Good catch.

If you believe circumcision is a good thing, by all means do it. If you don’t, than don’t do it. It’s as simple as that. I read much about those who don’t believe in circumcision and they use such rhetoric as amputation, mutilation, etc. Such passion over a minor procedure baffles me unless the detractors of this procedure are trying to convince themselves.

The foreskin, just like the appendix is a useless carryover from our more primitive ancestors as it was designed to protect the glans when our primate ancestors ran through the jungle and like the appendix, in modern times has become unnecessary and many times a health risk.

First of all Willy the appendix is a functional part of the body that from our current understanding helps maintain good bacteria and perhaps aids the immune system. Now then the foreskin is functional as well it reduces friction during intercourse especially the friction associated with penetration, at the end of the foreskin is something call the rigged band which looks and functions like a condom for her pleasure, the foreskin prevents the glans from drying when they dry out they become less sensitive, the foreskin is also filled with roughly 20,000 Meissner's corpucle nerve endings which provide a great deal of pleasure, it has been documented as well that the foreskin decreases the risk of becoming infected with some diseases. Also circumcisions are painful especially for infants who feel more pain than anyone else because that is how their bodies are designed to function which partially explains why infants have been known to go into a shock like state because that is the only way they can deal with the pain of the circumcision.

Now hypothetically lets say that none of what I just said was true and the foreskin is useless and circumcisions are painless it still doesn't change the fact that males of any age have the human rights to freedom from harm, and have the right to body integrity and the only way proxy-consent from a parent can override those rights are if the child's health or life is in danger and potential danger isn't justification enough. So the reason people make such a fuss over parents having circumcisions performed is because it is his body and his rights not his body his parents rights.

Nathan, These revelations about the appendix are recent and suggest that it can harbor safe (or good) bacteria. This is not yet accepted in all scientific circles but is a minor point in this discussion. It is, however, factual to state that people live normally without an appendix so the notion that the appendix is a vestigial organ may not be completely inaccurate. Time and research will tell.

In any event, the benefits of possessing a foreskin are subjective (I have never heard of anyone who regretted being circumcised) and I stand by my original statement, if you want to be circumcised, do so, if you don't, then don't.

Speaking from my own experience, I seriously doubt an infant being circumcised suffers anything more than a very brief bit of discomfort. This notion that circumcision causes great pain and traumatizes the infant is nothing more than another attempt to rationalize your position and I'm not even going to comment on your "freedom from harm" rhetoric.

There are lot of men who feel deep regret, anger and sadness because they were circumcised against their will I personally fall into that category however there are men who feel the same who choose on their own to be circumcised and this is evident by the existence of webpages such as http://www.cirp.org/pages/restore.html websites such as http://www.circumstitions.com/ web forums such as http://www.foreskin-restoration.net/forum/ or organizations such as NORM and Intact America.

Now you say there is just a little discomfort for the infants but can you honestly say that after seeing one? Here are two links to two infant circumcisions.

http://www.youtube.com/watch?v=XmX6RdRNoqk

http://www.youtube.com/watch?v=5MLtxCwdMv0&feature=related

I am not trying to rationalize anything at all I'm just standing up for the rights of male infants because if pricking a girls genitals for religious and/or cultural reasons once is considered female genital mutilation under federal law of the United States and it is considered morally wrong then the act of circumcising a male infant for cultural and/or religious reasons is thus mutilation as well and is thus wrong as well. I really hope one day that you realize this all boils down to human rights and how it is his body and his rights.

Have a good day.

