Tag Archives: Men’s Health

Propacandy

Ahhhh Halloween! That special time of year when children dress up as their favourite superheroes, cartoon characters, ghouls and goblins and then embark on a door-to-door journey to gather candy. Sure, adults and teens use it as a convenient excuse to dress up, party and binge drink, but kids tend to be the main revellers with their sugar filled goodie bags and the excitement of getting to stay up late.
Despite Halloween being about costumes, candy and the veil lifting between the living and the spirit worlds, there exists a special breed of asshole that also emerges this wonderful time of year.
I’m not talking about the people who give out mini toothpastes, raisins or those gross molasses candies (seriously. People actually like those?!). Nor am I referring to the people who don’t turn off their porch light or put up a sign indicating they’re not participating in giving out candy, and then react rudely when people ring their bell. No, I’m talking about those assholes who slip bible verses, pro life pamphlets or other political propaganda into young children’s loot bags.
This is nothing new, of course. Growing up, it seemed like every town had that one house that parents and their trick or treaters would skip past. Thanks to social media today though, a lot more attention has been brought around these proselytizing idiots who use Halloween to push their cause du jour.
What was once mainly the domain of relgious fundamentalists, handing out propaganda has been adopted by everyone from anti-vaxxers to PETA activists. And now, intactivists are getting in on it, too. You know, because it works so

well.image

Yes, much like how anti-choice protestors think they are “counselling” the women they scream at, harass, shame and bombard with blatantly false information, intactivists are “educating” young children and their parents by handing out “information”. Said information procured, no doubt, from biased intactivist websites that cite no credible studies, facts or resources. Not that hardcore intactivists like Hollie Redinger are concerned with facts, mind you, but who needs facts when you have hysteria and hyperbole? Loling forever at 50% of your penis missing..image

Speaking of Hollie, it seems as though her idea to use a much loved holiday to push her cause onto young children has caused a stir on her page. When one of her followers informed her (correctly) that people would get upset at her putting intactivist shit in kids bags, she threw a tantrum and flooded the thread with memes and berated the dissenter. Telling the poster she wasn’t a REAL activist (only a “hobby” intactivist) and then another follower accusing her of trying to tell her there was only one right way to be an intactivist (the hypocrisy is truly stunning). All because the poster didn’t think it was doing the cause any good to emulate rabid bible thumpers by handing out bullshit on Halloween.

Hilariously enough, Hollie used a meme that featured Albert Einstein, a circumcised Jewish male. Oh the irony.image

The poster is right, though. Parents don’t appreciate strangers putting political garbage in their child’s treat bags. Let alone strangers putting pamphlets talking about penis, foreskin and sexual function in the bags of young children. This is grossly inappropriate, and the excuse that it’s “for the parents” doesn’t fly. That’s bullshit. Intactivists push the importance of targeting young people and “planting the seed.”image

They target kids in particular like most fundamentalist fucksticks do, because kids don’t have the means to think critically about these issues and often believe most anything adults tell them. As opposed to adults, who ask for evidence backing up your claims. Gee whiz. Sounds kind of exploitive, manipulative and cowardly when you put it that way. Adults are about as likely to take your stickers and pamphlets on circumcision as seriously as they would pro life junk mail. Which is to say they won’t, and suddenly you wake up to a well deserved egged house. You’re not going to convince anyone, even if some people agree with the sentiment I guarantee they still don’t appreciate activists using Halloween as a platform. So if you think putting stickers on candy,image

posting inflammatory signs aimed at children in your yard,image

or doxxing/harassing people on the streets or internetimage

will change the hearts and minds of your target audience, then you’re as delusional as those people who think doing the same shit will lead others to God.
So hand out the goddamned candy, and for just one day keep the political bullshit to yourself. Don’t be a Halloweenie.


NCFM refutation

Stephen Moreton, PhD guest post

In July the National Coalition For Men (NCFM) sent an open letter to the Bill and Melinda Gates Foundation attacking the Foundation’s support for circumcision in Africa as part of the drive against HIV there.  The letter was co-authored by Peter Adler and Steven Svoboda of “Attorneys for the Rights of the Child”, though signed only by Harry Crouch of the NCFM.  You can see a copy here:

 

http://www.arclaw.org/our-work/letters/arcs-adler-and-svoboda-write-letter-about-hiv-and-circumcision-ncfm-sends-gates

 

It is bad even by intactivists’ standards (assuming they have standards, not so sure having read this latest effort).  They say it took months of painstaking research to write.  It took me about ten hours spread over a week to demolish.  Naturally I have sent a copy to the Foundation but am not optimistic they will take much notice (their website actually says not to send them unsolicited materials).  As intactivists have begun linking to the NCFM open letter in forums there is a need for an on-line rebuttal.

Annotated version of the NCFM’s open letter to The Bill and Melinda Gates Foundation.  Original text in normal font, annotations in bold.

