so dark.

Jakew... Can I make the pictures equal in brightness?TipPt 16:26, 29 March 2006 (UTC)

—Preceding unsigned comment added by TipPt (talk • contribs)

You don't need my permission. Jakew 20:42, 29 March 2006 (UTC)

Bummer, now I'll have to figure out how to get access and reload.TipPt 22:30, 29 March 2006 (UTC)

Sexual effects

I found the following: "Circumcision has been shown to increase the difficulty of penetration,15 16 to cause erectile dysfunction,16 17 and to cause symptoms of sexual arousal disorder in the spouse.18 The overall effect on marital happiness and the frequency of divorce has not been studied."

Jakew ... do you object to the inclusion of those sentences?

15 Taves D. The intromission function of the foreskin. Med Hypotheses 2002;59(2):180. 16 Shen Z, Chen S, Zhu C, et al. [Erectile function evaluation after adult circumcision]. Zhonghua Nan Ke Xue 2004;10(1):18-9. 17 Fink KS, Carson CC, DeVellis RF. Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. J Urol 2002;167(5):2113-6. 18 Bensley GA, Boyle GJ. Effects of male circumcision on female arousal and orgasm. N Z Med J 2003;116(1181):595-6.

—Preceding unsigned comment added by TipPt (talk • contribs)

Yes, I do object. As you'll see in sexual effects of circumcision, the evidence is contradictory. Any discussion would have to include all evidence, not just that which supports an argument against circumcision. Since the main article is already written, it's best just to give an overview, rather than going over the details. Jakew 11:49, 29 March 2006 (UTC)

Your evidence is from research primarily in adults, who underwent circumcision usually as therapy as adults for a condition detramental to the sexual function of the penis. That research is irrelevant to the topic, since nearly all circumcisions are performed soon after birth, or in boys without a disease. I suggest inserting a sentence for clairification ... what do you think Jakew?TipPt 17:28, 29 March 2006 (UTC)

The sentence and cites are for good research and valuable to the topic. You have pro-circumcision statements in the paragraphs. For example, "...delayed ejaculation may in fact be seen as a benefit."TipPt 17:16, 29 March 2006 (UTC)

I don't understand what you mean by me giving an overview, since I want to add to the article already written. I said include with all you other research, not replace. Where can they be inserted? (I'll exclude the last sentence)TipPt 17:28, 29 March 2006 (UTC)

There is already a detailed article that goes over the relevant studies and discusses findings, whether or not they are contradicted by other studies. It is utterly pointless to repeat that here. Since we have pointed users to the in-depth article, we need only discuss straightforward facts in this one. Jakew 20:45, 29 March 2006 (UTC)

As JakeW points out, there already is an article with the medical details in it. This is an overview article, not the detailed article. Overviews don't replicate details. Jayjg ^(talk) 17:39, 30 March 2006 (UTC)

I'm just learning all the process here, and apologize for my ignorance wasting your time. I know where to make the changes, so I guess we'll just head over there and waste more time?TipPt 05:55, 1 April 2006 (UTC)

Controversial topic warning...

This is a controversial topic, and the content is slanted and disputed. The writing is poor. There should be a warning on the first page.TipPt 17:23, 29 March 2006 (UTC)

I agree. If there's isn't already a POV warning on the article, I'll add one now. Alienus 23:48, 1 April 2006 (UTC)

Can you please specify what exactly in the article is not written from a neutral point of view? That will help us determine when it is appropriate to remove the tag. Thanks! Nandesuka 00:15, 2 April 2006 (UTC)

By placing "controversy" in the paragraph opening sentence and proximate to "association," the current version implies controversy at the association level, and that controversy is critical (being placed in the topic's opening) to the act of circumcision. It is neither.

Debate between individual doctors and controversy between parents and doctors appears significant where circumcision is practiced; therefore the “controversy” over the existence or relevance of preventative benefits and procedure risks and complications might be placed in the closing sentence of that paragraph. Both benefits and medical risks (which do not include impacts on sexuality) are relatively minor to the decision to circumcise, and they should not dominate later sub-articles.

Essentially all circumcisions are performed on neonatal and young males as a "cultural ritual." [[8]] The breadth and depth of the circumcision topics should likewise focus on the act as it is currently practiced.TipPt 21:24, 2 April 2006 (UTC)

The reader should know that no (searching for the word...respected?, significant?, major?, authoritative is probably the best) medical association in the world recommends neonatal circumcision or frenectomy. Neonatal circumcision is categorized "non-therapeutic" and "elective," which are specific medical terms and should be referenced because these are medical procedures. They easily fit the definition of "mutilation,” according the Stedman's medical dictionary (which should be referenced). The word mutilation should be in those opening sentences, because that gets to the heart of the current debate over circumcision as it is primarily (neonatal) practiced. How do I get permission to use specific words?

Those two pictures are not comparable. You can barely see the natural penis, and the darkness makes it unusual and relatively (to the brighter picture of the circumcised penis) unattractive. I looked into fixing that myself, but my PC (and me) couldn't get the wiki software download to work. Please someone help.

The penis is a sexual organ, and the most erogenous tissues reside on the front of the erect penis; therefore comparable erect frontal images need to be added. Please someone help.

Thank you for looking over us.TipPt 17:52, 2 April 2006 (UTC)

Lines moved to the topic below.TipPt 22:25, 2 April 2006 (UTC)

PS... The penis is a sexual organ, and stimulation to the penis is considered erogenous. The circumcised penis has less surface area to produce sensations. The reader should know that (at a minimum) reducing or removing frenular tissue will reduce or eliminate perceptions of sexual sensations. Thicker skin resulting from uncovering the glans will make it less sensitive. Removing highly innervated mucosa (all mucosa is highly innervated and sensitive relative to skin just by structure) will remove sensation, however degree erogenous. Finally, the reader should know that circumcision will limit potential skin and mucosal mobility; thus reducing stretch nerve (common to the frenulum and frenular delta, and commonly considered erogenous) stimulation. These statements can be made on the basis of changes to anatomical structure alone.TipPt 19:05, 2 April 2006 (UTC)TipPt 22:43, 2 April 2006 (UTC)

You keep inserting large amounts of personal opinion into the Talk: page, rather than referencing reliable sources. Please use the Talk: pages for their intended purpose. Jayjg ^(talk) 03:28, 3 April 2006 (UTC)

Debate with Jakew

Ok, let's address these one by one.

You object to the sentence concerning controversy ("Routine, non-therapeutic infant circumcision is controversial."). I suggest that we reword it, to say: "According to the BMA and AMA, there is controversy within the medical profession over whether circumcision should be routinely performed." This removes any ambiguity (I personally feel there is none), and is verifiable.(jakew)

Not acceptable. Controversy between individual doctors is not unusual, and not noteworthy to the topic as it is practiced. What doctors have to say about circumcision is almost irrelevant to the decision to circumcise.[[9]][[10]]

This article reports on a survey of 124 parents - a tiny proportion at a single site in the USA. It dates from 1987, which was before the AAP reversed their long-standing recommendation against circumcision (to paraphrase the AMA) and recommended discussion of the benefits and risks. It's stretching things a lot to state that the findings are valid in the general population today. It's unclear why you've given two different links to the same article, by the way. Jakew 10:46, 3 April 2006 (UTC)

The study was peer reviewed, and then validated somewhat by being cited by the Association. You say it's not acceptable research?TipPt 18:51, 3 April 2006 (UTC)

Peer review is not a guarantee of eternal truth, Tip, nor is it meant to be. Jakew 10:08, 4 April 2006 (UTC)

Peer review means other scientists approved its publication. It's a big deal. The 1987 Association statement serves as validation, and is currently posted on their site. I read the summary or larger study coming to the same conclusion, but have to find it again.TipPt 16:36, 4 April 2006 (UTC)

Certainly a peer reviewed study is more valuable than one which is not, but it does not constitute any guarantee that the findings of the study are correct (this is readily provable by the fact that peer-reviewed studies can easily be found with contradictory findings). Some studies are better than others, and a peer-reviewed study can and often does have flaws. I'm afraid I don't know what you mean by being cited by the association. The text at the bottom is a copyright notice that appears on all of their publications.

Please understand that I'm not saying that it is junk or even that it should not be cited in the article. I'm just saying that it's not the best of evidence on which to base a decision to completely restructure the article. Jakew 17:59, 4 April 2006 (UTC)

I trust you now, and won't waste so much time. You'll allow the cites above, and properly study my proposed outline and introductory paragraphs. It won't be as drastic as you think ... moving sections around is easy ... and most everything will be left (content wise). Now, I need to work in the libraries.

Oh, I woke up realizing your formula is correct, but the measurement method wrong. (100)F/F+L ... but you measure F by making the shaft skin/mucosa almost tight and marking the two points at the base of where you pinch with a pen. Now, stretch out and measure that marked section of skin. Your way, F is constrained by the circumference of your shaft skin. Now, a circumcision to my penis would remove 80% of the potential surface of my penis (if stretched tight and only left with 1/2" under the corona). I think the readers would benefit from having that formula and understanding those concepts.

Please consider where Americans heads are ... I read somewhere credible that 15% of US men didn't know their circ status. Most women think the foreskin is mostly only skin(not 50% mucosa). Right now, wiki readers think controversy is more important.

Ignorance....so that infant (in the video) is mutilited (IF I can cite properly evidences that the frenulum is highly erogenous, THEN that word will be used) by a ignorant surgeon.16:15, 5 April 2006 (UTC)

You state that benefits and risks are 'relatively minor' and should not dominate. However, most medical organisations devote the majority of the text in their statements to these, and recommend that they should be discussed with parents. I'm not saying that you are necessarily 'wrong', but you seem to hold a minority opinion here.(jakew)

It's a big issue for doctors because of the controversy they feel between an "elective procedure" being performed on an infant, and parents expecting the deed. Again, medical issues are not significant to the decision to circumcise, and are therefore minor.TipPt 22:38, 2 April 2006 (UTC)

Ok, firstly I'd like you to show me that it's a "big issue for doctors". I need rather more than your opinion. Secondly, I need evidence that medical issues are insignificant. Jakew 10:46, 3 April 2006 (UTC)

You want mention of the fact that some organisations have described it as 'non-therapeutic' and 'elective'. I see no harm in this, but there's no need to make a big deal out of it: the organisations themselves don't.(jakew)

The policy statements (from within nations where the practice is or was common) are the bottom line. That is the conclusion of the associations appointed body on the issue. It is THE DEAL as the concluding recommendation to member doctors and consumers.TipPt 22:43, 2 April 2006 (UTC)

No, it's just a word that they happen to use somewhere in the statement. It is not a final conclusion, and presenting it as otherwise distorts their statement. Jakew 10:46, 3 April 2006 (UTC)

You state that circumcision fits the definition of mutilation, and this should be included. That is POV and unacceptable. We can, however, include the fact that anti-circumcision ("genital integrity") groups make this claim.(jakew)

We'll need someone to adjudicate this isssue for us. Someone help please.TipPt 22:51, 2 April 2006 (UTC)

Better still, why don't you read WP:NPOV. Jakew 10:46, 3 April 2006 (UTC)

One of the things I'll get in the UCLA libraries is the Stedman's definition and cite.TipPt 16:36, 4 April 2006 (UTC)

Forgive me if I'm mistaken, but haven't you already quoted the Stedman's definition? Jakew 17:59, 4 April 2006 (UTC)

In my opinion, genital integrity groups are not that relevant to the topic (or their use of the word mutilation), other than they have provided lots of citations to scientific research.TipPt 22:51, 2 April 2006 (UTC)

Debatable, but this is not the place. Jakew 10:46, 3 April 2006 (UTC)

Again, the problem is the unreasonable emphasis you place on genital integrity groups.TipPt 16:36, 4 April 2006 (UTC)

Articles written from a neutral point of view cannot declare that circumcision is mutilation, because that is not neutral. What we can do, however, is state that specific entities have described it as such. Anti-circ (aka genital integrity) groups happen to be the most vocal groups who have done so. Jakew 17:59, 4 April 2006 (UTC)

You want the picture improved. Ok, fine. I've uploaded a gamma corrected version. Jakew 20:09, 2 April 2006 (UTC)

Thank you. Do you know what happened to those great pictures of the frenular delta?TipPt 21:46, 2 April 2006 (UTC)

The pictures appear unchanged.TipPt 23:01, 2 April 2006 (UTC)

I uploaded and confirmed that the picture was updated last night. I agree that the picture is back to how it was now, and there is no record in the history. I don't understand this. It may be a bug in the Wiki software, or an admin may have used the rollback facility (pun unintended). I may try again later today, but frankly, I did that as a gesture of good faith, and your reaction not been encouraging. Jakew 10:46, 3 April 2006 (UTC)

Thank you for making the pictures more comparible. All readers benefit.TipPt 18:46, 3 April 2006 (UTC)

There is no clear evidence showing that the perceptions of sexual sensations are reduced. Even if we were in agreement (we're not), we could not make such a statement without violating WP:NPOV and/or WP:NOR. Jakew 20:09, 2 April 2006 (UTC)

If you remove nerve receptors and damage nerves you loose all sensation to that area. If sensation in that area is erogenous, you loose that perception. Evidence is lacking because no proper control group exists. We will need someone to adjudicate this issue for us.TipPt 22:38, 2 April 2006 (UTC)

No, we need evidence to support a claim, otherwise it must not go in the article. It doesn't matter how confident you are of your theory. verifiability is required by policy. Jakew 10:46, 3 April 2006 (UTC)

Peripheral nerve regeneration is well documented. It has been suggested that receptors form at the new end of the nerves (at the incision line), and this possibility must be considered.(jakew)

If you put that in the articles somewhere, it will need to be removed because that is a well discredited hypothesis.TipPt 22:22, 2 April 2006 (UTC)

I don't intend to include that in the article, actually, but I'm curious: how has peripheral nerve regeneration been discredited? Jakew 10:46, 3 April 2006 (UTC)

In one of those medline ... like your glans sensitivity proof ... research abstracts they found ... started with an "ne..." some kind of tissue along the circ scar known to block regeneration potential. They conclude that it's unlikely (responding to prior hypothesis)>TipPt 16:52, 4 April 2006 (UTC)

Sorry, you've lost me. Which abstract do you mean? Jakew 17:59, 4 April 2006 (UTC)

Additionally, there may be increased stimulation of other parts of the penis, leading to a net increase in sensation.

That's silly. When you remove 50% - 80% of the surface area of the penis, sensation will decline.

No, it's not silly. Sensation is a product of the ability to sense stimulation and the degree of stimulation itself. Net sensation is the sum of stimulation at every point. Even if 50%-80% of the surface area is removed (and that's a bit of an exaggeration), you've a long way to go before you've established a net loss of sensation. Jakew 10:46, 3 April 2006 (UTC)

You must have seen that circ video linked in the article. The surgeon is skilled (probably done lots). He is removing 80%+, if you count both the skin and mucosa. When erect, my foreskin extends to within an inch of the base of my penis. Removing all but an inch (looks common) of the foreskin would represent about 80% of that surface area.TipPt 17:02, 4 April 2006 (UTC)

This is original research anyway, but try something for me. Without giving me your precise dimensions (I really don't want to know), let L be the length of your erect penis. Now between your thumb and forefinger, pinch out the loose skin on the shaft. Let F = twice this length. The maximum percentage of skin removed is (100)F/F+L. Unless your foreskin is unusually long, it'll probably be in the 20%-40% range. Jakew 17:59, 4 April 2006 (UTC)

I should have said mucosa (not skin above) that extends down nearly to the base of my penis...

Pinch up ant out at a 90 degree angle and and up tight to get F and mine comes to 58%, but point well taken.172.185.39.154 05:17, 5 April 2006 (UTC)

You have to agree that that infant got a low tight cut, that removed (if he was born with one) most of his frenular zone.

Parents should know that the ability to sense stimulation will be removed to some extent in all circ's, and that the loss could be significant.TipPt 05:27, 5 April 2006 (UTC)

And if you can find scientific evidence, that's fine. If it is merely your opinion, it is not fine. Jakew 17:59, 4 April 2006 (UTC)

There is evidence to support this idea. In Masood's recent study, for example, 38% of adult circumcision patients reported increased sensation, 18% decreased, and the rest no change. These issues would need to be addressed in an in-depth analysis, but of course Wikipedia is not the place to do so due to the prohibition against original research. Jakew 21:51, 2 April 2006 (UTC)

The nerve receptors we are concerned with are located in the mucosa and possibly the skin of the penis; they are at least partially cut away with the tissue. The tissue known to be erogenous ... I've shown you the citations, and why else would Europeans call the frenulum the "sex nerve."TipPt 22:38, 2 April 2006 (UTC)

The Mastood study, and other subjective response research on adult circumcised patients (meaning men who underwent circumcision as adults for cosmetic or therapeutic reasons) are not relevant to the predominant practice of neonatal and infant circumcision. We also don't know how much and where tissue was removed in the adults compared to the infants and boys. Studies of men circumcised as adults barely belong in the topic because they are so extremely rare and not representative of the overall patient population.TipPt 22:47, 2 April 2006 (UTC)

That's a very USA-centric view, my friend. Globally, I think you will find that most circumcisions are performed on Muslim boys or young teenagers, who may not be sexually active, but otherwise have a lot in common with these men. In other nations, such as here in the UK, adult circumcisions are not particularly unusual. Jakew 10:46, 3 April 2006 (UTC)

I included "boys." The point was the focus of the articles is on ADULTS (given the opening paragraphs content).TipPt 16:55, 4 April 2006 (UTC)

I can't see that it does focus on adults. Jakew 17:59, 4 April 2006 (UTC)

Most of the studies cited in the sexual effects section should also considered suspect, because patients elected to have the procedure (cog dis and all that) for cosmetic reasons or to correct a problem (that quite possibly interfered with their performance).TipPt 22:38, 2 April 2006 (UTC)

Perhaps, perhaps not. They are the best available evidence. Jakew 10:46, 3 April 2006 (UTC)

Jakew ... The topic must reflect reality. Your experience of adult circumcision represents (by numbers) a very tiny minority of those circumcised. All but a small fraction of a percent were circumcised as infants or boys.TipPt 22:22, 2 April 2006 (UTC)

See above. Jakew 10:46, 3 April 2006 (UTC)

Retrieved from "http://en.wikipedia.org/wiki/Talk:Circumcision"TipPt 22:38, 2 April 2006 (UTC)

Your view of "reality" is all well and good, but it must be backed up by reliable sources. Jayjg ^(talk) 03:27, 3 April 2006 (UTC)

The numbers of neonatal and young male circumcision are so huge, that they swamp the number of adult circumcised males into obscurity.TipPt 03:37, 3 April 2006 (UTC)

Yes, but what is the relevance? Jayjg ^(talk) 03:38, 3 April 2006 (UTC)

The article does not reflect practice.TipPt 16:56, 4 April 2006 (UTC)

In what sense? Is the surgery radically different when performed on young males? Jayjg ^(talk) 18:41, 5 April 2006 (UTC)

Please help.

I need some insulation from Jakew. I will rewrite these articles properly, but the best solution would entail deleting most of the current content. It will take considerable effort.

If my proposed rewrite is accepted as neutral and accurate by some governing body within Wikipedia ... can it's essential focus and scope be protected from Jakew?

