Author Topic: The Sandra Bullock Facial  (Read 1585 times)

zoltani

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The Sandra Bullock Facial
« on: May 22, 2018, 02:04:26 PM »
Sandra Bullock admitted that she uses skin care products containing stem cells from circumcised boys.

What are your thoughts on the ethic and morals of using stem cells derived from foreskin?
Do you agree with circumcision? Why or why not?

What if the tables were turned and they were using female genitalia?

I am personally against the practice. I think that a child is not able to give consent for a procedure that will change his body and sexual organ for life. It is not hard to teach a child to clean his penis. You don't pull out all of the child's teeth because you have to clean them and teach the child to do so.

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #1 on: May 22, 2018, 02:28:00 PM »
1.  Ethically, I think it's less wasteful than simply throwing out the stuff as medical waste.  I'd be surprised to hear that any parents chose to circumcise their child because Sandra Bullock wanted a facial, so think she's probably on solid moral ground.  I'd be even more surprised to hear that there's any real benefit to someone's face from doing this, so the retailers are likely somewhat ethically dubious.  (Also, ewwwwwww.)

2.  Medically, my understanding is that the evidence supports circumcision so I do as well.  The support isn't overwhelming though, so I figure that letting people choose to do what they think best with their child makes sense in this situation.  I certainly wouldn't hold it against someone for choosing one over the other.

3.  There is no equivalent of male circumcision for women, as there are no medical benefits to 'female circumcision'.

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Re: The Sandra Bullock Facial
« Reply #2 on: May 22, 2018, 02:45:42 PM »

2.  Medically, my understanding is that the evidence supports circumcision so I do as well.  The support isn't overwhelming though, so I figure that letting people choose to do what they think best with their child makes sense in this situation.  I certainly wouldn't hold it against someone for choosing one over the other.


I think the letting the individual decide makes sense in this situation.  Let's say this discussion was about parents opting for ear gauges or foot binding for their infant.  We'd say the parent should be locked up.  But if it gentile mutilation...then that makes it okay? 

zoltani

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Re: The Sandra Bullock Facial
« Reply #3 on: May 22, 2018, 03:08:24 PM »
1.  Ethically, I think it's less wasteful than simply throwing out the stuff as medical waste.  I'd be surprised to hear that any parents chose to circumcise their child because Sandra Bullock wanted a facial, so think she's probably on solid moral ground.  I'd be even more surprised to hear that there's any real benefit to someone's face from doing this, so the retailers are likely somewhat ethically dubious.  (Also, ewwwwwww.)

2.  Medically, my understanding is that the evidence supports circumcision so I do as well.  The support isn't overwhelming though, so I figure that letting people choose to do what they think best with their child makes sense in this situation.  I certainly wouldn't hold it against someone for choosing one over the other.

3.  There is no equivalent of male circumcision for women, as there are no medical benefits to 'female circumcision'.

1. You are still supporting non-consensual mutilation of boys. If the market for this continues, and grows due to celebrities hyping it, then there will be pressur eto continue the practice. I think your argument that parents aren't doing because some american actress wants a facial is super weak. In that case why should I care about any atrocities or abuse related to the manufacturing of any product?

2. What is the medical reason? The evidence is pretty weak. I'd suggest you do some research.
In a stable Copenhagen population with on average 10,858 boys born each year between 1996 and 2014, only 53 boys needed a circumcision for medical reasons before age 18 years during the calendar year 2014. This indicates that approximately 99.5% of Danish boys will go through infancy, childhood, and adolescence without any medical need to be circumcised (Sneppen & Thorup, 2016 Sneppen, I., & Thorup, J. (2016). Foreskin morbidity in uncircumcised males. Pediatrics, 137. doi: 10.1542/peds.2015-4340 [Crossref], [PubMed], [Web of Science ®], [Google Scholar]).

3. The proponents of female circumcision say it has medical benefits. For example, some say it reduces chances of infection. Sound familiar? Does that make it right?

I think if you want to cite medical reasons why stop there. I hear you can reduce the rate of testicular cancer if you remove the testes at birth!
« Last Edit: May 22, 2018, 03:11:51 PM by zoltani »

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #4 on: May 22, 2018, 06:42:00 PM »
1.  Ethically, I think it's less wasteful than simply throwing out the stuff as medical waste.  I'd be surprised to hear that any parents chose to circumcise their child because Sandra Bullock wanted a facial, so think she's probably on solid moral ground.  I'd be even more surprised to hear that there's any real benefit to someone's face from doing this, so the retailers are likely somewhat ethically dubious.  (Also, ewwwwwww.)

2.  Medically, my understanding is that the evidence supports circumcision so I do as well.  The support isn't overwhelming though, so I figure that letting people choose to do what they think best with their child makes sense in this situation.  I certainly wouldn't hold it against someone for choosing one over the other.

3.  There is no equivalent of male circumcision for women, as there are no medical benefits to 'female circumcision'.

1. You are still supporting non-consensual mutilation of boys. If the market for this continues, and grows due to celebrities hyping it, then there will be pressur eto continue the practice. I think your argument that parents aren't doing because some american actress wants a facial is super weak. In that case why should I care about any atrocities or abuse related to the manufacturing of any product?

There is medical reason to perform a circumcision early on (significant reduction of complications - please see below for links to the research that proves it).

I reject your use of the term 'mutilation'.  Mutilation refers to serious and lasting damage.  Removing a child's foreskin in the vast majority of cases has no lasting negative impact on him as a grown man* in terms of sexual pleasure (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042320/), and in fact confers well researched health benefits (see below). 

*It does appear that circumcision may slightly reduce sexual pleasure of women having sex with circumcised men though.  (https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1464-410x.1999.0830s1079.x)


2. What is the medical reason? The evidence is pretty weak. I'd suggest you do some research.
In a stable Copenhagen population with on average 10,858 boys born each year between 1996 and 2014, only 53 boys needed a circumcision for medical reasons before age 18 years during the calendar year 2014. This indicates that approximately 99.5% of Danish boys will go through infancy, childhood, and adolescence without any medical need to be circumcised (Sneppen & Thorup, 2016 Sneppen, I., & Thorup, J. (2016). Foreskin morbidity in uncircumcised males. Pediatrics, 137. doi: 10.1542/peds.2015-4340 [Crossref], [PubMed], [Web of Science ®], [Google Scholar]).