Nathan Powell, I am not condoning nor am I condemning circumcisions. However, a circumcision on an infant doesn't have to be painful. I am a medical student and in part of my preparation to get here, I had to shadow several different physicians. One of the physicians I shadowed was a pediatrician that performed circumcisions when parents requested it (she never suggested it to them). I was able to observe several circumcisions. The infant is strapped in a molded form - this is to keep them still (they tend to move a lot), a warm light is placed above them (the light also helps the physician see better). Then the infant is covered with a blanket the best that he can be to also help warm and comfort him. After this, if the infant is uses a pacifier he is given his pacifier. He is obviously upset at this point because he's being held flat out - but the nurse calms him the best they can before anything else is done. In fact, it is at this point that most of the babies fell asleep or stopped using the pacifier and simply looked around no longer showing fear. The entire time, the nurse talked calmly to the baby. Then the physician numbs the penis with a local anesthetic - the babies I witnessed get circumcised didn't even flinch at the local anesthetic because the nurse had them so relaxed. They waited a bit for the local anesthetic to work. Then the physician performed the circumcision. She used the "plasti-bell procedure". Now, she did say that the attending where she did her residency was a firm believer that infants didn't feel pain - so he did it without a local anesthetic. However, he was no longer in practice (he was older) and every other pediatrician she knew and I knew all used local anesthetic to avoid causing the infant pain. I see no reason they wouldn't feel pain if steps weren't taken to alleviate it. She also gave the infant Tylenol and advised the parents to do the same if he seemed to be feeling pain or discomfort. She also advised how to wash it and watch for infection and if the infant seemed to be in a lot of pain or anything seemed to be wrong to immediately bring him in (if that happened, she didn't require them to have an appointment - they could just walk in). She never had one infant have to be brought in for any complications.

Again, I'm not condoning or condemning circumcision - just pointing out that it doesn't have to be painful if done properly.

One other comment - to compare male circumcision to female genital mutilation is to not understand what female genital mutilation is. Female genital mutilation involves removal of the entire clitoris. Often times it involves removing the labia minora (the inner folds) and sometimes the inner parts of the labia majora (the part that makes the visible mounds). It can also involve stitching the woman closed so that only urine and menstrual flow is able to escape - this actually heals in this manner. You can imagine the first time she has sex with her husband how painful and damaging that would be - they are literally torn back open.The amount taken does vary - but, in the vast majority of cases it involves removal of a lot more tissue than a male circumcision does. Also, I should point out that the term pricking of the clitoris doesn't quite do it justice - you would imagine pricking like if you just barely stuck yourself with a needle or something. In this case, it is done deep enough and in large enough areas to scar the clitoris - it's more of a tearing than a pricking. Keep in mind that the vast majority of places that practice female genital mutilation do so without anesthesia or pain medication of any kind and it is done in an unsterile environment - often with non-surgical tools and/or very unsterile tools. Like a piece of sharped glass, for example. Traditionally, female genital mutilation is performed from ages 4 to 8. Even if it were allowed to be practiced in the US - it wouldn't be performed in a doctor's office in or at home but in a sanitary manner because of the beliefs that support this behavior. The vast majority of these are performed amongst African tribal people and in some middle eastern countries - their religious beliefs dictate who performs the procedure, etc. Furthermore, due to the complications associated with female genital mutilation, the WHO found that FGM increased infant mortality by 15 - 55% (depending on how much tissue had been removed during the procedure) and that it increased the need for a c-section by 30% and postpartum hemorrhage.

Like I said - I'm not condoning or condemning male circumcision. That said, I really wish those that oppose male circumcision would stop comparing it to female genital mutilation. They are vastly different procedures and have significantly different risks associated with them. I actually understand the argument of removing the choice from the male infant by performing the circumcision before he is old enough to make the decision for himself. The argument against that is that parents have the legal right to make medical decisions for their children - including decisions for the purpose of cosmetic procedures. Now, I'm not saying I agree with that - just pointing out the argument from the other side. IMO, they are both valid arguments.

Good post Summer and as you pointed out; the parents have the legal right to make such decisions. I agree that there is absolutely no comparison to female genital mutilation and these days, when performed properly, there is little or no pain associated with circumcision.

I reiterate that I personally have never encountered anyone who regretted being circumcised but according to Nathan there are indeed anguished souls who suffer a spectrum of emotions each time they remember they have no foreskin. In the case of these people I wish there was a way to restore their foreskin so they wouldn’t have to feel “incomplete”.

Nathan presents a passionate argument but is clearly an anti-circumcision activist as his attempt to compare circumcision with female genital mutilation would indicate.

Sadly many doctors still perform circumcisions with no pain killers at all or don't use adequate painkillers and many. Also while there many

What you have described is only one form of female genital mutilation and it is type III and it is the least common but most extreme form practiced with only about 10% of cases of Female Genital Mutilation being of that form. The World Health Organization lists female genital mutilation as follows

Type I: Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).

Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

Type III: Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.

So you can compare male circumcision to type I FGM and/or type IV FGM you just can't go and compare it to type II or type III.

Here is where I got my info if you wish to make sure I'm not lying LINK

I also want to point out that circumcision isn't just done on infants it is done on children and teenagers often with unclean instruments, in unclean environments, without pain killers, and often against their will especially with young children.

Also Willy yeah I am anti-circumcision activist and I am proud of it because I was wronged my body is my own no one had the right to circumcise me and I don't want anyone else to be wronged or to feel any of the pain that do everyday.

Nathan - Actaully, I didn't describe any specific FGM - what I said was that SOME include X, SOME include Y, and SOME include Z. And actually, no you can't compare removing the clitoris to a circumcision. While there are a substantial number of nerve endings in the foreskin of a penis, there is not as many nerve endings in the foreskin of the penis as in the external clitoris. Removal of the clitoris is much more similar to removing the most or all of penis - not just the foreskin. The procedures are entirely different, to compare them as similar is to be uninformed about female anatomy and the procedure of FGM.

Yes, there are draw backs to male circumcision - and I am in no way saying that just because circumcision is not like FGM it is ok to do. I just get really irritated when people try to compare the two vastly different procedures as justification to not do male circumcision. Give reasons to not do male circumcision based on male circumcision - not based on a something it is not comparable to. Advocate allowing the male to decide for himself once he is old enough to make that decision. All of those are much better arguments against circumcision that the misinformed comparison of male circumcision to FGM.

As far as circumcisions on children and teenagers in the US - I know of several men that were circumcised as teenagers - including one of my brothers. Every single one of them had to go to an appointment one day, wait a week, then have the procedure. Every single one of them had to consent to the procedure. Every single one of them had the procedure done in sanitary environments and with sanitary equipment. Could there be exceptions? Sure, and these are wrong.

As far as plenty of doctors doing circumcisions without local anesthesia and post-procedure painkillers - I'm sure there are some. However, I don't know of a single one that does the procedure without these - and I know a lot of physicians. btw, standard of care for performing circumcisions is to do so with local anesthetic and post-procedure painkillers. Physicians NOT following standard of care leave themselves open for liability issues in malpractice.

I got a little emotional I appologize it is a senstive topic for me. I mean no disrespect however you can compare the least destructive forms of female genital mutilation and the least destructive forms of male genital mutilation.

Bringing up points such as its his body his rights is nice but ignoring the fact boys and girls are hurt in similar ways is wrong because it is saying that equal abuse, pain, etc. is somehow unequal because of what someone has between their legs. There have been some women who went through hell you know being mutilated who came to the states or went to Europe and condemned circumcision of boys.

I'm sorry I should have been clear I was not referring not to children and teenagers who are circumcised in the U.S. I was referring to children and teenagers who are circumcised in Africa, the Middle East, and parts of Asia.

Using pain killers might provide some protection for doctors however it is not complete protection but then again doctors rarely get full protection from anything.

You have nothing to apologize for, Nathan! Boys died by the dozens every year due to circumcision in Africa, it simply isn't reported in the American press. As for "which is worse" - there ARE degrees of female genital mutilation, and even a pinprick is illegal in the US for females. But acknowledging degrees of difference in mutilations does not change the immoral ethics of cutting away healthy tissue without the (adult) consent of the person affected; I indict religious as well as non-religious circumcisions for their barbarity. I know of incidents where children and teenagers were forced into circumcisions in the US by their parents; this should be illegal for all ages, genders and religious backgrounds absent a direct urgent medical need. One friend cut in his teens reported a loss of about 30 percent of his sexual sensations. This clearly represents harm to a person, irrespective of gender. It is funny that respondents like WetWilly can only answer rational debate with ridicule; pro-circumcisionists often attack anti-circers as emotional, all the while revealing their near-hysterical defense of their own mutilation. Rather than face what was done to them, they descend into infantile attacks. That alone shows you are on the right side of this debate, Nathan.