How would you like me to correct my above (see the Controvercial topic warning reply to editors) proposed "fix" toward neutrality?TipPt 23:11, 2 April 2006 (UTC)

I will do my best to help, but Jakew has a small but determined cabal (with Jayjg and Nandesuka) that reverts changes to these articles. Then again, between the two of us and this Glass person who's been making constructive changes, perhaps there is sufficient force of numbers to defend the article from the cabal. Alienus 23:18, 2 April 2006 (UTC)

The articles are exquisitely neutral, and extremely well sourced. You have yet to be able to articulate exactly what is "non-neutral" about the article, aside from the fact that it doesn't conform to your personal point of view. And Alienus won't be able to help you if he gets himself sanctioned or banned for his continual violations of WP:CIVIL. Jayjg ^(talk) 03:26, 3 April 2006 (UTC)

You clearly (I'm being nice) didn't read my reply to Nandesuka's question in Controversial topic warning above. Again, the topic should reflect the current practice.TipPt 03:48, 3 April 2006 (UTC)

I read it. You want to call circumcision "mutilation". You think the picture is too dark. Etc. Please re-read WP:NPOV and WP:NOR. Jayjg ^(talk) 03:53, 3 April 2006 (UTC)

I don't think you know what neutrality is. You clearly don't know what civility is. Your threats, for example, are hardly civil. They're also empty. It's clear that TipPt has reliable sources, so there's no problem on that account, either. I say we're 100% on this. Alienus 03:38, 3 April 2006 (UTC)

I can't really have made an "empty" threat when I haven't made any threats at all, and so I can't have violated the civility policy. You, on the other hand, have made continual empty threats, interspersed with civility violations - continually placing those who disagree with your POV and policy violations in an imaginary "cabal" would be one small example. As for TipPt's sources, the problem is they tend to be poor at best, and generally don't back up his claims. So, yes, we're 100% on this, just not the 100% you imagine. Jayjg ^(talk) 03:46, 3 April 2006 (UTC)

It's perplexing that you state that it's 'clear' that Tip has reliable sources, since he has so far presented very few. It may well be that he will present some in future, but one can hardly call that 'clear'. Jakew 12:07, 3 April 2006 (UTC)

I may be mistaken, but someone messed up a link to http://pediatrics.aappublications.org/cgi/content/abstract/80/2/215 How can they be baned?TipPt 03:41, 3 April 2006 (UTC)

Perhaps you should spend a great deal of time reading our policies before making suggestions about banning. Jayjg ^(talk) 03:46, 3 April 2006 (UTC)

I have been quite impressed with the wiki process, and assume that clear cases of vandalism are treated harshly.TipPt 18:01, 3 April 2006 (UTC)

Well, it's not clear to me what vandalism has been done here, I don't know which edit you are referring to. In general, vandalism is simply reverted. If it continues, then the vandal is warned. If it is persistent, then the vandal is blocked, usually for a brief period, then for increasing periods. When was this link "messed up"? Jayjg ^(talk) 18:58, 3 April 2006 (UTC)

My time is best spent writing a great article.TipPt 03:51, 3 April 2006 (UTC)

Again, perhaps, but since it's clear you are not yet familiar with Wikipedia's content policies, it is inevitable that your "great article" will not be appropriate for this site. Jayjg ^(talk) 03:53, 3 April 2006 (UTC)

"Inevitable" is a bit strong. I'm interested to see what he comes up with, though. Nandesuka 05:38, 3 April 2006 (UTC)

Based on prior experience, it would be better to work on incremental changes. Jakew 12:07, 3 April 2006 (UTC)

No, "inevitable" is exactly the right word. It is inevitable that anything that doesn't fit your extremist pro-circumcision agenda will be rejected. That's what the cabal is all about. Alienus 05:55, 3 April 2006 (UTC)

You know, I happen to agree with some of your substantive points, but your methods of pushing it are anything but appropriate here. Like it or not, Jake and Jayjg are here and here to stay. You can either compromise like an adult, work with them, and produce something that might not be perfectly what you wish to see, but will at least be an accomplishment - or you can continue to insist on having it all your way, and be stonewalled out. It's your choice. This is a site that rewards consensus and punishes unilateralism, and you're putting yourself in a position where you're going to learn that the hard way. Learn to separate the person from the position. You may disagree with Jakew but he is not an evil person and he's not your enemy. -Kasreyn 07:33, 3 April 2006 (UTC)

My "method of pushing" my view was to try to work with these people here in the Talk page to find an acceptable way to mention CA-MRSA. See the history for why this didn't, doesn't and won't work. The truth is that Wikipedia punished unilateralism but rewards cabals, which is why Jayjg, Jakew and Nandesuka have formed one. Therefore, the only consensus we'll ever get that allows such things as the CA-MRSA is one that is viciously opposed by the existing cartel that owns this article, yet overcomes it. Call it cynicism, call it realpolitik; either way, it's the simple truth. This article will not get one bit better until the current cartel is overthrown by another one. Alienus 07:58, 3 April 2006 (UTC)

I don't think an anti-circ POV cabal would be any better for Wikipedia or for its readers. You make a lot of claims about conspiracies, but those are extraordinary claims that require proof that you're not supplying. If you're wondering why you're getting blasted for violations of WP:CIVIL, that's why. Calling people conspirators is uncivil, no matter how right you think you are. I'll agree with you that Jakew has a definite POV and guards the article zealously, but he's also one of the most well-informed people who's ever contributed to this page. He's contributed a great deal here, and if some bias has come with it, then (IMO) that's just life - apparently no one on the anti- side has cared as much as Jake has, to educate themselves and contribute. Democracy, which includes Wikipedia, is a system that favors those who get involved. Jake has invested a great deal of his time here, so as a result the article has a lot of his stuff in it. That bothers you, I know. It bothers me too, at least a bit - but since I haven't taken the time to educate myself and become equally involved, it obviously must not bother me that much... -Kasreyn 10:50, 3 April 2006 (UTC)

I think I'm making a rather ordinary claim, well supported by the evidence, but you wouldn't know because you haven't actually looked into this and likely never will. That's the problem with getting sucked into someone else's problem; you enter unprepared and can easily be used as a tool. Right now, Jakew has taken your text out of context and used it in an Rfc whose goal is to silence me. It's not bad enough that he has bias of his own, but he wants to make sure that anyone who doesn't share his bias doesn't get to contribute. Oh, and you're helping him. Congrats. Alienus 05:27, 7 April 2006 (UTC)

Kasreyn ... I am eager to work efficiently with all editors. Let me give you an example of gross wasting or time and worse. I change "young" to read "new" mothers [[11]] and it's changed back to "young" ... but the cite reads "new" mothers.http://www.circs.org/library/williamson/index.html

Again, I will devote considerable effort, but can't waste that kind of time.

Some thoughts on policy

I first edited this page back in October 2004. I had a POV then, and I still have one now. So too does each and every contributor. It may be strongly held, or less strongly, but you have one. Anyone who tried to convince himself or herself otherwise, or that their POV is the neutral POV, only deceives themselves.

We may be certain of your viewpoint. We may be passionate about it. We may be able to make a very good case that it is unassailable truth (alternatively, we may be able to make what you think is a very good case - which is somewhat different). None of this makes our viewpoint neutral. Nor does the quality of our 'case' justify ignoring NOR.

Policies are there for a reason. This is a controversial subject, and that makes it all the more important to adhere to these policies. An encyclopaedia does not endorse a point of view. It does not present new lines of reasoning. It reports on current knowledge, accessible in reliable sources.

I don't pretend to be perfect, but I make an effort to separate my POV from what is suitable for inclusion, and include only that which is based upon factual, verifiable evidence.

It's not easy to write from a truly neutral viewpoint, and that's perhaps why this article is somewhat cold and clinical. "So-and-so suggested", "Blahblah found", "the XYZ organisation states" - all these statements are verifiable. They are neutral (assuming that XYZ did indeed state that), and they are reliable sources. There is no original research, no novel narratives or interpretations, and no surprising conclusions.

The article may not be perfect, but it would be hard to find a part that is unverifiable or non-neutral. Even if you may disagree with a source cited, I doubt that you could argue that the source is misrepresented. Can anyone proposing a change say the same? Please, think about this. Jakew 12:07, 3 April 2006 (UTC)

I think this would come across as genuine if I didn't know better. Frankly, your actiosn speak much more loudly than your words, and they say something different. (Quick, quote this in your bizarre Rfc attack on me. Make sure to omit all context!) Alienus 05:27, 7 April 2006 (UTC)

You fail to grasp the fundamental issues

The issue of neutrality revolves around the heavy emphasis you have placed on circumcision on adults, and your heavy emphasis on potential medical benefits and risks. In the first case, that cohort is insignificant (by the relative percentage of total procedures, rational, type of operation, and by amount and location of tissue removed). For example, the second paragraph discussion should be much further down in the article and in a sub. Another way of focusing on circumcision as it is primarily practiced will be to place the third paragraph (to include boys as well as neonatal) after the first paragraph. In the second case (benefits and risks), the problem is that parents aren't having their kids circumcised for the medical preventative benefits, they are doing it as a "cultural ritual" (US)[[12]], or for religious reasons (mostly Muslims and Jews).

I'm afraid you failed to read an editor's request, and my response to that request: "Can you please specify what exactly in the article is not written from a neutral point of view? That will help us determine when it is appropriate to remove the tag. Thanks! Nandesuka 00:15, 2 April 2006 (UTC)"

... And these parts of my response: By placing "controversy" in the paragraph opening sentence and proximate to "association," the current version implies controversy at the association level, and that controversy is critical (being placed in the topic's opening) to the act of circumcision. It is neither.

Debate between individual doctors and controversy between parents and doctors appears significant where circumcision is practiced; therefore the “controversy” (should be addressed)

... Both benefits and medical risks (which do not include impacts on sexuality) are relatively minor to the decision to circumcise, and they should not dominate later sub-articles. Essentially all circumcisions are performed on neonatal and young males as a "cultural ritual." 8 The breadth and depth of the circumcision topics should likewise focus on the act as it is currently practiced.

And on another issue I wrote ..."They easily fit the definition of "mutilation,” according the Stedman's medical dictionary (which should be referenced). The word mutilation should be in those opening sentences, because that gets to the heart of the current debate over circumcision as it is primarily (neonatal) practiced.

(I just realized that's wrong ... probably far more muslims circ'd as boys than in the US as infants, but it still meets the medical definition of mutilation ..."mutilation" as "disfigurement or injury by removal or destruction of any conspicuous or essential part of the body."TipPt 16:48, 3 April 2006 (UTC)

How do I get permission to use specific words? As an aside, I think voluptuous might be reserved for the orgasm.TipPt 16:34, 3 April 2006 (UTC)

I have addressed your concern regarding the percentage of patients who are adults above (namely, in a global context, this is not an issue. Wikipedia is not US-only). Your concerns about "type of operation, and by amount and location of tissue removed" appear to refer to a private theory of your own, rather than any actual evidence. I have also addressed the problems with your dated link above.

I not only read Nandesuka's comment and your reply, but I also proposed an alternative wording that avoided any ambiguity.

You are free to regard the benefits and risks as minor, though as I've remarked this is the focus of most medical organisations, as well as the majority of available sources.

Again, while you are free to hold the opinion that circumcision fits the definition of mutilation, that is merely your interpretation and it does not belong in the article. Clearly reasonable people may disagree (since by that definition only procedures that disfigure or injure - in other words, cause functional or cosmetic harm - meet the criteria).

Finally, you don't "get permission" to use certain words. Wikipedia doesn't work that way. You try to gain consensus instead. If there is consensus, the word is incorporated, while if there is none, it is rejected. The same is true of any content. Jakew 17:03, 3 April 2006 (UTC)

Let me translate for TipPt: there will never be a consensus to support your reasonable changes so long as the cabal that currently owns this article remains. Never. Not ever. Regardless of your evidence. Alienus 17:33, 3 April 2006 (UTC)

Your inability to assume good faith is sad. Nandesuka 17:38, 3 April 2006 (UTC)

Your memory is failing you, as I've clarified this issue before. It is one thing to assume good faith in advance, which I did, and another to continue to believe in it even after it has been soundly disproven. In short, the rule requires only that we assume good faith, not that we conclude it. Conclusions are driven by the evidence and may override initial assumptions. Please make a note of this so that I don't have to repeat myself again. Thank you. Alienus 17:42, 3 April 2006 (UTC)

Your inability to assume good faith is still sad. Nandesuka 18:56, 3 April 2006 (UTC)

Lamentable. Jayjg ^(talk) 19:01, 3 April 2006 (UTC)

I have no idea what you're talking about. As I've once again explained, I did assume good faith. Sadly, you proved that my assumption was overly optimistic. That's what's truly tragic. Alienus 19:14, 3 April 2006 (UTC)

Let me phrase the question differently. How do we get a larger audience so there is a relavant concensus? Right now it's just (5?) people.TipPt 18:24, 3 April 2006 (UTC)

You could always try an article RfC here. They sometimes bring in more editors. Jayjg ^(talk) 19:01, 3 April 2006 (UTC)

Jakew made some questionable statements without citation, but they could be critical findings. He wrote "I don't see a problem with describing the glans as erogenous. Studies have been conducted in which erection and ejaculation have been induced through stimulation of the glans. I'm not aware of any that have tested the frenulum, however. Jakew 11:07, 1 April 2006 (UTC)

Jakew...Could you please provide those glans/orgasm studies (more than one would be really great) citations?TipPt 18:32, 3 April 2006 (UTC)

Ok, here's another. [13] Also, Schellen did some work on this subject in 1968. Try Fertil Steril 1968; 19(4): 566-9.

I really don't understand why you're demanding sources for a statement that isn't even in the article... Jakew 10:34, 4 April 2006 (UTC)

Getting to know where you are coming from is critical to my deciding to help. Thank you.TipPt 17:20, 4 April 2006 (UTC)

Note (I've seen another similar study) they used "vibratory stimulation," ... with a warning that tissue damage can result. The vibration would also stimulate the frenular zone.TipPt 17:20, 4 April 2006 (UTC)

This is meant simply to be an observation from a neutral observer, NOT a new member of some perceived "cabal." I have, in the last 2 weeks, learned more than I ever wanted to know about circumcision in preparation for the birth of my 1st son, Zidon. Wikipedia is the first place I went for information, and in my further research I have come to believe that this article is about as neutral and informative as possible, given the nature of the subject. People seem to have very, very strong opinions regarding this issue, so it's understandable that tempers will flare; however, what's truly regrettable is to read the degradation of conversation from obviously intelligent individuals into simple, juvenile bickering. I do not want to take sides, but I would like to point out to alienus that a group of consenting opinions does not create a cabal, a mob, a conspiracy or any type of other paranoia-induced group. Jaileer 21:48, 3 April 2006 (UTC)

You're right; their mutual agreement is not what makes them a cabal. Rather, it's their strong-arm tactics and refusal to be reasonable. They're convinced that they own the article. Alienus 01:27, 4 April 2006 (UTC)

Yes, that's right. The cabal decided upon these tactics at the 2005 Circumcision Cabal Strategic Review. We're due to assess them at the next review meeting. One item on the agenda is discussion of whether to purchase more black helicopters. ;) Jakew 10:34, 4 April 2006 (UTC)

I think Jakew is sincere, but callused by all the constant nuts messing around. I certainly started out stupid, and wasted his time. I still have lots to learn, but my time is better spent writing. The library is still the best place to write this kind of stuff because you have access to expensive periodicals and lots of help.

I know a UCLA professor who is considering a study using brain activity imaging and uniform stimulation to measure penile zone sexual response. If he doesn't, it will be because it's too political.

Jaileer ... I agree that wiki better and its all in one place. But the focus is on adult circs, not infants and boys ... which account for most circ's. Most of the It therefore misleads regarding potential effects on sensation and sexuality.

The frenulum and frenular area is considered a primary erogenous zone in college sexuality texts. The frenulum is called the "sex nerve" in Europe, and the "eye" of the penis in France. I've found a survey where teens rate it the prime real estate. In the Wiki erogenous zone article it is listed as primary.

Personally, 90% of my highly erogenous (orgasm trigger?) sensation comes from my frenular delta, which includes my frenulum. I get effectively nothing from my glans or base of shaft. I love the warm wet slide feeling I feel from my mucosa during intercourse. I love the feeling of my prepuce rolling back as I get an erection (it's thus self-perpetuating).

I would hate to loose any mucosa, and would miss any loss of skin. If a surgeon removed the too much (variable by individual) mucosa, he would reduce my frenular delta and my potential to feel pleasure. Most important, if he removed my frenulum, he would also be damaging and removing most of the delta. I would be left with a small fraction of the nerve receptors that, for me, produce all of the highly erogenous pleasure.

Circumcision is used in some countries as a sort of neurological castration (yes, I've that cite too Jakew ... and descriptions of the practice that matches the frenectomy).

Two pediatricians and a doctors website (selling circ's basically) state that the amount of mucosa left after the circ will be variable, again partly because of differences in individual anatomy, but also due to the tools used and the skill of the surgeon. I’d personally use an experienced mohel if I had to have it done on my infant ... at least you can ask to preserve the frenular zone and it's quick. I personally think the Gomco Clamp is crude (65% are done with this tool), and is designed so an idiot could perform the surgery.

The Circumcision article does not reflect reality. Most circ's are performed on infants and boys, not adults, but the emphasis is on adults. "Controversy" gets top billing, but it is not relevant because circ's are usually done as a "cultural ritual." Likewise, when a doctor informs parents about medical risks and benefits, it doesn't change the average decision (to circ or not).

Excess removal of skin and mucosa is not considered a risk or complication of circumcision or frenectomy. Parents are not aware that there is even the potential that they will be removing erogenous tissue. Choosing a good surgeon takes knowledge.TipPt 16:19, 4 April 2006 (UTC)

You still don't seem to have any good medical sources for your claims about erogenous zones, neurological castrations, etc. And there does not appear to be any focus on adult circumcisions, particularly given that the introduction in particular mentions "infant circumcisions", and discusses potential complications, many times, and the rest of the article focusses almost exclusively on infant circumcisions. Jayjg ^(talk) 18:46, 5 April 2006 (UTC)

If anyone is truly a cabal, they should truly fear hell.TipPt 16:13, 4 April 2006 (UTC)

Someone has Vandalized the pictures again

Probably twice now. There's no way to stop these kinds of actions?TipPt 23:10, 3 April 2006 (UTC)

Check out WP:Vandalism. Add an appropriate warning template to the vandal's talk page. Once they get enough warnings for vandalism, an admin will consider blocking them. That's how. -Kasreyn 09:11, 4 April 2006 (UTC)

I'll read that, thanks, but I don't have the time. I write well, and welcome a good editor managing over. I will never be an editor.TipPt 15:00, 4 April 2006 (UTC)

South Africa rates and updated U.S. rates

I've been watching this page as part of a health class-related project I'm doing. I have not seen any Soouth Africa circumcision rates, but I know the practise there is nowhere near universal. Shouldn't Souh Africa be removed if no official source gives its rate as 50%+? Also, on that note: I know there are rates somewhere near the mid-50% range? Why aren't those being used? They are more recent, I believe. Shalom. --Trafton 07:12, 4 April 2006 (UTC)

The figures given in the article for US rates are the most recently published. Some anti-circumcision activists claim to have more recent data, but they are not reliable sources. Jakew 09:10, 5 April 2006 (UTC)

Which anti-circ activists are these, Jake, and why aren't they reliable? Please tell me you don't think they're unreliable because they're anti-circ, why that would just be... umm... circ-ular. (ouch. yes, I know, I deserve to die horribly for that pun) But seriously, I'm merely curious as to how vast your information network really is.  ;) -Kasreyn 11:10, 5 April 2006 (UTC)

I had in mind a press release from MGMBill.org and the CIRP website, Kasreyn. I'm sure that I don't have to tell you that press releases are not always totally factual, so let's focus on CIRP. As the personal site of two anti-circ extremists, CIRP does not meet the requirements of WP:RS. Furthermore, they have previously ignored requests to change false statements on their site, the stats they present are unverifiable (they do not specify their criteria, and when I tried, I got different results), and they airily claim that the NCHS data disagrees with theirs due to a technicality that - again - cannot be verified. Jakew 15:43, 5 April 2006 (UTC)

I am glad you are so vigilant in regards to accurate sources, Jake - kudos on that. Now that we've settled that, could you please provide the accurate source for the South Africa claims? I can understand assumed indicators (Israel, Muslim countries, etc.), but in South Africa - where rates are nowhere near 100% - information needs to be sourced or there should be an "unknown" status. Don't you agree? --Trafton 07:51, 6 April 2006 (UTC)

Probable resolution with Jakew

Just to keep ya'll up ... hopefully more editors when I actually have a product ... here's TipPt and Jakew's last conversation:TipPt 16:21, 5 April 2006 (UTC)

"Please understand that I'm not saying that it is junk or even that it should not be cited in the article. I'm just saying that it's not the best of evidence on which to base a decision to completely restructure the article. Jakew 17:59, 4 April 2006 (UTC)"

"I trust you now, and won't waste so much time. You'll allow the cites above, and properly study my proposed outline and introductory paragraphs. It won't be as drastic as you think ... moving sections around is easy ... and most everything will be left (content wise). Now, I need to work in the libraries."TipPt 16:21, 5 April 2006 (UTC)

Why don't you just explain a) what changes ought to be made, and b) what sources support what you think the article should say. Jakew 20:08, 5 April 2006 (UTC)

I will now, just please be fair.TipPt 22:08, 5 April 2006 (UTC)

"Oh, I woke up realizing your formula is correct, but the measurement method wrong. (100)F/F+L ... but you measure F by making the shaft skin/mucosa almost tight and marking the two points at the base of where you pinch with a pen. Now, stretch out and measure that marked section of skin. Your way, F is constrained by the circumference of your shaft skin. Now, a circumcision to my penis would remove 80% of the potential surface of my penis (if stretched tight and only left with 1/2" under the corona). I think the readers would benefit from having that formula and understanding those concepts."TipPt 16:21, 5 April 2006 (UTC)

Benefit they might, but our policy is clear: no original research. Jakew 20:08, 5 April 2006 (UTC)