As you've pointed out, an actual need for circumcision is not too common.  Technically there's no need for most people to be vaccinated either.  However vaccines confer a lifetime of potential benefit to a child.  The evidence is very clear that circumcision is safe, less risky/detrimental when performed during infancy, and carries with it permanent benefits through life.

The evidence is quite strong actually, but some may decide that the benefit is not worth the risks for their child (which seems perfectly reasonable to me):


Quote
Benefits of male circumcision
Urinary tract infection (UTI): A UTI is an infection that affects part of the urinary tract. Of any year of life, UTI in males is most common in the first year, affecting 1%-2% of uncircumcised boys compared to 0.1%-0.2% of boys who are circumcised[22,23]. Risk reduction continues, however, beyond infancy. The most recent meta-analysis (in 2013) noted that over the lifetime 1 in 12 circumcised males experience a UTI compared with 1 in 3 uncircumcised males[22]. Recurrent UTI in particular may lead to renal parenchymal disease[24,25]. While treatment by oral antibiotics can be used for older children and men, an infant with a UTI presents with fever, often leading to blood collection, lumbar puncture, and if UTI is diagnosed, hospitalization to enable intravenous antibiotic administration[26]. Emergence of resistance to most or all antibiotics, including methicillin, will make treatment of UTI more challenging[27-29], including in Australia[30]. Swabs taken under the foreskin of boys aged 7 d to 11 years identified 50 bacterial isolates, most of which were multi-drug-resistant strains[31]. Maternal antibiotic use during pregnancy also increases the risk of resistant pathogens causing early infant UTI[32].

Phimosis: Phimosis is a penile condition where the foreskin cannot be fully retracted over the glans penis. Phimosis affects approximately 10% of uncircumcised adolescent and adult males[33-47]. Even though regular application of steroid creams, which may cause undesirable systemic absorption of glucocorticoids, can be used to alleviate this condition, the definitive treatment is MC. Paraphimosis (a condition in which the foreskin cannot be returned after retraction) is less common, but when it occurs represents a medical emergency because of haemostasis and risk of gangrene[48].

Inflammation: Inflammation of the glans (balanitis) or the foreskin and/or the underlying glans (balanoposthitis) is also common in uncircumcised males and can contribute to secondary phimosis[49-53]. A meta-analysis found circumcised males are at reduced risk of balanitis [odds ratio (OR) = 0.32; 95%CI: 0.20-0.52][54]. A form of penile inflammation, lichen sclerosis, is diagnosed in up to 40% of foreskins removed for phimosis and peaks at around 10 years of age[51,52]. Early infant MC virtually eliminates the risk of lichen sclerosis[53,55]. MC is, moreover, the definitive cure.

Hygiene: Hygiene is less easily attained for an uncircumcised penis[56]. In the more highly populated east coast states of Australia, MC prevalence increases from south to north[20], correlating with the greater frequency of inflammatory conditions and skin irritation in an uncircumcised penis in hotter more humid climates. Candidiasis (thrush) is 60% lower in circumcised Australian men[19].

STIs in men: Several STIs are more prevalent in uncircumcised males[57,58]. These include oncogenic types of human papillomavirus (HPV)[59-65], that are the most common STIs in Australia and New Zealand, just as in the United States, and HSV-2[62,66-69] that is also common. There is a disproportionate burden of these STIs among adolescents and young adults[66].

Randomized controlled trials (RCTs) showed MC reduced infection of men by high-risk HPV by approximately 40%[61-63,70-72]. A meta-analysis in 2012 of 21 observational studies and 2 RCTs of MC found risk reductions in high-risk HPV of 43% and 33%, respectively[73]. A similar result was obtained in an earlier meta-analysis[65]. In one RCT circumcision of heterosexual men was found to reduce flat penile lesions, which typify oncogenic HPV, by 98%[63], and in another RCT viral load was reduced by 95%[72]. In those Australian homosexual men who predominantly practice insertive anal intercourse, protection afforded by MC against the major oncogenic type, HPV16, was 57%[74].

In the case of HSV-2, RCTs have shown MC reduces infection by approximately 30%[68,69,75,76] and a meta-analysis of older observational studies found infection to be 15% lower in circumcised men[67].

Other STIs against which MC affords protection include Trichomonas vaginalis[77], Mycoplasma genitalium[78], syphilis[67,79,80], chancroid[67], genital ulcer disease[81,82] and HIV[83-90]. Coital injuries, which increase risk of HIV infection, are higher in uncircumcised men[91]. In comparable developed countries in which HIV prevalence is low, the prevalence of heterosexually acquired HIV in those with low MC prevalence (the Netherlands and France) was 6 times higher in men and 10 times higher in women compared with Israel, a country having a very high MC prevalence[92].

National HIV statistics for Australia show that after excluding cases from a high prevalence country, the number of cases whose exposure to HIV was attributed to heterosexual contact has increased by 28% over the past decade. In 2013 there were 1236 new diagnoses, 313 (25%) of these being attributed to heterosexual contact (29% of the latter involving individuals born in Australia)[93].

HIV prevalence is high amongst Australian men who have sex with men, but a Sydney study found those adopting an exclusively insertive role during anal intercourse exhibit 89% protection if circumcised[94,95].

In the United States the latest data show approximately 10% of new HIV cases were in men infected heterosexually, with one estimate suggesting that universal infant MC could prevent 2500 HIV infections annually[96]. The increase in HIV infections in African Americans, however, has been faster than in all other groups in the United States[97]. The CDC has recommended MC for HIV prevention in such groups[90]. Such findings indicate an important public health role for early infant MC in developed countries, including Australia and New Zealand[98,99].

It is anticipated that a steep increase in multiple morbidities and drug interactions in aging HIV-infected patients on combination antiretroviral therapy is looming and will lead to a major medical burden[100], suggesting a flow-on of benefits resulting from the ability of MC to reduce HIV cases.