Everyone should applaud how your Foundation is funding proven methods to slow the spread of HIVand AIDS in sub-Saharan Africa, including testing, teaching the so-called ABC’s (Abstinence, Be Faithful, and Condoms), retroviral therapy, treating schistosomiasis (which causes vaginal bleeding) and STDs, and helping to lead the search for an HIV vaccine. It is time, however, for your Foundation to stop funding the scientically, morally, ethically, and legally unjustified program to circumcise 38 million African men as an HIV preventive strategy. After seven years and 6 million circumcisions, your program has failed.

On the contrary, it is working (Auvert et al, 2013).

1

Biased, Deeply Unethical Trials and Buried Results. The mass male circumcision program is being justified based on four random controlled trials (RCTs) conducted in sub-Saharan Africa. The RCTs suffered from numerous ethical, scientific and methodological flaws that render the results meaningless. 1,2,

Here the author ignores multiple debunkings of these criticisms. They have been answered in painstaking detail by authorities in the field, and to the satisfaction of all professional bodies involved. For examples of comprehensive debunkings see Halperin et al (2008) and Morris et al (2012). Tellingly, some of the articles cited in the open letter at this point attracted debunkings specific to those articles. Thus Green et al (2010) in ref. 2 was refuted by two separate letters to the editor: Banerjee et al (2011) and Wawer et al (2011); Boyle & Hill (which the author neglects to provide the full reference for) were refuted by Wamai et al (2011); and Van Howe & Storms (2011) in ref. 2 were refuted by Morris et al (2011). Ignoring criticisms, and citing discredited studies, is a pattern in Harry Crouch’s open letter, as we shall see.

Worse, one of the RCTs produced evidence that was quickly buried suggesting that circumcision may increase male to female transmission of HIV by 61%.3

The reference given (no. 3) merely refers the reader to the list of discredited studies above it, leaving the reader with the tedious task of searching through them to find the primary source. (Bad referencing is a problem with this open letter). Presumably it is Wawer et al (2009) who found that the female partners of recently circumcised HIV positive men had a higher risk of becoming positive themselves. This was because some men resumed sex before they had completely healed. So it is really an argument for educating men about the need to wait for complete healing before resuming sex, rather than an argument against circumcision per se. Of course this problem would not arise if the men were circumcised at birth. It has just been announced at the recent International AIDS Society conference that circumcising men reduces the risk to their female partners by about 20 % (Jean et al, 2014).

Moreover, the African circumcision program may be completely unnecessary, as a Ugandan RCT4 showed that intact men who wait at least ten minutes to clean their penis after sexual intercourse are 41% less likely to contract HIV than circumcised men.5

Here the author refers to a study which found that men who were quick to wash themselves after intercourse were more at risk than those who took their time and eventually merely wiped themselves with a cloth. Intactivists have enthusiastically seized on this curious finding and promoted it as an HIV-prevention strategy. This is premature as it is not proven why waiting and wiping should be of benefit. Speculations about enzymes in vaginal fluids have been made but the truth may be far more mundane. If a man has sex with a stranger, a prostitute, or someone else he considers to be at high risk of having HIV, then he will be far more likely to wash thoroughly and quickly as soon as proceedings have concluded. On the other hand, if he is with his regular partner, or someone he knows to be at low risk, he will be relaxed, and may take some time before merely reaching for a cloth and drying himself off. In short, the difference is simply a reflection of the accuracy of the men’s perception of risk (Ndebele et al, 2013). In light of this simple, prosaic explanation, it is reckless and irresponsible to promote “wait and wipe” as an HIV prevention strategy.

Thus, the program’s targets could be achieved without a single circumcision and at minimal cost versus a projected cost for the current program of $16 billion. African men and women should have been informed of these facts critical to their health and safety.

As the author’s basis for this comment comprises discredited studies and an irresponsible instruction about waiting and wiping, it can be dismissed. What the author is presenting is not factual at all, but dangerously misleading pseudoscience.

   2

Circumcision Offers Men Little or No Protection From HIV.

About 60 % reduction in female to male transmission as indicated by three randomised controlled trials, rising with time to around 76 % in the S. African trial, putting it on a par with influenza vaccine.

Some Africans are being told, and many will reasonably assume (why else are they being circumcised?) that circumcision will protect them from HIV, but that is false. Circumcision is no vaccine. Circumcised or not, men who have sex with HIV infected females risk becoming HIV positive. Africans should be informed as follows: “For highly exposed men, such as men living in southern Africa, the choice is either using condoms consistently, with extremely low risk of becoming infected, or being circumcised, with relatively high risk of becoming infected.”6

Getting African men to use condoms at all, let alone consistently, has proved very challenging despite massive condom promotion. Circumcision provides added protection for when condoms fail (as sometimes they do) and for those who don’t or won’t use them. The reference cited (no. 6) refers one to no. 5 above, which is a duplicate of no. 4, and is not the source of the quote. More sloppy referencing. Presumably it is intended to be Garenne (2006).