We'll need other editors to chime in on that one ... it's an intuitive workable mathematical formula that edifies. We assume the reader understands basic math.TipPt 22:08, 5 April 2006 (UTC)

Ok. People? Your thoughts, please? Jakew 13:54, 6 April 2006 (UTC)

"Please consider where Americans heads are ... I read somewhere credible that 15% of US men didn't know their circ status. Most women think the foreskin is mostly only skin(not 50% mucosa). Right now, Wikipedia readers think controversy is more important!"TipPt 16:25, 5 April 2006 (UTC)

America has a lot of very smart people. Let's just stick to the facts and trust them to form their own conclusions. Jakew 20:08, 5 April 2006 (UTC)

"Ignorance....so that infant (in the video) is mutilited (IF I can cite properly a range of evidence that the frenular zone is highly erogenous, THEN that word should certainly be used because the parents weren't informed and that's not what the parents intended) by a ignorant surgeon.TipPt 16:21, 5 April 2006 (UTC)

No, if and when you can cite evidence that the frenulum is erogenous, then you cite that evidence. If you can find evidence that the frenulum is removed in a certain percentage of circumcisions then cite that, too. Neither is an excuse to start including POV language. Jakew 20:08, 5 April 2006 (UTC)

Please study the definition of mutilation. If the frenular zone is erogenous and the parents are not informed that it might be damaged (and that this result may be difficult to avoid) ... if it is damaged (not missing), that is certainly mutilation. It is relevant to many subs of the topic.TipPt 22:11, 5 April 2006 (UTC)

Ok, I have examined two definitions of mutilation, and it is not clear that circumcision is mutilation. If you can show that it definitely is, I'd be interested, though if you care to study no original research, you'll see that such a 'proof' still does not belong in the article. Jakew 13:43, 6 April 2006 (UTC)

The key is what the parents and surgeon expected. IF what they got was different, and IF it was worse, and IF it damaged...THEN it meets the strict definition that Wiki requires.TipPt 19:21, 6 April 2006 (UTC)

Agreed, which is why you need to find a source that mentions this, so that they have no excuse to revert you. We know they'll use any excuse available, so don't give them one. Alienus 19:25, 6 April 2006 (UTC)

So far, I'd like to use several citable facts to evidence that the frenular zone is highly erogenous. First, it is labled a primary erogenous zone, second, it was mentioned in your glans sensitivity study (as receiving signal from the dorsal nerve), third, it is mentioned in many fellatio technique articles, (for example, "use your tongue to tickle him around the glans, and especially on his frenulum, the split on the underside of his penis," or "There is a small ridge of skin on the underside of the penis directly below the head called the frenulum, which is extremely sensitive. Make sure your thumb strokes this in that movement" ... based on it's site order of use ranking in Google, that evidence should be cited), forth, tribes where they remove the frenulum to make someone asexual or passive, and fifth, prime real estate in a teen survey (ie THE most erogenous place on your penis?).TipPt 16:41, 5 April 2006 (UTC)

TipPt, have you read the WP:NOR and WP:RS policies yet? They're rather crucial. In a nutshell, you can't draw your own conclusions, but must find reliable sources which draw those conclusions. A "teen survey" would hardly be reliable, particularly when compared to the many medical studies cited in this article, would it? Jayjg ^(talk) 18:49, 5 April 2006 (UTC)

Quite so. Jakew 20:08, 5 April 2006 (UTC)

The teen survey would not belong in the adult sub article.TipPt 22:05, 5 April 2006 (UTC)

What survey in particular do you refer to, Tip? If we knew what it was, it would be easier to evaluate whether it meets the criteria of WP:RS, and as such, whether it would belong in any article. Jakew 13:54, 6 April 2006 (UTC)

I'd also like to see this survey. In addition, I don't understand what you mean by an "adult sub article"; this article deals mostly with infant circumcision. Is there enough material about adult circumcision to put it in a "sub-article"? In what way is the surgery radically different when performed on adults? Jayjg ^(talk) 16:46, 7 April 2006 (UTC)

TipTp, I'd generally ignore Jayjg's unreasonable complaints and focus instead on supporting your text changes with solid references. You're not going to satisfy Jay no matter what you do, so don't bother trying. Save your time for reasonable requests and focus on improving the article, not placating the partisans. That's my $0.02 worth. Alienus 20:07, 5 April 2006 (UTC)

I agree that your advice in this case is worth only $0.02. Nandesuka 21:46, 5 April 2006 (UTC)

The truth is priceless. Alienus 18:07, 6 April 2006 (UTC)

Perhaps you should restrict your comments to things you are familiar with. ;-) Jayjg ^(talk) 16:43, 7 April 2006 (UTC)

I love it when you set an example in civility. Then again, you're following up on Nandesuka's outright insult, so I guess your options were limited. Alienus 17:34, 7 April 2006 (UTC)

Penis pictures

I am not for or against circumcision, but the use of these penis pictures is quite offensive. Is there a need for some horny man to have his penis showing on WIKIPEDIA? Why cant there just be a graphic instead? Not to mention such images could be violating numerous laws. Mattrix18 15:42, 6 April 2006 (UTC)

Wikipedia is not censored for the protection of minors. This is an encyclopedia; encyclopedias have pictures. The article is about circumcision of penises. You shouldn't be surprised to see a picture of a penis here. Nandesuka 18:02, 6 April 2006 (UTC)

Scan the heavens for a syzygy; Nandesuka and I are agreeing on something. It'll never last.

What this article needs is less censorship, not more. Alienus 18:09, 6 April 2006 (UTC)

Those pictures are not educational, and it could be shown in a different way, such as like: http://medicalimages.allrefer.com/large/circumcised-vs-uncircumcised.jpg . Wikipedia isn't exempt from the law. Mattrix18 20:14, 6 April 2006 (UTC)

It's solely your opinion that the pictures are not educational. The consensus among the rest of us appears to be that they are. I once looked in my ex-girlfriend's anatomy textbook (she was in med school at the time) and there were photographs of penises. So it would appear that medical doctors disagree with you about whether photos of penises are educational, since they saw fit to print them in an anatomy text. -Kasreyn 04:01, 12 April 2006 (UTC)

You just made me spray soda on my monitor. Thanks for the laugh - but I'm sending you the cleaning bill. :P -Kasreyn 03:59, 12 April 2006 (UTC)

That cleaning bill will remain unpaid, because all of my spare cash is going to my legal defense fund. The cabal's trying to Robert-Blair me into oblivion with an RFC, and they're using you to you to help. Alienus 04:31, 12 April 2006 (UTC)

And what law is that? Alienus 20:38, 6 April 2006 (UTC)

Say hello to our good friend, the copyright law. This good friend of Wikipedia prevents us from using those pictures, and pretty much forces someone to take pictures of their wangs and upload them to wikipedia, because that's the only way one can make sure the wangs, er, the pictures are rightfully donated to wikipedia. Dabljuh 12:49, 11 April 2006 (UTC)

Well, then perhaps the Mattrix18 could provide professional-quality illustrations that are mysteriously free of copyright restrictions. Then we could put them next to the small photos of penises. Alienus 04:31, 12 April 2006 (UTC)

Rfc against me.

Editors of this article may be interested in User:Jakew/Alienus_RFC. If you have an opinion, I encourage you to participate. Alienus 03:15, 7 April 2006 (UTC)

Lets just try to fix ONE misleading misquote....

The Mastood (2005) study is correctly cited in the text, but wrongly in the table.

In the Summary of Research Findings table, this study is listed three times stating that the "Finding" was "no difference," or "favors circumcision." In fact the "finding" in all three should be the study conclusion "CONCLUSIONS: Penile sensitivity had variable outcomes after circumcision. The poor outcome of circumcision considered by overall satisfaction rates suggests that when we circumcise men, these outcome data should be discussed during the informed consent process."

Basically, the 61% "overall satisfaction" was considered low, given the disease state prior to circumcision.

Nowhere in the study do the authors state "no difference," or "favors circumcision." At best, someone is trying to interpret results.

http://en.wikipedia.org/w/index.php?title=Sexual_effects_of_circumcision&action=edit&section=5

If you would like to discuss that article, the correct place to do so is Talk:Sexual effects of circumcision. Not here. Jakew 15:25, 12 April 2006 (UTC)

I WAS HOPING TO ATTRACT THE ATTENTION OF EDITORS INVOLVED IN MEDIATION. See what kind of junk goes on here....TipPt 02:45, 13 April 2006 (UTC)

I've already addressed this issue above. What's more important than the percentage number is the simple and scientifically undisputable fact that asking someone whether they are satisfied with one of two states of being where they have no memories of the opposite state of being, is a completely worthless question. It is a "study" only in the sense that it reveals the universality of the self-serving bias. It has nothing to do with real science, since any real scientist could instantly see the underlying logical fallacy of using loaded questions. The "study" does not deserve to even be a part of this article, much less this talk page. -Kasreyn 22:38, 15 April 2006 (UTC)

Baised article?

There seems to be a "pro" article. I see no information sited from books such as: Circumcision Exposed: Rethinking a Meidcal and Cultural Tradition by Billy Ray Boyd OR What Your Doctor May Not Tell You About Circumcision: Untold Facts on America's Most Widely Performed'and Most Unneccessary-Surgery by Paul M. Fleiss, M.D.

You have to think of it this way: Would you want a girl to be circumcised because it prevents cervical cancer, Urinary Trac infection, etc? The view point from N. America is that "no", then it should be the same as boys. This article sites little risks for uncircumcised boys (2% UTI).

Let's put it this way: if it was given to you by your creator and if the hospitals are not doing it to baby girls, then why on earth would parents want to do it to little baby boys? (I am speaking to the fact that it is a non-religious thing like in USA). None, of these points are mentioned in the article, after reading the article it seems like it is a "pro" circumcision article.

Conclusion: Doctors want to get money for infant circumcision (most insurances do not pay for it anyway which should be a wide wake up call to parents). I would recommend the two books above to parents.

You seem to misunderstand Wikipedia. An NPOV encyclopaedia should not 'make points'. It should present factual, verifiable information.

I've removed your addition, since you used the wrong section (external links contains links). If you care to look, you'll see that Boyd is already listed in the 'further reading' section. Jakew 12:04, 15 April 2006 (UTC)

Help us find specific cases of bias (other than the general use of misleading words and misleading qualifying phrases). You will never change Jakew. His control over this topic needs to be restricted.TipPt 05:34, 16 April 2006 (UTC)

Another general problem with the table

Jakew lables "penile sensation" results from studies that only tested the glans.TipPt 04:41, 16 April 2006 (UTC)

HIV section ref link to thelancet.com: remove?

I'm concerned about the reference link to thelancet.com. When arriving at the site, it requires a free registration before you can log in and see the article. I personally have no wish to have to spend time creating a proliferation of new accounts merely to check up on an article's sources, and I don't doubt many other Wikipedia users feel the same. I'm of the opinion that sites that require a user login (or worse yet, a paid account), should not be considered or used as sources on Wikipedia as they put a burden on the reader and raise an unneccessary bar to checking our sources.

I've raised this question as a matter of policy on the talk page for WP:RS. My question may be found here. I will report back here on this article if an admin replies to me or any sort of consensus is reached. Kasreyn 20:51, 17 April 2006 (UTC)

I agree about the link. The Lancet Infectious Diseases does exist as a stand alone, print journal; is there an appropriate way to simply cite the article as published in Vol 5, Iss 3, (March 2005) pp. 165-173? Is that a possible/appropriate solution?Zandrous 16:40, 18 April 2006 (UTC)

The Lancet certainly meets the criteria of WP:RS. However, I agree that the link presents a problem. I'd suggest linking to the PubMed abstract instead, which contains the full print citation, but also includes a link to the publisher's website. Any thoughts? Jakew 17:23, 18 April 2006 (UTC)

Recent changes

A number of changes have been recently made that seem questionable at best. In my view, these should be reverted.

• Removal of the images.

I actually like the difference in brightness. It helps the reader see the topic bias.TipPt 22:41, 24 April 2006 (UTC)

• Removal of the quoted conclusion of the AMA (and AAP). This quote is necessary as a result of an earlier change by TipPt, because we no longer have anything on their position on non-routine circumcision (ie., that chosen by parents).
• Inclusion of the text "There are several slight medical benefits to circumcision, with the most noteworthy relating to a reduction in UTI’s in the first year of life." This is POV. Slight according to whom? Most noteworthy according to whom?

It was from the cite, based on benefits relative to other surgical procedures of similar risk.TipPt 22:45, 24 April 2006 (UTC)

Then you say 'according to X...' Jakew 10:44, 25 April 2006 (UTC)

Good lord ... we'll be saying 'according to' very frequently! Should I start removing "improper" sentences from the existing article ... there won't be much left. Seems like when a citation follows a sentence, it pertains to the sentence contents.172.195.43.176 18:38, 25 April 2006 (UTC)

It depends upon whether something is an opinion, an disputed fact, or an undisputed fact. In the case of the first, Wikipedia does not hold opinions (NOR/NPOV), so we must specify who has the opinion. In the case of the second, we do not take sides (NPOV), so we must specify who found what. In the case of the last, there is no problem. Jakew 18:47, 25 April 2006 (UTC)

• The quote immediately following ("“Most of the other medical benefits of circumcision probably can be realized...") is ok, but is an opinion, and needs to be attributed. To state it as truth, rather than the words of a particular author, violates NPOV policy.

It was in the cite.TipPt 22:41, 24 April 2006 (UTC)

Then you say 'according to X...' Jakew 10:44, 25 April 2006 (UTC)

• Israel is once again spelled incorrectly, despite my having fixed this earlier. Do you (TipPt) not like the correct spelling, for some reason?

No, I just find it easier to paste and didn't check the spelling. Sorry.TipPt 22:41, 24 April 2006 (UTC)

Don't paste, then. Edit. Jakew 10:44, 25 April 2006 (UTC)

• "Epidemiological studies comparing..." is no longer attributed, and is again presented as fact. However, it is clear from Apt that it is no longer a fact.

It was in the Hass citation.TipPt 22:41, 24 April 2006 (UTC)

See above. Jakew 10:44, 25 April 2006 (UTC)

It was not their opinion, but they don't provide the supporting citation. It is a widely used university textbook.TipPt 21:08, 25 April 2006 (UTC)

So it is an unverifiable assertion. Is it widely used in the field of epidemiology? Jakew 21:28, 25 April 2006 (UTC)

• Apt has been moved to the following paragraph. It belongs in the same paragraph as Hass, however, according to normal English usage.
• Both Hass and Apt should really be removed, since this is about circumcision, not Israel and Sweden.

The Hass cite states that there was no difference in disease incidence between men in the two countries ... one almost exclusively circ'd, and the other intact. This citation corroborates the lack of net benefit (in the cost/benefit with respect to longevity).TipPt 22:45, 24 April 2006 (UTC)

That is your interpretation. Comparing aggregate statistics for varying nations is known in epidemiology as an ecological study. It is considered a weak methodology.[14] Jakew 10:44, 25 April 2006 (UTC)

I am not including my interpretation in the topic. Epidemiology studies are OK if the samples are large.TipPt 21:18, 25 April 2006 (UTC)

Sample size is not the only concern. Study methodology is equally, if not more important. Jakew 21:28, 25 April 2006 (UTC)

• UTI: My correction to the English has been removed (should be "assumed that patients" rather than "assumed patients").
• "(based on a documented range of 2%-10%)" has been restored, in spite of the fact that it is false (it's based upon an estimate).

It was based two studies cited in the study THAT I provided the citation for...I will provide the specific citations required. The estimate (2%) seems conservative when you consider meatal stenosis occuring almost exclusively in circ'd boys at roughly a 5% rate, generally requiring a meatodomy (which does more damage to the frenulum). We should also consider redo's a complication.TipPt 22:45, 24 April 2006 (UTC)

Singh-Grewal et al had no knowledge of your contributions to Wikipedia when they wrote their study, and therefore could not base their chosen figures on any studies that you cite.

Jakew 10:44, 25 April 2006 (UTC)

You misunderstood ... Singh-Grewal have two citations in their analysis to support their 2% as being conservative within the 2%- 10% range. I will provide those two citations directly in the text (instead of just citing Singh). I have also given you four cites showing very high rates of meatal stenosis and redo complications TipPt 21:29, 25 April 2006 (UTC)

• The criticism of Singh-Grewal has once again been moved to a separate paragraph. It shouldn't be.

Unless someone wants to make sure the reader is biased.TipPt 22:41, 24 April 2006 (UTC)

A new paragraph is generally used in English to introduce a different subject. The subject, however, is the same: Singh-Grewal's comparison. Jakew 10:44, 25 April 2006 (UTC)

• My corrections have again been removed. The AAP did not criticise the study - the criticism was in Schoen's editorial, which cited the AAP.
• The criticism is incorrectly attributed to the AAP.
• The AAP's criticism of some UTI studies is now attributed to Schoen.

Why? Jakew 17:49, 18 April 2006 (UTC)

All of these changes sound good. The pictures need to go back in; without them it is uncertain that the reader will know what is being discussed. There is no reason not to use the pictures of real penises either: if readers have a problem with seeing penises, they probably wouldn't be reading an article about their mutilation. Christopher 03:17, 19 April 2006 (UTC)

All of them sound good? Perhaps you could explain why, for example, attributing criticism to the AAP that they did not make "sounds good"? Jakew 16:46, 19 April 2006 (UTC)

I'm sorry I was unclear with my wording. By changes, I meant your proposed changes. Christopher 02:12, 20 April 2006 (UTC)

I am taking action to restore the pictures now. An anon (IP) user removed them without attempting to garner consensus. IMO that's next door to vandalism no matter how good the reasons one suggests. -Kasreyn 23:40, 19 April 2006 (UTC)

Dear Jake, I've made some changes. I've restored the images, since they were removed without gaining consensus by an anon user. I've reverted what appeared to be a pro-Islam POV push. And I've removed a dead link. Hope this helps. Kasreyn 23:47, 19 April 2006 (UTC)

Smegma

I disagree with the placement of this statement on this article:

Interestingly, 'smegma is a transliteration of the Greek word σμήγμα for soap.

Yes it is factual to the etmology of the word, but its presence here on this very controvisal article is a form of bias, it’s a loaded term associating smegma with soap, as the issue of smegma being beneficial or detrimental to the genitals is a controversial issue of relevance to circumcision. Smegma meaning soap in greek is a interesting tidbit, but is provides no factual or physical evidence for the issue of penis hygiene, at worst it provides a emotional association fallacy. --BerserkerBen 03:21, 19 April 2006 (UTC)

The only part that bugs me is "interestingly". That appears to be POV to me. We should let the readers decide what is "interesting". Wikipedia isn't a tour guide. :P -Kasreyn 23:37, 19 April 2006 (UTC)

I agree with you there, but it does introduce subtle bias. Consider this: in a parallel universe, the word derives from the greek word for poison. Is it necessary to mention this in an article not focusing on smegma? Does it paint smegma in a negative light? Jakew 10:41, 20 April 2006 (UTC)

Misconceptions about smegma are pervasive in the U.S. It doesn't have a bad smell if you keep yourself clean. It contains pheromones, and it helps keep the mucosa and glans supple. The ancients (greeks and romans at least) considered it an asset ... maybe like soap. The reader should know that given good hygiene, smegma has value, and circumcision will usually eliminate production of that asset.TipPt 22:50, 24 April 2006 (UTC)

Then by all means include citations to studies demonstrating this 'value' in the smegma article. Jakew 18:39, 25 April 2006 (UTC)

I see. Knowing the literature as I do, I doubt that you'll be able to find anything, but I await your sources with interest and curiosity. Jakew 19:20, 25 April 2006 (UTC)

The "valued" (properly cited) loss of smegma production will be included within the list of long-term complications, and the sexual effects sections.

Most people know that natural selection ... evolutionary forces ... means that smegma has value or nature wouldn't waste the resources producing the stuff. (even if scientists haven't studied, or don't fully understand).TipPt 19:30, 25 April 2006 (UTC)

I don't understand. If scientists haven't studied the value, or don't understand it, then how do you intend to properly cite sources for it? Jakew 19:34, 25 April 2006 (UTC)

It's constituent properties, and animal studies.TipPt 21:00, 25 April 2006 (UTC)

The value of smegma is controversial, the very evidence you state (worse of all humen pheromones) are controversial and debatable. Also do not appeal to nature, natural selection does not come up with prefect systems and it is conceivable that smegma and the foreskin are as ill evolved as external testacies, menstruation, curved spines while bipedial, etc. --BerserkerBen 18:30, 29 April 2006 (UTC)

I don't follow. What's so ill-evolved about external testicles? Without the scrotal expansion and contraction ability, what better temperature regulation system could we have evolved for the delicate testes? What better system than menstruation do you imagine?