STIs in women: Circumcision of males also partially protects their female sexual partners from oncogenic types of HPV[59,60,101], HSV-2[102], Trichomonas vaginalis[103], bacterial vaginosis[103], Chlamydia trachomatis[104] and syphilis[79]. MC, by reducing HIV prevalence in heterosexual men, will help reduce HIV prevalence in women[105] and children[106]. Other STIs that MC protects against include ones that exacerbate HIV risk[107-110].

The impact of condoms on STIs: Condoms are 80% protective against HIV infection, but must be used consistently and correctly[111,112]. A Cochrane systematic review and meta-analysis of RCTs of condom use (two in the United States, one in England and four in Africa) found, however, “little clinical evidence of effectiveness” and no “favorable results” for HIV prevention[113]. This study did, however, find condoms exhibited 42% effectiveness against syphilis[113]. Unlike condoms, MC is a one-off procedure that does not require future voluntary compliance each time a man has sexual intercourse. In this respect MC can thus be compared with vaccination. However, the only vaccines currently in widespread use for STIs are those that protect against certain types of HPV (discussed below). Nevertheless both MC and condom use should be advocated[98].

Genital cancers: Penile cancer affects approximately 1 in 1000 uncircumcised men over the lifetime, thus making it uncommon, but not rare[2,114,115]. Infant MC reduces penile cancer later in life by 95%-99%[116-118]. Prevalence was 22-fold higher in uncircumcised men in a United States study[116]. MC appeared to afford lesser protection in a meta-analysis[119], although the inclusion of men circumcised as part of their treatment for penile cancer meant the level of protection was under-estimated. Oncogenic HPV is found in one-quarter to one-half of penile cancers[73,114,120], prevalence varying with type of penile lesion[121]. Based on meta-analyses of risk factors, phimosis increases risk of penile cancer 12.1-fold (95%CI: 5.57-26.2), balanitis increases risk 3.82-fold (95%CI: 1.61-9.06) and smegma is associated with a 3.04-fold (95%CI: 1.29-7.16) increase in risk[114]. Each of these conditions is much more common in uncircumcised males. Vaccination of boys against HPV16 and HPV18 may, under the most optimistic of scenarios, reduce penile cancer by 35%[115]. Vaccination, MC, consistent condom use and monogamy should all be advocated to achieve maximum protection.

For prostate cancer, MC prior to sexual debut reduces prevalence by 15%-50%[115,122-124]. The significant protective effect was confirmed in a recent meta-analysis[125]. In countries globally in which MC prevalence is greater than 80%, prostate cancer-related mortality, corrected for potential confounding factors, is half that of countries with a low or intermediate MC prevalence[126].

Cervical cancer is 10 times more common than penile cancer. This malignancy is up to 5 times more prevalent in women whose male partner is uncircumcised[59,60]. Since virtually all cases of cervical cancer are caused by oncogenic types of HPV, the ability of MC to reduce transmission of high-risk HPV to women[59,60,101] accounts for its protective effect against this commonly fatal and difficult to treat cancer. While prophylactic HPV vaccination of 12-13 years old girls can attenuate, but not eliminate, their future risk, vaccine uptake has not been universal. Current vaccines do not protect against all oncogenic HPV types, but only types HPV16 and HPV18 seen in approximately 70% of cervical cancers. Vaccination has a smaller effect against vulval epithelial neoplasia[127], oncogenic HPV types being present in only half of cases. There is uncertainty about the long-term durability of the benefits of vaccination. Although introduction of a nonavalent HPV vaccine, which will protect against additional high-risk types 31, 33, 45, 52 and 58 (meaning approximately 90% coverage), should further reduce cervical cancer prevalence, concerns about breadth of protection, adherence and long-term immunity will remain.

Therefore a benefit from MC remains, both for males and for their female sexual partners, in partial protection against genital cancers. In Australia, universal MC would prevent 2800-8400 cancers, comprising 2400-8000 of the prostate, 67 of the penis and 350 of the cervix annually[115].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296634/


Quote
Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved.
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020298


Quote
The single risk factor of lack of circumcision confers a 23.3% chance of urinary tract infection during the lifetime. This greatly exceeds the prevalence of circumcision complications (1.5%), which are mostly minor. The potential seriousness of urinary tract infection supports circumcision as a desirable preventive health intervention in infant males.
https://www.jurology.com/article/S0022-5347(12)05623-6/fulltext


Quote
The American Urological Association, Inc.® (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks. Neonatal circumcision is generally a safe procedure when performed by an experienced operator. There are immediate risks to circumcision such as bleeding, infection and penile injury, as well as complications recognized later that may include buried penis, meatal stenosis, skin bridges, chordee and poor cosmetic appearance. Some of these complications may require surgical correction. Nevertheless, when performed on healthy newborn infants as an elective procedure, the incidence of serious complications is extremely low. The minor complications are reported to be three percent.

Properly performed neonatal circumcision prevents phimosis, paraphimosis and balanoposthitis, and is associated with a markedly decreased incidence of cancer of the penis among U.S. males. In addition, there is a connection between the foreskin and urinary tract infections in the neonate. For the first three to six months of life, the incidence of urinary tract infections is at least ten times higher in uncircumcised than circumcised boys. Evidence associating neonatal circumcision with reduced incidence of sexually transmitted diseases is conflicting depending on the disease. While there is no effect on the rates of syphilis or gonorrhea, studies performed in African nations provide convincing evidence that circumcision reduces, by 50-60 percent, the risk of transmitting the Human Immunodeficiency Virus (HIV) to HIV negative men through sexual contact with HIV positive females. There are also reports that circumcision may reduce the risk of Human Papilloma Virus (HPV) infection.
https://www.auanet.org/guidelines/circumcision


Quote
Recent studies have found that circumcision may provide relative benefits including the potential prevention of UTIs (urinary tract infections) in infancy. Among adults in developing countries where the prevalence of sexually transmitted disease is high, circumcision reduces the risk of HIV/AIDS, syphilis and chancroid. In developed countries, circumcision may decrease the lifetime risk of penile cancer in men and cervical cancer in women among high-risk populations later in life. Despite these potential benefits, evidence must be placed in the context of study settings, local prevalence rates, timing of circumcision and cultural and religious beliefs. It should also be highlighted that circumcision provides only partial protection from the above conditions and there is a need for proper hygiene of the penis. Safe sexual practices are still essential and should not be replaced by circumcision.
Quote
Circumcision provides some benefit in preventing UTI in boys, particularly in those with underlying anatomical anomalies of the urogenital tract. In low prevalence populations such as Australia and New Zealand circumcision does not provide significant protection against STIs and HIV, and is less effective than safe sex practices. Circumcision decreases the risk of penile cancer probably by preventing phimosis.Circumcision may offer protection against development of cervical cancer in high risk populations, but is overshadowed as a protective measure by HPV vaccines.
https://www.racp.edu.au/docs/default-source/advocacy-library/circumcision-of-infant-males.pdf


3. The proponents of female circumcision say it has medical benefits. For example, some say it reduces chances of infection. Sound familiar? Does that make it right?

