Talk:Circumcision/Archive 50

Archive 45

←

Archive 48

Archive 49

Archive 50

Archive 51

Archive 52

→

Archive 55

---

Small

Re this edit which removed a "verify source" tag: I looked at the abstracts of the four sources (I'm not sure if I can access the full text), and except for Ganiats, I'm not sure if we can justify the word "small" as verifiable for either the benefits or costs. Perhaps the "verify source" tag is still needed. ☺ Coppertwig (talk) 14:58, 17 October 2008 (UTC)

More he said, she said.

The source: If insufficient foreskin is removed the cosmetic appearance is such that the penis does not appear to be circumcised; phimosis may still subsequently develop.

Wikipedia's interpretation: If insufficient skin is removed, the child may develop pathological phimosis in later life.

The source: In a series of consecutive circumcisions in Australia, 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 age.

Wikipedia: Cathcart et al. report that 0.5% of boys required a procedure to revise the circumcision.[118]

Blackworm (talk) 20:54, 17 October 2008 (UTC)

What is your point? The first I think I amended it. The second wasn't me - I don't know who added that - i think Jakew amended that one. I remember adding the Leitch reference but in relation to something else. Jakew took it out saying it had nothing to do with circumcision. I don't think that gives a good representation on the amount of circumcisions that get re-done -surely it is higher. Tremello22 (talk) 22:52, 17 October 2008 (UTC)

Medical analysis section

I'm starting to think though that the whole medical analysis section of the circumcision article should be left at a few lines. Something like "There exists a debate over the medical advantages and disadvantages of circumcision..." ,and then just have a link to the main Medical analysis of circumcision article. This means the topics can be dealt with in the fairest manner possible, without the restriction of space. Therefore, there would be no fear of violating NPOV. I appreciate we all have different views on this matter so I would like to see all opinions expressed. It is getting quite tiresome editing back and forth over which bits to include - which sources are relevant, etc. As it stands, it seems like there is no real method or criteria as to what studies to include. For instance, look at the UTI section. This wouldn't be a problem on the medical analysis of circumcision page. Also, most of the stuff in the medical analysis section of the circumcision page is repeated on the Medical analysis of circumcision page. Some sections of the circumcision page go into greater detail than on the medical analysis of circumcision page. Transferring would also have the advantage of cutting down the size of the circumcision page to the recommended size. It already warns you when making an edit that this article is too long. So, would anyone disagree with this? Tremello22 (talk) 21:03, 14 October 2008 (UTC)

Please don't shorten the medical section down to just a few lines without first getting agreement on this talk page about what exactly it will say. "A few lines" sounds probably too short, to me. I have another idea:

Consider this version, which was just after I finished shortening the article in September 2007. If there is any section such that you can't find an acceptable version either there or in a more recent version, then I suggest that you explain on this talk page what things you feel are not explained adequately and why, and then we can consider how to handle each thing.

Note in the talk page archive link I give above (labelled "shortening the article"), there's a table with a target number of words for each section to provide a reasonable balance. I don't think shortening the medical part down to just a few lines would leave a balanced article: the religious and cultural parts would be too big in comparison, in my opinion. ☺ Coppertwig (talk) 21:26, 14 October 2008 (UTC)

Making the material more concise would certainly be a good idea, but I think your proposal is too extreme.

This article is written in summary style. and there are several sections, each of which summarises a more in-depth article. These in-depth articles include: Circumcision in cultures and religions, Bioethics of neonatal circumcision, Circumcision and law, Medical analysis of circumcision, Sexual effects of circumcision, History of male circumcision, and Prevalence of circumcision.

As I say, I'd agree with making the medical aspects section more concise, because it would reduce the overall article length, and it would keep the length of this section in proportion. But similarly, reducing medical aspects to a "few lines" as you suggest would be disproportionate: it would give too much coverage to other aspects at the expense of medical aspects. What we need to do is to summarise the important information without going into too much detail. It's not easy, unfortunately, but while just giving up may be tempting, I don't think it would serve the reader well. Jakew (talk) 21:33, 14 October 2008 (UTC)

I agree the sections should be proportional however sections with stubs may be summarized to condense space and prevent redundancy. Garycompugeek (talk) 22:08, 14 October 2008 (UTC)

They are summarized; all the sections of this article are summarized. I still prefer a balance; I believe this is consistent with WP:SUMMARY, which says, in part, "The summary in a section at the parent article will often be at least twice as long as the lead section in the daughter article." ☺ Coppertwig (talk) 00:06, 15 October 2008 (UTC)

Simple solution, just leave the "Policies of various national medical associations". It is more than a few lines and would leave the medical considerations in proportion with the rest of the article. Surely that is the easiest and most sensible option? Divide the medical associations policies into "policies on therapeutic circumcision" and "policies on non-therapeutic circumcision"; at the moment it is unclear which the medical analysis section is dealing with. It is also unclear what the section is trying to accomplish? Most of it can be found on the medical analysis of circumcision page.

It is easy to say just leave it as a summary for each medical condition,not so easy in practice. As often, to put across both points of view, often takes up space. I am sure if people are concerned with specifics it wouldn't be too hard for them to click a link. But most people just want to know a risk - benefit analysis - i.e would it be worth it, all things considered; and that is already provided by solid reliable secondary sources - i.e the medical associations. Again, it is unclear how going into specific conditions relates to anything? It is just beyond the basic reader if you ask me - mentioning authors names and individual studies and whatnot. For those that are interested in how the medical associations made their decisions or if they want a more in-depth analysis - they can go to the "medical analysis of circumcision" page. Tremello22 (talk) 19:21, 15 October 2008 (UTC)

The effect of that would be much the same as reducing the section to a few lines: we would fail to summarise the medical aspects themselves.

In principle, policy statements are excellent secondary sources about specific aspects of circumcision, and could be used as such for a brief summary of the individual medical aspects. However, the content of the current policies section is such that we only discuss their recommendations, for which they are primary sources. They are, of course, highly notable primary sources, and should not be excluded. But by themselves, the recommendations are not an adequate summary of the literature about the medical aspects of circumcision. Jakew (talk) 19:58, 15 October 2008 (UTC)

(unindent) The point I was trying to make Jakew is that discussing specific medical conditions in detail can get out of context and we lose sight of the bigger picture of circumcision. Hence my question what is the purpose of this section? The views of secondary sources such as medical associations or the WHO or whatever, see the bigger picture - if people want to know the nitty-gritty (the general reader does not want read a compilation of studies) then they can go to medical analysis of circumcision. You now say they are primary sources yet above you say they are secondary sources; make up your mind. They are clearly the most reliable sources on the subject of circumcision - be it therapeutic or non-therapeutic. I'll ask again, what is the purpose of the medical analysis section? If the purpose of the medical analysis section is to debate whether to circumcise or not, then there is always going to be conflict over what gets put into the section - easiest solution is to take it our of our hands and veer ourselves away from promoting our own points of view and just leave the views of respected secondary sources. Then, how they came to their decisions could be left to the page where there is enough space to give both sides of the debate. At the moment the medical analysis of circumcision page is quite poor, there is no reason why we couldn't merge the medical analysis section from here into that page and make a very good article. Any future debates over what to put in the section and any ambiguity over what the medical analysis section is for would be put to rest. Tremello22 (talk) 20:24, 15 October 2008 (UTC)

Since the literature about circumcision includes a lot of information about medical aspects, then reducing the medical aspects in this article down to only a few lines would be undue weight; as would making it much longer in proportion to the history, religious etc. sections than it was when shortened according to consensus in July-Sept 2007.

No specific problems about the section have been raised in this discussion. While it may be difficult to arrive at a consensus version of intermediate length, I'm not convinced it's impossible.

Garycompugeek, you reminded us of "be bold" I would like to point out that that guideline also says "...but be careful." That guideline is very useful for people who are in situations for which they can't find instructions or for which there are no instructions, especially for new users or for users in situations that are new to them. However, in my opinion, it is not intended to encourage people to do things which they know, or can be reasonably expected to predict, are likely to be opposed by other editors. ☺ Coppertwig (talk) 21:10, 15 October 2008 (UTC)

The views of medical associations in regards to circumcision would still be left, and they are more than a few lines. It could also be divided to views on therapeutic and non-therapeutic(routine infant circumcision). At the moment the medical analysis section does not make this distinction. I'm still not sure what purpose the section serves given that the general reader would just like to know about the overall consensus on circumcision whereas the person that is interested in the medical studies of circumcision's effect on certain conditions would be going to the medical analysis section anyway. Tremello22 (talk) 20:32, 16 October 2008 (UTC)

The "medical analysis" section is intended to give an overview of the medical aspects of circumcision, including the (proposed) medical risks and benefits (in a nutshell - what are the medical consequences of circumcision or non-circumcision?). The "policies" section is an overview of the recommendations of medical organisations (in a nutshell - in the view of these prominent organisations, is there enough evidence of benefit to recommend circumcision as a routine procedure?). If you consider the two "nutshells", you'll see that although they're related, the questions are actually quite different, and answering one does not answer the other.

I'm afraid that I don't share your viewpoint that the "general reader" is only interested in recommendations, and is uninterested in other medical aspects. I'm not even sure that it's possible to define what a "general reader" is interested in. Some readers will be interested in medical aspects, some recommendations, some history, some religious aspects, and so on. The parts of the article that I find most interesting are probably not the same parts of the article that you find most interesting. All we can do is to present a well-rounded general overview of the subject, summarising each more detailed article, and leave it to the reader to decide which of these (s)he is interested in.

If you read my previous comment carefully, you'll see that I describe these statements as both primary and secondary. As with many sources, it depends upon what part of them is used: they're secondary sources for some summarised conclusions from scientific studies, and primary sources for statements of what their own recommendations are. Regarding policy statements being highly reliable sources, I certainly agree with you.

