Talk:Circumcision

Revisions to the intro

So I remember that one was my edit and looking at the intro I think it is more balanced this way and all the content is still there... + I added the reference to Southern Africa for the sake of the context of the sources as the focus is on regions with extraordinarily high HIV rates. Sf89wei (talk)

The sentence you edited is already problematic, as it is original research; none of the sources claim to be "circumcision advocates" "particularly" focussing on HIV as the main reason for it allegedly being a public health measure. The sources merely claim that circumcision reduces risk of HIV. That claim is cited repeatedly elsewhere. Your change does not address this. Any suggestions? Blackworm (talk) 23:44, 22 November 2007 (UTC)

Again, when the original research argues in favor of circumcision, none of the gatekeepers here give a damn. Blackworm (talk) 01:18, 19 December 2007 (UTC)

Should the paragraph beginning "In March 2007 the WHO and ..." really be included in the intro? There is plenty of information in the HIV section on this topic, and the preceding paragraph in the intro refers to it too. Isn't the intro currently unbalanced? Its current structure is:

• 1st para ("Circumcision is the removal..."): brief technical definition of the word circumcision and some etymological information.
• 2nd para ("The earliest pictures are ..."): earliest evidence of circumcision and its association with religion.
• 3rd para ("Circumcision is most common ..."): current prevalence of circumcision in the world (by the way: doesn't the phrase "Circumcision is most common ..." misleadingly imply that the practice is also common, but to a lesser extent, in parts of the world not mentioned in the rest of this paragraph? Why not just use the phrase "Circumcision is common ..."?
• 4th paragraph ("Opponents of circumcision condemn ..."): brief summaries of the stances of circumcision opponents and circumcision advocates, including a reference to the topic of intro paragraph 5.

The intro seems reasonably well-balanced so far, but then we have:

• 5th paragraph ("In March 2007 the WHO ..."): description of announcement by WHO and UNAIDS about circumcision and HIV prevention
• 6th paragraph ("Circumcision may also ..."): another statement about circumcision's use to treat a medical condition.

The 5th paragraph is dedicated to a more detailed description of one aspect of circumcision advocacy which is already refered to in paragraph 4; and which is treated, in detail, elsewhere in the article. There is no paragraph in the intro dedicated to any aspect of circumcision opposition. This seems unbalanced.

I would like to suggest the removal of intro paragraph 5, and perhaps intro paragraph 6 could be incorporated into paragraph 4 in some way. Also, I would like to change the phrase "Circumcision is most commmon ..." to "Circumcision is common ...". Any opinions? Beejaypii (talk) 11:30, 6 April 2008 (UTC)

Please see WP:LEAD, Beejaypii. To quote:

The lead should be able to stand alone as a concise overview of the article. It should establish context, summarize the most important points, explain why the subject is interesting or notable, and briefly describe its notable controversies, if there are any. The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources. The lead should not "tease" the reader by hinting at but not explaining important facts that will appear later in the article. It should contain up to four paragraphs, should be carefully sourced as appropriate, and should be written in a clear, accessible style so as to invite a reading of the full article.

I would think that this almost requires paragraph 5, since it "summarize[s] the most important points", "explain[s] why the subject is interesting or notable", and "reflect[s] its importance to the topic according to reliable, published sources".

I can't see any way of incorporating para 6 into para 4, since the two paragraphs have different subjects. In the language of WP:LEAD, para 4 serves to "briefly describe its notable controversies" (we briefly describe both pro- and anti-circumcision viewpoints), whereas para 6 "establish[es] context", explaining why circumcision may be performed as treatment (as opposed to arguments about whether it should be performed). Having said this, I'd be interested to read any suggestions you may have.

As for "most common", I suggest keeping the text as it is. Changing it to "common" would imply that circumcision is not common elsewhere, which may or may not be true depending on the definition, and would therefore would require us to define "common". As a relative statement, however, we avoid that difficulty. Jakew (talk) 13:03, 6 April 2008 (UTC)

Jakew, you state that paragraph 5 is "almost" (is this sufficient?) required because it "summarize[s] the most important points", "explain[s] why the subject is interesting or notable", and "reflect[s] its importance to the topic according to reliable, published sources". However, in that section of your response you didn't quote this bit of WP:LEAD: "...and briefly describe its notable controversies." Doesn't this extract from paragraph 4 of the intro "... ,while advocates of circumcision regard it as a worthwhile public health measure, particularly in the control of HIV in Sub-Saharan Africa.", together with its citations already serve the cited purposes of the lead, including the "briefly describe" bit, as far as the HIV/circumcision issue is concerned, and bearing in mind that the advice you quote from wp:lead actually applies to the lead as a whole?

The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources.

How can we establish roughly how much emphasis is given to the circumcision/HIV issue by published sources without introducing POV and weighting issues? Do we try to establish what percentage of relevant published sources emphasise this issue? If so, do we include all published sources or only those published in the last X years? And how do we estimate the importance ascribed to this issue by particular sources? Can it be proven, objectively, that the HIV/circumcision issue should receive so much weight in the lead whilst many of the other issues dealt with in the main body of the article are not mentioned there at all? If is not possible to prove this then I don't believe the inclusion of paragraph 5 can be justified.

I agree about the word common: its definition is problematic, even when relativised by using the word more. Therefore, I think we need to find a way of re-phrasing the passage in question in order to avoid these difficulties. There is more detailed information about circumcision prevalence in other sections of the article so why not just state in the intro that circumcision rates vary significantly by country and region, citing the extremes as an illustation (one estimate of the global average is provided in the intro anyway)? We could say that circumcision is almost universal in the Middle East (or cite a specific country, such as pakistan) whilst also citing the rate of 1.6% by age 15 in Denmark, for example (with appropriate citations of course). Wouldn't this be more balanced and avoid the problems associated with the imprecision of the term common.

I haven't yet come to a conclusion about paragraph 6. Beejaypii (talk) 17:03, 6 April 2008 (UTC)

Beejaypii, no, I don't think that the "advocates of circumcision" part of para 4 is sufficient, at least in its present form, because the focus of that paragraph is on (controversial) claims made by advocates on each side of the debate. To (heavily) paraphrase, it basically says "people opposed to circumcision say that it's bad (because XYZ), while people in favour of circumcision say that it's good (because XYZ)". It's a paragraph about people and their views, not the subject itself. It doesn't by itself establish notability (or perhaps even that the subject is interesting).

Para 5 does establish that the subject is notable, because it tells the reader that a significant international health organisation has deemed it to be an important issue.

I also think it would be harmful to combine these paragraphs in a modified form. At present, para 4 is quite carefully balanced, and largely contrasts the views held by some advocates with views held by advocates of another position. If we were to combine the two paragraphs, we'd be comparing anti-circumcision advocates with pro-circumcision advocates plus the WHO and UNAIDS, and would have to adjust the relative weights accordingly. This might be somewhat unkind to the anti-circumcision advocates.

You ask: "How can we establish roughly how much emphasis is given to the circumcision/HIV issue by published sources without introducing POV and weighting issues?" Well, there are two obvious ways. First, one could examine statements from medical organisations that have been issued since the RCT evidence became available (WHO and AUA). Second, one could examine recent publications. For example, if you search PubMed for "circumcision 2007[dp]", you'll find that 268 medical papers about circumcision were published in the last full year. And if you search for "circumcision hiv 2007[dp]", you'll find that 116 (more than 40%) of these discussed HIV (to put this in perspective, searching for "circumcision phimosis 2007[dp]" returns 16 papers, or approx 6%, and "circumcision balanitis 2007[dp]" returns 7 papers, or approx 3%). (According to Google News, the situation in the media is similar: 2840/5210 (~55%) of circumcision articles discuss HIV.)

Re "common", I don't think that extremes would give a representative picture, but a possible alternative might be to simply remove these sentence(s). Jakew (talk) 18:54, 6 April 2008 (UTC)

Jakew, I disagree with your assessment of paragraph 4. I think it's about people and their views on circumcision. I think it's about the fact that one group of people advocate circumcision, and another group oppose circumcision. It's about the existence of a significant debate concerning various aspects of circumcision, and some of the main aspects of both sides of that debate. It's about human rights, physical impairment, public health, HIV, and Sub-Saharan Africa. Doesn't paraphrasing (in fact, haven't you heavily abbreviated rather than heavily paraphrased?) in the way you have done divert attention away from the detail? And isn't the detail the primary focus of our discussion? Also, If I were to adopt the approach you adopt when describing paragraph 4 as being "about people and their views, not the subject itself", wouldn't I be entitled to describe paragraph 5 as being about two organisations and their statements, not the subject itself?

Is it accurate to state that paragraph 5 "tells the reader that a significant international health organisation has deemed it [the subject:circumcision] to be an important issue."? Doesn't this paragraph simply tell the reader that the WHO and UNAIDS stated in March 2007 that circumcision is effective in preventing HIV, but only partially, and not in the absence of other interventions? Does that really tell us that these organisations deem the whole subject of circumcision to be an important issue? Or does it simply tell us that these organisations deem one aspect of the effects of circumcision to be important enough, in the context of HIV prevention, to warrant the issuing of a statement?

I'd like to revisit this passage from wp:lead:

The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources.

Do your proposed methods of establishing relative emphasis meet these requirements, even roughly? Don't your methods just measure frequency of co-occurrence of key terms in reliable, published sources, rather than "importance to the topic according to reliable published sources"? Also, wouldn't the papers returned by your PubMed search, if their contents were examined, be likely to demonstrate the importance of one possible effect of circumcision to the subject of HIV, rather than the importance of that possible effect of circumcision to the whole topic of circumcision?

I'd also like to draw your attention to other passages from wp:lead:

The lead should be able to stand alone as a concise overview of the article.

Avoid lengthy paragraphs and over-specific descriptions, especially if they are not central to the article as a whole.

Does the lead, with paragraph 5 intact, "stand alone as a concise overview of the article"? I believe it doesn't because the concision of paragraphs 4's reference to the HIV aspect of the article is compromised by the "over-specific description", in paragraph 5, of one particular event related to this aspect.

Readers should not be dropped into the middle of the subject from the first word; they should be eased into it.

Doesn't paragraph 5 drop the reader into the middle of the subject?

in a well-constructed article, the relative emphasis given to information in the lead will be reflected in the rest of the text.

Is the relative emphasis given to the information in paragraph 5 reflected in the rest of the text? I've carried out some word counts which, I believe, suggest it is not: approximately 300 words out of 4600 are dedicated to the HIV/circumcision issue in the main body of the text (excluding the lead, table of contents, and everything from the see also section to the end). That's only about 7%. Paragraph 5, together with the HIV bit of paragraph 4 (from "particularly in the ...") contains approximately 60 words, which is approximately 30% of the total word count of the lead - which stands at about 210 words.

Provide an accessible overview

Does the lead, with paragraph 5 intact, provide an accessible "overview"?

Finally, I'm going to temporarily refrain from discussing the details of paragraph 3 for the moment. I intend to return to it at a later stage. I think that trying to discuss several issues at once can get overcomplicated. Beejaypii (talk) 01:12, 9 April 2008 (UTC)

Beejaypii, I deliberately omitted the detail because the content of the arguments is less important than noting that there is a controversy. In fact, we could list a completely different set of arguments for and against (as we have done in previous versions), and the paragraph would fulfill exactly the same function. But the existence of a controversy doesn't necessarily make any of the arguments involved valid, nor does it necessarily make a subject interesting.

When paragraph 5 is taken together with the material it summarises (in "HIV and other sexually transmitted diseases"), particularly "In 2007, the WHO and UNAIDS recommended that male circumcision should now be recognized as an efficacious intervention for HIV prevention,[14] but emphasised that it does not provide complete protection against HIV infection.[78]", I think it does constitute an important issue.

If you dislike my methods for determining importance, please propose an alternative. I'd be delighted to assess the subject from a different angle. Jakew (talk) 18:25, 9 April 2008 (UTC)

Jakew, can you provide an alternative version of paragraph 4 which lists a "completely different set of arguments for and against" but still fulfills "exactly the same function"? Yes, a different version would still fulfill the particular function of noting that there is a controversy, but that's not the only function which paragraph 4 is fulfilling: it also plays its part in rendering the lead "a concise overview of the article". I suspect that if a completely different set of arguments were to be provided in that paragraph, this aspect of its function would be altered to some degree. For example, would the function of the paragraph be "exactly the same" if its current reference to the HIV related argument were removed and replaced with a different argument (which I'm certainly not implying should be done by they way, it's just the example I choose to illustrate my point)? I would say that amongst paragraph 4's current functions is the one of providing a concise reference to the HIV issue in the lead, and the presence of this concise reference is one of the reasons I cite for removal of paragraph 5 and the "over-specific description" of one event related to this issue in said paragraph.

You have not responded to most of the points I made in my previous contribution. In particular, you have not countered my assertion that paragraph 5 does not reflect the relative emphasis given to its contents in the rest of the text (and you have chosen not to comment on the word counts I provide in evidence of this assertion). You have not demonstrated that paragraph 5 is not "over-specific" and you have not demonstrated that its contents are "central to the article as a whole" (with reference to the guidance provided in wp:lead). You have not shown that the presence of paragraph 5 does not compromise the concision of the reference to the HIV prevention issue in paragraph 4 in the way I suggest in my previous contribution. You have not demonstrated that your proposed methods for establishing "importance to the topic according to reliable published sources" can achieve their stated aims (and the point is not whether I dislike or like these methods, or whether I can come up with an alternative method; the point is whether or not they can be shown to be valid: can they demonstrate "importance to the topic according to reliable published sources"?). Finally, I'm aware that, with respect to the contents of paragraph 5, you "think it does constitute an important issue.": but that's a declaration of your point of view, and not sufficient justification for the continued presence of paragraph 5. Beejaypii (talk) 12:37, 11 April 2008 (UTC)

You appear to have misundersood, Beejaypii. I'm not saying that my view is that it is an important issue. I'm saying that the World Health Organisation's view is that it is an important issue, sufficiently important that they "recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men" (to use their language [1]).

So, I see three options: a) we leave para 4 and 5 as they are, one expressing viewpoints of pro- and anti-circumcision advocates, and the other establishing notability and global context; b) we amend para 4 so that it covers a different pro-circumcision argument; or c) we amend para 4 so that it includes viewpoints of pro- and anti-circumcision advocates in addition to the WHO and UNAIDS. Jakew (talk) 13:03, 11 April 2008 (UTC)

Jakew, I would like to take the opportunity to briefly summarise some of the arguments I've described in more detail above:

1. Paragraph 5 does not reflect the relative emphasis given to its contents in the rest of the text.
2. Paragraph 5 is "over-specific" and not "central to the article as a whole" (with reference to the guidance provided in wp:lead).
3. Paragraph 5 compromises the concision of the reference to the HIV prevention issue in paragraph 4.

In your option a) you suggest that we might leave the lead as it is. This would not address any of the three points above. Furthermore, doesn't para 3 already "establish global context" in relation to the main topic? And didn't I cast doubt, in a contribution earlier in this debate, on the validity of your assertion that para 5 establishes the notability of the article topic?

The changes you suggest in your option b) do not effectively address any of the three points above. Yes, substitution of para 4's reference to the HIV prevention issue with a reference to another pro-circumcision argument would avoid the issue of the concision of the para 4 reference being compromised by the contents of para 5, but it would also mean that the concision would be lost from the lead: we would be left only with an "over-specific" description of an event related to the HIV prevention issue - an issue which I would describe as "not central to the article as a whole" (wp:lead).

And how might the changes you suggest in option c) be made in such a way that the issues associated with an "over-specific" description which is "not central to the article as a whole" would be resolved? And how would such changes resolve the problems associated with compromising or losing the concision of the existing reference to the HIV prevention issue in para 4?

In keeping with my suggestion at the beginning of this debate, I'm going to suggest a fourth option, d): we remove paragraph 5 from the lead. I believe that we would then be left (in accordance with wp:lead) with a lead which is more consistently a "concise overview of the article", which would not, to a greater extent at least, include "over-specific descriptions, especially if they are not central to the article as a whole" and in which the "relative emphasis given to information" would be more consistently "reflected in the rest of the text".

It seems to me that complying with the suggestion, in wp:lead, that the lead should "explain why the subject is interesting or notable" is proving to be problematic due to the contentious nature of aspects of the topic of this article. Therefore, might I suggest that we keep the lead simple and try to ensure that it can at least "stand alone as a concise overview of the article" and that the article is at least "well-constructed" in the respect that, amongst other things, "the relative emphasis given to information in the lead" is "reflected in the rest of the text." Beejaypii (talk) 11:33, 13 April 2008 (UTC)

Beejaypii, thank you for summarising your arguments. With respect to your point 2, I disagree with your application of WP:LEAD, which states "Avoid lengthy paragraphs and over-specific descriptions, especially if they are not central to the article as a whole." I think that this would discourage, for example, needless detail such as specific odds ratios or the finer points of arguments, but a simple statement about what the WHO recommended is not over-specific. On the contrary, it is just specific enough to establish notability and interest, and no more.

Regarding your third point, I again disagree with your interpretation, for two reasons. Firstly, I don't see "concise" as a concrete limit on the word count (and how on earth would it be measured anyway?), but rather that we should avoid saying more than necessary. Secondly, as I've explained above, I think that paras 4 and 5 are separate issues. Sure, they both mention HIV, but from different angles.

On your first point, I agree with you to some extent. However, this needs to be balanced against what should be included. WP:LEAD lists four points that should be included: "It should establish context, summarize the most important points, explain why the subject is interesting or notable, and briefly describe its notable controversies, if there are any." Of these, para 5 covers requirements (2) and (3). As such, it is clear to me that removing para 5 would do far more harm than good, and we need to think about alternatives. Jakew (talk) 13:34, 13 April 2008 (UTC)

Recent edits

Re this edit by Blackworm which "Restored some of Mahasona's edits, removed anonIP's vandalism, rephrased some statements to better match sources": I would like "Several hypotheses have been suggested:" to be restored because it organizes the material to guide the reader; and I would like "statistically significant" and "significantly" to be restored as these have important mathematical meanings. --Coppertwig (talk) 00:29, 28 November 2007 (UTC)

It's incorrect to describe unrelated findings as hypotheses lending weight to a previous conclusion. This seems to fall under WP:SYN. The information is already organized, the paragraph describes the relation between circumcision and other inflammations or infections from the ones previously described.

As far as "significantly," the word has an entirely different meaning in statistics (the language of these papers) versus general prose, such as an encyclopedia. Basically, in statistics, "significant" means "not insignificant," i.e., not explained by random chance in all but the most extreme cases. This is definition 1 of [Merriam-Webster]. In general prose, it means, "very" or "much" -- definition 2 of same. In the sentence in question the word is used in a misleading way, once as "statistically significant" (weakening the finding, implying that there was a difference but it didn't meet some arbitrary threshold), and again only as "significant" (exaggerating the second finding). The authors of the study did not say (as to a layman), "it was significantly higher." They showed that there was no statistically significant difference in the case of HPV, and there was a statistically significant difference with urethritis. As an exercise, swap the phrases "statistically significant" and "significant" in the previous form of the sentence, and see how the POV shifts. I prefer a neutral POV, and a proper summary of the source. Blackworm (talk) 09:06, 28 November 2007 (UTC)

Jakew, you changed the sentence to reinsert "statistically significant," weakening the finding of no link between HPV and circumcision. Your edit summary said, "'no statistically significant difference' is not quite the same as 'no difference'." That's true, it isn't quite the same, but I ask you -- if the difference is not significant enough to be called significant by the researchers, from a scientific point of view, why is the difference significant enough to you? In a scientific paper, a finding of no statistically significant difference is a finding of no difference. Period. That is science. Are we to start putting "statistically significant" before every finding of no difference between circumcised and uncircumcised men in every study cited by the article, or just the ones where we want to imply there is a difference? Blackworm (talk) 17:03, 28 November 2007 (UTC)

it's not our job to assume that our readers are morons... i say leave "statistically significant" in since it is accurate. ^Law/_Disorder 10:21, 29 November 2007 (UTC)

I agree.

The source states that "There was no significant difference in the incidence of HPV infection ... between uncircumcised and circumcised men", so we are simply reporting what it says. I am concerned by protests that this results in "weakening the finding": why would we want to present a stronger claim than that presented by the source? Jakew (talk) 12:14, 29 November 2007 (UTC)

You tell me -- the previous summary indeed did, and I corrected it. It's unfortunate I don't have the time to check every source in the article, because 90% of the time that I do, the Wikipedia summary takes a more pro-circumcision stance than the source by misrepresenting its position in some way. But fine, I have no objection to this change -- I just think it's silly to insert "statistically significant" every time we report on a scientific paper finding no difference between two groups -- and it's POV to do it selectively since it injects doubt as to the finding. I will "correct" other instances of this elsewhere, I guess. Blackworm (talk) 17:53, 29 November 2007 (UTC)

we can't deal with vague accusations of selective bias.... 67.164.220.177 (talk) 06:41, 30 November 2007 (UTC)

Nothing vague about this. Quite the contrary. I'd say it was very detailed. Garycompugeek (talk) 15:07, 12 April 2008 (UTC)

Sexual pleasure

This article has a section for external links. One of the sections under external links is called "Circumcision opposition". I added a link to Sex as Nature Intended It. A couple of hours later, Avraham reverted to the previous version, calling this a "minor" edit.

As the article currently stands, there is a section for external links that represent "Circumcision opposition". One of the main arguments to be made against male circumcision is that it reduces pleasure for both circumcised males and their female partners. None of the links under "Circumcision opposition" points this out; that's why I added the link to Sex as Nature Intended It. Thus, I think that the link I added is completely legitimate (especially given that it was in an advocacy category). If anyone disagrees, I'd like to hear reasons. —Preceding unsigned comment added by Hyperion (talk • contribs) 07:44, 13 December 2007 (UTC)

"On articles with multiple points of view, the number of links dedicated to one point of view should not overwhelm the number dedicated to other equal points of view, nor give undue weight to minority views." WP:EL#Avoid undue weight on particular points of view Jakew (talk) 12:05, 13 December 2007 (UTC)

Exactly. And Hyperion, being that there is no little black m next to the reversion, from where did you get the idea that I called it minor? -- Avi (talk) 14:15, 13 December 2007 (UTC)

Avi, there is a little black m next to your reversion. What are you smoking? -- Hyperion (talk) 18:54, 13 December 2007 (UTC)

Yes, you're correct. I did not realize that rollbacks automatically coded as minor. Sorry about that. -- Avi (talk) 19:59, 13 December 2007 (UTC)

There are currently four links under "Circumcision opposition" and three links under "Circumcision promotion". Therefore, adding one more link to the former, to yield a 5:3 ratio, would hardly "overwhelm" the point of view promoting circumcision. Thus, it is clear that you are abusing this Wikipedia guideline in order to censor a point of view that makes you personally uncomfortable. And the view being represented hardly constitutes a "minority view". The only places where male circumcision is significantly practiced is America and the Muslim world. Therefore, it is the "circumcision promotion" category which is the minority view. Thus, a 5:3 ratio is entirely appropriate.

A comment on Amazon about the book that this Web site summarizes states: "After reading several books on circumcision, if I could recommend only one book on the "c" word, this would be the one." Thus, this link is essential for Wikipedia readers to be properly informed about the current stated of the male circumcision debate. If you don't like this, find another link to put in the "promotion" section.

Jakew, looking over earlier posts in the Talk page, I see you have been suppressing anti-circumcision points of view for some time time now. Give it up. -- Hyperion (talk) 18:54, 13 December 2007 (UTC)

Having nearly twice the number of anti-circumcision links is a clear case of undue weight, Hyperion, and one cannot infer being opposed to something from not practicing it. If you feel it is important to add this link, I suggest that you propose a way of doing so that does not imbalance the links. Jakew (talk) 12:32, 14 December 2007 (UTC)

I see Avi has removed the 'circumstitions.com' link, which is a satisfactory solution. I've removed the POV description of O'Hara's site. Jakew (talk) 12:39, 14 December 2007 (UTC)

What a big joke. There's an entire section of "circumcision techniques" links which are obviously from groups which support, if not encourage circumcision, that no one is counting under the "pro-" links -- meanwhile, Avi, a circumcision advocate, picks the most convincing and grisly "anti-" circumcision link to be deleted for someone else to add a mild, warm and fuzzy link that isn't convincing at all. What a farce. Blackworm (talk) 18:32, 14 December 2007 (UTC)

HIV

I've once again reverted an addition to the HIV section, which had several problems:

• Currently, four sentences cover mainstream (WHO etc) views about circumcision and HIV. The addition dedicates an additional four sentences to minority viewpoints, effectively giving them undue weight.
• The citing of Thomas (one of the ~40 or so observational studies to date) is bizarre. If we're to discuss observational studies at all, it makes more sense to cite a systematic review of observational studies rather than any individual study.
• The text also gives the impression that Thomas is an example of an author who disagrees "that male circumcision reduces female to male transmission", yet the source makes no such statement (the conclusion is limited only to one particular population).
• Similarly, the citing of Talbott is inexplicable. There are several ecological studies, why this one in particular? Jakew (talk) 14:12, 24 December 2007 (UTC)

• The four sentences from the WHO (there is no "etc.") dominate the section (as they do the lead). There is room for opposing views without undue weight issues, and invoking WP:SUMMARY when someone is claiming violation of WP:NPOV seems misguided.
• This is not a valid argument against the edit. If you have such a systematic review of relevant observational studies, present it.
• I agree that the sentence that begins "Not all authorities..." is misplaced and should be removed.
• Again, not an argument against the edit.

I support Nigelj's edit, with the exception that I believe the sentence "Not all authorities" should be deleted. Blackworm (talk) 00:36, 25 December 2007 (UTC)

I thought maybe a single sentence could be inserted instead of the four sentences, and I read through the HIV section at Medical analysis of circumcision looking for material on which to base that single sentence. I wasn't able to come up with anything. The major publications that express doubt that circumcision helps against HIV were published before the controlled trials and apparently said that we can't conclude it helps until we get the results of the controlled trials. Now that we have those results, those views are no longer relevant or are difficult to interpret or to summarize in a sentence. --Coppertwig (talk) 02:21, 25 December 2007 (UTC)

No longer relevant? I dispute that strongly. If I remember correctly, the controlled trials referenced by the WHO were halted. They were presumably scientific studies, with strict, predefined methodology, that were not carried out to their conclusion. To use "results" from incomplete trials is the prerogative of the WHO, or any group, and it certainly does not invalidate or render irrelevant studies on HIV and circumcision published previously or since. Most certainly, it does not render criticisms of the WHO's view irrelevant. What you are suggesting seem to be that we should exclude other studies from mention, because they contrast with the "mainstream" (i.e. WHO) view. That seems to me to be a violation of WP:NPOV. All of this WHO/UNAIDS stuff is recent scholarship at best; it is arguable that undue weight is given the WHO's current view given that it is a current event. That is most evident in the lead section. I suppose one could ask oneself, does the presentation of the WHO's view in the article read like a dry, factual description of their view, or does it read like an endorsement of that position? Remember that "undue weight" doesn't mean the majority view is presented as the correct view (if indeed the WHO's view represents a majority, a claim yet to be proven). Blackworm (talk) 09:16, 25 December 2007 (UTC)

All three trials included one or more interim analysis stages in their protocols, in which the monitoring board assess the data and decide, among other things, whether to stop the trial. In the case of these particular trials, they were in fact stopped.