I'm not terribly familiar with female circumcision (I thought that it was all clitorodectomies) or the evidence touting benefits.  Can you please provide me some of the peer reviewed medical articles that recommend it?

The evidence pretty clearly indicates that male circumcision has medical benefits.  Because of that I'd recommend it if someone asked my opinion, but am also fine with a person who isn't comfortable with it.


I think if you want to cite medical reasons why stop there. I hear you can reduce the rate of testicular cancer if you remove the testes at birth!

There's typically a weighing of risk/reward when choosing to recommend a procedure.  There are significant and common disadvantages (ranging from hormonal and growth problems to sexual function) to removing the testes.  According to the evidence (please read some of the links I've posted above) these are quite rare when considering circumcision.

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #5 on: May 22, 2018, 06:45:00 PM »

2.  Medically, my understanding is that the evidence supports circumcision so I do as well.  The support isn't overwhelming though, so I figure that letting people choose to do what they think best with their child makes sense in this situation.  I certainly wouldn't hold it against someone for choosing one over the other.


I think the letting the individual decide makes sense in this situation.  Let's say this discussion was about parents opting for ear gauges or foot binding for their infant.  We'd say the parent should be locked up.  But if it gentile mutilation...then that makes it okay?

I mentioned this in my previous post, but will do so again . . . circumcision as an infant carries with it significantly reduced risks.

Quote
The timing of MC is crucial. Medical and practical considerations point to the neonatal period as the ideal time[54]. A neonate is less mobile, is amenable to any intervention, surgical risk is minimal and the health benefits conferred begin immediately[2,54]. The CDC pointed to a study that found the first week post-partum to be the best time for MC because pain using local anesthesia is negligible[148], possibly because this period precedes the foreskin growth, thickening and increased vascularization starting in week 4 and ending at 4 mo of age[149]. Failure to circumcise early in infancy means loss of the benefit of protection against UTIs that result in considerable pain and can cause kidney damage[22]. It is not correct to suggest that MC is comparable at any age[146]. Later circumcision is a more substantial, more expensive operation, carries a higher risk of complications, entails risk from general anesthesia (as is often used for older boys and men), healing time in longer and cosmetic outcome is diminished by use of sutures[2,54]. If the adolescent or adult male normally engages in sexual activity temporary sexual abstinence for 6 wk is required, which some males and their sexual partners find challenging. Education or employment is interrupted, and there is a delay in protection against STIs if the male is sexually active[2,54]. Such barriers in older males reduce the likelihood that MC will occur. Furthermore, an adult cannot consent in retrospect to his own MC as an infant[146].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296634/

Telecaster

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Re: The Sandra Bullock Facial
« Reply #6 on: May 22, 2018, 09:10:54 PM »

I mentioned this in my previous post, but will do so again . . . circumcision as an infant carries with it significantly reduced risks.


I'll wager castration as an infant carries with it significantly reduced risks.  Amputation of leg too for that matter.  Does that give you the right to do it?

TheWifeHalf

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Re: The Sandra Bullock Facial
« Reply #7 on: May 22, 2018, 09:32:08 PM »
We had our 2 boys circumcised. Why? I left the decision up to TheHusbandHalf and he decided they should look like him.
OK, they were circumcised.

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Re: The Sandra Bullock Facial
« Reply #8 on: May 22, 2018, 09:38:08 PM »

I mentioned this in my previous post, but will do so again . . . circumcision as an infant carries with it significantly reduced risks.


I'll wager castration as an infant carries with it significantly reduced risks.  Amputation of leg too for that matter.  Does that give you the right to do it?

That's a good point, the foreskin and a leg are very similar in terms of usefulness and there are well established medical benefits to removing both of them.

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #9 on: May 23, 2018, 07:27:52 AM »

I mentioned this in my previous post, but will do so again . . . circumcision as an infant carries with it significantly reduced risks.


I'll wager castration as an infant carries with it significantly reduced risks.  Amputation of leg too for that matter.  Does that give you the right to do it?

I was hoping that when Zoltani brought up a similar false equivalence (https://en.wikipedia.org/wiki/False_equivalence) and it was responded to, that would be the last we would see of the logical fallacy.  It appears not.  Since this appears to be difficult for some to grasp I'll attempt to spell it out even more clearly:

Castration/removing the testes is rather different than circumcision.
Amputation of a leg is also rather different than circumcision.

They differ in likely outcome for the person, they differ in risk, they differ in impact upon life, they differ in proven medical benefits.

Comparing amputation to circumcision is about as valid an argument as comparing cutting hair with circumcision.

daverobev

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Re: The Sandra Bullock Facial
« Reply #10 on: May 23, 2018, 09:04:42 AM »
@GuitarStv it would appear that those in favour of circumcision are generally from a culture where it is, or was, the norm.

As this random link says https://goodmenproject.com/featured-content/the-good-life-why-do-we-still-circumcise-boys/

there are plenty of counters to the research saying it isn't a bad idea to do routinely.

UTI - can be treated with antibiotics.

My feeling is the same as with any other choice - it should be left up to the person in question, when they are old enough to make the decision. There is just - in most, nearly all - cases no reason to circumcise. There is a 'reduction in function' - sexual function - in a lot of cases, so I would say it does certainly have a potential for a significant impact.

I wouldn't choose to do any cosmetic surgery on my children, and IMHO that is what circumcision is.