I agree that discussing specific conditions in too much detail is undesirable, but I think that not discussing them at all is too extreme. Jakew (talk) 21:29, 16 October 2008 (UTC)

Jakew, I still don't agree with going into this much detail in the medical analysis section as we are always going to disagree - so it seems pointless (especially when there is an article dedicated to the subject). It's always going to be your interpretation over mine. There is only so many wikipedia rules you can use as a get-around before it gets obvious that the medical benefits of circumcision are presented way out of context. I think secretly , you know this. If we wanted a fair article then we would just cite the medical associations views on circumcision as a whole. The problem being that if we don't cite the medical associations views, it is up to us or you to use our/your own judgment to determine what medical conditions to discuss in the medical analysis section and what to put in there. This is part one of the problem. Part 2 is that, say if you are read one section , there is no context in terms of circumcision as a whole. No thought is given to the relative weight(measured in terms of words written and number of subheadings) of the supposed benefits in relation to to the downsides. In other words it reverses the views of the medical associations - that find not enough evidence to recommend circumcision. Tremello22 (talk) 23:24, 17 October 2008 (UTC)

Or that the benefits outweigh the risks. Garycompugeek (talk) 23:40, 17 October 2008 (UTC)

Downsides/risks, same difference only risks makes it seem like we are just referring to the immediate physical complications post-circumcision -or maybe that is just me. Tremello22 (talk) 23:49, 17 October 2008 (UTC)

Actually, if you examine the amount of coverage in the policy statements themselves, you'll find that the degree of coverage is similar. At a rough count, for example, the 1999 AAP statement dedicates a total of 24 paragraphs to discussion of proposed benefits and 1 to complications. The situation is similar with many other statements. So unless you wish to assert that the medical associations reverse their own views, this line of reasoning appears to be dubious at best.

Nobody has suggested that we remove the medical associations' views, so I don't quite understand why you raise concern about that. Jakew (talk) 12:17, 18 October 2008 (UTC)

Jakew I meant that leaving the medical associations statements on their own without the analysis means that there is less of a problem over what to put in the medical analysis section.

So what if the AAP dedicates a total of 24 paragraphs to discussion of proposed benefits and 1 to complications in their statement? At the end of it they didn't recommend it and people only read that they didn't recommend it. In a wikipedia article people read everything - so it would be easy for an uninformed person to look at the contents of this page and get the impression that the risk of getting all those conditions listed in the medical analysis section is lowered by circumcision. Tremello22 (talk) 19:54, 18 October 2008 (UTC)

I'm sorry, I don't understand. You seem to be saying that when people read the AAP statement they only read the conclusion, but when they read a Wikipedia article they read the whole thing. I disagree: I think people do a variety of things. Some will read the whole Wikipedia article; many will read only part of it. Some will read the whole AAP statement; others will read part of it. Regardless, the policy WP:UNDUE says we must base the amount of weight we give things on the amount of weight in the sources. If the AAP spend a lot more space on benefits than complications, then this is a reason for the Wikipedia article to also give more weight to benefits than to complications (though we also need to balance this with what other sources do). ☺ Coppertwig (talk) 20:07, 18 October 2008 (UTC)

People don't generally read the full statement Coppertwig, for one, they ususally don't have access to it. It would be too much specialised information and they probably wouldn't understand it all. They usually rely on the opinions of doctors and then they put it in layman's terms for them. They will usually summarise by saying if it is worth it or not , or if the risks outweigh the benefits. Tremello22 (talk) 20:50, 19 October 2008 (UTC)

Improvments

I have made improvments to the article by listing the benefits of circumcision as demonstrated by empirical evidence. —Preceding unsigned comment added by 70.68.174.22 (talk) 11:52, 18 October 2008 (UTC)

I apologize; somehow I didn't see this section earlier and thought you hadn't posted to this talk page. Thank you for your contributions!

We've had extensive discussion here to determine how much space to devote to each subtopic. This article is a concise summary; more detailed information goes in the subarticles, linked to from the tops of various sections. See for example Talk:Circumcision/Archive 32#Article too long?. Please note the template at the top of this talk page which says "Please read this page and discuss substantial changes here before making them." I generally oppose making this article much longer. The material you added didn't seem neutral to me in terms of a balance between pro-circ and anti-circ viewpoints. ☺ Coppertwig (talk) 23:38, 18 October 2008 (UTC)

Improvements #2

I feel it is important that people understand the benefits of circumcision. There is much empirical scientific evidence showing that it reduces the risk of all kinds of different problems. There is also new evidence showing that male circumcision can reduce the rate of cervical cancer among women by 20%!

I am completely in the dark as to why there are so many people opposed to receiving this information; it is very important and practically useful. Moreover, there are a number of instances in this article where details are either discarded or fudged. For example, somebody has suggested that circumcision affects “sexual performance.” Most research finds that it “IMPROVES” sexual performance by increasing ejaculatory latency time, and it reduces the risk of spreading or acquiring an STD.

I find that the editors of this article would like nothing more than to convince people that circumcision is purely cosmetic, religiously based, or “bad.” That is absolutely absurd and there is a mountain of scientific studies showing this. There are many practical reasons…

In addition, circumcision practically eliminates the risk of men from acquiring penile cancer!! So please, stop challenging my edits, they are valid and should be listed. --70.68.174.22 (talk) 22:00, 18 October 2008 (UTC)

Perhaps you would like to enlighten all the major medical organizations who unilaterally do not recommend circumcision because they feel the risk's outweigh the benefits. Garycompugeek (talk) 23:27, 18 October 2008 (UTC)

Gentlemen (and/or ladies & gentlemen), this isn't the place to argue about the merits of circumcision.

To 70.68.174.22: these changes seemed to add a large amount of material to the lead section of the article, which is already very long. Additionally, they were insufficiently neutral, and contained some personal interpretation or extrapolation beyond sources. This is a somewhat controversial article, and changes — especially drastic ones — are unlikely to succeed unless there is consensus for them. I would suggest trying to gain that consensus, here, on the talk page, instead of repeatedly trying to force through your changes. Jakew (talk) 23:43, 18 October 2008 (UTC)

Agree with Jakew. Gary, while the IP user is clearly not familiar with Wikipedia's policies on original research, I believe you should consider whether because they feel the risks outweigh the benefits is also an interpretation beyond sources. Blackworm (talk) 00:08, 19 October 2008 (UTC)

Your both right of course. Still I thought a response was in order. Education goes a long way in these matters. Garycompugeek (talk) 01:26, 19 October 2008 (UTC)

Non-religious what?

"The American Medical Association defines non-therapeutic circumcision as the non-religious, non-ritualistic, not medically necessary, elective circumcision of male newborns. ... Reasons for non-therapeutic circumcision include religious beliefs as well as cultural and family conformity."

Is this written this way for a reason? —Preceding unsigned comment added by 67.240.138.239 (talk) 14:12, 18 October 2008 (UTC)

LOL! Good point! We'll have to look at that! ☺ Coppertwig (talk) 15:47, 18 October 2008 (UTC)

What exactly is wrong with that wording? Am I missing something? --Pwnage8 (talk) 01:47, 19 October 2008 (UTC)

the second sentence comes from the BMA, I'll remove it, it shouldn't be in the USA section. Tremello22 (talk) 21:27, 19 October 2008 (UTC)

External links

I oppose this edit on the grounds that a link to a discussion forum is not encyclopedic. Please discuss here on the talk page any links or other information you want to add, before editing the article. See WP:EL#Links normally to be avoided, which says, "Links to social networking sites (such as MySpace), chat or discussion forums/groups (such as Yahoo! Groups), USENET newsgroups or e-mail lists." ☺ Coppertwig (talk) 17:47, 18 October 2008 (UTC)

It is a minor revert and the editor is being told what policy pertains to it. If the editor does this again, he/she should be reported to a sysop or administrator's board. forestPIG^(grunt) 17:48, 18 October 2008 (UTC)

Source says "excruciating pain." Why can't we?

The source says "excruciating pain." I don't understand the reason behind this edit, as referring to it as excruciating once would be enough to verify the source's view. The word is used three times in the source, including in the abstract. On what policy grounds was this edit made? Blackworm (talk) 01:49, 19 October 2008 (UTC)

See also the #Defining the controversy section. ☺ Coppertwig (talk) 01:52, 19 October 2008 (UTC)

Yes, that dispute is relevant, since language used in one side's sources is also apparently censored there. Blackworm (talk) 01:57, 19 October 2008 (UTC)

See also Wikipedia:NPOV#Impartial_tone. Jayjg ^(talk) 01:53, 19 October 2008 (UTC)

What isn't impartial about it? We are attributing the view to the proponents of the view. Also, read WP:NPOV, which states that To write from a neutral point of view, one presents controversial views without asserting them; to do that, it generally suffices to present competing views in a way that is more or less acceptable to their adherents, and also to attribute the views to their adherents. Blackworm (talk) 01:57, 19 October 2008 (UTC)

It says "more or less acceptable to their adherents"; it doesn't say "precisely the way the adherents would word it". I think "excessively painful" would be "more or less acceptable". I think the word "excruciatingly" is a colourful word, not what I would consider "impartial tone"; it conveys emotion as well as meaning. Its meaning is not clear. Does it mean "as painful as torture"? What does it mean?