Systematic reviews of observational studies include Weiss et al (including 27 studies) and Siegfried et al (including 37 studies). To quote from the full text of the latter's 'conclusions' (accessible at the Lancet's site via free registration):

• "The possibility exists that the observed results included in this review could be explained by confounding. Although the positive results of these observational studies suggest that circumcision is an intervention worth evaluating in randomised controlled trials, the current quality of evidence is insufficient to consider implementation of circumcision as a public-health intervention. Therefore, the results of the three randomised controlled trials underway will provide essential evidence about the effects of male circumcision as an intervention to prevent HIV infection." Jakew (talk) 12:37, 25 December 2007 (UTC)

Also, please note that the WHO did not themselves 'decide' to use these results, but 'convened an international expert consultation', and 'Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men'.[2]

The systematic reviews of observational studies indicate that most observational studies found a protective effect, but that exceptions exist. Bearing this in mind, how can we justify citing only two such exceptions? How can this be anything other than undue weight? If we're to refer to observational studies at all in the limited space available (which seems questionable), then wouldn't it make more sense to refer to a systematic review which gives a broad overview? Jakew (talk) 13:49, 25 December 2007 (UTC)

I had another look and this for example may still be of some relevance: "We found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men. " from the Cochrane thingamy. Blackworm, no, I'm not suggesting what it seemed to you that I was suggesting. I was talking about conclusions like the following, also from the same paragraph of the Cochrane whatchammy: "The results of [RCT's] will need to be carefully considered before circumcision is implemented as a public health intervention for prevention of sexually transmitted HIV." Written before the RCT results were around. Now that those results exist, it seems difficult to iterpret or summarize this statement. I'm not aware of any published criticisms of the position the WHO has taken based on the RCT results.

(edit conflict) I propose the following edit. Insert "Earlier, meta-analyses of observational data differed as to whether there was evidence of a protective effect of circumcision against HIV." at the end of the first paragraph of "HIV and other sexually transmitted diseases". At the same time, to avoid lengthening the article, shorten the material on balanitis and balanoposthitis as follows: change this:

“ The usual treatment for balanoposthitis is to use topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams.

Circumcision is sometimes used to treat balanitis, although there are less invasive treatments than circumcision that have been shown to be effective in treating most mild cases. The less invasive procedures are not as successful in treating balanitis xerotica obliterans, or BXO, which is much less common but harder to treat. Circumcision is believed to reliably reduce the threat of BXO.

”

to this:

“ Circumcision is one treatment for balanitis. The usual treatment for balanoposthitis is to use topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams. ”

The deleted material is already present, I believe, in the Medical analysis of circumcision article.

The material I propose to insert can be supported by the following references, which will have to be formatted appropriately and possibly the first one replaced by a reference to the study it mentions: USAID Cochrane Cochrane. --Coppertwig (talk) 14:34, 25 December 2007 (UTC)

Jakew, you make good points re the foundation of the WHO position. Looking at Medical analysis of circumcision I get the impression that there were two major meta-analyses of the observational data, which in my edit above I suggest citing. re WHO: are we (merely :-) citing WHO, or can we also (or do we already) cite the conference they base their recommendation on? --Coppertwig (talk) 14:39, 25 December 2007 (UTC)

Coppertwig, I think that the essence of your edit is fine in principle, but I have a couple of concerns about the details.

My first concern is that while one meta-analysis may provide some background information to the RCTs, I think it may be excessive to discuss two reviews of observational data. Given that the available space is limited, how much of it should we dedicate to "quality of evidence [that] is insufficient", and how much to "essential evidence"?

My second concern is that I think it is inaccurate to say that "Earlier, meta-analyses of observational data differed as to whether there was evidence of a protective effect of circumcision against HIV". Both Siegfried et al and Weiss et al reported finding that this evidence existed ("Although most studies show an association between male circumcision and prevention of HIV" - Siegfried, "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" - Weiss). However, Siegfried et al were concerned about whether the evidence was good enough to warrant implementing circumcision programmes: "these results may be limited by confounding, which is unlikely to be adjusted for ... the current quality of evidence is insufficient to consider implementation of circumcision as a public-health intervention."

Although the following is too long, I think it is probably the best way to summarise:

• "In March 2005, Siegfried et al. reviewed 37 observational studies. Although most studies showed an association between circumcision and prevention of HIV, they found the quality of evidence available at the time insufficient to warrant implementation of circumcision as a public health intervention. They concluded that the results of the three randomised controlled trials then underway would therefore provide essential evidence about the effects of circumcision. The first of these trials..."

Incidentally, I'm a little confused because you seem to have given the same (www.psi.org) link for both USAID and Cochrane references. Could you clarify whether this was your intent, and if not, what the links ought to be? Jakew (talk) 12:23, 26 December 2007 (UTC)

Oh, sorry about the URL's. OK, we're considering four references:

• USAID 2002 Male Circumcision: Current epidemiological and field evidence, which says "A systematic review and meta-analysis of 28 published studies by the London School of Hygiene and Tropical Medicine, published in the journal AIDS in 2000, found that circumcised men are less than half as likely to be infected by HIV as uncircumcised men. A subanalysis of 10 African studies found a 71 percent reduction among higher-risk men. A September 2002 update considered the results of these 28 studies plus an additional 10 studies and, after controlling for various potentially confoundnig religious, cultural, behavioral and other factors, had similarly robust findings. Recent laboratory studies in Chicago found HIV uptake in the inner foreskin tissue to be up to nine times more efficient than in a control sample of cervical tissue."
• Weiss et al. 2000, which says "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."
• Cochrane = Siegfried et al. 2003 which says "We found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men. The results from existing observational studies show a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups. However, observational studies are inherently limited by confounding which is unlikely to be fully adjusted for. In the light of forthcoming results from RCTs, the value of IPD analysis of the included studies is doubtful. The results of these trials will need to be carefully considered before circumcision is implemented as a public health intervention for prevention of sexually transmitted HIV."
• Siegfried et al. 2005 which says "Study quality was very variable and no studies measured the same set of potential confounding variables. Therefore, conducting a meta-analysis was inappropriate. Detailed quality assessment of observational studies can provide a useful visual aid to interpreting findings. Although most studies show an association between male circumcision and prevention of HIV, these results may be limited by confounding, which is unlikely to be adjusted for."

I suggest this edit (along with the balanitis changes): "Earlier, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV" and using Weiss et al 2000 and Siegfried et al 2003 as the references. I think Siegfried et al 2003 and Siegfried et al 2005 are saying essentially the same thing: that there is evidence of correlation but insufficient evidence of causation. --Coppertwig (talk) 15:14, 26 December 2007 (UTC)

Ok, thanks for clarifying. Unless I'm greatly mistaken, USAID 2002 is citing Weiss 2000. I think that Siegfried 2005 is an updated version of 2003, and as you say makes a similar conclusion: that observational studies aren't sufficient (because they are "inherently limited by confounding") and that RCTs (will) provide more definitive data. I think that, if we're to discuss the observational data, we need to distinguish between these data and those from RCTs. Jakew (talk) 15:51, 26 December 2007 (UTC)

How about this? I think it makes the distinction clearer: "Before there were any results from randomized controlled trials, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV." --Coppertwig (talk) 16:28, 26 December 2007 (UTC)

That seems perfectly reasonable to me. Jakew (talk) 22:43, 26 December 2007 (UTC)

(<<outdent) OK, I did the edit, including shortening the balanitis section. One advantage is that the two edits led to a net reduction in number of footnote superscripts of four. (I believe it's the number of footnote superscripts that causes the page to render slowly, I presume also putting a load on Wikimedia's servers.) The deleted references are still present on the Medical analysis of circumcision subpage, so that's fine. --Coppertwig (talk) 03:02, 27 December 2007 (UTC)

Since WHO just published yet another report advocating circumcision for the prevention of heterosexual HIV transmission, I think the AMA reference from almost ten years ago should be removed from the summary at the top. Many new studies have come out since that time, and it is disingenuous to claim that the AMA would still express the same view today as it did in 1999. 75.3.239.32 (talk) 07:07, 9 June 2008 (UTC)

Sexual Effects

It seems like the sexual effects article is biased by showing more studies against circumcision then for it. Obviously, there are numerous amounts of studies on both sides. I am trying to add 2007 payne study but i am sure that it wilil get reverted by anti-circ zealots. By the way, most pro-circumcisers that try to bias it is in response to the anti circ people. 67.35.83.97 (talk) 13:38, 31 December 2007 (UTC)

I think it's amusing when people who support nonconsensual bodily amputations call others "zealots". 68.40.196.149 (talk) 06:56, 14 March 2008 (UTC)

I have to agree.

by Wild Mountain Thyme (talk) 06:45, 10 April 2008 (UTC)

It is when you use terms like "nonconsensual bodily amputations" that people think you are a zealot. Could you describe a consensual bodily amputation to me? Or a nonconsensual non-bodily amputation? Consensual non-bodily amputation? In one sentence, you added enough bluster to keep the rest of us shaking our heads for a good long while. The same is almost always present in your version of the "facts." No matter how many times doctors from around the world advocate circumcision to prevent transmition of HIV, the anti-circumcision zealots will never budge. I hope you understand why the rest of the world thinks you are a kook. It is because you present yourself as one. 75.3.239.32 (talk) 07:16, 9 June 2008 (UTC)

Circumcision scars and hardens the glans of the penis which acts as a slight barrier against HIV infection. This is hardly a compelling reason in favour of circumcision.

Okay, I guess "nonconsensual amputations" would have sufficed. Examples of consensual amputations would be an adult male electing to be circumcised after being fully informed of all the risks, or a woman electing to have her breasts removed as a prophylaxis for breast cancer, also after having been fully informed of the risks. Cutting up babies is nonconsensual. Actually, as most of the world does NOT practice circumcision, they would probably consider you the "kook", but I doubt you've ever been outside the U.S. Learn how to spell "transmission" and we'll talk more then.Gimmethoseshoes (talk) 05:31, 12 June 2008 (UTC)

That makes no sense, 75.3.239.32, and is a violation of Wikipedia's policies of no personal attacks and civility. If you continue to violate these policies you may be subject to administrative action, including blocking. Gimmethoseshoes, please try not to respond to personal attacks with a discussion of the subject, as difficult as that may be. This user, and other non-neutral users use terms like "zealot" to marginalize editors and create a kind of fake consensus. The neutrality of "nonconsensual amputation" is in question because some people believe that parents have a right to give surrogate consent for non-medical, non-therapeutic, non-recommended, non-anaesthesized, gender-specific genital surgeries of their male infants and children (and a far fewer number, for their female infants and children). Suggest you use "surrogate consent-baesd amputation" instead. Of course that doesn't make you a kook, any more than people who claim that it's more humane not to use anaesthesia, or who compare circumcision to the cutting of hair or the trimming of fingernails. Blackworm (talk) 05:44, 12 June 2008 (UTC)

Point taken. But the term you suggest is even more contrived than the one I used... at a certain point the language gets ridiculous in an effort to be Wiki-PC. "Amputation" is accurate and objective, though it is the "nonconsensual" which is lacking neutrality (supposedly). I wouldn't know what "surrogate consent-based amputation" meant if it were not already in the context of our discussion. And I consider myself pretty smart. Is "Female Genital Mutilation" neutral? Is anyone looking into the non-neutrality of that page with respect to the (male) circumcision page? If we truly are to remain neutral, perhaps it should be "Female Genital Modification" or something. I know this is the wrong forum for that specific question, but you get my point.Gimmethoseshoes (talk) 04:19, 13 June 2008 (UTC)

Aha, but you clearly haven't read the last few archives of this Talk page, as seemingly contrived language is common in a milieu where the only civil discussions have a level of pedantry unseen anywhere else in Wikipedia. Neutral language does seem ridiculous upon first hearing. Those who are sometimes accused of vigorously defending material pushing a pro-circumcision POV also seem to use such "so neutral it seems non-neutral" (paraphrasing) language. Ultimately I believe that in Wikipedia the more neutral term should always be used over the more common term. Apparently a few others here disagree. If you want to label that Wiki-PC, so be it; but that doesn't sound to me like a valid argument.

It's not a question of your intelligence ("smart"), it's a question of your level of expertise on the subject of circumcision. If you're unsure what something means in discussion (e.g, surrogate consent), just ask. Around here that definition isn't under debate. But no, you say you did understand. So what was the problem, exactly? You had a gut feeling about something, perhaps? I can't help you with that.

And no, I don't get your point, if your point was to make a reductio ad absurdum, as is apparently the case. If you were serious, and not being facetious, then I agree with you entirely that "female genital mutilation" isn't very neutral; in fact, there is a current majority of editors who believe that female genital cutting is the most neutral term, and thus that's the title of the article on that subject (perhaps a clear example of systemic bias). This, despite the demonstration that both "female genital mutilation" and "female circumcision" are more common terms -- editors there specifically argue, as I do there, that the more neutral term is preferred over the more, or most common term. Curiously, when we examine the male equivalent of the topic, then instead of a common, more neutral term ("male circumcision"), only the most common term ("circumcision"), with one sense of the term meaning one specific form of male genital cutting, is considered. This, by those very same editors making the argument for the title female genital cutting, due to its neutrality. I disagree with those editors, and point to the apparent contradiction. I believe the best solution is that (a) this article be called male genital cutting and made to correspond to the broader definitions used in female genital cutting, or, (b) this article be renamed male circumcision and an article created for female circumcision. Female circumcision is a subset of female genital cutting, in the same way male circumcision is a subset of male genital cutting. This ordered, neutral, logical perspective comes from my scientific training, and I'm unimpressed by those putting forth scientific credentials here, who brush off these contradictions with a wave -- often biting the heads off some editors who are perhaps less educated on the topic of circumcision for whom the non-neutrality of this article organization is also apparent. Blackworm (talk) 05:38, 13 June 2008 (UTC)

7int tends to be geared towards infant circumcision. I believe this needs to be addressed. —Preceding unsigned comment added by 68.150.33.190 (talk) 22:20, 5 January 2008 (UTC)

Good point. ~ Homologeo (talk) 19:44, 1 February 2008 (UTC)

In Africa circumcision happens at adult age. Khayav made some video about it on youtube. He was circumcised as an adult. --Zslevi (talk) 18:10, 9 April 2008 (UTC)

I agree. I was circumcised as an adult and it would be very useful if Wikipedia adressed this topic. Sephiroth21 (talk) 13:47, 12 June 2008 (UTC)

Pictures?

Not to be inappropriate at all, but would there be any way to have a side-by-side comparison of a circumsized and uncircumsized penis? For comparison? (And those of us who are chicks, and don't really know the difference...) 63.166.22.254 (talk) 11:21, 6 January 2008 (UTC)

We used to have comparison pictures, but the uncircumcised picture was deleted according to CSD criteria I9 and G7 (copyright infringement and author request).

Here's an image of an uncircumcised penis from Commons: Image:Uncircpn.jpg. Would it be a good idea to add it to the article? I found two other pictures at Commons which at first glance seem to be labelled "uncircumcised", but apparently are actually of circumcised penises. --Coppertwig (talk) 15:11, 6 January 2008 (UTC)

There are two images at Erection#Penis erection, both of which are public domain. We could use these, or combine them into a suitable image illustrating the differences. I'd be happy to do this myself if there was consensus to do so... Jakew (talk) 16:50, 6 January 2008 (UTC)

Should we perhaps wait until we can find a suitable image of a circumcised penis that doesn't have a skin bridge, or any other sign of a botched circumcision? Blackworm (talk) 19:41, 6 January 2008 (UTC)

I can't even see the skin bridge on that picture, so I'd suggest going ahead and including both pictures, but am happy to wait if Blackworm prefers. (Congratulations for showing neutrality there, Blackworm.) (I don't dare put up a request at Commons for such a picture. Maybe someone else is braver than me about that.) --Coppertwig (talk) 23:13, 6 January 2008 (UTC)

I agree you can't see it in the thumbnail, but I definitely see it if I click on it. I'm fine with it, just thought I'd note that. Blackworm (talk) 23:17, 6 January 2008 (UTC)

I believe we're talking about Image:Flaccid-erect.jpg. OK, maybe I see the skin bridge now. In the erect picture, I think the skin bridge is something that if you follow it down towards the body, it seems to meld into a vein that sticks out. Is that right?

I'm not sure how much work it would be for Jakew to combine the images. Ideally I guess the skin bridge one would be replaced when a more suitable image is found. Actually, two images. I suggest one of a circumcised penis without skin bridge or other problems, and also (in another section of the article perhaps) a clearer, more obvious image of a skin bridge. --Coppertwig (talk) 01:14, 8 January 2008 (UTC)

Now that I've seen the difference in both pics (good Lord, what IS that thing on the end?!)(rhetorical, don't worry), I strongly think a comparison pic would be a good idea. Pictures say a thousand words, and what better way to describe the procedure than by showing the, if you will, "before" and "after" pics. No?

63.166.22.254 (talk) 08:39, 8 January 2008 (UTC)

Re survey

This material was removed from the article by Jakew: "However, in the 2007-08 global Durex sexual activity study, the United States (in which the majority of males are circumcised) ranked 25th for sexual activity, while all of the European nations surveyed (which have a majority of uncircumcised men) were in the top ten. One of the reasons for this can be attributed to the fact that circumcision was formed in religious circles as a way to prevent masturbation, as more religious societies have proven to be less sexually active than secular cultures. Also, modern polls of men show that uncircumcised males tend to masturbate more compared to their circumcised counterparts, due to the self-lubricating properties of the foreskin" with edit summary "rv original research". OK, there does seem to be some OR there -- but the last sentence looks merely unsourced, not OR. However, we might as well leave it out until somebody finds an actual source. I did some web searches and didn't find anything much. --Coppertwig (talk) 14:55, 12 January 2008 (UTC)

Off the top of my head, I can think of two studies that have assessed masturbation frequency by circumcision status. Neither support the claim. Laumann (JAMA 1997;277:1052-7) found that circumcised men masturbated more frequently, while Richters (Int J STD AIDS 2006;17:547-54) found no statistically significant difference. So even if some sources exist that support the claim, the sentence would be problematic. The "due to" claim in that sentence also looks rather OR-ish to me. Jakew (talk) 15:22, 12 January 2008 (UTC)

Jakew presents solid reasoning for removing this material - definitely looks like OR. ~ Homologeo (talk) 19:49, 1 February 2008 (UTC)

Whether or circumcision discourages masturbation (that's difficult to reliably proove) there are many quotes by religious or moral leaders who advocated it for that reason.

Campaigns, etc

Recently, the BBC carried a story headlined Rwanda in mass circumcision drive, in which it is explained that "Rwanda has launched a campaign to encourage all men to be circumcised, to reduce the risk of catching HIV/Aids." I'm not certain of the best article for this information. It seems likely to affect the prevalence of circumcision, but technically that's OR and a little crystal ball-ish. I suppose it could go into circumcision advocacy, though it would change the focus of that article. Previous reports indicated that several countries have similar plans, so it's probably worth giving this some careful thought. Does anyone have any ideas? Jakew (talk) 18:16, 24 January 2008 (UTC)

Perhaps Male circumcision and law or perhaps reproductive rights or human rights since it seems like a case of forcing teenage and adult males to be circumcised against their free will (the article described it as "nominally voluntary" and states that "many in the armed forces will regard it as an order"). It's also definitely circumcision advocacy since the campaign will be started, among others, "with the new born." Blackworm (talk) 20:12, 24 January 2008 (UTC)

Instead, perhaps we should start a Campaigns for semi-voluntary mass male circumcision article? I'm sure it will get filled out in the coming years, if the WHO has their way. Blackworm (talk) 22:29, 24 January 2008 (UTC)

Such silence on this momentous development...? Maybe it should just go in the main Circumcision article next to the information about the WHO's push for mass circumcision in Africa. I wonder if Wikipedia senior administrator Jayjg, a former member of ARBCOM, would now reverse his comments in the "Articles For Deletion" proposal Jakew initiated for the circumcision advocacy article:

Delete. Obvious original research, no evidence such movement or social activity actually exists. Jayjg (talk) 00:10, 5 December 2005 (UTC)

— User:Jayjg, Senior Wikipedia administrator and former ARBCOM member, in the AfD for circumcision advocacy.

Blackworm (talk) 21:15, 25 January 2008 (UTC)

And Kenya. (Filing here for convenient access at a later date.) Jakew (talk) 21:15, 9 April 2008 (UTC)

Where would this hypothetical edit go in Wikipedia?

In the context of fieldwork among the Kenuz Nubians, El Guindi has argued for "the significance of the notion of the cultural equivalence of male and female circumcision," and further argues "that this cultural equivalence extends analytically as a structural equivalence: that is, the two gendered rituals play equivalent roles in the transition of male and female children to adulthood."[3]

Since this article inexplicably bans all discussion of the circumcision of females, and the female genital cutting article bans any comparison to male circumcision (but oddly, not contrasts), it seems that there is nowhere in Wikipedia a place for scholarship concerning any comparisons of any kind between the circumcision of males and females. It seems El Guindi's published views, like all views concerning any such comparisons, are suppressed by the imposed structures. Could the reason be POV? Blackworm (talk) 07:46, 25 January 2008 (UTC)

How does an article ban anything? And what exactly are "imposed structures"? Either a piece of information is referenced and relevant to the article subject, or it's not. That said, of course there are strong POVs involved on an immediately and unavoidably personalised hot button topic like this. The only advice I can offer you is to do what I did: look for other areas of interest and don't lose yourself in the same endless dispute over and over. Wikipedia offers an increasingly comprehensive bouquet of heat and noise to dive in; endless conflicts of interest, gaming the system, intellectual dishonesty, ownership, bullying, low-level long-term disruption. There are far more places where you can't do anything to improve the encyclopedia because of dirty tactics being shamelessly employed for the sake of a questionable status quo. Why try in vein here, when you can as well try in vein elsewhere for a change? Alternatively, create a niche for yourself and write about something completely different or find other ways to participate. If however your primary goal is to educate others, then I can only hope you are willing to be educated in turn. Otherwise, you're no better than the trolls who come here with a set agenda. User:Dorftrottel 08:13, January 28, 2008

Thank you for the comment. I'm not sure if it was intended as humour but I must say I found the part about trying in vain elsewhere for a change very amusing. One major point of Wikipedia is to assume good faith, and the day I give up on that, I might as well give up on Wikipedia entirely. My primary goal is not to educate others, it's to help make a encyclopedia worthy of being called a neutral reference work. I have indeed been educated on how to do that, mostly by reading WP policies. I believe that if they are put into practice, they will work. Unfortunately, WP is still edited by humans with points of view, and sometimes even by humans wishing to promote or oppose the presentation of specific, notable, verifiable points of view.

As for how an article bans an idea, the mechanism and effect are clear -- through a strongly enforced, narrow, and incomplete definition of a topic, this article and all related articles ban the idea that circumcision also includes the circumcision of females, thus implying that the topic refers strictly to procedures on males, and that any other usage is incorrect. Any reader of George Orwell knows how control of language gives rise to control of ideas. The groups who wish to control (i.e. eliminate) the idea that male and female circumcision are in any way comparable or related have an interest in separating the terminology. This isn't done in secret; organizations like the UN's specialized agency the WHO, openly admit to be promoting the introduction of new terminology to describe female circumcision (and thus effectively redefining the term "circumcision") so as to eliminate undesired associations between the practices of male circumcision and female circumcision. They simultaneously campaign for mass male circumcision (with alarming effects, IMO) and claim that female circumcision is a human rights violation. These two tasks would be much more difficult to justify if the term used was "circumcision" in both cases. I don't believe Wikipedia, as a supposedly neutral reference, should engage in or assist this advocacy, even if 99% of editors were convinced that the advocacy is otherwise something they would support. I believe the current organization of the articles does just that, and find it difficult not to conclude that it is either purposely done to support this advocacy, or, perhaps as a matter of greater concern, done unconsciously because the WHO and similar groups have already succeeded in eliminating ideas through their recent redefinition of words and phrases in the English language. Sorry if this is soapboxish, but you asked about my goals... WP:NPOV pretty much sums them up, along with the Five Pillars. Can WP:NPOV be followed here, or are we to give up on it? Blackworm (talk) 09:03, 28 January 2008 (UTC)

FWIW, I believe the article is currently as fair & balanced as it will get. Why not go to WP:FAC? If there are still issues that could and should be improved, the article can only benefit from the attention of multiple uninvolved users. User:Dorftrottel 11:48, January 28, 2008

Female genital cutting already contains a quote which comments on a comparison of male and female circumcision: "this procedure in whatever form it is practised is not at all analogous to male circumcision." I think right next to that quote would be a good place for the above quote, per WP:NPOV. (Is it a real quote, or just hypothetical?) Since the words for female circumcision are being changed, the page on that topic seems to me a good place to discuss related nomenclature. There's no particular reason why female circumcision can't be mentioned on this page, or male circumcision on that page, if it's somehow relevant to the topic. This page may also be a possible place for such a quote; or Circumcision in cultures and religions. --Coppertwig (talk) 03:07, 29 January 2008 (UTC)

The above quote doesn't seem to be discussing terminology, and I wonder if perhaps a better approach might be to shorten the Cook quote, so that it stays closer to the topic within the 'terminology' section? In any case, Talk:Female genital cutting seems a more appropriate place to discuss changes to that article, so perhaps we should discuss it there.

I think that comparisons are sometimes useful in an encyclopaedia. For example, it might be helpful to describe a skyscraper as "about the height of the Eiffel Tower". However, where the comparison is itself controversial, the value can be diminished. For example, if we were to say that "according to author X, it is about the height of the Eiffel Tower, but according to author Y, X is a 'bloody idiot' and there is 'no comparison'", it doesn't seem to tell the reader very much about the skyscraper. Indeed, the subject no longer seems to be "the skyscraper", but instead "[the dispute over] the relationship between the height of the skyscraper and the Eiffel Tower".

I'm not saying that such material doesn't belong anywhere in Wikipedia, but I think that we need to think carefully about whether it belongs in a particular article. Since Wikipedia articles are of limited length, we can't include every piece of information that's remotely related to the subject; we must select information to summarise. "Because it's there" may be a good reason for climbing Everest, but I think we need something better for selecting material. If the dispute is itself notable, perhaps a case can be made for an article about 'the relationship between male circumcision and female genital cutting'. As an alternative, since this quote is about the cultural significance of practices "in the context of ... the Kenuz Nubians", perhaps Nubians is an appropriate place?