I will admit to feeling VERY strongly that it should not be done unless medically necessary - I just don't feel the parent has that right, I don't feel the parent should feel they have that right; it goes against my belief of what a parent's job is.

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Re: The Sandra Bullock Facial
« Reply #11 on: May 23, 2018, 09:41:37 AM »
Insert pun about skin care "tips."

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #12 on: May 23, 2018, 09:48:35 AM »
there are plenty of counters to the research saying it isn't a bad idea to do routinely.

UTI - can be treated with antibiotics.

Sure.  UTIs can be treated with antibiotics.  By the same token, most people will survive mumps without even needing a special treatment.  We still routinely vaccinate against it though, because the evidence shows that it confers a net benefit.  Just like there's a net benefit to not having to pump an infant full of antibiotics (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489621/, https://www.sciencenews.org/blog/growth-curve/antibiotics-early-life-may-have-lingering-effects, http://pmj.bmj.com/content/80/942/196).


There is a 'reduction in function' - sexual function - in a lot of cases, so I would say it does certainly have a potential for a significant impact.

This 'reduction in function' in 'a lot of cases' is not indicated by the research that I've linked above.  Can you provide the research that you're basing your claims on?


I wouldn't choose to do any cosmetic surgery on my children, and IMHO that is what circumcision is.

Cosmetic surgery is surgery performed to enhance the cosmetic appearance, especially to remove a scar, birthmark, or normal evidence of aging.  This is not a remotely accurate description of circumcision.  I don't believe that circumcision enhances the appearance of a man's genitals, and certainly wouldn't recommend it for that reason.


My feeling is the same as with any other choice - it should be left up to the person in question, when they are old enough to make the decision. There is just - in most, nearly all - cases no reason to circumcise.

I will admit to feeling VERY strongly that it should not be done unless medically necessary - I just don't feel the parent has that right, I don't feel the parent should feel they have that right; it goes against my belief of what a parent's job is.

How do you feel about vaccinating a child without waiting for consent (like the mumps vaccine mentioned above)?  A vaccine is almost never medically necessary, it just confers benefits upon a child through life . . . much like circumcision.  Most children are routinely vaccinated without their consent (indeed, many children get quite upset while being vaccinated).

Waiting until a child is grown to do a circumcision is taking away a child's choice too.  As has been mentioned, the complications and risks are significantly higher when a child is grown.



I don't feel particularly strongly about this one way or the other, but the balance of evidence appears to point to a medical benefit for circumcising a child.  It's not the biggest benefit, but it does exist and has been proven.  If you choose not to do this for your child that's fine . . . but do it because you've objectively weighed the risks and benefits.  Not because you've been listening to emotionally charged language about 'cosmetic surgery', 'mutilation' and comparing circumcision to amputation.

zoltani

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Re: The Sandra Bullock Facial
« Reply #13 on: May 23, 2018, 10:40:19 AM »
Speaking of false equivalences how can you bring up vaccinations. There is an obvious difference between permanently altering a child's body and sticking them with a needle.

I suggest reading this which touches on all of your arguments GuitarSTV.
http://blog.practicalethics.ox.ac.uk/2018/04/should-iceland-ban-circumcision-a-legal-and-ethical-analysis/

From the above link:
Health benefits that have been attributed to male circumcision include a reduction in the risk of acquiring a urinary tract infection (UTI) in early childhood, some sexually transmitted infections (STIs) after sexual debut, and penile cancer later in life. With respect to UTIs, boys with normally developing anatomy have a low risk of infection regardless of circumcision status—far lower than the risk for girls after the first few months of life—and these can typically be cured with antibiotics, just as they are for girls. Penile cancer is rare in developed countries, such that, according to the American Academy of Pediatrics (AAP), it would take between 909 and 322,000 circumcisions to prevent a single case. Most of the reliable evidence suggesting a reduced risk of STIs comes from studies of adult, voluntary circumcision in third world countries whose applicability to circumcision of infants in other contexts is unclear. Moreover, STIs are not a relevant health risk to children who are not sexually active. In light of alternative, less invasive means of achieving the above-mentioned health benefits, including basic hygiene and the adoption of safe sex practices, relevant health authorities worldwide generally agree that the potential medical advantages of non-voluntary childhood circumcision in developed countries are not sufficient to offset the costs, harms, and other disadvantages associated with the surgery in those contexts, some of which may be subjective in nature and therefore difficult to quantify. Thus, none of the paediatric or other medical bodies that have issued formal policies on routine neonatal circumcision consider the health benefits of the surgery to exceed the risks, regardless of the metric used. The sole exception to this is the AAP, whose 2012 policy is now expired. After considerable international criticism from experts in epidemiology and children’s health, including heads and representatives of national medical societies in England, mainland Europe, and Canada, a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology.
http://euromind.global/en/brian-d-earp-and-rebecca-steinfeld/?lang=en


And from your country we get: "Canadian Paediatric Society does not recommend the routine circumcision of every newborn male."
https://www.cps.ca/en/documents/position/circumcision

When my pediatrician asked if I was circumcision my son and I said no he said "good, we don't like to do that anymore." Maybe he is just emotional about it, or maybe he is a doctor that has research the risks/benefits and has decided it is not worth the supposed benefits.
 

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #14 on: May 23, 2018, 11:02:04 AM »
Speaking of false equivalences how can you bring up vaccinations. There is an obvious difference between permanently altering a child's body and sticking them with a needle.

Please re-read my post.  I don't believe or claim that circumcision is equivalent to vaccination.  The similarity lies in the fact that both are medical unnecessary procedures that confer potential health benefits and are routinely performed on children without consent.