Even if circumcision did reduce the relative risk by 50%, Garenne concluded,” a 50% reduction in risk [if true] is likely to have only a small demographic effect. “Observational studies of general populations have for the most part failed to show an association between circumcision status and HIV infection.”7

Again the reference is wrong.  In fact it comes from Van Howe and Storms (2011) in ref. 2 which, as explained previously, was discredited by Morris et al (2011).

Thus, the true protection that circumcision provides to men from HIV infection is negligible or nil.8

False, for reasons stated above.

3

Ironically, Circumcision Will Likely Increase HIV Infections Among African Men and Women. Experts have concluded that “circumcision programs will likely increase the number of HIV infections.”9

The reference given here is to husband and wife Van Howe and Storms, although confusingly it says “Supra n.12” which means “note 12 above”, when 12 is actually below. It should be n.2. Such repeated careless referencing does not inspire confidence in the author’s academic skills. And, as Van Howe and Storms have no relevant research background in African HIV, but are in fact prominent intactivists, and Van Howe has a history of shoddy scholarship (see below), the description of them as “experts” is misleading. As stated before, the article in question has been debunked (Morris et al, 2011). Some of the co-authors of the debunking were involved in the African trials – real experts.

First, only 30%-35% of HIV in African men is attributable to sexual transmission, not 90% as experts initially claimed.10 HIV in Africa is often blood borne, spread by contaminated needles.

Once again the author makes a bogus claim from a discredited source. In this instance he cites Gisselquist whose ideas about African HIV being mostly spread by vaccinations were thoroughly debunked in 2004 by the WHO (Schmid et al 2004). Gisselquist continues to be cited by anti-vaccination groups, HIV/AIDS deniers and, it seems, intactivists, but amongst the scientific community he has no credibility.

 Circumcision surgery in Africa often causes HIV.

Having been regaled with discredited studies, and fringe sources like Gisselquist, we now have the other stock-in-trade of the pseudoscientist – the half-truth. Traditional African-style circumcision, by a shaman with a razor blade and no regard to hygiene, pain control or cosmetic outcome, does spread HIV (not “cause” it, how do you “cause” a virus?) This has been known for years (e.g. Brewer et al 2007) and is why in some African countries (e.g. Lesotho, Cameroon & Tanzania) circumcision actually correlates with HIV (something intactivists never tell their audiences when they gleefully point to such countries).

The problem will much worse when millions of Africans are circumcised in multiple, often unsterile venues on a rush basis by poorly trained workers.

Then see that they are trained and have the time and resources to do the job properly.

Second, volunteers, reasonably believing that they are completely or substantially protected from HIV, are less likely to use condoms,11,12 and circumcised men are less likely to use condoms anyway.

This is the “risk compensation” argument. As usual the references cited are both discredited studies by the unreliable Robert Van Howe. No. 12 in particular became a textbook example – literally – of how NOT to do a meta-analysis (Borenstein 2009). Undeterred, Van Howe went on to do a second meta-analysis (on circumcision & HPV) that was so bad that when experts from the Catalan Institute of Oncology examined it they concluded it ought to be retracted from the literature (Castellsagué et al 2007). But Van Howe didn’t learn and when his third meta-analysis came out (on circumcision & STIs) it was again found to be so bad as to merit retraction (Morris et al 2014). Whenever Van Howe gets on his anti-circumcision hobby-horse he attracts criticisms. These episodes are just a sampling of the impressive tally of rebuttals and critiques he has clocked up over the years. And he was described earlier in Crouch’s open letter as an “expert”! Readers are advised to be deeply wary of anything bearing the name Van Howe.

Of course the notion of risk compensation has already been well examined and found not to be an issue when men are given proper counselling. Here are the studies demonstrating this which Crouch ignores: Mattson et al (2008), Reiss et al (2010), L’Engle et al (2014), Westercamp et al (2014).

Third, mass circumcision diverts resources from the proven methods of HIV prevention listed in the introduction. Thus, your mass male circumcision program will not only fail but will backfire.

4

Circumcision Is Also Painful, Risky, and Harmful. Africans report surprised at how painful circumcision is. Even if local anesthetics are used and given time to work, they are largely ineffective, and pain continues during the healing period.

This is just false as millions of men circumcised in this way know. Where is Crouch’s evidence?

Even the American Academy of Pediatrics ‘Task Force on Circumcision concedes that circumcision risks a long list of minor injuries , serious injuries (including hemorrhage, infection, deformed penis, and loss of all or part of the glans or of the entire penis) and death. In the United States, the risk of injury is estimated to be between 2% and 10%.

In the largest study yet (n = 1.4 million) the CDC have determined the risk of all complications, whether serious or not, from infant medical circumcision to be 0.5 %, and about 10 to 20 times higher for those carried out later (Bcheraoui et al 2014).

In Africa, the risk of injury is much higher, estimated to be 17.7% clinically and 35.2% for traditional circumcisions.13

As usual Crouch does not tell the whole story. The clinical practitioners in the study had not the training or equipment to conduct circumcisions safely. Great efforts have since been put into developing safe methods and providing resources so it is misleading to base a complaint on one study of one district in one country which identified issues that have since been addressed. And to compare medical circumcision with crude traditional circumcision by a shaman is just absurd.