Thank you for replying as expected, I'll just re-paste my explaination on the fault of mammalian testis: "... how many mammals have to suffer the pain of externalized testicles? Being exposed protected by nothing but a thin layer of skin, why you might ask? Sperm can only be viably produced at temperatures lower then core body temperature, so then nature did the right thing by moving the testis out into the open for keeping them cool? Wrong! Why not just evolve sperm that can grow at core body temperature, in fact birds maintain their testis at core body temperatures (as high as 41°C!)[15] and still produce plenty of viable sperm. When mammals and birds evolved from reptiles (birds from dinosaurs (likely already warm blooded) that evolved from reptiles) the evolving warm blooded body systems needed to find a solution to the still cold-blooded biochemistry of sperm production, in birds evolution though seemingly random trial and error corrected the biochemistry to a warm-blooded system, in mammals in seemingly random trial and error moved the testis outside of the body to keep them in a colder climate."

As for menstruation most mammals have estrous cycles and re-absorb thier endometrium rather then "bleeding" like humans and apes do.--BerserkerBen 16:04, 30 April 2006 (UTC)

The point is, "ill-evolved" is a point of view. Both methods are evolutionary solutions to a problem. Just because the solution our species wound up with makes some of us uncomfortable doesn't matter in the slightest when it comes to viability. Natural selection didn't factor in whether we would enjoy having external genitalia. So I reiterate that you don't have any meaningful frame of reference from which to call something "ill-evolved". Kasreyn 20:13, 30 April 2006 (UTC)

The appeal here isn't saying "we're perfectly evolved". It's saying "we're complex organisms who, time and time again, have overestimated our understanding of ourselves. It's highly possible therefore, that the body parts we're removing from ourselves have much more functionality and are more beneficial than we have heretofore imagined." The folly in every era of popular understanding of science has been the widespread belief that the discovery of ourselves was at its peak, and there was nothing new to learn about our own bodies. Wrong every time. Kasreyn 05:58, 30 April 2006 (UTC)

Surely we do have more to learn, but you originally suggested that smegma must be good or have a useful purpose, simple because nature allows it, this is a fallacy, I’m not saying that we know its bad, we don’t, what I’m saying is that we can’t be sure it good either. --BerserkerBen 16:04, 30 April 2006 (UTC)

No, what we can say we know is that at some point it evolved. At whatever point it evolved, it served a purpose. However, it is quite possible that, like the appendix, it no longer serves that purpose and has become extraneous. I never suggested that smegma must be good, you were replying to someone else. I was simply replying to the idea behind your "nature does not come up with perfect systems" and other things as being "ill-evolved". I hardly think creatures which were, and still are, subject to that process are capable of the objectivity required to judge how well it shaped them. We don't have an adequate frame of reference with which to decide whether we were well- or ill-evolved, because we only know what we are, not what we might have been. Kasreyn 20:12, 30 April 2006 (UTC)

Your argument is a fallacy, it equivalent to saying that one cannot judge them selves, as if one cannot determine if a quality of theirs is inadequate even without reference. I did provide plenty of reference: I demonstrated that better solutions are possible, even that superior solutions exist in nature. Lets say a caveman knows only of a spear to hunt with nothing else, if he can’t throw his spear far enough can he not determine that the spear is a crummy weapon? In my case I even provided the metaphoric equivalent of a bow and arrow but you claim that is beyond reference why?--BerserkerBen 21:33, 30 April 2006 (UTC)

Female Circumcision

Female circumcision is only practiced in few countries around Horn of Africa i.e. Somalia, Ethiopia, etc. It is unknown in the other parts of Islamic world.

Siddiqui 23:27, 19 April 2006 (UTC)

The article on female circumcision would seem to disagree with your assertion. I think I prefer to believe it over you. -Kasreyn 23:36, 19 April 2006 (UTC)

Re: "inherent bias" in images

Dear 81.159.10.202, or 81.159.14.95, or whoever you are today (hint: get a user id): Please stop removing content from this page without even attempting to gain consensus from the other users. Your removal of the images because you believe there is an "inherent bias" (specifically, you feel one of the pictures is apparently prettier than the other and that this was the result of a deliberate conspiracy) borders on vandalism.

Please refer to WP:Point and WP:OWN; it is not appropriate to disrupt Wikipedia to make a point, nor is it appropriate to treat an article as your personal property. If you continue to remove the images on this page without attempting to gain consensus from the other editors, I will have no other option than to report you for vandalism.

I have in the past and will continue to revert any edit which blanks content which is not obvious vandalism without attempting to gain consensus. Wikipedia is a group effort. Please take part in the discussion with us. I've tried being polite, and it doesn't seem to have worked. I'm also asking the other editors of this article, at least two of whom appear to agree with me that the images should remain, to assist me if this user tries to make a revert war out of this.

As for your substantive "point": ridiculous. Most reasonable editors and readers would not find the images to be substantially unbalanced or unfair. Any two pictures of two different men's penises will naturally have different lighting and focus qualities. To obstruct Wikipedia over such a trivial issue is a violation of WP:Point.

Please reply in this section with your arguments in favor of removing the images. I will continue to revert (up to the 3rr limit) any removals of the images which are not at least accompanied by a justifying argument. Thanks, Kasreyn 01:37, 20 April 2006 (UTC)

And I see that you did so while I was writing this, using IP 81.159.12.112. Reverted, of course. Please reply here, not with the edit summary. Use of the edit summary to carry out an argument is inappropriate. Kasreyn 01:38, 20 April 2006 (UTC)

Note to other editors who may be concerned with this issue, I have reached the 3rr limit. One further revert from 81.159.12.112 will place him at the 3rr limit. It IS the same person, after all, and he has not denied it. Other editors interested in maintaining the images will therefore realize that if 81.159.12.112 reverts my most recent edit, they could then revert him and a further revert would be a violation of WP:3RR. Failing that, I will have to resort to administrator arbitration or the warning/block steps for vandalism. I don't exactly know what else to do. Kasreyn 01:43, 20 April 2006 (UTC)

Very well then.

You've made your contempt for engaging in any sort of discussion with other editors quite clear. I won't waste my breath on trying to get you to be part of this project any more. Shame. Kasreyn 02:07, 20 April 2006 (UTC)

I have semi-protected the article from editing by anons for a bit. Nandesuka 03:55, 20 April 2006 (UTC)

Long lists of countries

Ok, the lists of countries with high/low circumcision rates have changed dramatically. One problem: not a source in sight, so it's impossible to verify that the new lists are accurate. Can it be rectified? Jakew 10:46, 20 April 2006 (UTC)

No cite, get rid of it.TipPt 19:06, 25 April 2006 (UTC)

Moved the laundry list to "Circumcision worldwide"

I figured the list should not be removed per se (someone may well actually want a list like that from wikipedia) but its ugly and bulky and shouldn't be in the main article. So I put it in a separate article, Circumcision worldwide. Couldn't think of a better name for now. Maybe make it an actual list:circumcising countries eventually? Dabljuh 06:19, 21 April 2006 (UTC)

• This is a sourcing nightmare. If I can remember to, I'll start working on verifying the latest additions. I may have to make a category for unknown status. Frankly, though, there are going to be a lot of unknown status countries where the majority of males are uncircumcised, so studies are useless. --Trafton 06:52, 21 April 2006 (UTC)
  • We are Wikipedia. We will assimilate you. If we announce that France performs routine satanic human sacrifices, then that's the god damn way it is. WP:BOLD!!!1 Anyhow, you can't source every single country with reasonable effort anyway - If something's wrong, a member (or expert) of the country should correct it. Given the exhausting list, I'd say its a lot more correct than not. Otherwise, I don't really see what the big problem is. Dabljuh 12:31, 22 April 2006 (UTC)
    • The problem is that wikipedia information pages to be verifiable, through citing reliable sources. Notice that the policy does not say "Dabljuh thinks it's probably correct, and anyway if it's not, someone will probably fix it." Jakew 16:41, 22 April 2006 (UTC)

A bigger problem is the text stating that 1/6 to 1/3 of males in the world are circ'd. The latter number is unrealistic (given that Asia save So. Korea, India, the old USSR, Europe, and old east block, and all of So. America are intact primarily. That quote should be removed. Most often, ~20% is claimed.TipPt 23:34, 24 April 2006 (UTC)

Hmm. It might be better to make no claim at all. I have a hard time imagining anyone's been able to even get decent sampling rates in very much of the second and third worlds. I have serious doubts about the reliability of a source that purports to be a worldwide study that claims one third of all men are circumcised. I'd rather Wikipedia make no claim at all than an unverified and highly suspect one. Kasreyn 05:10, 25 April 2006 (UTC)

The text clearly states that it's an estimate, Kasreyn. Jakew 10:34, 25 April 2006 (UTC)

It states that estimates vary within this range, Tip. That's perfectly accurate. I'm sorry that you don't like the higher figure, but that's too bad. It doesn't matter whether you agree with it or not. My own view (I mention this as an aside, not for inclusion in the article, as it's purely original research) is that it's probably about right. NOHARMM estimated 23%[16], but this ignores circumcisions performed out of medical necessity. Looking at UK statistics[17], about 12% to 15% of young adults are circumcised, but only about 3% of the UK population are Jewish or Muslim, so that suggests that this figure is about 9%. 9% of the 77% not circ'd for religious reasons is 6.93% of the total. 23% + 6.93% is 29.93%. Jakew 10:34, 25 April 2006 (UTC)

Seems like NOHARM would tend to overstate (not understate) the incidence of circs. Either is wrong.

Please clarify your UK argument. All I can think is ... "and the population of the UK is? compared to the world. How does that help us determine the world figure?"

I don't care if the number is higher or lower, just farily accurate. Again, given that highly populated regions of the world (China, India, and So Am) have very low rates of cirs, 1/3 for the world seems silly.

The author provides no data to substantiate their estimates. We should not include any guesses, especially when they are significantly higher than commonly cited estimates (around 20%).TipPt 18:53, 25 April 2006 (UTC)

Given that a common anti-circ argument is "85% (or whatever) of the world is 'intact'", I would suggest that they would in fact tend to understate. Nevertheless, with the exception of medical circumcisions, their methodology appears reasonable.

The "UK argument" is this. To adjust NOHARMM's estimate to include medical circumcisions, we need to know the rate at which these occur. Since in the UK the rate of neonatal circumcision is essentially zero, the proportion of young men that are circumcised here is the rate of religious circumcisions + the rate of medical circumcisions. Since we know the total and religious figures, we can calculate that about 6.9% of UK boys are circumcised for medical reasons.

Garbage in, gargage out, besides the article you cited is about complicationsTipPt 20:25, 25 April 2006 (UTC)

Please be civil, and please do not insert your comments in the middle of mine.

Yes, it is about complications, but if you scroll down to the box with the yellow background, you'll see the estimate. Jakew 20:39, 25 April 2006 (UTC)

It's a perfectly reasonable figure. According to adherents.org, Muslims count for 21% of the world's population. Add Jewish people and countries with a cultural tradition of circumcision (such as the US and South Korea), and you're already at 23-24%. As I pointed out, adding medically-indicated circumcisions adds another 7% or so.

You are assuming that "medically-indicated" (probably overstated because of new treatments for Phimosis and paraphimosis) are UK-like around the world ... doubtful given wealth effects.TipPt 20:41, 25 April 2006 (UTC)

All muslims may not be circ'd. There is a huge difference between 24% and the contested 33% estimate. Would you settle at 20 - 25%? (I still prefer no guesses).TipPt 20:25, 25 April 2006 (UTC)

True, not all Muslims will be circ'd, but most will. As I said, 24% does not include medically indicated circumcisions. Once the 7% figure is added, the figure is 31%.

I'm afraid that there is nothing to settle. All this is original research, and cannot go into the article. I'm only having this conversation with you in order to inform you why the estimate is reasonable (this is why I suggested discussing it on one of our talk pages instead). Jakew 20:39, 25 April 2006 (UTC)

Your last argument is nonsensical. Firstly we only link to an abstract, and such data may well be in the full text. Secondly, do the 'commonly cited estimates' provide data? If not, what reason is there to assume that they are any more accurate?

I read the full text.TipPt 20:25, 25 April 2006 (UTC)

I suggest continuing discussion on one of our user talk pages. Jakew 19:11, 25 April 2006 (UTC)

The NOHARM estimate says "(Muslim, Jewish, North American, and African Tribal populations only)" (again, garbage in, garbage out) ... how does that apply to the world?

You cannot assume the rate of "medical" circs is uniform (to the UK rate) around the world.TipPt 20:47, 25 April 2006 (UTC)

Tip, the overall percentage of circumcised men is 100 x circ'd / total. Let circ'd = muslim + north american + african tribal, and let the total be the total male population of the planet, and you have the answer.

Yes, I'm assuming that the rate is uniform, but it doesn't seem to vary that much. It's about 7.1% in Finland, and 9.6% in Kaiser Permanente (California, USA). Jakew 21:02, 25 April 2006 (UTC)

Quite likely, 25% of the world pop are Muslims; so the range is OK (including the 1/3 est). New info to me. Thank You.

As an aside, I would question applying a Western "medical" rate to China or India, just as I question using circ's to cure phimosis unless other treatments are tried first (the rate is coming down).TipPt 00:06, 26 April 2006 (UTC)

Hold your horses, there. So 25% of the world are Muslims. We're not done yet. What percentage of self-described Muslims actually are circumcised? Has anyone bothered to check their genitals? Has anyone bothered to factor in a margin of error for the possibility of people answering the question dishonestly? -Kasreyn 00:23, 26 April 2006 (UTC)

This study suggests it's below ~100% outside the sub-Sahara (given some HIV protection you should otherwise pick up) ... "All 38 sub-Saharan African countries with a minimum of 1 million inhabitants were included in this analysis. Initially, countries from North Africa, Asia, and the Pacific were also included in this endeavour, but sub-Saharan Africa emerged as the only region for which sufficient national variation in HIV prevalence and percentage Muslims seemed to enable meaningful multivariate comparisons." [[18]]TipPt 04:14, 26 April 2006 (UTC)

Meatal Stenosis

Check out these articles: [[19]] "Meatal stenosis is a relatively common acquired condition occurring in 9-10% of males who are circumcised. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream and, occasionally, dysuria and urgent, frequent, and prolonged urination. Surgical meatotomy is curative."

(Can we use an emedicine citation?)

[[20]] [[21]]

Here's a recent study we can cite: [[22]] "All of the boys with meatal stenosis were circumcised neonatally (exact OR=3.54, 95%CI=0.62-infinity). The ratio of circumcised boys to noncircumcised boys in this study provided 80% power to demonstrate a 21.4% difference in the incidence of meatal stenosis between circumcised and noncircumcised Tanner I boys 3 years and older. Meatal stenosis may be the most common complication following neonatal circumcision."TipPt 23:32, 24 April 2006 (UTC)

Preputial plasty

Is preputial plasty addressed in the topic? It is pertinent because you don't (per cites) have to be circ'd to gain several of the potential benifits of a circ. Here's a way to retain erogenous tissue!TipPt 23:44, 24 April 2006 (UTC)

It's included in the phimosis topic, as another form of treatment. Jakew 19:23, 25 April 2006 (UTC)

Thank you. But it prevents phimosis and paraphimosis, cancer, and complications (and should be in those main article sections). It may belong in the UTI, the sexual effects, procedures, and history sections.TipPt 19:52, 25 April 2006 (UTC)

Then perhaps you'd like to document the evidence of all these benefits in a new article and/or include mention of these effects in the relevant articles on those conditions? Jakew 19:58, 25 April 2006 (UTC)

I thought we should discuss changes first.TipPt 20:14, 25 April 2006 (UTC)

Yes, in the relevant article's talk page. If you want to include it in urinary tract infection, you need to discuss it in Talk:Urinary tract infection. Editors interested in that page can then comment, but they can have no way of knowing that you previously mentioned it here or, for that matter, at Talk:Jet engine, so they're denied the opportunity to discuss it. Jakew 20:21, 25 April 2006 (UTC)

You're the one insisting on including all potenital medical benefits in the main section. The reader should know (at the same time) that those benefits do not require a circ.TipPt 20:30, 25 April 2006 (UTC)

Additional complications

"Leitch found that in 9.5 per cent of patients the operation had to be repeated because of inadequate skin excision at the initial procedure. MacCarthy et al.17 reported this figure to be 1 per cent in a study from the UK. In a more recent series from Israel, where religious circumcision is widespread, of 60 children referred following potentially inadequate circumcision 42 required recircumcision; the majority of these children were operated on before 4 years of age18. The rest were treated conservatively and had a satisfactory cosmetic follow-up to 10 years of age. Insufficient excision of the foreskin and inner preputial epithelium may result in wound contraction and cicatrization of the distal foreskin. The fibrotic ring so produced may result in true phimosis, an event observed in 2 per cent of cases in one UK series15. In severe cases urinary obstruction may ensue19."

Given what we can cite for meatal stenosis, redoes, and the removal of too much tissue ... the AAP complication rate is silly AND SHOULD BE REMOVED (or the supporting data should be provided).TipPt 19:04, 25 April 2006 (UTC)

Wikipedia is not the place to argue that the AAP has the complication rate wrong. However, if others have made such an argument in reliable sources, it is fine to cite them. Jakew 19:14, 25 April 2006 (UTC)

I just think you are silly insisting on including obvious whitewash.TipPt 19:39, 25 April 2006 (UTC)

Your opinion on my level of silliness is duly noted. Jakew 19:43, 25 April 2006 (UTC)

Silly is to simple a word. You insist on including statements from U.S. medical associations as though they are scientists. They are doctors citing outside research. You should use the underlying sources where possible, especially when the weight of the evidence clearly shows the AAP judgement to be wrong.

Why have you choosen to leave out obvious, serious complications?TipPt 19:59, 25 April 2006 (UTC)

Some time ago, Tip, the article looked very different from how it does now. It was still a product of negotiation and compromise, but it was different. Then along came a user who made a huge fuss (and many personal attacks), and essentially rewrote the article, again involving a lot of negotiation and compromise. One of his more reasonable requirements was that the article should not give undue weight to fringe opinions - that is, that it should reflect, by and large, the content of the mainstream medical organisations' policy statements, and not deviate too much from them.

Given two very unreasonable statements (the rate of complications, and citing the old Masters study), I do not find U.S. medical assoc. statements to be reasonable. They cite only one old (1991) study to state "There also are isolated case reports of other complications such as..." (including redo's and meatal stenosis). You should not consider compromise among doctors (versus scientists) to be qualified.172.191.221.142 21:29, 25 April 2006 (UTC)

Your opinion is duly noted. Jakew 21:24, 25 April 2006 (UTC)

You throw "medical assoc" around like it's gospel. You might try to cite other than U.S. associations. The cites you use are old (1999) and, at a minimum, do not consider new evidence.TipPt 21:45, 25 April 2006 (UTC)

That seems reasonable enough to me. After all, the (often conflicting) details of the individual studies can be discussed at length in medical analysis of circumcision. In this article, we keep it fairly simple and straightforward, reflecting for the most part that which has already been agreed upon by committees of qualified persons, who have doubtless compromised between themselves already.

Again, I would like more than just U.S. associations represented in the main text. You have already evidenced intense debate within those associations, suggesting bias in their compromise.TipPt 21:45, 25 April 2006 (UTC)

That is not to say that more controversial information cannot be included, only that we should as a general rule be guided by these statements. Jakew 20:57, 25 April 2006 (UTC)

We know there is new information ... post the AAP statement. We know the nature (versus the Masters study) and thrust of the new research. The quality of information rules, not some compromise you made with another writer in some past battle Jakew.TipPt 21:57, 25 April 2006 (UTC)

UTI

The main article UTI section should include this study: "CONCLUSIONS: Previously reported differences in the rate of urinary tract infection by circumcision status could be entirely due to sampling and selection bias. Until clinical studies adequately control for sources of bias, circumcision should not be recommended as a preventive for urinary tract infection."[[23]]TipPt 20:11, 25 April 2006 (UTC)

An entirely speculative 'study' by the notorious anti-circumcision activist Van Howe. Hmm... Jakew 20:00, 25 April 2006 (UTC)

Your label. I have no information about his background, nor do I find it relevant. It's good research. It could be better; since UTI's are (especially in the first year of life) also associated with use of baby formula's, frequency of diaper changes, and lack of breast milk feeding.

