Science is not the enemy

Many who read AMERICAblog consider themselves progressives or liberals.

As such, we generally favor truth, science, honesty, people over corporations, citizens’ welfare (education, health care, health insurance, jobs, living wages, housing and a variety of similar goals), freedom, voting rights, civil rights and other causes often espoused by the Democrats. Often, we are diametrically opposed to conservatives and their beliefs.

Often when conservatives post replies to liberal blog posts, articles or comments, they use a number of techniques that really don’t add anything to the topic at hand. Sometimes they just do an ad hominem personal attack. Other times they may use disproven information or even lie. They may introduce other topics to try to divert from the posted topic. Or they may deny the validity of the original argument or the information presented without presenting any evidence to the contrary.

And frequently, they’ll attempt to generate some kind of strong feeling in the readers such as anger, fear, hatred or some other adrenalinized emotion. When they use the latter on us, it is usually with the hope that it will cloud our judgment, our logic, our facts, because the truth offends them.

Often we’ll chortle to ourselves just how foolish our opponents are, resorting to their standard techniques as a much-used reflex and not thinking through the issue. And show that they are unable to come up with an intelligent reply. With them, it seems to be a stimulus-response reaction. Much like a knee jerk in response to a tap with a reflex hammer.

Angry egg via Shutterstock

Angry egg via Shutterstock

Recently, I did two posts that obviously touched a nerve and perhaps incited a reflex among readers.  The first article was about the potential risks posed by e-cigarettes.  The second, about the known medical benefits of male circumcision.  Both articles were my analysis and synthesis, as an M.D. and practicing physician, of the best medical science to date.

You’d have thought I spat on the flag.

Many of the replies posted used the conservative tactics mentioned above. Some people used wild hyperbole, questioned my credentials and honesty, others just denied the evidence posted. Some, clearly, didn’t read the post, much less the information in the links. Several of those who posted clearly had a liberal bent (at least from what I’d seen of their posts on other topics on AMERICAblog and other sites.) Yet, on these two topics, had I not seen those previous posts, I would have thought that they were definitely of the conservative persuasion. At least from the tactics used in the post, if not the content that they wrote.

The tone of many of the replies to these posts was sung in the key of “I.”

E-cigarette via Shutterstock

E-cigarette via Shutterstock

On the e-cigarette post, the overwhelming response to my article was: “But, I want to be able to smoke.” Few of the replies were concerned with others who might possibly be affected by the smoke: former smokers, children, asthmatics and others with breathing problems. It took us generations to realize that second-hand smoke from tobacco was dangerous. Might it not be the same here? Could our smoking of e-cigarettes lead children and other adults to become addicted?

Apparently not. Many of those who responded seemed to use the conservative, “I got mine (e-cigarettes), now you get yours.”

 An anti-circumcision protester stands in front of the White House in Washington DC on March 30, 2013. Rena Schild / Shutterstock.com

An anti-circumcision protester stands in front of the White House in Washington DC on March 30, 2013. Rena Schild / Shutterstock.com

The replies to the post on circumcision was  similar in nature. Denials of the data, anger, hyperbole and diversion. Few were concerned that someone who is uncircumcised could well spread disease to a partner or multiple partners (I had noted, for example, the fact that female partners of circumcised men have a lower risk of getting HPV, which can cause cancer in women). Some voiced opinions with no, or limited, basis in fact. No one seemed overly concerned about uncircumcised infants and children who are at risk for genitourinary diseases. The key of “I” resonated here, too.

I’d like to ask you to go back to these two posts and just skim through the comments. Look at a few from each post.

Perhaps the anger generated prevented clear thinking about the topics. Whatever the cause, I was amazed that many progressives/liberals/Democrats reacted as they did, by mimicking conservative tactics: denying, distracting, distorting, demonizing.

AMERICAblog editor John Aravosis has written a number of articles about the larger “outrage” problem in American politics today. I’d hope that when considering science, of all things, everyone, conservatives and liberals both, would at least keep an open mind.


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Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • Moderator3

    It wasn’t your post that was the problem. It was linking to another blog without Mr. Aravosis’ permission that was the problem.

  • ottnott

    No thanks. I’ll continue to post what I think adds to the discussion.

    You can continue to act as if the conventional journalists have been right all along to assert that blogs are an entirely different breed of media that deserve none of the privileges and respect granted to the traditional information media.

  • Ninong

    Here’s a good news story. Man was able to conceive a son with his reconstructed penis. Doctors had to amputate nearly all of his penis at age 7 following a botched circumcision, but a wonderful plastic surgeon was able to reconstruct his penis and he is now the father of a baby boy.

    http://www.sfgate.com/health/article/Man-may-be-1st-to-father-child-with-reconstructed-5416853.php#photo-6189914

  • vejo

    Male “circumcision” is at its origin a religious practice designed to reduce sexual pleasure, thereby allowing a “circumcised” person to deny themself before their god. It’s completely unnecessary. Evolution gave us foreskins for many reasons. People should not be circumcised without their consent.

  • Moderator3

    I am breaking your links. Please get Mr. Aravosis’ permission to link to another blog.

  • ml66uk
  • ottnott

    PZ Meyers of the Pharyngula blog an enemy of science? Umm, no.
    http://freethoughtblogs.com/pharyngula/2014/04/11/should-you-circumcise-your-child/

  • Jhon Murdock

    @Jim Since your foreskin was forcibly amputated while you were an infant, any comments regarding the quality your sexual experience as an adult just amount to useless information. You are lacking any basis for comparison. Assuming you began your prodigious sex life at age 17 you would have had 571+ encounters each and every year. Were you employed in the porn industry?

  • Mike_in_the_Tundra

    You really need to see the movie “The Road to Wellville”.

  • Ninong

    For bonus points, as well as laughs, read what Dr. John Kellogg, the inventor of Kellogg’s corn flakes, had to say about masturbation. Just scroll down to his views on sexuality. You have to read it to believe it.

    https://en.wikipedia.org/wiki/John_Harvey_Kellogg

  • Ninong

    Why are the major medical associations of Europe, Canada and Australia “enemies of science?” Why aren’t they concerned about the risk of UTIs in baby boys? Why did the Danish Association of Family Physicians call ritual circumcision of boys “mutilation?”

    Don’t they know as much as the eight American pediatricians who reviewed the evidence and decided the AAP should endorse the procedure? Are the Europeans culturally biased because they are probably not circumcised? Or maybe it’s the American doctors who are biased because they are circumcised?

    It seems to me that there is a push among American doctors to find reasons to support routine neonatal circumcision that has become more pronounced as the rates of neonatal circumcision in the U.S. have declined. From a high of 91% in the 1950’s, circumcision rates have gradually declined to approximately 54% today, although the rates vary by region with the Western United States being the lowest at 31%.

    Personally I don’t think STD and HIV transmission studies in Uganda, Kenya and South Africa are a good way to justify neonatal circumcision in the U.S. That’s a stretch in my opinion and just makes the effort look that much more desperate.

    I assume you are familiar with the response to the AAP’s recommendation? If not, please check it out. The AAP published it on their site.

    http://pediatrics.aappublications.org/content/131/4/796.full

  • Ninong

    What else did I learn from this article? I learned that anyone who is against the ritual circumcision of minors is against science. It’s right there in the condescending title: Science is not the enemy.

    I also learned that to be opposed to the mutilation of baby boys’ dicks is equivalent to being in favor of inhaling nicotine.

  • http://heimaey.us/ heimaey

    Ah the classic “they don’t agree with me they’re an idealogue” defense.

  • Ninong

    They also thought it was “sinful” and caused insanity.

  • Ninong

    “No one seemed overly concerned about uncircumcised infants and children who are at risk for genitourinary diseases.”
    There is less than a 1% risk of UTIs in young boys under two years of age. There is a 2% risk of complications resulting from neonatal circumcision. UTIs are easily treated with antibiotics. The rate of UTIs in young boys in Western European countries with very low rates of circumcision is no higher than that in U.S. where circumcision rates are very high. Why is that?
    All of the other claimed benefits for circumcision can wait for the boy to reach adulthood and make that decision for himself. Of course, we all know what 99% of them will decide, don’t we? More and more European jurisdictions are outlawing the practice of ritual circumcision. It’s banned in Sweden and in some jurisdictions in Germany. San Francisco tired to do this in 2011 but a state court judge forced them to remove the measure from the ballot on the grounds that only the state can regulate medical practice.

  • Tora Spigner

    Only a few American men feel shamed by not being circumcised. Once they learn that the natural and intact penis is preferred by real women, they lose their shame and are proud. Otherwise, they are free to circumcise themselves. It is healthy to be whole. Since 85% of men in the world have foreskins, they are the majority or the norm.

  • ml66uk

    If you say something like this:
    “In light of the fact that there are clear benefits to circumcision, and
    negative consequences when this procedure is not performed…”

    but so many national medical organizations are against infant male circumcision (I quoted from some position statements on the other article), then you can expect to get a barrage of hostile comments.

    There are plenty of circumcised doctors who are against male circumcision, but it’s surprisingly difficult to find male doctors in favor who weren’t circumcised themselves as children.

  • ml66uk

    From a USAID report:
    “There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.”

  • sanfranguns

    It actually is a false equivalency since they aren’t the same thing at all. There is no grand health crisis created by not circumsizing like there is for not vaccinating, for one example. But hey.. it’s nice to see you’re honoring the topic of respectful dialogue by calling my a whiner. Maybe you can elevate yourself to calling me poopy face in your next post

  • Jim

    You’re being willfully obtuse.
    Which is one of the things the author implied in the criticisms of his article.

    Hue-man made a blanket statement about not mentioning risks, as if other procedures don’t come with risk. Hence my response. If you don’t get it, it is because you don’t want to get it–very much like talking about evolution to a christian. Good for you.

  • Jim

    I think you missed the point: to refute an argument, peer reviewed data is more useful than opinion.

  • Jim

    Why are they useless?
    Source?

  • Jim

    vaccinations: used to improve health and to curtail infections to others.
    circumcision: the author made the point that it improves health and curtails infections (his example was hpv) to others.
    Not a false equivalency.

    You claimed that because you’re born with an organ it must be useful. Appendix, not so much.
    Not a false equivalency.

    By the way, your anecdotal story is not evidence of anything except profound intellectual laziness.