As the AAP conceded in its 2012 policy statement, the true extent of the risks associated with circumcision is unknown.

Bcheraoui et al 2014.

5

Circumcision Diminishes Every Man’s Sex Life. Circumcision removes one-half of the penile covering, the size of a postcard in an adult.

There is such variation in penile sizes and proportions it is not possible to give a “one size fits all” figure. Intactivists also count both inner and outer surfaces to make it seem larger.

The foreskin is replete with blood vessels and specialized nerves such as stretch receptors. The foreskin is, and circumcision removes, the most sensitive part of the penis.14

Here Crouch cites another dubious work by intactivists. Aside from the round of criticism (Waskett & Morris 2007), counter-criticism (Young 2007) and further criticism (Morris & Krieger 2013) it attracted, the study looked only at one kind of sensitivity – fine touch. But is this the right kind of sensitivity? Fine touch comes from nerve endings called Meissner’s corpuscles which are present in the foreskin, but even more so in the fingertips (Bhat et al 2008), and we do not consider fingertips erogenous. Pleasurable erotic sensations come from genital corpuscles which are concentrated around the glans, not the foreskin. So the whole study may be a red herring. It is certainly cherry-picked. Other studies find no difference between the circumcised and the uncircumcised. Like Bleustein et al (2005) who tested a broader range of sensation types (vibration, pressure, spatial perception and temperature) and found no difference between circumcised and uncircumcised. For every study the intactivists cherry-pick to suit their agenda, another can be found that contradicts it. Tellingly, the only meta-analysis to date, on the ten best studies, found that circumcision makes no difference to male sexual function (Tian et al 2013). An independent review found the same (Morris & Krieger 2013).

African men will be outraged to learn that circumcision not only has failed to protect them from HIV but has forever diminished their sex lives. Female partners of circumcised men also report reduced sexual satisfaction.15

More cherry-picking. There are studies which found that women report a preference for circumcised partners (e.g. Williamson & Williamson 1988) including a randomised controlled trial (table 2 in Krieger et al 2008).

6

Africans Are Being Misinformed, Coerced, and Exploited. African men are not being informed of the truth, that circumcision is painful, risky, and harmful; that in itself it gives little to no protection from HIV, and the surgery itself may infect them with HIV. Serious ethical violations are occurring as usually poor Africans are being offered valuable incentives to volunteer such as free medical care.16 Boys as young as fifteen years old are being coerced, such as being offered team uniforms and equipment in exchange for being circumcised.

As usual the reference Crouch cites here (no. 16) is one that was comprehensively debunked, as mentioned earlier.

7

Call For Action. Your Foundation’s mass circumcision program violates science, medical ethics, and the law. Your Foundation should immediately terminate its misplaced support of the African mass circumcision program. Your Foundation should also immediately initiate a comprehensive investigation into the program led by unbiased experts, ethicists, and of course Africans. Otherwise, the legacy of the Gates Foundation, and inevitably your personal legacy, will be that you and your Foundation funded one of the most harmful medical programs in human history, and also that you and your Foundation failed to stop it after being informed that it had failed.

Respectfully submitted,

Harry Crouch

Harry Crouch’s letter violates truth and reason. Although there is plenty of evidence in it for scholarly incompetence (such as the garbled referencing), the ignoring of detailed debunkings and the use of discredited studies, are so systematic from start to finish that it is difficult to see this as being due to mere ineptitude. The selectivity and use of fringe sources like Gisselquist add to the charge that Crouch’s open letter is agenda-driven anti-medical pseudoscience. I urge the Foundation to disregard it, and any future pressure from anti-circumcision groups, and to continue to back scientifically proven interventions, including circumcision, in the face of a deadly epidemic that has killed millions.

1 G.W. Dowsett and M. Couch, “Male circumcision and HIV prevention: is there really enough of the right kind of evidence?,” Reproductive Health Matters, 15, no. 29 (2007): 33-44; L.W. Green, R.G. McAllister, K.W. Peterson, and J.W. Travis, “Male circumcision is not the HIV ‘vaccine’ we have been waiting for!,” Future HIV Therapy, 2, no. 3 (2008):193-99; D. Sidler, J. Smith, and H. Rode, “Neonatal circumcision does not reduce HIV/AIDS infection rates,”. South African Medical Journal, 98, no. 10 (2008):762-6.

2 Robert S. Van Howe and Michelle R. Storms, “How the circumcision solution in Africa will increase HIV infections”, Journal of Public Health in Africa, Vol. 2, No. 1 (2011)

(http://www.publichealthinafrica.org/index.php/jphia/article/view/jphia.2011.e4/html_9 ); Boyle & Hill, supra n.1; D.D. Brewer, J.J. Potterat, and S. Brody, “Male circumcision and HIV prevention,” Lancet, 369 (2007): 1597; L.W. Green, J.W. Travis, R.G. McAllister et al., “Male circumcision and HIV prevention: insufficient evidence and neglected external validity,” American Journal of Preventive Health, 39 (2010): 479-82.