How about saying "traumatically painful" instead? That sounds like a more impartial tone to me than "excruciatingly", although I think it's a stronger claim. I only see the word "excruciating" twice in the source, but I see "traumatic" or "trauma" four times. ☺ Coppertwig (talk) 02:12, 19 October 2008 (UTC)

How about "causes significant pain"? That sets a nice impartial tone. Jayjg ^(talk) 16:48, 19 October 2008 (UTC)

I don't think "causes significant pain" is an appropriate summary of the words "excruciating pain" used in the source, especially considering that we often use "significant" to mean "statistically significant" or "detectable" in the article. I would accept "traumatically painful" or "extremely painful." Blackworm (talk) 20:01, 21 October 2008 (UTC)

The source describes the pain as "excruciating" twice. The source uses "pain" or "painful" without any modifiers five times (not including quotations from other sources), including in the conclusion. In what way does inclusion of "excruciatingly" better reflect the source? AlphaEta 02:16, 19 October 2008 (UTC)

"Excruciatingly" summarizes their message. An article doesn't have to repeat something over and over again to get the point across. Note the other words I also quoted, and their statements that the trauma has long-term effects, etc. Using the word "pain" unqualified several times doesn't erase the earlier adjective; if it did we would have to repeat the phrase "male circumcision" throughout this article to get the point across. They're not saying it's like stubbing your toe. ☺ Coppertwig (talk) 02:25, 19 October 2008 (UTC)

I realize I'm not the sharpest tool in the shed, but I do know that adjectives, adverbs and other modifiers are subsequently implied and that their repetitious use is unnecessary. Look, I'm not trying to be a stick in the mud. I simply disagree that using the word "excruciatingly" "summarizes their message" or better reflects the source. I may be completely wrong, it happens all the time.... AlphaEta 02:43, 19 October 2008 (UTC)

It's perfectly valid to have that opinion. I apologize if my message seemed to imply that you needed obvious things explained, AlphaEta. I have great esteem for your encyclopedic ability and intelligence. Any shortcomings of my message were due solely to my difficulty in figuring out how to formulate and express my argument. ☺ Coppertwig (talk) 02:56, 19 October 2008 (UTC)

Perhaps we could keep "excruciatingly", but put quotation marks around it. I'm not very comfortable having it in a Wikipedian sentence without the quotation marks, because it seems to me to lack encyclopedic precision. It's not clear what it means. I don't think we can confidently assert that the source is claiming that circumcision is literally as painful as torture. ☺ Coppertwig (talk) 13:21, 19 October 2008 (UTC)

Just the threat of cutting the penis is an effective form of torture. Garycompugeek (talk) 14:09, 19 October 2008 (UTC)

Please restrict discussion on this page to article content and reliable sources, rather than discussion of the subject matter itself. See WP:Talk#How to use article talk pages. ☺ Coppertwig (talk) 15:39, 19 October 2008 (UTC)

AlphaEta, if it didn't summarize their message, they wouldn't put it in the abstract. Some of the time they use "painful" elsewhere, they aren't even referring to the immediate pain of having tissue cut off the body, but to later, lingering pain. Again, similar to "medically unnecessary," that it is painful isn't even disputed anymore; it's the extent of the pain that is emphasized by opponents. The word "torture" doesn't appear in the source, so the comparison to torture doesn't apply here -- and it seems odd for Coppertwig to apparently claim that the source's actual words imply a pain equivalent to torture, then want to scare quote the word based on our own rejection of that view. "Excruciating" may seem like a strong word if it conflicts with one's views, but then here we are specifically attributing the view to opponents, using their exact words. Other sources don't avoid the word either:

• "Unanesthetized babies showed excruciating pain during circumcision..."[1]
• "6 Patients [...] experienced excruciating pain when the foreskin was clamped..."[2]
• "Because we now know that the infant experiences excruciating pain at the time of the circumcision..."[3]
• "The excruciating pain which the children are subjected to..."[4]

• "...endure the excruciating pain of circumcision..."[5]

That male circumcision results in excruciating pain is their sourced, cited view. Let's present that view. Blackworm (talk) 21:44, 19 October 2008 (UTC)

Note that I've requested discussion of a suggested version of the paragraph in section #Defining the controversy above. ☺ Coppertwig (talk) 16:53, 19 October 2008 (UTC)

I would put it like this: That male circumcision results in "excruciating" pain is their sourced, cited view. If we use the word ourselves without quotation marks in the article, we should have some idea of what it means. My Collins dictionary doesn't mention torture in the definition of "excruciating", but does mention it in the definition of "excruciate"; the definition of "excruciating" at dictionary.com does mention "torturing". It seems somewhat unclear to me what "excruciatingly" is supposed to mean in this context.

Blackworm, you said "The word "torture" doesn't appear in the source, so the comparison to torture doesn't apply here -- and it seems odd for Coppertwig to apparently claim that the source's actual words imply a pain equivalent to torture, then want to scare quote the word based on our own rejection of that view." I'm not sure what I wrote that caused me to appear to make that claim, but I did not actually make that claim, nor do I want what you state that I want. My actual position is expressed in my own words in my comments above. I'm not suggesting scare quotes; I'm suggesting quotation marks to indicate a quotation; and I don't think I've indicated that I or anyone else accepts or rejects the view expressed in the source. ☺ Coppertwig (talk) 22:07, 19 October 2008 (UTC)

Sorry if I did not understand you properly. As I state above, I can abide by "traumatically painful" or "extremely painful," but I do feel quite strongly about emphasizing the high degree of pain opponents state, rather than have them state merely that pain exists (which I do not see as controversial, nor an accurate reflection of the source). Blackworm (talk) 20:01, 21 October 2008 (UTC)

"Extremely painful" seems to accurately represent the high degree of pain that is noted in the citation while maintaining an encyclopedic tone. AlphaEta 01:14, 22 October 2008 (UTC)

I agree with AlphaEta about "extremely painful". ☺ Coppertwig (talk) 23:30, 22 October 2008 (UTC)

HIV lead tweak

The World Health Organization (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex when not practicing Safe sex.

This is shorter, more to the point, and provides good link. Thoughts? Garycompugeek (talk) 18:51, 23 October 2008 (UTC)

This seems to be an inaccurate representation of what the sources actually state. The World Health Organisation, for example, state "The efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt." They do not state "The efficacy of male circumcision in reducing female to male transmission of HIV when safe sex is not practiced has been proven beyond reasonable doubt." Jakew (talk) 19:11, 23 October 2008 (UTC)

They say "but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV." in other words safe sex. Garycompugeek (talk) 19:23, 23 October 2008 (UTC)

Two problems. First, "should not replace [safe sex]" means something like "should be used as well as [safe sex]", which would seem inconsistent with a belief that circumcision was only effective when practicing unsafe sex. Second, there is a distinction between stating whether something is effective and stating when and if it should be done (I might say that "holding a sheet while jumping off a building may reduce your risk of injury", but I would not say that "you should hold a sheet and jump off a building"). In this case, the WHO are saying that circumcision is effective, but should be used in addition to other interventions. These are two different statements. Jakew (talk) 20:00, 23 October 2008 (UTC)

I understand your points Jake, however, if one is practicing safe sex then one is already protected or it wouldn't be safe sex. Garycompugeek (talk) 20:12, 23 October 2008 (UTC)

That may be so, Gary (assuming that safe sex is indeed 'safe' rather than 'safer'). However, the statement is attributed to the WHO, etc, and needs to represent what they actually say, not what you and I might have said if we were in their place. And the source quoted above discusses "female to male transmission of HIV", not "female to male transmission of HIV when practicing unsafe sex", not "female to male transmission of HIV when there is a full moon", not "female to male transmission of HIV in Africa", and not "female to male transmission of HIV on the third Tuesday of the month". Jakew (talk) 14:34, 24 October 2008 (UTC)

I agree with Jakew that we have to convey the meaning accurately, paying attention to a number of distinctions that are involved. "Safe sex" generally doesn't mean "100.00% safe sex", in my opinion. Methods of birth control generally have nonzero pregnancy rates, generally on the order of something like 1% per year; it seems likely to me that methods of avoiding disease transmission (i.e. "safe sex") also involve significant nonzero disease transmission rates. Even if we believed that the disease transmission rate while practicing "safe sex" was zero, that wouldn't justify making a logical deduction on that basis and attributing the resulting conclusion to the WHO. ☺ Coppertwig (talk) 14:57, 24 October 2008 (UTC)

"Surgical" in first sentence

Relevant discussion at

→ Circumcision is, of course, surgery

Re "surgical removal" versus "removal" in the first sentence: how about "excision" instead? ☺ Coppertwig (talk) 15:15, 24 October 2008 (UTC)

How about "amputation?" How about "cutting off?" How about "severing?" Why must we couch circumcision in medical jargon and immediately act as if it only exists in a medical context? Blackworm (talk) 18:08, 24 October 2008 (UTC)

I'm sorry; I'm not sure if I understand your position. Do you oppose using the word "excision" here? If so, on what grounds? "Cutting off" or "severing" are OK with me but have been opposed by some other editors, I believe. "Amputation" is most often used for limbs, so it makes it sound to me as if the whole penis is being cut off by mistake. ☺ Coppertwig (talk) 20:42, 24 October 2008 (UTC)

I oppose using "excision" to define circumcision, to the exclusion of other terms, as it is a needlessly technical term for "cutting out." (See Wikipedia:Technical_terms_and_definitions, which has guidelines for technical articles -- I don't believe this to be a generally technical article, but even if it was, we'd still have to explain that "excision" means "cutting out.") Besides being needlessly technical, "excision" conveys a medical context that is both unjustified, and non-neutral. It arguably conveys medical precision, medical care, medical cleanliness, medical ethics, and medical benefits. "Cutting (out/off)" is neutral, tells us in plain English what circumcision is, and to my knowledge is only opposed by User:Jakew on invalid grounds, and using non-reliable sources to present his objection.[[6]] Blackworm (talk) 21:10, 24 October 2008 (UTC)

bodily rights

I prefer the term "bodily rights" to "human rights" in this context, and disagree with the statement in Blackworm's edit summary where he made this edit. I don't think the term "bodily rights" was invented by Wikipedians. Google hits: '"bodily rights"': 4,820; '"bodily rights" Wikipedia': 517. "Bodily rights" is a more specific term than "human rights". "Human rights" is a broad term encompassing (arguably) such things as bodily rights, reproductive rights, freedom of association, intellectual rights, possibly even property rights. Here, we're talking about bodily rights, so we should avoid the unnecessarily vague (in this context) "human rights". ☺ Coppertwig (talk) 18:43, 24 October 2008 (UTC)

The cited source says "human rights." Let's say "human rights," which incidentally has 72 MILLION hits on Google. Also, if over 10% of pages on the Internet containing the phrase "bodily rights" also contain the word "Wikipedia," I'd say that's a startling correlation; wouldn't you? Furthermore, "bodily rights" (which is ill-defined, obscure, and doesn't even have an article in Wikipedia) aren't the only human rights opponents state are violated; there is the right to be free from pain and suffering, the right to proper care as an infant, and the right to be free of sex discrimination (gender equality). Proponents of male circumcision hate when opponents talk about "human rights," but that is no reason to to change the sourced, cited claim of opposition on human rights (~72,000,000 hits) grounds, to some obscure, vague, incomplete, and ill-defined term bodily rights (~5,000 hits, or 0.007% of human rights). Blackworm (talk) 18:57, 24 October 2008 (UTC)

Here -- a little wikifying of your words so that you may see for yourself which one is "different", and thus seems not to be a notable concept: "bodily rights, reproductive rights, freedom of association, intellectual rights, possibly even property rights." Blackworm (talk) 19:04, 24 October 2008 (UTC)

OK, I'm convinced: "human rights" is OK. I see the term actually appears in the title of the cited source. Although, for a term allegedly invented by Wikipedians, it's odd that "bodily rights" is the only one with a redlink. ☺ Coppertwig (talk) 20:42, 24 October 2008 (UTC)

"Invented by Wikipedians" doesn't mean "approved by the Wikipedia community."  ;) But seriously, I only meant that the term as used here was original research. Thanks, Coppertwig. Blackworm (talk) 20:57, 24 October 2008 (UTC)

I was only kidding about the redlink. Should've put an extra-big smiley. ☺ Coppertwig (talk) 21:47, 24 October 2008 (UTC)

Radical suggestion

Hey, I don't know about the rest of you, but I think our extreme focus on two or three paragraphs in the lead has come at the expense of the rest of the article. We've had a few embarrasing errors (including a misspelling of the word circumcision) go unnoticed for months while we squabbled about a few points.