    How about some peer reviewed data instead of the whining.

  • Jim

    You should also include the number of men who feel shamed by not being circumcised. By the way, the issue the author brought up was one regarding health. You managed to avoid that and make a broad emotional appeal.

    I believe your response was what the author was criticizing.

  • Jim

    I could patronize you as easily: sorry you don’t know what you’re missing. Must be sad for you.

  • Jim

    I think you missed the point.
    Probably intentionally.

  • PeteWa

    lol nothing to apologize for, just talking about how I saw things.

  • http://heimaey.us/ heimaey
  • 4th Turning

    I’m down 3 for 3 and so far haven’t experienced clinical remorse over the
    preemptive attack on any particular part. The one would probably have
    gotten unwelcome attention in the showers. Agree on the need for 2
    (or more) second opinions re any medical procedure-especially those
    requiring “the knife”.

    The American Academy of Otolaryngology-Head and Neck Surgery points to a study showing the benefit of tonsil removal for kids who have had three or more tonsil infections in a year. Other medical groups, including the American Academy of Pediatrics, say tonsillectomy and adenoidectomy may not be necessary unless the child has had seven infections in one year or five infections in each of two years. However, a tonsillectomy (and typically a simultaneous adenoidectomy) is recommended if the tonsils are so large they obstruct breathing or swallowing, or if your child is diagnosed with obstructive sleep apnea, a condition where children briefly stop breathing during sleep and wake up frequently throughout the night. But there’s no research that definitively proves what’s most appropriate, so if your doctor recommends surgery and you’re unsure about it, it’s a good idea to seek a second opinion. –Amy Linn
    http://www.parents.com/advice/big-kids/health/should-my-childs-tonsils-be-removed/

  • 2karmanot

    “You’d have thought I spat on the flag.” If it was the Confederate flag I’d join you in a nano second Doc.

  • Indigo

    Threatening violence, I see. Troll much?

  • http://heimaey.us/ heimaey

    Good come back! LOL I’m the one who won’t put up with barbaric mutilation and my mind is closed. You’re the one who likes cut dick and so everything should be latida fine…but you’re the one with the open mind?

  • Nathanael

    I’ll be happy to stab you in the penis and see whether you have any health risks from the open bleeding wound.

    All surgeries are dangerous for health. You know this if you aren’t a complete moron. Perhaps you are a complete moron?

  • Nathanael

    “Doctor” Mark Thoma is simply wrong. The AAP is correct. And KenD is also correct: medicine is mostly extremely unscientific. Doctors aren’t scientists and they don’t think like scientists.

  • Nathanael

    Sean: Marx was acting in an environment where the existing governments were, mostly, dictatorships. The Tsar was certainly a dictator. In that situation, presumably proposing another dictatorship doesn’t sound that bad *because it isn’t actually a change*.

    By contrast, proposing dictatorship in England with its elected Parliament was quite rightly seen as repugnant.

  • Nathanael

    Then you like to needlessly mutitate babies against their will. Creep.

    If an adult male wants to chop off his foreskin, that’s fine, just as it’s fine if an adult wants to get body piercings or tatoos. Babies shouldn’t receive forcible mutilations. Although we’re probably not going to be able to ban them in the case of religious rules (so, religions which brand babies with hot irons will still be allowed to do so), we certainly shouldn’t be doing so for bogus “medical” reasons.

    Doctors generally don’t understand what science is and couldn’t tell a scientific study from a fraud if their lives depended on it. Dr. Thoma is proving to be a typical doctor in this regard.

  • Nathanael

    Actually, removing the appendix is usually a bad idea; the appendix has turned out to have an important role in the immune system. You’ve got to remove it in cases of appendicitis, but it has bad side effects.

    “Preventative surgery” is almost always an error.

  • Nathanael

    I’ve read the doctor’s sources. They’re worthless. Sure, circumcision may help people without access to sanitation, in Uganda. Doesn’t help the rest of the world.

  • Indigo

    Nonsense.

  • Nathanael

    IF you’re interested in honest debate, you should be condemning Dr. Thoma for his incredibly dishonest argumentation.

  • Nathanael

    Circumcision is actually dangerous for health, like most injuries.

  • Nathanaerl

    Yes, the poster’s irrational circumcison advocacy is guilty of the faults of which he accuses his opponents.

  • Nathanael

    The “benefits of circumcision” are mostly bullshit, for people who have access to soap and water. There are greater benefits from shaving off all your hair, and those benefits aren’t very large either.

    E-cigarettes are nicotine. What do you expect from nicotine.

  • http://www.rebeccamorn.com/mind BeccaM

    Well then, I do apologize for that.

  • Sean

    You’re the one with the closed mind.

  • 4th Turning

    Wouldn’t mind seeing 98 more thank you notes below your comment…

  • 4th Turning

    After carefully weighing the pros and cons here, when the time comes, I’d still want you and your
    practice inserting those inevitable catheters… (Sure you aren’t going to be jumped on for peddling snake oil now? Already missing the humor)

  • pappyvet

    Thank you Doc for taking a stand on these issues and starting discussions.

  • http://heimaey.us/ heimaey

    No they’re not. Not when they involve unnecessary mutilation. You’ve been conditioned to like what you like. Open up your mind.

  • PeteWa

    while I do have an interest in male circumcision I also feel that the debate and rhetoric was uneven on both sides, not just one. and I didn’t see much of a debate as legitimate points brought up were not discussed.
    however… I did find some of the responses to your response to me to be less than helpful. :)

  • docsterx

    Some of the posts here are very logical, express differing views and are evidence-based. Others are opinions, not based in fact. Still others seem to reflexively seem to feel the need to generate heat by continuing to use conservative tactics.

    My feeling is that discussions need to generate light. Sometimes heat gets generated as well. That’s not necessarily a bad thing if we can stay clear-headed. Some seem to be unable to do that and their posts are designed to solely generate heat. Those immediately stop the exchange of information and thoughts. That is what forums like this are designed to do – allow for presentation of different (or similar) views. The heat-generating comments seem to support my initial feeling that, at times, progressives/liberals/Democrats respond just as their conservative counterparts do. That’s not surprising, we’re all human and tend to get very emotional over issues that are close to us.

    I really appreciate the different points of view and ideas expressed in the replies, even though I disagree with some.

  • Ninong

    It is unethical to disregard a child’s intrinsic human rights to privacy, dignity, autonomy, and physical integrity by altering genitals through irreversible surgeries.

    Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany and other countries have stated that there is no justification for performing the procedure without medical urgency. Medical associations in these countries are calling for the practice to stop due to ethical and human rights concerns.

  • Tora Spigner

    Then, obviously, you have never witnessed a circumcision being performed. As an RN, I have seen them and they ARE harmful. Pain, bleeding, infection, death are all side effects of circumcision. I would call those all harmful, especially for someone who has not consented to the procedure. An adult man can consent, get anesthesia and analgesia and dictate how much foreskin he wants removed, a baby boy can not. https://www.youtube.com/watch?v=bXVFFI76ff0

  • Tora Spigner

    A circumcised man who is conscious of what he has lost will notice the scar around his penis and the fact that the glans is not protected anymore by that sensitive foreskin every time he pees, is naked, masturbates or has a sexual encounter. How do you know your partner’s preferred cut or is that just what was available and usual? Missing 20,000 nerves from your penis DOES affect sexual encounters, especially as we get older. That is what I am talking about.

  • 4th Turning

    First, I’m glad you got gift-wrapped up top. Very few seem to realize the
    art of getting one’s point across is in the story-telling. Sorry this format doesn’t really allow space for the depth of exchange your question deserves. To begin at the beginning-not my statement but a bit of historical wrack that was intended humorously for John to insert circumcism or whatever popped into his head. Barry Goldwater was the gop guy that ran against lbj and lost in a proverbial landslide thanks to the enclosed tv ad. You can google the whole sentence if you want to place it back in context.
    Read Marx’s bio which if you have you might give me a pass for not going
    into a more extensive study of his work. But do have a fairly solid idea.
    Am proletariat to the bone. The problem as I’ve come to understand it
    is 1. power is a drug/poison and 2. The first halluciation is that the very
    downtrodden revolution/redistribution of wealth is suppose benefit cannot
    be trusted to determine what’s is best for themselves by those formulating
    grandiose visions. Which unfortunately is true as neuroscience is
    confirming almost by the day. Parental/clan/tribal values get hard-wired
    into our brains making us think the rich and powerful are inherently
    better than us rabble and the scraps they dole out are all we really

    deserve or expect.(The original wizard of oz was a socialist screed
    as you may know.)
    Anyway. the cultural revolution, pol pot, the french revolution, any
    number of other experiments gone off the rails are all the result of
    extreme attempts at re-wiring in a contrary to evolution hurry-up.
    I see a huge gulf between (god-given) ideology and the idealism
    I like to think I embrace. It and 5 bucks only gets me a coffee.
    I just finished Mark Matousek’s Ethical Wisdom which explains a lot at
    least to my personal satisfaction, about the dark underbelly of extreme
    solutions meant as remedies for desperate problems. He likes Erich
    Fromm. Weirdly enough I saw one of my own acquaintance’s story profiled. Wouldn’t mind hearing your thoughts/reaction if you decide to read it on my recommend. Enclosing an excellent ted/talk and the tv ad.

    http://www.npr.org/2014/04/04/295360962/does-money-make-you-mean

    https://www.youtube.com/watch?v=dDTBnsqxZ3k

  • http://www.circumstitions.com/ Hugh7

    https://yourlogicalfallacyis.com/ad-hominem People either make a point or they don’t. If they don’t, point that out (and why they don’t). If they do, answer it. You don’t think plenty of the pro-circumcision side are not ideologues?

  • http://www.americablog.com/ Naja pallida

    Rule #1: Wash your damn dick. All of it. Regularly. With soap and water.

    Rule #2: If you’re gonna touch another person with your dick, wear a condom.

    Following those two rules the mentioned medical concerns are mitigated without any bleeding or pain involved, unless you’re entirely too vigorous with the washing.

  • Ninong

    You don’t consider that a human rights violation?

    What about the consensus opinion of the major European medical associations that the practice is medically unwarranted, a violation of the baby’s human rights and a violation of medical ethics?