3 Id.

4 F.E. Makumbi, R.H. Gray, M. Wawer et al., “Male post-coital penile cleansing and the risk of HIV acquisition in rural Rakai district, Uganda,” abstract from presentation at Fourth International AIDS

Society Conference on HIV Pathogenesis, Treatment and Prevention, Sydney, 2007, available at

http://www.iasociety.org/Default.aspx?pageId=11&abstractId=200705536.

5 F.E. Makumbi, R.H. Gray, M. Wawer et al., “Male post-coital penile cleansing and the risk of HIV acquisition in rural Rakai district, Uganda,” abstract from presentation at Fourth International AIDS

Society Conference on HIV Pathogenesis, Treatment and Prevention, Sydney, 2007, available at:

<http://www.iasociety.org/Default.aspx?pageId=11&abstractId=200705536&gt;.

6 Id.

7 Id.

8 M. Garenne, A. Giamland, and C. Perrey, “Male Circumcision and HIV Control in Africa: Questioning

Scientific Evidence and the Decision-making Process,” in T. Giles-Vernick and J.L.A. Webb Jr., eds., Global Health in Africa: Historical Perspectives on Disease Control (Athens, Ohio: Ohio University Press, 2013): 185-210, at 190 (“Garenne Male Circumcision and HIV Control”).

(http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030078 ).

9 Van Howe & Storms, supra n.12.

10 Gisselquist D, Potterat JJ. Heterosexual transmission of HIV in Africa: an empiric estimate. Int J STD

AIDS 2003;14:162-73 (www.rsm.ac.uk/new/std162stats.pdf ).

11 Van Howe & Storms, supra n.12.

12 Van Howe RS. “Circumcision and HIV infection: review of the literature and meta-analysis”. Int J STD AIDS 1999;10:8-16.

13 Bailey RC, Egesah O, Rosenberg S. “Male circumcision for HIV prevention: a prospective study of

complications in clinical and traditional settings in Bungoma, Kenya”. Bull World Health Organ 2008; 86: 669-77.

14 Sorrells et al. “Fine-touch pressure thresholds in the adult penis”, BJU Int. 2007 Apr;99(4):864-9 at

http://www.ncbi.nlm.nih.gov/pubmed/17378847 .

15 Frisch et al, “Male circumcision and sexual function in men and women: a survey-based, crosssectional study in Denmark” (2011), at http://ije.oxfordjournals.org/content/early/2011/06/13/ije.dyr104.full ; and “Effects of male

circumcision on female arousal and orgasm”, New Zealand Medical Journal, Vol. 116, No. 1181: 595-96, September 12, 2003.

16 Boyle & Hill, supra n.1.

References for the annotations

Auvert, B., Taljaard, D., Dino Rech, D., Lissouba, P., Singh, B., Bouscaillou, J.,

Peytavin, G., Mahiane, S.G., Sitta1, R., Puren, A., Lewis, D. (2013) Association of the ANRS-12126 Male Circumcision Project with HIV Levels among Men in a South African Township: Evaluation of Effectiveness using Cross-sectional Surveys. PLoS Med., 10(9), e1001509.

Banerjee, J., Klausner, J.D., Halperin, D.T., Wamai, R., Schoen, E.J., Moses, S., Morris, B.J., Bailis, S.A., Venter, F., Martinson, N., Coates, T.J., Gray, G., Bowa, K. (2011) Circumcision Denialism Unfounded and Unscientific. Am. J. Prev. Med., 40(3), e11-e12

Bcheraoui, C.E., Zhang, X., Cooper, C.S., Rose, C.E., Kilmarx, P.H., Chen, R.T. (2014) Rates of Adverse Events Associated With Male Circumcision in US Medical Settings, 2001 to 2010. JAMA Pediatrics, E1-E10.

Bhat, G.M., Bhat, M.A., Kour, K., Shah, B.A. (2008) Density and Structural Variations of Meissner’s Corpuscle at Different Sites in Human Glabrous Skin. J. Anat. Soc. India., 57(1), 30-3.

Bleustein, C.B, Fogarty, J.D., Eckholdt, H., Arezzo, J.C., Melman, A. (2005) Effect of neonatal circumcision on penile neurologic sensation. Urology, 65(4), 774-7.

Borenstein, M., Hedges, L., Higgins, J.P.T., Rothstein, H.R. (2009) Introduction

to Meta-Analysis, John Wiley and Sons, West Sussex.

Brewer, D.D., Potterat, J.J., Roberts, J.M., Brody, S. (2007) Male and Female Circumcision Associated With Prevalent HIV Infection in Virgins and Adolescents in Kenya, Lesotho, and Tanzania. Ann. Epidemiol., 17(3), 217-26.

Castellsagué, X., Albero, G., Cleries, R., Bosch, F.X. (2007) HPV and circumcision: A biased, inaccurate and misleading meta-analysis, J Infect., 55, 91-3.