How about this ridiculous set of suggestions to settle things down a bit:

1. Move the current advocates and opponents paragraph down to the "Ethical issues" section (a skeleton version already exists there anyway).

2. Move the AMA and WHO/CDC/HIV paragraphs down to the "Medical analysis" section

3. Summarize all three points in the lead with something like:

The medical and moral aspects of male circumcision make it a controversial issue. Currently, non-therapeutic circumcision is not recommended by any major medical association in the English speaking world. However, the WHO has recently advocated the use of circumcision in Africa to stem the heterosexual spread of HIV/AIDS.

Thoughts? Am I a moron, or what? AlphaEta 01:42, 19 October 2008 (UTC)

Why does the lead still quote a ten-year-old statement from the AMA about what medical organizations "currently" do? Does that not strike you as ridiculous? Jayjg ^(talk) 01:45, 19 October 2008 (UTC)

That would only be ridiculous if someone would provide reliable sources stating that these medical organizations have changed their positions. I'm not aware of any WP:RIDICULOUS policy. Blackworm (talk) 01:54, 19 October 2008 (UTC)

See Wikipedia:RS#Scholarship: "...scholarly material may be outdated, [or] superseded by more recent research...." The AMA's position cannot take into account more recent studies, including the WHO studies. Outdated medical statements fail WP:RS. Jayjg ^(talk) 16:53, 19 October 2008 (UTC)

1. No, the controversy being made less prominent is the crux of the dispute over the lead. Your suggestion to make it less prominent is not acceptable.

2. No, the AMA paragraph is an important summary of medical organizations positions, which we explore is great detail later the article.

3. Your suggested paragraph only mentions the WHO as an authority, lending undue weight to that organization's views, especially on their views as pertaining to the controversy -- since the controversy is what you lead the paragraph with. Blackworm (talk) 01:52, 19 October 2008 (UTC)

Okay, I admit that the suggested text was thrown together in haste and can't really even be considered a proper "paragraph" (on second look, it's quite horrible). It was meant to serve as a rough approximation of a shorter, more-compact synopsis of moral and medical issues surrounding circumcision. The goal was is not to minimize (especially controversial issues), but to summarize. Oh well, figured I give it a try. AlphaEta 02:55, 19 October 2008 (UTC)

"WHO has recently advocated the use of circumcision in Africa" doesn't sound quite right to me. What quote from the WHO is that based on? I suspect that may not be quite a precise reflection of their position.

I think medical association policies from 10 years ago are the current policies if no new policy has been announced. It would be different if it were from 100 years ago. The article clearly states that it's from 1999, so there's nothing misleading there. Medical facts may go out of date, but medical policies are more like laws in my opinion: they tend to remain in force until they're repealed or have been ignored for a long time. ☺ Coppertwig (talk) 17:01, 19 October 2008 (UTC)

They are indeed the current policies, but they are still fatally out of date, and fail Wikipedia:RS#Scholarship. What is the AMA position regarding circumcision in light of the WHO studies? It doesn't have one, of course, because its policy is "outdated, [or] superseded by more recent research". Jayjg ^(talk) 17:04, 19 October 2008 (UTC)

I know, I didn't put enough thought into the proposed "paragraph". I'm striking the text so we don't waste any more time on it. AlphaEta 17:10, 19 October 2008 (UTC)

Jayjg, the WHO studies are about using circumcision to lower the rate of HIV in Africa. The medical association policies are about neonatal circumcision in developed countries. The policies are not out of date; if they found new information then they would re-write the policies. Also please note that those RCT trials in Africa have not studied the long term effects of circumcision in relation to HIV reduction. They have only done it in a controlled setting too - in the real world many other things may come into play - such as increased risky behaviour due to thinking that they are now invincible now that they are circumcised; also less condom use as the penis becomes keratinized and so they don't want to reduce the sensation further. Tremello22 (talk) 21:19, 19 October 2008 (UTC)

Jayjg, if you have reliable sources criticizing the current policies of major medical organizations on that basis, or any basis, please bring them, and we can summarize them. Otherwise, your view is original research. If the year of any medical organization's last published policy review isn't given in the text, I invite you to add it, and let the reader decide whether the policies are out of date.

Coppertwig, here are sources on the WHO "advocating" or "recommending" or "urging" male circumcision with the reason given that it will reduce the spread of HIV: [7] [8] [9]. Blackworm (talk) 07:02, 22 October 2008 (UTC)

Well done Blackworwm! Garycompugeek (talk) 13:09, 26 October 2008 (UTC)

Blackworm, you have failed to address the issue raised by Wikipedia:RS#Scholarship: "...scholarly material may be outdated, [or] superseded by more recent research...." Many of the studies cited in the article post-date that statement. Please justify citing out-of-date medical statements in the lede in terms of policy. Jayjg ^(talk) 02:54, 26 October 2008 (UTC)

Only WHO seems to be recommending circumcision (along with much criticism). The AMA statement is still the best sourced policy summary we have for the the lead. The fact that it is 10 years old means little considering it is still true. If major medical associations did an about face (trend is not going that way) then the AMA statement could be considered out of data and misleading. Garycompugeek (talk) 13:04, 26 October 2008 (UTC)

Gary, to my knowledge two major policy statements have been released in the period since publication of the RCTs. One is WHO. The other is AUA, who added the recommendation "that circumcision should be presented as an option for health benefits" in 2007 (their previous statement, for comparison, can be found here).

Understood, however that certainly is not enough weight to dislodge the AMA summary statement. Garycompugeek (talk) 13:44, 26 October 2008 (UTC)

The WHO document briefly discusses criticism of the US and Australasian statements in s2.3.2 (see p16, 2nd paragraph). Jakew (talk) 13:34, 26 October 2008 (UTC)

I realize that they recommend circumcision. I'm just concerned about the precise wording with respect to "Africa": i.e. are the WHO recommending circumcision specifically in Africa? Or more generally? I think we need to be very careful with the precise wording there; it might be necessary to quote them. ☺ Coppertwig (talk) 23:25, 22 October 2008 (UTC)

Notice of RfC

A request for comments has been filed that may involve some or all editors of this article. See discussion here. ☺ Coppertwig (talk) 00:54, 25 October 2008 (UTC)

Should you do the work of identifying all editors active on this article since I've arrived, and notifying them, Coppertwig, or should I? Also, please include my block log on the RfC you've filed, as is customary in these situations. Thank you. Blackworm (talk) 08:15, 25 October 2008 (UTC)

Defining the controversy

Two concerns about the advocates versus opponents paragraph in the lead:

1. The "introductory" sentence (There is scientific evidence supporting both sides of the circumcision controversy.) was removed on August 10, 2008 (based on wp:weasel).

The sentence was re-added on September 26, 2008 for reasons that, based on the discussion that prompted its re-addition, aren't entirely apparent.

After two editors (one being me) voiced concern that the sentence did/does a poor job of introducing the paragraph, no counterpoint was made, so I removed it again on October 9, 2008.

It has since been deleted and re-added a couple of times. The last time it was re-added, the edit summary stated that: this illustrates important controversy - gain consensus for lead changes. However, the sentence does not illustrate or define the controversy (at all). Moreover, it was re-added without consensus 1.5 months after the initial removal.

Multiple editors have claimed that the sentence is misplaced, includes weasel terms, and does not introduce or illustrate the controversy, or the paragraph. Therefore, I propose that it either be removed (not preferred), or re-written so it actually introduces the material in the paragraph and defines/illustrates the debate.

Which leads me to my second, more pressing, concern...

2. As written, it is unclear whether the paragraph refers specifically to neonatal circumcison, or circumcision in general. The idea that someone would claim elective, adult circumcision is a bodily rights violation is somewhat absurd. While some people may hold this opinion, I don't think it is common, and I don't believe it is the point we are trying to illustrate. However, because the paragraph has been "worked over" so many times, we've lost this distinction. Thoughts on these concerns? AlphaEta 23:35, 14 October 2008 (UTC)

There is nothing weasely about stating the controversy of circumcision. You seem to be the only editor taking issue with it. Don't be obtuse Alpha, of course it illustrates controversy. It illustrates it by stating it. Then is followed by examples from both sides of the controversy. Just because you keep removing it doesn't mean it did not have consensus. I welcome other editors thoughts on the matter. Garycompugeek (talk) 01:45, 15 October 2008 (UTC)

I never said the sentence was weasely. Nor am I the only one who has removed it or questioned its purpose (see the links I provided above). AlphaEta 18:42, 15 October 2008 (UTC)

My apologies Alpha. Let me redirect the weasel comment towards Tremello and strike out the only editor part. Garycompugeek (talk) 22:51, 15 October 2008 (UTC)

Re point 1, I agree that the sentence should be removed, at least until it can be rewritten so that it's more meaningful. The sentence has been discussed previously, of course, and I don't want to repeat the arguments made at the time. However, I'm just wondering how it might be rewritten. "Proponents on both sides of the circumcision controversy cite scientific evidence in support of their position" is slightly better, though it still presumes that the existence of a controversy is already established. Additionally, it's still somewhat empty - after all, what else are they going to cite? Secret messages from the planet Zarq? Moreover, what does it have to do with claims that it "is best performed during the neonatal period" or that it "violates the individual's bodily rights"? Neither of these are scientific statements, and they cannot directly be supported with scientific evidence. They're value judgements.