Nathan Pannell - I understand why you get emotional over this topic - you've explained how your circumcision has made you feel. If I were you, I'd probably be emotional over it too. As much as you believe least destructive forms are likened to the least destructive forms of male genital mutilation - you are wrong. I can understand why you feel this way; but, there really, truly isn't a comparison. That's why I feel it is a weak argument against male circumcision. In fact, I feel that it is such a weak argument against male circumcision, it ends up hurting your position because people shut out entire arguments when they hear something that is false. Unfortunately, that means your good points get lost.

For example, there have been studies that have indicated that a certain percentage of circumcised men go through the shame, anger and embarrassment, etc. that you have gone through when someone took your choice away from you. IMO, if you want to attach an emotional aspect to the argument against male circumcision - this is much more effective. Women, who are usually the parent to make medical appointments and attend medical appointments with their children, are much likely to get that position and re-think circumcision based on this information. When you attempt to compare male circumcision to female genital mutilation (even the "least severe") forms women tend to get upset about this - the reason is not only because of the method of FGM but also the reasons behind performing FGM vs the modern reasons behind performing male circumcision. Male circumcision for most people today is viewed as a cosmetic procedure; whereas FGM is done specifically to take away sexual pleasure from the woman and is performed in cultures where the woman is often considered property of her father until she is married and then property of her husband.

Realistically, I'm trying to give you some pointers on ways to make your argument more effective when talking to women. Yes, convincing men that circumcision isn't something that must be done is part of it also - and maybe comparing male circumcision to FGM would work good for that audience. But, when you get down to it - it is usually (not always) women that take their children to the physician, they are the one's signing the consent forms (most of the time) - so you need to target women with your arguments. Remembering who your audience is is one of the key factors in convincing them to agree with you. You won't change everyone's mind no matter what you do. But, if you're in a room full of women who have a good understanding about FGM (both methods and reasons for it) - comparing a male circumcision to FGM is probably not the most effective argument. Instead, stick with there is no scientifically supported evidence that a male circumcision is medically beneficial, it reduces sensation for them as adults when they become sexually active, the child isn't making the choice for themselves, talk about the rare, but still real, risks of circumcision (like infections, bleeding, etc.), talk about the studies that have shown that there is a small, but significant, percentage of men that suffer emotionally and/or psychologically because their choice was taken away from them regarding circumcision, etc. I just think those are more effective arguments.

Yes, when you clarified that you were talking about children and teens in Africa, the Middle East and parts of Asia - that makes more sense about the non-sterile environments and tools. IMO, this is flat wrong - ANY procedure of this nature - sanitation of environment and tools are essential. Without proper sanitation the risks of infection so much it's not even funny.

You're right that use of painkillers doesn't completely protect physicians from liability - there are a number of other ways they could screw up a circumcision (or any other procedure for that matter). Not following current standards of care is a big deal though.

Like I've said all along - I'm not really for or against circumcision. I have two boys - both are circumcised because my ex-husband wanted them to be. The main reason I went along with it my younger brother was not circumcised until he was 16. The reason he was circumcised was because he felt weird being the only boy in the locker room that wasn't circumcised - this caused him a lot of emotional stress. The locker rooms had those big communal showers - so everyone saw each other, even if they weren't looking. My brother's experience, combined with my ex's firm belief that they should be circumcised and the relative low risk of having it done prompted me to do it. Now, had my brother been like you and suffered from being circumcised, I probably would've stood firmly against my ex-husband on this issue (and I would've made sure I won).

I agree with you Summer, that many women are turned off by comparisons between FGM and MGM, but historically they have been done for the same purposes. Maimonides specifically states that circumcision is performed to make sex less pleasurable for men, so that they will be more studious instead. And of course we all know about crazy Dr. Kellogg's belief (more widespread at the time than you might think) that masturbation caused a host of ills that can only be prevented by circumcision (physicians may be as likely to believe received cultural wisdom as anyone else). In fact, the medical justifications for male circumcision were also used to justify the (far less common) female mutilation in this country as well; I believe some women were still being operated on in the US well into the twentieth century. Most of the modern medical justifications for male circumcision were developed to replace these outmoded arguments.