Similarly, there is some debate in the literature over whether circumcision may be compared to a vaccine (this often, but not always, seems to occur in the context of HIV). I'm not convinced that covering this debate would add value to the article, since it would convey little information about circumcision itself. Jakew (talk) 13:20, 29 January 2008 (UTC)

Coppertwig, I would argue that any information concerning the circumcision of females is directly related to the topic of circumcision. It seems... self-evident? As for your statement that the words for female circumcision are being changed, that seems to beg the question, Who are these benevolent masters working to change the words for female circumcision for us? And, how exactly are the words being changed? By decree? Finally, for what purpose do you believe the words are being changed? Note, I do not disagree that they are indeed being changed, in fact you seem to echo my very points above. Maybe you didn't mean it that way, but I think the particular choice of words was bang on. Blackworm (talk) 05:22, 30 January 2008 (UTC)

Female genital cutting is not "circumcision". It is amputation of the clitoris rather than the skin around it and often includes sewing up the labia. It is directly comparable to removing the entire glans of the penis and sewing the foreskin closed rather than amputating just the foreskin. Sure there are aspects of similarity, for example the social coming-of-age aspect and the fact that both procedures involve sharp implements and the genitals, but the differences are more fundamental than the similarities. Calling the amputation of a clitoris 'female circumcision' is an aspect of POV in action (I know that this is the 'traditional' term but I suspect that it originated from a misunderstanding and therefore changing the term to 'female genital cutting' or 'clitoral amputation' provides clarity rather than obscuring anything). This is not to get involved in the argument over whether the amputation of a foreskin is a good thing, but comparing the two procedures is not valid. It is like comparing electric shock treatment to using a crash cart to restart a heart... yeah, they both involve electricity but they are not really related otherwise.SimonHolzman (talk) 20:30, 30 January 2008 (UTC)

Your assertions are either debatable opinion, or patently false. Webster's gives one definition of "circumcision" as a cross-reference to "female genital mutilation." Also, your other assertions are contradicted by multiple reliable sources in the Female genital cutting article. Female genital cutting, a phrase redefined by the WHO, encompasses a range of procedures greatly varying in severity; from a piercing, a pinprick, or contact with herbs, to cutting (excision) of tiny amounts of tissue, to excision of larger amounts of tissue, to excision and infibuation (which is what you refer to). Since "female genital cutting" also encompasses procedures that do not involve any cutting, excision, or removal of any tissue, your assertion that the term provides clarity is also demonstrably false. Your other assertions are original research, unsupported by reliable sources, and are at best opinion. Luckily for you, your opinion seems to be reflected by the organization of this article. For the moment, anyhow, until a neutral party with authority reviews the multiple policy violations in this article, from the title, definition and lead on down. Blackworm (talk) 21:17, 30 January 2008 (UTC)

So the term 'Female Circumcision' is more accurate in your opinion ? The point I was making was that female circumcision is minimally comparable with male circumcision and your list of the variety of procedures encompassed by 'female genital cutting' confirms my point. Thank you for your support. BTW, since when was opinion or original research forbidden on Talk pages ?SimonHolzman (talk) 18:54, 31 January 2008 (UTC)

The above user, SimonHolzman, has likened me personally to Hitler, on my talk page, [with this edit]. I will not be responding to this user. Blackworm (talk) 23:54, 31 January 2008 (UTC)

I did not liken Blackworm to Hitler, I said that Blackworm appeared to have nothing positive to say about circumcision and then commented that most topics have some positive aspects, for example, Hitler was supposedly fond of dogs. My comparison was between circumcision and Hitler, not between Blackworm and Hitler. I apologized immediately Blackworm made me aware that he felt offended. It was not my intention to offend or insult him and while I might perhaps have expressed myself better, I still do not think that my comment can be taken as abusive by anyone who is not hypersensitive. Please look at the message I left Blackworm in his comment above and judge for yourself. I had asked Blackworm a question on his personal talk page because of a genuine interest in the answer and aware that Blackworm might legitimately choose not to answer it. However, if Blackworm refuses to respond to my questions on THIS talk page, I think it reflects more on him than on me and harms the discussion rather than furthering it. As such, since Blackworm claims to have accepted my apology, I hope that he will reply to my message above.SimonHolzman (talk) 18:12, 1 February 2008 (UTC)

I will not, because despite your apology, you continue to be incivil with comments such as "Thanks for your support" and your accusation of hypersensitivity. I too invite readers to judge for themselves whether an editor introducing themselves as Jewish, regarding a topic of high sensitivity and importance to Jews, appropriately told an editor he viewed as critical of the topic: I am curious because you seem to have no positive feelings about it, and so I wonder why this is. After all, Hitler was apparantly kind to dogs. At the very best, it was an extremely poorly chosen and ambiguous analogy. At worst, and reasonably interpreted as such, it was a gross accusation of antisemitism. Blackworm (talk) 20:30, 1 February 2008 (UTC)

Including the sentence immediately before the excerpt you chose to quote I said, Overall, I have mixed feelings about [circumcision] and see some benefits and some dangers. I am curious because you seem to have no positive feelings about it, and so I wonder why this is. After all, Hitler was apparantly kind to dogs. As I have said, I intended it as comparison between circumcision and Hitler and did not intend any slur on you. The Thank you for your support above was prior to any misunderstanding on this issue. I do not think this dialogue between us serves any further purpose. Please feel free to reply to this as I do not want to be seen to be shutting down this by having the last word, but I will not reply unless you say anything inappropriate, which I am sure you would not do.SimonHolzman (talk) 22:16, 1 February 2008 (UTC)

I have to concur with the observation that it's reasonable to compare the two practices, as long as legitimate sourcing is provided, because female genital cutting does indeed encompass a number of procedures, some of which can be considered milder and some harsher than male circumcision. Thus, I see nothing wrong with including neutrally worded comparisons in either of the articles. ~ Homologeo (talk) 20:23, 1 February 2008 (UTC)

The problem is that any reasonable comparison will be meaningless since female genital cutting encompasses many procedures while male circumcision is basically a single procedure. It's like comparing cats with Bill Gates. You would need to specify which procedure you are comparing and the differences probably outweigh the similarities. If you can draft a fair comparison, by all means do so, but I would suggest that it would be better in a standalone 'Comparison of Male and Female Circumcision' article.SimonHolzman (talk) 22:16, 1 February 2008 (UTC)

There are several authors who would agree with you, Simon, though of course there are others who would disagree. Similarly, there are several authors who believe it to be appropriate to compare circumcision to a vaccine, and others who would disagree with that. As I see it, though, this article is already quite long enough, and adding sufficient material to cover both sides of these sub-debates would make it far longer. Unfortunately, in spite of that added length, it would tell the reader relatively little about the subject of the article, but would instead discuss at great length whether certain analogies are appropriate or inappropriate. Looking at it another way, if we were to cut material from the article to make space for these analogies, I can't find anything suitable. I tend to agree that such material, if it belongs anywhere, should probably be in its own article. Jakew (talk) 23:43, 1 February 2008 (UTC)

This article's title is "Circumcision". It does not specify a gender and therefore neither should we. Garycompugeek (talk) 15:24, 12 April 2008 (UTC)

This has, of course, been discussed at some length previously (both in this section and in the archives), and I would encourage you to read through those discussions. It would be foolish to have multiple articles about "female circumcision", and as the hatnote at the start of the article notes, "This article is about male circumcision. For female circumcision, see Female genital cutting...." Jakew (talk) 15:39, 12 April 2008 (UTC)

Redirect to Male Genital Cutting?

In the interests of NPOV, perhaps this article should be moved to 'Male genital cutting' and redirected from here, in order to correspond with the page on female circumcision which is entitled 'female genital cutting'. Bagofants (talk) 16:17, 2 February 2008 (UTC)

If and when "male genital cutting" becomes the commonly used term for circumcision, then we can move the article to reflect that. Until then, Wikipedia needs to reflect the language used in the real world. Jakew (talk) 16:32, 2 February 2008 (UTC)

Wikipedia is an Encyclopaedia, not a dictionary. It should reflect the *facts*. 'Male Genital Cutting' is a much more descriptive title for an article about the cutting of the male genitals. Perhaps upon renaming the article you could clarify with "Male Genital Cutting AKA circumcision". 'Male Genital Cutting' currently redirects to 'Genital modification and mutilation', which incidentally has a section on male circumcision. Perhaps the best solution would be to merge this article into that page, as circumcision is a form of genital modification, and some would argue a form of mutilation. Bagofants (talk) 17:08, 2 February 2008 (UTC)

This article is not about the cutting of the male genitals. It is about the removal of the foreskin of the penis, a procedure known as circumcision. Per use common names, we therefore call it 'circumcision'. "Male genital cutting", if the term were in common usage, would presumably include vasectomy, castration, penectomy, subincision, and indeed any procedure in which the male genitals were cut.

Your proposal to merge this article into the page about GM&M makes no sense. Would you propose to merge every surgical procedure article into surgery on grounds that they are forms of surgery? Jakew (talk) 17:21, 2 February 2008 (UTC)

The foreskin is an integral part of the penis and the section of the penis with the most nerve receptors. Do you also advocate considering the clitoral hood separate to the vagina? The clitoral hood of the vagina is analogous to the foreskin of the penis. In fact, they are the same thing until male genitals begin forming. Jookieapc (talk) 09:30, 20 June 2008 (UTC)

'Every surgical procedure' is not related to genital mutulation or modification. Similarly, whilst in the Western world circumcision is usually carried out as a surgical procedure, in some parts of the world it is carried out as a ritual and for non-medical purposes. Whilst, obviously, merging all forms of surgery into one article is ludicrous, circumcision and 'genital cutting' are closely enough linked to be merged, and the total length of the article would not be excessive, so my proposal makes perfect sense. Also, you seem to have an unhealthy obsession with male circumcision. Were you circumcised yourself or it it just a sexual fetish? Bagofants (talk) 17:40, 2 February 2008 (UTC)

The fact remains that you are proposing to take an article that can be categorised in a certain way (a procedure that modifies the genitals), and to merge this into the article for that category. Logically, this is equivalent to arguing that an article that is a form of surgery should be merged into surgery. Indeed, one wonders what you propose to do with the other procedures I mentioned. Should they be merged into GM&M as well? Or perhaps they should be merged into surgery instead? Or maybe initiation rite? Actually, since most articles fall into several categories, should we get rid of separate articles and just have a single, giant article called 'Wikipedia'? Jakew (talk) 17:53, 2 February 2008 (UTC)

Following your logic, then yes, Circumcision should exist as it's own article, in which case the few paragraphs about male circumcision should be removed from the 'Genital modification and mutilation' article. In fact, the article 'Genital modification and mutilation' should be split and a new article created for each type of genital modification and mutilation featured in the article (or content merged with existing articles if they already exist), namely: body modification, voluntary gender-reassignment, involuntary gender assignment, male circumcision, and female circumcision. As articles for these subjects seem to already exist, the content within the article 'Genital modification and mutilation' is superfluous. This is, of course, following your logic of having a separate article for every single aspect of something. Bagofants (talk) 22:59, 3 February 2008 (UTC)

I guess Jakew is trying to come up with an answer, 6 days later. Funny how that works when they (him and his friends) are wrong about something. I can't wait for my comment to get reverted (as quickly as possible) or shot down by him and his pro-circ/admin/mod friends who try so hard to push their POV. I think, of all the edits ever done to the Circ page and this talk page over these years, this one suggesting the merge is the most intelligent of all. Of course Jakew and his friends would never allow their precious page to turn into a redirect and have their pro-circ agenda be smashed into a sub-category. —Preceding unsigned comment added by 206.248.159.46 (talk) 07:55, 8 February 2008 (UTC)

Circumcision is the commonly used term. It makes sense to keep it distinct. If there is future shift in word usage, then we can consider consolidation. I will add that I could not find online any dictionary that refers to circumcision as "Male genital cutting." To suggest that we ignore the conventional meaning of words is quite simply bad writing. So while Wikipedia is not a dictionary we should still use words and categories that are most broadly understood. Mattnad (talk) 12:15, 7 March 2008 (UTC)

I agree. The problem is that circumcision is the commonly used term for the act of "[cutting] off the foreskin of (a male) or the clitoris of (a female)."[4] This article is strictly about male circumcision, and thus should be titled "Male circumcision," per WP:TITLE. That there is vehemently strong resistance to this idea from a core group of editors with the minority point of view that "female circumcision" does not exist as a valid term, suggests that WP:NPOV issues continue to run wild in this article. Blackworm (talk) 21:55, 8 March 2008 (UTC)

Blackworm is unfortunately misrepresenting the position of those with whom he disagrees, and nobody has claimed that "female circumcision" is an invalid term. For previous discussions, please see the archives or Talk:Circumcision and law#Neutrality. Jakew (talk) 22:06, 8 March 2008 (UTC)

I never said you claimed that female circumcision is an invalid term, I said you believe that female circumcision is an invalid term. You avoid it, you put it in quotes when you use it, and you define "circumcision" as exclusively applicable to males and you defend that definition vigorously. You want to separate the concept of circumcision from anything related to females. I don't blame you. I could support your advocacy. But Wikipedia isn't the place for your advocacy. Blackworm (talk) 08:23, 9 March 2008 (UTC)

I agree that the title should not be changed to "male genital cutting" because circumcision is the term most commonly used. However this article should either be renamed to "Male Circumcision" or "Female Circumcision" should be merged into this article. This follows the reasoning about terms in common use. Female genital cutting, however, is a more accurate term for female circumcision types II and III as these procedures are more severe and analogous to the removal of the penis and scrotum. Jookieapc (talk) 09:52, 20 June 2008 (UTC)

POV?

Am I the only one who read this article and got a Circumcision propaganda pamphlet? I think it needs some serious revising, but I won't throw up a POV tag if I'm the only one who thinks so. 202.182.83.31 (talk) 08:21, 11 February 2008 (UTC)

I agree, but there's not much point putting in a POV tag as it will get instantly removed by editors insisting to the people in the neutrality dispute that there is no neutrality dispute. And if you don't have six hours a day to engage in "discussion," I wouldn't bother trying to revise the article either. Blackworm (talk) 11:07, 11 February 2008 (UTC)

Yes throw up a POV FLAG on circumcision. This is probaly THE MOST biased page on all of wikipedia (or at least that I have ever seen.) If anything it should be about the PRACTICE. There should be a separate page with equal length given to the pro and con side. But this is a ridiculous site. It's all about how this procedure can reduce HIV even tho circumcision INCREASES herpes and clamitia, no discussion about that. It's so biased. Everyone knows that there are PROS and CONS to practically everything. But with the penis, people get touchy and wants the "truth" to spin their way. This site is a pro-circumcision propaganda page. It should be neutral. Flag it.

Yes, this article is highly biased. Let us not forget the many past studies showing medical "benefits" to circumcision which have almost all been discredited due to original authors' high disregard for the scientific method. Authors of this page seem to have their own agenda, favoring opinions of American researchers (who are themselves mostly circumcised) over non-American investigators. POV is justified. Gimmethoseshoes (talk) 00:54, 27 February 2008 (UTC)

The thing is, you can't just throw up a POV flag and then walk away. The non-neutral POV in this article, if any, has to be spelled out and challenged. I've attempted to do just that, as have others. In some cases, perhaps the challenge is unjustified; in others, perhaps it is, but we won't ever know, since all challenges seem to be intensely resisted by the same few editors, who in turn remove the POV flag without consensus. My advice would be to zero in on the content you believe violates policy, and make a case challenging it, or voice your support for others' arguments. There are plenty here and in the archives (restart archived discussions on the current page, not the archive). Do so neutrally, without attempting to simply shift the non-neutral POV to an opposing POV, and without injecting bias or losing good faith in the other editors. This is a lot of work. Is anyone up to the task? Blackworm (talk) 18:24, 27 February 2008 (UTC)

I do agree that it seems slightly biased but not, imho, worth a POV flag. I hope people continue attempting to fix it though. English wikipedia isn't North American, it's international and should reflect international standards and practices. This article seems like it's written based pretty much entirely on North America when it comes to the parts detailing pro/cons and ethical ideas. It seems to represent people against circumcision as a minority group and/or "special" in some way, while it is, worldwide, the other way around. Like I said previously most of the article is fine but if most of the people contributing weren't North American I think it'd have quite a different wording even if it would contain most of the same studies/facts. Most Scandinavians I've talked with about this, and for that matter most Europeans, seem to pretty much equate circumcision with genital mutilation. This article in no way reflects this quite prevailing point of view. I'd have a hard time pointing out the specific parts that left me with the above impression, it's pretty much just the pro/con and very value-addled way the article is presented. I might give it a shot at a later date. Araziel (talk) 05:21, 1 April 2008 (UTC)

As I understand it, your argument seems to be that the prevailing point of view is anti-circumcision, and the article ought to reflect that. Unfortunately, there are two problems with this argument. First, you haven't provided any verifiable evidence to support your claim (suitable evidence might be, for example, a reliable study in which a representative sample of people of various nationalities were polled for their views on circumcision). Second, it is difficult to understand how one could "reflect" this point of view while adhering to the neutral point of view policy. Jakew (talk) 12:54, 1 April 2008 (UTC)

Why would Araziel need evidence of that type, but you don't need evidence of that type to call those opposed to circumcision fringe or zealots or a tiny minority, running them out of this article, and throwing phrases like "undue weight" around based on your assumptions of relative prevalence of the views? Congrats, though, on your awards on your user page for keeping out anti-circumcision views. Blackworm (talk) 15:12, 1 April 2008 (UTC)

You completely misunderstand me. I didn't mean to say that the article should read like an anti-circumcision pamphlet, and bringing up studies about how people feel about circumcision is way besides the point. The offhand comment I made about my friends was just that, an offhand comment, it has nothing to do on a wikipedia article. It was done to illustrate the fact that as of right now the wording of some parts is obviously done by someone who is pro-circumcision, as opposed to, if this was written by western Europeans, it would read more like the aforementioned anti-circumcision pamphlet. As the nice and neutral people we are we naturally want neither to be prevailing, but rather it all sound rather unbiased and plain.Araziel (talk) 07:22, 6 April 2008 (UTC)

Oh, ok. I can't see the pro-circumcision wording myself (evidently being western European is not enough!). But it might help if we could discuss a concrete example. Can you give me any examples of such material? Jakew (talk) 13:08, 6 April 2008 (UTC)

The article appears to lean towards pro circumcision however it may simply be my natural aversion to genital mutilation clouding my judgment. What comes to mind after reading the entire article is the feel of it being weighted with more sources for circumcision. Sure I could add many more sources against to balence out but feel this is a hot topic and wish to throw in my 2 cents here. Garycompugeek (talk) 21:29, 8 April 2008 (UTC)

How is the attempt going so far? Blackworm (talk) 02:55, 11 April 2008 (UTC)

Pretty gritty. Deeply estabished bias. Many players. I did get a chuckle over the circumcision is evil anon ;P —Preceding unsigned comment added by Garycompugeek (talk • contribs) 03:15, 11 April 2008 (UTC)

Dubious edits

I'm reverting these edits for the following reasons:

• The edit changed *"The act of cutting off the prepuce or foreskin of males, or the internal labia of females." Webster's Revised Unabridged Dictionary (1913) [5] to *"The act of cutting off the prepuce or foreskin of males, or the labia of females." Webster's Revised Unabridged Dictionary (1913) [6] -- why would we want to misquote a source?

• Addition of: "In 1997 the New York Times printed an article on circumcision increasing one's risk of contracting herpes, clamidia, and even HIV. Since then, doctors have debated these facts with different studies, showing different results. However, the UN's World Health Organization only backs one study. [7] [8]"

• Problem 1. This report is about Laumann's study (JAMA 1997;277(13):1052-7). As I've already noted in an edit summary, we should not give undue weight to a single observational study. Since there have been some 30 or so observational studies, we clearly haven't room to discuss every primary source. Instead, if we are to discuss non-HIV STD studies, it is most logical to cite a systematic review, such as that of Weiss et al.
• Problem 2. The cited article in the NY Times mentions herpes and chlamydia, but not HIV. We should not misrepresent sources.
• Problem 3. The sentence beginning "Since then" is unsupported by sources.
• Problem 4. The WHO do not "back one study", but explicitly refer in their recommendations to three randomised controlled trials and the earlier observational studies.
• Problem 5. The second link is apparently unrelated to the preceding text.

For these reasons, I'm reverting. Jakew (talk) 23:13, 15 February 2008 (UTC)

You're right about the HIV. That was a totally different article. I'm trying to find it now but I can't remember where I found it. Anyway, yeah, just make it herpes and chlamydia or "STD's" But don't delete the entire sentence. That's mean. Please stop. The New York Times and many other well known papers have articles online about this stuff but the New York Times seems like the most well-known. They all said circumcision increases risks of many STD's other than HIV. The HIV article was a bit controversial. But thankfully, the New York Times has been around longer than the UN even. (: —Preceding unsigned comment added by 70.114.38.167 (talk • contribs)

The New York Times was simply reporting on a paper published in the Journal of the American Medical Association (arguably somewhat inaccurately: the paper reported that "We find no significant differences between circumcised and uncircumcised men in their likelihood of contracting sexually transmitted diseases."). But the problem is that Laumann's study was just one of many observational studies to assess the link between circumcision and STDs, and we need to present a representative picture. If we say "the procedure may potentially increase the risk of herpes and chlamydia", we're misleading the reader when systematic reviews indicate that the evidence overall suggests that it reduces the risk (herpes) or that there is no association (chlamydia). Jakew (talk) 12:05, 17 February 2008 (UTC)

LOL. That's the most pathetic argument I've seen in a long time. The New York Times piece should stay. LPRABCMP (talk) 21:05, 17 February 2008 (UTC)

If you want to balance the article, discuss genital warts. It's not discussed at all in this article; I'll leave the reader to decide why that is. As for undue weight, the singular opinion in a letter to the editor that it is "more humane" not to give infants anaesthesia during circumcision shines as the best example -- but good luck getting that removed, too. Blackworm (talk) 00:15, 16 February 2008 (UTC)

Great quote from a study we cite

This is from a source we use to claim that uncircumcised men are at greater risk of human papilloma virus (HPV) infection:

Circumcision was reported as being present by examination in only 14 (1.4%) participants. Self-reported and physical examination circumcision were discordant in 88 participants who classified themselves as circumcised and six who reported no circumcision but who were evaluated as circumcised by interviewers. We chose to report the findings of self-reported circumcision. The prevalence of circumcision in Mexico is very low and the interviewers who did the physical examination may not be accustomed to it and may have been unable to identify its presence.

These guys really seem like they know what they're doing, eh? The subjects could have been thinking, hmmm, I'll say I'm circumcised, and the results of my STD test will influence matter-of-fact statements about circumcision in Wikipedia, which is supposedly "more accurate than Britannica." Ha. Just goes to show how studies can show whatever they want to show. Like editors. Blackworm (talk) 19:57, 17 February 2008 (UTC)

Another great quote from a source we cite, describing another amputated penis as a result of circumcision: Immediate re-suturing of the amputated glans led to a satisfactory outcome. Haha! I love that! "Satisfactory outcome." What a world. Blackworm (talk) 20:29, 17 February 2008 (UTC)

Metzizah b’peh : isnt this where a rabbi sucks the blood off of a babies penis after he makes the incision? Should this be mentioned somewhere under the religion section? Or will the propoganda continue..... —Preceding unsigned comment added by 70.23.242.84 (talk • contribs)

Hey people. I noticed female circumcision at the top says "also known as female genital mutilation (fgm)" well we have to be fair and make sure everyone knows where to find this page. So, let's say right after the first word, "also known as male genital mutilation (mgm)" After all, some people do call it that. That's what "also known as" means. Here is some proof. http://www.mgmbill.org/ http://www.fathermag.com/health/circ/net-quot/ LPRABCMP (talk) 21:21, 19 February 2008 (UTC)

Just let me hear what you all think. (I already know what Jakew is going to think) Let me know what anybody else thinks about MGM. LPRABCMP (talk) 21:23, 19 February 2008 (UTC)

Random websites can call it whatever they wish. We are concerned with terms used in reliable sources. Jakew (talk) 21:31, 19 February 2008 (UTC)

Uh??? Also known as means... What some people may know it as...That's why you put it down. Seriously, dude. Retarded. 70.114.38.167 (talk) 21:45, 20 February 2008 (UTC)

new study

http://www.msnbc.msn.com/id/22096758/

New study (US Center for disease control, CDC) finds that circumcision does not affect HIV in American men. This is HUGE, it's definately worth going up. 70.114.38.167 (talk) 07:32, 4 March 2008 (UTC)

I doubt it will see the light of day in this article. Good luck. Blackworm (talk) 08:45, 4 March 2008 (UTC)

Same problem as with Laumann - we can't give undue weight to a single observational study. Jakew (talk) 11:24, 4 March 2008 (UTC)

Told ya. My reason was that we're not allowed to suggest that anyone believes circumcision doesn't cure AIDS. Blackworm (talk) 15:23, 4 March 2008 (UTC)

Circumcision does not cure AIDS. I am not aware of anyone reputable that claims it does. There is some evidence that circumcision reduces the chance of being infected by AIDS but I suspect that this only applies to people who are not engaged in high-risk lifestyles.SimonHolzman (talk) 23:57, 4 March 2008 (UTC)

WP:NOR. Circumcision prevents AIDS and we will not allow any studies implying otherwise to be cited in this article. Wait, uhhh... Ask Jakew why again, I'm not sure. Blackworm (talk) 01:39, 5 March 2008 (UTC)

Blackworm, I know why. (: hehehehehehe it has to do with little jake 70.114.38.167 (talk) 09:10, 5 March 2008 (UTC)

Um..why don't you actually read the article Jakew, it's not based off a single study, the CDC claims it is based off YEARS of studieS! Please stop edit warring. The CDC is reputable. Please, let's not have this again. Facts are facts jakew. 70.114.38.167 (talk) 06:00, 5 March 2008 (UTC)

I suggest that you re-read the article yourself. Jakew (talk) 09:19, 5 March 2008 (UTC)

And please do not misrepresent things by claiming that "the U.S. Center for Disease Control officially states that circumcision does not affect HIV in American men". Their factsheet on circumcision (Feb '08) may be found here. Jakew (talk) 09:25, 5 March 2008 (UTC)

A Centers for Disease Control study found that circumcision "does not appear to help American men of color" in the context of HIV prevention. Would that be an unacceptable rendering of this secondary source, Jakew? Blackworm (talk) 03:19, 6 March 2008 (UTC)

In medical analysis of circumcision#Circumcision and HIV/AIDS, we describe Millett's study as follows:

'Millett et al in a study published in The Journal of Acquired Immune Deficiency Syndromes in 2007 found no association in three major US cities between circumcision and HIV infection among Latino and black men who have sex with men (MSM). They conclude as follows: [paragraph break] "In these cross-sectional data, there was no evidence that being circumcised was protective against HIV infection among black MSM or Latino MSM."'