Re point 2, it is indeed unclear what the paragraph is about. Looking at the arguments, it is probably about neonatal circumcision, which seems quite reasonable, as I think it is safe to say that controversy tends to focus on circumcisions performed in infancy. However, this needs to be made clear. As an alternative, I suppose we could modify the paragraph to have a broader scope, but I think that it would be (even) more difficult to do. Jakew (talk) 11:13, 15 October 2008 (UTC)

Suggested new versions of sentence; I prefer the first one:

• Routine neonatal circumcision is controversial, with both scientific evidence and value judgements coming into play on both sides.
• There are reasons both for and against routine neonatal circumcision.
• There are reasons, with some support from scientific evidence, both for and against routine neonatal circumcision.
• There are reasons, some supported by scientific evidence, both for and against routine neonatal circumcision.
• Routine neonatal circumcision may be associated with both risks and benefits.

I agree with AlphaEta's statement "the sentence does not illustrate or define the controversy"; merely asserting something does not necessarily illustrate it. ☺ Coppertwig (talk) 13:55, 15 October 2008 (UTC)

I think any of those would be reasonable. However, I think use of the term "routine" should be avoided. It implies that controversy is about the idea that all newborn boys should be circumcised, but in practice controversy tends to focus on whether parents should be permitted to choose circumcision for their son(s). A couple of relevant quotes from the literature: "I believe that the term "routine infant circumcision" is a misnomer. It denotes a position that nobody really holds, namely that as a matter of routine, all healthy boys should be circumcised. Opposition to a policy of "routine infant circumcision" does not have to indicate opposition to a parent’s right to choose for their son to undergo the procedure, nor the provision of the procedure in general." (Footnote 2 in: Viens AM. Value judgment, harm, and religious liberty. J Med Ethics. 2004 Jun;30(3):241-7) "Burger and Guthrie"4 made the valid point that the term "routine circumcision", which appears so frequently in the literature, should never be used for a procedure with so many contraindications." (Warner E, Strashin E. Benefits and risks of circumcision. Can Med Assoc J. 1981 Nov 1;125(9):967-76, 992) Jakew (talk) 15:02, 15 October 2008 (UTC)

As you say yourself, the term is frequently used in sources. Advocates such as Edgar Schoen, cited in this article as an impartial expert, do in fact take the position that all healthy boys should be circumcised. "Routine" also may simply mean "common" or "expected," which definitely describes circumcision in medical milieu of the last century in the United States and elsewhere. Blackworm (talk) 16:28, 15 October 2008 (UTC)

I added [[10]] back on July 2nd. Avi said this was OR and as a compromise we added [[11]]. It was subsequently modified by Avi again to [[12]] and I later changed discussion to controversy. Alpha has tried to move sentence to end of para and/or delete it. I have no qualms about modifying sentence as long as we illustrate controversy neutrally. Garycompugeek (talk) 16:20, 15 October 2008 (UTC)

Can I request that we stop for a moment and discuss the purpose of this sentence? I don't fully understand what it's intended to do. What piece of information do we want the reader to have? Why is this sentence (in whatever form it may take) needed? That is, if the purpose is to say that there is a controversy, don't the other two sentences make that obvious enough?? Gary, can you clarify these questions please? It's difficult for me to propose or think constructively about proposed sentences when I don't understand the purpose. Jakew (talk) 16:28, 15 October 2008 (UTC)

By "routine", I didn't mean circumcision of all infants. I meant circumcision in cases where there was no specific medical indication for that particular infant, but only general purposes such as preventing possible future disease. Would "elective" be a better term, or is there another term that can be used? How about "neonatal circumcision of healthy infants" or "neonatal circumcision of normal infants" or "neonatal circumcision in the absence of [specific] medical indication"?

As for the purpose of the sentence: I think that, like the "disposition" sentence which has been disposed of, it isn't there for the purpose of providing any information except that information, useful in the extremely short term, about what the paragraph is about. In other words, it makes the paragraph easier to read by letting the reader know what is coming, so that the following sentences are not surprising and can be easily understood on first reading. I think the sentence does this job well and mildly prefer having such a sentence, but deleting it is OK with me too. ☺ Coppertwig (talk) 16:47, 15 October 2008 (UTC)

Thank you Coppertwig. That was very concise and to the point. Garycompugeek (talk) 17:20, 15 October 2008 (UTC)

"Routine neonatal circumcision has created much controversy."? —Preceding unsigned comment added by Garycompugeek (talk • contribs)

I suggest: "Circumcision of male newborns, children, and adolescents is controversial when there is no immediate medical need." We shouldn't assert that there are "reasons" for and agaisnt circumcision (though we may assert that reasons for and against have been put forth by others). Blackworm (talk) 18:12, 15 October 2008 (UTC)

I agree with the content of Blackworm's suggestion. If the sentence is re-worded so that it briefly defines the nature of the controversy (i.e. circumcision of healthy people who are incapable of consenting is controversial), it would fulfill a useful function. AlphaEta 18:42, 15 October 2008 (UTC)

I can see what you're saying, AlphaEta, but I'm concerned that "when there is no immediate medical need" is very similar in meaning to one of the arguments attributed to opponents of circumcision ("is medically unnecessary"). In effect, it would frame the paragraph and the controversy in terms of one of the arguments used by opponents. "...Is controversial when performed for prophylactic purposes" would have exactly the same problem, but framed in terms of one of the arguments attributed to advocates. If we need a sentence to introduce the paragraph, we should do so in such a way that is neutral with respect to the controversy itself. Jakew (talk) 19:05, 15 October 2008 (UTC)

Huh? Does anyone actually argue that male circumcision is medically necessary? The medical sources all seem to agree that unless there is medical indication in each specific case, the procedure is elective. That male circumcision is not generally medically necessary is accepted by everyone involved in the controversy, except perhaps the most extreme, fringe advocates (I say "perhaps" because I have seen no source, even a fringe pro-circ website, make the claim that it is generally medically necessary). The differences in opinion begin where one side perceives medically unnecessary procedures on minors to be wrong, and the other perceives the harms of the medically unnecessary procedure to be outweighed by the benefits. In any case, it is the opponents who "create" the controversy, not the proponents, and thus it seems appropriate for us to specify precisely what forms of male circumcision are opposed -- i.e., non-therapeutic, elective (i.e., "no immediate medical need") male circumcision of minors. Blackworm (talk) 21:19, 15 October 2008 (UTC)

You do however shed light on the fact that the article implies only those opposed state that it is medically unnecessary -- very problematic given that all or virtually all sources agree that it is. Opponents do not argue or "claim" that it is medically unnecessary, because no one argues against that -- they do argue that as it is medically unnecessary, and carries other harms, it should not be performed on minors. Blackworm (talk) 21:43, 15 October 2008 (UTC)

I think "elective" is a suitable word. "Non-therapeutic" is an alternative option, but I think in this context it might introduce bias since it is not immediately obvious, if one is unfamiliar with the usage of the term, whether circumcisions performed to protect against disease are therapeutic or not. (An additional problem is that it implies that therapeutic neonatal circumcisions are non-controversial, though often there seems to be controversy over whether they're therapeutic or not.) I'd prefer to use something shorter than "circumcision of healthy infants", but otherwise it seems fine. Jakew (talk) 18:24, 15 October 2008 (UTC)

If you take religious circumcision out of the equation (30% circumcise, two-thirds of which are Muslim, Jews would take up a percentage of that 30% too)- that would leave about 5-10% who circumcise in infancy for medical reasons vs. 90-95% who do it for other reasons, or don't do it at all. So advocacy of infant circumcision for medical reasons is surely a minority view-there is no debate in the majority of countries - they are against it. So, we shouldn't give WP:Undue weight to a minority viewpoint. Also the last 2 paragraphs giving the opinions of the WHO and other medical associations should probably be merged into the same paragraph. Tremello22 (talk) 20:02, 15 October 2008 (UTC)

Faulty argument. You can't conclude that someone is opposed to something just because they haven't done it. (By the same line of reasoning, you'd have to conclude that approximately half the world's population are against access to clean water.) Consequently we can't conclude that advocacy or opposition is a minority view based solely on the prevalence of circumcision. Jakew (talk) 20:13, 15 October 2008 (UTC)

Faulty analogy. People don't have access to clean water because they do not have a choice. In most countries that do not circumcise, they do have a choice and they choose not to do it. —Preceding unsigned comment added by Tremello22 (talk • contribs)

Your argument seems to rest on the assumption that the outcome represents a conscious decision. How can you be sure that people have actually considered the issue and have made a deliberate decision not to circumcise? What if it didn't occur to them? What if there is demand that cannot be met? Regardless, the essential point remains: in the absence of large-scale surveys, there is no way to know whether people who do not circumcise are neutral or opposed to circumcision (or even in favour of it). Consequently, one cannot use prevalence data to judge the issue. Jakew (talk) 20:50, 15 October 2008 (UTC)

Jakew writes: I think in this context ["non-therapeutic"] might introduce bias since it is not immediately obvious, if one is unfamiliar with the usage of the term, whether circumcisions performed to protect against disease are therapeutic or not. The reader's ignorance about terms isn't really our problem, Jake. They can look up the word[13] to confirm that therapeutic basically means "for immediate medical need." Or, we can say, "for immediate medical need," as I suggest above, which eliminates any problem. Blackworm (talk) 21:25, 15 October 2008 (UTC)