One reason why so many intactivists bring up FGM as a comparison is, not because we think it's a great tactic, but because it is so often used against us! I can't tell you how many times, when stating my position, someone has said "if you saw what they did to women in Africa, then you'd really have something to complain about!" Pro-circumcisionists frequently make the comparison first, to belittle the harm of male genital mutilation, and to turn the subject into a joke, so the anti-circ argument can be "safely" ignored. I try to defuse this by arguing that, while cutting off some fingers isn't as bad as cutting off a whole hand, that doesn't make cutting off healthy fingers good.

While it is true that comparing mutilations is not a good tactic, there are still comparisons that can be made, and it is important to be informed rather than just spout "received wisdom"; the form of female genital mutilation that removes labia and the clitoral hood (but not the clitoris) is an exact analogy to male circumcision. The labia are formed from the same infant tissue that will become the foreskin. Female clitoridectomies can most accurately be compared to male castration (or to the practice, in some rare circumstances in the Middle East, of peeling a layer of skin off a man's entire penis and scrotum on his wedding night - hopefully, like clitoridectomies, a practice that soon will no longer exist).

Rachel Stalling's study of FGM women found that they have lower rates of AIDS; this may very well be culturally (not medically) based, but then lower rates of AIDS among circumcised men in Africa may also be culturally based (I'd say that was definitely true, since at least six African countries have HIGHER rates of AIDS among circumcised men). A study of FGM women who emigrated to Italy found that they reported an orgasm from penetrative sex 69% of the time. This is NOT to compare the extent of the harm of male and female mutilation, but rather to make people aware that both FGM and MGM are cultural memes, not medically necessary.

In many African cultures the point of both mutilations is to "purify" the sex; the foreskin is a woman's labia attached to a man, the clitoris is a man's penis attached to a woman - removing both makes the man more male, the woman more female. They don't believe they are controlling or reducing sex, but rather strengthening gender identity.

It is important, I believe, to understand cultural motives for mutilation, as well as medical and religious ones - the only way to purue an argument or position is to be well-informed. However, I think we both agree that the strongest arguments to be made against male circumcision are the direct harm to the male infant and the future man he will become, not comparisons to any other practice.

Actually, no it doesn't mean this study is worth nothing. You start with a base-line of, in this case, uncircumcised men take longer to clear these HPV vaccines, then you add the other variables that you mention individually and then in combinations until you get the full picture. You always have to look at each individually and then together. This allows you to know which of the variables have the most impact, and how the variables work together.

For researchers looking at this yeah this study might help them in some way however for average people it does mean nothing because it is not conclusive.

Nathan Pannell - I agree. In fact, in the article, the authors of this study basically say the same thing. They say that it doesn't explain why circumcised men clear the virus quicker than uncircumcised men - it may have nothing to do with the circumcision, that may just be a correlation not causation. Like with all scientific studies repetition is needed and further investigation to discover the cause is needed.

The sad part with this article is the fact that people even doctors will put the horse in front of the carriage and go off saying things that may or may not be true, that is the main reason why I don't like these types of articles.

I can understand that. I too wish they would hold off on publishing articles in the regular media until they have more substantial information. Also, the media are journalists - and many, many times they get information wrong when creating these articles. You pair that with a general misunderstanding about science - and the general public gets a lot of misinformation.

The study being discussed in the article doesn't say that the risk for contracting HPV is higher for uncircumcised men compared to circumcised men. It says that in their study (which would have to be replicated to determine if it's accurate or if it's just a fluke of their sample group), uncircumcised men didn't clear the HPV virus as quickly as circumcised men. The study in the article and the study you cited are looking at two very different questions that deal with a similar topic.

Summer, did you read the same article I did? Here's a quote: "The researchers had previously found that circumcised men were less likely than their uncircumcised peers to be infected with HPV at a given point in time."

Here's another quote:

"There's evidence that circumcision lowers a man's likelihood of developing cancer of the penis and contracting HPV infection, as well as HIV infection, in some populations. Because partners of uncircumcised men face a higher risk of cervical cancer, it's possible that circumcision could affect the spread of the virus as well, Hernandez and her team note."