The Howe analysis sheds light on why older studies do not find an increase in UTI's, why longevity cost/benefit is ~zero.TipPt 20:26, 25 April 2006 (UTC)

I can't see why you call it good research. It's speculative and entirely based upon his own estimates. Incidentally, you're mistaken. All studies, old and new, find an increase in UTIs among uncircumcised males. Jakew 20:28, 25 April 2006 (UTC)

I already cited Hass. Older research did not note, suggesting they did not find.TipPt 20:34, 25 April 2006 (UTC)

And I've already shown that Hass is a) wrong in the case of at least one disease, and b) using a fundamentally weak methodology. I'm curious, does Hass actually cite studies? I'm curious to know whether UTIs were actually included. Jakew 20:42, 25 April 2006 (UTC)

We know little of the methodologies (more than one study), and I do not claim otherwise (either good or bad). The paragraph indicates large enough studies (comparing populations nations(limiting your criticism of epidemiological studies). It (Hass book) is the University of CA system intro sexuality class textbook (editions used in the system for many years). Several professsors have reviewed and approved it's use ... unrelated to any circ "controversy" (the textbook is more positive than neg. on the topic of circs). The Fifth (latest) edition is dated (I think 1992), and at that time UTI's were not an issue with respect to circs.

The paragraph wasn't cited.TipPt 03:23, 26 April 2006 (UTC)

Actually, we know that the methodology compared Sweden to Israel. That's an ecological study by definition. The size of the population doesn't affect the weakness of the methodology. Jakew 09:13, 26 April 2006 (UTC)

We have no studies with proper controls. We are left with epidemiological studies (again jakew, it's plural). You can get highly statistically significant results from large samples. Wonderful t-stats. You seek to paint all such studies as suspect.

As for what you insist on calling the methodology ... eco or epid, the New York Times recently cited a study, calling it an epidemiological study. You might assume that amongst our readers, either is OK. There's no bias either way, but I prefer to quote the book properly.TipPt 16:57, 26 April 2006 (UTC)

'Epidemiological' describes all studies intended to reveal information about a disease. 'Ecological' is a particular type of epidemiological study, which is notoriously poor. (In other words, all ecological studies are epidemiological, but the reverse is not true.) Yes, you can get a statistically significant result from a large-scale ecological study, but it is still a poor methodology, and yes, it's suspect. Jakew 17:59, 26 April 2006 (UTC)

Apparent ban on male infant circumcision in South Africa

The National Assembly and the National Council of Provinces passed the new Children's Act[24] on 15 December 2005. This act contains the following text:

"The circumcision of male children under the age of 16 is prohibited, unless the circumcision is 11 performed for religious purposes in accordance with practices of that religion, or for medical reasons. The circumcision of male children over the age of 16 is subject to the same restrictions as those pertaining to virginity testing, and must take into account the child’s age, maturity and stage of development. Every male child has the right to refuse circumcision."

This does, if I'm not crazy, effectively ban male infant circumcision. Why is this not mentioned in the article? I think South Africa can safely be removed from the "majority circumcised list" if I'm not missing anything. --Trafton 19:56, 25 April 2006 (UTC)

No, it prohibits infant circumcision unless performed for religious reasons or if it is recommended by a medical practitioner.

As for the 'majority circumcised list', discussion of that belongs in the appropriate article's talk page. Jakew 20:02, 25 April 2006 (UTC)

Fair enough. Does it not effectively ban elective, non-medical, non-religious circumcision? Is that not worth including a mention of somewhere, under legal developments, or something of that sort? --Trafton 23:14, 25 April 2006 (UTC)

Something from the British Medical Association

"In the past, circumcision of boys has been considered to be either medically or socially beneficial or, at least, neutral. The general perception has been that no significant harm was caused to the child and therefore with appropriate consent it could be carried out. The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks - read more here. It is essential that doctors perform male circumcision only where this is demonstrably in the best interests of the child. The responsibility to demonstrate that non-therapeutic circumcision is in a particular child’s best interests falls to his parents." ... "It is clear from the list of factors that are relevant to a child’s best interests, however, that parental preference alone is not sufficient justification for performing a surgical procedure on a child."

[[25]]TipPt 22:33, 25 April 2006 (UTC)

I recently saw a program on manhood rituals in Africa. What was most interesting was that the circumcision shown only removes a small area of skin, rather than the more common view of total removal of the foreskin. It might be interesting when discussing circumcision to remark on the aboumt of the foreskin removed.

Removing the very tip of the foreskin in no way affects the glans, frenumlum, production of natural secretions. Whereas the full removal of the foreskin (and frenulum in some instances)will affect the above. 04:29, 18 May 2006 (UTC)~~ Dave

Biased images revisited

File:Q16.jpg

Fairly healthy looking, no major concerns

File:Q06.jpg

Somewhat unhealthy looking, blotchy skin and unkept hair

File:Q18.jpg

Unhealthy looking, spotty, sweaty, slightly feverish

These pictures illustrate that selective imaging can result in bias. The subject is the same person in each picture but has had his appearance modified. The images are used to study people's reaction to healthy and unhealthy individuals. The "healthy image" was universally more appealing than the "less healthy", which in turn was universally more appealing than the "unhealthy image". The test was carried out by Dr Val Curtis of the London School of Hygiene and Tropical Medicine. Those surveyed cited inter alia that the man in the "unhealthy image" looked diseased, spotty, sewaty, feverish, unkept, disgusting. This in turn made the man in the "unhealthy image" the least likely they would like to socialise with. The image of the particular uncircumcised penis is likely to produce a similar reaction especially when compared with the image of the particular cirmcised penis. The particular circumcised penis is well groomed, generally pink in colour, better lighted, straight and overall more appealling. The particular uncircumcised penis is poorly groomed, various colours, (some even touching on black), badly lighted, bent and much less appealing. Therefore, I once again remove the images of the penes in the hope that two comparable and balanced images can replace them. To maintain the status quo will only reinforce bias and is contrary to Wikipedia's own principles.

Many aspects of the topic reflect warped principles and bias. I wish I could fix the pics, or better, find one looking at the front of both a circumcised and intact erect penis. That's where all the sexual action is. The Wiki software and my PC didn't get along.TipPt 03:37, 26 April 2006 (UTC)

The images add a lot to the article. I'm all for finding less 'biased' pictures, but until we find them, leave the pictures we have alone. Biased pictures are better than no pictures. Also, you are very welcome to come up with some better pictures, I wish you luck. Christopher 03:19, 26 April 2006 (UTC)

Like I said earlier, the pictures help the reader know the topic bias. Unfortunately, the pictures do not help the reader understand penile anatomy. It's sad how badly the Wiki system works sometimes.

Nonsense. A reader who does not see the pictures will naturally be less well informed than one who does, regardless of topical bias. Data is still data. Stop saying grandstanding things that you know are nonsense. It weakens your case. Also, you had no reason to start a second section about this same debate, unless perhaps it was to draw attention away from how you tried to ignore debate previously. Kasreyn 19:20, 26 April 2006 (UTC)

So even misleading images are better than no images? Hmmm...

Hint: no one here agrees with you that the images are misleading. Please refer to WP:Point. Kasreyn 22:44, 26 April 2006 (UTC)

Not long ago there were great pictures of the top four inches of the front of an intact erect penis. They were in the frenular delta article, and are still used in other websites (link to Wiki broken, but they still show the pics). If someone knows how ... those pictures helped the reader understand what tissues are removed by circumsicion.TipPt 03:42, 26 April 2006 (UTC)

Does even one person agree with the anon that those pictures are representative of "bias"? Different people have different penises. It never occurred to me to think of one or the other of them as "dirtier" or "ungroomed." I think he's projecting his own biases on to the photos. Nandesuka 04:16, 26 April 2006 (UTC)

The two pictures are (at least) intended for edification and comparison. But they are neither comparable nor fully visable! It's kind of funny actually. But the reader can barely see the intact penis, let along gain an understanding of anatomy, and that's sad. The dark has been lightened at least twice, but someone intentionally darkens is back.

You're not making any sense. The article as it currently stands does not show any such picture as you describe. I see four pictures of two penises, and all four are sufficiently well-lit to show the anatomy in sufficient detail for the sort of surface identification they were intended for. If one is darker than the other, you might consider the outlandish possibility that perhaps one of the men has darker skin than the other. Are you suggesting that only photos of alabaster white penises be accepted at Wikipedia? Shall we replace "topic bias" with racism? Kasreyn 20:28, 26 April 2006 (UTC)

Predictable response. Maybe you should actually read and digest my point rather than project your own bile.

Calling me "predictable" does not refute any of my substantive points. It only reveals that you cannot find any other way to rebut me than ad hominem attacks. Please refer to WP:NPA and WP:AGF. As far as I can tell, the one of us who is not reading and digesting the other's points is you. I have replied consistently to almost every point you have ever raised in this discussion. You have never bothered to reply to a single point I have raised. It speaks of remarkable arrogance to then say that I'm the one who's refusing to read. Good day. Kasreyn 22:44, 26 April 2006 (UTC)

I prefer them in the topic. Gives me a smile, and shows the topic bias.TipPt 04:48, 26 April 2006 (UTC)

Yes, even one person agrees with the anon. I've thought for some time that the pictures are an unfortunate comparison. I think the difference in lighting and skin color also makes the implicit suggestion that caucasians are circumcised and other peoples are not. I'm undecided as to whether they add or subtract from the article (which is to say whether their added information outweighs their added bias), but I do think there is some bias in juxtaposing the two. I don't think it was intentional bias, but it is there now. ^L_Wizard @ 04:55, 26 April 2006 (UTC)

I continue to disagree firmly with the anon. The images should remain. If better are found, then they should be replaced. Under no circumstances should this article be without images for the education of our readers. Kasreyn 19:10, 26 April 2006 (UTC)

Done.

Well, it sounds like there's a consensus then that we should get better images (but not that we should delete images until we have replacements). Any volunteers? Nandesuka 06:00, 26 April 2006 (UTC)

I suggest that if the anon cares so much about the issue, that he can upload some appropriate (and, of course, copyright-free) images of penises. Kasreyn 19:10, 26 April 2006 (UTC)

I do care about the issue and I've taken your advice and uploaded a further image to the consent section.

I would, but don't know how to revert back that frenular delta (you don't have to call it that anymore, if Jakew objects) picture. It was probably 6 months ago now.TipPt 16:30, 26 April 2006 (UTC)

It seems we now do have a better set of pictures of an uncircumcised penis. What's wrong with this one (old images put beside it for comparison):

• New version
  New version
• Old version
  Old version
• 
  Circumcised

This one seems much better to me. I was pleasantly surprised to see it added to the article, and dismayed to see that addition reverted. ^L_Wizard @ 01:51, 28 April 2006 (UTC)

Images: views please

Images should be retained

1. Jakew 09:57, 27 April 2006 (UTC) (though they can certainly be replaced with better ones)
2. Christopher 14:43, 27 April 2006 (UTC) (The pictures have significant room for improvement, they should not however, be removed before better ones are acquired)
3. Agree with Christopher. Nandesuka 15:01, 27 April 2006 (UTC)
4. DanBlackham 17:52, 27 April 2006 (UTC)
5. Kasreyn 01:15, 28 April 2006 (UTC) Straw polls are evil, but fwiw, general policy when images are accused of subtle bias is to look for better ones *before* replacing. They should only be removed if it's absolutely impossible to find fair images.

Images should be deleted

Jakew saying I can't cite a UC sexuality textbook?

I intend to quote from two books held at the UCLA central library. One is the human sexuality encyclopedia reference book, and the other the UC system human sexuality course textbook.

Any problems with that?TipPt 03:52, 26 April 2006 (UTC)

Do you intend to cite them in the context of sexuality? Jakew 09:11, 26 April 2006 (UTC)

Yes, and on the Topic page.TipPt 16:27, 26 April 2006 (UTC)

Then I don't foresee a problem. Jakew 16:33, 26 April 2006 (UTC)

Cool. Off to the library again....TipPt 17:00, 26 April 2006 (UTC)

Jakew insists on citing ridiculous complication figures.

We have recent research finding complications several times greater than emphasised in the topic. The circ topic reads "The AAP, AMA, and AAFP state that the rate is between 0.2% and 0.6%, based upon large series."

Here's a couple for meatal stenosis...[[26]][[27]]

The numbers for redos are also a multiple of the US Assoc rate.

When you know the US medical associations are so off, why do we still cite them?TipPt 04:35, 26 April 2006 (UTC)

The official statements of medical organizations in Australia and Canada report a higher complication rate than the AAP.

"The complication rate of neonatal circumcision is reported to be around 1% to 5% and includes local infection, bleeding and damage to the penis.-- The Royal Australasian College of Physicians. Policy Statement On Circumcision. Sep 2004. http://www.racp.edu.au/hpu/paed/circumcision/summary.htm

"The incidence rate of the complications of circumcision reported in published articles varies, but it is generally in the order of 0.2% to 2%." -- Canadian Paediatric Society. Neonatal Circumcision Revisited. http://www.cps.ca/english/statements/FN/fn96-01.htm

It is inaccurate for the article to only cite the AAP's complication rates. -- 4.246.213.29 08:47, 26 April 2006 (UTC)

The article cites other rates. To quote: "The AAP, AMA, and AAFP state that the rate is between 0.2% and 0.6%, based upon large series. The CPS acknowledge these series, but additionally cite a review which suggested that a rate of 2% to 10% would be more realistic. The Royal Australasian College of Physicians states the rate of complications of infant circumcision as "between 0.2% and 0.6% to 2%-10%" in one section, and "1% to 5%" in another." Jakew 09:10, 26 April 2006 (UTC)

What exactly is the CPS?TipPt 16:09, 26 April 2006 (UTC)

Canadian Pediatric Society. Jakew 16:41, 26 April 2006 (UTC)

What percentage will you permit (given the four citations I provided) for meatal stenosis? Given the strength of research behind that number ... why quote the AAP at all?

OR, Can we qualify the AAP "large series" by reminding the reader that these series involved no post hospitalization/procedure followup?

What percentage will you permit for redo's, and removing "too much" (lets define as pulling up the scrotal skin again, given the citations I provided)?

The way the section is written gives undo weight to the AAP, and serves to discredit the Royal Australasian College of Physicians. The BMA is missing.

How could we qualify the AAP number so the reader understands the reasons for the large discrepancies in complication rates?TipPt 16:08, 26 April 2006 (UTC)

To address your other points in order, I suggest citing the percentages something like: "Various rates of meatal stenosis have been reported, from N1% [28], N2% [29], ... to N4% [30]". We do not comment on the AAP's large series unless someone else has done so previously. I suggest citing revisions and excess skin removal the same way as meatal stenosis. I'm sorry that the RACP come across poorly, but it's their own fault for citing two different figures in the same document. We can't honestly say that they do anything else. The BMA do not cite a complication rate - hence we can't include one. Jakew 16:41, 26 April 2006 (UTC)

OK, thanks.

I would like to include BMA's statement that "The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks - read more here. It is essential that doctors perform male circumcision only where this is demonstrably in the best interests of the child." That is a strong conclusion, and worthy of inclusion in the Topic.TipPt 17:26, 26 April 2006 (UTC)

Statistics misrepresented in the Topic....

I would like to explain my study result reservations more clearly. The results are frequently "not statistically significant," but Jakew insists on saying "no difference."

At a min., you need to say "not statistically significant" when you say "no difference." Right now, the table [[31]] contains violations of a neutrality.

The specific point I wanted to make is ... when you have SMALL SAMPLES (especially with poor participation rates) and LOW VARIABILITY within those samples you very frequently get insignificant results. For example, a study where guys generally say "I'm went from a 1 to a 2", or "5 to 3" or "7 to 6," will provide weak correlations relative to studies where guys range "1 to 4," and "2 to 9," and "3 to 7," and "7 to 1."

There simply isn't enough information in several of those Tabled small study samples to say anything, including "no difference." The proper thing to say is simply "insignificant results," or "not statistically significant." Most readers don't understand the limitations of regression analysis, and saying "no difference" without lengthly qualification is introduces bias.TipPt 18:56, 27 April 2006 (UTC)

New York Times article on potential of circumcision to address AIDS

http://www.nytimes.com/2006/04/28/world/africa/28africa.html. Just wanted to point that out to the regular editors of this article. Postdlf 23:14, 28 April 2006 (UTC)

To Nandesuka

I'm concerned about your removal of this image. Was this an accident while reverting the vandalism? It has been in the article for quite a few days now, with no protest. Did you remove it for a particular reason, and if so, what was that? Kasreyn 05:11, 29 April 2006 (UTC)

Yes, I didn't realize that was back in. The main thing I was reverting was the opinion statements sprinkled throughout the article eg the bare statement "The child should decide." And I was feeling lazy :-). Nandesuka 11:19, 29 April 2006 (UTC)

Now both images have been removed. The picture of the Muslim circumcision managed to last a few days but the picture of the Jewish circumcision was taken down almost instantly. Why so?, they both merely show the actuality of the process. A picture of the process can surely be no less valid than a picture of its end result.

Both images have been inserted merely for propagandistic value, to imply great pain during the process. They inflame, rather than illuminate. As well, they are undoubtedly illegal copies of pictures; the copyright information given for them was false. Jayjg ^(talk) 23:10, 1 May 2006 (UTC)

Is Jayig suggesting that one can circumcise a child without anaesthetic and not cause pain? Is Jayig suggesting that circumcision is painless? Are all strong pictures to be regarded as purely propaganda? Where is the evidence that either picture is illegally copied? Where is the evidence that the copyright information given for them is false? Instead of making assertions without evidence, let's see the evidence for these claims.Michael Glass 23:18, 1 May 2006 (UTC)

These pictures are obviously propagandistic, and the uploader gave false information about their provenance, describing them as "Wikipedia screenshots". If you want to include pictures more representative of the ceremonies, you should be thinking about shots like this or this. Jayjg ^(talk) 23:30, 1 May 2006 (UTC)

Your pictures are even more propagandistic by simply showing groups of people standing around smiling. The babies (the subjects of the circumcision) aren't even shown let alone the penes or the procedure. As Michael Glass states elements of pain and distress are involved in circumcision and the pictures that have been removed merely reflect this fact.

Agreed. There's no point in showing an image purporting to be of the procedure if the procedure itself cannot be seen because it's been deliberately obscured by someone's shoulder or back. It's not appropriate to have misleading images on Wikipedia. Any image purporting to be an image of a circumcision taking place ought to have the actual procedure be visible. Unfortunately for those highly sensitive to the possibility of a negative image of the procedure, most newborns and children have a decidedly unpleasant look on their face and are often crying during. This, however, could be attributed to fear of strangers and strange situations rather than pain. The expression, and the cry, are nearly universal.

My suggestion is that a compromise be found: such captions as "clearly distressed" are unwarranted editorializing that should not be allowed, but an image of a typical procedure, complete with the nearly-universal appearance of distress which is natural to a child being circumcised, should be included. What definitely should not be included are images that claim to show something that they do not. Kasreyn 00:27, 2 May 2006 (UTC)

I'm not understanding the point of the images in the first place; does Wikipedia or this article benefit from showing naked pictures of infants and young children? Or is that, in fact, illegal? Since so many here seem to be concerned about ethical issues surrounding circumcision, has there been informed consent regarding the displaying of these images? Have the subjects agreed to this? Jayjg ^(talk) 16:24, 2 May 2006 (UTC)

Well, we certainly can have a discussion over whether it's appropriate to include graphic images of circumcision here, and I'd be happy to join in that discussion with you. But it seems to me that you're using an objection from one discussion to quelch a different discussion. That is, the question of whether a given image is propagandistic needs to be put on the back burner if it turns out that we don't actually have consensus for even including an image of the procedure! I must admit that I had merely assumed that all editors would find an image of the procedure to be notable and informative on this article. You seem to disagree, so perhaps we should back up a step and debate whether any image of the procedure should be included, before we waste any more time on the pro's and con's of specific images. What do you think? Kasreyn 22:39, 2 May 2006 (UTC)

Neither picture has any copyright information given for them. Images that have no source information should never be used in Wikipedia articles, and all such images should be deleted seven days after the copyright problem is identified. Nandesuka 23:29, 1 May 2006 (UTC)

The Turkish boy image may be found on this page (near the bottom): [32]. It was the second hit when searching images.google.com for 'turkish circumcision'. Jakew 09:55, 2 May 2006 (UTC)

The "Jewish" (is there any evidence that he is?) boy image may be found on the same page.