AlphaEta, I think there's more controversy than solely about circumcising those who are too young to consent. If an adult approaches a doctor and asks whether it's a good idea to get circumcised in order to prevent disease, isn't there also controversy as to what the answer to that question is? ☺ Coppertwig (talk) 22:12, 15 October 2008 (UTC)

That's a good point. The current advocates and opponents sentences encompass both the medical and consent aspects of circumcision, which, as your example illustrates, may exist as separate debates. AlphaEta 22:36, 15 October 2008 (UTC)

How about "Scientific evidence and value judgements have come into play on both sides of the question of circumcision in the absence of immediate medical need." Medical associations have mentioned both benefits and risks of circumcision, and generally don't take a strong position either way, so I think this sentence is reasonable as far as due weight is concerned. ☺ Coppertwig (talk) 23:11, 15 October 2008 (UTC)

What is "the question of circumcision [...]"? Is it the same as the circumcision-related question parents currently often ask themselves, or their doctors, when a baby boy is born? Let's use the word "controversy," as in "the controversy surrounding the practice, common in some areas, of circumcising male minors for non-therapeutic reasons," as the word "controversy" is used in sources,[14][15][16] and in other articles on topics with controversial elements. Blackworm (talk) 02:32, 16 October 2008 (UTC)

I think we've talked this through. I agree with Blackworm that the word "controversy" should be used as the most descriptive adjective and typical word used by sources. I will support this change if you would like to modify the sentence Coppertwig. Garycompugeek (talk) 11:53, 16 October 2008 (UTC)

"Controversy" should include a discussion on the fact that there is no controversy in most of the world. If one looks in the index of baby care books not printed in English, one cannot even find the cognate for the word "circumcision."

Please make this article less provincial. Brit Pariah (talk) 05:32, 16 October 2008 (UTC)

Welcome to Wikipedia! Just go ahead and edit the article, bringing reliable sources supporting your claims and referencing them in the article. Blackworm (talk) 07:10, 16 October 2008 (UTC)

If we're careful with words, we can say that a controversy exists without implying that there is universal controversy. Still, it might well involve adding yet more words to an already complex sentence. Moreover, the sentence is that is at present unsourced (and becomes increasingly difficult to source as we add to it), and slightly tilts the paragraph away from NPOV by framing the controversy in terms of one of the opponents' arguments.

There is an obvious alternative: "" (that is, no sentence). The advantages include: no sourcing issues, no NPOV issues, and no problems with defining the controversy in a way that is too broad or too narrow. Per Coppertwig's explanation, the sentence is not essential anyway, so this seems a fairly obvious solution. Any comments? Jakew (talk) 13:01, 16 October 2008 (UTC)

This is a controversial topic. We should say that a controversy exists, and fully explain the controversy, which naturally will begin in terms those with opposing views use. Why wouldn't those opposing something be allowed to frame the controversy? If supporters want to frame it differently we can reflect that, and let the reader decide which framing is appropriate. But your argument just sounds like a call to (again) silence any mention of controversy. There is also no implication of "universal controversy," whatever that means, that isn't already present in the sources. By the way "controversy" means, 1. a discussion marked especially by the expression of opposing views : dispute 2. quarrel, strife.[17] Naturally, strong supporters would wish to deny a controversy exists, or minimize the controversy, and we must be aware of that when considering the NPOV aspects of this controversial topic. This must be the only controversial topic in Wikipedia where resistance to actually calling the topic controversial in the article is taken anywhere seriously. Blackworm (talk) 13:39, 16 October 2008 (UTC)

I have no objection to stating that it is controversial, provided that we do so in a way that is neutral and appropriately sourced. For example, a simple statement of the form "neonatal circumcision is controversial" (citing "Considerable controversy surrounds neonatal circumcision" in the AAFP statement) would be fine, since it would avoid framing the argument in terms of arguments used by one side or another, and would, of course, be appropriately sourced. Jakew (talk) 13:52, 16 October 2008 (UTC)

It sounds like your agreeing to my previous suggestion - "Routine neonatal circumcision has created much controversy.", however doubts have been cast that this is not accurate enough because controversy exist outside of neonatal circumcision as Coppertwig points out. This topic is steeped in controversy. It should be illustrated not brushed under the rug. That would be a violation of WP:NPOV. Garycompugeek (talk) 14:47, 16 October 2008 (UTC)

I'd agree that there are some similarities between the two sentences, Gary, though obviously there are some differences as well. I think that the example sentence I gave is closer to that particular source.

Strictly speaking, the problem you mention is that the scope is too narrow: in addition to controversy about neonatal circumcision, there is also controversy about non-neonatal circumcision. And in addition to controversy involving those who cannot consent, there is also controversy involving those who can consent. However, I'd like to make two observations about that.

First, in an ideal world, we would be able to describe all controversies in a brief, neutral, well-sourced sentence. However, in practice, we may find that we cannot construct such a sentence, or that even if we could construct such a sentence we cannot find a source to support it. Consequently, we may find that we have a choice between a sourced statement describing some of the controversy or nothing. Which is better? I don't know. Personally, I favour illustrating controversy using opposing arguments, but avoiding asserting that there is a controversy, which seems unnecessary given the illustrative examples anyway. An alternative view is that it is important to state that there is a controversy, and from that point of view I suppose it would seem better to use a sourced statement describing a subset of the total controversies.

Second, we need to think about the relationship between the first sentence (if any) and what follows. If we assert the existence of a controversy about neonatal circumcision, then the arguments that follow make sense (to clarify, I'm not saying that they're right or wrong, just that they are consistent with this context). However, if we try to include all controversies, which would include (as Coppertwig points out) those over whether it's a good idea for an adult to get circumcised in order to prevent disease, then some of the arguments listed are nonsensical in this context. Jakew (talk) 15:55, 16 October 2008 (UTC)

If we can source it, we can use a very short sentence or a sentence fragment joined to the following sentence with a colon:

• There is controversy.
• There is controversy connected with the topic of circumcision.
• There is controversy:
• Controversy:
• Controversy about circumcision:

If it can be justified in terms of sources (i.e. if we can justify based on sources that there is controversy about (male) circumcision in general, not only about neonatal circumcision), then I would prefer to reorganize the third sentence of the paragraph to allow it to refer to both circumcision in general and neonatal circumcision. I think the second sentence is already OK in this regard. The 3rd sentence can become, "Opponents of circumcision claim that it is medically unnecessary, adversely affects sexual pleasure and performance, is a practice defended by myths, and when performed neonatally violates the individual's bodily rights." This has the advantage, I think, of making the two sentences more parallel: for example, mentioning sexual function as the second item in both. ☺ Coppertwig (talk) 16:54, 16 October 2008 (UTC)

This brings me back to my first edit (I think) of this article. "There is great controversy surrounding circumcision." That controversy exist seems defacto. Its not necessary to source every sentence in an article however if we wish to list a source that states there is controversy we have plenty to choose from. Garycompugeek (talk) 17:28, 16 October 2008 (UTC)

Jakew, There is a subtle difference in my opinion between stating that something is controversial, and mentioning opposition to it. The mentioned opposition could be a tiny fringe minority, or insignificant, but if sources generally agree that controversy surrounds a topic (especially "considerable" controversy), it shows that there is more than fringe opposition. As for any weight given various controversies, I'd be interested in seeing sources mentioning controversy in circumcision of consenting male adults. It is certainly not nearly as controversial as circumcision of minors, and I would assume that any such controversy is probably restricted to a small, dispassionate debate among a very small group of people in the medical field -- therefore its mention is secondary (and seemingly not good for the lead). I like your edit suggestion, but would prefer "circumcision of children is controversial," (instead of "neonatal circumcision...") as "neonatal" excludes circumcision of older children and adolescents (which is apparently more common than neonatal circumcision, as it is common among Muslims). Blackworm (talk) 17:09, 16 October 2008 (UTC)

Coppertwig (and others), what do you think of "medical associations admit that it is medically unnecessary" instead of "it is medically unnecessary"? Again, the way the paragraph is written ("claim") makes it seem as if there is significant dispute over whether circumcision is medically necessary, which I do not believe is reflected by the sources (i.e., it seems virtually everyone agrees that it isn't). Blackworm (talk) 17:09, 16 October 2008 (UTC)

Btw here are some sources for "children" (or alternately "minors", or "infants and children" in case "children" alone might be taken to exclude infants) rather than "neonatal:"

• The removal of the foreskin of male babies and young boys, whether for religious or medical reasons, is a controversial issue.[18]
• 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.[19]

Also the Milos source quoted as opposition in that paragraph mostly discusses circumcision of neonates, but also mentions children several times, and this: It is imperative that mutual respect for these inalienable human rights be extended, not only to the women in Africa with whom we can identify, but also to men, male children, and male newborns. Blackworm (talk) 17:39, 16 October 2008 (UTC)

Blackworm, do you think we should make the paragraph pertain to circumcision of male babies and children (i.e. not include adults)? Based on your sources above, I think we can say something like "Circumcision of babies and children is controversial." I would still prefer to rewrite the 3rd sentence as I suggested above anyway: it makes the sentences more parallel, and the fact that the first 3 parts of each sentence could apply to either children or adults doesn't detract, in my opinion, from having the main focus of the paragraph be children. Garycompugeek, as I read the policy WP:V, it is necessary for every sentence in an article to contain only assertions attributable to a reliable source. ☺ Coppertwig (talk) 19:08, 16 October 2008 (UTC)

"Views differ on whether limits should be placed on caregivers having a child circumcised." Coppertwig I took this sentence from the beginning of the consent section. Notice it is not sourced. I think your taking my meaning a bit to literally but I may be mistaken. Garycompugeek (talk) 19:21, 16 October 2008 (UTC)

Maybe "not sourced" has more than one interpretation. Not every sentence needs a footnote attached, but every sentence must contain information which is attributable to reliable sources. I oppose using that sentence in the lead, as it narrows the controversy specifically to whether limits should be placed, rather than the broader question of whether to circumcise or not, a decision which is often made by parents; therefore I see it as being too specific for the lead, which is a more general summary. ☺ Coppertwig (talk) 19:43, 16 October 2008 (UTC)

I oppose using the consent sentence for the lead also Coppertwig. It was merely an example to my statement. I also understand every sentences need to be attributed to reliable sources. My point was every sentence does not need a footnote. I guess this means we are on the same page. Garycompugeek (talk) 20:51, 16 October 2008 (UTC)

Great! Apparently we agree. High five! ☺ Coppertwig (talk) 21:26, 16 October 2008 (UTC)

Blackworm, re "medical associations admit that it is medically unnecessary": That's an interesting suggestion. We would need a source which is a circumcision opponent stating that medical associations admit that in the context of giving a reason not to circumcise. I'm not sure that the word "admit" is NPOV here; would it count as a quote from such an organization? This might misrepresent the actual positions of medical associations, which are more complex than that; I think it may be better to leave the shorter wording and let the reader see the positions of the medical associations in the section for that purpose. How about "Opponents of circumcision claim that it is medically unnecessary, citing position statements of medical associations, ..." (if verifiable). This assumes re-arranging the sentence, e.g. as I had suggested. ☺ Coppertwig (talk) 19:52, 16 October 2008 (UTC)

Rearranging the sentence seems a good idea to me. I would suggest using the word "argue" in both cases, rather than "claim". I think the word "argue" is more neutral in general, as "claim" can sometimes suggest that an argument is dubious. I believe that this would address the concern raised by Blackworm.