  • http://www.circumstitions.com/ Hugh7

    ” All treatments come with a risk. Getting a hip replacement has a small risk of death.”
    When we replace the hips of healthy newborns with stainless-steel implants, that will be a useful comparison with infant male genital cutting.

  • http://www.circumstitions.com/ Hugh7

    “The tone of many of the replies to these posts was sung in the key of “I.””
    Glad to hear you don’t think you’re missing anything. Sorry you don’t know what you’re missing.

  • Olterigo

    I don’t think I’ll add anything new by saying that here you are running not into liberals or conservatives. You are running into ideologues. When you hit an ideological point, it’s pointless to argue.

  • http://www.circumstitions.com/ Hugh7

    “Some people used wild hyperbole, questioned my credentials and honesty, others just denied the evidence posted.”
    I saw wild hyperbole on the pro-circumcision side, reasoned rebuttal of the evidence, and no questioning of Dr Thoma’s credentials. The main problem is that he started from the position of neonatal infant male genital cutting as a norm, when it is now a norm for non-religious reasons only in the USA. He gave no attention at all to what is removed or why those who still have it (as I do) like to keep it, and those who’ve had it removed without their consent are as mad as hell and not going to take it any more.

  • http://heimaey.us/ heimaey

    You’re not very bright are you?

  • http://heimaey.us/ heimaey

    I’m not basing it on personal feelings. It’s not right to mutilate a man – I think we can all agree on that. It’s just that you’ve been tricked into believing it’s not mutilation and your preference for uncut dick is based off of what you’re accustomed to, not any scientific reasoning or fact. Educate and expose yourself.

  • James3D

    There is no problem with having a boy, the care is the same. DO NOT CUT AND MUTILATE ANY CHILD’S GENITALS. See how easy it it?

  • Sean

    I can’t help myself here – a woman’s POV on circumcision is useful because…..? (When deciding whether female circumcision is a good thing or bad thing, should we listen to men, or to women?)

  • crazymonkeylady

    I remember when I was pregnant (21 years ago) and worrying that if it was a boy should I have him circumcised. People were worried about mutilating babies and screaming about natural intact males. All I can say, thank goodness I had a girl. No problem.

  • DonewithDems

    I am a liberal because I question ALL authority figures, especially when they make vague arguments and attach only studies that support their position. And, especially when they write articles saying an increase in this and a decrease in that without presenting any real facts. Yes, the arguments are based on real studies, great! Making the reader slog through very dry reports to pull out information that should have been presented in the article is sloppy writing. I imagine it takes guts to have readers do the author’s research for them, to find other studies and situations where the “science” doesn’t stand up to scrutiny and then get offended when they do. This is a typical Rovian ploy. Instead of answering valid concerns and points, Dr. Thoma throws up a straw man by saying that Americablog readers who disagree with him ignore science and are filled with rage! Also, lumping dissenters of the e-ciggarette article and the circumcision article is a false equivalence. Being addicted to nicotine and cutting off infant body parts are not the same issue. Instead of having a tantrum about being disagreed with, how about answering some of the very valid concerns brought up in the comments?

    Nope, I’m not going to take everything that comes out of the writings of Dr. Thoma as fact. In fact, this article makes me distrust this writer even more.

  • Sean

    Interestingly ambiguous statement. And here’s a serious question about extremism, but from economics. The Soviet Union’s “Dictatorship of the Proletariat” was created to solve a real, and serious problem (income and power inequality) – but was such an extreme option justified, in your opinion? Spoiler alert! I’m very sympathetic to Marx’s goals. But when Lenin and then Stalin say they need a dictatorship to solve the problem, I jump ship. At this point in my life, I agree with the adage that extremes meet. Very Far Left, or Very Far Right, those who demand utopia create a nightmare.

  • Sean

    Just a minute Buster. You are basing your arguments on your personal feelings. And your notions of liberated sexual awareness. Which is fine. But my feelings, and notions, are just as valid as yours.

  • Sean

    As my earlier posts indicated, I can attest, through my own direct personal experience, that no harm is done to baby boys through circumcision. I refute your basic proposition.

  • http://www.circumstitions.com/ Hugh7

    I’ll go to your specific post and reply more specifically, but aren’t you guilty here of several of the faults of your opponents, at least on the circumcision side? You focus on two of the medical claims for circumcision, the UTI claim (slight) and the HPV claim (disputed), and ignore the much wider picture of the risks and certain harms of infant male genital cutting, and more important than either, the inevitable human rights violation.

    Of course men who resent being circumcised focus on themselves (especially if they have had genitourinary troubles, or exchanged HPV with their partners, anyway – or if their circumcision was botched). It was (the best) part of THEIR penises that was cut off for these illusory benefits. Genital autonomy for all, male, female and intersex, is a liberal, even libertarian position.

  • Sean

    Yes I would! Thanks for asking.

  • Hue-Man

    This ties in with my comment below about advocating circumcision of African infants by various international organizations. The U.S. spends more than any other country per capita on health care – and U.S. governments spend more than any other country per capita on health care but cover much less than 100% of population – and this is an excellent example of that wasteful spending. “if it’s not broke, don’t fix it” seems to apply only to the rest of the world.

    The tie-in with Africa is even worse than “cosmetic surgery” not covered by health insurance – every dollar spent on male circumcision is diverted away from spending on needed health services, whether it’s diabetes treatment, childbirth, HIV treatment, or other life-saving treatment or medication. African people of all ages die today in the hopes that in 15 years, some boys have a slightly lower risk of being infected by HIV from having unprotected vaginal sex with an HIV+ female. But remember: “Science is not the enemy”!

  • http://heimaey.us/ heimaey

    And who says that’s not mutilation?

  • Ninong

    “No one seemed overly concerned about uncircumcised infants and children who are at risk for genitourinary diseases.”

    There is about a 1% risk of UTIs in boys under two years of age, and the majority of incidents occur in the first year of life. There is good but not ideal evidence that circumcision reduces the incidence of UTIs in boys under two years of age.

    So in order to lower that 1% risk of urinary tract infections, we should cut off the offending part of the infant’s anatomy that is responsible for harboring the bacteria rather than just do a better job of bathing the baby. I wonder if anyone has statistics from Sweden, where routine mutilation of baby boys’ dicks is against the law?

    Maybe that’s why “no one seemed overly concerned about uncircumcised infants and children” who are allegedly at risk for genitourinary diseases? Should we do a better job of bathing the baby? No, let’s just cut off the tip of his dick instead, then we won’t have to worry about all that nasty bacteria hiding in there.

    Oh, I’m sorry, there I go again denying science.

  • http://www.rebeccamorn.com/mind BeccaM

    I’m having a comment-conversation with my friend PeteWa, and was responding to him and his comment. Y’see, he and I don’t delegitimize each other, even when we don’t see eye to eye on every last thing. Nor do we suggest that the other shouldn’t say anything or leave because our opinions aren’t wanted or welcome.

  • Ryan
  • Lil Peck

    Even IF there were “benefits” with circumcision (there are none), it would not be justification for subjecting helpless infants and children to such a barbaric, brutal procedure.

  • http://heimaey.us/ heimaey

    You should have an opinion. If you have ever had sex with men you might have had a more pleasurable time with them because THEY were having a more pleasurable time. Also, even if you don’t have sex with men, why would you condone mutilation? I’m a gay man and I’m pro-choice and pro-pill. You don’t see me not caring because I don’t have any interest in a vagina.

  • ComradeRutherford

    “mimicking conservative tactics: denying, distracting, distorting, demonizing.”

    Um, no, you were the one distorting. You’d say ‘circumcision reduces X by N%!!!’ without telling us the real numbers. In most cases the rates of infection you didn’t cite are lower then the numbers of cases of circumcision-gone-wrong.

    Your argument is NO different than suggesting that all newborn girls that test positive for the BRAC gene have their breasts removed immediately. Or, as I pointed out, why aren’t you arguing for all girls to also have their labia minora and clitoral hoods removed for exactly the same reasons you cite?

    The FACT is that circumcision IS genital mutilation for very, very small benefit.

    I’ve had numerous sex partners over the years, and I’ve no HIV, herpes, HPV, etc, etc. I’m so glad I have a foreskin, and it’s too bad you don’t have yours (which is your true motivation for your work).

  • Damien Noir

    If you have no interest in it, then why are you even commenting on it? You seem to have a thought on comments you find fallacious, so PeteWa posts something that fits your guidelines of a valid argument and suddenly you are disinterested.

  • http://heimaey.us/ heimaey

    The circumcision rate is going down too. Part of that has to do with changing attitudes, but part has to do with insurance not covering it anymore. It’s an elective surgery with no benefits so why should they cover it?

  • http://heimaey.us/ heimaey

    Or you just don’t know what you’re missing. PS no one believes you had 20k sexual encounters.

  • http://heimaey.us/ heimaey

    Me too. But baby strollers don’t cause cancer.

  • Damien Noir

    Just because you are fine with it does not mean it should be forced on everyone. I’m glad you haven’t experienced any negative effects from your circumcision, but I know many men who have. Would you like to talk to them?

  • Damien Noir

    First of all, I don’t see any facts on your end. I never have. I have only seen the opposite, actually. The US has a much higher rate of HIV/AIDS infection than any country in Europe, all of which have much lower circumcision rates than the US. Second, it doesn’t actually matter if a normal penis is more likely to spread a disease. It is not your penis. It’s disgusting that you talk about it as if the penises in question didn’t belong to anyone. Men are people. Cutting off a girl’s breasts will reduce her risk of breast cancer by 100%. Why aren’t you removing those? Because it’s barbaric! You don’t perform surgery before a problem arises. That’s poor medicine. No medical organization in the world even recommends routine infant circumcision, including our own. Use protection or just don’t have sex with diseased people. It’s that simple. Would you have sex with someone who has AIDS just because they were circumcised? I sure hope not! It’s ridiculous that someone who “has a long history of social activism” talks about men as if they don’t have the right to genital autonomy. Your argument has absolutely no logic whatsoever. I am amazed that you are trying to demonize people who defend human rights. And circumcision is in an entirely different realm than e-cigarettes. I find it extremely odd that you group them together. E-cigarettes are not forced on babies. That’s something people choose to do for themselves.

  • sanfranguns

    You know what pisses me off? Baby strollers. I don’t ask for a law banning them though.

  • sanfranguns

    So – I appreciate your response, but I have some issues with it.