I suggest reading this which touches on all of your arguments GuitarSTV.
http://blog.practicalethics.ox.ac.uk/2018/04/should-iceland-ban-circumcision-a-legal-and-ethical-analysis/

From the above link:
Health benefits that have been attributed to male circumcision include a reduction in the risk of acquiring a urinary tract infection (UTI) in early childhood, some sexually transmitted infections (STIs) after sexual debut, and penile cancer later in life. With respect to UTIs, boys with normally developing anatomy have a low risk of infection regardless of circumcision status—far lower than the risk for girls after the first few months of life—and these can typically be cured with antibiotics, just as they are for girls. Penile cancer is rare in developed countries, such that, according to the American Academy of Pediatrics (AAP), it would take between 909 and 322,000 circumcisions to prevent a single case. Most of the reliable evidence suggesting a reduced risk of STIs comes from studies of adult, voluntary circumcision in third world countries whose applicability to circumcision of infants in other contexts is unclear. Moreover, STIs are not a relevant health risk to children who are not sexually active. In light of alternative, less invasive means of achieving the above-mentioned health benefits, including basic hygiene and the adoption of safe sex practices, relevant health authorities worldwide generally agree that the potential medical advantages of non-voluntary childhood circumcision in developed countries are not sufficient to offset the costs, harms, and other disadvantages associated with the surgery in those contexts, some of which may be subjective in nature and therefore difficult to quantify. Thus, none of the paediatric or other medical bodies that have issued formal policies on routine neonatal circumcision consider the health benefits of the surgery to exceed the risks, regardless of the metric used. The sole exception to this is the AAP, whose 2012 policy is now expired. After considerable international criticism from experts in epidemiology and children’s health, including heads and representatives of national medical societies in England, mainland Europe, and Canada, a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology.
http://euromind.global/en/brian-d-earp-and-rebecca-steinfeld/?lang=en

Thanks for the link to this blog, I'll give it a read through when I've got time.


And from your country we get: "Canadian Paediatric Society does not recommend the routine circumcision of every newborn male."
https://www.cps.ca/en/documents/position/circumcision

This quotation was taken out of context and as such distorts the position of the Canadian Pediatric Society.  If you include the two paragraphs previous:

Quote
Current evidence indicates that there are potential health benefits associated with male circumcision, particularly in high-risk populations. Infant circumcision reduces the incidence of UTI in young boys and eliminates the need for medical circumcision in later childhood to treat recurrent balanoposthitis, paraphimosis and phimosis. Circumcised men have a lower risk of developing penile cancer, while the incidence of trichomonas, bacterial vaginosis and cervical cancer in the female partners of circumcised men is also reduced. Circumcision in adult men can reduce the risk of acquiring an STI (specifically HIV, HSV and HPV). Minor complications of circumcision can occur, although severe complications are rare. The risk of complications is lower in infants than in older children. The complication rate decreases significantly when the procedure is performed by experienced health care professionals, with close follow-up in the days postprocedure to ensure that bleeding does not increase. It is important to remember that most data regarding the benefits and outcomes following circumcision come from countries other than Canada, which can make application to our population difficult.

Because the medical risk:benefit ratio of routine newborn male circumcision is closely balanced when current research is reviewed (Table 1), it is challenging to make definitive recommendations for the entire male newborn population in Canada. For some boys, the likelihood of benefit is higher and circumcision could be considered for disease reduction or treatment. Health care professionals should provide parents with the most up-to-date, unbiased and personalized medical information available so that they can weigh the specific risks and benefits of circumcising their son in the context of familial, religious and cultural beliefs. Having the right information will enable them to make the best decision for their boys. Decision aids based on current medical information can be helpful.]Current evidence indicates that there are potential health benefits associated with male circumcision, particularly in high-risk populations. Infant circumcision reduces the incidence of UTI in young boys and eliminates the need for medical circumcision in later childhood to treat recurrent balanoposthitis, paraphimosis and phimosis. Circumcised men have a lower risk of developing penile cancer, while the incidence of trichomonas, bacterial vaginosis and cervical cancer in the female partners of circumcised men is also reduced. Circumcision in adult men can reduce the risk of acquiring an STI (specifically HIV, HSV and HPV). Minor complications of circumcision can occur, although severe complications are rare. The risk of complications is lower in infants than in older children. The complication rate decreases significantly when the procedure is performed by experienced health care professionals, with close follow-up in the days postprocedure to ensure that bleeding does not increase. It is important to remember that most data regarding the benefits and outcomes following circumcision come from countries other than Canada, which can make application to our population difficult.

Because the medical risk:benefit ratio of routine newborn male circumcision is closely balanced when current research is reviewed (Table 1), it is challenging to make definitive recommendations for the entire male newborn population in Canada. For some boys, the likelihood of benefit is higher and circumcision could be considered for disease reduction or treatment. Health care professionals should provide parents with the most up-to-date, unbiased and personalized medical information available so that they can weigh the specific risks and benefits of circumcising their son in the context of familial, religious and cultural beliefs. Having the right information will enable them to make the best decision for their boys. Decision aids based on current medical information can be helpful.

it offers a more clear understanding of their position.


When my pediatrician asked if I was circumcision my son and I said no he said "good, we don't like to do that anymore." Maybe he is just emotional about it, or maybe he is a doctor that has research the risks/benefits and has decided it is not worth the supposed benefits.

Or maybe he knew that his job (for this particular issue) is to do whatever you tell him to, not to attempt to talk you out of what you've already decided upon.
« Last Edit: May 23, 2018, 11:04:20 AM by GuitarStv »

daverobev

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Re: The Sandra Bullock Facial
« Reply #15 on: May 23, 2018, 12:17:37 PM »
there are plenty of counters to the research saying it isn't a bad idea to do routinely.

UTI - can be treated with antibiotics.

Sure.  UTIs can be treated with antibiotics.  By the same token, most people will survive mumps without even needing a special treatment.  We still routinely vaccinate against it though, because the evidence shows that it confers a net benefit.  Just like there's a net benefit to not having to pump an infant full of antibiotics (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489621/, https://www.sciencenews.org/blog/growth-curve/antibiotics-early-life-may-have-lingering-effects, http://pmj.bmj.com/content/80/942/196).


There is a 'reduction in function' - sexual function - in a lot of cases, so I would say it does certainly have a potential for a significant impact.

This 'reduction in function' in 'a lot of cases' is not indicated by the research that I've linked above.  Can you provide the research that you're basing your claims on?


I wouldn't choose to do any cosmetic surgery on my children, and IMHO that is what circumcision is.