Although the language could doubtless be improved, that seems a fairly accurate description. Furthermore, because it is in an appropriate article in which we can and do discuss observational studies at length, we can include such a description without giving undue weight to a single study. Jakew (talk) 11:27, 6 March 2008 (UTC)

That's a rendering of the primary source. It is preferred to quote secondary sources where possible. This article dedicates a large amount of text to convincing the reader of the protective effect of male circumcision against HIV. How can one sentence presenting an opposing opinion, sourced by a major news source, be "undue weight?" I don't see anything in policy about the appropriateness of observational studies in the main circumcision article, but please correct me if I'm wrong. Your claim of undue weight seems, again, purely arbitrary; especially considering your vehement defense of the worst example of undue weight in this aticle, namely the singular opinion of two people, expressed in a letter to the editor, that it is somehow more humane not to provide anaesthesia to male infants before cutting off their foreskins. Blackworm (talk) 15:31, 6 March 2008 (UTC)

The primary source is more reliable than the secondary source (see WP:MEDRS#In science, avoid citing the popular press), and so it is preferred. However, if you insist on a secondary source, we alter that article to cite the CDC factsheet, which briefly discusses Millett's study in the section entitled "HIV Infection and Male Circumcision in the United States" (Millett is their ref 27).

As for the appropriateness of observational studies, I refer you to WP:MEDRS#Assess the quality of evidence available. Observational studies are class III in the AHRQ scheme, whereas RCTs are 1b. Where space is limited, we should therefore prefer higher quality evidence.

If we were to discuss each and every observational study, there would be no undue weight problem. However, since that is unrealistic, we need to ensure that we're painting a representative picture. Since "most [observational] studies show an association between male circumcision and prevention of HIV"[9], we need to be careful that our coverage reflects that fact. If the only observational studies we discussed were exceptions to this rule, then we would be misrepresenting the majority of the literature by giving undue weight to the exceptions. Jakew (talk) 16:01, 6 March 2008 (UTC)

Jake, your quote is disingenuous. Restoring the context of the quote: Study quality was very variable and no studies measured the same set of potential confounding variables. Therefore, conducting a meta-analysis was inappropriate. Detailed quality assessment of observational studies can provide a useful visual aid to interpreting findings. Although most studies show an association between male circumcision and prevention of HIV, these results may be limited by confounding, which is unlikely to be adjusted for. The people you quote seem to believe that the "representative picture" you wish to present as uncontested fact is actually quite blurry indeed. The problem is, of course, that what "most studies show" is presented as absolute, unopposed fact. Nowhere in this article is there any implication that it is possible that circumcision does not prevent HIV. Everywhere in this article there are implications that it does. That's JW:NPOV, not WP:NPOV. Blackworm (talk) 23:33, 6 March 2008 (UTC)

Blackworm, since I have already noted that observational studies are relatively low quality, I don't quite understand what you expect to achieve by including a long quote that basically says the same thing. Perhaps we can save time by agreeing that a) observational studies are inherently limited, and b) that most have nevertheless found similar results to the RCTs. The questions seem to be a) given the limited space, is it worth discussing observational studies, and b) if we do discuss them, how can we ensure that our discussion is representative?

As a result of a previous discussion, we added the following: "Before there were any results from randomized controlled trials, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV.[80][81]" Jakew (talk) 11:10, 7 March 2008 (UTC)

I did re-read the article, several times. It says that the US CDC claims that circumcision really does not affect the rate of HIV in American men. It did talk in detail about Hispanic and African American men, but their point is..it is not a reasonable measure, at this time, to prevent HIV in the US. Will you, kind sir, please re-read the MSNBC CDC article. Thanks. 70.114.38.167 (talk) 08:25, 9 March 2008 (UTC)

Perhaps you'd be kind enough to quote the statements, attributed to the CDC, that led you to these conclusions? Also, please quote the statement supporting your assertion that "the CDC claims it is based off YEARS of studieS". Jakew (talk) 11:27, 9 March 2008 (UTC)

Oh, okay you just edited out the whole thing instead of just putting the blacks and latinos thing (which i think is controversial in there.) Okay, we'll do it your way putting race involced, lol, always with the race with this HIV stuff. When did the Circumcision article become an HIV article? We'll quote two sources. 70.114.38.167 (talk) 12:09, 9 March 2008 (UTC)

You've now stated that: "However, the U.S. Center for Disease Control states that circumcision does not affect HIV rates among Hispanics and African Americans in the U.S."

Unfortunately, while a slight improvement, this is still problematic:

1. The claim is attributed to the CDC. However, if you look at the first slide on Millett's presentation, you'll see that "The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention". So we'd have to correct the attribution, which should be "Millett states that...". Alternatively, we could actually represent the CDC's views...
2. The claim is stronger than that made by the authors. Please examine slide 22 ("Discussion") of Millett's presentation. Their finding was that "Circumcision status was not associated with HIV infection [in Black or Latino men who have sex with men]" and there was a "Discrepanc[y] with 2 U.S.-based studies that found protective effect". On slide 28, they conclude that "Male circumcision may not provide benefit for MSM of color in the United States" (emph added), which is a weaker claim than yours.
3. The undue weight problem still exists. For example, why are we citing this study rather than the 3 others that Millett discusses in slide 5 of his presentation? Why are we not citing the 30-40 other observational studies? And what possible reason is there to cite an observational study in the lead? Jakew (talk) 12:36, 9 March 2008 (UTC)

Dubious changes

I have once again reverted a change to the lead, which added "[circumcision] is most uncommon in Canada, Europe, South America and Australasia."

Unfortunately, not only is this statement unsourced, but it contradicts the apparent source (ie., ref 8 at the end of the paragraph). In the map in ref 8, Canada and Australia are listed as '20-80%', the same as the USA which we list under "most common". The editor who inserted it may have been confused by the text of ref 8, which states "In contrast, Australia, Canada, and the United Kingdom have seen a decline in male circumcision"; this is of course a statement about trends, not absolute prevalence.

Most sources, I think, discuss where circumcision is common. If a source can be found that explicitly discusses where it is uncommon, it could be cited, but we need to take care to avoid original research (and, indeed, pointless original research - if we're going to discuss "most uncommon" then we should provide more information than all countries minus most common, which is redundant information). Jakew (talk) 15:04, 21 March 2008 (UTC)

I agree with your changes, but not your reasoning. You appear to view the statement as one about prevalence in the existing population, not the incidence of new circumcision procedures. Since circumcision is the act of circumcising, and not the state of being circumcised, "circumcision is common/uncommon..." is better interpreted as a statement on incidence, not prevalence.

The reason I agree with your changes is that the statements are unsourced and vague. Blackworm (talk) 04:31, 26 March 2008 (UTC)

To the best of my understanding, the term is used in both ways. So perhaps it should be specified which meaning is intended. DGG (talk) 15:00, 27 March 2008 (UTC)

Removed Source

Jakew you reverted my edit and listed (rv. see WP:RS and WP:SPS.) for The Circumcision Resource Center states "Circumcision removes the most sensitive parts of the penis.".

So you believe circumcision.org which has everything properly sourced is invalid? Please explain or it will go right back in. Garycompugeek (talk) 22:07, 9 April 2008 (UTC)

The source is Sorrells et al, as published in BJU International. I restored the material with proper attribution. Jakew reverted it claiming undue weight -- we'll have to see what evidence he presents of this. Blackworm (talk) 22:11, 9 April 2008 (UTC)

Certainly. To quote from WP:SPS:

"Anyone can create a website or pay to have a book published, then claim to be an expert in a certain field. For that reason, self-published books, newsletters, personal websites, open wikis, blogs, forum postings, and similar sources are largely not acceptable"

So, a self-published website (Ron Goldman's circumcision.org) is not a reliable source. Jakew (talk) 22:18, 9 April 2008 (UTC)

Thanks I've been around long enough to know what a source is. You are not the judge and jury of what is a good or bad source. First of all who supposedly own's a site is a red herring and irrellevant. Circumcision.org has all or their documentation sourced. After all it is circumcision.org not Billy Bob's blog from billybobisgreat.com. Garycompugeek (talk) 12:15, 10 April 2008 (UTC)

Whether you consider the owner of a site to be relevant or not, Wikipedia policy clearly states that "personal websites ... are largely not acceptable". WP:RS provide some guidance, too: "Articles should rely on reliable, third-party published sources with a reputation for fact-checking and accuracy." Note that it does not say "should rely on websites on the sole basis of whether they have impressive domain names." Jakew (talk) 13:38, 10 April 2008 (UTC)

Also, you seem to be under the impression that Goldman's page is reliable because he cites sources. That isn't the case. Any page can cite sources and could misrepresent them (or could even cite nonexistent sources). Unfortunately, with self-published sources (especially highly partisan sources prone to bias), that can happen quite easily, and for that reason (among others) we can't rely on them. With a source published by a third-party with a reputation for fact-checking and accuracy (such as a peer-reviewed journal), that's much less likely to happen. Jakew (talk) 14:07, 10 April 2008 (UTC)

No you simply are misunderstanding me if that's what you truly believe. My analogy is correct. If we were as stringent as you claim half of Wikipedia would qualify for speedy deletion. You seem to have some animosity towards this website because it doesn't support your POV. It is medically sourced and quite valid. The sources are not misrepresented or trying to mislead. Garycompugeek (talk) 14:56, 10 April 2008 (UTC)

Unfortunately it's true that much of Wikipedia's content fails to meet policy requirements, but that is no excuse. Wikipedia policy calls for high standards of sourcing, and with a topic such as this one that is, if anything, especially important. We can't include private, partisan websites, regardless of whether individual editors agree or disagree with the content. That means that we don't include "circumcision.org" (anti-circumcision) and we don't include "circinfo.net" (pro-circumcision), but we do include, for example, articles published in the Journal of Urology, whether pro- or anti-. Jakew (talk) 15:10, 10 April 2008 (UTC)

I hear you Jake, but you seem to be taking a literal narrow view of the policy. Perhaps you need to confirm to Wikipedia norms, not the other way around. It's clear we disagree and should step back and let consensus decide. Garycompugeek (talk) 16:37, 10 April 2008 (UTC)

I have once again reverted the addition of some material that gives undue weight to one of the five studies to test the sensitivity of the penis with respect to circumcision. If we're going to cite Sorrells, then to avoid undue weight we must as a minimum cite Masters and Johnson, Bleustein 2003, Bleustein 2005, and Payne (2007 as I recall), and probably also other studies of sensation (Masood, etc). If we were to do so, however, we would add a considerable amount of material to the article, which would basically replicate the sub-article (sexual effects of circumcision), and this would be incompatible with summary style. Jakew (talk) 22:18, 9 April 2008 (UTC)

Bah! Pure balderdash. You site undue weight when it isn't your POV. I've also noticed that Jakew and User:The way, the truth, and the light have reverted then quickly added something to article to prevent another revert. This is dirty pool in the extreme. Let's stop these silly games and work together. This article seems far from neutral. To make it neutral we need all viewpoints. I'll respect yours. Please respect mine. Garycompugeek (talk) 22:37, 9 April 2008 (UTC)

There is already a better discussion of the evidence at the detailed article Sexual effects of circumcision. That's his point. Importing only some of the studies into this article, ones that support your desired conclusion, is undue weight and clear bias. The way, the truth, and the light (talk) 22:40, 9 April 2008 (UTC)

I could say the same exact thing to you thing to you. In fact that's exactly how I feel. Garycompugeek (talk) 22:48, 9 April 2008 (UTC)

Let's please avoid labels and accusations and keep cool heads. If I understand correctly, at least some of the sources Jakew mentions make conclusions of the sensitivity of the glans of circumcised vs. uncircumcised men -- unlike Sorrells, which makes a conclusion about the sensitivity of the foreskin itself relative to other parts of the penis. Find other studies discussing the low- or non-sensitivity of the foreskin, if any exist, and we can summarize them and present a more balanced picture. Otherwise, for now, this soruce stands on its own. Including this source isn't undue weight. Undue weight is actually what we have now: citing three sources claiming no change due to circumcision, or an improvement, with no countering nor balancing views despite the existence of sources. Blackworm (talk) 22:51, 9 April 2008 (UTC)

Blackworm, if the section was about "the sensitivity of the foreskin relative to other parts of the penis", you might have a valid point. However, the section is about "sexual effects", and therefore the correct context for assessing questions of undue weight is "studies that have investigated the sexual effects of circumcision". One aspect of this is penile sensation. Some authors have chosen to address this by measuring the sensitivity of the foreskin, some by measuring the sensitivity of the glans, and others have addressed it by prospective questionnaire. There seems no reason to include only one of these categories, and to be neutral we ought to avoid doing so.

With this in mind, citing only Sorrells et al. is a clear example of undue weight. Jakew (talk) 23:18, 9 April 2008 (UTC)

Not clear at all. You propose unless multiple sources support your view point it is undue weight which is not what the policy is about at all. Garycompugeek (talk) 00:19, 10 April 2008 (UTC)

I suggest that you read through this discussion again, Garycompugeek, because you seem to have misunderstood. As you'll see, I haven't even mentioned my viewpoint. Jakew (talk) 11:03, 10 April 2008 (UTC)

By that logic, the current edit, which discusses glans sensitivity for about half the section, specifically citing Masters and Johnson, would also be undue weight. There's no reason not to summarize the other categories you mention. Blackworm (talk) 23:27, 9 April 2008 (UTC)

The current section does not cite Masters and Johnson, Blackworm. That's part of a quote. The present system is to cite highly reliable reviews from reputable medical organisations, and to rely on them to summarise for us. Jakew (talk) 11:03, 10 April 2008 (UTC)

Except that the system also seems to be that you, Jakew, get to choose which organization, and which precise section of that organization's review we will present. Whether we cite M&J or not, the fact is that by your logic, we present undue weight given to analyses of glans sensitivity, ignoring the seemingly more relevant question of the sensitivity of the severed foreskin. As of "the way"'s edit, the section is now horribly unbalanced. It presents sexual effects as, simply, "none, or good effects." It's JW:NPOV. Blackworm (talk) 15:33, 10 April 2008 (UTC)

Your claim is somewhat dubious, Blackworm, given that we actually quote all of the AAP's section entitled "SEXUAL PRACTICE, SENSATION, AND CIRCUMCISION STATUS" and the vast majority of the AAFP's section entitled "Sexual Functioning and Penile Problems". That's hardly evidence of selective quoting.

Personally, I would have said that prospective studies of adult circumcision patients were more relevant, but I respect the fact that you disagree. The fact that there are multiple viewpoints about what studies are most relevant is one of the things that make this issue so difficult to summarise. The question of which primary sources are "more relevant" is best left to reliable secondary sources, and we should not use a primary source to debunk the secondary (WP:MEDRS##Using_primary_sources_to_.22debunk.22_the_conclusions_of_secondary_sources). To date, as can be seen from the article, these secondary sources have focused mostly on glans sensitivity. Jakew (talk) 16:26, 10 April 2008 (UTC)

You mean a secondary source like this]? Or does the secondary source have to be an organization of people who profit financially from circumcision? Blackworm (talk) 22:57, 10 April 2008 (UTC)

No, not like that. Jakew (talk) 23:05, 10 April 2008 (UTC)

The guideline you cite is irrelevant -- a secondary source specifically commented on this study, indeed wrote an article about it, making it appear quite relevant. We don't have to cite the press; having established its notability, we can cite the original source, as I did (and which was reverted by you). Medical organizations have one point of view about male circumcision -- and their opinions on this lucrative procedure are valid, but there is no reason to decree that they are the exclusive source of information on male circumcision, especially when other researchers are indeed studying it from several other angles. That would be like insisting the "oil" article be exclusively written by Exxon/Mobil, BP, or OPEC. In any case, this is tangential -- the material is sourced, relevant, presented neutrally, and not to be suppressed because of your opinion of how much weight material critical of circumcision should receive (zero). Blackworm (talk) 16:11, 11 April 2008 (UTC)

You appear to forget, Blackworm, that Sorrells' article is cited in the full article, (sexual effects of circumcision). Nobody is suggesting that it should be excluded from Wikipedia altogether; the question is whether it should be included in a summary.

Since news articles are written about many studies (eg., [10] [11] [12] [13]), your proposed inclusion criteria (include studies which are mentioned in news articles) seems rather inadequate, since we would still end up adding an enormous amount of material, and replicating much of the content of sexual effects of circumcision. Jakew (talk) 16:30, 11 April 2008 (UTC)

As I've told you many times, I'm not really interested in the subarticles (what you call "full articles") that no one reads, as I view them as POV-forks, or apparent dumping grounds for any material critical of circumcision, or suggesting any controversy, that editors attempt to add to this article.

"My" inclusion criteria follow from WP:V and WP:NPOV. I didn't "propose" anything; I was responding to your call for secondary sources. It is not clear to me what policy or policies your inclusion criteria follow from, that would outweigh these policies. It is also not clear why your inclusion criteria causes you to vigourously insist on presenting a single letter to the editor, never referenced elsewhere, that claims that it is more humane NOT to give anaesthesia to infant boys being circumcised, when that opinion is contrary to the published statements of all medical organizations. You appear to be arguing for the exact opposite approach here. This grave inconsistency adds to the difficulty in finding a common ground as to your editorial opinions. Blackworm (talk) 21:59, 11 April 2008 (UTC)

Blackworm, the detailed articles exist in accordance with a Wikipedia editing guideline known as WP:SUMMARY, and are necessary in order to prevent this article from becoming too long. I'm afraid that I don't understand why you're telling me whether or not you're personally interested in them, and how you view them.

Perhaps my request was unclear to you, but I was asking for reliable secondary sources (policy statements, systematic reviews, etc) that were suitable for inclusion, rather than to use as guidance for selection of primary sources. As I have noted many times (eg #Payne study above), there simply isn't room in this article to discuss all the primary sources, and so it is sensible to limit ourselves to citing secondary sources that can summarise and take stock of the primaries. Jakew (talk) 22:16, 11 April 2008 (UTC)

WP:SUMMARY does not trump WP:NPOV. Further, the AAFP quote doesn't even properly reflect the source -- a part is omitted ("[...]"), making it read as if the AAFP disagrees with the belief of many that the glans of a circumcised penis is less sensitive. In fact the omitted part states (in the omitted text), Opinions differ about how this decreased sensitivity, which may result in prolonged time to orgasm, affects sexual satisfaction. But we don't seem interested in quoting that part, preferring to make it read as if the AAFP disagrees with "many" on the topic of decreased sensitivity. The AAFP saw fit to summarize sexual effects one way, and an editor here saw fit to pick and choose which parts of their summary to present, and paint a different picture. You now have editors familiar with the topic clamoring for balance and adherence to WP:NPOV, and you can seemingly only cite WP:SUMMARY to defend your reversion of their perfectly verified, neutral, and relevant edits. I don't see how you can realistically expect these editors to withdraw their objections under these circumstances. Blackworm (talk) 23:43, 11 April 2008 (UTC)

Please no more colons. These skinny paras hurt my head. —Preceding unsigned comment added by Garycompugeek (talk • contribs) 01:21, 12 April 2008 (UTC)

(Replying to Blackworm/23:43, 11 April 2008.) Blackworm, nobody is claiming that WP:SUMMARY trumps WP:NPOV. Quite the opposite, in fact: summaries must conform to WP:NPOV. So it is very important to use the limited space carefully, and to be aware that there is insufficient space to discuss every primary source. And so instead of violating WP:NPOV by giving WP:UNDUE weight to selected primary sources, we need a better strategy. The obvious strategy, strongly encouraged by WP:V, is to rely upon secondary sources instead.

I've just checked the revision history, and as I thought we originally had the full AAFP quote, but it was shortened on 16:16, September 2, 2007. I don't agree that we're misrepresenting the AAFP, but I've no objections to restoring the full quote. Jakew (talk) 11:09, 12 April 2008 (UTC)

The actual diff where the quote was shortened is here. I do not share your apparent opinion that it is "obvious" that we must suppress primary sources on sexual effects merely because their conclusions are not considered by or repeated by medical organizations profiting from circumcision. The primary source is referenced by a secondary source, which I cite above. Looking at the section as a whole, however, now that I've restored Boyle et al., it seems balanced, and I won't push any more for this source to be cited here. However, you set a precedent for reversion of cited, reliable material that I have trouble believing you would accept should it be used to remove any material casting circumcision positively. Indeed, your (and Avi's) vigourous defense of arguably fringe pro-circumcision material ("more humane not to use anaesthesia") seems incongruent with your present position. Blackworm (talk) 18:51, 15 April 2008 (UTC)

In reply to Garycompugeek's post of 12:15, 10 April 2008 (UTC): If you consider a source reliable because they cite reliable sources, I suggest instead using directly the sources cited by that source (if they're in publications considered reliable). This doesn't address other points raised above. ☺Coppertwig (talk) 23:32, 10 April 2008 (UTC)

Coppertwig, I am glad you are following the discussion, but the issue of sourcing is seemingly moot. My edit citing and attributing the material to the original source was reverted by User:Jakew. Jakew now suppresses the material on alleged undue weight grounds, supported apparently by two other editors (including an uncommon appearance by Avi), grounds disputed by two editors, including myself. Blackworm (talk) 01:14, 11 April 2008 (UTC)

It should perhaps also be noted that the article now stands with less material arguably critical of circumcision than before this new edit under dispute was made. Blackworm (talk) 01:19, 11 April 2008 (UTC)

NPOV = Balance

This article needs balance. This can be achieved in two ways. Either we start deleting some pro references (which I am against by the way), or we include more con references. Garycompugeek (talk) 16:03, 10 April 2008 (UTC)

Apparently User:The way, the truth, and the light does not agree although his voice is silent in discussion. That's 3 for you in 24. Your out of cards. I have one left but prefer to hold off and let others chime in. Your User Page suggest we have similar goals so your actions surprise me. Shine a little bit of that light in the mirror. Garycompugeek (talk) 17:41, 10 April 2008 (UTC)

I've said all I have to say. Jakew has made my case better than I could. The way, the truth, and the light (talk) 17:45, 10 April 2008 (UTC)

Penile cancer Myth

The curent vrsion is very Biased and misleading: "Studies have reported (what studies?) a rate of penile cancer from 3 to 22 times higher (where ?)in uncircumcised than circumcised men"

In "Circumcision: An American Health Fallacy," Edward Wallerstein writes: "If infant circumcision reduces penile cancer we could expect to see proportionately less penile cancer in circumcising nations as compared to noncircumcising ones. No such difference is found." Wallerstein reports that, for various years between 1966 and 1972, the annual rate of new cases of penile cancer was

0.8 for the United States (which circumcises), 0.5 for Finland, 0.9 for Denmark and 1.1 for both Norway and Sweden (all of which do not).

None of these differences is statistically significant. Further, within the same time frame, both France and the United States had the same rate, 0.3, of deaths due to penile cancer.

The American Cancer Society does not consider routine circumcision to be a valid or effective measure to prevent such [genital] cancers. Research suggesting a pattern in the circumcision status of partners of women with cervical cancer is methodologically flawed, outdated and has not been taken seriously in the medical community for decades.

Again, (a rate of penile cancer from 3 to 22 times higher ??? where?) Or, is this the American Version? Can we have some objectivity? Please! —Preceding unsigned comment added by 82.29.103.153 (talk) 19:59, 10 April 2008 (UTC)

If you read the article carefully, you'll see that after the statement ("Studies have reported a rate of penile cancer from 3 to 22 times higher in uncircumcised than circumcised men") there are footnote numbers. If you click on these, or scroll down to the references, you will find references to each study cited. For your convenience, the references are 94 and 95, which are:

1. Maden, C; et al (Jan 1993). "History of circumcision, medical conditions, and sexual activity and risk of penile cancer". J Natl Cancer Inst 85 (1): 19–24. PMID 8380060.
2. and Schoen, EJ; Oehrli, M; Colby, C; Machin, G (Mar 2000). "The highly protective effect of newborn circumcision against invasive penile cancer". Pediatrics 105 (3): e36.

As you'll note, we also cite in that section the policy statement of the American Academy of Pediatrics, as well as the American Cancer Society. With the exception of the ACS, all of the cited sources are in peer-reviewed publications. Jakew (talk) 20:12, 10 April 2008 (UTC)

That is not what the American Cancer Society states: —Preceding unsigned comment added by 82.29.103.153 (talk) 20:36, 10 April 2008 (UTC)

Misleading Information (Penile Cancer Myth)

"Statements about circumcision preventing penile cancer and cervical cancer are cropping up on the Internet" American Cancer Society. http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Misleading_Information.asp

Yes, it is an exact quote. The webpage you cite is dated 1998. The webpage cited in the article is dated 2006, and can be found here. The quote is taken from the last sentence of the third paragraph. (Incidentally, there is also another recent page here.) Jakew (talk) 20:53, 10 April 2008 (UTC)

Biased Version

"Bias is a term used to describe a tendency or preference towards a particular perspective" In our case the curent version is very biased by citing "a rate of penile cancer from 3 to 22 times higher" It is ridiculous! There are literally hundreds of contrary studies on the subject "The carcinogenicity of smegma: debunking a myth" 75 References. Yet someone chooses to disregard all the evidence to support his personal belief, based on sporadic quotes...

Whether or not prophylactic - circumcision rates are falling in the US... Paradoxically! —Preceding unsigned comment added by 82.29.103.153 (talk) 21:21, 10 April 2008 (UTC)

Agreed! Add some recent sources. Garycompugeek (talk) 21:27, 10 April 2008 (UTC)

To my knowledge, every epidemiological study has found higher risk of penile cancer in uncircumcised men. For references, see Medical analysis of circumcision#Penile cancer. Jakew (talk) 21:32, 10 April 2008 (UTC)

!!! Most info here comes from American Sources, International Sources are not present. No European studies confirm the American Circumcision Propaganda. The USA is the only Western Society promoting Genital Mutilation, a country with the highest number of Jewish doctors!!!

Be bold and add sources! Garycompugeek (talk) 19:28, 11 April 2008 (UTC)

Penil Cancer Myth Promoted by the American Academy of Pediatrics “Pediatricians have a vested interest in encouraging you to circumcise your child. They make money by selling surgery. Their organization, the American Academy of Pediatrics (AAP) provided a brochure for use by pediatricians. This brochure claimed that cancer may be prevented if you circumcise your child” http://www.fathermag.com/health/circ/acs/

American Cancer Society “As representatives of the American Cancer Society, we would like to discourage the American Academy of Pediatrics from promoting routine circumcision as a preventive measure for penile or cervical cancer” http://www.cirp.org/library/statements/letters/1996-02_ACS/

“European medical association (27 Countries) loudly to condemn the North American medical community for participating in and profiting from what is by any standard a senseless and barbaric sexual mutilation of innocent children. [Paul M. Fleiss. Circumcision. Lancet 1995;345:927.”

BRITISH MEDICAL JOURNAL - NEONATAL CIRCUMCISION DOES NOT PROTECT AGAINST CANCER
l'Association Française d'Urologie – Circumcision not encouraged for Medical reasons.
The Royal Australasian College of Physicians “After extensive review of the literature the RACP reaffirms that there is no medical indication for routine male circumcision.” http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_330.pdf

Western Medical organizations around the world oppose infant circumcision (amputation of the foreskin) Institutions against circumcision: European Medical Association, Canadian Medical Association, Australasian College of Physicians, and most of the world.