    Since we’re using the terminology… Your comparison between vaccinations and circumcision would be considered a false equivalency. Also, you don’t need to make assumptions about what I believe – you can just ask me, thank you.

    Same thing with comparing the foreskin and the appendix. That comparison is totally ludicrous

    I acknowledged that data exists suggesting that circumcision reduces disease. But your proposition is that it is the be all and end all. You know as well as anyone that there are a number of ways to prevent those diseases. To me, it makes more sense to give the person the opportunity to make the determination on their own as to how to practice prevention – not you.

    I am partially circumcised and am extremely grateful for my foreskin. I’ve never had an issue with disease or preventing disease utilizing other means.

    I’m also not aware of any medical association that recommends circumcision as medically necessary. It wasn’t created in response to disease prevention either.

  • Keith

    Sadly, my penis was mutilated just before genital cutting went out of fashion in the UK. Sex was never as good as it should have been, and now I have anorgasmia.

  • Keith

    The reason that so many Africans have HIV is promiscuity! Genital cutting didn’t prevent American men falling victim by the thousands, that was also caused by promiscuity.

  • Hue-Man

    I forgot one of my most specious complaints. Fauci and others have been out promoting mutilation of African babies for many of the reasons outlined in the article. Not only is this bad policy for Western countries, it diverts scarce medical resources in poor countries – including HIV treatment – to an even more dangerous operation carried out in non-surgical settings with benefits that may appear in 15 years!

    As anyone who has read my comments knows, my points are not a personal attack on the author but a call to challenge the orthodoxy within the American medical industrial complex. I hope Dr. Thoma will consider a third posting after he’s had time to reflect on all the comments. I have no vested interest in the outcome here – I am at the age that the risk of having my first son is as close to zero as can be imagined.

    If you’re struggling with medical orthodoxy, consider what’s starting to seep out to the public regarding the efficacy of vitamin supplements….

  • Reasoning101

    I think you’ve missed the point. One doesn’t even get into potential health benefits — which, again, I emphasize have never actually turned up in any population; they remain speculative — if the body part in question is healthy and functional, having value to its owner. To say “studies show circumcision may make you healthier” addresses the wrong question entirely, unless the quest was to find as many justifications for foreskin removal as possible. It is unethical to take parts off of people because of belief, however sincere, that it might reduce the risk of disease.

    In fact, among nearly all demographically comparable populations, the non-circumcising societies regularly have better sexual health (lower disease, less dysfunction) than the largely circumcising societies. This has been consistent for decades. Australia and Canada have seen only health improvements since substantially abandoning infant circumcision starting 35 years ago; Western Europe routinely enjoys better sexual health than North America, including lower STI and cervical and penile cancer rates; and studies like the Laumann report from 1999 show that health outcomes in the United States among circumcised and intact populations of men are statistically no different, although there appears to be somewhat more tendency of circumcised men to engage in sex other than intercourse; perhaps in pursuit of greater stimulation. No one can point to a single study that proves circumcision has improved the health of Americans and lowered health costs. It’s done quite the opposite. If any conclusion can be drawn, it is that being genitally intact aids health.

  • Keith

    Let’s not forget that that the AAP recently wanted the FGM ban reversed in the USA. And the circumcision industry is worth $4bn annually. Money talks, and money lies.

  • E-van_la
  • http://www.rebeccamorn.com/mind BeccaM

    Believe it or not, I have no position on male circumcision. None. No interest. No opinion one way or the other. Cut or un-cut, penises have always looked a little weird to me.

    But I do have an interest in honest debate and rhetoric that doesn’t stoop to ad hominem attacks or which just assert the unsubstantiated equivalent of “nuh uh!”

  • Ninong

    “Science is not the enemy” except when it is. In this case it is. And it isn’t even science.

    Once again the American medical establishment is out to prove that circumcision is good for us. Why? Is business in that field slipping a little? Originally they pushed it as a cure for masturbation.

    Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany and other countries have stated that there is no justification for performing the procedure without medical urgency. Medical associations in these countries are calling for the practice to stop due to ethical and human rights concerns.
    Are European doctors less ethical than American doctors?

  • cole3244

    most people are right of center and only claim to be otherwise even some who claim to be progressive aka liberal with no passion.

    science is the enemy of religious fanatics, the ignorant, haters, and conservatives in general, this is just another reason the world is on a path to destruction and not salvation, their word not mine.

  • Ninong

    Would you recommend the procedure to a young man? What if he is only 1-week old? Would you wait for his informed consent?

    If circumcision can be done to young men who are only 1-week old without their consent, then why shouldn’t it be done to 21-yr-old men without their consent?

  • Jim

    The doctor gave sources for his information that strongly suggests circumcision gives both men and women a healthier life. What are your sources and where can I read them?

    And, in this case the origin doesn’t matter. The question is whether circumcision promotes greater health. Your point about the origin is an unnecessary obfuscation, which is extremely poor reasoning, especially for someone with the name reasoning101.

    As to disfigurement: no one who has sucked my cock thought it was disfigured. And that would be thousands of men.

    Best to stick to peer reviewed data. Getting into areas of aesthetics promotes unnecessary vitriol.

  • Reasoning101

    It all turns on #4: Circumcision is not a treatment, except in the rare situations where there is a diagnosis and circumcision is the appropriate route to address it. Unless and until there is an underlying condition to treat, circumcision is gratuitous wounding in the sincere hope that it will prevent something. Being born male is not a condition requiring treatment.

    All surgeries are woundings; modern medicine and law recognize a defense to wounding when used as a conservative treatment for illness or injury. The question is not whether circumcision has any potential benefit — population-based evidence suggests it does not, or is so inconsequential as to be invisible — but whether circumcision is necessary. Can anyone prove that circumcised Canadian men lead longer lives, more fulfilling lives, and experience better lifetime health than intact Canadian men? More specifically, are 15-year-old Canadian boys without foreskins objectively healthier than intact 15-year-old boys? If not, circumcision can safely be delayed to that age or later, when pain relief is more effective, the complication rate is dramatically lower and the death rate is zero.

    All the studies that arrive at a benefit from circumcision have one thing in common: they ignore or vastly downplay any function or value of the foreskin. As such, they are able to bypass ethical considerations. Hundreds of millions of intact men can attest to the sexual, aesthetic and protective value of their foreskins, but study authors — curiously almost always from countries that already practice and may be trying to defend circumcision — choose to listen instead to circumcised men who doubt such value.

    I’d have a lot more faith in studies by researchers that have no connection to circumcision whatsoever. Only they could evaluate the intervention objectively. Every circumcised male, partner of a circumcised male, parent of a circumcised male, or member of a religion that expects circumcision has a conflict of interest that need be disclosed. Sadly, it almost never is, to the detriment of the quality of research.

  • PeteWa

    personally I feel that this post completely ignored what were legitimate concerns that were brought up by various people.
    one topic brought up that I thought should have been addressed was the reliance on the one study set in Uganda to prove that there seems to be a marginal health benefit to circumcision… well, only 46% of households in Uganda have indoor plumbing – which I would gather would lead to certain hygiene problems that are rather foreign to most of us in the United States. This is not addressed.
    it seems that we are left with half a picture.
    to my way of seeing, that makes as much sense as adhering to early 1900 knowledge that circumcision leads to higher incidence of tuberculosis among male children, and thus is to be avoided… yeah, it was true then, it’s not true now.

    I do see what you have brought up, and I saw the reverse as well in the other article for those defending the practice of circumcision. probably to be expected when writing on a topic that is addressing a *cough* touchy subject.

  • Jim

    You made some pretty powerful claims:
    “[circumcision] will affect his life forever, every time he pees, is naked, masturbates or
    has a sexual encounter.”

    I’m 52 and was circumcised shortly after my birth. I’ve peed I don’t know how many times. Did this affect me. Yes, I felt better after I peed. When I was six, I peed in my pants and I was upset. Did any of this have anything to do with being circumcised. No. I’ve been naked many, many times. I’ve been naked in front of many, many men. Did this affect me. Yes, it got me laid many many many times. Did this have anything to do with being circumcised? I’m not sure. Could be that many of my partners prefer cut, but I don’t know. Was there anything negative from being cut. No. I have masturbated many many times. Was it satisfying. Not like a great blowjob. Did this have anything to do with being circumcised? No. I think I’ve had over 20,000 sexual encounters (and with no STDs) and some where really hot, some not so much. Did this have anything to do with being circumcised? No.

    My question: what the fuck are you talking about?

  • Ninong

    HIV infection rates are sky high in many African countries mainly due to behavioral differences. In South Africa, for instance, men who work in the mines usually live in company camps and get only one day a week off and only one 3- or 4-day holiday per month to return home to their family. During the rest of the month they live in company dormitories and get only one day a week off. On that one day off, they visit the nearby ‘establishments’ that always pop up wherever there are large groups of men seeking relaxation and entertainment.

    The women who work in those ‘establishments’ service dozens of men per month. Disease is easily transmitted because condoms are rejected by many men. When those men do get to return home once a month to visit their families, they spread disease to their wives or girlfriends.

    The studies didn’t control for behavioral differences. They weren’t interested in finding out whether taking a shower before and after every sexual encounter would totally eliminate any difference between circumcised and uncircumcised individuals because that wasn’t the point of the study. They didn’t tell the men in the study that using a condom would prevent disease.

    The only point of those studies was to measure a difference in disease transmission rates between circumcised and uncircumcised individuals and the difference was there but it wasn’t all that great. Obviously it’s due to personal hygiene but that’s not the point. Everyone already knows that the uncircumcised men should be careful to wash everything down there but that’s like telling a little kid to be sure to wash between the toes. Some do, some don’t.

    So what did we learn from the studies? We learned that unwashed uncircumcised dicks are better transmitters of disease than unwashed circumcised dicks. Why did we need a study to tell us that?

  • Reasoning101

    There is credible evidence that vaccination, with an extremely high efficacy rate, prolongs and even saves lives. Circumcision has never been shown to increase quality of life, much less life expectancy. In fact, it has been amply demonstrated to be completely unnecessary in many large populations closely paralleling the United States, the last remaining country to circumcise most healthy infant boys for alleged “medical” reasons. The ethical question is not “Why can’t we do it if we think (so far) that it doesn’t harm?”, but rather, “What evidenced health reasons, benefiting a majority of the population, compel and permit us to circumcise prophylactically?” The answer is: none. As long as the foreskin has function, it has value. If it has value, it belongs to its owner as much as eyelids, fingers and ears do. The threshold to bypass that value, or rather steal it, would have to be very high indeed.