Garenne M (2006) Male Circumcision and HIV Control in Africa. PLoS Med 3(1), e78-e79.

Halperin, D.T. & 47 others (2008) Male circumcision is an efficacious, lasting and cost-effective strategy for combating HIV in high-prevalence AIDS epidemics. Future HIV Therapy, 2(5), 399-405.

Jean, K., Lissouba, P., Taljaard, D., Taljaard, R., Singh, B., Bouscaillou, J., Peytavin, G., R. Sitta, R.,  Mahiane, S.G., D. Lewis, D., A. Puren, A., B. Auvert, B. (2014) “HIV incidence among women is associated with their partners’ circumcision status in the township Orange Farm (South Africa) where the male circumcision roll-out is ongoing (ANRS-12126)”. 20th International AIDS Conference; Abstract FRAE0105LB.

Krieger, J.N., Mehta, S.D., Bailey, R.C., Agot, K., Ndinya-Achola, J.O., Parker, C., Moses, S. (2008) Adult male circumcision: Effects on sexual function and sexual satisfaction in Kisumu, Kenya. J Sex Med., 5, 2610-2622.

L’Engle, K., Lanham, M., Loolpatit, M., Oguma, I. (2014) Understanding partial protection and HIV risk and behavior following voluntary medical male circumcision rollout in Kenya. Health Education Research. 29(1), 122-130.

Mattson, C.L., Campbell, R.T., Bailey, R.C., Agot, K., Ndinya-Achola, J.O., Moses, S. (2008) Risk Compensation Is Not Associated with Male Circumcision in Kisumu, Kenya: A Multi-Faceted Assessment of Men Enrolled in a Randomized Controlled Trial. PlusOne, 3(6), e2443.

Morris, B.J., Bailey, R.C.,  Klausner, J.D.,  Leibowitz, A., Wamai, R.G., Waskett, J.H., Banerjee, J., Halperin, D.T., Zoloth, L., Weiss, H.A., and Hankins, C.A. (2012) A critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries. AIDS Care. 24(12), 1565-1575.

Morris, B.J., Hankins, C.A., Tobian, A.A.R., Krieger, J.N.,  Klausner, J.D. (2014) Does Male Circumcision Protect against Sexually Transmitted Infections? Arguments and Meta-Analyses to the Contrary Fail to Withstand Scrutiny. ISRN Urology, Article ID 684706.

Morris, B.J. and Krieger, J.N. (2013) Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction? – A Systematic Review. J. Sex. Med., 10(11), 2644-57.

Morris, B.J., Waskett, J.H., Gray, R.H., Halperin, D.T., Wamai, R., Auvert, B., Klausner, J.D. (2011) Exposé of misleading claims that male circumcision will

increase HIV infections in Africa. J. Public Health in Africa, 2(e28), 117-122.

Ndebele, P., Ruzario,S., Gutsire-Zinyama, R. (2013) Point of View: Interpreting and dismissing the relevance of the “wait and wipe” finding from the circumcision studies conducted in Africa. Malawi Medical Journal, 25(4), 113-115.

Riess, T.H.,  Achieng’, M.M., Otieno, S., Ndinya-Achola, J.O., C. Bailey, R.C. (2010) ‘‘When I Was Circumcised I Was Taught Certain Things”: Risk Compensation and Protective Sexual Behavior among Circumcised Men in Kisumu, Kenya. PlusOne. 5(8), e12366.

Schmid, G.P., Buvé, A., Mugyenyi, P., Garnett, G.P, Hayes, R.J., Williams, B.G., Calleja, J.G., De Cock, K.M., Whitworth, J.A., Kapiga, S.H., Ghys, P.D., Hankins, C., Zaba, B., Heimer, R., Boerma, J.T. (2004) Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections. The Lancet, 363, 482-8.

Tian, Y., Liu, W., Wang, J.Z., Wazir, R., Yue, X. & Wang, K.J. 2013. Effects of circumcision on male sexual functions: a systematic review and meta-analysis. Asian J. Androl., 15, 662-6.

Wamai, R.G., Morris, B.J., Waskett, J.H., Green, E.C., Banerjee, J., Bailey, R.C., Klausner, J.D., Sokal, D.C. & Hankins, C.A. 2012. Criticisms of African trials fail to withstand scrutiny: Male circumcision does prevent HIV infection. J Law Med., 20(1), 93-123.

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What More Can I write

I don’t know.  At this point it sorta feels like chasing my own tail to update this blog.  There really is only so much that can be said on this topic.  Despite the Google Alert Brigade posting endlessly, they’re also repeating themselves over and over.  In amusingly pseudo-intelligent language.  Quite hilarious, that.   In any case, the Intactivism blogs tend to post updates of what Slate or The Baskerville Times said about circumcision that they think was wrong (BTW did you see that piece from Slate?  It really was a good piece!).  So THEY have stuff to write about, but I don’t really want to update multiple times a day to complain about what the Intactivism blogs are doing.  After all, it might end up just giving them more traffic.   No thank you.  Also I’m just not into that kind of minutia.