The article states categorically that uncircumcised men are more likely to get HPV (and penile cancer) and to transmit HPV (and its attendant cancers) to their female partners than circumcised men. That makes the issue of who actually has and transmits HPV, and who actually gets cancer, vital to this whole study! Since many, perhaps all of their stated presumptions (see my comments above) are wrong, that makes their entire study irrelevant, and the comments from doctors running the study farcically (perhaps tragically) incorrect.

Do you really not understand that the purpose of such biased studies (and articles) is to reinforce infant circumcision in America?

Scott, Yes I read same article.

Let's break down the quotes you posted (and are misinterpreting).

"The researchers had previously found that circumcised men were less likely than their uncircumcised peers to be infected with HPV at a given point in time."

The finding of this study was that uncircumcised men clear the infection slower than circumcised men (154 days vs. 91 days, on average). This quote from the article makes sense. They tested the men every 2 months for 14 months. Now, take a moment to think about this - Day 60 rolls around and the first test is done - since 154 d and 91 d, are both averages, it stands to reason that if you are someone in the group averaging 154 d you have a higher risk of being infected on day 60 (the first test) than someone from the group averaging 91 days, and so on. Basically, saying more uncircumcised men at any given time are infected than circumcised men, makes since in light of the clearance of the virus.

Now let's look at the second quote your posted:

"There's evidence that circumcision lowers a man's likelihood of developing cancer of the penis and contracting HPV infection, as well as HIV infection, in some populations. Because partners of uncircumcised men face a higher risk of cervical cancer, it's possible that circumcision could affect the spread of the virus as well, Hernandez and her team note."

To be fair to you, I wouldn't blame this misinterpretation on you - rather on poor writing on the part of the journalist. You really need to look at these sentences apart because they really aren't related and should have never been put together in a paragraph. So, let's look at the first sentence:

"There's evidence that circumcision lowers a man's likelihood of developing cancer of the penis and contracting HPV infection, as well as HIV infection, in some populations.

The bold emphasis is very important when analyzing this sentence. This sentence is clearly referring to subsets of men. The scientist may have or may not have defined what those subsets were to the journalist. However, there has been studies that have shown in some populations, this is true. HOWEVER, it is not true for the general population. So, any questions and studies arising from this would only, obviously, apply to those subsets of men.

Now, let's look at the second sentence of this quote:

Because partners of uncircumcised men face a higher risk of cervical cancer, it's possible that circumcision could affect the spread of the virus as well, Hernandez and her team note."

Again, I emphasied an important part of this statement. It's possible implies correlation - not causation. This correlation has shown up in studies regarding cervical cancer. The question in regards to this particular issue then becomes, is this a cause, or simply a correlation? This is also an important study.

Now, it is important to take all of these quotes in combination with other aspects of the article. Such as, uncircumcised men clear HPV on average in 154 d., vs 91 d. for circumcised men - and the difference is more pronounced when looking at only the cancer-causing strains when comparing circumcised v. uncircumcised men. It is also very important to not ignore the last sentence in the article: However, they add, "whether circumcision is an effective means of facilitating HPV clearance has yet to be demonstrated."

The data from this study basically shows a reason why some studies have shown a positive correlation between penile cancer and not being circumcised in subsets. The data shows a reason why the studies have shown a correlation between cervical cancer and uncircumcised men. However, it doesn't show any mechanisms that explain this correlation - which is what is needed to show causation. To show causation, they would have to find out what specifically about circumcision reduces penile cancer in some subsets of men and reduces cervical cancer in women. This would require cellular biology studies, RNA and DNA work, possibly immunological studies - these were not part of this study. This study basically is a guidance type study. What I mean by this is it's a study that gives the scientists some direction on what the next step in the grander scheme of things is.

IMO, it's premature reporting and a not so well written article. It wasn't written in a way that clearly indicated this was just another correlation - not a causation. Since it was a correlation, not a causation, it was premature also. Many laypersons assume correlations are causations.

I should add, that at the bottom of this news article, they sited their source as:http://www.journals.uchicago.edu/doi/abs/10.1086/651607 Journal of Infectious Diseases, May 1, 2010.