    Vaccinations were developed in response to health epidemics, many fatal. Circumcision has no such noble medical pedigree. It arose as a religious rite claiming no health benefit (yet implying, via Moses Maimonides and others, a sexual impairment) and later as medical quackery to address masturbation, bedwetting, paralysis and rectal prolapse. Once in for a penny, in for a pound… and the scavenging for better justifications was off and running. The search has continued for 100 years, but not a shred of data proves Americans are better off for having widely adopted this fad. It does, however, consume nearly a billion dollars a year to perform and repair.

    This is a trainwreck compared to vaccination… which normally leaves no physical trace compared to what many consider permanent disfigurement from circumcision. The foreskin is a normal, integral part of male anatomy. It has function and value. In contrast, vaccination takes nothing away. It is not a surgery, making a comparison inapporpriate. A closer analogy to vaccination is feeding a child certain foods.

  • Jim

    1. Ad Hominem: What is your evidence that the author has a personal bias? What is your evidence that the author is making money off of circumcision?

    2. Can you adduce any peer reviewed research that shows the data are flawed. Internet opinion is not evidence.

    3. Specious: by your argument, no one should get vaccinated, no one should ever go to the doctor. We’re all going to die, so why even eat?
    Modern medicine has not conquered death, but is has made life longer and with less

    pain.

    4. Again, specious. All treatments come with a risk. Getting a hip replacement has a small risk of death. Some people have negative reactions to inoculations. The issue isn’t whether there might be a case of malpractice, negligence, or bad sanitation. There will be. The issue is whether or not the treatment helps more than it hurts. The evidence I’ve seen strongly suggests that circumcision is useful. If you have peer reviewed evidence that contradicts it, then present it in a polite, reasonable form.

    5. Another ad hominem. Where is your evidence that the doctors involved in the studies are all circumcised? Where is your evidence that circumcised men have an intrinsic bias? By your logic, white people cannot dispassionately write about racism, Chinese could not dispassionately write about Chinese corruption, etc.

    6. Flagrant hyperbole: The article was about circumcision, which by definition requires cutting. No where in his posts did the author say that surgery is the answer to everything. If your point were true, then the author would have recommended cutting out the lungs so that no one could use e-cigarettes. He didn’t.

    You have proved the author’s points: many commenters have had a knee jerk reaction to the posts and have used hyperbole, ad hominems, and poor reasoning to attack the posts.

    Suggestion: if you disagree with his position, do the necessary research in peer reviewed journals, read and comprehend the articles, and if they refute the author, make a rational polite argument with your sources cited.

    Throwing a tantrum based on opinion is for christians and reactionaries. Progressives use manners, reason, and the scientific method, fyi.

  • Craig Adams

    The
    forced body modification of children, including forced circumcision of
    healthy boys, is a human rights violation and a violation of medical
    ethics. One can claim there are potential preventive benefits to
    removing any body part, but only the owner of the body should make that
    decision when he or she is of an age to understand the consequences.
    Surgery that amputates human tissue should always be a last option when
    all other options are exhausted. Unfortunately, one cannot be un-circumcised. Circumcision by definition is mutilation. I wish I were un-circumcised. I wish my body were left alone as nature intended. I endured traumatic corrective surgery at age 5 and other complications. I have seen a video of non-therapeutic infant circumcision surgery, and I conclude that it is barbaric, un-American, and criminal battery.

  • Ninong

    All of the scientific studies cited by Dr. Thoma had one thing in common. They set out to prove a medical benefit to circumcision.

    If circumcision lowers the rate of heterosexual HIV transmission then the United States, which has a high prevalence of circumcision, should have a lower HIV infection rate than countries like Sweden or Japan, where circumcision is practically unknown. Why would Sweden and Japan have much lower HIV infection rates than the U.S.? Could it be behavioral differences?

    Oh, wait, I almost forgot, we’re only looking for excuses to circumcise infants without their consent. Carry on, Dr. Thoma.

  • Tora Spigner

    What is better, using a condom or getting an STI from another person, be it HIV, syphillis or other STI!? The foreskin is no more prone to disease or infection than any other body part. Did you know that part of the reason Europe has fewer heterosexual HIV cases is due to the fact that most European men aren’t circumcised?

  • http://heimaey.us/ heimaey

    Thank you – it’s good to get a woman’s POV here – and so well put.

  • Lars

    To be honest, even if circumcision did help against urinary tract infection (it doesn’t) it would still be a horrible excuse for the procedure. If you were told that your kids could avoid ear infection by cutting off their outer ears, would you do it? I’m guessing the answer is no.

  • Tora Spigner

    So you should only be with men who are circumcised as adults, with their own free will. No child should be circumcised for the beliefs of adults, there is harm in not defending genital autonomy in a child. The child’s body belongs to him and him alone, not his parents, not his culture, not his religion or his community. Let the man grow up and choose whether he wants the most sexually sensitive part of his body removed, that is his choice. Less than 1% of men choose circumcision as adults, for medical or personal reasons. Circumcision, the more you know, the more you are against it.

  • Lars

    “It didn’t do a thing to me”

    Yes, it did, you just haven’t realized it. Here’s a list of functions the foreskin provides:

    http://www.circumstitions.com/Functions.html

    “I’m not seeing a lot of good science”

    Except for the list of reference material in the link provided. A quick google search gave me this:

    http://www.intactamerica.org/resources

    with plenty of good research. You just have to take the time to read it.

  • Jim

    “but I also think its still an individual’s right to make that choice for themselves.”:
    So, I suppose you would be against vaccinating young children: they can’t give any credible consent because they can’t fully understand the consequences. Yet, getting vaccinated saves the lives of children.

    “Surely you can acknowledge that that skin exists for a reason and there is also a benefit to having it?”:
    As to there being a reason for a foreskin: there is also an evolutionary reason for an appendix. Yet, the appendix does very little and has the potential to kill. When appendicitis occurs the only remedy is appendectomy. There has been no known adverse effects of removing the appendix even though we were born with it.

    “If science is of the utmost importance here, then why focus on e-cigarettes and not car exhausts, for example?”:
    I believe this is an example of bait and switch, just as the author mentioned.

    If the data strongly suggest that being circumcised reduces disease and if the data strongly suggest that circumcision has little or no negative consequences, then it is reasonable to circumcise. If you have peer reviewed data that contradict this, then present the data. There is no need to bait and switch, no need to discuss a hypothetical usefulness of an organ just because we’re born with it. Stick to the data, that is what is reasonable and progressive.

  • Tora Spigner

    Sorry, you get “disease”, whether you are minus a foreskin or whole. Disease does not care who it comes for, it is carried by bacteria, virus or fungus ~ it does not differentiate who is in possession of all his body parts or only some of them. STIs come from other people with STIs. That is real science.

  • Tora Spigner

    Cleanliness comes from getting clean, taking a shower or bath. Not cutting off normal, healthy erogenous tissue.

  • http://heimaey.us/ heimaey

    I’m 40 and been having gay sex for over 20 years and I concur. The uncut men I’ve been with have a different way of exploring sex and often have a lot more heightened sensuality.

  • Tora Spigner

    We are seeking to teach and educate parents why it is not necessary to
    cut their sons. More and more parents are learning that the baby boy
    they birth, will grow up to be a man, harmed by genital cutting. It will
    affect his life forever, every time he pees, is naked, masturbates or
    has a sexual encounter. Learn the facts about circumcision, the more you
    know, the more you are against it. When you know better, you do better.
    http://www.wholenetwork.org

  • Reasoning101

    You may want to state the case a little more accurately. The AAP has never recommended infant circumcision from the time it first pronounced on the subject in 1971, when it stated that there are no medical indications for circumcision in the newborn period. The subsequent statements in 1975, 1989, 1999 and 2012 are all merely nuanced back-and-forths, with each of them emphasizing that their analysis is not a recommendation of circumcision or to circumcise.

    The 1999 task force, chaired by Dr. Carole Lannon, found that there are known risks and potential benefits, about equally balanced. The 2012 task force, chaired by Dr. Susan Blank (who is not a pediatrician), intriguingly found that the potential health benefits of circumcision do outweigh the risks, although the risks are not accurately known. Also, the committee did not discern a function of the foreskin. As such, it felt comfortable saying that the decision is best left to parents without pressure one way or the other by physicians.

    Most medical associations around the world affirmatively recommend against routine (non-therapeutic) infant circumcision, and have no trouble identifying functions of the foreskin and the ethical considerations of removing it from a healthy child. They also acknowledge the studies that show a considerably higher complication rate than the ones the AAP preferred to include.

    The AAP’s current statement says that in their review the benefits of circumcision accrue mostly after childhood and are better known than the risks; and as such, the benefits appear to outweigh the risks. However, the benefits are not so great as to recommend circumcision. (It may be worth noting that risk/benefit analysis is the accepted standard for choosing among options for conditions that require medical treatment. It is generally not appropriate for cosmetic or other elective surgery, for which advantage/disadvantage is more suited, with risk being just one subset of the possible or known disadvantages.)

  • http://heimaey.us/ heimaey

    Right…if if if. Like if you had a solid argument and weren’t just basing your opinion off the kind cock you like to suck.

  • Ninong

    “Science is not the enemy” but it is sometimes used the same way some people use the Bible. They pick and choose which parts fit in with their preconceived notions.

    If circumcision lowers the rate of heterosexual HIV infection then why does the United States have much higher rates of HIV infection that countries like Sweden or Japan? Circumcision is practically unknown in those two countries and yet their rates of HIV infection are much lower than in the U.S., which has a high prevalence of circumcision.

  • Reasoning101

    I think the essential part here is “not for me at any rate”. I’m gay, I’ve had sex with men for 30 years, and for me there is a very real and very significant sexual cost in circumcision. In my experience, circumcised men function and react differently than intact men, so much so that sex is less pleasurable because it is less versatile and more work. It took me a number of years to quite understand what I was noticing, but once I put the physiology and the experience together, the penny dropped and I understood just how valuable the foreskin is to complete and enjoyable sex –> for me at any rate, as they say.