I recall seeing both images on other sites too, though I'm not certain where. Jakew 11:45, 2 May 2006 (UTC)

Ah ha! http://www.sexuallymutilatedchild.org/trk.htm http://www.sexuallymutilatedchild.org/post1.htm Jakew 11:49, 2 May 2006 (UTC)

Well, that pretty much settles the legal copyright issues, and whether or not they are propaganda pictures. As well, the second image wasn't even of a Bris, but rather of an infant circumcision in a hospital. Jayjg ^(talk) 16:24, 2 May 2006 (UTC)

Removal of image of Turkish child being circumcised

- I notice that this picture has been removed under the pretext that it is "propaganda". I suspect that this is a pretext for removing a picture that the editor, for ideological reasons, finds not to his liking. If there is a rational objection to the picture, present it. Otherwise, the picture should be restored to the article. Michael Glass 23:08, 1 May 2006 (UTC)

See above. Thanks. Jayjg ^(talk) 23:11, 1 May 2006 (UTC)

Declaration of the editors' interests

I can anticipate the response that this question will receive but I would like to ask the editors if they would volunteer information as to whether they are circumcised or not circumcised. I'm not interested in an individuals status but I would like to know the percentage as a whole for over the past few weeks I have noticed a subtle but definite inclination towards circumcision in how this article is edited. I think this is important for two reasons: i) Objectivity does not and cannot exist even the most enlightened and balanced person holds and projects favour and bias; and ii) this being the case editorialship, especially in contentious issues, must have balanced views or a non-dominant view at the very least. And in *trying* to add an impossible element of objectivity I'll volunteer that my penis is not circumcised. —The preceding unsigned comment was added by 86.132.239.168 (talk • contribs) .

I can warn you that you're in for a hard time, as you suspected. I, and a few others, have raised the specter of cognitive dissonance before, and have been attacked for doing so. One editor took great offense at my contention that a person who has spent his entire life in one state (circumcised or uncircumcised, doesn't matter) lacks the life experience to make a meaningful value judgment between the two states; even though my statement applied equally to myself, since I have lived my entire life in one state, this editor called my statement "condescending". Once there was an attempt by someone to add a "study" which apparently asked the ridiculous question of whether men were "satisfied" by their penises - as if they could be anything else but satisfied, not knowing anything else! However, when I attempted to point this out, I was once again attacked.

I suggest you don't even bother. The concept that anatomy may determine bias is considered anathema by many on both sides of this debate, and you're likely to be pilloried for even suggesting it. As for myself, I decline to give any information on the status of my genitals, but I do disagree with the practise on ethical grounds pertaining to consent. I specifically believe that freedom of worship should not extend to issues of medical ethics and parental consent, such as circumcision. However, I've tried my best to keep this article NPOV, which frequently means reverting insertions of POV I happen to agree with. That would probably be a better way for you to spend your time than asking personal questions that can only get you attacked for your trouble. Kasreyn 00:37, 2 May 2006 (UTC)

Kasreyn, if a man can't determine if he is satisfied with his penis because of a lack of experience or reference then why are there adult men that get circumcisions?, obviously they had some kind of unsatisfaction with their penis to take on a elective surgery. Many man our unsatisfied with their penises, but not for any reason on this article. --BerserkerBen 01:12, 2 May 2006 (UTC)

There are other reasons than dissatisfaction; desire for social acceptance is so strong in the human race that people have frequently done a great many things that they knew were not in their own best interests out of the desire to belong, to be accepted. What if a man converts to Judaism as an adult, and undergoes circumcision? It doesn't necessarily follow that he was dissatisfied with his penis, it's possible that circumcision was just seen as a way to identify himself as Jewish.

Of course, then there are people who are dissatisfied with their anatomy, such as transsexuals. It's always confused me, and I consider it confusingly irrational, but it definitely does happen. So allow me to rephrase a bit for clarity. I'm not saying no one ever feels dissatisfied with their lifelong anatomy, or with experiences that they have no standard of comparison for. I'm saying that no one can have any logical reason to feel dissatisfied with their lifelong anatomy, or with experiences that they have no standard of comparison for. A gay friend once asked me whether I would have preferred to have been born a woman, and I refused to answer the question - how can I? I have no standard of comparison, so I don't know whether I'd have been happier or less happy. If someone is dissatisfied with the anatomy they've had their entire life, and wishes to change it, the only basis they can have for perceived anatomical benefit after the change is a fantasy that it will be better. And, of course, pride and cognitive dissonance will provide a barrier to admission of error, if it turns out to have had a deleterious effect. Kasreyn 01:26, 2 May 2006 (UTC)

Many have logical reasons to be dissatisfied with their anatomy! Do you think a cripple has no logical reason to be dissatisfied with s/he body? How about women that take birth control pills not just to prevent pregnancy but to mitigate menstruation, do they have no logical reason to be dissatisfied with a natural anatomical function? How about the old guy that has to pee every 10 mins because his prostates is the size of a basketball, does he not have any logical reason to be dissatisfied with his body and seek corrective surgery? How about the guy that suffered pain when peeing and has chronic inflammation of his glands because his foreskin was to long and/or un-retractable, he does not yet know what its like being circumcised, but he can make a logical and researched judgment, determine the possible benefits and side-effect and make a reasoned decision. Surely almost nothing is for sure, but a person can still make a reasonable judgment about there own state of being and to do something about it, even if that person has no personal experience to validate s/he judgment.--BerserkerBen 17:37, 2 May 2006 (UTC)

Well, I think that's getting a bit off topic... circumcision and sex-changes are examples of elective surgery (except for phimosis and the other rare medical indications for circumcision). Corrective, medically indicated surgery, you are right, is of course something that one can make a logical decision, a value judgement, over. I was really only intending to refer to value-neutral (as in, people on both "sides" believe their quality of life is just as good as the other's) changes, such as voluntary circumcision or sex changes. I should have been more specific in my wording to avoid confusion. Kasreyn 22:35, 2 May 2006 (UTC)

My issue is perfectly on topic, you refused to show research that claims to say who is or is not satisfied with their penis status. I think that a person can logically decided if they are satisfied with a quality of them selves even if they have not experienced an alternate version of that quality. --BerserkerBen 23:58, 2 May 2006 (UTC)

You know perfectly well there is no such research. No scientist would waste their time on it. You can't base meaningful data on the well-known self-serving bias. There is no experimental model that can avoid it. "Are you satisfied with your penis" is a ridiculously leading question. Any answers given to it can have no scientific value. Kasreyn 16:45, 3 May 2006 (UTC)

On a second reading, I think I snapped at you too hard on that one. My apologies. I misunderstood what you meant by "you refused to show research". I thought you meant you were asking me to back up my claims with a study on penis satisfaction. It appears more likely that you were referring to my original critique of the concept of including such studies, which I stand by. Such studies do not qualify as scientific, since their experimental model does not include the possibility of falsification. This is due to certain well-known biases inherent to the human mind. No matter what group of males you pick, a sizable majority will always declare they are satisfied with their genitals, because to feel otherwise would be too unpalatable. This "satisfaction" has very little to do with actual physical quality of life, and very much to do with projecting a self-image of being happy and complete. Kasreyn 17:40, 3 May 2006 (UTC)

Additionally, I don't think you understood my initial proposition. I clearly referred to dissatisfaction with anatomy one has had for one's entire life. This divides cripples into two categories: A), those who have been crippled from birth (or so young they can't remember any other way), and B), those who were crippled at an age old enough to remember the full use of their bodies. I would agree with you that group B definitely has a logical reason to be dissatisfied with their anatomy - when you remember what it was like to have two arms, having only one could definitely be seen as a lower quality of life. Group A, however, can only be dissatisfied if they compare their own abilities to others and find them lacking. For instance, they can compare their one-armed lifestyle to that of people with two arms, and decide that the lack of that arm is a bad thing. They can be told by others that it is a bad thing, and believe them or not believe them.

The problem with analogizing this to the penis is simple: There is only one foreskin, not two, so a circumcised man can't extrapolate what it would be like to be uncircumcised, the way a one-armed man can extrapolate what it would be like to be two-armed. A one-armed man can easily figure out that it is better to have two arms than one. A circumcised man, however, cannot easily determine whether he has benefited or not by the loss of his foreskin. If, as has been contended, ownership of a foreskin results in greater pleasure during sex, there is no way for this to be readily apparent through comparison - degrees of pleasure cannot be reliably measured visibly. It also cannot be explained. How is an uncircumcised man to explain the difference in sensation (if there even is one) to a circumcised man? Impossible. The uncircumcised man can only say "it feels good". Well, it feels good to the circumcised man, too, so no information is being exchanged.

A better analogy than a one-armed man might be a person who is crippled of something humans only have one of, such as the nose. But again, this isn't a good analogy. The nose is highly visible, not constantly concealed inside clothing. Lacking a nose is universally considered a great loss of physical appearance / beauty. The same cannot be said of lacking a foreskin. Another example would be a hare-lip: it, too, is far more visible than a foreskin in our society, and so isn't a good analogy. And aside from the nose and mouth, I can't think of any other non-vital appendage or organ which isn't duplicated on both sides of the body. Legs, ears, eyes, etc., can all be judged through extrapolation from an existing part. So I really feel your argument, at least where cripples are concerned, doesn't hold water, because it doesn't analogize well to circumcision. Furthermore, the cripple analogy cannot be used in the article because it would constitute a POV comparison of circumcision to crippling, which is just the same thing as calling it mutilation, which there is a clear consensus against.

In any case, this is dragging on for far too long, and I've exhausted most of the different ways in which I can say the same thing. If you wish to keep discussing it, please contact me at my talk page, so we don't begin to drown out other discussion here. Cheers, Kasreyn 17:04, 3 May 2006 (UTC)

hmmm, the anon's request for editor disclosure of the status of one's penis first of all makes the assumption that all the editors here are male. Secondly, and more importantly, we're actually not here to discuss editors' personal views, religion, politics, gender, or anatomy, just adhere to policy standards in our writing. --MPerel ^{( talk | contrib)} 08:29, 2 May 2006 (UTC)

Good point. For my part, I'm quite happy simply to affirm that I will do my level best not to be biased by my own circumcision status, and that I don't think it does bias my viewpoint all that much anyway. However, you do raise an interesting issue - might women be more objective on this topic than men? Procrastinator supreme 09:55, 2 May 2006 (UTC)

Excellent point, MPerel. I did make a wrongful assumption and in doing so I completely failed to consider half the Earth's population. However I think this reinforces how hard (impossible?) it is to be objective regarding an emotive subject and consequently comes back to my original point about editorial balance. I also support Kasreyn's notion that the status of a persons genitals is, of course, a private matter and irrelevant to the subject, but that a simple pro/anti statement might be more appropriate. I do think a statement of personal views would be helpful no matter how objective a person tries to be (if this is at all possible). Wikipedia editorialship is an immensely powerful tool and can and does form/sway opinion. Therefore the answer to the question - Quis custodiet ipsos custodies? - we do! —The preceding unsigned comment was added by 86.132.239.168 (talk • contribs) .

Please login when editing or commenting, and please use Wikipedia Talk: pages for their intended purpose. Wikipedia is not a discussion board. Jayjg ^(talk) 16:26, 2 May 2006 (UTC)

Suitable image of circumcision?

File:MHbaby.jpg

Baby undergoing circumcision (Gomco technique)

What's the consensus on incorporating this image into the article, preferably the consent section? The circumstraint and strappings are not clearly visible so hopefully this won't inflame (but I don't see why this might be objectionable given that they are part of the process). It seems a fairly neutral picture presenting a process of circumcision. Any objections or support? (There is an excellent series of pictures at http://www.cirp.org/library/procedure/plastibell/ some might find the comments partial but the images are extremely illustrative).—The preceding unsigned comment was added by Alainejosey (talk • contribs) .

Wow, another propaganda image from another propaganda source. Speaking of consent, has the image been released to us under the GFDL? And has the subject consented to have this image displayed on the internet? Jayjg ^(talk) 17:51, 2 May 2006 (UTC)

That image can be found at http://www.sexuallymutilatedchild.org/jenkins.htm

Also, even if it were suitably licensed, it would not belong in the consent section but as an illustration of the method. A picture of a consent form might be relevant to that section, but an image like this would only illustrate methods of circ at best. I'm surprised that anyone who is aware that Wikipedia is not a propaganda vehicle would even propose such a blatant attempt to manipulate the reader. Jakew 18:18, 2 May 2006 (UTC)

How on earth can this be deemed propaganda! What does it matter if the image is from a partial site (as I stated). The image stands on its own. It is a baby being circumcised. It is not sensationalist or provocative in itself other than the values people attach to it. The absolute stonewalling by some editors makes one think that they are ashamed of the process and would like to try and cover up what is actually involved. —The preceding unsigned comment was added by Alainejosey (talk • contribs) .

Why do you propose including it in the 'consent' section? What purpose is served? Clearly it does nothing to illustrate the concept of consent. It shows a baby, apparently in distress. As human beings, we are inclined to protect infants. As such, the only apparent function of the image is to bias the reader towards one side of the argument in the consent section. Information intended to manipulate is the very definition of propaganda. Thus, it is propaganda.

I suggested placing this image in the consent section because it entirely illustrates a fundamental arguement in this area. i.e. childrens' rights balanced with parents' rights. I think it is fairly clear that my position is against childhood circumcision and could have proposed much, much more graphic and traumatic baby/child circumcision images. Nonetheless, you admit yourself that even this more sanitized image is likely to cause bias, that the baby is in distress (and pain) and that readers might be disinclined. You say this is propaganda on my part, not so. I have proffered an image that reflects the actuality of a circumcision. I defy anyone to present an image of a baby being circumcised that does not mirror the given image. I suggest that it is you who is trying to maintain an unbalanced, unrealistic status quo and helping to censor contributions that are not in accordance with your views. Is it the image that you are unhappy with (and if yes, how so?) or the fact that people might evaluate the topic in a different light from seeing the actual process of circumcision. Circumcision just doesn't occur - this is how it is carried out. There is no value in it other than what a person attaches to it. Someone with your conviction might consider 'This is an image of a procedure that is central to my health/hygiene/religion/culture and which I support.' Someone with my conviction might consider that 'This is an image that reinforced my opposition to circumcision on the grounds that it is unethical/traumatic/risky/lacking consent.'

Jayjg, I think you're being unreasonable. Will you only be satisfied by an image of an infant smiling as it's being cut? Are you aware of how utterly unreasonable such a standard is? Fact: most infants appear distressed during the procedure. If it would reduce your worries of inflammatory bias and/or propaganda, we could include a caption with the picture noting that fear and distress can cause such facial expressions even when the procedure is painless. Would that satisfy you? Because I'm beginning to believe that there is no such thing as a picture of a circumcision that you'll accept, and that bothers me. Kasreyn 22:29, 2 May 2006 (UTC)

Note: perhaps the above comment should be disregarded for the time being, since it appears that the support among editors of this article for even including any image of a circumcision procedure may be in doubt. Kasreyn 22:45, 2 May 2006 (UTC)

Right. Jayjg ^(talk) 16:10, 3 May 2006 (UTC)

A brief aside - I don't know whether it was yourself but why did someone feel fit to add my username to my posts. I'm not sure what the intent was it to 'out' me or some other ridiculous notion. I stand by my assertions 100% but if I choose not to add my username should someone else make the decision for my... oh, sorry I forgot, this is the circumcision talk page. —The preceding unsigned comment was added by Alainejosey (talk • contribs) .

Signing posts is a matter of Wikipedia:Etiquette, so that other editors can follow the conversation. --MPerel ^{( talk | contrib)} 22:18, 2 May 2006 (UTC)

It doesn't matter which site the image is from, incidentally, since unless it is public domain or has been given to us by the copyright holder under the GFDL, Wikipedia cannot use it. That said, a propaganda site is likely to select images that serve its purpose. Rather than presenting images that are representative, they are likely to choose those that give a certain impression. Jakew 19:09, 2 May 2006 (UTC)

Infant circumcision is a different breed of issue, rather then just the issue of circumcision it also brings up the issue of surgery without consent or anesthesia (same goes for ritualistic circumcisions), the extra issue can bias the argument of circumcision making it seem as though all circumcision procedures are wrong. Not only do I oppose any pictures of the procedure I would also like to get those homoerotic images made by some perverts replaced with some relatively abstract diagrams.--BerserkerBen 03:51, 3 May 2006 (UTC)

"Un"circumcised

Well I think the article shouldn't use the "uncircumcised" word because well there are no "unamputated" or "unmutilated" words in the mutilation and amputation articles, are there? I think this whole article is biased towards circumcised people.

By the way, when I was a kid (11, 12 years) I began watching pr0n movies and that kind of stuff, and all of the male actors were circumcised (now I know this is normal because those pr0n movies were mostly made in U.S. and other countries where pretty much everyone is jewish) and since I had a foreskin I tought I was anormal or something, but now I know THEY were the anormal ones, the mutilated ones. I think there should be an article about "un"circumcision in pr0nography as well. Cuzandor 01:45, 3 May 2006 (UTC)

Please review WP:NOT#Wikipedia_is_not_a_soapbox, which points out that Wikipedia is not a soapbox. If "unamputated" was the commonly accepted English word to describe a person with two hands and two feet, then Wikipedia would use it. While I understand that your particular political, moral, or ethical beliefs make you believe that circumcision is wrong and that the word "uncircumcised" is therefore politically charged, your linguistic position does not agree with the common English usage. Kind regards, Nandesuka 02:26, 3 May 2006 (UTC)

But Wikipedia must be neutral point of view, not biased toward cultural aspects of anglophones, unless that "neutral point of view" policy is merely BS designed to sound pretty, cool, "scientific". Also I know several guys who had doctors to circumcise them because they watched pr0n movies and tought they were anormal and because in the school a guy once came to show pictures of DSTs and then there was a picture of a "un"circumcised d*ck and one of a circumcised one and he said "Look in this one the foreskin covers the glans and this is WRONG, the glans must be uncovered like this (points to the other picture)" and then they thought they had phimosis. The article should also point that at least 1% people who get circumcised at like 12 or 13 only do so because they were somehow tricked into doing that. Cuzandor 02:42, 3 May 2006 (UTC)

I hear you stating your belief that use of the word "uncircumcised" somehow implies that "circumcised" is the normal, healthy state and that "uncircumcised" is abnormal or wrong. I disagree. I am a non-smoker. That doesn't imply that smoking is normal, or indicate cultural bias in favor of smoking. This issue has been discussed in detail here: Talk:Circumcision/Archive_7#Uncircumcised_vs._Intact. You might want to read through that. It's interesting reading. Regards, Nandesuka 02:54, 3 May 2006 (UTC)

And of course, according to WP:UE (use english), we are biased towards anglophones. That is to say, we use English as it is used by native speakers in the English-speaking world. This only affects our naming conventions, not our presentation of facts, so it's not really incompatible with our NPOV policy, but it does dictate our choice here. -lethe ^{talk +} 17:00, 3 May 2006 (UTC)

NPOV tag

Who added it anyway? Is the particular issue for which it was added resolved? I don't see anything here on the talk page indicating what was in dispute. If no one can provide an explanation for its presence, I'm going to remove the NPOV tag. Kasreyn 22:14, 4 May 2006 (UTC)

I agree. --Nigelj 22:25, 4 May 2006 (UTC)

Replace with Controversial tag --BerserkerBen 16:18, 5 May 2006 (UTC)

Sand

I am aware that some people believe that sand under the foreskin may have been a problem for men in the desert. This statement is repeated in several places. However, when Darby reviewed the evidence and published his finding in the New Zealand Journal of Medicine, it is worthwhile looking at what he found:

Claims about sand and circumcision, such as in the RACP policy on circumcision are unreferenced.

Originally, no health benefits were claimed for circumcision.

These claims came later, as circumcision was being popularised in the late Nineteenth Century.

There was no evidence for this in the British History of the Second World War.

Australia's official history does not mention this idea.

It's the same for the New Zealand official history.

When checked, there was no evidence for this story with the German troops.

That is why Darby concluded that there was no evidence for this story. What Darby did, and what others showed no evidence of doing, is that he checked the evidence. Therefore what I inserted is fair comment.Michael Glass 11:53, 6 May 2006 (UTC)

It is a novel interpretion to infer that "unreferenced" means "did not review the evidence." So let's just stick to neutral language. Nandesuka 12:05, 6 May 2006 (UTC)

It's worth noting some points here. Firstly, the stuff about health benefits is clearly nonsense, since we're talking about therapeutic circumcisions. Secondly, absence of evidence is not evidence of absence, so Darby's claim that it is not mentioned in various war histories proves nothing. Thirdly, sources have been cited in the past about German (and other) troops, and a fair review would recognise this fact. It is simply ridiculous to dismiss this evidence because Darby and his fellow anti-circer Hugh Young don't believe it. Jakew 15:35, 6 May 2006 (UTC)

No. In the case of the RACP policy there was no reference given for this point. That's what I meant and that's what I wrote. If it wasn't clear I hope that meaning is clear now. 'Unreferenced' means unreferenced. The difference between what Darby wrote and other points that have been made is that Darby went to some trouble to find out if there was any credible evidence of the sand myth. He checked the war histories of Britain, Australia and New Zealand and found no evidence to back up this story. When someone else he know corresponded with the son of the commander of the German forces that also fought in the desert he drew another blank. On the basis of the war experience of four countries he concluded that the 'sand' story was just an urban myth.

Please read the article.