I think that we should avoid an addition of the form "citing position statements of medical associations", since if we did so for the opponent we'd have to do something similar with the proponent (Schoen, for example, cites the WHO in support of one of his arguments). To my mind, the evidence cited by opponents and proponents in support of their arguments is far too much detail for the lead. Jakew (talk) 23:16, 16 October 2008 (UTC)

Verbatim repeat of my comment above: Opponents do not argue or "claim" that it is medically unnecessary, because no one argues against that -- they do argue that as it is medically unnecessary, and carries other harms, it should not be performed on minors. Also if your last sentence is true, then let's remove the part about "0.5%" of circumcisions having complications, as that is cited by Schoen. Blackworm (talk) 21:02, 17 October 2008 (UTC)

Good point Blackworm - I think the same. Yes there is no medical claim it is unnecessary, we know it is unnecessary - all medical associations say so. If people choose to do it later when they are an adult then there is no controversy over that. There are 2 aspects to the controversy as far as I can see. One is that this is being done to the child without his personal consent. Secondly there is controversy over why it still goes on even though the medical associations agree that there is no net benefit - this bit is particularly relevant to the USA. I definitely think the Schoen 0.5% claim should be taken out. Do we even know what he is basing that on? I guess he disagrees with the most reliable estimate by williams and kappilla of 2-10%. And what is a complication - how many undesirable cosmetic results go under-reported as the people just live with it? Is that even considered by Schoen a complication ? And why should we be specific to one circ advocate when the sentence implies otherwise? (i think I have mentioned this point before).Tremello22 (talk) 00:11, 18 October 2008 (UTC)

Blackworm, I think Schoen's argument could be simplified to something like "that it has a low complication rate". Tremello, his source in this particular article is unclear, but elsewhere he has cited the AAP's estimate of 0.2% to 0.6% (see, eg., Schoen EJ. Circumcision for preventing urinary tract infections in boys: North American view. Arch Dis Child. 2005 Aug;90(8):772-3.) Jakew (talk) 12:26, 18 October 2008 (UTC)

Blackworm, you have a good point. Now, since we're trying to express things in just a few words, I think we need to avoid trying to express the precise degree to which there's consensus as to whether it's medically necessary; that can be done later where there's more room. I think the following wording avoids implying that they're the only ones who argue that, while also avoiding implying anything else that might require additional detail to explain properly: "Among their arguments, opponents of circumcision state that it's medically unnecessary, ...". (Other alternatives: "Among other arguments, ..."; and "Arguments of opponents of circumcision include that it's medically unnecessary...") I suggest modifying both the opponents and proponents sentences in this way. I suggest simply deleting the first sentence. Rearranging wording a bit for flow and replacing the 0.5% according to Jakew's suggestion, this gives us (I have not included the full footnote info though):

Among their arguments, Advocates for circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision, on the other hand, state among their arguments that it is medically unnecessary, adversely affects sexual pleasure and performance, is a practice defended by myths, and when performed neonatally violates the individual's bodily rights.

Here, the phrase "on the other hand" helps the reader orient themself in the paragraph, serving a similar purpose to the earlier first sentence, which I suggest leaving out; it alerts the reader that the entire paragraph is not about advocates, making it easier to assimilate the information. ☺ Coppertwig (talk) 16:05, 18 October 2008 (UTC)

New suggestion, based on recent edits:

Among their arguments, Advocates for circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision, on the other hand, state among their arguments that it is excessivelytraumatically painful, adversely affects sexual pleasure and performance, may increase the risk of certain infections, and when performed on babies and children violates the individual's bodily rights.

AlphaEta deleted the word "excruciatingly" on the grounds that "descriptions of pain in the source are seldom accompanied by the adverb "excruciatingly"". Words appearing only once in a source often end up in the article. In this case, the source uses, besides the word "pain" by itself a number of times, the phrases "excruciating pain", "painful and traumatic", "overwhelming pain" and "excruciatingly painful". Just saying that it's painful doesn't seem to me to convey adequately the message of this source. On the other hand, "excruciatingly" could be considered to not be in an "impartial tone" as required by NPOV. I suggest "excessively painful". ☺ Coppertwig (talk) 01:48, 19 October 2008 (UTC)

Request for discussion: I would like to see whether there's consensus for replacing the controversy paragraph with the above suggested paragraph; note that this suggestion involves deleting the current first sentence of that paragraph, which is "There is scientific evidence supporting both sides of the circumcision controversy.". I've just replaced "excessively" with "traumatically" in that paragraph. If we can establish consensus, I'll recopy the paragraph to remove the struck-out word, insert the full footnote info and ask an admin to put it in via an "editprotected" request. (Note: if anyone wishes to argue for lifting the page-protection early I would go along with that; I had made a mistake when filing the 3RR report, as noted at WP:3RRN.) ☺ Coppertwig (talk) 16:51, 19 October 2008 (UTC)

I think this is simpler:

Advocates for circumcision state that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision state that it causes significant pain, adversely affects sexual pleasure and performance, may increase the risk of certain infections, and when performed on babies and children violates the individual's bodily rights.

The "among their arguments" wording is over-wordy, and it is understood that not every single detail of the pro or con view needs to be in the lede. Jayjg ^(talk) 16:59, 19 October 2008 (UTC)

You're right. That's less wordy. I think it's an improvement. "significant pain" sounds OK to me: I think it gets the point across. ☺ Coppertwig (talk) 17:06, 19 October 2008 (UTC)

Clarification: I assume your suggestion, Jayjg, also includes deleting the current first sentence of the paragraph.☺ Coppertwig (talk) 20:42, 19 October 2008 (UTC)

Blackworm, would you please clarify your position? I see you've edited the first sentence of the 3rd paragraph, and I think your edit is probably an improvement. However, I've proposed deleting that sentence (stating that there is a controversy) entirely. Do you oppose deleting that sentence? ☺ Coppertwig (talk) 18:04, 23 October 2008 (UTC)

I oppose removing the sentence stating there is a controversy for the reasons I've listed above. Initially you supported stating there is a controversy. What has made you change your mind? Garycompugeek (talk) 19:05, 23 October 2008 (UTC)

Blackworm's recent edit to the opening sentence of the advocates/opponents paragraph is a perfect compromise! AlphaEta 18:28, 23 October 2008 (UTC)

Hmm, thank you although perhaps it was a bit too bold given all the discussion here. Maybe some more feedback from others? I appreciate the desire to keep the paragraph short (this is the lead after all) but I think we now succeed in three points where we didn't: One, we mention a controversy before discussing it (the previous sentence talked about the controversy as if we've already mentioned it), two, we make clear that the controversy we are focussing on here is the major one, i.e. the one concerning infants and children, and three, we refrain from asserting a non-neutral view that both sides are correct to some degree. Blackworm (talk) 19:42, 23 October 2008 (UTC)

Garycompugeek, I don't remember supporting stating that there is a controversy. I very weakly supported having a first sentence in the paragraph that tells the reader what the paragraph is about; most or all suggested versions of such a sentence happened to mention controversy. Later, since it seemed difficult to reach consensus on the wording of such a sentence, it seemed to me to be a good idea to delete it; the advantages of shortening the lead also appealed to me. However, Blackworm has come up with a version of the sentence which seems promising in terms of achieving consensus, so perhaps everything is working out. ☺ Coppertwig (talk) 15:23, 24 October 2008 (UTC)

I think that the current statement of the controversy ("Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions") is problematic.

The first problem is that the scope is arbitrarily narrow. As noted above, controversy also exists (albeit perhaps to a lesser extent) about the circumcision of adults. Without this sentence, the paragraph can be interpreted in a broader sense. Why, then, are we imposing this unnecessary reduction in scope?

The second problem is that the final sentence already includes the words, "...and when performed on babies and children violates...". The purpose of these words is unclear if the first sentence is present. However, if the first sentence is deleted, it helps to distinguish between sub-controversies.