The “penil cancer” issue invented by the American Pediatrics was already ridiculed by the American Cancer Society.

Lets keep Wikipedia unbiased! —Preceding unsigned comment added by 82.29.103.153 (talk) 06:08, 12 April 2008 (UTC)

First of all, can I encourage you to familiarise yourself with WP:RS and WP:MEDRS? You'll find that a dubious online magazine and unpublished personal communications do not qualify.

Second, can I ask you to stay on topic? You're mixing up two different topics here: a) whether circumcision protects against penile cancer, and b) whether it is recommended. The two are, of course, separate issues.

Third, can I ask you not to misrepresent sources? You misquoted Fleiss (Lancet 1995;345:927). He did not claim that a "European medical association" actually does condemn, but instead suggested that they should. The full sentence is: "It is now time for European medical associations loudly to condemn the North American medical community for participating in and profiting from what is by any standard a senseless and barbaric sexual mutilation of innocent children."

Fourth, you cite only one reliable source (in the Wikipedia sense) that's relevant to the issue. This is another letter by Fleiss, entitled "Neonatal circumcision does not protect against penile cancer" (BMJ 1996;312:779-780). You may care to read Stanton's reply, entitled "Authors ignored main conclusion of study that they cited" (BMJ 1996;313:47) [14] Jakew (talk) 11:47, 12 April 2008 (UTC)

To date, there are no (international) replication studies confirming this hypothesis. This subject remains a controversy in the USA. No European, Canadian, or Australian studies confirm the Penile Cancer risk... —Preceding unsigned comment added by 82.29.103.153 (talk) 17:55, 17 April 2008 (UTC)

The ACS & the AAP's recommendations

Note: new subject heading inserted for clarity. Jakew (talk) 10:57, 11 April 2008 (UTC)

You cannot cherry pick items out of a source Jake. To quote your above link "Neither the American Academy of Pediatrics nor the Canadian Academy of Pediatrics recommends routine circumcision of newborns. Ultimately, decisions about circumcision are highly personal and depend more on social and religious factors than on medical evidence. " Garycompugeek (talk) 21:47, 10 April 2008 (UTC)

Garycompugeek, think for a moment. Given that the subject is the policy of the AAP, which is a more reliable source: the AAP's policy (as it appears in a peer-reviewed journal) or a webpage from the American Cancer Society? And what is actually verifiable? For the first source, one can verify that it says what it says. For the second, one can only verify that the ACS states that the AAP have this position. Jakew (talk) 21:58, 10 April 2008 (UTC)

Jake here is a direct quote from American Academy of Pediatrics. "Scientific studies show some medical benefits of circumcision. However, these benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised. " on thier site [15] Garycompugeek (talk) 22:54, 10 April 2008 (UTC)

Yes. I'm afraid that I don't understand what point you're making. Jakew (talk) 23:08, 10 April 2008 (UTC)

Now your being obtuse on purpose. My point is that the American Academy of Pediatrics "does not recommend that all infant boys be circumcised". That clearly states they do not recommend circumcision. Let me clarify futher. Above you state my source from the American Cancer Society is trumped by a direct source from American Academy of Pediatrics yet I've pulled another source directly from American Academy of Pediatrics. Surely you understand my point now. Garycompugeek (talk) 00:01, 11 April 2008 (UTC)

I don't follow your logic. There's a huge difference between "circumcision of all infant boys" and "circumcision". Also, maybe I missed something, but I thought this discussion was about what the article should say about whether circumcision affects penile cancer rates. There's a big difference between on the one hand not recommending circumcision, and on the other hand stating that circumcision does not reduce cancer rates. ☺Coppertwig (talk) 00:23, 11 April 2008 (UTC)

Lot's of discussons and that is one of them this is another. If you would follow some of the threads you would note that I have not made one post about penile cancer aside that I agreed it seemed bias. Furthurmore penile cancer rates are so rare the distiction between circumcision is irrelevant. Garycompugeek (talk) 00:51, 11 April 2008 (UTC)

I've inserted a subheading above to clarify matters. Jakew (talk) 10:57, 11 April 2008 (UTC)

I agree with Coppertwig: there's a difference between what the AAP actually say and what you seem to interpret their words to mean. In their policy, they state that "these data are not sufficient to recommend routine neonatal circumcision", and in their Q&A document, which you cite, they state that "these benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised". In both cases, there's a qualifier: "routine" or "[of] all infant boys", and if we omit that qualifier we change the meaning. In the article, which cites the policy, we also use the term "routine": "insufficient data to recommend routine neonatal circumcision". So what, exactly, is the problem? Jakew (talk) 10:57, 11 April 2008 (UTC)

If you're suggesting that the article be changed, Garycompugeek, please describe exactly what change you're advocating. ☺Coppertwig (talk) 12:33, 11 April 2008 (UTC)

I prefer to be bold and simply make my change however I will give this shot. "The American Academy of Pediatrics (1999) found both potential benefits and risks in infant circumcision. It felt that there was insufficient data to recommend routine neonatal circumcision, and recommended that parental decisions on circumcision should be made with as much accurate and unbiased information as possible, taking medical, cultural, ethnic, traditional, and religious factors into account." The first sentence seems misleading to me. It projects that the AAP is on the fence concerning circumcision. I propose "The American Academy of Pediatrics (1999) felt that there was insufficient data to recommend routine neonatal circumcision." plus this is unnecessary " recommended that parental decisions on circumcision should be made with as much accurate and unbiased information as possible, taking medical, cultural, ethnic, traditional, and religious factors into account." Garycompugeek (talk) 14:48, 11 April 2008 (UTC)

Garycompugeek, that's what the source says: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision ... In the case of circumcision, in which there are potential benefits and risks". Or, in the document that you cite: "Scientific studies show some medical benefits of circumcision. ... parents should choose what is best for their child by looking at the benefits and risks." Jakew (talk) 15:04, 11 April 2008 (UTC)

So far every source I've come across on the net mentioning the AAP stance on circumcision flatly states they do not recommend it. I'b be happy to list them or you may simply do what I have done and google circumcision and start reading the links. The studies show that medical benefits do not merit circumcision. Once again you are cherry picking parts of the source to support your POV and missing the general point. This seems to be on purpose and making it increasingly difficult to assume good faith. Garycompugeek (talk) 19:44, 11 April 2008 (UTC)

This is perhaps a problem with relying on third party websites. I recommend that instead you read the AAP policy itself. Some websites have an agenda, and are likely to select the parts to quote that best serve to promote that agenda. If their agenda is anti-circumcision, they might highlight "do not recommend routine circumcision", and ignore the rest. If their agenda is pro-circumcision, they might highlight "potential benefits" and ignore the rest. (It's interesting that you should mention cherry-picking, since this is a fair description of what many of these sites do, and of the edit you propose.) Since Wikipedia has a policy of WP:NPOV, we can't promote either agenda, and must fairly represent the AAP's conclusions, not just the parts that suit a particular POV. Jakew (talk) 21:16, 11 April 2008 (UTC)

I'm willing to go along with shortening the AAP summary as Garycompugeek describes (but please retain the sentence about analgesia and stable-and-healthy, which comes after that.) Having put a lot of work into shortening this article per WP:SUMMARY, and seeing that most disputes tend to be solved by lengthening the article, I tend to be in favour of shortening edits if they're reasonable. If what we're summarizing is their recommendations about circumcision, then Garycompugeek's suggested edit seems a reasonable summary to me; benefits and risks and informed choice are relatively inessential when what's wanted is just their recommendation. ☺Coppertwig (talk) 15:39, 12 April 2008 (UTC)

I agree that what's wanted is their recommendation, Coppertwig, but there are four recommendations in the following quote, and as far as I can tell Garycompugeek intends to omit mention of all but one.

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision.

1. That there are potential medical benefits, but that these are insufficient to recommend routine neonatal circumcision.
2. That parents should determine what is in the best interests of the child.
3. That parents should be given accurate and unbiased information, and should be given the opportunity to discuss the decision.
4. That is it legitimate for parents to take cultural, religious, and ethnic traditions, as well as medical factors, into account.

I can't see how that can be justified. Jakew (talk) 15:46, 12 April 2008 (UTC)

These are all self evident facts and not note worthy. Garycompugeek (talk) 15:58, 12 April 2008 (UTC)

If they were self-evident then I am sure the AAP would not have felt the need to state them (and many anti-circumcision advocates would doubtless disagree that point 2 is self-evident). However, they did, and they form a part of the AAP's conclusions. Jakew (talk) 16:22, 12 April 2008 (UTC)

An additional problem is that the following paragraph is: "The American Medical Association supports the general principles of the 1999 Circumcision Policy Statement of the American Academy of Pediatrics". If you turn to the AMA's policy, and scroll down to their recommendations, you'll see that they quote the above text in full (plus a sentence about pain relief). So not only did the AAP decide to state these "self-evident facts", but the AMA quoted them in full and supported them in their entirety, not just the part which you wish to quote. So your edit not only paints a misleading picture of the AAP's policy, but it also in effect paints a misleading picture of the AMA's policy as well. Jakew (talk) 16:39, 12 April 2008 (UTC)

I'd like to be able to say that medical associations whole-heartedly recommend circumcision. Unfortunately, they don't (for political and other irrational reasons). Nonetheless I'd like the statement to be presented as it was actually made. You on the other hand are attempting to introduce bias by omitting the parts of the statement that might be considered to support circumcision, and implying that there are no valid reasons to circumcise. The way, the truth, and the light (talk) 17:19, 12 April 2008 (UTC)

The reason you may not say "medical associations whole-heartedly recommend circumcision" is because scientific fact does not justify it, however your bias is clear. Garycompugeek (talk) 18:19, 12 April 2008 (UTC)

Jake you are showing disturbing signs of WP:OWNERSHIP. Perhaps you should consult others on the talk page before you revert anything not related to your POV? Garycompugeek (talk) 16:05, 12 April 2008 (UTC)

Jakew, by your argument, we would have to include the AAP recommendations in full, no matter how lengthy they are. In fact, to write a Wikipedia article, we need to condense and select. It's not enough to argue that some words supply some important information; you have to argue that it's sufficiently important to be worth lengthening the article for; or to put it another way, you have to argue that it's more important than other groups of words of similar length elsewhere in the article. So far, your only argument seems to be that those are their recommendations. If they had 75 recommendations, that argument would ask that they all be included.

I'm OK with either the original wording, or Garycompugeek"s suggestion, and I have another suggestion: keep the first sentence but delete the second bit that Garycompugeek wants to delete. It can be shortened slightly to "The American Academy of Pediatrics (1999) found both potential benefits and risks in infant circumcision, but insufficient data to recommend routine neonatal circumcision."

The AAP are not family law experts, so whether they think parents should do what's in the best interests of their children is not very relevant. It may be important enough for the AAP to include in their statement, but we have much less room here for representing the AAP's views. (It can be expanded in a sub-article -- lots more room there.) I agree that this, and the idea that it's good for parents to have information, are more or less self-evident, therefore not of high information value for this article. ☺Coppertwig (talk) 18:07, 12 April 2008 (UTC)

OK, that does seem unnecessary to me. It doesn't really make an argument for either side, and is essentially a cop out by the AAP to avoid admitting that circumcision is a good idea. The way, the truth, and the light (talk) 18:24, 12 April 2008 (UTC)

WP:NPOV, WP:OR, WP:SOAP. I thought admins were here to remind people of these? Blackworm (talk) 02:18, 15 April 2008 (UTC)

Coppertwig, I'm not saying that we have to include every recommendation, but we should include the important ones, as well as those that provide context for the first (compare "Fred does not recommend routine circumcision" with "Fred does not recommend routine circumcision, but recommends that parents should decide based upon benefits and risks" - the first could be interpreted as "recommends against parents choosing circumcision", while the second provides context to avoid that ambiguity). In particular, I think we need to include enough facts to be balanced in our treatment of the AAP's position.

I think it's reasonable enough to delete the text about information that should be given to parents, though.

Additionally, the underlying reason why they recommend that parents should decide is outlined in an Authors' Reply in Pediatrics by Dr Lannon on behalf of the Task Force. She indicates that this recommendation is based upon the AAP's assessment of the potential medical benefits, not of legal issues. To quote: "The critical distinction between female genital mutilation and male circumcision is the potential medical benefits of male circumcision. These potential benefits warrant a parental role in decision making about this procedure."[16] (emph. added) Jakew (talk) 18:36, 12 April 2008 (UTC)

Still not note worthy. Very self evident that a parental role should always be assumed ie parents should be parents. Garycompugeek (talk) 18:44, 12 April 2008 (UTC)

Please re-read the quote again. Lannon specifically contrasts circumcision with a situation in which a parental role in decision making is not warranted (in the AAP's view). She's saying, in effect, that because' of these potential benefits, a parental role in decision making is justified. So this recommendation (that parents should determine what is in the best interests of the child) is made on the basis of the AAP's determination of the potential medical benefits. Jakew (talk) 18:51, 12 April 2008 (UTC)

I see your point, Jakew. If we just say they "do not recommend" routine circumcision, then that could be misinterpreted as meaning that they recommend against it; but if we also include some of the self-evident phrases, then their meaning becomes clear. So the self-evident stuff may be necessary to establish the meaning of the other stuff, even if it's not of much value on its own; unless there's a slight chance we could come up with shorter wording that carries the same meaning as understood by people from a variety of POV's. E.g. they "do not recommend for or against routine neonatal circumcision" or something. ☺Coppertwig (talk) 18:54, 12 April 2008 (UTC)

(ec) You sure they're not family lawyers? Do they really assert that there are situations where a parental role is not warranted? I don't think they go that far. ☺Coppertwig (talk) 18:54, 12 April 2008 (UTC)

Hmm, I'd go along with your suggestion, Coppertwig, but I think that it might be best to use language similar to that used by the AAP itself. How about something like "The American Academy of Pediatrics do not recommend that all infant boys be circumcised, and state that parents should choose what is best for their child by looking at the benefits and risks" (this is adapted from the AAP's Circumcision Information for Parents)? Jakew (talk) 19:10, 12 April 2008 (UTC)

The CDC seems to think this "In 1999, the American Academy of Pediatrics (AAP) changed from a neutral stance on circumcision to a position that the data then available were insufficient to recommend routine neonatal male circumcision." [17] Garycompugeek (talk) 19:00, 12 April 2008 (UTC)

I don't know why that should be interpreted as an anti-circumcision statement. Perhaps there is more context? The way, the truth, and the light (talk) 19:05, 12 April 2008 (UTC)

Perhaps you see this as a circumcision endorsement? If you beleive I've taken out of context follow the link I've provided and read the entire paragraph. Your vague accusations ill become you. Garycompugeek (talk) 19:15, 12 April 2008 (UTC)

No, I don't, as I already stated. However, I don't think we have any evidence to suggest that it is anti-circumcision; and I did read the link you provided. The way, the truth, and the light (talk) 19:18, 12 April 2008 (UTC)

Arbitrary section break

That sounds fine to me, Jakew.☺Coppertwig (talk) 19:22, 12 April 2008 (UTC)

I don't understand the CDC's statement at all. What do they mean by implying that that's non-neutral? In which direction do they think it's non-neutral? I can see arguing either way. ☺Coppertwig (talk) 19:22, 12 April 2008 (UTC)

First, good break. Come now, the CDC clearly states that they believe the APA is not neutral, therefore they must be for or against. Do you truly wish us to believe CDC wishes us believe the APA is pro circumcision? Garycompugeek (talk) 21:21, 12 April 2008 (UTC)

WHO ARE YOU

There are many sources stating WHO is incorrect or the data is inconclusive. I feel it should be removed on this basis. Thoughts? Garycompugeek (talk) 19:59, 11 April 2008 (UTC)

Please review the usage of the {{disputed}} template. It is only meant to be used to identify "…a Wikipedia article as having content whose truth or factual nature is in dispute." That the WHO made the statement is completely factually accurate. That others dispute it should be brought in the text. Thank you. -- Avi (talk) 20:02, 11 April 2008 (UTC)

In response to your initial statement, the proper WP:NPOV response would be to bring the WHO statement and representative notable disagreements. not to remove the WHO. There are many statements in the article that are disputed; perhaps every statement in this article is disputed, is it your intention to have it deleted? -- Avi (talk) 20:03, 11 April 2008 (UTC)

Negative. The intention would be to remove if false (not sure why we wish to publish) or add the sourced disagreements (which wouldn't be necessary if we remove) confusing to the reader but I'll play along... Perhaps you can help me in my endeavors? Garycompugeek (talk) 20:18, 11 April 2008 (UTC)

It might be helpful, Garycompugeek, if you were to cite some reliable sources that have criticised the WHO's statement. Jakew (talk) 21:19, 11 April 2008 (UTC)

Are the peer-reviewed studies being contested? If so, which of them are suspect and who is questioning their validity? Or is it the WHO's interpretation of the findings that are in question? It's a little unclear exactly what the objection is without more details. Kindest regards, AlphaEta 21:35, 11 April 2008 (UTC)

The CDC quotes "There are as yet no convincing data to help determine whether male circumcision will have any effect on HIV risk for men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner." [18] sourcing Koblin BA, Chesney MA, Husnik MJ. Garycompugeek (talk) 22:20, 12 April 2008 (UTC)

Presumably this isn't an example of a source stating that the WHO is incorrect, since it is very similar to the WHO recommendation 3.5: "Clear messages should be developed to inform communities about what is known and what is not known about male circumcision, including lack of data on direct protection for women, or for either partner during anal sex with men or women."[19] Jakew (talk) 22:29, 12 April 2008 (UTC)

An Inconsistency between the summary and the body of the article

The article summary reads:"Male circumcision is a religious commandment in Judaism as well as in Islam." However, the article says:"Some Fiqh scholars state that circumcision is recommended (Sunnah); others that it is obligatory.[24] Some have quoted the hadith to argue that the requirement of circumcision is based on the covenant with Abraham.[25] While endorsing circumcision for males, scholars note that it is not a requirement for converting to Islam."

In view of this, it would be preferable for the summary to state: Male circumcision is a religious commandment in Judaism and is customary in Islam. Michael Glass (talk) 23:04, 11 April 2008 (UTC)

How about "is a religious commandment in Judaism as well as sometimes in Islam." ☺Coppertwig (talk) 02:09, 12 April 2008 (UTC)

How about is a religious commandment in Judaism and recommended or obligatory in Islam. It is also and customary in some Christian churches in Africa including some Oriental Orthodox Churches. This wording mirrors the wording later in the article and makes it clear that it is only some Christian churches in which circumcision is customary. Michael Glass (talk) 08:39, 12 April 2008 (UTC)

Yes, very good. ☺Coppertwig (talk) 15:30, 12 April 2008 (UTC)

Neutrality tag removed?

If you do not believe the neutrality of this article is in question then you are ignoring large swaths of this discussion. I suggest you put it back or explain yourself better than "silly tag". Garycompugeek (talk) 18:25, 12 April 2008 (UTC)

Since you have refused discussion User:The way, the truth, and the light I have replaced the tag. Garycompugeek (talk) 21:37, 12 April 2008 (UTC)

Intro

I oppose this edit which removes pro- and anti-circumcision info from the intro. While I think perhaps the intro could be balanced more between pro- and anti- by adding a tiny bit of info on risks and/or pain and/or by shortening the WHO/HIV bit, nevertheless taking almost all the really interesting information out of the intro is not the answer IMO. NPOV means presenting both sides, not sweeping both sides under the carpet. Garycompugeek, could I convince you to revert back to the original intro? What are your reasons for shortening it? ☺Coppertwig (talk) 18:45, 12 April 2008 (UTC)

I am not opposed to putting both back into the article but feel the intro should be without controversy. Garycompugeek (talk) 18:50, 12 April 2008 (UTC)

Why do you feel the intro should be without controversy? There is controversy in the real world about this subject; the article should reflect that controversy, per NPOV; and the intro should be a summary of the article, per WP:LEAD, and therefore should also summarize the controversy IMO. —Preceding unsigned comment added by Coppertwig (talk • contribs) Jakew (talk) 19:39, 12 April 2008 (UTC)

I tend to agree - WP:LEAD is fairly clear that we should "briefly describe its notable controversies, if there are any". This deletion has also messed up the references. Could you restore the material, Gary? Jakew (talk) 19:39, 12 April 2008 (UTC)

Sure we can state the controversy but lets break down sources in thier respective sections. Garycompugeek (talk) 21:39, 12 April 2008 (UTC)

Can you explain what you mean? It isn't at all clear. Jakew (talk) 22:33, 12 April 2008 (UTC)

I see you believe there is no controversy concerning the benefit of circumcision. Please explain? Garycompugeek (talk) 22:56, 12 April 2008 (UTC)

To whom is that comment addressed? That doesn't represent my belief and I don't think it represents Jakew's. I don't see anything in what you've written, Garycompugeek, that looks to me as if it's intended to be an argument in support of your position that there should be no controversy in the lead. If I missed something, please mark it clearly as being such an argument. ☺Coppertwig (talk) 23:13, 12 April 2008 (UTC)

I was referring to Jakes comment edit. Perhaps I misundertood it? Garycompugeek (talk) 23:17, 12 April 2008 (UTC)

Jakew's comment of 22:23, 12 April seems to be not expressing Jakew's beliefs, but asking for clarification, which you haven't provided, of your message of 21:39, 12 April. ☺Coppertwig (talk) 23:22, 12 April 2008 (UTC)

I'm refering to "restore properly sourced and NPOV material in lead, instead of one-sided claim of controversy. this should also fix broken refs" this comment of Jakes. I showed him my clarification when he asked with my edit. This was my clarification. Garycompugeek (talk) 23:32, 12 April 2008 (UTC)

Gary, why are you removing properly sourced, relevant material from the lead, expressed in quite neutral ways, and replacing it with an unsourced opinion? Jayjg ^(talk) 02:20, 13 April 2008 (UTC)

Read the discussion Jayjg. They are back now and I shall abide by consensus. Please assume good faith. Garycompugeek (talk) 03:04, 13 April 2008 (UTC)

Garycompugeek, I'm not sure whether I understand what you're saying. I think you mean that this edit is your clarification of what you mean by this comment. I still don't see any arguments for removing controversy from the lead, but I gather you're now willing to keep the original material in the lead so perhaps that doesn't matter. ☺Coppertwig (talk) 03:25, 13 April 2008 (UTC)

I think JakewJayjg was assuming good faith. He was just asking for you to give a reason for your edit. Asking for a reason for an edit is a normal Wikipedian interaction. ☺Coppertwig (talk) 03:35, 13 April 2008 (UTC)Apologies to all concerned: I confused two familiar 5-letter usernames beginning with Ja. Of course, I think Jakew is also AGF. 13:48, 13 April 2008 (UTC)

As you note, Coppertwig, this may be a moot point, but it seems that some explanation would be helpful, as there seems to be some confusion. I think that this confusion may be due in part to my edit summary when I restored the material in the article; evidently this was not sufficiently clear. I also think that it is partly due to Garycompugeek's comment above, which did not make it clear that it was in response to an article edit, and instead gave the impression that it was in reply to an earlier comment.

In my message above (of 22:33, 12 April 2008), I asked for clarification of Garycompugeek's earlier message. I understood Gary's edit to the article (of 23:44, April 12, 2008) to be a response; judging by Gary's message above (dated 23:32, 12 April 2008, but timestamped 00:32, April 13, 2008), this was his intent.

Gary, somehow my edit summary gave you the impression that I believe that there is "no controversy concerning the benefit of circumcision". I don't understand why this is, as I thought I had made it clear that the problems were sourcing and one-sidedness, and I didn't suggest that the statement was incorrect. The problem was that your summary ("There is great controversy concerning the benefit of circumcision") was entirely one-sided: it considered only the "pros" and presented them as controversial, in effect advancing an anti-circumcision point of view. A slight improvement would have been to say "There is controversy concerning the benefits and harms of circumcision", but of course this is still a fairly narrow view of the controversy that omits, for example, claims of violations of rights. And, of course, it is completely unsourced and hence unverifiable. Jakew (talk) 11:58, 13 April 2008 (UTC)

Oh, I see. Garycompugeek may have thought that by deleting the sentence "There is great controversy concerning the benefit of circumcision" you were expressing an opinion that the sentence was false, when actually you were stating that it was unsourced and that presenting only that sentence without others to balance it gives a misleading impression. Analogously but more extremely, a misleading impression could be given by stating only "Some people have died from circumcision", which is true (I believe) but ignores benefits and a low death rate. NPOV is more than just keeping only true statements.

Although it was clear to you that Garycompugeek's edit was a reply, nevertheless someone like me who may not be checking the page as frequently might not happen to notice the relative timing of edits and messages and might expect the discussion here to be readable on its own. When an edit or edit summary becomes part of a discussion, I think it's helpful for one of the participants to quote or link to it, to assist others who might be trying to follow the discussion either at that time or later on. ☺Coppertwig (talk) 12:29, 13 April 2008 (UTC)

You do understand correctly now Coppertwig. I do apologize for the lack of clarity. I was being bold and showing Jake what I meant and and should have expounded better here. I have no problem with the revert and would not object to Jake's suggestion "There is controversy concerning the benefits and harms of circumcision". Surely we can source something to this degree if we wanted to. The point I am/was trying to make was more of an encapsulation of the intro stating the controversy in simpler terms. Garycompugeek (talk) 12:54, 13 April 2008 (UTC)

Can you help me to understand what problem you're trying to solve here, Garycompugeek? Why do you think the lead needs to be simpler? Jakew (talk) 13:42, 13 April 2008 (UTC)

Thats a great question Jake. Thank you for asking. You may have noticed I feel the article is out of balence. The Pro source of WHO endorsing circumcision to prevent AIDS is itself very controversal. Nothing wrong with controversy but a source like that should have other sources illustrating the controversy and that makes the intro too busy taking the focus away from simply what is circumcision. The fourth paragraph sums up both pro and con with sources. That I feel is perfect, more is WP:UNDUE. Summerizing I would like to move the WHO pro source to another location than the intro or a con source illustrating circumcision no HIV benefit. Garycompugeek (talk) 20:31, 13 April 2008 (UTC)

Garycompugeek, in the above section you've been asked for some sources criticising the WHO's recommendations. Since you say that their endorsement is "very controversal", it seems to me that we really need to be able to examine some of these sources, in order to be able to determine the scope and extent of this controversy, and to evaluate questions of undue weight. For example, if it turns out that there is a relatively large amount of criticism in reliable sources (perhaps more so than agreement), then we would need to reflect that in terms of the weight given to each viewpoint. On the other hand, if there is relatively little (or no) criticism of the WHO's decision in reliable sources, then again we need to reflect that state of affairs. Jakew (talk) 20:56, 13 April 2008 (UTC)

Title dispute

Is the title of this article still in dispute? If so, could someone please clearly state the problem, or point me to the discussion, so that it may be addressed? Otherwise, the tag should be removed. Thanks, AlphaEta 01:10, 14 April 2008 (UTC)

The title was never in dispute. The tag states "The neutrality of this article's title and/or subject matter is disputed." This would be an or subject matter case in point. Garycompugeek (talk) 01:23, 14 April 2008 (UTC)

Okay, I see. Is the subject matter dispute separate from the concern regarding the article's balance, or lack thereof? Thanks, AlphaEta 01:28, 14 April 2008 (UTC)

The neutrality of the article is in dispute and it is considered unbalanced. Garycompugeek (talk) 01:46, 14 April 2008 (UTC)

The title is actually disputed. As this article is about male circumcision, and not circumcision, it should be titled Male circumcision per WP:TITLE. This one required pages and pages of "discussion" to keep the status quo safe. Blackworm (talk) 03:50, 14 April 2008 (UTC)

I have removed both tags, since they were added inappropriately. If anyone wishes to restore them, please create a section on the talk page including a clear and detailed statement of the specific problems to be addressed. There is some useful guidance in Wikipedia:Dispute templates (both in the intro and in the section entitled "Banner templates"). Jakew (talk) 11:57, 14 April 2008 (UTC)

Jake you have inappropriately removed these tags and there is nothing wrong with the way they were added. Your refusal to work with editors who do not share your viewpoints is telling. You must learn to compromise and incorporate other viewpoints. Garycompugeek (talk) 15:06, 14 April 2008 (UTC)

"They should normally not be used without a clear description from the applying editor of the rationale, preferably presented in a numbered list form in a separate section which includes the template name. ... If one must be used, please make a thorough note listing deficiencies or items being disputed in bulleted or numbered paragraph format under a clear notice section heading." Wikipedia:Dispute templates Jakew (talk) 15:40, 14 April 2008 (UTC)

These tags were added at 21:06, April 11, 2008 and 21:36, April 11, 2008. They were removed at 12:48, April 14, 2008, and were then re-added at 15:41, April 14, 2008. Nearly four days have therefore elapsed since they were first added, and almost a day has elapsed since they were restored. Due to the above messages (including a quote from the appropriate page), in addition to the edit summary used when they were removed, it should be crystal clear that, for each tag, a "clear description from the applying editor of the rationale"/"thorough note listing deficiencies or items being disputed in bulleted or numbered paragraph format under a clear notice section heading" should be made on this talk page. This has not been done.