Cosmetic surgery is surgery performed to enhance the cosmetic appearance, especially to remove a scar, birthmark, or normal evidence of aging.  This is not a remotely accurate description of circumcision.  I don't believe that circumcision enhances the appearance of a man's genitals, and certainly wouldn't recommend it for that reason.


My feeling is the same as with any other choice - it should be left up to the person in question, when they are old enough to make the decision. There is just - in most, nearly all - cases no reason to circumcise.

I will admit to feeling VERY strongly that it should not be done unless medically necessary - I just don't feel the parent has that right, I don't feel the parent should feel they have that right; it goes against my belief of what a parent's job is.

How do you feel about vaccinating a child without waiting for consent (like the mumps vaccine mentioned above)?  A vaccine is almost never medically necessary, it just confers benefits upon a child through life . . . much like circumcision.  Most children are routinely vaccinated without their consent (indeed, many children get quite upset while being vaccinated).

Waiting until a child is grown to do a circumcision is taking away a child's choice too.  As has been mentioned, the complications and risks are significantly higher when a child is grown.



I don't feel particularly strongly about this one way or the other, but the balance of evidence appears to point to a medical benefit for circumcising a child.  It's not the biggest benefit, but it does exist and has been proven.  If you choose not to do this for your child that's fine . . . but do it because you've objectively weighed the risks and benefits.  Not because you've been listening to emotionally charged language about 'cosmetic surgery', 'mutilation' and comparing circumcision to amputation.

I came to my own conclusions about it, thanks. I consider it cosmetic surgery; I will absolutely concede that if it helps stop the spread of HIV where unprotected sex is rampant (Africa), then it makes some sense... perhaps. But the comparison to a vaccine is silly. The general outcome of a circumcision is a change in look, and not much else - for many/most. That is cosmetic. Whether you consider it more or less attractive is moot; 'because that's how a penis should look' is *basically* the reason people do it. In a western country there is a tiny reduction in cancer, maybe. People getting circumcisions doesn't stop a plague of uncircumcised penises (or anything else); a mumps vaccination for the population DOES stop a plague of mumps.

https://www.circinfo.org/Circumcision_and_sexual_function.html has various links to things. I have no way of knowing if http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=55256#.VScSRqZ5gmY is 'good' or not. But it does seem to argue that those saying there is NOT a change in sexual function twisted their data.

The wikipedia article says there is nowhere that either bans circumcision, nor anywhere that mandates it. It seems to be that the medical profession says 'eh, doing it won't kill you; not doing it won't kill you either', which leads to my conclusion - unless you have a reason TO cut a chunk of your baby off, why the hell would you? It'd be like cutting the nipples off. Or giving them a tattoo.

alanB

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Re: The Sandra Bullock Facial
« Reply #16 on: May 23, 2018, 01:22:55 PM »
Comparing amputation to circumcision is about as valid an argument as comparing cutting hair with circumcision.

I think a better comparison would be to treatment of polydactyly (extra digits), where an extra finger/toe might not cause any true medical problems but is removed anyway.  Somehow I consider that to be more severe mutilation, yet I am more comfortable with that than circumcision... it is funny how we rationalize things.

https://en.wikipedia.org/wiki/Prevalence_of_circumcision
Overall circumcision rate has been declining in western countries, and the #1 predictor of incidence is whether the father is circumcised, so it will probably continue to decline.  Also an important factor is whether the procedure is covered by insurance.  If you were going to max out your deductible anyway it might make sense to throw in the circumcision.

I thought this part of the wiki article was interesting as a contrasting trend:
Quote
South Korea
Circumcision is largely a modern-day phenomenon in South Korea. While the rate in the twentieth century has been nearing 80%, virtually no circumcision was performed just a century ago, as it was against Korea's long and strong tradition of preserving the body as a gift from parents.[31] A 2001 study of 20-year-old South Korean men found that 78% were circumcised.[32] At the time, the authors commented that "South Korea has possibly the largest absolute number of teenage or adult circumcisions anywhere in the world. Because circumcision started through contact with the American military during the Korean War, South Korea has an unusual history of circumcision."

So if you are circumcised you probably belong to at least one of these categories: American, African, Muslim, Jewish, Korean. 

craiglepaige

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Re: The Sandra Bullock Facial
« Reply #17 on: May 23, 2018, 01:33:50 PM »

I mentioned this in my previous post, but will do so again . . . circumcision as an infant carries with it significantly reduced risks.


I'll wager castration as an infant carries with it significantly reduced risks.  Amputation of leg too for that matter.  Does that give you the right to do it?


Yeah, cause that's about the same.
WTF.

Johnez

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Re: The Sandra Bullock Facial
« Reply #18 on: May 23, 2018, 01:52:31 PM »
Medically unnecessary
Cosmetic value

Why the hell am I going to pay $200 (or whatever it is) to cut a piece of my boy off? I think if people stopped to think about what the decision entails rather than going along because that's what everyone else does-circumsision wouldn't be "a thing." A complete waste if you ask me.

Glenstache

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Re: The Sandra Bullock Facial
« Reply #19 on: May 23, 2018, 01:55:16 PM »
Argument by analogy is rarely useful. People often just argue about if the analogy is correct rather than being specific to the issue at hand.

If circumcision were purely for cultural or religious reasons (which in some cases it is), then it is probably something that can be argued about and I would lean in the side of not doing it. If it is an elective procedure that has clear medical benefits that outweigh the downsides and is done for those reasons, then I think there is a lot more merit.

In reality, it is a cultural thing that has some medical benefit which is somewhat negated by modern medicine (though I've had friends who are not circumsized have some not so great infections as a result). Circumsion is not nearly the same order of disfigurement that FGM represents. Just not even close.

This is something that can be done later in life, so I would lean towards leaving it for age of informed consent, but also don't feel the severity of it is huge.

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #20 on: May 23, 2018, 01:57:30 PM »
Comparing amputation to circumcision is about as valid an argument as comparing cutting hair with circumcision.

I think a better comparison would be to treatment of polydactyly (extra digits), where an extra finger/toe might not cause any true medical problems but is removed anyway.  Somehow I consider that to be more severe mutilation, yet I am more comfortable with that than circumcision... it is funny how we rationalize things.