As I stated in my post of 13:01, 16 October 2008 (UTC), I think that the best approach is to include no initial sentence. Jakew (talk) 15:40, 24 October 2008 (UTC)

I find your argument convincing, Jakew, and now prefer to delete the sentence than to have the current sentence, though some other versions of the sentence may be OK. Although we didn't find a source that states that there is any controversy about circumcision of adults, it would be OR to imply that there is none. Blackworm, surely you wouldn't be prepared to state that the WHO's advocacy of circumcision to reduce HIV transmission (or whatever it is they're recommending) is uncontroversial? I don't get the impression that they're just talking about babies and children. ☺ Coppertwig (talk) 16:03, 24 October 2008 (UTC)

The only reason the WHO's position is controversial is because adult men are being circumcised on a "nominally voluntary" basis, and perhaps also do not have the resources to make an informed decision; and also because the programs encourage circumcision of infants and children. The "circumcision controversy" as described by reliable sources concerns infants and children. Let's actually present this controversy. Blackworm (talk) 18:25, 24 October 2008 (UTC)

I do not find your argument convincing. Jakew, please bring sources stating a controversy in the circumcision of adults. This is ridiculous -- the male circumcision controversy is the controversy of cutting parts off the penises of infants and children, not the obscure, scholarly and friendly debate among three or four researchers as to whether adult circumcision is beneficial. Stop obscuring this controversy. Blackworm (talk) 18:14, 24 October 2008 (UTC)

Note also that the Schoen source used to present the propronents' position entirely describes circumcision of infants (note the title of the article). Thus statements like "low complication rate" are misleading unless one already reduces the context to infants. Blackworm (talk) 18:37, 24 October 2008 (UTC)

As requested, Blackworm: "Should men be circumcised to help slow the spread of HIV infection? The controversial idea is on the agenda..."[20] Jakew (talk) 21:02, 24 October 2008 (UTC)

Well done, Jakew! Thanks! I thought infants weren't the only controversy. ☺ Coppertwig (talk) 22:13, 24 October 2008 (UTC)

Well, okay, that this is controversial also would be a welcome addition to the article, which as it stands presents the WHO's position on HIV and male circumcision as if it is not controversial at all. Thus, based on the source Jakew brings, we could add this sentence: The idea of circumcising men in an attempt to slow HIV infections is controversial. It could be added immediately after the WHO's 2007 recommendation in the lead. This of course does not involve nor affect the paragraph of the much more explored controversy of routinely circumcising male infants and children. Blackworm (talk) 18:09, 27 October 2008 (UTC)

That suggestion is problematic for several reasons, Blackworm. First, it would imply through juxtaposition that the WHO's 2007 recommendations were controversial, for which we'd need a source stating that they are (a source published 18 months before the recommendations were issued cannot do so for obvious reasons). Second, as previously noted, the recently-added sentence "Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions" is problematic, partly because it describes the controversy in a way that is too narrow, and partly because it renders part of the same paragraph ("...and when performed on babies and children violates...") nonsensical. The correct solution is either to remove the problematic sentence, or to amend it so that it is no longer problematic. Simply adding material may be tempting, but it is difficult to justify when it a) fails to address the underlying problem, b) introduces new problems, and c) adds bulk to the lead without justification. Jakew (talk) 19:06, 27 October 2008 (UTC)

My thoughts

There is scientific evidence supporting both sides of the circumcision controversy. Advocates for circumcision claim that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a complication rate of less than 0.5% when carried out by an experienced physician, and is best performed during the neonatal period.[19] Opponents of circumcision claim that it violates the individual's human rights, is painful, may increase the risk of certain infections, and adversely affects sexual pleasure and performance.[20]

My criticisms for what they are worth. O.K, i think that a complication rate of less than 0.5% should be replaced with has a low rate of complications. Also, the controversy is related to infant circumcision not circumcision in general. Nobody cares if an adult circumcises himself. So the opening sentence should reflect that. Also, given that the opponents are the ones who are creating the controversy, their opinion should come first. Also explain why their is a controversy - this: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice." should be incorporated. Here is my suggestion (rough):

There is a controversy, particularly in the USA (where the neonatal circumcision rate is high), over whether boys should be circumcised. Opponents state that it is not medically necessary, reduces sexual pleasure, violates the child's right to genital integrity and carries serious risks.^ref^ Virtually all national medical associations do not recommend routine infant circumcision, however they do support the parents right to choose.^ref^ Advocates of circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate, and is best performed during the neonatal period. The WHO have recently stated that circumcision could be used to lower the rate of HIV contraction in Africa.^ref^ Tremello22 (talk) 21:52, 19 October 2008 (UTC)

Tremello22, It's not clear to me whether your comments are about the current lead, or about Jayjg's suggestion above. Do you have any strong objections to replacing the current 3rd paragraph of the lead with Jayjg's suggestion of 16:59, 19 October 2008?

Before I comment on your suggestion, would you please clarify what text in the current lead it's intended to replace? Note that the lead already provides information about the WHO's position with respect to HIV and about the positions of medical associations. Thanks. ☺ Coppertwig (talk) 17:18, 23 October 2008 (UTC)

Yes I do have a problem with Jayjg's suggestion. I was just throwing out the idea of merging the last 2 paragraphs of the current lead together to make the lead flow a bit more. The current lead as it stands now, after Blackworm's modification, is a bit better though because it makes clear we are talking about circumcision in children. Tremello22 (talk) 18:15, 23 October 2008 (UTC)

Thank you, Tremello22. I re-read your comments above, and I could be wrong but it seems to me that the problems you have with Jayjg's suggestion also mostly apply to what was in the lead, so I took the liberty of putting in Jayjg's wording, except that I kept the first sentence of the paragraph in place and also kept the phrase "extremely painful". I hope you don't mind. This edit removed the "0.5%" as you suggested, so perhaps it's closer to your suggestion than the lead was.

In reply to your comments: I've left the opening sentence in place, and Blackworm has edited it to reflect that it's about children. Re the opponents coming first: I guess that's probably OK with me; I don't see much reason for having one or the other first, but I think you're right that it sounds more logical with the opponents coming first: the advocates' views seem unimportant until one has been exposed to opponents' views to be refuted by them, especially since most of the advocates' views stated in that sentence are arguing that it does no harm, rather than giving positive reasons for doing it. I have not changed the order of the sentences, in order to give others time to comment.

I think your suggestion is interesting; however, it implies that the AMA is an opponent of circumcision and that the WHO is an advocate of circumcision, and I think that's OR. I think the AMA and WHO might be offended at being cast in that light. They have made measured statements; they have not stated, as far as I know, that they recommend that people be circumcised or that they recommend that people not be circumcised.(Not sure exactly what they said.)^{(15:07, 24 October 2008 (UTC))} Therefore I think the current format is better; although the last two paragraphs, with the AMA and WHO positions, could be combined into one to reduce the number of paragraphs. I wouldn't shorten the sentences. In any case, having the paragraphs immediately follow the controversy paragraph joins the ideas together reasonably well. Another option might be to join the 3 last paragraphs while keeping the sentences of the last 2 paragraphs in the current order and not mixing them in with the 3rd paragraph; but I think that would make too long a paragraph.

I don't think the AMA and WHO statements "explain why there is a controversy"; I think the last two sentences in the 3rd paragraph explain that, and that the organizations are responding to the controversial situation by taking positions.

One problem with your version is that I don't think we can confidently say that "Virtually all national medical associations do not recommend routine infant circumcision,...": how do we know a new policy wasn't published last week, (or last year, in Chinese or something, and we haven't happened to notice)? And the statement is likely to go out of date. (I think there's something in the Manual of Style about avoiding making statements that will go out of date, but I can't find it at the moment.) The current version, stating that the AMA stated something in 1999, is easily verifiable and will not go out of date. Re "The WHO have recently stated that circumcision could be used to lower the rate of HIV contraction in Africa": see my comment of 23:25, 22 October 2008 on this talk page. ☺ Coppertwig (talk) 14:42, 24 October 2008 (UTC)

Please consider that the USA, with the highest rate of RIC in the developed world has the highest HIV infection rate in the developed world and that the experiments that "prove" circumcision lowers chances of HIV infection could be simply "junk science" with flawed methodology and data manipulation. Circumcision, by removing the penis's natural defense against HIV, Langerhans cells, may increase the risk of HIV infection through heterosexual contact. The science is there but suppressed in the anglophone world. DO YOUR HOMEWORK AND STOP ACTING AS THE PATSY FOR MOHELSOFT AND THE GOMCO CLAMP LOBBY AND RANCID MISSIONARY ANGLO-AMERICAN SEXUAL MORALITY.````

It is not feasible to try and make statements that never go out of date. Article's are continually updated to reflect current changes in the present. I can live with Tremello's and/or Blackworms suggestions however as Jake points out circumcision of adults can also be considered controversial to a lesser extent. Maybe we are going about this the wrong way. Perhaps we should state it in a way that frames the benefits vs the risk. IE . There is much controversy regarding the risks of circumcision versus its benefits. Garycompugeek (talk) 17:49, 24 October 2008 (UTC)

Some statements can be expected to go out of date sooner or to be more likely to go out of date; it's certainly feasible to try to avoid those. I suppose some scholar in the distant future might discover that the AMA hadn't actually stated that in 1999, but let's not worry about such remote scenarios. Re this edit which changes "Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions" to "There is great controversy regarding the risks of circumcision versus its benefits": I agree with Blackworm that we haven't verified that it's the risks and benefits that are controversial; also I don't think we can justify use of the word "great" as NPOV. How about just using the short sentence, "There is controversy."? ☺ Coppertwig (talk) 12:59, 29 October 2008 (UTC)

I think "There is controversy" would be fine, but I'm also quite happy with Blackworm's latest edit, which changes the sentence to read: "There is controversy surrounding circumcision." Jakew (talk) 13:39, 29 October 2008 (UTC)

I was trying to define the controversy but this is acceptable to me. Garycompugeek (talk) 14:22, 29 October 2008 (UTC)

Sorry, I hadn't noticed that; I thought Blackworm had just been reverting to the previous version. Yes, it's fine with just "There is controversy surrounding circumcision". The problem with trying to put more information into the sentence is that it's difficult to word it in a NPOV way. Different sources might express different opinions about how much controversy there is around adult versus baby circumcision; and we don't have many sources stating clearly that there is controversy; for example, I don't think we have anything like that for adult circumcision after the WHO position statement. Looking at stuff that's published that expresses differing opinions and calling it "controversy" could be OR. Also, it's hard to find words to express concisely that there's controversy about infant circumcision and that while there's also controversy about adult circumcision, (or was a couple of years ago anyway), it might be either somewhat less or a lot less controversial although we don't really have a source stating that so it could even be more controversial for all we know. ☺ Coppertwig (talk) 15:02, 29 October 2008 (UTC)