These descriptions are essential if we are to understand and deal with these issues. If the article is unbalanced, for example, we need a clear and detailed description of how it is unbalanced, in what sections it is unbalanced, and what the correct balance ought to be. Put simply, you need to explain the problem in sufficient detail that someone else can understand it, fix it, and know that it has been fixed. Comments made so far (eg., "the article appears to lean towards pro circumcision however it may simply be my natural aversion to genital mutilation clouding my judgment.") are simply inadequate, as they are far too vague and subjective.

Since the tags were added inappropriately, without these descriptions, they currently serve no function (indeed, they are actively misleading, since they point towards a talk page section that doesn't exist) and should really be removed. However, to give Garycompugeek time to prepare the rationales, I will wait for another day. Jakew (talk) 11:51, 15 April 2008 (UTC)

Come now Jake. You have lifted my very first comment on this page. I wished to state my position and not labor under false pretenses. You on the other hand claim neutrality yet show tremendous friction towards any con stance. I did not post these banners and walk away. I have been very active and will remain so. I shall try and summarize my doubts of unbalance. Note however I am far from the only editor who shares concern. I will start a new title for the banners listing my concerns and urge other editors to do the same. Garycompugeek (talk) 13:14, 15 April 2008 (UTC)

Ok, Gary, I will look forward to your explanations.

To be fair, I could have used a more recent example. For example, when AlphaEta asked you in this section whether the tags were independent of each other, or whether they covered the same issue, you replied "The neutrality of the article is in dispute and it is considered unbalanced", which is simply a restatement of the tag itself, rather than providing information that allows anyone to evaluate the underlying issues.

As for "show tremendous friction towards any con stance", I believe that your efforts have thus far attempted to move the article away from WP:NPOV, for reasons that I've explained in detail elsewhere on this talk page, and for that reason I've largely opposed them. I'm not suggesting that you're acting in bad faith; far from it, in fact. I'm sure you're trying to fix some problem or other which you consider to be "unbalanced", but until I can understand what you're trying to do, all I can do is to evaluate the effect of your fixes as edits in their own right and, where necessary, fix those. Jakew (talk) 13:39, 15 April 2008 (UTC)

I appreciate that response Jake. Pardon the analogy but you simply cannot see the forest for the trees. I do not mean that in a belittling way but if you saw the problems you would have already have tried to solve them. Whether by design or not your edits generally represent the pro side or slanted in that direction. You may have noticed other pro editors who have been backing you up for this reason. There is nothing wrong with any of that as long as both sides are fairly represented. I am working on the banner summation and will post it when complete. Garycompugeek (talk) 17:20, 15 April 2008 (UTC)

Balance Tag

Note to editors: These are my reasons please feel free to add your on own concerns.

1. I would to flesh out the medical and sexual effect/aspects respectively. I have many peer reviewed sources that seem to be missing.
2. The US policies should include a summary from the CDC
3. Only the United Kingdom is represented for Europe a few more notable med associations from other European countries should be included ie France, Spain, Germany…am not particular about inclusion just better representation of European stance
4. China being the most populous country in the world should probably be represented. Garycompugeek (talk) 20:05, 16 April 2008 (UTC)

Thanks for posting this explanation, Gary. Some questions in response:

1. What peer-reviewed sources do you have in mind?
2. Half agree, half disagree. I have considered adding the CDC, along with the WHO, to the 'policies' section but decided against doing so for two reasons. Firstly, they are already represented elsewhere in the article, and secondly we have to be conscious of the article length (it is supposed to be written in summary style, after all).
3. To my knowledge, no English-language versions of circumcision policies are available for medical association policies representing these countries. If you've been able to find them, I'd be grateful if you can let me know where. After all, if we can't find them, we can't cite them!
4. Again, if you're aware of where Chinese medical association policies may be found, I'd be grateful if you'd share that information.

These seem to be general comments about additions that you'd like to make or see made. They don't seem to warrant the "unbalanced" tag. Do you agree that it can be removed? Jakew (talk) 20:20, 16 April 2008 (UTC)

No. I am content with the intro and allowed the neutrality tag to be removed. The medical and sexual sections are unbalenced. I will post them soon time permitting. Garycompugeek (talk) 21:32, 16 April 2008 (UTC)

Ok. Can you please post your explanation as soon as possible (say, within the next 24 hours)? The tag has been present for five days now, and you still haven't justified its presence. Jakew (talk) 21:38, 16 April 2008 (UTC)

Circumcision reduces penis length - Some of the penis length and circumference because its double-layered wrapping of loose and usually overhanging foreskin is now missing, making the circumcised penis truncated and thinner than it would have been if left intact. An Australian survey in 1995 showed circumcised men to have erect penises an average of 8mm shorter than intact men. [1. R. D. Talarico and J. E. Jasaitis, "Concealed Penis: A Complication of Neonatal Circumcision," Journal of Urology 110 (1973): 732-733. 2. Richters J, Gerofi J, Donovan B. Why do condoms break or slip off in use? An exploratory study. Int J STD AIDS. 1995; 6(1):11-8. ]

"circumcision is an iatrogenic cause in the etiology of a concealed penis" - Concealed Penis:Rare Complication of Circumcision A. Adil Esen, Güven Aslan, Hatem Kazmolu, Deniz Arslan, lhan Çelebi - Department of Urology, Dokuz Eylül University School of Medicine, Izmir, Turkey Garycompugeek (talk) 22:17, 17 April 2008 (UTC)

I have looked up "Why do condoms break or slip off in use? An exploratory study" in the Department of Public Health, University of Sydney, Australia. While circumcision is one reason given I was looking for data on penis length. I have reviewed both sources directly and see no justification of that point in those sources however we should probably include the concealed penis complication. Jake I see what you mean about left and right side websites posting their own conclusions. I shall continue researching the other sources. Garycompugeek (talk) 22:41, 17 April 2008 (UTC)

Gary, thanks for checking out the Richters et al. article. As you probably know, the International Journal of STD & AIDS' website hasn't posted articles pre-dating January 1996, so you saved me a trip to the library! Kindest regards, AlphaEta 01:26, 18 April 2008 (UTC)

The Frenar Ridged Band, the primary erogenous zone of the male body. Loss of this delicate belt of densely innervated, sexually responsive tissue reduces the fullness and intensity of sexual response. [Taylor, J. R. et al., "The Prepuce: Specialized Mucosa of the Penis and Its Loss to Circumcision," British Journal of Urology 77 (1996): 291-295.]

The Frenulum The highly erogenous V-shaped web-like tethering structure on the underside of the glans; frequently amputated along with the foreskin, or severed, either of which destroys its function and potential for pleasure. [1. Cold, C, Taylor, J, "The Prepuce," BJU International 83, Suppl. 1, (1999): 34-44. 2. Kaplan, G.W., "Complications of Circumcision," Urologic Clinics of North America 10, 1983.]

The Foreskin's 'Gliding Action' - the hallmark mechanical feature of the normal natural, intact penis. This non-abrasive gliding of the penis in and out of itself within the vagina facilitates smooth , comfortable, pleasurable intercourse for both partners. Without this gliding action, the corona of the circumcised penis can function as a oneway valve, scraping vaginal lubricants out into the drying air and making artificial lubricants essential for pleasurable intercourse. [P. M. Fleiss, MD, MPH, "The Case Against Circumcision," Mothering: The Magazine of Natural Family Living (Winter 1997): 36-45.]

Emotional Bonding Circumcision performed during infancy disrupts the bonding process between child and mother. There are indications that the innate sense of trust in intimate human contact is inhibited or lost. It can also have significant adverse effects on neurological development. Additionally, an infant's self-confidence and hardiness is diminished by forcing the newborn victim into a defensive psychological state of "learned helplessness" or "acquired passivity" to cope with the excruciating pain which he can neither fight nor flee. The trauma of this early pain lowers a circumcised boy's pain threshold below that of intact boys and girls. [1. R. Goldman, Circumcision: The Hidden Trauma (Boston: Vanguard Publications, 1997), 139-175. 2. A. Taddio et al., "Effect of Neonatal Circumcision on Pain Responses during Vaccination in Boys," Lancet 345 (1995): 291-292.]

Circumcision Removes the Most Sensitive Parts of the Penis - Sorrells, M. et al., “Fine-Touch Pressure Thresholds in the Adult Penis,” BJU International 99 (2007): 864-869.

This peer reviewed and published information needs to be incorporated into the article. Garycompugeek (talk) 22:51, 16 April 2008 (UTC)

For goodness sake, Gary, this is a blatant copyright infringement of this anti-circumcision website. Not only does it utterly fail WP:NPOV, but it is plagiarism. Jakew (talk) 22:59, 16 April 2008 (UTC)

As if I had copied them onto the article Jake. The examples were copied from the above website, in the UK, I'm sure you are familure with it. This does not invalidate the science or the sources. It also does not matter if an "anti circucision" website host the sources. I'm not proposing we quote the website just the studies. I repeat these studies need mention in the article. Garycompugeek (talk) 00:33, 17 April 2008 (UTC)

A little advice for all of us: I would suggest that all information added to this article be derived from a direct reading of the peer-reviewed studies. It would be a mistake to base new information on the editorial synopeses of pro- or anti-circumcision sites. This is the only way we can guarantee that information isn't misrepresented. Kindest regards, AlphaEta 01:21, 17 April 2008 (UTC)

Why can we not quote the sources directly? Garycompugeek (talk) 01:48, 17 April 2008 (UTC)

I don't have a problem with direct quotes from peer-reviewed sources. Is that what you meant? Maybe I misunderstood the question. AlphaEta 02:17, 17 April 2008 (UTC)

We can (and do) cite peer-reviewed sources directly. For example, we already cite Taddio (1997) in this article (ref 54). And we cite Sorrells (2007) and Taylor (1996) in sexual effects of circumcision. And we cite Kaplan in medical analysis of circumcision. All of which is perfectly appropriate. (Others are less appropriate, for example neither Fleiss' magazine article nor Goldman's book are peer-reviewed articles.)

But in each and every case we cite the article directly, and the claim we attribute to the article is based upon a careful reading of the source itself. And because we have policies such as WP:NPOV and WP:V, we must treat the material neutrally, we can't extrapolate beyond the sources, and we can't, to be blunt, invent claims out of thin air which we then attribute to sources. Jakew (talk) 10:58, 17 April 2008 (UTC)

So this Dr. Ronald Goldman who has wrote the book "The Hidden Trauma" and runs the Circumcision Resource Centert in Boston, a non profit organizaion, is not quoteable? Garycompugeek (talk) 19:07, 17 April 2008 (UTC)

See ref 49. Jakew (talk) 19:14, 17 April 2008 (UTC)

Thank you Jake. I thought I remember seeing him somewhere in the article. Ok so we do quote him but you object to quoting him from the Circumcision Resource Center because it is not peer reviewed magazine or university publication. Note that it is permissible to quote from there however if all of our sources are peer reviewed I can understand wanting to keep it that way. I am content with Goldman's ref although I may attempt to change some order or phrasing. I will attempt to locate the other above sources in likewise peer reviewed articles. I'm sure they were published somewhere. Garycompugeek (talk) 20:21, 17 April 2008 (UTC)

Tags are not weapons. No compelling rationale for the tag has been advanced, beyond an ideological opposition to circumcision itself. Please do not deface articles with spurious tags; instead work with editors to improve articles. Jayjg ^(talk) 02:08, 18 April 2008 (UTC)

I disagree. This article has multiple open disputes, especially regarding neutrality. Please do not accuse editors of bad faith without evidence beyond your personal conclusion of their ideological opposition to circumcision. Some editors here are working together in an atmosphere of civility and respect. Blackworm (talk) 03:33, 18 April 2008 (UTC)

The Tags have the same purpose they have always had. I have used them to illustrate unbalance and neutrality disputes while working with other editors here in discussion. Regardless of my personal stance I have only interest in truth and facts and have readily admitted any misconceptions I have encountered. Progress has been made in my opinion and I shall continue my endeavors. Garycompugeek (talk) 14:34, 18 April 2008 (UTC)

Choice of source in lead

As noted in the above section, the CDC and WHO make very similar statements about lack of data regarding whether circumcision is protective against HIV for either partner during anal sex with men or women. Because of this, it seems best to cite WHO for this and the preceding statement: there seems little reason to cite both, and in fact doing so adds several hundred bytes to the article length while containing the same information.

Arguments expressed in favour of using the WHO source for both include (taken from edit summaries):

• "WHO source makes the same claim as the CDC." -- AlphaEta [20]
• "no point citing two sources here when one supports both statements. happily, this also reduces the article length slightly" -- Jakew [21]

The argument expressed in favour of using separate sources was (again, taken from edit summaries):

• "I prefer a different source than WHO" -- Garycompugeek [22]
• "Reverted to AlphaEta intro edit" (technically not an argument, but included here for the sake of completeness) -- Garycompugeek [23]

Besides the personal preferences of one editor, are there any actual arguments in favour of using separate sources? Jakew (talk) 17:29, 14 April 2008 (UTC)

AlphaEta has specificly stated no side per "minor cleanup of duplicated material -NOT making an editorial decision on which reference should stand". Are you going to straw poll for every edit that doesn't support your POV? Garycompugeek (talk) 18:22, 14 April 2008 (UTC)

In general, discussion is preferable to polling, Garycompugeek. Consequently the above is an attempt to review and summarise arguments that have been made in favour of one or the other source, and to request elaboration and/or further input. Since I understood AlphaEta's edit summary (please correct me if I'm wrong, AlphaEta) to mean that (s)he did not intend the edit to be taken as an editorial decision, I did not include it. Jakew (talk) 18:50, 14 April 2008 (UTC)

As per Jake and AlphaEta, I do not see any reason to remove the WHO other than Gary's preference. While it would be wonderful to be able to accommodate each and every one of us and our preference in wikipedia, that is an impossibility, and without a valid and compelling reason to change the current consensus, it should remain as it is. -- Avi (talk) 19:18, 14 April 2008 (UTC)

Wonderful but not practical. Which is why we do things through consensus. Be Bold and make changes then come to discussion to talk about edit conflicts and differece of opinion. You and Jake have expressed yours and I have shown mine. We can be patient and see if anyone else ways in or you may revert. 3R should prevent an edit war and I will abide by consensus. Once again AlphaEta has stated no decision see please stop putting words in his/hers mouth. Garycompugeek (talk) 19:41, 14 April 2008 (UTC)

Both of the references (CDC and WHO) support the new material, so I'm not compelled to argue one way or the other. I do like the fact that including the CDC reference (in addition to the WHO ref) grants readers access to a broad spectrum of information, but it certainly isn't necessary to support the new sentence. Perhaps Gary could explain exactly why the CDC link is preferred. More importantly, does the newly added information ease concerns regarding article neutrality and balance? Previous comments seemed to indicate that the WHO findings were the primary area of contention, is this correct? Kindest regards, AlphaEta 19:47, 14 April 2008 (UTC)

I feel WHO's statement "but also stated that male circumcision only provides partial protection and should not replace other interventions to prevent the heterosexual transmission of HIV." is not equal to the CDC quote that "male circumcision may not prevent HIV transmission". The CDC quote is part of my effort to balance the article out in this section. Your help is appreciated regardless of personal feelings about this contentious issue. Garycompugeek (talk) 20:27, 14 April 2008 (UTC)

Gary, as far as I can tell, you're comparing the wrong statements. The CDC's statement is this:

• "There are as yet no convincing data to help determine whether male circumcision will have any effect on HIV risk for men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner"

Which we presented as:

• Furthermore, the Centers for Disease Control and Prevention (CDC) indicates that male circumcision may not prevent HIV transmission from men to women, and data is lacking for the transmission rate of "men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner."[15]

And the WHO's statement is this:

• "Clear messages should be developed to inform communities about what is known and what is not known about male circumcision, including lack of data on direct protection for women, or for either partner during anal sex with men or women."

Which we presented as:

• The WHO also indicates that male circumcision may not prevent HIV transmission from men to women, and data is lacking for the transmission rate "for either partner during anal sex with men or women."[14]

Jakew (talk) 20:39, 14 April 2008 (UTC)

Negative Jake. I meant exactly what I said with quotes directly from the article. While both sources cover the same topic the CDC's has more weight and clarity. If you feel they are the same why not compromise with me and drop the WHO source? I have no problem keeping them both as one currently one backs up the other and gives the reader another valuable source. Garycompugeek (talk) 20:54, 14 April 2008 (UTC)

Gary, you're comparing part of the second sentence in one version with part of the first sentence in both versions. Yet the two versions only differ in the second sentence. To show you what I mean, here are longer extracts from the two versions:

• (CDC version) In March 2007 the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that male circumcision is an effective intervention for HIV prevention, but also stated that male circumcision only provides partial protection and should not replace other interventions to prevent the heterosexual transmission of HIV.[14] Furthermore, the Centers for Disease Control and Prevention (CDC) indicates that male circumcision may not prevent HIV transmission from men to women, and data is lacking for the transmission rate of "men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner."[15]
• (WHO version) In March 2007 the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that male circumcision is an effective intervention for HIV prevention, but also stated that male circumcision only provides partial protection and should not replace other interventions to prevent the heterosexual transmission of HIV.[14] The WHO also indicates that male circumcision may not prevent HIV transmission from men to women, and data is lacking for the transmission rate "for either partner during anal sex with men or women."[14]

I've put "also stated" in bold to clearly show that it is present in both versions. The following sentence is what differs between the two versions.

As for dropping the WHO source, I think that would be a mistake, because the present version is potentially confusing. To illustrate why, consider the following scenario:

• Bob thinks that circumcision is a terrible thing, but he thinks that there may be a reduction in urinary tract infection rates.
• Alice thinks that circumcision is a terrible thing, but he thinks that there may be a reduction in urinary tract infection rates.

Now, suppose we said "Bob thinks that circumcision is a terrible thing. Alice thinks that there may be a reduction in urinary tract infection rates." It's technically true, but does it represent the sources fairly? I think not: it creates the impression that Bob is opposed to circumcision, while Alice is in favour of it. In fact, both have very similar positions.

There's a similar situation in this case. The CDC introduce their document by stating that "Several types of research have documented that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex", and the WHO "recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men". But both express caveats, and indicate that there are certain types of transmission in which it may not be protective.

But the problem is, if we quote the WHO's recommendation and the CDC's caveat, we create the illusion that the two are in disagreement. To avoid creating that misconception, we should either a) quote the WHO for both the recommendation and caveat (thus representing the caveat as what it is: a part of a larger whole), or b) quote the WHO's recommendation and caveat, in addition to the CDC's overview and caveat. Since that would involve a large amount of repetition, though, it seems best to just quote the WHO. Jakew (talk) 21:14, 14 April 2008 (UTC)

Oh, one addition: I think we can cite the CDC elsewhere in the article. The reader can benefit from this additional source wherever it is cited; it doesn't have to be in the lead. Jakew (talk) 21:26, 14 April 2008 (UTC)

Corroboration from another source does not imply ambiguities. Garycompugeek (talk) 22:35, 14 April 2008 (UTC)

I'm sure that's true, but I don't understand what relevance it has to the present discussion. Jakew (talk) 22:44, 14 April 2008 (UTC)

I made a few additions to the intro, resulting in the following paragraph:

In March 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that male circumcision is an effective intervention for HIV prevention, but also noted that male circumcision only provides partial protection and should not replace other interventions to prevent the heterosexual transmission of HIV.[14] Furthermore, while the WHO and the Centers for Disease Control and Prevention (CDC) acknowledge that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, both indicate that it may not prevent HIV transmission from men to women, and that data is lacking for the transmission rate of "men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner."[14][15]

Rationale: Gary's primary concern was an overreliance on the WHO meta-analysis and a possible overstatement of the benefits of circumcision on HIV transmission. He also felt we should include a citation to the CDC's interpretation of these findings. A sentence was formulated to address the lack of data for penile to vaginal and penile to anal/anal to penile transmission of HIV in circumcised men. Jake felt that the new sentence did not accurately reflect the level of agreement between these two health organizations. More specifically, the paragraph may be misconstrued to indicate that the CDC and WHO positions are actually at odds with one another. After reading his argument, I agree, and to alleviate this concern I've added extra information to hint at the robust agreement between these two organizations while also accurately and honestly demonstrating the weak points of the meta-analysis. AlphaEta 01:44, 15 April 2008 (UTC)

Well done. Garycompugeek (talk) 02:03, 15 April 2008 (UTC)

So previous to this, we had only about 30% of the lead being about how great the WHO and other advocates think circumcision is for HIV prevention. Now, it's about 50%. The lead is now even more unbalanced than it already was. Male circumcision is not all about being awesome and great and how the WHO loves it, even if that's mostly what it is to the editors here. That part of male circumcision was already overrepresented in the lead, and now it's just ludicrous. Blackworm (talk) 02:11, 15 April 2008 (UTC)

The material was greatly expanded to address previous concerns about balance. If you think it should move from the lead to the body, I won't object. In fact, I'll be bold and give it a shot. Or we can just complain about it, but I doubt that will be too fruitful. Regards, AlphaEta 03:49, 15 April 2008 (UTC)

My being bold hasn't historically been appreciated. When I suddenly see six editors, including admins, some with previous connections, come in here, throw up a neutrality banner, then proceed to edit such that the material is more unbalanced, I tend to be a bit too intimidated to be bold. Or perhaps I'm frozen in confusion. I support your edit, even if overall it gives even more weight to the idea the circumcision "prevents" HIV (by repeating the claim). Here, I'll be bold, too. Blackworm (talk) 06:57, 15 April 2008 (UTC)

The word "acknowledged" seemed like we were stating a truth (i.e., who were they acknowledging it to?). I edited it. Blackworm (talk) 07:31, 15 April 2008 (UTC)

I goofed on the edit summary, it should read that it HAS become highly detailed.... Sorry for the confusion. AlphaEta 03:55, 15 April 2008 (UTC)

While it is not how I would have done it, I also must compromise. AlphaEta has demonstrated just balancing of given data. The addition of the CDC article illustrates more doubt. It's true it corroborates lower HIV infection with circumcision, it also negates those findings lacking data to speculate. It also brings up an important point of geography linking the majority of Americans already circumcised. Continue to provide sources. Your help is appreciated. Garycompugeek (talk) 02:35, 15 April 2008 (UTC)

I would assume any attempt to bring more sources would result in more objections of undue weight or questionable editorial judgments citing WP:SUMMARY. Modus operandi around here. Stick around, your help is appreciated. Have you stopped arguing for the inclusion of the sourced material you brought to this article and which has been reverted? Blackworm (talk) 02:44, 15 April 2008 (UTC)

No I have not. I ran out of reverts at the time and have been researching the matter. Third parties may be quoted as long as they use valid peer reviewed sources and you broke down the source well. Garycompugeek (talk) 03:40, 15 April 2008 (UTC)

(unindenting) I think that if the paragraph is considered in isolation, these are excellent edits. However, we seem to have forgotten what the paragraph is for. I'm now very concerned, because the lead no longer contains any reference to the WHO recommendations. Yet these should be included in the lead, because they "summarize the most important points, [and] explain why the subject is interesting or notable". So either a) we need to write a new paragraph for the lead, or b) we need to move the paragraph back to where it was. I understand and agree with concerns about the length of the paragraph, and for this reason I would suggest that we use something similar to the "WHO version" quoted above, which a) addresses Gary's concern about balance, and yet b) doesn't imply disagreement between the WHO and CDC. Jakew (talk) 11:23, 15 April 2008 (UTC) (edited 12:33, 15 April 2008 (UTC))

Arbitrary section break

Thinking about this some more, I may have a possible alternative for use in the lead (I'm quite happy with the full paragraph in the body of the article):

• The World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Centers for Disease Control and Prevention (CDC) state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but indicate that it may not prevent HIV transmission from men to women, and that data is lacking for the transmission rate of men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner.[ref][ref]

My rationale is as follows. I have identified the following constraints on the wording:

1. Blackworm has expressed concern about the amount of content dedicated to the HIV issue, and indicated that fewer words would be preferable.
2. Gary has expressed a desire to cite both the CDC and WHO, and has also expressed the view that the second sentence is a stronger caveat than the "but also stated" part of the first.
3. I have expressed the view that we need to accurately reflect the level of agreement between the respective health organisations.

Meeting these requirements simultaneously is a challenge, to say the least. Adding the CDC as a source requires at least seven additional words for attribution alone, which of course conflicts with the first constraint. At first I thought of deleting the second part of the first sentence ("but also noted...). Then, it occurred to me that with a little restructuring we can actually delete the entire first sentence. As a result, we a) reduce the word count, b) cite both the CDC and WHO in the intro, and c) avoid creating the impression that the CDC and WHO are at odds with each other.