    At this point in my life I can’t deny that the foreskin is functional; I’d venture to say it is the most versatile and functional (sensation and movement) part of the penis. The intact penis is a brilliant design. As such, I respect and value that part of the body very much. It doesn’t mean that circumcised men and their partners can’t be satisfied with what they have to work with, but in my experience they do, indeed, have less to work with and will miss out on a number of the benefits of being intact. When it comes to penis parts, I don’t really subscribe to the “less is more” theory. I choose not to waste time lecturing my friends about it, just as I don’t waste time these days trying to make partial penises perform right.

  • Sean

    If…..if…..if…..if……

  • Ninong

    The American tradition of circumcision was started by one of the founders of the American Medical Association in the latter part of the 19th century as a cure for masturbation, among other things. It wasn’t based on science of any sort. It began to gain wide acceptance in the U.S. in the early 20th century. And, of course, it has a long history as required religious practice in some religions.

  • Swami_Binkinanda

    Too many uncontrolled variables and reliance on correlation that may be spurious due to the lack of controls.
    And how about that Tamiflu? Billions spent, causes more harm than good, works less effectively than Tylenol for influenza.

  • Ninong

    Dr. Thoma,

    Your “Science is not the enemy” title of this article, as well as your decision to equate criticism of your position on circumcision with e-cigarettes, is an ad hominem attack on anyone who would question the ethics of circumcision of infants. The study you touted was done specifically to find a medical justification for circumcision. Is it any wonder they chose Uganda as a good place to achieve the hoped for results?

    “Study Design and Subjects

    “We conducted two parallel but independent trials of male circumcision for the prevention of HIV infection and other sexually transmitted infections in Rakai, Uganda…”

    Why Uganda? Why not a study of male college students in the U.S.? Oh, that’s right, their HIV rates aren’t high enough. I forgot. And they take showers every now and then. Let’s find a place where we’re sure to achieve the results we’re looking for. Hey, how about Uganda?

  • Reasor

    Circumcision did plenty to you. You grew up to become an adult who doesn’t see the harm in needlessly mutilating babies.

  • judybrowni

    I think the word you’re looking for here, John, is “entitlement.”

    Rampant in the conservative world, but apparently there are strains outside that toxic body, as well.

  • Indigo

    Cleanliness.

  • Cletus

    Maybe citing one off small population studies and lumping all manufacturers together could be the reason for the reaction to the e-cig story. A simple ‘the jury is still out” tone would have been easier to accept than the outright fear mongering found in so many e-cig stories today.

  • emjayay

    mu·ti·late

    1. to injure, disfigure, or make imperfect by removing or irreparably damaging parts.
    2. to deprive (a person or animal) of a limb or other essential part.

  • emjayay

    Personally I like dicks of any persuasion. Strength in Diversity.

  • emjayay

    And some legitimate argument as there was before.

  • emjayay

    I’m guessing the American tradition of circumcision not seen in the mother culture of Europe has something to do with some Puritan anti-sex traditions plus some hygienic health ideas in the early 1900’s plus a lot of Jewish doctors. Just a guess. Meanwhile, I’m wondering why so many Chinese born guys are cut.

  • emjayay

    I think what happens is that young people smoke them and get addicted who wouldn’t start with cigarettes because of the current legal and social prohibitions. Then they smoke cigarettes when they are somewhere where they can.

  • http://heimaey.us/ heimaey

    It’s fine that you like it, and I’m glad you had a good experience, but if you hadn’t been circumcised and most people weren’t you’d’ probably have the same positive experience with penises. So the “positive” experience is likely a result of nurture not nature. If we all cut off one of our arms you’d probably be accustomed to that too and might not mind. So your positive experience doesn’t justify cutting off the tip of people’s cocks.

  • Fireblazes

    Aside from all of the science, I just think they look silly.

  • beergoggles

    Having grown up in Europe, I’ve noticed most men in Europe are not circumcised and yet their incidence of HIV is lower than it is in Africa. Also the choice isn’t between ‘a little surgery or having ones immune system crushed by HIV’. It’s between slightly lowered HIV transmission rates and a little surgery with it’s own array of risks and issues. Either way I think people should be allowed to make their own informed decision as adults about things like body alterations that cannot be undone when they are older.
    Going back to the vast difference in HIV infections in Africa vs. the rest of the uncircumcised continents – just because some research shows something worked in Africa doesn’t mean we should be forcing solutions on Africans. I can’t help but think there’s a certain element of racism here because I don’t see the freakout about lack of circumcision in Europe and Asia.

  • Sean

    I’m circumcised, and like it. In fact, I prefer men who are. There is no sexual cost, not for me at any rate. Based on my personal experience, circumcision is not a barbaric act of mutilation. I don’t think my friend’s opposition to circumcision is silly – it’s the way he would rage on about at length, and the HATE he would express for anyone who disagreed with him. So much dark emotion invested into something that I can’t see warrants such extreme censure. And again, I have that opinion from my own personal experience with circumcision, which has been nothing but positive.

  • http://www.americablog.com/ Naja pallida

    It took decades to get decent studies on the impacts of cigarettes. There’s not much reason to believe it won’t be the same situation all over again.

  • http://www.americablog.com/ Naja pallida

    It is certainly not just water vapor, things like benzene, toluene, acetalehyde, formaldehyde, isoprene, lead, etc, have all been found in the vapor. Whatever the person is inhaling, they’re also exhaling. It does vary by brand, but the “juice” is almost entirely unregulated. They could be putting anything at all in it. And by ‘they’, I mean the tobacco companies, who we all know without a shadow of a doubt cannot be trusted. Their entire business model has been to get people addicted, and then make as much money as possible off of watching them slowly kill themselves and others.

  • http://heimaey.us/ heimaey

    Then you’re not reading the other side of the argument properly. My good friend is a gynecologist and he will not mention circumcision unless his patients specifically asks, and then he advises against it if they are looking for an opinion (aside from Jewish people, of course). This is not uncommon nowadays and he says more and more gyno-obs are recommending NOT to in NYC and does not believe any of these studies that have been brought up claiming the benefits out weigh the risks. The current climate is much more divided than Dr. Mark would have us believe as circumcision rates in the US have dropped 10% in the last decade.

  • http://www.rebeccamorn.com/mind BeccaM

    Disingenuous rhetoric and dishonest debating techniques have no particular political borders, and just glancing through the comments here, I’m still seeing yet another round of what you described, Mark. Ad hominem attacks on you and your profession. Attempts to deflect — “Why’d you write about X when Y is worse?” And so on.

  • BrandySpears

    Interesting you brought up the panic that vaccinations may be harmful to someone who makes the same argument about e-cigs.

  • http://heimaey.us/ heimaey

    There’s a big difference between changing your diet and body disfigurement/mutilation. Those kids can make their own choice about whether or not to be vegan later in life, people like me, unfortunately, cannot get our foreskin back.

  • BrandySpears

    You wouldn’t make that same argument if we were speaking of females.

  • sanfranguns

    If science is of the utmost importance here, then why focus on e-cigarettes and not car exhausts, for example? Wouldn’t you think that people’s lungs are more impacted on a daily basis by all the crap cars are pumping into the air vs. second hand smoke (mist?) from e-cigarettes? On that issue it seems like we’ve just demonized smoking to the point that no matter what people do everyone is going to have a problem with it. I never see anyone discuss other things that are harmful to people’s health with the same level of ire as people discuss second hand smoke.

    I posted something against the circumcision post, specifically. I can accept that there are health benefits to the practice, but I also think its still an individual’s right to make that choice for themselves. Surely you can acknowledge that that skin exists for a reason and there is also a benefit to having it?

    I see your point about living in an era where everyone’s a fucking genius about everything sitting behind the anonymity of their computers and yeah – it’s obnoxious. But constantly posting it isn’t exactly elevating the conversation. It just comes off as petty – fwiw

  • pappyvet

    Sorry to disagree Dr. Mark but good science has always been an enemy to some. The earth is not 6000 years old and the panic that vaccinations can be harmful to children is dangerous mythology. I could go on but you get the point. If enough people want to suck on the lit end of a road flare they will ignore or rebuke anyone who tells them that they shouldn’t. If someone wants to run through the streets stark naked with a stick of dynamite shoved up his ass yelling that he has found the cure for hemorrhoids there are those who would be absolutely livid if you threw a bucket of water on him.
    You have thrown a very reasonable bucket of water today but it will no doubt be met with some hostility.
    It is the nature of humans to tug against reason when “don’t like it” rules the hour.

  • 4th Turning

    “I would remind you that extremism in the defense of _______ is no vice!”

  • 4th Turning

    “The key to a good ankle, according to those in the know, is the curve.”
    And no doubt this dictum holds true in other areas as well.
    When confronted, I suspect all of us don’t mind holding
    our peace.

  • http://heimaey.us/ heimaey

    I think the lack of condom use probably plays a much bigger role in the spread of HIV.

  • http://heimaey.us/ heimaey

    You just like cut penis because you’re used to it. I feel like you may be biased on this because you find uncut cock unsightly. That said, I did laugh.

  • http://heimaey.us/ heimaey

    Many people feel very strongly about having their foreskin cut off against their will, and I guess them getting enraged is silly to you for whatever reason. And them being lost to reason I guess just means that they don’t agree with you that there are health benefits. Mutilation *should* outrage people. I’d imagine something you were passionate about would enrage you and that you’ve even been “lost to reason” on occasion.

    I have nothing to say about e-cigarettes because I don’t smoke them. I will say that as a pot smoker I can somewhat identify because the government is infringing on their right to smoke. I LOATHE cigarette smoke and I understand the government stepping in and the effects it has on the health care system, etc, but at some point you need to reach a compromise.

  • 4th Turning

    Your stuff always resonates well with me. Clarification is welcome especially
    whenever I trip over my thoughts trying to make a point on this most valued
    blog. I keeping aiming for several decibels below shrill…

  • Hue-Man

    I had composed a strident response to your first mutilation post but didn’t hit the SEND button knowing that my comments would get lost in the cacophony.

    1. You’re biased. You and your industry make billions by cutting up boys unnecessarily.

    2. The research is flawed and doesn’t immediately extend to North American gay or straight men – unless you’re a transplanted long-haul driver from sub-Saharan Africa who had unprotected sex with female prostitutes (or maybe with fellow drivers or with undisclosed male prostitutes or who knows). The studies themselves are subject to ethical challenge.