It's published in a peer-reviewed journal.

It gives a detailed account of the steps Darby took to chase the story.

The documents that record the sand story usually do so in passing.

Noting that Darby reviewed the evidence simply states facts for which there is ample evidence.

Of course, you might know of other credible evidence. If so, please produce it. Michael Glass 14:40, 6 May 2006 (UTC)

"Review of the evidence" implies a certain amount of fair, impartial scholarship. I would argue that his essay is logically meritless and typical of his biased, atrocious scholarship. I don't intend to put that in the article, as it's clearly POV. Jakew 15:35, 6 May 2006 (UTC)

Jake, as you have just admitted, your opinion of Darby is clearly POV. You say that his scholarship is 'atrocious'. If so, I would be interested in your producing credible evidence that this article is wrong in fact or interpretation. My latest edit is to put down the steps that Darby took to chase the story of sand under the foreskin and to quote his conclusion on this matter. This leaves the reader in the position of accepting Darby, checking what he said (via the link) or rejecting what he said on whatever grounds. I believe that it is a fair summation of what was published in a peer reviewed journal. If you feel it is not, please let us discuss this further. However, suppressing any mention of the fact that Darby looked for credible information is clearly unfair. Michael Glass 00:46, 7 May 2006 (UTC)

Michael, any opinion is inherently POV. I have pointed out some of the severe logical errors in his essay above. There is no point whatsovever in mentioning the war histories, because this argument is a logical fallacy. The closest Darby got to real scholarship was noting the sources that others had used, though unfortunately, unable to be fair and impartial, he effectively stated that they were lying. Jakew 09:52, 7 May 2006 (UTC)

Jake, I think my wording points out what Darby did in a fair manner and does not make any value judgements about who was right and who was wrong. You are quite right in saying that absence of evidence is not evidence of absence. However, absence of evidence is evidence of a lack of evidence. If the sand problem was mentioned in the official histories of any of the countries that would be strong evidence of a problem with sand. The fact that is is not mentioned suggests that it was not a notable problem. Both Hutson and the RACP mentioned the 'sand' idea but neither supplied references, so this weakens their position. If you have other evidence, on this 'sand' story please present it. Michael Glass 13:02, 7 May 2006 (UTC)

"However, absence of evidence is evidence of a lack of evidence." Huh? It is no such thing. Nandesuka 14:51, 7 May 2006 (UTC)

Dubious edits

TipPt, you've made a number of edits that, in my opinion, make the article considerably worse.

Your opinion is noted. The opening paragraphs are now introductory, and pertinant to actual current practice. Your version places emphasis on "Circumcision may be recommended to treat a variety of conditions" (in fact, circs to treat disease are very rare as a percentage of total procedures), and "controversial in recent decades" (it's not controversial ... relevant ... when parents have already decided to circumcise, or are not influenced by the "controversy.")

Your opinion is likewise noted. Do you have evidence to support either assertion? Jakew 16:44, 7 May 2006 (UTC)

The evidence is properly addressed in the paragraph and later in the topic. I mention it here for discussion purposes. The second and third paragraph of your version Jakew is neither relevant to actual practice, nor introductory to the topic. Your paragraphs are left in later.TipPt 18:04, 7 May 2006 (UTC)

If they were not relevant to actual practice, the cited sources would not have been written. Jakew 18:27, 7 May 2006 (UTC)

The question is priority. We know actual practice is mostly religious but otherwise a cultural ritual ... very few for medical reasons so your emphasis is not warranted.TipPt 18:49, 7 May 2006 (UTC)

So you keep saying, but evidence exists to the contrary. Jakew 19:17, 7 May 2006 (UTC)

If you speak in vague generalities, how can we address issues? What evidence do you have that "exists to the contrary"?

I think you are trying to claim that medically indicated circumcisions are more than rare, relative to circ's for religious or cultural ritual reasons. Good luck.

Your emphasis on disease (second para) and controversy (third para) is inappropriate to actual practice.TipPt 21:52, 7 May 2006 (UTC)

Evidence such as Adler's study, for example, in which health reasons were found to be most important of all. Regardless, whatever the reasons for it being performed in individual cases, it is a medical procedure, and it does have medical consequences (both risks and benefits). If the purpose of this page was to influence parents' decisions, then your argument might have some merit, but Wikipedia is not a soapbox. It is an encyclopaedia, intended to provide information. Jakew 11:04, 8 May 2006 (UTC)

• "The practice of ritual circumcision predates..." - this belongs in the 'history' section, and actually duplicates some of that material. I suggest adding content/citations to that section instead.

It's an interesting introduction to the topic.TipPt 16:27, 7 May 2006 (UTC)

• "Parental decisions regarding circumcision are dominated by cultural ritual considerations..." This is contradicted by Adler's study, in the 'circ since 1950' section. It's also unclear why you're citing Goldman's opinion piece here.

There are several relevant paragraphs in the Goldman article, including: "The importance of conformity in the decision to circumcise is illustrated by a survey of parents of 124 newborn males born at an American hospital. The results showed that for parents making the decision, social concerns outweighed medical concerns. Parents' reasons for circumcising were based mainly on an interest that the baby 'look like' his father, brothers and friends. (Because of the large variation in appearance in circumcised boys, circumcision should be discouraged for cosmetic reasons [71].) Only 23% of the intact fathers had circumcised sons. In contrast, 90% of the circumcised fathers had circumcised sons. The authors concluded that the decision to circumcise 'is more an emotional decision than a rational decision' and has a strong base in social and cultural issues [72]." and "Social concerns were also a major consideration among parents making the decision about circumcision in a study an another American hospital. A group of parents were given special information about circumcision, based on the 1975 report of the American Academy of Pediatrics Ad Hoc Task Force on Circumcision which concluded that circumcision is not medically necessary [73]. (there was no information on significant harm caused by circumcision). A control group in the study was given no information on circumcision. The circumcision rates of the two groups were not statistically different. Parents found social reasons alone sufficient to choose circumcision. The researchers concluded, 'Circumcision is a custom in our society; to change the attitude toward it is not an easy task' [74]." and "Because it commonly affects behaviour, social science researchers have extensively investigated the issue of conformity and have verified what is suspected here; group pressure can lead people to abandon their judgement and conform. In a well known study, 80% of subjects conformed to the false consensus of a group, even though that consensus was contradicted by visual evidence [77]. Conforming to group practice has also been shown to be more likely when the group is large [78]. Furthermore, when the situation is ambiguous, people are especially influenced by the group, and the greater the ambiguity, the greater the influence of the groups on the judgement of individual members [79-81]. The need for social approval drives our tendency to conform. Until the environment of conflicting information and general support for the practice changes, conformity will continue to be a strong factor in circumcision decisions by parents."

At best, Goldman is just giving his take on studies that we can cite directly (and have already done so, in several cases). There is no good reason for citing an opinion piece when factual evidence can be cited instead. Jakew 16:44, 7 May 2006 (UTC)

Goldman is citing several good studies, a few quoted above. It's better for the reader to see several studies quoted from one link.TipPt 17:59, 7 May 2006 (UTC)

Any cited studies can perfectly well be cited here, in a balanced manner. It is not good for the reader to present a biased opinion piece as fact. Jakew 18:27, 7 May 2006 (UTC)

Again, it's simply easier for the reader to gain access to several studies in one link. It may be your opinion that it presents a biased view, but leave that to the reader. The quotes I listed above are specific to the topic and properly cited.TipPt 18:59, 7 May 2006 (UTC)

We do not cite opinion as fact. If you'd like to cite individual studies, that's not a problem. Jakew 19:17, 7 May 2006 (UTC)

I couldn't find Adler's in the 1950's section. Please link directly here.TipPt 16:27, 7 May 2006 (UTC)

ok Jakew 16:44, 7 May 2006 (UTC)

Adler does not consider the immediate decision to circumcise, but rather the statements and opinions of parents years later. The results are strongly influenced by social class effects.TipPt 17:59, 7 May 2006 (UTC)

If you'd like to cite criticism of his study, fine, go ahead. However, you cannot state that something is a fact when evidence exists to the contrary, even if you believe that evidence to be faulty. Jakew 19:17, 7 May 2006 (UTC)

Novel interpretation. Jakew 18:27, 7 May 2006 (UTC)

It is a study of parents opinions years after the actual decision.TipPt 18:59, 7 May 2006 (UTC)

See above. Jakew 19:17, 7 May 2006 (UTC)

• Complications section: You've reversed my previous edit, which better organised the section and made it more readable. Some specific problems:

• Instead of introducing the topic with an overview (such as the medical orgs positions), you dive straight in to discussing meatal stenosis. You've also isolated the paragraphs dealing with that subject from each other. They are best presented as a single paragraph, so that the reader can see the reported rates, Altschul's observation, and the AAFP note that it is uncertain that it's a complication.

Note that meatal stenosis is likely the single most frequent complication of circumcision.TipPt 16:27, 7 May 2006 (UTC)

Why should I note that, when "there are no well-controlled cohort related studies to document their relationship"? Jakew 16:44, 7 May 2006 (UTC)

How about weight of the evidence? There are several studies (I have) properly cited that show meatal stenosis ONLY in circumcised boys.

The treatment is meatodomy ... which is a serious additional complication of circumcision not yet considered in the topic.TipPt 18:15, 7 May 2006 (UTC)

We state something as fact only if it has been proven to be so. We do not make assessments based upon weight of evidence. Furthermore, since the meatus cannot be observed in uncircumcised boys, it stands to reason that it would only be documented in circumcised boys.

Also, it has been successfully treated through stretching. Jakew 18:27, 7 May 2006 (UTC)

I list the major complications in the first paragraph. The second paragraph goes into detail ... hospital setting complications, longer-term complications, and complications from poorly performed circumcisions. The third tries to incorporate Association opinions (you should leave out "benefits" Jakew), the forth lists Association cited rates. The rest are paragraphs from other editors, that I thought were OK, but mostly didn't want to remove without strong cause.TipPt 16:27, 7 May 2006 (UTC)

The organisation is poor, and flows badly, as I explain below. Jakew

Altschul refers to intact boys and meatitis. The sentence doesn't belong at all in circ complications.TipPt 16:27, 7 May 2006 (UTC)

If a condition cannot be diagnosed in uncircumcised boys, then wouldn't one expect a higher rate of diagnosis in circumcised boys? Jakew 16:44, 7 May 2006 (UTC)

Why assume there's a hidden infection in intact boys? They are not complaining of painful urination (as circ'd boys do because of meatitis), and they do not develop meatal stenosis (which only circ'd boys develop ... not intact).TipPt 18:15, 7 May 2006 (UTC)

Why assume that there isn't a hidden problem? I'm not saying that there is, but unless one assumes that there isn't, the stats prove nothing, so it's pretty important to be sure. Also, many of these cases were detected during a routine genital examination, suggesting no such complaints. Finally, you cannot say that only circ'd boys develop meatal stenosis, since (once again) "there are no well-controlled cohort related studies to document their relationship". Jakew 18:27, 7 May 2006 (UTC)

It is only found in circumcised boys. You are confusing two potential complications ... meatitis and meatal stenosis. Check out what your Associations say about the complication.TipPt 19:08, 7 May 2006 (UTC)

Ok, to quote: "One author(10) reports that meatitis, meatal ulcer and consequent stenosis occur in an estimated 8 to 31 percent of circumcised infants, while another(11) states there are no well-controlled cohort related studies to document their relationship." Jakew 19:17, 7 May 2006 (UTC)

• The previous organisation was straightforward: introduction, with med organisation's views, 'official' rates, immediate complications, more severe immediate complications, and finally meatal problems as a possible delayed complication. Your changes confuse things. It now reads: immediate complications, meatal stenosis (1st time), other immediate complications (all in one paragraph), med organisation's views, 'official' rates, skin bridges, severe immediate complications, meatitis, meatal stenosis (2nd time).

Jakew 15:19, 7 May 2006 (UTC)

You love those Association views, but the introduction should list complications (that's the topic). The second paragraph goes into detail, with emphasis on setting (hospital versus traditional) and the most common complications. The third and forth paragraphs are yours Jakew. Association statements and figures. The rest is other editors writing, which I don't like to remove.TipPt 18:23, 7 May 2006 (UTC)

The section is reasonably short, and there is no good reason to list complications twice. We should go from most general to most specific. Jakew 19:17, 7 May 2006 (UTC)

This is funny, because you are insisting on listing medical benefits ... in great length ... twice.TipPt 22:05, 7 May 2006 (UTC)

Actually, I am not. I am insisting on discussing them once. Jakew 11:04, 8 May 2006 (UTC)

"Medical Aspects" and "Medical Analysis of Circumcision"

The main topic is too long, and redundant.

Under "Medical Aspects" the reader finds lengthly information: 4.1 Risks of circumcision 4.2 HIV 4.3 HPV 4.4 Hygiene 4.5 Infectious and chronic conditions 4.6 Penile cancer 4.7 Phimosis and paraphimosis 4.8 Urinary tract infections

4.1 should be placed after Prodedures of Circ.

4.2 through 4.8 are better placed in the Medical Analysis of Circumcision main article.

That medical analysis article already contains those same topics (4.2 - 4.8)

Please see the changes made to the circumcision topic lead paragraphs, and the "Risks of circumcision" article.TipPt 15:48, 7 May 2006 (UTC)

As I've commented previously, this article should contain an overview of these topic, leaving detailed discussion for the med. analysis article. It is wholly inappropriate to remove them, as this article discusses a subject that is principally medical, and these aspects are clearly relevant. Clearly, discussing risks but not benefits is inappropriate and POV. Jakew 17:40, 7 May 2006 (UTC)

Circumcision is very rarely practiced for medical reasons, why do you insist on otherwise in the topic? You waste space repeating the information properly contained in a separate main topic. The main topic addresses the cost/benefit analysis, which serves to summarize the risks and benefits.TipPt 18:37, 7 May 2006 (UTC)

On the contrary, a 1999 study found that circumcision was performed for medical benefit in 41% of cases, and a 2001 study reported that health reasons were the most important reason for circumcision. Both of those were in America. In the UK and much of Europe, almost all circumcisions are performed for medical reasons. This does not meet the definition of "very rare".

Secondly, we do not 'waste space'. The purpose of this article is to give an overview, directing readers to more detailed discussion where appropriate. We summarise, but do not completely omit all information, as that denies the reader the opportunity to find out what he might wish to learn more about. Jakew 18:41, 7 May 2006 (UTC)

After the fact, parents say medical benefit in the US. That factor is much less relevant than the fathers status. As a percentage of circ's, those done for legit medical reasons are very few ... we did the math in a previous discussion jakew.TipPt 19:12, 7 May 2006 (UTC)

Not less relevant according to Adler. Regardless, it's still a medical topic, and that requires discussion of the medical aspects. Jakew 19:24, 7 May 2006 (UTC)

Why don't you write a few paragraphs outlining medical benefits, which would go after the cost/benefit paragraph but before risks?TipPt 19:18, 7 May 2006 (UTC)

Because suitable paragraphs have already been written, revised, and sourced, after lengthy negotiation and discussion between various editors here. What's there is perfectly adequate, and I've no intention of reinventing the wheel unless a pressing need is demonstrated. Jakew 19:24, 7 May 2006 (UTC)

You do not represent other editors.TipPt 22:01, 7 May 2006 (UTC)

However, he does represent both the medical literature and Wikipedia policy. Jayjg ^(talk) 02:49, 8 May 2006 (UTC)

Here's a proposed change to the introductory paragraphs

You define the term, and describe its origins and current practice. The emphasis is on cultural ritual and religious circumcision, in keeping with the nature of the practice.

The existing version is dominated by treatment of disease, and then controversial non-therapeutic infant circumcision. Those paragraphs should come later.

Circumcision is the removal of some or all of the foreskin or prepuce from the penis, generally to fully uncover the glans. The frenulum may also be removed at the same time, in a procedure called frenectomy. The word "circumcision" comes from Latin circum (meaning "around") and caedere (meaning "to cut"). Female circumcision is a term applied to a variety of procedures performed on the female genitalia. Except where specified, "circumcision" in this article should be understood as "male circumcision".

The practice of ritual circumcision predates recorded human history, with depictions found in stone-age cave drawings and Egyptian tombs.^[33] The origins of the practice include ritual sacrifice, offering, or sign of submission to a deity, a rite of passage to adulthood, a mark of defeat or slavery, or an attempt to alter esthetics or sexuality. ^[34] Circumcision and frenectomy remain the most common surgical procedures performed on young males, predominately members of the Muslim and Jewish faiths, Americans, and South Koreans.

Parental decisions regarding circumcision are dominated by cultural ritual considerations ^{[35] [36] [37]} [38] or religious beliefs, not by potential medical applications. [39] In two studies, strong parental cultural expectations clashed with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.” Discord arises from the implication that parental desire to circumcise involves “undue risks” and provides “limited medical benefit” to their child.^{[40] [41]}

Non-therapeutic infant has become controversial in recent decades. National medical associations in the United States, Canada, and Australia do not recommend routine infant circumcision, and American associations recommend that doctors discuss the benefits and risks with prospective parents.[42][43] [44] The British Medical Association looks to a broad list of factors relevant to a child’s best interests, and states “that parental preference alone is not sufficient justification for performing a surgical procedure on a child.”[[45]] The genital integrity movement condemns non-therapeutic infant circumcision as a human rights violation that they consider comparable to female genital cutting,[46] while circumcision advocates stress the medical benefits of the procedure.[47]

Circumcision may be recommended to treat disease conditions, such as pathological phimosis, chronic inflammations of the penis and penile cancer. The frequent use of circumcision is often criticized as the indicators for circumcision are regularly misdiagnosed, e.g. confusing the normal unretractable foreskin of a young boy with pathological phimosis, [48]. Circumcision is also often resorted to when non-invasive or less invasive treatments are available and effective. [49][50]

You seem to have missed Jakew's comment above, when he stated "On the contrary, a 1999 study found that circumcision was performed for medical benefit in 41% of cases, and a 2001 study reported that health reasons were the most important reason for circumcision. Both of those were in America. In the UK and much of Europe, almost all circumcisions are performed for medical reasons." Although I don't see how you could have missed it, since you responded to it. Jayjg ^(talk) 21:57, 8 May 2006 (UTC)

So why not include that as well? The line about decisions dominated by ritual and cultural considerations, with its sources. Then, for instance, "However, a 1999 study found that etc." with its source. The material on the origins of the custom also seems notable and worth including to me. Kasreyn 22:44, 8 May 2006 (UTC)

That study is already discussed in the paragraph in the 'circumcision since 1950' section. Since there are contradictory findings, we cannot make any absolute statements about reasons for decisions.

Jakew has two separate issues, history and reasons. First, Circumcision (relative to other surgical procedures) has a very rich history, and the age and origins of the practice should be in the introductory paragraphs ... particularly because they have significant bearing on current practice. Second, the reasons issue ... Note that I took out Goldman. You should also note that one cite is an Association conclusion [[51]], and another cite [[52]]found "easier to keep clean" to be a primary consideration, but concluded "this study suggests that parents continue to have preformed decisions regarding circumcision based primarily on non-medical concerns." You are encouraged to add studies that conclude otherwise.TipPt 14:19, 9 May 2006 (UTC)

As I've already commented, the origins belong in the history section (and duplicate some of that material). Jakew 09:13, 9 May 2006 (UTC)

You might see a double standard in your insisting on the two existing paragraphs headed by "treat a variety of conditions" and "Non-therapeutic infant circumcision is routinely practiced" ... both are treated at length later in the topic. Neither are as important to current practice as cultural ritural.TipPt 14:28, 9 May 2006 (UTC)

Will you please stop inserting your comments in the middle of mine. It makes it difficult for readers to see who is saying what.

I don't know what you mean by an 'Association conclusion' - Brown & Brown's study was an ordinary study, not a policy statement. Both of these studies are cited in the 'circumcision since 1950' section. Such information does not belong in the introduction because a) the information is contradictory rather than simple fact, and b) it is specific to a single nation (and, apparently, is a function of time).

I've added your history paragraph. Jakew 14:53, 9 May 2006 (UTC)

How about if it's toned down and in just one paragraph (the second): The practice of circumcision predates recorded human history, with depictions found in stone-age cave drawings and Egyptian tombs.^[53] The origins of the practice include ritual sacrifice, offering, or sign of submission to a deity, a rite of passage to adulthood, a mark of defeat or slavery, or an attempt to alter esthetics or sexuality. ^[54] Circumcision and frenectomy remain the most common surgical procedures performed on young males, predominately members of the Muslim and Jewish faiths, but also the majority of Americans, and South Koreans. Parental decisions regarding circumcision are dominated by cultural ritual considerations [[55]] ^{[56] [57] [58]} or religious beliefs, not by potential medical applications. [59] In two studies, strong parental cultural expectations clashed with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.”^{[60] [61]}TipPt 14:35, 9 May 2006 (UTC)

You've just completely ignored what Jayjg and I have said above. There is some perfectly valid evidence showing that the decisions are indeed based upon medical reasons. Jakew 14:53, 9 May 2006 (UTC)

Wiki relies on the weight of the evidence. Please provide links to those medical reasons studies. You only mentioned them previously.TipPt 15:08, 9 May 2006 (UTC)

Links may be found in the 'circumcision since 1950' section of the article. I'm sure you're perfectly capable of finding them. Jakew 15:29, 9 May 2006 (UTC)

I read the cites in 'circ since 1950.' section.