So, any thoughts? Jakew (talk) 15:31, 15 April 2008 (UTC)

My concern is that instead of providing a general overview of the article, we may be trying to add too much detail to the lead. The question then becomes, if the material is detailed in the body, should we simply re-work the existing sentence to become an accurate and inclusive summary? I agree that the WHO finding is one of the more important aspects of this article. Can it be integrated into the existing sentence as follows?

• Opponents of non-medical circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure,[10] particularly in light of the WHO's meta-anlysis and recommendation that it should be recognized as an effective intervention for heterosexually acquired HIV infection in men.[WHO ref]

Specific implications for sub-Saharan Africa (... be used to control HIV transmission in Sub-Saharan Africa.[11][12][13]) can be moved to the relevant paragraph in the body, as the WHO recommendation does not limit itself to this geographic area. Regards, AlphaEta 16:38, 15 April 2008 (UTC)

I have a few reservations, but I think I'm happy to go along with that suggestion with one change: change "...WHO's meta-anlysis and recommendation..." to simply "...WHO's recommendation...". The reason is simple: WHO did not perform a meta-analysis (in the conventional sense), but simply reviewed the available evidence (the first - and, to date, only - published meta-analysis of the HIV RCTs was published somewhat later, in PMID 18316997). Jakew (talk) 16:51, 15 April 2008 (UTC)

What part of the opponents' position are we going to focus on, with a phrase like "particularly in light of ..." ? Blackworm (talk) 17:02, 15 April 2008 (UTC)

Are we trying to turn the lead into something it isn't? The current sentence reveals that there is opposition to and support for non-therapeutic and infant circumcision. As far as I'm concerned, pointing out that a debate exists should suffice. However, the sentence also includes some of the arguments used by each side to support their positions. It is not meant to serve as an in-depth analysis of the strenths and weakenesses of each and every argument. The main text is a more appropriate place to conduct such comprehensive analyses. Thanks, AlphaEta 18:56, 15 April 2008 (UTC)

There is no argument presented in support of the anti-circumcision position in the lead. By using a phrase like "particularly in light of," we are making an argument for circumcision in the lead. I suggest we add, particularly in light of state-sponsored mass circumcision programs described as "nominally voluntary" by the BBC.[24] Blackworm (talk) 19:02, 15 April 2008 (UTC)

We're not making an argument for circumcision, just documenting an argument that has been made (eg., "The preventive effect of circumcision against HIV has now officially been accepted by the World Health Organization, the United Nations, and the National Institutes of Health, and some African countries have begun adult circumcision as a public health measure." Schoen EJ. Should newborns be circumcised? Yes. Can Fam Physician. 2008 Jan;54(1):22.). But more importantly this change is an attempt to incorporate the WHO's recommendation into the introduction while, at the same time, addressing your earlier concern about the word count. The result is that we discuss three claims made by anti-circumcision advocates ("medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment") and one (albeit more detailed) argument made by pro-circumcision advocates ("worthwhile public health measure, particularly in light of..."). Jakew (talk) 19:31, 15 April 2008 (UTC)

The HIV transmission issue is an integral part of the pro-circumcision position, as evidenced by the link you provided. The circumcision campaign in Rwanda isn't a response to random "public health" concerns, it is specifically a response to the WHO's position. That's why I felt it deserved mention. Of course, there's a good chance I'm wrong, so any serious suggestions are greatly appreciated. AlphaEta 19:34, 15 April 2008 (UTC)

If there is significant objection to the current entry, here's a possible alternative:

• Opponents of non-medical circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure,[10] particularly in the control of HIV transmission.[WHO ref]

Thoughts? AlphaEta 19:51, 15 April 2008 (UTC)

The current article state "Opponents of non-medical circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure,[10] particularly in light of the WHO's recommendation that it should be recognized as an effective intervention for heterosexually acquired HIV infection in men.[11]" kind of brings us back to where we were originally. While things are a bit more condensed I dislike the WHO reference without a rebuttal. I have studied much of the testing and admit the findings show circumcision reduces risk because the skin is not as soft and susceptible as an uncircumcised penis however it does not prevent, it simply lowers the risk of acquiring. If I was circumcised I would not feel safe having sex with an HIV person without a condom (not sure I would even do that). We must not mislead the reader that circumcision prevents HIV transmission or that condoms or other contraceptives are not a better alternative. Garycompugeek (talk) 20:00, 15 April 2008 (UTC)

(edit conflict; this is in reply to AlphaEta) Problematic, I think, for several reasons. Firstly, I think we need to name the WHO, so that the reader can decide how much credibility to give to their position. Secondly, I'm not comfortable with describing the WHO as an "advocate of circumcision", and I think it's inappropriate and disrespectful to describe them as such. Thirdly, I think it presents a distorted picture of the debate to compare, on one hand, individual authors with anti-circumcision views, and on the other hand, the World Health Organisation. Jakew (talk) 20:04, 15 April 2008 (UTC)

(Outdent.) Jakew writes, We're not making an argument for circumcision, just documenting an argument that has been made... I think that's debatable, but it's moot; the point I was trying to make is that in the opposing case, we are not even documenting any arguments made. We only document the opposition, and present vague grounds (i.e. conclusions) of the opposition without presenting any of their arguments. In the supporting case, we also present conclusions ("public health measure"), but we additionally present facts to support the position (i.e. the WHO's position). Thus we actually present the argument. I much prefer (and support) AlphaEta's above version, which avoids presenting the argument.

I don't believe describing the WHO as an advocate of circumcision is inappropriate nor disrespectful. They clearly advocate not only male circumcision, but mass male circumcision to the extent that state-sponsored programs citing the WHO are now circumcising their males on a "nominally voluntary" basis. I'm not alone in thinking so: WHO and UNAIDS Advocate Circumcision to Fight HIV Infection By Jon Cohen ScienceNOW Daily News 28 March 2007.[25][26] Blackworm (talk) 20:29, 15 April 2008 (UTC)

After reading Blackworm's prior analysis, I understand the point that the current construct supports the pro- position (i.e. public health) with an argument (the WHO's recommendation). The con- position simply notes their views, but does not qualify them with supporting arguments/recommendations. In other words, we bolster the pro- position with the WHO recommendation, but we simply list the con- arguments. If necessary, we can re-word the sentence so as not to mis-represent the WHO's position (by asociation with the citation). AlphaEta 20:39, 15 April 2008 (UTC)

(edit conflict) I don't dispute that since March 2007 they advocate circumcision, Blackworm. After all, their role is to evaluate evidence and recommend accordingly. The problem is that the WHO are no more "advocates of circumcision" than they are "Mycobacterium tuberculosis opponents" or "advocates of clean water", and describing them as any of these presents them solely in terms of their position on a single issue. Compare "WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends." and "WHO is an advocate of circumcision." Don't you see a slight problem?

Since there seems to be some opposition to the present version, which seem to stem from using a single paragraph to express both the controversy and the WHO's views, can I request comments on my alternative suggestion above (dated 15:31, 15 April 2008)? Jakew (talk) 20:46, 15 April 2008 (UTC)

No, Jake, I don't see a problem. Obviously the WHO's position on circumcision is what's relevant here, not the fact that they describe themselves as "responsible for providing leadership..." or the other things you mention. We're not defining the WHO here, we're stating the views of circumcision advocates; and the WHO is among the most prevalent, influential, powerful and outspoken advocates, along with certain organized religions.

To be honest I don't fully understand your suggestion -- you state we can remove the first sentence, but as far as I can tell the paragraph is composed of only one sentence. What sentence are you referring to? Blackworm (talk) 21:04, 15 April 2008 (UTC)

And by the way, Jake, I question your writing, I don't dispute that since March 2007 they advocate circumcision, Blackworm. After all, their role is to evaluate evidence and recommend accordingly. What is the purpose of writing that if not to state your personal view that circumcision advocacy is grounded in a sound evaluation of all evidence? Blackworm (talk) 21:29, 15 April 2008 (UTC)

(edit conflict) Blackworm, there is a difference between "WHO advocates circumcision" and "WHO is an advocate of circumcision" (or, similarly, citing WHO as an example of "advocates of circumcision"). The former describes an act or stance, whereas the other characterises the source itself as an advocate (with connotations of possible bias).

As for my suggestion, I proposed to remove the reference to the WHO from the paragraph we're currently discussing, and instead treat the controversy and the WHO recommendations separately, as before, with a following paragraph reading: "The World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Centers for Disease Control and Prevention (CDC) state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but indicate that it may not prevent HIV transmission from men to women, and that data is lacking for the transmission rate of men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner.[ref][ref]" Jakew (talk) 21:43, 15 April 2008 (UTC)

Sorry, Jake, I don't see a difference. One who advocates/opposes X is an advocate/opponent of X. If calling someone who advocates circumcision "an advocate" has an improper connotation of possible bias, then so does calling one who opposes circumcision "an opponent" (as we have in the lead, currently, with apparently no objection from anyone).

Your proposed edit appears to misrepresent the CDC's position. Nowhere do they state that circumcision reduces the risk; they state that several types of research document that circumcision reduces the risk. The former is a statement of belief in the view, the latter is a statement that research espousing the view exists. Clearly the UN agencies (WHO/UNAIDS) you mention have that view, but it's not clear that the CDC does. Blackworm (talk) 22:01, 15 April 2008 (UTC)

I oppose this edit, which again makes the focus of the lead section the UN agencies' reasoning for their advocacy of circumcision, and subtly interprets the CDC's position as concurring with the UN ("evidence indicates"). All this, while neglecting mention of the CDC's caveats in extrapolating the data obtained in Sub-Saharan Africa to other parts of the world, neglect of mention of any criticism of the view, as well neglect of mention of the "nominally voluntary" mass male circumcision programs underway in Africa that the's WHO's promotion of this view has apparently caused. Blackworm (talk) 23:37, 15 April 2008 (UTC)

Re this sentence proposed by Jakew: "The World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Centers for Disease Control and Prevention (CDC) state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but indicate that it may not prevent HIV transmission from men to women, and that data is lacking for the transmission rate of men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner." I think this is a little too detailed for the lead: I see the reader's eyes starting to glaze over. Also, the last part seems unnecessary to me. How about just "The World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Centers for Disease Control and Prevention (CDC) state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex". It really means the same thing as the whole sentence, IMO. The word "specifically" could be inserted before "by men" to try to emphasize the limitations, thus performing a similar role as the deleted last part of the sentence. I agree with Blackworm that there shouldn't be too large an amount of space taken up in the lead with the HIV stuff. By the way, Jakew, I like your Bob and Alice point. ☺Coppertwig (talk) 00:54, 16 April 2008 (UTC)

I agree with Coppertwig. Perhaps we are trying to pack the lead with too many details, modifiers and qualifiers. A brief sentence in the introduction noting the effect of circumcision on HIV transmission, as drafted by coppertwig, should suffice. Furthermore, it will direct readers to the relevant, highly-detailed section in the body of the article. AlphaEta 01:29, 16 April 2008 (UTC)

(Edit conflict.) I support a shorter summary in the lead along the lines of what Coppertwig suggests. However, Jakew's "Bob and Alice" analogy fails to note the difference between what the two sources say. Bob and Alice say identical things. The CDC and WHO do not. I've seen no evidence to show that the CDC state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex -- the CDC source brought indicates that they believe several types of research have documented such a conclusion. These two ideas cannot be considered equivalent. It is apparent from the CDC's subsequent detailed recounting of the studies undertaken and the conclusions drawn, and their caveats regarding universal extrapolation of these conclusions, that they are silent in that source on the WHO's position (which apparently embraces this extrapolation). To present these two sources as one, unified statement implies a unity between the sources that is the product of careless editorial judgement, and not a demonstrated real-world agreement or joint statement. In short, in my opinion, it fails WP:OR. Can I suggest, The World Health Organisation (WHO), other UN agencies, and the Centers for Disease Control and Prevention (CDC) (U.S.) note research concluding that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex. (I'm not rigid about removing UNAIDS although frankly if we were to list every agency of the UN every time they say the same thing (which seems to be all the time), that seems like a case of undue weight through repetition.) Blackworm (talk) 01:37, 16 April 2008 (UTC)

I also agree with Coppertwig. Unless anyone can think of a better suggestion, I think we should stick with this. Jakew (talk) 10:54, 16 April 2008 (UTC)

I'm not sure about your point, Blackworm. The CDC statement says "Several types of research have documented that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex." and "After adjustment for confounding factors in the population-based studies, the relative risk for HIV infection was 44% lower in circumcised men. " These sound to me to be stating that there is such a risk reduction, although I acknowledge some ambiguity in that regard. Your wording also seems accurate and I would accept it. I would avoid having two parentheses in a row either by using a semicolon "(CDC; U.S.)" or by putting "(U.S.)" before "Centers for Disease Control". ☺Coppertwig (talk) 12:18, 16 April 2008 (UTC)

"Note research concluding that" is a little too weak to be a fair representation of any of these organisations: none are merely noting - all three are taking action as a result, whether "consult[ing] with external experts in April 2007 to receive input on the potential value, risks, and feasibility of circumcision as an HIV prevention intervention in the United States and to discuss considerations for the possible development of guidelines" (CDC) or actively recommending in the case of WHO and UNAIDS). I think that the present wording is fine, but I've no objection to changing it to "state that evidence indicates that". Jakew (talk) 13:34, 16 April 2008 (UTC)

I'm afraid I stand by my objection. Not to be difficult, but none of the other quotes brought verify that the CDC state that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex. The two CDC quotes Coppertwig brings could be copied verbatim right into Wikipedia without attribution to the CDC, they are so neutral and verified (the first references research, the second refers to one study). The quotes Jakew brings show that there is interest in further study; that is clearly far from stating that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, on the contrary it could be taken as evidence of the CDC exercising caution in reaching that seemingly bold conclusion. Far from a call to action (I don't see the CDC calling for mass male circumcision, for example), it's a call for consultation. To lump the CDC in with the WHO (who do call for mass male circumcision) in that view is not verified, and thus seems unacceptable. Blackworm (talk) 06:31, 17 April 2008 (UTC)

Upon reflection, I think Jakew's suggestion ("state that evidence indicates that") is close enough to the source that I can abide by it. It's certainly an improvement. I still think it goes further than the source by implying that the CDC hold the view, and cannot understand both your objections to this criticism. Blackworm (talk) 18:26, 24 April 2008 (UTC)

I feel this is important and should be worked into the end of the paragraph... "3) confers only partial protection and should be considered only in conjunction with other proven prevention measures (abstinence, mutual monogamy, reduced number of sex partners, and correct and consistent condom use)." number three of the CDC's closing summary. Garycompugeek (talk) 16:49, 16 April 2008 (UTC)

You mean something like "but also stated that male circumcision only provides partial protection and should not replace other interventions to prevent the heterosexual transmission of HIV"? Jakew (talk) 16:52, 16 April 2008 (UTC)

Yes... See last edit to article. Garycompugeek (talk) 18:10, 16 April 2008 (UTC)

Prevalence info in lead

Jakew, you recently edited the paragraph, in the lead, about the global prevalence of circumcision. I believe your edit has now removed the information I included in order to try to avoid the problems associated with the imprecision of the term common. We are now left with the unqualified relative phrases "most common" and "less common" to contrast different prevalences of circumcision in selected countries. Unfortunately, "less common" is very ambiguous. For example, let us consider a hypothetical world made up of just six countries: a, b, c and x, y, z. If the prevalence of circumcision is 90% in countries a, b and c, and the prevalence is 89% in countries x, y and z, it is logically correct to state that circumcision is most common in a, b and c and less common in x, y and z (if we can agree that 90% equates to common that is). However, if the prevalence in a, b and c is >80% and the prevalence in x, y and z is <20%, then I believe that simply stating that circumcision is most common in a, b and c and less common in x, y and z, whilst logically correct, is extremely imprecise, perhaps even to a misleading and unencyclopaedic extent: it effectively conceals that fact that a large majority prevalence is being contrasted with a small minority prevalence. And where imprecision leads to such a high degree of interpretability, and the cost of greater precision is just a couple of sets of parantheses, four digits, six words, and two percentage symbols, perhaps greater precision should win the day. I suggest that this:

Circumcision is most common (greater than 80% prevalence) in the Middle East, the USA and parts of Africa and Asia. It is uncommon (less than 20% prevalence) in Central and South America, India, China, some southern African states, New Zealand, and most of Europe.

is more encyclopaedic (and therefore preferable) to this:

Circumcision is most common in the Middle East, the USA and parts of Africa and Asia, and less common in Central and South America, China, and much of Europe

What do you think? Beejaypii (talk) 20:31, 16 April 2008 (UTC)

Hi Beejaypii,

I tried to retain your addition of "uncommon", while addressing a serious problem. By saying "circumcision is most common (greater than 80% prevalence) in..." or "is uncommon (less than 20% prevalence) in...", we are implying that what follows is an exhaustive list. Not only is an exhaustive list inappropriate for the lead, containing too much detail, but the above may well omit countries that should be in either category but aren't.

If you're concerned about "less common", then please suggest some other alternatives. Jakew (talk) 20:43, 16 April 2008 (UTC)

Ok Jakew, I see your point. How about this:

The prevalence of circumcision varies across the globe. For example, it is greater than 80% in the Middle East, the USA and parts of Africa and Asia, whilst it is less than 20% in Central and South America, China, parts of southern Africa, and most of Europe (these lists are not exhaustive). According to the World Health Organization (WHO), global estimates suggest that 30% of males have been circumcised.[8]

What do you think? Beejaypii (talk) 22:35, 16 April 2008 (UTC)

If you say "for example", then I think it's unnecessary to also say "these lists are not exhaustive", and I would mildly prefer leaving it out for brevity. ☺Coppertwig (talk) 22:43, 16 April 2008 (UTC)

(edit conflict) Much better. I suggest three small changes (deletions struck out):

• The prevalence of circumcision varies across the globe. For example, it is greater than 80% in the Middle East, the USA and parts of Africa and Asia, whilst it is less than 20% in Central and South America, China, parts of southern Africa, and mostmuch of Europe (these lists are not exhaustive). According to the World Health Organization (WHO), global estimates suggest that 30% of males have been circumcised.[8]

My rationale: Firstly, "much" is somewhat better, and "most" may even be inaccurate, depending on whether we're talking about number of countries, land area, total population, and indeed what definition of Europe one uses (for example, if one includes Turkey and the Muslim states in Eastern Europe). Hence "most", to my mind, raises more questions than it answers, and is a little WP:ORish, too. Secondly, I think that the parenthetical comment is redundant, since the sentence begins with "for example" which, to my mind, makes it clear that these are just examples. Finally, since these are examples, it makes sense to give the same number of examples (4) of each. Jakew (talk) 22:47, 16 April 2008 (UTC)

I believe that it is most accurate to state that circumcision is not usual in most of Europe. This is true of Northern and Western Europe and also Russia, where circumcision is largely confined to the Muslim and Jewish minorities. In the Balkans, circumcision is again largely confined to Muslim and Jews and not to the other religious groups. My understanding is that Muslims are in a majority in Albania, Bosnia and around Kosova. Turkey is overwhelmingly in Asia Minor but even including European Turkey, most of Europe is not predominantly Muslim or Jewish. Michael Glass (talk) 23:05, 16 April 2008 (UTC)

Jakew and Coppertwig, I too had my doubts about the parenthetical comment. The second and third opinions you've offered have convinced me it should be removed. However, with a nod to the comments of Michael, and looking at the map in the WHO information package referenced by the paragraph, I don't think the phrase "much of Europe" is adequate. I suggest the following version:

The prevalence of circumcision varies across the globe. For example, it is greater than 80% in the Middle East, the USA and parts of Africa and Asia, whilst it is less than 20% in Central and South America, China, and most of the countries of Europe. According to the World Health Organization (WHO), global estimates suggest that 30% of males have been circumcised.[8]

How's that? Beejaypii (talk) 23:19, 16 April 2008 (UTC)

Good, Beejaypii. How about "most European countries"?

Isn't it misleading to say that the prevalence of circumcision is greater than 80% in the U.S.? Perhaps over 80% of males are currently circumcised, but I think the rate of circumcisions of newborns is lower than 80%. (Not sure.) "prevalence of circumcision" could be understood as meaning "prevalence of the custom of circumcision", in other words, that over 80% of newborns are regularly circumcised. I'm not keen on the word "prevalence", anyway -- makes it sound as if circumcision is superior or something. How about "The percentage of males who have been circumcised varies across the globe. ..."

Quoted from manual of style: "In American English, U.S. is the standard abbreviation for United States; US is becoming more common and is standard in other national forms of English. ... When the United States is mentioned along with one or more other countries in the same sentence, U.S. or US can be too informal, and many editors avoid it especially at first mention of the country (France and the United States, not France and the U.S.). ... U.S.A. and USA are not used unless quoted or as part of a proper name (Team USA)." Therefore it should be probably "United States" and otherwise "U.S." or perhaps "US", not "USA". (What spelling convention is used in this article?) ☺Coppertwig (talk) 01:43, 17 April 2008 (UTC)

Looking at the cited source, it does actually say "prevalence" in the title, so I don't think that's a problem. However, the US is categorised as "20-80%", not >80%. (Another problem caused by introducing such specific language - when I expressed concern about omitting countries that should be in either category but aren't, I completely forgot about the risk of including countries in either category but shouldn't be!)

I think that "most European countries" suffers from the same problems as "most of Europe". There would be a similar problem in saying ">80% in most of Africa" - it may well be true, but it might not be, depending on definitions, and in any event we'd need to cite a reliable source to avoid original research. Jakew (talk) 15:10, 17 April 2008 (UTC)

Jakew, you are are correct: the US is incorrectly categorised in the way you describe. I'm afraid this was simple human error on my part.

Would you mind providing an example of a definition of the phrase "most European countries" which would cause the statement "The prevalence of circumcision ... is less than 20% ... in most European countries" to be untrue in relation to the map provided in the cited source? And is it really original research to observe said map, see that most of the European countries are coloured yellow (which is the colour used to indicate "< 20% prevalence" according to the map legend) and deduce that the prevalence of circumcision is less than 20% in most European countries? Isn't that an "obvious deduction" (wp:notor)? Beejaypii (talk) 07:59, 18 April 2008 (UTC)

Beejaypii, I recognise that this was a simple human error on your part, and I don't blame you for it, but wouldn't you agree that it illustrates rather nicely why we need to rely upon the analyses of reliable sources, especially for more complex claims such as "most" (ie., >50%) of a geographical area with more than one definition? Jakew (talk) 11:18, 18 April 2008 (UTC)

Global prevalence should be stated before individual regions. This paragraph is disputed owing to the fact that the WHO estimate of 30% is among the highest quoted in reliable sources, which present a range of one-sixth (16%) to one third (33%). These truths are in the prevalence of circumcision article, but Jakew has incomprehensibly refused to allow the one-sixth figure to appear in any form in the circumcision article lead section. Now, it seems we are stating more WHO estimates as fact without attribution to the WHO, with odd, potentially misleading prose apparently extrapolated from a WHO prevalence map, where the lowest prevalence category is "less than 20 percent." If I said "less than 20 percent of planet Mars is composed of water," that may be technically true, but it is misleading in that it implies that the percentage is somewhere close to 20%, not 0.0% as the case may be. Similarly, stating that the prevalence of circumcision is "less than 20%" in China or other areas has the same problems. Rather than base our detailed prose on such vague estimates, we should present the ranges of global prevalence estimates, and keep estimates about regional prevalence attributed and with a similar level of vagueness ("common," "less common," "more common") as the sources. Blackworm (talk) 19:09, 17 April 2008 (UTC)

Consent and the Levinson article

At present, the part of the Consent section reads as follows:

In a cultural or religious context, Levenson argues that circumcision is of significant enough importance that parental consent is sufficient and that any possible misgivings surrounding the issue of consent are not significant enough to limit the exercise of infant/childhood circumcision. [27].

The Levinson article is a significant discussion of circumcision from a Jewish perspective which ridicules the idea that the only one to consent to circumcision is an adult. It says:

The only persons who may consent to medically unnecessary procedures upon themselves are the individuals who have reached the age of consent," goes the Declaration of the First International Symposium on Circumcision--is like saying that he will at the same point decide what his mother tongue will be."[28].

I have no objection to Levinson's article being linked to the Circumcision article but this does not amount to the detailed argument in favour of parental consent that is attributed to him. Therefore the argument wrongly attributed to Levinson should be removed from the article forthwith. Michael Glass (talk) 12:46, 22 April 2008 (UTC)

I agree that the attribution is incorrect, Michael, but I suspect that it ought to be attributed to Adrian M Viens (Value judgment, harm, and religious liberty. J Med Ethics 2004;30:241-247)

To quote:

• What anticircumcision proponents maintain is that parents are unjustified in believing their child would also maintain their religious values. It is argued that because we do not know if a child will decide to become a follower of their parents’ religion, it would be better if circumcision decisions were delayed until adulthood, so that if an individual wants to remain a member of the religious community and his uncircumcised status was a barrier to religious marriage or burial, he could consent to the procedure as an adult. The problem is that such decisions are not seen to be able to be delayed until this time—the religious significance of the procedure is to be done in childhood. ... Anticircumcision proponents argue that in as much as it is important for parents to be accorded religious liberty (that is, the freedom to appeal to religious principles to guide their moral choices), concomitantly, it is just as important for the child to be accorded religious liberty (the freedom to choose whether he wants to join his parent’s religion, another religion, or no religion at all). It is maintained that people are not born with a particular set of religious beliefs and it is not a child’s choice to be brought up under certain religious traditions or customs. A valid point; however it would be untenable in practice not to make decisions for children because they may have chosen differently. Infants and children cannot make decisions for themselves, and parents have a duty to make decisions on behalf of their child concerning their wellbeing, such as religious upbringing, choice of schooling, immunisation, living environment, dietary requirements, insurance and investments for the child, and so on. Parents need to have the freedom to make decisions for their children based on what they view as best, on the balance of benefits and risks. ... As it presently stands, there is an absence of sufficient evidence or persuasive argumentation to warrant changing the current policy—that parents should have the freedom to make an informed and well deliberated choice concerning whether the procedure is in their son’s interest.

Jakew (talk) 13:27, 22 April 2008 (UTC)

WP:SOAP. Odd, however, that the "Declaration of the First International Symposium on Circumcision" isn't mentioned in the article. Perhaps if it took a more positive spin, it would be. Blackworm (talk) 14:26, 22 April 2008 (UTC)

Banning Jakew from editing this page any longer

Folks, while I think Jake must be a fine and upstanding gentlemen, it seems to me that if his contributions to this article were to be considered as a whole, it would become pretty clear that, no matter how much he may protest, he is pushing an agenda. He tirelessly monitors this specific article, so much so that he has a barnstar awarded for it and now has taken to posting missives in support of one viewpoint.

While his enthusiasm is certainly there, I would argue that it has taken on an oppressive quality over the years: smacking down and/or ruthlessly engaging anyone who dares to contribute in a way he does not consider within the guidlelines. And while he may argue that he is within the letter of the guidelines, I think he's missing the overall rationale and has fallen pretty clearly outside anything reasonable.

