[ ARC forum 2 ]
Written by Paul B. at 07 Jul 2002 13:32:15: Possibly MIGHT be on to something, yet to be seen.
As an answer to: Re: They are on to something written by Halfclip at 06 Jul 2002 20:11:11:
>> Scientists and doctors devote years and even decades of their lives learning how
>> to be objective and rational about medical and biological matters.Well, I'm not too sure how truthful that is, or how effective that is. They learn a profession to be sure, and it is generally held that scientific method is the unifying principle of that profession, but then they go out into the real world of grant allocations in the case of scientists, and patients in the case of doctors.
In both cases, but particularly the latter, they generally find the largest part of their practice then becomes that of manipulating people into, in the first case, supporting their research, and in the second, altering their (the patients') behaviour to (try to) achieve a desirable end such as reduction or elimination of the effects of a disease.
Now the fact is, that along the way, scientific method may be compromised, and the original goal may not be so achievable if one cannot make a decent living from it!
> The problem is that in all too many cases, those famous studies are not done to find out what is true, but rather to support their own beliefs. This applies to both sides of the fence.
And that is most certainly true.
> The pro-circ camp will find statistics that show lower incidence of problems without really qualifying the importance of such problems (or considering that better education of parents on how to teach the kids would almost eliminate such minor problems).
Excellent analysis.
> ("People without noses, tend not to have runny noses when they have colds").
Most astute observation on the matter of circumcision!
> And the anti-circ camp will conveniently forget that there are still foreskin problems, even if it isn't worth it to snip all babies at birth.
Well, they may, but I don't think that is an honest assessment of those who argue here.
> The biggest problem I have with the anti circ camp is that their tactics want to eliminate all circumcisions instead of just those at birth.
Now this is pretty close to the truth, but see further below.
The point is, why would one ever advocate an operation if there is a much better way to fix the problem? Frank need not be so "discreet". It would be nice indeed to see circumcision go the way of nephrectomy for stones, radical mastoidectomy and open meniscectomy.
We are indeed as Frank says, truly alarmed to see someone who might act on out-dated information, and anyone who is considering circumcision for phimosis needs to understand that surgery is the outdated approach.
> They want guys with phimosis to believe that their adult penis is perfectly normal with an unretractable foreskin etc etc.
That is a deliberately deceptive mis-statement of what I, and the vast majority of the others who post here, would claim. "Perfectly normal" it most certainly is not. Whether it is within "normal" range is a good question - it most certainly is up to the age of five years, at the 95% level it may just be into puberty, depending on the group.
But this (the all-important American "normal") is not the point anyway. The two most important points are that a non-retractile foreskin does not prevent normal sexual expression (any more, as I always say, than a circumcision most certainly does), and that it can be remedied without surgery.
Having a non-retractile foreskin puts a man in a small minority and in turn, a minority of these men do suffer sexual difficulties which are in general, lack of sensation, and discomfort when the foreskin is retracted with force (such as when penetrating a tight and unlubricated partner).
We therefore advise that if a man has these problems with phimosis, or indeed if he is simply concerned that his foreskin function is less than optimum, he embark on a correctional program (note just that we clearly state - it is less than optimum and should desirably be corrected), by stretching.
However, if a fellow chooses to say that he has a non-retractile foreskin and is happy to leave it that way, we do (perhaps reluctantly) say to him "Yes, by all means do that".
We consistently say that if one wants to enjoy sex to the maximum, than any form of surgery - cutting - and particularly circumcision, whether "partial" (mere euphemism for "loose") or traditional, will damage nerves, exactly as reduction mammoplasty damages nerves in the nipple.
So the only group who should have circumcision are those who having (themselves, as adults) been advised on the damage to sexual function, wish to have it solely for the appearance and/ or because they choose to view sexual function differently to the majority. If that is their honest reason, and they do not seek to pervert others, then that is fine.
> And each camp will find ways to produce statistics that support their claims.
Perhaps.
> The one study which brought some refreshing news was the recent on in africa where they discovered a significant different in aids propagation between varous tibes and found that the differences in lifestyle was circumcision and then proceeded with some studies to find that it wasn't the glans that was different between cut and uncut, but rather the inner foreskin.
That would be of some interest if such a thing had been "found", but the point is - it hasn't. It has been theorised.
It remains that most of the differences in Africa are tribal, and circumcision is but one of many behaviours that differ from tribe to tribe, and among groups within tribes. It is for this very reason that the study to the review of which "Cry all you want" pointed on the Fathermag forum, has been started and that is in fact the "state of the nation" right now. This study is hoped to provide some actual evidence on whether circumcision helps, is irrelevant, or is even counter-productive.
> The way they arrived at that conclusion seemed to indicate that they did not have an agenda when they begun and that their finding seems to be more believable.
If you are in fact referring to the National Post review of the study in question, then firstly, it is most certain that they do have an agenda, as the whole point of the study is to assess whether circumcision reduces the spread of HIV/ AIDS from females to males (noting that it has been validly postulated that it may well substantially increase transmission from males to females due to increased trauma during intercourse, something not addressed in this study, and under-reported in previous studies) and whether this may therefore be a cost-effective means of reducing the spread of HIV/ AIDS in Africa.
The review clearly points out that the results will not be indicative for transmission in first-world countries with better medical care and perhaps more to the point, vastly more conservative social behaviour. The study does seem to be well-thought-out and to attempt to control for as many confounding studies as possible.