You know what that tells me? It tells me that the journalist didn't actually speak to the scientist and did their best to interpret the journal article. Which would really explain the misinterpretation since many times the journalist misinterprets the info. When I tried to follow the link it said "The requested article is not currently available on this site." So, I did a PubMed search for the Journal Article. At this time you can only see the abstract. Here's the abstract:

The relationship between circumcision and the acquisition and clearance of human papillomavirus (HPV) infection was examined in a cohort of 357 men followed up at 2-month intervals for an average of 431 days. There were no differences in HPV acquisition by circumcision status. Clearance of HPV infection, including infection with oncogenic types, was slower in the glans/coronal sulcus of the penis of uncircumcised men than circumcised men. The median duration of HPV infection of the glans/coronal sulcus was significantly longer in uncircumcised men (154 days) than circumcised men (91 days) ([Formula: see text]). Circumcision may protect against HPV-associated disease by enhancing the resolution of infection.

The last sentence may catch you up a bit. However, having written many abstracts for research I have done. I know what this is, it's basically stating a hypothesis for future studies. Technical science writing is not like journalistic or standard writing - as I'm sure you know. If I were to write this for a lay person, I would probably write the last sentence something like: The results indicate that circumcision might protect against HPV-associated disease by enhancing the resolution of infection. To determine if circumcision provides this protection, further study is needed. However, since the journal article is written for other scientists, this is understood. When you get a journalist that doesn't get this writing an article, that is not made clear.

I agree with you Summer, that the article is written by a journalist that summarized what may not have been clearly understood, but I also realize that this is the basis for long-lasting ingrained cultural beliefs (memes) that, like a virus of the mind, can permanently take hold of the public's (and the political, and the non-specialist medical) mind, affecting beliefs and practices in the future. Do you think that if the scientists who originally studied AIDS and circumcision in Africa had also disseminated the information that at least six African countries had HIGHER rates of AIDS among circumcised men, that we would now have the conventional wisdom that circumcision protects against AIDS (with subsequent massive funding of widespread male genital mutilation in Africa, funded by the World Health Organization and the Bill Gates Foundation)?

I did not misinterpret the first quote. No medical researcher is going to study something like the clearance rate for a virus unless they believe that clearance rate makes a difference for the spread of disease; the underlying concept behind studying the clearance rate of HPV in circumcised and intact males is the belief that one particular genital state (in American culture, presume intact males) are more likely to get and spread disease. My point is that, since this underlying assumption is wrong, the researchers are approaching the subject with bias, and it is distorting both their research and their conclusions.

I don't believe your parsing of the second quote is correct (unless, as is certainly possible, the journalist utterly rewrote what was said to fit a preconceived notion of what the study was about). You have no reason to assume that the two parts of the statement were not related when spoken, but even if they were:

1. "There's evidence that circumcision lowers a man's likelihood of developing cancer of the penis and contracting HPV infection, as well as HIV infection, in some populations." Where are the studies that break this down by "some populations"? You assume that this statement is being made about some tiny controlled group, yet in fact the studies done in the US and abroad are national studies, based on reported statistics of penile cancer - clearly, reports made about the general population, not a subgroup. If this statement was actually made by one of the researchers, then s/he is fudging their statement. The only information I ever heard relating to penile cancer and subgroups was that it might be more common among poor men (presumably, with less access to hygiene and medical information; this breakdown of incidence of penile cancer by income level, by the way, was only true in the US, not in other countries).

As for the second part of the statement, that circumcision reduces HIV (let us say, "in some groups"), this is blatantly misleading. Since studies have shown that women are not protected from becoming HIV positive if their husbands are circumcised, and there is no protection for gay men either, then the only group that might be protected (according to the well-known African studies) is men becoming sero-positive from exposure to AIDS-infected women. Since the African studies showing this have come under fire from many sources (especially outside the US), that means that there is no clear evidence of a subgroup whose HIV status is clearly protected by circumcision. I repeat my charge that this study group started with a biased position that colors their initial presumptions, their research, and their conclusions.