The first [[62]]supports my writing (non-medical reasons): "A majority of boys born in the United States still undergo nonritual circumcisions. This occurs in large measure because parental decision-making is based on social or cultural expectations, rather than medical concerns.63-67 Studies from the 1980s suggested that the presentation of medical information on the potential advantages and disadvantages of circumcision had little influence on parents' decisions.64-66 This finding was recently confirmed.68 In another contemporary study, nearly half of those physicians performing circumcisions did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision.67,68 Major factors in parental decision-making are the father's circumcision status, opinions of family members and friends, a desire for conformity in their son's appearance, and the belief that the circumcised penis is easier to care for with respect to local hygiene.

The second supports my writing,[[63]]stating "The circumcision decision in the United States is emerging as a cultural ritual..."

The third supports my writing[[64]], concludes "...showed that (1) that the circumcision decision is most often made before parents discuss the issue with their care providers, (2) that social concerns are more important than medical ones, and (3) that providers' discussions have limited impact on the decision made. (Your quote states "A 1999 study reported that reasons for circumcision included "ease of hygiene (67 percent), ease of infant circumcision compared with adult circumcision (63 percent), medical benefit (41 percent), and father circumcised (37 percent)." The authors commented that "Medical benefits were cited more frequently in this study than in past studies, although medical issues remain secondary to hygience and convenience."[103]

The forth is Adler. The objective of the study was to "investigate parental attitudes about circumcision and their satisfaction with the decision", not to study parental reasons for circumcision. You should add the Adler info to the history/reasons paragraph.TipPt 18:17, 9 May 2006 (UTC)

The fifth is clearly speculation on the part of the authors, and no part of the study addressed parental decision making.TipPt 18:17, 9 May 2006 (UTC)

Tip, the first predates Adler's study, and can only report on the evidence available to the authors at time of writing. It is also worded much more cautiously than your absolute statements.

The second was written in 1987, and as noted in the third, things changed since then. It is interesting in a historical context, but that was nearly two decades ago.

If you read the third more carefully, you'll see the words "studies from 15 years ago, which showed that" before the text you quote. In other words, Tiemstra is summarising previous summaries. He states that the results are largely consistent, but notes that medical benefits were cited more often than in earlier studies. My wording accurately reflects this. Yours attempts to use his words to make a case, which is not the purpose of Wikipedia.

The objective of Adler's study does not affect his findings, which are in direct contradiction of your theory. You simply cannot state something when the most recently available evidence states the opposite.

As for the fifth, yes, it is speculation, but it does seem to corroborate Tiemstra's view of historical trends. This would likely explain why your theory appears to agree with earlier evidence but is increasingly contradicted by later evidence. Jakew 20:28, 9 May 2006 (UTC)

Other writers please consider Jakew's logic ... "the evidence has changed." We are taking about factors in circumcision decision making. The foundation of his contention is the Adler study [65] Please take a look at the study! Strong class effects, lousy methodology, and the results would be better summarized as "39.6% of respondants choose "Health Reasons" over "Looks like father," "not necessary," ect. ect. "Health Reasons" is not defined.

The study states: "First, the study was retrospective in nature, in that parents were asked to comment on a decision made well before completing the survey. This may have lead to inaccurate information being provided. Second, some of the participants were foster parents or other relatives who may not have had sufficient knowledge about the factors involved in the decision. Finally, some of the participants may have misinterpreted some of the questions. It was noticed that some of the participants, when asked for the most important reason for circumcising or not circumcising their child, checked more than one reason."

Here's the paragraph I would like to use: The practice of circumcision predates recorded human history, with depictions found in stone-age cave drawings and Egyptian tombs.^[66] The origins of the practice include ritual sacrifice, offering, or sign of submission to a deity, a rite of passage to adulthood, a mark of defeat or slavery, or an attempt to alter esthetics or sexuality. ^[67] Circumcision and frenectomy remain the most common surgical procedures performed on young males, predominately members of the Muslim and Jewish faiths, but also the majority of Americans and South Koreans. Parental decisions regarding circumcision are dominated by cultural ritual considerations [68]^[69][70][71]or religious beliefs, not by potential medical applications[72], though a 2001 study reported that "The most important reason to circumcise or not circumcise the child was health reasons."[73] In two studies, strong parental cultural expectations clashed with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.”^{[74] [75]}TipPt 15:24, 10 May 2006 (UTC)

If you can find criticism of Adler's study, then go ahead and cite it.

As for your proposed paragraph, it violates NPOV policy and cannot be included. You are welcome to your opinion that parental decisions are dominated by cultural and ritual considerations, but since evidence contradicts that, you cannot assert it as fact. Jakew 17:32, 10 May 2006 (UTC)

References

1. ^ Wrana, P. (1939). Historical review: Circumcision. Archives of Pediatrics, 6, 385-392.
2. ^ Gollaher DL. Circumcision: a history of the world's most controversial surgery. New York: Basic Books, 2000: 53-72.
3. ^ Herrera AJ, Cochran B, Herrera A, Wallace B, Parental information and circumcision in highly motivated couples with higher education. Pediatrics 1983; 71: 234
4. ^ Ciesielski-Carlucci C, Milliken N, Cohen NH. Determinant of decision making for circumcision. Camb Q Heathcare Ethics 1996; 5: 228-36
5. ^ Shaw, R. A. and Robertson, W. R.: : Am. J. Dis. Child., 106: 216, 1963.
6. ^ Brown M, Brown C: Circumcision decision: prominence of social concerns. Pediatrics 1987; 80:215-219
7. ^ Rand C, Emmons C, Johnson J: The effect of an educational intervention on the rate of neonatal circumcision. Obstet Gynecol 1983; 62:64-67
8. ^ Griffiths DM, Atwell JD, Freeman NV. A prospective study of the indications and morbidity of circumcision in children. Eur Urol 1985; 11:184-7
9. ^ Fleiss, F M Hodges, R S Van Howe Sexually Transmitted Infections, vol. 74, no. 5 (October 1998): pp. 364-367 1998

And on the the risks section....

Note, jakew, that if you insist on saying "benefits and risks" instead of just "risks" in the risk article, I should include the full BMA statement (including the sentence "The medical benefits previously claimed, however, have not been convincingly proven") —Preceding unsigned comment added by TipPt (talk • contribs)

Ok, I'll find an alternative quote. Jakew 15:07, 9 May 2006 (UTC)

Risks of circumcision

Circumcision is a surgical procedure, and there is a risk of complications. Bleeding and infection are the most common complications of the procedure, according to the AMA. Longer term complications include infections, urinary fistulas, meatal stenosis, ulceration of the glans, removal of too much tissue, and secondary phimosis. (Contradicts the AAFP quote. Say 'and, according to some authors, meatal stenosis' instead) The risk of complications is strongly related to the setting and experience of the practitioner. ^[76] (Better phrasing: 'According to Griffiths, ...')

That paragraph is unchanged from your version Jakew (save the last sentence). Regardless, you confuse meatitis and meatal stenosis. The AAFP which states: "Meatitis and meatal stenosis are more serious complications that have been reported to occur in 8% to 21% of circumcised infants, (6) however no well-controlled cohort study has clearly identified a causal relationship between circumcision and meatitis."

In other words, the finding of meatitis is questioned, not meatal stenosis.TipPt 16:06, 9 May 2006 (UTC)

Different quote. I meant the one saying: "One author(10) reports that meatitis, meatal ulcer and consequent stenosis occur in an estimated 8 to 31 percent of circumcised infants, while another(11) states there are no well-controlled cohort related studies to document their relationship."[77] Also, please note that stenosis is often caused by meatitis. Jakew 16:21, 9 May 2006 (UTC)

SAME QUOTE jakew ... the two Association quotes cite the SAME article "(11.)Anderson GF. Circumcision. Pediatr Ann 1989; 18:205,209-10,212-3" and "(7) Anderson GF. Circumcision. Pediatric Annals 1989;18:205-213." Maybe you should cite the article directly (and correctly whichever it is).TipPt 17:09, 9 May 2006 (UTC)

You should cite that one study (the actual quote) from the article cited by both those Association statements so the reader knows that more research needs to be done.

The wording is unclear ... document the relationship between meatitis and meatal stenosis, or document the relationship between circumcision and meatal stenosis. Meatal stenosis in not found in intact males.TipPt 17:02, 9 May 2006 (UTC)

Different quotes, actually, citing the same reference. The fact remains, there is doubt over a possible association between circumcision and meatal problems, and we must not present it as fact. Jakew 17:42, 9 May 2006 (UTC)

We are not talking about meatal problems generally, but meatal stenosis.TipPt 20:06, 9 May 2006 (UTC)

Same pages cited from the same reference. The pertinant question is ... does the actual cite say "no well-controlled cohortrelated studies to document their relationship" or "however no well-controlled cohort study has clearly identified a causal relationship between circumcision and meatitis."TipPt 20:06, 9 May 2006 (UTC)

One of the quotes is wrong. You should cite the original work properly. There is doubt about meatitis, not meatal stenosis. I'll find the review article at UCLA.TipPt 20:06, 9 May 2006 (UTC)

Tip, Wikipedia is not about your opinion. According to the AAFP, there is doubt about meatal stenosis. That is verifiable, your opinion is not. Jakew 20:12, 9 May 2006 (UTC)

According to which AAFP statement? Both AAFP statements cite the same research but have different meanings. Again, is it "no well-controlled cohort related studies to document their relationship" or "however no well-controlled cohort study has clearly identified a causal relationship between circumcision and meatitis. Relationship would include meatal stenosis, while the second AAFP cite quote says only meatitis. You are confusing the issue.TipPt 20:20, 9 May 2006 (UTC)

(Paragraph 3 should be here.)

You see a very wide range of risk probablilties (see the AAFP quote above) ... the most important consideration is the skill of the circumciser, and the setting (is it septic?). That fact should be immediately known to the reader.TipPt 16:06, 9 May 2006 (UTC)

Disagree, the assessment of these organisations should be known first. Note that the final sentence of that paragraph notes the variation. Jakew 16:21, 9 May 2006 (UTC)

What is important is for readers to understand the source and nature of risks. The primary source is the degree of skill and the settting. The most common risk is meatal stenosis. The assessment of these organizations is properly stated.TipPt 17:20, 9 May 2006 (UTC)

No, Tip. Griffith's opinion is that the difference is due to setting and the degree of skill. Nobody knows whether he is correct or not. Also, some people have an opinion that meatal stenosis is a risk, while others disagree. You must stop trying to present one side as fact - it's incompatible with WP:NPOV. Jakew 17:42, 9 May 2006 (UTC)

While the immediate risks of circumcision related complications are very low in a hospital setting[78], complications resulting from a poorly carried out circumcision ('can be') catastrophic. [[79]] The American Academy of Pediatrics recommend that parents should be informed about the potential benefits and risks of the procedure.[80] The British Medical Association states “The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks [81] (Section is about risks, not benefits)

I know, which is why I object to your insistance on "benefits and risks" and not just "risks" from the AAP. Neutrality means that we leave out benefits completely (both the AAP and BMA) or leave them both in.TipPt 16:06, 9 May 2006 (UTC)

The AAP, AMA, and AAFP state that the procedure complications rate is between 0.2% and 0.6%, based upon large series. The CPS acknowledge these series, but additionally cite a review which suggested that a rate of 2% to 10% would be more realistic. The Royal Australasian College of Physicians states the rate of complications of infant circumcision as "between 0.2% and 0.6% to 2%-10%" in one section, and "1% to 5%" in another. They suggest that the variation in reported rates will depend upon how the circumcision is performed and what definition of complication is used.

Meatal stenosis may be the most common longer-term complication from circumcision, and is variously reported to occur in .9% [82], 9% - 10%, [[83]] and 7.29% of circumcised boys. [[84]]. (Where has the quote from the AAFP gone?) Meatotomy is the definitive treatment to resolve meatal stenosis. (According to whom? Not these authors)

What AAFP quote?

According to [[85]] and [[86]].

The study you cited [87] is for urethral meatus, not meatal stenosis.TipPt 16:17, 9 May 2006 (UTC)

I've included the AAFP quote above. As for the sources you mention, I suggest either a) stating that authors X and Y prefer meatotomy, while Z prefer home dilation, or b) leaving out mention of treatment (this seems to be a more sensible approach, since treatment of meatotomy is somewhat off-topic). Jakew 16:21, 9 May 2006 (UTC)

Loss of the penis itself has been documented. The RACP states that the penis is lost in 1 in 1,000,000 circumcisions. Fatal complications have been reported. The American Academy of Family Physicians states that death is rare, and cites an estimated death rate with circumcisions of infants of 1 in 500,000 [88].

(does anyone see the inconcistancy between those two statistics??? The paragraph should be removed or fixed.TipPt 14:43, 9 May 2006 (UTC)

The Royal Australasian College of Physicians and the American Medical Association criticise neonatal circumcision without anaesthetics [89] [90]. The American Academy of Pediatrics explicitly recommends that if the procedure is to be performed, anaesthesia should be used [91].

Physician Insurers Association of America (PIAA), cited by the American Academy of Pediatrics (wrong. should be: 'cited by George Thomasson') [[92]] found that ninth out of the top ten reasons Pediatricians are sued was for “Circumcision adverse outcomes.”

How about: "The Physician Insurers Association of America (PIAA), cited by George Thomasson MD in The American Academy of Pediatrics May 1997 news update [[93]] found that ninth out of the top ten reasons Pediatricians are sued was for “Circumcision adverse outcomes.”"

1. ^ Griffiths DM, Atwell JD, Freeman NV. A prospective study of the indications and morbidity of circumcision in children. Eur Urol 1985; 11:184-7

I've already explained the problems with this version above. Would you care to explain the inconsistency you mention? Jakew 14:57, 9 May 2006 (UTC)

I changed the version to meet your requests Jakew.

If 1 in 500,000 die, you would expect that many penises to die too, not 1 in 1,000,000.TipPt 15:04, 9 May 2006 (UTC)

They refer to loss of the penis, not death. We are required to state what they say.

Many problems remain. I've inserted some comments in italics above. Jakew 15:21, 9 May 2006 (UTC)

Another problem with duplication

The main topic is too long (according the Wiki), and it is redundant.

Under "Medical Aspects" the reader finds lengthly information: 4.1 Risks of circumcision 4.2 HIV 4.3 HPV 4.4 Hygiene 4.5 Infectious and chronic conditions 4.6 Penile cancer 4.7 Phimosis and paraphimosis 4.8 Urinary tract infections

4.1 should be placed after Prodedures of Circ.

4.2 through 4.8 should be summarized in few paragraphs in "Medical aspects" and then discussed at length "Medical Analysis of Circumcision" main article.

Right now, 4.2 and 4.8 take up nearly 20% of the main topic space, and the medical analysis articles already contain the same information.TipPt 14:59, 9 May 2006 (UTC)

Both risks and benefits belong under 'medical aspects'. Arguably s4.2 and s4.8 can be made shorter, but otherwise I see no problems. Jakew 15:06, 9 May 2006 (UTC)

The format is to summarize and then detail in separate articles. 4.2 - 4.8 should be summarized, not repeated in length twice ... making the topic is "too long" (according to Wiki).TipPt 15:20, 9 May 2006 (UTC)

You're trying to lengthen and add detail to the 'risks' section, which is also in medical analysis of circumcision. Jakew 15:27, 9 May 2006 (UTC)

My proposed 'risks' summary is six lines shorter than your version Jakew. It is a short summary, not lenghtly individual articles that are then repeated.TipPt 15:37, 9 May 2006 (UTC)

"My" version is an attempt to incorporate some of the information you seem so desperate to add to the article into the existing text, but rather than trying to advance one point of view, it treats the material fairly and neutrally. Jakew 15:44, 9 May 2006 (UTC)

There is a huge difference between my reorganizing and adding a few sentences to the existing risks of circumcision article, and your insistance on using 20% of the main topic article to discuss potential medical benefits that are fully discussed in their own articles. Those benefits should be summarized, just as the risks are.TipPt 16:24, 9 May 2006 (UTC)

They are summarised, Tip. I have folders full of studies weighing several kilograms on the subject, and the medical analysis article goes into far more depth than we do here.

As for my 'insistence', this version has, in general, consensus among editors. I am not arguing that they should be lengthened. The fact that you are adding content to the risks section insisting upon shortening or eliminating discussion of benefits makes it difficult to assume good faith. If you were genuinely concerned about duplication of content, you'd be reducing both. Jakew 16:33, 9 May 2006 (UTC)

They are two separate issues to be resolved, why confuse them? I am adding relevant information to risks summary, and seeking to summarize (not detail) benefits.TipPt 16:40, 9 May 2006 (UTC)

Your arguments about the benefits text apply to risks, too, as both articles cover them. Yet instead of reducing detail and summarising these sections, you are adding detail. Jakew 17:46, 9 May 2006 (UTC)

Specifically, the reader should gain from quickly learning that the most likely potential benefits are reduced UTI's in the first year, and a lowered HIV infections rate.TipPt 16:47, 9 May 2006 (UTC)

By all means reorder the 'benefits' section such that those are listed first. Jakew 17:46, 9 May 2006 (UTC)

Medical benefits should be summarized, and then detailed. Right now, they are detailed and detailed.TipPt 18:29, 9 May 2006 (UTC)

Jakew on Meatitis, Meatal Stenosis, Meatodomy, Urethral Meatus

Jakew is confusing these words. I am checking the exact Anderson GF. Circumcision. Pediatr Ann 1989; 18:205,209-10,212-3 quote used by the AAFP twice, but they are very different!

"however no well-controlled cohort study has clearly identified a causal relationship between circumcision and meatitis. (7)"[94]

versus

"(10) reports that meatitis, meatal ulcer and consequent stenosis occur in an estimated 8 to 31 percent of circumcised infants, while another(11) states there are no well-controlled cohortrelated studies to document their relationship."[95]

Jakew ... the two Association quotes cite the SAME article "(11.)Anderson GF. Circumcision. Pediatr Ann 1989; 18:205,209-10,212-3" and "(7) Anderson GF. Circumcision. Pediatric Annals 1989;18:205-213." Maybe you should cite the article directly (and correctly whichever it is).TipPt 17:09, 9 May 2006 (UTC) You should cite that one study (the actual quote) from the article cited by both those Association statements so the reader knows that more research needs to be done. The wording is different ... document the relationship between meatitis and meatal stenosis, or document the relationship between circumcision and meatal stenosis. Meatal stenosis in not found in intact males.TipPt 17:02, 9 May 2006 (UTC) Different quotes, actually, citing the same reference. The fact remains, there is doubt over a possible association between circumcision and meatal problems, and we must not present it as fact. Jakew 17:42, 9 May 2006 (UTC)

Any particular reason for repeating text which can be quite easily found above? Jakew 17:38, 10 May 2006 (UTC)

Jakew also cites [96] to refute [97] and[98]. Note that his cite is for urethral meatus not meatal stenosis (the first citatioin specifically says "Serial dilatation results in small tears of the meatus, which are followed by secondary healing. In the long term, this creates a tighter stricture at the tip of the penis; therefore, this procedure is discouraged.")TipPt 15:55, 10 May 2006 (UTC)

The study I cited concerned "stenotic urethral meatus". This is meatal stenosis.

Also, I'm not citing it to refute other studies. I'm citing it to show that we can't make sweeping statements that contradict it. Jakew 17:38, 10 May 2006 (UTC)

Here's the paragraph I would like to use: Meatal stenosis may be the most common longer-term complication from circumcision, and is variously reported to occur in .9% [99], 9% - 10%, [[100]] and 7.29% of circumcised boys. [[101]]. Meatotomy is the definitive treatment to resolve meatal stenosis.TipPt 15:49, 10 May 2006 (UTC)

I understand that you'd like to use this. If you rephrase it to make it clear that some authors have the opinion that it is a complication, and include the AAFP quote, you'll have addressed my concerns. Simply repeating yourself helps noone. Jakew 17:38, 10 May 2006 (UTC)

For the love of god!

Can someone archive this discussion page now? --BerserkerBen 12:22, 11 May 2006 (UTC)