So I suppose I have a few topics that were promised to be addressed, so I could address those.  Religious Circumcision (though really, I’d prefer someone much more educated on myself to write on that particular topic, and you bet your cutie mark the comments will be closed on THAT blog), more on the AAP, maybe about how next year there’s not going to be some mind blowing ruling outlawing circumcision (and yeah the misunderstanding of the 14th Amendment in that manner makes me chuckle).  But honestly that’s still really not that much to write about.

Oh but I do have an idea.  I definitely have an idea. So for tonight, let’s just leave you guys with this little bit of positivity, from the totally sane, not fucked up or obsessed Intactivism crowd.  L’Chaim!

“My heart sure doesn’t break for her. On the contrary, she got exactly what she deserved. If every baby who was mutilated died, it might put a stop to the practice. This so-called tragedy is good publicity for outlawing genital mutilation. I hope she feels guilty for the rest of her miserable life & my sympathy for her is ZERO.”

“They didn’t care. It was more important that his penis be cut up than he live.”

“The doctors are trying to feed them the lie that the circumcision didn’t kill their son. This is why, even though it doesn’t seem ‘compassionate,’ people need to let’er rip on her. No, people should not be silent and ‘compassionate.’ While everyone is feeling sorry for the mother, what about the child?”


Some New Stuff!

Ok ok ok, first things first.  We have two new contributors to the blog, and a part time author.  One contributor will be working with me on the issues with intactivism specifically, with occasional commentary on other topics of woo, and the other will give us a weekly blog about various topics of woo interest, sure to piss off those in the homebirth movement, anti-vaccination movement and the uber boobers.

Unfortunately, most of my comments are coming from the same people or same kinds of people.  People who, when I look up their email address, are active in assaulting virtually any web page, article or blog post that has anything remotely to do with circumcision.  I honestly wish I would hear more from other people, but perhaps it’s because I’m not writing in a way that seems inviting to parents who are questioning this issue.

With the new statement out from the AAP, I think it’s more clear than ever that the decision to circumcise or not circumcise is really up to the parents.  There are risks and benefits to either decision, and while for me, I don’t find the procedure necessary and therefore decline it, I’ve been moving further and further away from the idea that circumcision causes harm (other than the immediate harm of the procedure).

I know that intactivists are really banking on the coming-of-age of the boys circumcised after the anti-FGM legislation, but I really don’t think that equal protection can or would be applied in that way.  They’re very very convinced of this, but I think that’s a product of their echo chamber.  When you choose to surround yourself only with those of a like mind and a like opinion, who’ve accepted the same assertions as facts, then those assertions start to look more and more rock solid, as though they’re indisputable, widely known facts.  The truth is that this is an illusion, caused by limiting yourself to those sources of information.  As you become more and more involved, it becomes harder and harder to to accept any outside or dissenting source of information.  The fact is that the only people who consider FGM and RIC comparable ARE intactivists.  Virtually everyone else sees this for the nonsensical gross over-reaction that it is.  They’re hardly comparable, except on levels that enormous mental gymnastics are required to reach.  I’ll write a new blog post about this tomorrow, cross my heart and hope to die.

I also recently saw a post in STFUParents with a woman whose husband said he was thankful for all the babies who still had their foreskins left.  I think, to me, this is so absurdly representative of the movement and how it’s just really missing the mark.  Though again, it goes back to the echo chamber environment, and the almost religious zeal it causes.   Are children who are kidnapped and sold into slavery EVEN MORE victimized if they were subject to RIC?  Should they be thankful all they have to deal with is daily rape, and not the horror that their most intimate parts were hacked away at birth by a doctor who only cared about the paycheck (rhetoric of the movement, not my opinion).

I recognize this blog post is sort of all over the place, there’s not much of a unifying theme to it, other than my belief that the online communities of intactivism are innately crippling.  If you were truly interested in the truth and empirical, evidence-based information, then you absolutely would not dismiss EVERYTHING that doesn’t bolster your viewpoint.  The only intellectually honest position is one that recognizes that there are pros and cons, or at the least that there is compelling information in the decision to circumcise; after all, if there wasn’t, why would anyone choose to?


My Absence

As I stated in a prior post, things are quite frantic right now.  Unfortunately that means infrequent updating of my blog.  However, there’s quite a lot of good information in my blog…and most of my readers are intactivists, so I doubt they’re sitting here refreshing their screens constantly waiting for an update.  I’m not giving up on the blog, don’t worry.  My opinion also hasn’t changed.  I do not circumcise, I don’t think circumcision is necessary.  I also do not approve of the tactics used by intactivists, and were they to change those tactics, I would support them wholeheartedly.  Much like the rabid pro-life crowd, intactivists generally resort to appeals to emotion, twisting of facts, offering up studies (that they haven’t even read) claiming they say one thing, when in fact they do not (relying, instead, on the fact that many will not actually read the study, simply providing one counts as support of their argument), sometimes outright lying.  That includes setting up studies in such a way as to pre-determine the outcome.    These are things that I disagree with, and will continue to disagree with.  Since most intactivists, instead of actually reading my site objectively, believe that I am actually pro-circumcision and that my site advocates for circumcision, I’m attacked quite often.   However, I’m not trying to go into a pity-party for myself.  I don’t feel sorry for myself, and honestly, it’s pretty much what I expected.