2. "Because partners of uncircumcised men face a higher risk of cervical cancer, it's possible that circumcision could affect the spread of the virus as well, Hernandez and her team note." Your emphasis on the words "it's possible" is simply more fudging on the part of Hernandez. Scientists on the whole like to avoid clear declarative statements as a protective device - "I'm wrong? Oh well, I only said it was 'possible', not definite!" to avoid criticism in the future for biased assumptions. No one spends time and money researching such topics if the really believe they are chasing ghosts, nor would Hernandez have made such a statement if she didn't feel she had a strong likelyhood of being correct. By the way, the phrase "circumcision could affect" indicate causation, not correlation. I repeat what I have before, that the link between circumcision and cervical/penile cancer has long been disproved (please see my links and references above, in the previous post), therefore the basis for Hernandez's statement and her research is specious. She is drawing relationships based on unproven (in fact disproved) assumptions.

You stated "To show causation, they would have to find out what specifically about circumcision reduces penile cancer in some subsets of men and reduces cervical cancer in women. This would require cellular biology studies, RNA and DNA work, possibly immunological studies - these were not part of this study. This study basically is a guidance type study. What I mean by this is it's a study that gives the scientists some direction on what the next step in the grander scheme of things is."

Again, I have to repeat, that a study based on faulty assumptions is flawed to begin with; if you assume that the partners of uncircumcised men, for example, are more likely to get cervical cancer, then you will design your study to search for that mechanism; any slight possibility of a means of transmission then gets magnified into a "cause" for transmission to take place. A classic example of such bias: scientists believed that the presence of a foreskin meant that men were more likely to catch HIV; therefore when studying severed foreskins in a lab, one group of scientists noted that HIV was strongly attracted to Langerhans cells in the tissue. Voila! A mechanism for HIV to enter the body was discovered! Unfortunately for them, a few years afterward it was discovered that Langerhans cells produce a substance called langerin, that binds HIV and prevents it from entering the body (thus the reason for the attraction of HIV to Langerhans cells in the first place). The very justification used to promote circumcision was actually a reason NOT to perform it. Sadly, to this day scientists and non-scientists alike refer to "specialized cells" in the foreskin that attract HIV, requiring circumcision as a protective measure.

Bad science has real-world results that cause real harm; apologizing for errors later does not make up for harm done and money and time wasted. I repeat my position: Hernandez and her team are operating on incorrect and biased assumptions, paving the way for future misleading research based on cultural beliefs, not medically valid positions. It is true that bad science writing (as in this article) contributes to the problem, but that does not absolve scientists themselves from their faulty and biased assumptions.

Men in foreign countries don't need this news - one of the biggest scandals about the American medical community's insistence on (and profit from) circumcision, is its widespread refusal to acknowledge that non-circumcising countries in Western Europe have the same (or lower) rates of STDs than we do; if circumcision is so protective, the numbers should be wildly different, and they are not.

ScottEshu: Actually, the American medical community's position is that circumcision doesn't hold any scientifically supported medical benefit. There are still some people (including some physicians) that believe it is beneficial - but there is nothing that truly supports that.

I disagree, Summer; it is American physicians pushing the (badly conducted) studies of HiV and circumcision in Africa; one of these physicians, Robert Bailey, has made it clear that one of the main purposes of the study is to increase infant circumcision in America. Further, it is due to these studies that the AAP is considering revising its recommendations about infant circumcision, in fact is actively working on this now.

Scott - I am a medical student and as such I have worked with many physicians. I am also a parent of two boys. I have never once heard any physician push studies of HIV and circumcision in Africa or advocate for circumcision. In fact, every single physician I have ever worked with has clearly stated that there is no medical evidence that circumcision is beneficial.

The AAP's current position on circumcision:

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.

Basically - their position currently is to not recommend it. Are you saying they are changing it to support circumcision or to actively go against circumcision?

Summer - I'm glad to hear that the physicians you work with do not push circumcision, but I do not believe that they are necessarily a representative sampling. My point related not to the current position on circumcision, but the fact that an AAP committee has been actively working/rewriting these positions since late last year, based mainly on the African AIDS studies. What that rewriting will consist of, no one at this stage knows but, from comments that have been dropped by some of the participants, it does not look good. I'm sure there are many physicians who like to think for themselves, but there are also quite a few sheep in the profession who will simply parrot whatever the latest statement is. That may be generational - I am hopeful that new medical professionals your age may be more willing to challenge established orthodoxy. Here is a link to an Intact America visit to the American Medical Students Association convention that may interest you: http://www.intactamerica.org/amsa