That is a good example.  I think I'd be far more inclined to get the extra finger or toe that's not causing my kid any harm removed too, and that is a purely cosmetic thing.

mm1970

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Re: The Sandra Bullock Facial
« Reply #21 on: May 23, 2018, 02:28:30 PM »
For the most part, it's cosmetic surgery.  Nearly everyone I know who has had it done ONLY has the reason of "to look like his dad", and this is in granola crunching California.  We were quite shocked to discover we were the only parents who opted to keep our child intact out of our birthing class, being that we are transplants to the state.  There really is no point to it in the vast majority of cases.  Of course, we have relatives in Europe where it's not really done routinely, so that affected our opinions - if it's not broke, don't fix it.

As it happens, I have several friends who have boys younger than my older son, and they asked me which doctor we used, and I said "none".  Three friends had to use the "backup" doctor in the practice, because the main guy was on vacation.  All three had complications and ended up back in the hospital with their infants due to infections or having to correct a mistake.

Lest anyone think I'm incredibly hardcore, kid #2 was born with a birth defect (hypospadias with chordee) that required surgery at the age of 9 months.  The standard method of surgery requires use of the foreskin to do the penile repair, though there is another method that keeps most of it (whatever there was in the first place, which was not much) intact.  As our surgeon performed the "standard" method weekly, and the other method only 4-5 times total in his practice, we opted for the standard every day surgery.

So one of my kids is intact, the other is not.

DreamFIRE

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Re: The Sandra Bullock Facial
« Reply #22 on: May 23, 2018, 05:23:16 PM »
Yeah, the procedure should be done.  I fully support that.

GuitarStv

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Re: The Sandra Bullock Facial
« Reply #23 on: May 24, 2018, 09:12:34 AM »
http://blog.practicalethics.ox.ac.uk/2018/04/should-iceland-ban-circumcision-a-legal-and-ethical-analysis/

From the above link:
Health benefits that have been attributed to male circumcision include a reduction in the risk of acquiring a urinary tract infection (UTI) in early childhood, some sexually transmitted infections (STIs) after sexual debut, and penile cancer later in life. With respect to UTIs, boys with normally developing anatomy have a low risk of infection regardless of circumcision status—far lower than the risk for girls after the first few months of life—and these can typically be cured with antibiotics, just as they are for girls. Penile cancer is rare in developed countries, such that, according to the American Academy of Pediatrics (AAP), it would take between 909 and 322,000 circumcisions to prevent a single case. Most of the reliable evidence suggesting a reduced risk of STIs comes from studies of adult, voluntary circumcision in third world countries whose applicability to circumcision of infants in other contexts is unclear. Moreover, STIs are not a relevant health risk to children who are not sexually active. In light of alternative, less invasive means of achieving the above-mentioned health benefits, including basic hygiene and the adoption of safe sex practices, relevant health authorities worldwide generally agree that the potential medical advantages of non-voluntary childhood circumcision in developed countries are not sufficient to offset the costs, harms, and other disadvantages associated with the surgery in those contexts, some of which may be subjective in nature and therefore difficult to quantify. Thus, none of the paediatric or other medical bodies that have issued formal policies on routine neonatal circumcision consider the health benefits of the surgery to exceed the risks, regardless of the metric used. The sole exception to this is the AAP, whose 2012 policy is now expired. After considerable international criticism from experts in epidemiology and children’s health, including heads and representatives of national medical societies in England, mainland Europe, and Canada, a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology.
http://euromind.global/en/brian-d-earp-and-rebecca-steinfeld/?lang=en

OK, so I had some additional time to read through your blog post.

The argument being made is not that there is no medical benefit to circumcision (as there is demonstrable medical benefit), but that in the opinion of the authors do not believe the benefit is great enough . . . which is a perfectly legitimate opinion to hold.  (I think I've mentioned this several times now.)

Specific to the quoted section above:
- Estimates for UTIs for boys are as high as 1 in 909 and that scientific evidence (previously posted) shows serious problems with prescribing antibiotics to infants.  To give some comparison, the likelihood of contracting typically non-fatal mumps is only 1/500 (http://degreesofclarity.com/writing/mmr/).  Mumps requires no anti-biotics to recover from, and is typically non-fatal . . . but most parents vaccinate for mumps anyway.
- Certainly, STIs are not a concern for the vast majority of children.  However, they are a concern for the vast majority of adults.  Circumcision offers permanent protective benefit for both male and female partners.  By delaying circumcision until a child is fully grown the risks and complications associated with the procedure are significantly increased.  While I'd absolutely argue that people should adopt safe sex practices, it is naive to believe that every person will do so and thus negate the need for additional protection from STIs.
- The following statement:
Quote
none of the paediatric or other medical bodies that have issued formal policies on routine neonatal circumcision consider the health benefits of the surgery to exceed the risks, regardless of the metric used. The sole exception to this is the AAP, whose 2012 policy is now expired. After considerable international criticism from experts in epidemiology and children’s health, including heads and representatives of national medical societies in England, mainland Europe, and Canada, a representative from the AAP Circumcision Task Force acknowledged significant problems with the AAP findings and methodology.
is misleading to incorrect.  While they don't push that everyone get circumcised, they are well aware of the benefits of doing so and will explain them to allow parents to make their own decision.  The CDC (for example) also recommends routine circumcision of children and adult men.

The upshot of all of this is not to convince you what to do.  If you feel strongly one way or the other, go for it.  There are well researched medical benefits to circumcision and very low risks . . . but your kid will probably grow up fine without.  There's a legitimate case to be made for both sides.  In this thread though, people who are anti-circumcision have repeatedly discounted the scientific evidence in favor of emotional rhetoric . . . and that's rather disappointing.

daverobev

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Re: The Sandra Bullock Facial
« Reply #24 on: May 24, 2018, 11:29:51 AM »
In this thread though, people who are anti-circumcision have repeatedly discounted the scientific evidence in favor of emotional rhetoric . . . and that's rather disappointing.

You mean like how we all keep driving petrol powered cars, burning natural gas to heat our homes, destroy forests, despite the fact we pretty much know it is going to cause catastrophic climate change, completely fucking over our (circumcised or uncircumcised) descendants?

Yeah, we do that.