So, a few things – Hugh Intactivist, based on the sheer bulk of commentary, I’m having a hard time determining whether you’re a troll or legitimate.  If you want to comment, please keep it within as few comments as possible per reply.  I’d greatly appreciate it.  If you’re legitimate.  If you’re simply trying to troll me, well, then I’d appreciate if you’d stop.

I’m also soliciting for guest authors right now, and have a dear friend that’s already agreed to post for me sometime in the near future.  She’ll be writing a few articles, and I’ll edit them and then post them.  So hopefully this will be updated a little bit more frequently, but perhaps not by myself.


Is There A Possibility That You Are Wrong?

I’ve continued to receive comments after my break.  Many people were actually rather supportive, which I appreciate.  I took an almost 6 month break, because I had quite a few big events in my life, some wonderful, some not so wonderful.  But I’m back.

First of all, I get a lot of comments from people who seemingly can see nothing beyond the fact that I have called out many inappropriate tactics, statistics and assumptions by the self-labeled intactivist crowd.  Further,  I got quite a few comments from people who were kind enough to actually read my blog, and who understood what I was saying.  I am not attacking the position against circumcision, but I am very thoroughly against the accepted method of trying to end the practice.  Unfortunately, a lot of intactivists tend to regurgitate (sometime verbatim) things that other intactivists said, and eventually it becomes accepted as fact, with no backing evidence.   Because of the emotional way the subject is discussed, very real people can be hurt.  One commented on a post I wrote, wracked with guilt because of the rhetoric used by zealous intactivists.  I find that very, very unfortunate.  People are people, and they make the best choice they can at the time with the information they have available.  I’d say by far, the vast majority of parents who circumcise are doing it because they believe it is a good choice for their son.  That they are helping him.

There are widespread misconceptions and myths in the circumcising community…just as there are in the intactivist community.  Yes, to have someone say the foreskin is ‘disgusting’ is offensive.  Why would you counter that with something equally offensive?  You’re not going to get people to change their minds by beating them over the head with your opinion.  I think that many of the intactivists who disagree with me think that’s what I am doing.  I don’t think it is, but I’ve been accused of it.  If so, do you see how effective it is?

I have a  question for you, Intactivists.  Is there a possibility that you are wrong?  If the answer to that is no, then there is no point for you to engage in any discussion about this whatsoever.  None.  There is always a possibility that you (general you) are wrong.  I believe that there is a possibility that I am wrong (however minute) and that’s why I’m willing to have a conversation about this.

If you wish to post links to studies on my comments, you are welcome to.  However, be aware that I have seen most of the ‘studies’ in this area, and so  I am familiar with what they say.  I have actually read them, and I do not rely on any one else’s interpretation of what they say.  So if you want to post a study, please do so, but read it, and explain your interpretation of it when you do.

I am also looking for guest bloggers, no matter what your stance.  Pro-Circ, Rabid Intactivist, Neutral….I would like to hear from you and offer you an opportunity to have your words posted on my blog.  So please let me know through the comments section if you are interested, and I will send you an email.


What’s Most Important?

I’m genuinely curious.

Is it more important to put the ‘we’re actually doing something’ face on intactivism by posting circ rates as 32.5%?  Or is it more important to be truthful and admit that they’re actually higher?  A good example of this is fine touch sensitivity and penile cancer.  Being intact raises the risk of penile cancer, but penile cancer is so rare that circumcision for it makes no sense.  However, when it comes to a study about fine touch sensitivity, even though the actual difference is negligible, intactivists show misleading charts that make it seem as though intact penises are miles more ‘sexually sensitive’.  Just as in the cancer argument, the actual difference at which point a man can simply sense the least amount of pressure on his penis, the difference between circumcised and intact is small, so small that it makes no sense not to circumcise based on this.  So why use that to try to prove a point?  It doesn’t really work.

Again, why not focus on the argument about how unnecessary it is to routinely circumcise all or a majority of boys in the US for supposed ‘prophylaxis’ reasons?  These arguments are much better.  I do understand that intactivists want it to appear as though there are mountains of evidence in favor of the foreskin and against circumcision and nothing good about circumcision, but in all honesty, the publicly available information does not indicate this.  Most of it pretty shaky.  Have evidence that supports your claim, make sure you’re 100% familiar with that evidence, or don’t bring it up.  It’s very annoying to have the same links and arguments regurgitated at me by people who don’t understand them.  I’m sure that’s true for parents researching circumcision as well.  Add in the bullying and generally unpleasant disposition, and that is not a formula that’s going to encourage change.