    3. We’re all going to get infections, viruses, and parasites over our lifetimes and 100% of us will ultimately die. The risk of not being mutilated were not placed in context in terms of frequency or severity. Example: 100% of all infants fall down as they learn to walk. Almost zero – but more than zero – suffer major trauma and death as a result. CONCLUSION: Put your child in a straight-jacket, immobile until she’s 10.

    4. Conversely, not a word about the risks associated with the mutilation: infections, disfiguration, death through negligence, malpractice, poor sanitation. How many of these stories are suppressed by the Medical Industrial Complex? From December, 2013: “Botched circumcision allegations against Quebec doctor grow” http://www.cbc.ca/news/canada/montreal/botched-circumcision-allegations-against-quebec-doctor-grow-1.2468653

    5. If the science is so well settled, why have MD’s questioned the recommendations, why have the recommendations changed in scope and tone? Yes, I know how science works but this topic is not pure science because the “scientists” are mostly circumcised men and suffer a second bias – in addition to the money.

    6. The “tone” of your two posts is dismissive of dissent. If the solution to every potential medical problem were the scalpel, I have a movie reference you might have missed. Runny noses – amputate. Ear infections – amputate, Psoriasis – amputate. Skinned knees – amputate. Bad drivers – amputate. http://www.imdb.com/title/tt0067277/

  • http://heimaey.us/ heimaey

    They’re buzzwords but so what? You use buzzwords all the time. Aside from that they’re also true – cutting off part of someone’s body against their will is barbaric and is mutilation. How is cutting off skin not considered mutilation? W hat would you call it? What else do we cut off of children? The umbilical cord and that’s about it.

    It’s unnecessary. And no Andy – there are some that argue that there *may* be benefits. And a large part of the problem is also that we don’t teach people how to clean properly because we’re so puritan. If people learned how to clean properly and were taught how to do it there would be less infections. But most boys are in the dark about their hygiene and it’s because we just want to snip off the skin and forget about it the rest of our lives.

  • http://musephotos.wordpress.com/ GarySFBCN

    There are millions of circumcised men with HIV who can dispute the conclusions drawn from the data.

  • pappyvet

    As soon as you claim that ignorance and intolerance are confined by a border , you just crossed it.

  • http://heimaey.us/ heimaey

    Ah well that’s different.

  • 4th Turning

    As the “bride-price,” or dowry, for Michal, Saul demands that David bring him 100 foreskins from the penises of Philistine warriors. Gruesome as this sounds, it held great significance for the Israelites. First, it would prove David’s prowess as a warrior. Second, because circumcision was the physical symbol of their covenant with God, foreskins would prove that David had killed Philistines and not some other tribal group. Finally, the collection of so many foreskins would demonstrate Israel’s military strength to its neighbors.

    Saul was sure that David would be killed attempting such a monumental task, thus removing a strong rival to Saul’s kingship. Instead, David presented Saul with 200 Philistine foreskins and claimed Michal as his wife.

  • Moderator3

    Perhaps I should have worded that differently. Exchange of ideas would have been better.

  • 4th Turning

    Mostly not going for disagreeable either-just trying to widen the perspective
    like that thing people do with their thumb and fore-finger on their ipads.

  • Mike_in_the_Tundra

    Okay, today you’re responsible for me spitting coffee all over my screen.

  • http://AMERICAblog.com/ John Aravosis

    I think a lot of people were being mean. They weren’t just disagreeing with a doctor.

  • http://AMERICAblog.com/ John Aravosis

    I think those are buzzwords. Why is it mutilation, why is it barbaric? And everything your parents do to you from age zero to 18 – actually, until death – is against your will.

  • http://AMERICAblog.com/ John Aravosis

    Though I’m starting to lean that direction now ;-)

  • keirmeister

    I think this is a much more reasoned way of stating it than simply saying medicine is the “least scientific.” I would still argue the point based on the notion of what’s being studied. A human body (and mind) is a complicated thing to study, and is different than studying, say, how photons interact or planets orbit a sun.

    This doesn’t make the study of medicine a less legitimate scientific endeavor, it simply means how it’s conducted is different. Perhaps your argument is that it’s not conducted with the proper level of scientific rigor?

  • http://AMERICAblog.com/ John Aravosis

    I know what it entails personally. It didn’t do a thing to me, other than put me and my partners at less of a risk of disease. And the only “bad science” is the science that you disprove with “good science.” I’m not seeing a lot of good science being used to refute Mark’s analyses :)

  • Comfortably numb

    All right, it wasn’t concern trolling. It was offtopic trolling:

    http://en.wikipedia.org/wiki/User:Kadin2048/Slashdot_Trolling_Phenomena

  • http://AMERICAblog.com/ John Aravosis

    First, they came for the foreskins, and I didn’t not speak out…

  • KenD

    Just to elaborate a little more. In 2000 circumsicion was not recommended by the AAP, and now in 2014 it is. This is a 100% change in position.

    Whereas the difference between “the earth is flat” and “the earth is a sphere” is a curvature difference of 0.000126 miles per mile. It is an refinement to a theory. Not a reversal.

    (5) Asimov http://chem.tufts.edu/answersinscience/relativityofwrong.htm

  • Moderator3

    4th Turning is a regular commenter, and his views are appreciated by many. That is not a troll. Disagreements are normal and not trolling.

  • Sean

    Dear Heavens! Who said anything about killing e-cigarette users?

  • Comfortably numb

    You can take your concern trolling elsewhere.

  • KenD

    I understand how science is supposed to work. Good science changes via refinement, not via reversal. Relativity doesn’t mean that Newtonian gravity was wrong. You can still get to the moon using Newton. Recommending that people live their lives certain ways based upon studies that get thrown out means that medicine is not setting the bar high enough when they draw conclusions. Meta-analysis of medical studies draw conclusions from observed correlations. There are always non-statistically valid correlations that can be observed. This is a huge problem in existing medical research and can be stated as follows: “Doctors are not statisticians”

    (1) http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/
    (2) http://onlinelibrary.wiley.com/doi/10.1111/j.1740-9713.2011.00506.x/abstract
    (3) http://xkcd.com/882/
    (4)http://slatestarcodex.com/2013/02/17/90-of-all-claims-about-the-problems-with-medical-studies-are-wrong/

  • 4th Turning

    The lifeless body of a six-month-old baby, brutally murdered alongside 12 of her relatives in front of her cousin, who was forced to witness her own father being decapitated. This is what I have seen of life in the Central African Republic.

    Talk about being comfortably numb…

  • http://frankdisalleisadummy.wordpress.com/ Get Chutney Love

    The problem is, most Africans are too poor to afford condoms, and there is the drive by the Catholic Church there to disallow their use for any purpose, because, you see, they also provide birth control which is a real no-no for the RCC.

    If you have any specific problems with the studies, or know of any scholarly works that identify any of them, please, share it with the rest of us here on this thread.

  • Comfortably numb

    Mutilating babies isn’t important?

    I posted this below. It’s a good place to start reading: http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds

  • Indigo

    and yes, that’s a scary avatar. :-)

  • Indigo

    The frontier between liberal and ideological is mined with disinformation, opinion, fear, and superstitions. Clear minds only rarely tread the foreground.

  • 4th Turning

    wahwahwah. Hard to believe we’re back on this gnawed through bone when a lot of really impt.
    stuff is closing in from all sides. My beloved is Jewish and inherited his mom’s cooking gene-total
    perfection top to bottom. Never once have either one of us noticed anything missing including my appendix which almost removed me from the planet at 12.

    As an aside, there’s not much new under the sun.

    According to Egyptian myth, Osiris’ brother Seth butchered the black skinned god (hence the missing heart). When his sister-lover, Isis, found him, she physically reconstructed him, except for the missing penis that she could not locate. But she had a solution. She made herself into a hawk and hovered over the empty crotch of her dead lover, using her flapping wings to resurrect his penis. Isis then lowered herself onto the resurrected organ and was impregnated by the god. She then gave birth to the son of god, Horus, from whom all pharaohs claimed descent.

    Read more: Mummy penis | Simcha Jacobovici | Ops & Blogs | The Times of Israel http://blogs.timesofisrael.com/mummy-penis/#ixzz2yUoLLI5S
    Follow us: @timesofisrael on Twitter | timesofisrael on Facebook

  • Comfortably numb

    There is this thing called bad science, and it seems very prevalent with circumcision. Here’s one page in a series of pages that run through the whole list of myths:

    http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds

    Studies that claim positive results from circumcision are usually heavily biased, and those that aren’t usually use logical fallacies.

    Edit: I’m amazed at the lengths people are willing to go to defend this barbaric practise.

  • jomicur

    I don’t think your first comment was too snarky at all. There are far too many progressives/liberals who insist that if you don’t toe every single party line–and if you don’t endorse their particular rhetoric, to boot–you are their enemy. Their typical response is to shriek that “if you don’t agree with me about [fill in the issue], you must be a conservative Republican!” That kind of hysterical, vindictive paranoia has driven more than a few people–valuable people, good allies–out of the progressive movement.

  • keirmeister

    An interesting read, Dr. Thoma. With regard to the “I” responses, I think it’s only fair to note that most people would not have done the hardcore research into these topics, so their ability to understand it will be based on personal, anecdotal experience. Thus, “I”. I don’t think there’s anything wrong with that. The problem is when folks think their personal opinion/experience closes the book on the discussion.

  • keirmeister

    “Medicine seems to be one of the LEAST scientific sciences of them all.”

    Forgive me, but I think this is a horrible way of thinking. It shows a lack of what science is, what it means, and how it’s used. Science allows itself to be wrong. New discoveries have the possibility of changing what’s considered “true” at the time, and real science will always beat dogma in accepting it.

    That scientific consensus changes with new information is not a bug – it’s a feature.

  • Comfortably numb

    The problem of course with those studies is that they are heavily biased and don’t reflect real world situations. And even if they were valid, the effects of circumcision is marginal at best, and cannot be compared with real remedies: education and condom use.

  • http://musephotos.wordpress.com/ GarySFBCN

    Well, if you have two friends like that, by all means, let’s chop off every foreskin on the planet and kill everyone who want to use e-cigarettes. Because, you know – you have a friend who is an addict.

  • AndyinChicago

    To some vegan out there, so’s feeding your kids chocolate chip cookies. That’s not the point. These are facts: there is a statistically significant health benefit to circumcision. It doesn’t mean that your opinions are less valid, and it’s not an attack on people who feel circumcision is wrong, it’s simply what it is. There are likely statistics out there on the changes in total nerves and the benefits of the foreskin, but you can’t dismiss facts that argue the other side because you don’t like them. You can still think that it’s wrong or barbaric, but that’s not the argument being made here.

  • Sean

    Excellent analysis of the techniques of rage! At the time of your posts I thought you were very brave to take on these new taboos. I have two dear friends, both very liberal. One is an e-cigarette addict. He was recently enraged that New York City is considering banning them in public places. (Not sure where we are on that.) The other became obsessed with foreskins several years ago. Many a time his conversation devolved into a hyper-emotional screed against circumcision. He never used the word genocide, but it felt like he was coming pretty close. I’m always dismayed when I see either of these good people descend into those pits of wounded rage and hate. Neither fixation, e-cigarettes or uncut cocks, seems to address the sources of their pain, and in the meantime they become lost to reason.

  • http://musephotos.wordpress.com/ GarySFBCN

    So we are going to use inconsistent data comparing rates of infection correlated with rates of circumcision in African countries and project that the everyone in the world?

    Circumcision should be a choice.

  • http://frankdisalleisadummy.wordpress.com/ Get Chutney Love

    The foreskin only leads to a greater possibility of infection and disease transmission. Did you know that part of the reason Africa has a lot of heterosexual HIV cases is due to the fact that most African men aren’t circumcised?

    Conclusion: Male circumcision is associated with a significantly reduced
    risk of HIV infection among men in sub-Saharan Africa, particularly
    those at high risk of HIV. These results suggest that consideration
    should be given to the acceptability and feasibility of providing safe
    services for male circumcision as an additional HIV prevention strategy
    in areas of Africa where men are not traditionally circumcised.

    http://journals.lww.com/aidsonline/Abstract/2000/10200/Male_circumcision_and_risk_of_HIV_infection_in.18.aspx

    What’s better, a little surgery, or having ones’ immune system crushed and compromised by HIV?

  • http://musephotos.wordpress.com/ GarySFBCN

    Mark, if you are going to throw a bomb by writing that we are denying, distracting, distorting, demonizing, you should be responding to our responses. Otherwise, you are using a conservative tactic: Blaming folks and then getting-out before anyone can ask difficult questions.

  • KenD

    My problem with the circumscion story is that in
    2000 the AAP came out with recommendations AGAINST circumscion. I remember this because my wife and I wrestle with the decision for our newborn son. At the time we ended up deciding to go against the recommendation. Now 14 years later you say we made the right decision by ignoring the current recommendations.
    Medicine seems to be one of the LEAST scientific sciences of them all. We put up with it because we are talking about life and death. But “butter bad, margarine good!” becomes “margarine AWFUL, butter not so bad”. At least with dietary recommendations you can adapt and follow the new recommendations. Once you’ve circumsized there is no going back. Too much medicine seems to be based upon profit motives and / or inadequate study.
    I do remember there was a time when the AMA thought smoking was good for you.

  • Fireblazes

    Education involves much more than trusting a manufacturers biased data. Of course they are going to tell you it is safe. Especially since the FDA has no legal right to question it.

  • Fireblazes

    I was at a bowling alley recently. A young man was puffing on an E-cig. He puffed on it constantly for over 3 hour, rarely did he put it down The smell of the “perfume” emanating from it was overwhelming and noxious. I can only imagine what his nicotine load was. As to the “only water vapor” being expelled, I would question how much nicotine is being released into the air. To me and my asthmatic lungs it was a very similar experience. Not as bad, but still there. Say what you will, but sucking on a high concentration of “juice” cannot be healthy for anyone. I quit smoking 20 years ago, I was overjoyed when smoking was banned from most public spaces and businesses. Now I have to relive all of the same arguements that were used to counter the addiction to cigarettes, now being used by people puffing on mini-hookahs to satisfy their addiction.. The junk in the E-cigs has not been tested or regulated. Anybody can buy the ingredients and brew up a batch in their bathtub, kitchen sink or filthy house. Anybody can get a business license and exploit the addicted. Nobody really knows what is in the juice, because there is no one regulating it. Besides when you smoke it inside you are intruding on my space, my lungs, and my health. If this makes you angry then you need to understand it is the addiction talking not your rational self.

  • http://musephotos.wordpress.com/ GarySFBCN

    I see. If there is no apparent secondary use, the body part is a good candidate for elimination.

    Fail.

  • http://frankdisalleisadummy.wordpress.com/ Get Chutney Love

    Because foreskins aren’t used to nurse children, like breasts are.

    Any other questions?

  • http://musephotos.wordpress.com/ GarySFBCN

    FYI, I am not a smoker and I support every prohibition on tobacco. But, if the relative health risk is greatly reduced with e-cigarettes, and they are very expensive, I don’t see a lot of new users being cultivated. No, I see existing tobacco smokers transitioning to something less harmful to themselves and others. And that is a good thing.

    The Puritanical zeal that so many people and governments have acted to ban these things, previous to the release of any data is astonishing.

    Are there secondary risks introduced with the e-cigarette? Yes. Children consuming the liquid, etc.

    Are there secondary risk eliminated with the e-cigarette? Probably. According to FEMA, the #1 cause of home fires is cigarettes. About 1,000 people a year die in these fires. Many more are injured.

  • 2patricius2

    I didn’t make any comments to the posts of either e-cigarettes or circumcision. But I sure wish that I had had a choice in whether to be circumcised, rather than having had that choice made for me when I was just an infant.

  • http://heimaey.us/ heimaey

    Yes please change that scary avatar.

  • http://musephotos.wordpress.com/ GarySFBCN

    What I don’t recall being discussed is comprehensive comparison of relative risks to users and bystanders regarding e-cigarettes and cigarettes.

    A sincere presentation of that data and related opinions may have demonstrated some objectivity.

  • goulo

    Mark: changing your rather off-putting (to put it mildly) avatar might help…

  • http://heimaey.us/ heimaey

    Because it’s mutilation. It’s barbaric. It’s against someone’s will. It’s disfigurement without consent.

  • AndyinChicago

    Science isn’t going to give you a definitive answer on what anyone needs to do in life, but it gives you the knowledge to make an informed decision. There is a health benefit to circumcision, and someone saying there are health benefits isn’t wrong, but at the same time it doesn’t mean circumcision is the right choice for everyone. It’s upsetting to me that so many people are offended by anyone presenting straight forward facts, and that’s just what Dr. Thoma’s doing. There’s no health statistic that it’s any way beneficial to eat chocolate chip cookies, but science isn’t telling you you can’t do it. People who are getting offended seem to be just taking facts as personal offenses.

  • http://heimaey.us/ heimaey

    Exactly.

  • http://musephotos.wordpress.com/ GarySFBCN

    Removing glands and breast tissue of newborn females would dramatically reduce the incidence of breast cancer, but it would be ridiculous to do that. Why is not circumcision seen in this same context?

    My problem isn’t with science. My problem is with zealots who refuse to consider scientific data as ONE FACTOR that should be considered making decisions, especially those involving removing pieces of one’s body.

  • http://heimaey.us/ heimaey

    I must say that I hate smokers on the street. Walking past them pisses me off. I don’t want to inhale that horrible stench. Now, I don’t know enough about the benefits or risks of e-cigarettes to form an opinion on its health stats, but I can say that the more I see of them the less smoke on the street I smell and the happier that makes me. It’s like smokers are trying to respect me, so I’ll give them credit for that.

  • http://heimaey.us/ heimaey

    Your writing is terrific and I respect you as an MD, and value your posts on here, but just because we’re not doctors doesn’t mean we don’t have valuable and insightful opinions. You can tell me all you want about the benefits of circumcision but I’m not going to ever agree with you. I think it’s mutilation, pure and simple. And there are plenty of doctors who agree with me, and there are facts that contradict everything you noted about the benefits or feel that they are greatly exaggerated. The tone of this piece reads like, and forgive me if it was not your intention, but – why don’t you agree with me? I’m a doctor! Science wins. Sure, science is the foundation of our lives, but science isn’t always right.

  • BallPlayer1990

    Regarding your e-cigarette article and its comments, it could be that e-cig users, like myself, have the education about the product and so they know it’s unnecessary to remark about its affects on other people. Everyone agrees e-cigarettes should not be sold to minors, and that parents–not big brother–need to keep e-liquid away from kids who may drink it. There’s no secondhand smoke with e-cigarettes. No fire. No carbon monoxide. There is no conclusive study that e-cigarettes contain carcinogens. What is inhaled and exhaled with e-cigs is water vapor made of nicotine, and flavoring made of glycerin and propylene glycol which is rated GRAS by the FDA, (generally regarded as safe), and used in toothpaste and asthma inhalers. Nicotine is non-carcinogenic, and its the same used in nicotine gum and patch paid for by Medicare and Medicaid. I mean, you wrote the article… don’t you know this? This is why e-cig users commented the way they did. People who are worried about what’s in the inhaled and exhaled vapor need to educate themselves by visiting a U.S.retailer like where I buy (www.southbeachsmoke.com), who list the e-liquid ingredients. Research, you might learn something.

  • Dan

    This was a really great article and one that, i hope, all liberals read. It amazes me how my fellow liberals can get rightfully so upset with climate deniers then defend the craziest quackery from the chiropractors that claim they can heal all diseases with an adjustments to spine to the very dangerous anti vaccination crowd. The science always matters. Thank you doctor. Great article

  • zadig

    OK, replying to myself, because that came off as a little too glib even for me. Just because we’re progressives doesn’t mean we (collectively) are immune to snake oil and knee jerk responses. Some of the worst anti-vaxxers are progressive hippies who’d be living on a commune if they could just track one down in Cambridge. Even-the-liberal Huffington Post is host to an embarrassing amount of pseudoscience on a daily basis.

    So, yes, we should be better than denying the science because it gores our particular ox. But I’m surprised you’re amazed by it.

  • zadig

    Whatever the cause, I was amazed that many progressives/liberals/Democrats reacted as they did

    Hi, welcome to the internets. You must be new here.

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