Again, this is only my opinion, but I think it's now past the point of common sense and wonder if anyone here agrees with me? Jake, would you consider holding off on touching this page for some period like 30 or 60 days - just to see what might flourish? Lexlex (talk) 04:30, 24 April 2008 (UTC)

Not going to happen, especially since this bizarre edit of yours will be pounced upon as clear evidence of your lack of good judgment. If anything your post above distracts from the real issues, and by association diminishes the arguments of those who may indeed believe this article is unbalanced toward one viewpoint, or that Jakew and his longtime supporters here have in fact displayed a disregard for neutrality and a disregard for any editor who would bring to light any sourced material critical of circumcision. Blackworm (talk) 04:53, 24 April 2008 (UTC)

Really? That's a rather agressive response. Wow. A one time attempt at semantic consistency is considered a lack of good judgement? My goodness, how weird. Truly, would you not agree that this article is being monopolized and it's really becoming rather silly? What might you propose? Lexlex (talk) 06:42, 24 April 2008 (UTC)

I apologize if my response startles you, but it is peanuts compared to the accusations of POV-pushing and bad faith that routinely fly here, on the basis of things very similar to your edit I link above. I've proposed plenty in the last three or four archives of this Talk. I would propose that more editors who don't have much of an opinion on the topic read past discussions and join in current discussions, but that is beyond my control. I am not affiliated with an e-mail network or a Wikiproject. The only RfC in recent memory attracted one outside editor. I'm not that surprised, as this topic seems to instill fear of being labeled an "anti-circumcision zealot" or worse, as has been done by the administrators here. Blackworm (talk) 07:05, 24 April 2008 (UTC)

Oppose. Jakew's contributions to this page are very valuable. He helps the page maintain stability, precision of factual accuracy, and NPOV. Every editor has a personal bias. From each person's POV, their own POV is exactly neutral and all the others are biassed one way or another. The interaction among editors of different POV's tends to help produce a NPOV article. Jakew has an excellent understanding of Wikipedian NPOV and is very skilful and diligent at finding ways to word the article so that it does not claim even slightly more than what the sources say. I've learned from Jakew while working together on this page about details of how to implement the NPOV and NOR policies. This page gets frequent contributions from drive-by editors ranging from vandalism to well-meaning but in most cases off-base edits, and Jakew's tireless monitoring helps maintain a quality article, keeping only those few edits which improve on an already carefully honed article.☺ Coppertwig (talk) 11:13, 29 April 2008 (UTC)

Wait a second! This whole discussion is out of order. I shouldn't have participated in it. This page is for discussion of the content of the article Circumcision. Comments about individual editors are not appropriate here. Maybe you want dispute resolution. This discussion should be closed. ☺ Coppertwig (talk) 23:46, 29 April 2008 (UTC)

Yes, you're likely right, both of you. It isn't going to happen and it's likely that this topic probably runs afoul of something in the tome of wiki. As an admitted "drive by editor" I thought the point of this project was to allow the contribution of many, not a single-faceted, strict interpretation of "rules" by some self-appointed few. I'm just a bit annoyed at the amount of, for lack of a better term, "mental masturbation" that seems to go on here and was making a vain attempt to bring some sense of respite - at least for a little while. Masturbate away gentlemen, with much gusto and grunting if you please. I'll go do something else with my time. Lexlex (talk) 06:25, 30 April 2008 (UTC)

Circumcision since 1950

This section starts off with an incomplete discussion about changes in incidence, and then veers into the completely irrelevant. The third par - "In some South African ethnic groups, circumcision has roots in several belief systems, and is performed most of the time on teenage boys" - has presumably been true since white colonization. It should be deleted. The next paragraph, though it cites sources that discuss incidence, addresses itself to motivations for choosing infant circumcision in the US. There is no reason to believe that parental motivation (primarily social conformity plus "perceived medical benefit" in unknown proportions) have changed since 1950. Worse the first sentence - "A study in 1987 found that the prominent reasons for parents choosing circumcision were 'concerns about the attitudes of peers and their sons' self concept in the future,' rather than medical concerns" - misrepresents its source, which says: "The strongest factor associated with the circumcision decision was whether or not the father was circumcised." The second sentence seems to have no purpose except to introduce a speculation that has no evidentiary basis in the study itself. It would seem best to delete the entire paragraph. The two obvious trends since 1950 are the steep declines in incidence for all English-speaking countries beside the US, and the rise in incidence in S Korea. It would seem logical to therefore exand the first paragraph to include Australia, New Zealand and (white) South Africa, where rates have declined from > 80% to < 20%. Johncoz (talk) 20:03, 24 April 2008 (UTC)

Prevalence of circumcision

This section seems to have two major problems.

1. It confuses prevalence[29] and incidence[30]. These are only the same in countries that have had stable incidence rates for several generations, and the mix-up is very confusing for the reader.

2. More seriously, it fails to give the expected overview of global prevalence by region and religion, and instead seems to randomly pick a handful of countries. For a general article on circumcision it should provide a short snapshot of the findings in the main prevalence article (which also needs some work). I suggest something like the following:

Estimates of the proportion of males that are circumcised worldwide vary from one sixth to a third. WHO has estimated that 664,500,000 males aged 15 and over are circumcised (30% global prevalance), with almost 70% of these being Muslim. Excluding majority Muslim countries and Israel, prevalence in Latin America and Eurasia is less than 20% (often much less), with the exceptions of the Philippines, which has a prevalence greater than 80%, and South Korea, which is approaching that level. Estimates for individual countries include United Kingdom 16%, Spain and Denmark < 2%, Finland and Brazil 7% and Thailand 13%.

WHO estimates prevalence in the United States and Canada at 75% and 30%, respectively, though there is wide variation in published estimates for the US with figures as low as 56%. Prevalence in Africa varies from less than 20% in some southern African countries to near univeral in North and West Africa. Both Australia and New Zealand, like Canada, are experiencing long-term drops in prevalence as a result of declining incidence rates since the 1970s. The change is strongly age-graded, with a 2000-01 Australian survey finding 32% of those aged 16-19 years circumcised, 50% for 20-29 years and 64% for those aged 30-39 years.

The citations for all these figures already exist. Note that I have rounded the percentages, since giving such guesstimates to one or two decimal places conveys an altogether unreal impression of accuracy. Johncoz (talk) 20:03, 24 April 2008 (UTC)

This looks very good. Your use of percentages is much more consistent than the current section. Also, it maintains a neutral point of view and is well written. My advice is to be bold and add it to the article (with references). We can hash out the details here. Kindest regards, AlphaEta 23:19, 24 April 2008 (UTC)

I have a couple of concerns about this proposal. First, while the figures may well be sourceable, there seems to be rather a lot of interpretation and synthesis. It's possible that sources can be found for this, of course, but I'm concerned that it may be original research. Second, "Excluding majority Muslim countries" seems to be a rather odd (and not entirely neutral) way of expressing things - one could just as easily say "excluding non-Muslim countries, the rate is high in...". But perhaps this is how the source in question puts it?

I certainly agree with the desire to give an "overview of global prevalence by region and religion", as Johncoz puts it. Jakew (talk) 23:35, 24 April 2008 (UTC)

It looks good to me. I don't see anything odd about saying "excluding majority Muslim countries"; a statement has just been made about Muslims (70% of world circumcisions) so it's natural to then also comment on relatively non-Muslim areas. Mathematically it's the most concise way to describe the situation. Maybe "other than" would sound better than "excluding". I think Johncoz has done a good job of describing the whole world as opposed to the current version which I suppose is basically the summary I arrived at mostly by deleting material from the previous longer version. NOR doesn't mean we always have to use precisely the same words as the sources. Thanks for clarifying the definitions of prevalence and incidence. ☺ Coppertwig (talk) 23:54, 24 April 2008 (UTC)

Jake, it is worrying to me that you feel there may be OR-violations, since that is something I have scrupulously tried to avoid. It would be helpful if you could specify which passages are concerning you so we can either discuss or I can alter, if required. [[User:Johncoz|Johncoz](talk) 00:40, 25 April 2008 (UTC)

Johncoz, it's difficult to make any definite statement until I can see a version with sources. At the moment I can only guess, based on asking myself how I'd go about sourcing the material. However, the sentences I'm concerned about include "Excluding majority...", "Prevalence in Africa...", and especially "Both Australia". We'd need sources for these, per WP:NOR: "All interpretive claims, analyses, or synthetic claims about primary sources must be referenced to a secondary source, rather than original analysis of the primary-source material by Wikipedia editors." Jakew (talk) 10:39, 25 April 2008 (UTC)

Jake, I have placed my proposed version with all citations on my user page. Check it out and let me know what you think Johncoz (talk) 20:15, 25 April 2008 (UTC)

Thank you, Johncoz. I was mistaken about the sentence beginning "Prevalence in Africa". It looks very good indeed, but I would like to propose some improvements.

• The sentence beginning "Excluding majority Muslim" seems to contain some synthesis and interpretation. I propose to replace it with something much closer to the sources, such as: "The prevalence in low in Latin America.[cite Drain or WHO] Circumcision is nearly universal in the Middle East and in Central Asia, but is generally low elsewhere in Asia.[WHO] In Europe, circumcision is generally associated with religion or immigration.[WHO]"
• The sentence beginning "Both Australia and New Zealand, like Canada" is a synthesis of three sources. What's needed is a single source. I don't know of such a source, but the WHO document (p17) covers both Australia and Canada. I would therefore suggest editing the sentence to read "Both Australia and Canada...", and attributing the sentence to the WHO. I'd also suggest deleting the following sentence, which gives a disproportionate amount of detail to Australia.

Jakew (talk) 21:48, 25 April 2008 (UTC)

Jake, thankyou for your feedback. However, I find myself disagreeing with your assessment.

• I don't believe there is any "synthesis" or "interpretation" happening. Though there may be several different facts in each sentence, each fact is independently supported by reference to a verifiable source. The empirical reality that the UK, Australia, NZ and Canada have all experienced large falls in circ rates over the past few decades is surely well supported by the sources and uncontroversial, and combining these facts in one sentence is hardly synthesis. Interpretation would be to suggest a common reason for these trends without having a secondary source to reference.
• More seriously, your suggested redraft deletes verifiable content with vague generalisations. Eg "the prevalence is low in Latin America" when the WHO doc actually says "A recent multi-country survey found no countries in Central or South America with circumcision prevalence greater than 20%"; that survey was Drain, which I reference. Even worse, "In Europe, circumcision is generally associated with religion or immigration" changes gear from hard data to a discussion of the reasons for prevalence, a distinctly backward step, IMHO. I would suggest my formulation (with footnotes) precisely represents the situation displayed in the WHO map.
• The last sentence is intended as an illustration of the trends in all non-US English-speaking countries. We could use UK or Canadian data to a similar effect, but Richters is the most recently published and based on a very substantial survey. Since these falls are in fact the most substantial change in circumcision prevalence globally for 50 years (apart from South Korea), it would seem to be worth the extra few words in what is already a pretty tight section.Johncoz (talk) 23:00, 25 April 2008 (UTC)

Johncoz, allow me to respond:

• If each fact is independently supported by reference to a verifiable source, yet no verifiable source makes the overall claim (in this case, that that "the UK, Australia, NZ and Canada have all experienced large falls in circ rates over the past few decades"), then it is synthesis. Please see WP:SYN.
• Re "the prevalence is low in Latin America", I have no objection to being a little :more specific. How about "the prevalence is reported to be <20% in Latin America"?
• Re Europe, the problem is that a colour-coded map is a primary source. Per WP:NOR, "Any interpretation of primary source material requires a reliable secondary source for that interpretation." Unfortunately, the WHO document contains relatively little discussion of Europe; the only relevant material I could find was "...currently, as in the rest of Europe, neonatal circumcision predominantly related to Muslim or Jewish religion, medical indications or immigration from circumcising countries.", which I attempted to paraphrase.
• I would suggest that we need to find a source that makes generalisations about trends in non-US English-speaking countries, and use any illustration from that. Jakew (talk) 23:16, 25 April 2008 (UTC)

Jake, it seems we agree on Latin America ;-)

• On Europe, my proposed text is doing no more than summarising in a few words what is in the main prevalence of circumcision article:

Less than 20%

The following countries have a circumcision rate of less than 20%: Iceland,[5] United Kingdom,[5][28] Ireland,[5] Sweden,[5] Norway,[5] Finland,[5] Denmark,[5] Estonia,[5] Latvia,[5] Lithuania,[5] Portugal,[5] Spain,[5] France,[5] Switzerland,[5] Italy,[5] Netherlands,[5] Belgium,[5] Slovakia,[5] Germany,[5] Poland,[5] Czech Republic,[5] Hungary,[5] Greece,[5] Bulgaria,[5] Romania,[5] Moldova,[5] Ukraine,[5] Austria,[5] Belarus,[5] Russia.[5]

Where footnote 5 is in fact referencing the WHO map as its primary and only source. Whats's the difference?

• On the issue of non-US English-speaking countries, I am not keen to be making any generalisations, implicitly or explicity, but simply in presenting the facts and letting the reader draw their own conclusions. So perhaps this might work for everybody. 1) Delete ", like Canada," and attach the Wirth citation to the first mention of Canada (so at least we cover the fact that there has been a change. 2) Add a final sentence: "Prevalence in the UK is also age-graded, with 12% of those aged 16-19 years circumcised, and 20% of those aged 40-44 years", referencing Davis et al. That way we enrich the content while avoiding any appearance (however tenuous) of "synthesis" (we also lose the Montreal Gazette citation, which is a pretty low quality source). Does this work for you? (I've made the changes on my user page so you can more easily evaluate them. Johncoz (talk) 00:56, 26 April 2008 (UTC)

I have also removed the parenthetical "(often much less)" from the draft, as it was redundant given that specific examples of the range of values follow. Johncoz (talk) 01:49, 26 April 2008 (UTC)

Included Colombia and Taiwan estimates (from peer-reviewed sources) in the examples list, providing a much better balance. Also appended some word counts. Any further comments or suggestions for improvement on the draft most welcome.Johncoz (talk) 05:12, 26 April 2008 (UTC)

Johncoz, the WHO map contains no more and no less information than a table of countries and percentages, so for the sake of argument, imagine that it is. The list you quote, then, is nothing more than a simple re-expression of the "table" itself. However, if we state "Excluding majority Muslim countries and Israel, prevalence in Latin America[5] and Eurasia[1] is generally less than 20%[6] with the notable exceptions of...", this contains more information than is present in the "table", since it is an analysis of the table. The "table" itself does not contain the division into Muslim/non-Muslim countries, nor a subdivision of non-Muslim countries into exceptions, etc. If the source in question was a table of schoolchildren and their heights, we couldn't stratify by gender and calculate the mean height & 95% CI ourselves; we'd need a source for that. This is no different.

Re non-US English-speaking countries, I've had a look at the (current) version of the 2nd paragraph on your user page, and I think it's a definite improvement. However, we need to delete Wirth from the sentence "WHO estimates prevalence in the United States and Canada[14] at 75% and 30%, respectively[1]", as this is actively misleading (Wirth is not the WHO). Also, we need to delete "Prevalence in the UK is also age-graded...", as we're already covering UK prevalence in the preceding paragraph, and this serves no purpose here except to perform implied synthesis by juxtaposition.

The sentence "Both Australia and New Zealand are experiencing long-term falls" needs to be made closer to the cited source (suggest "In both Australia and New Zealand, the circumcision rate has recently declined.")

Finally, I wonder if we could reduce the number of references cited, perhaps by extracting examples from, eg., the WHO document. The current version on your user page is 6,874 bytes, which is probably due to the large number of refs. Jakew (talk) 11:03, 26 April 2008 (UTC)

Jake, some useful suggestions - let me deal with them in reverse order.

• I agree there is an issue with many citations, but I cannot see a way around it without compromising verifiability. I have tried to recycle as many references as possible. The WHO document, which in many respects is a tertiary source, has some severe limitations and egregious factual errors (look at the adult male population figures for the UK and Australia in table 1, for instance). I'd welcome any specific suggestions.
• I am happy with the existing wording of the OZ/NZ sentence (note that Richters is also a source), since the stated fact is not disputed by anyone commenting on this trend, but I will nonetheless have a second look at the wording in search of an acceptable compromise.
• The final two sentences are not about overall prevalence, but about age-grading - which is a crucial point about past and future prevalence trends. Having made the addition in the response to your earlier criticisms, I am now strongly in favour of retaining it.
• I am happy to delete the Wirth citation. On reflection, you are quite right - it does not sit comfortably there.
• The Latin America and Eurasia phrasing looks like becoming a real sticking point. Having carefully considered your response, I maintain my position that this sentence (with its footnote) does no more than precisely state what is both in the WHO map and the main prevalence article. If this is disallowable "analysis", then we may as well delete the other 2.5 million articles on Wikipedia, IMHO. It is also an extremely economical way of presenting a large swathe of data in what is of necessity a very short overview (as Coppertwig noted). Perhaps other editors may have some views on this question.
• I will advise here when I have updated the draft. Regards, Johncoz (talk) 12:34, 26 April 2008 (UTC)

Thank you for your response, Johncoz. I'll look forward to reading the updated draft. In the meantime, a few comments, in no particular order:

• I don't think that it's essential to reduce the number of citations, but it would be desirable to reduce their number by citing secondary sources with data for several countries instead of primary sources. Another option may be to simply cite fewer specific examples. I would regard any unpublished criticism of the WHO document as original research by definition.
• I think you're overreacting in saying that 'If this is disallowable "analysis", then we may as well delete the other 2.5 million articles on Wikipedia'. This is a problem with a single sentence in a mostly excellent proposed addition to an article. The basic principle of WP:NOR is that if an analysis has not been published in reliable sources then we shouldn't publish it either. The alternatives aren't that terrible: we either remove the claim or we find a reliable source that makes it (or an approximation, as in my earlier suggestion). This also applies to the "crucial point about past and future prevalence trends" - if it's that crucial, it will already have been made in a reliable source, and if it proves impossible to find such a source, it may not be all that crucial.
• Whether or not the stated claim is disputed is largely irrelevant. If we're attributing a claim to a source, we can't extrapolate beyond that source, otherwise the claim is not only unverifiable but the source is misrepresented. In this respect, citing sources in Wikipedia carries a "promise" that the reader can verify that claim attributed to the source is actually made by the source. Jakew (talk) 13:24, 26 April 2008 (UTC)

I have updated the draft. On the points you raise, Jake …

• "I would regard any unpublished criticism of the WHO document as original research by definition." So would I. One can only hope a peer-revoewed critique will appear in the future.
• On the examples, reliable prevalence data for non-English-speaking countries is as rare as hen's teeth and I am not aware of any source that has pulled together these studies (apart from pro and anti circ propagandists). That's why we have encyclopedias.
• On age-grading, both sources (Davis for the UK and Richters for Oz) explicitly mention age-grading, and link it to a historic decline in incidence. So we don't have a problem.
• In relation to the "Excluding Muslims ..." sentence, consider this. The WHO map is in fact not a table but a totally unlabelled map. Whoever compiled the main prevalence article must have painstakingly compared the splotches of colour with an atlas in order to generate the lists. Was this creating information that was not in the source? Yes. Was it "original research" in the sense of WP:NOR? Of course not. Utilising basic geographic (including demographic) data to clarify source data is not OR. Johncoz (talk) 18:36, 26 April 2008 (UTC)

(unindenting) Johncoz, am I correct in thinking that this diff represents the sum of your changes? Assuming that it does, a few comments:

• Agree with the removal of Wirth (also, I'm pleased to note that this reduces the number of references by one).
• The sentence "The circumcision rate has declined sharply in Australia and New Zealand since the 1970s, leading to an age-graded fall in prevalence, with a 2000-01 survey finding 32% of those aged 16-19 years circumcised, 50% for 20-29 years and 64% for those aged 30-39 years." is now problematic for two reasons. First, it is misleading, as the second of the two sources is a survey of Australian data, yet it is presented as data for both Australia and New Zealand. Second, it is synthesis of two sources to advance a claim made by neither. One source (Richters) states that circumcision rates in Australia have fallen since the 1970s. The other source states that rates in both countries have "fallen considerably in recent years". The correct thing to do is to report on what one or the other says, not to try to synthesise the two.
• And I've discussed the problems with "Excluding majority Muslim..." above.

Regarding the above points:

• I'm glad we both agree that such unpublished criticism is original research.
• There is some prevalence data in Drain and WHO that may be usable.
• Re age-grading, there isn't an WP:NOR problem with citing either Dave or Richters. The trouble comes when we use them both together, to advance a position stated by neither. In this case, both the juxtaposition and the choice of wording ("Prevalence in the UK is also age-graded") appear to advance your stated belief that there have been "steep declines in incidence for all English-speaking countries beside the US", and what you need to do instead is to find a source that makes this specific claim.
• Finally, regarding "excluding muslims", we could certainly consider removing the information in that article, but I have to say that I don't find your argument persuasive. The WHO labels their map "Global Map of Male Circumcision Prevalence at Country Level", so there can be little doubt that the "splotches of colour" are, indeed, countries. Reading the map requires no more special skill than reading English, and indeed this task could easily be automated. This contrasts sharply with a) taking the map, b) taking additional data from elsewhere, c) stratifying the resulting data by both circumcision prevalence and dominant religion, and d) making generalisations about the results. For such analysis, as WP:NOR clearly states, we must cite a reliable source. Jakew (talk) 21:37, 26 April 2008 (UTC)

Johncoz has my support for this redraft. It summerizes in a clear concise manner. Garycompugeek (talk) 02:05, 25 April 2008 (UTC)

Jakew, re "excluding muslims": I suppose you may be right. For example, (in the spirit of WP:SYN), if a different source is used for the religion data, we wouldn't know whether they're using a definition of religion that's relevant to circumcision rates, e.g. with respect to practicing versus non-practicing members of a religion, or whatever. However, in the spirit of WP:IAR: are you just applying the SYN rule for the sake of it, or do you really think there's an important concern here? After all, this is an overview using rounded-off numbers. Look at it this way: suppose we said "Except for African countries..." and then somebody objected because the list of which countries are or are not in Africa wasn't from the same source as the data. Wouldn't that be taking NOR too far? ☺ Coppertwig (talk) 22:12, 26 April 2008 (UTC)

Coppertwig, I think this sentence violates WP:NOR in several ways, including but not limited to WP:SYN. Regarding primary sources such as maps, we're supposed to "make no analytic, synthetic, interpretive, explanatory, or evaluative claims about the information" therein. In my view, this sentence does most if not all of these.

Am I just applying this rule for the sake of it? Categorically not, for several reasons.

One of these is that, generally speaking, this kind of analysis can be susceptible to errors, and we owe it to our readers to ensure that they receive information that has gone through publication processes (peer-review, etc) that have been set up to check for such errors. This policy, as with others, is beautifully designed, and properly applied helps to minimise the chances of that happening. Also, given consistent application of WP:V and WP:NOR, readers should be able to expect that the cited sources will likely give further information (as is true with most other sources). For example, suppose we could find a source that stated that "Excluding majority Muslim countries and Israel, prevalence in Latin America and Eurasia is generally less than 20%". If I were reading that, I might want to read the source in more detail, with the expectation that I'll be able to find out about the sources used in this analysis, how "majority Muslim" was determined, etc. Why violate that expectation?

Another reason is that WP:NPOV requires us to represent, with appropriate weight, significant views that have been expressed in reliable sources. When an analysis proves to be so difficult to source then I think that's a clue that we're trying to represent a view that hasn't been expressed in reliable sources, and that's an WP:NPOV minefield (for example, if Wikipedia is first to publish this interpretation, we could find scholars citing us, and perhaps criticising the analysis, so what then? "Wikipedia says X but author Y disagrees" is absurdly self-referential...). That problem doesn't occur when we stick with statements that have been made elsewhere (even if they aren't ideal), for example in my suggestion of 21:48, 25 April 2008.

Finally, as I commented above, "Excluding majority Muslim countries..." is somewhat non-neutral. Even phrased differently, the underlying message of the sentence structure is that majority Muslim countries are unimportant (consider "excluding families of immigrants, the population of England is 100% white" - how would a black person feel about that? And what about "the population of England is 10% black, 6% other, and 84% white"?). Again, if we stick to published analyses, this problem doesn't occur (or if it does we can at least attribute the claim).

I think that there's rarely a case for applying WP:IAR to the core policies, and I don't think this is such an occasion. Jakew (talk) 23:09, 26 April 2008 (UTC)

OK, how about this approach: the question is whether we're talking about an unambiguous list of countries or not. If we say "excluding countries listed in Table 3 in publication X, ..." then that's unambiguous. (I think.) In that case, it's simple application of logic and is OK and does not violate WP:SYN (I think). Just saying "countries with majority Muslim population" is probably not unambiguous and may change with time, but it might be possible to say "countries listed by publication X as being majority Muslim countries", even if publication X has nothing to do with circumcision.

This doesn't solve the possible connotations of the use of the word "excluding", but I figure if we're going to use "prevalence" because it's technically correct and we ignore its connotations, we can do the same with "excluding". As someone who tends to think like a mathematician, I would tend to exclude the application of any argument that excludes the use of the word "exclude". ☺ Coppertwig (talk) 00:02, 27 April 2008 (UTC)

Coppertwig, thinking over your suggestion it occurs to me we could just link to Majority Muslim countries article, which has a spiffy table that presumably is updated as new data comes to hand. Johncoz (talk) 03:05, 27 April 2008 (UTC)

The problem then is how do we ensure that it is correct? To set aside, for the moment, the issue of WP:SYN, here is what I would want to do (or see) before I could be confident that there were no errors. First, I would want to convert the WHO map into a table (fairly straightforward). Then, I would want to add a column for % Muslim, taken from that article (as an aside, do we know if that article is complete?). Finally, I'd need to add a boolean-valued column to indicate whether the country is in Eurasia. Only when all this is done could I even check the assertion.

What I don't understand is this: what is so terrible about the alternative (citing verifiable analyses such as, eg., my suggestion of 21:48, 25 April 2008)? Jakew (talk) 11:27, 27 April 2008 (UTC)

I will put together a table along the lines you suggested, Jake. I was going to check the accuracy of that data anyway, and tabulating it systematically is probably a good idea. Johncoz (talk) 13:43, 27 April 2008 (UTC)

Jake, I fear we are in danger of losing sight of our goal here, which is to provide a snapshot in about 200 words of global circumcision prevalence that is accurate (ie true), properly sourced and consistent with Wikipedia guidelines and the main article on the subject. A tall order, but I would suggest the draft text does a substantially better job than the existing section. And the consensus in this discussion seems to favour that judgement, particularly since no one has raised any issues in relation to the facts as stated.

On Eurasia, the question surely is: does the sentence accurately convey what the reader will see on the WHO map (which by the way is not a primary source), should they consult it, or what they will read if they go to the prevalence article? The answer is surely yes. There is in fact no dispute about which countries are “majority Muslim” with the exception of Kazakhstan (est. 47-53%), which I have now added to the footnote of 20-80% exceptions. The importance of Islam to circumcision prevalence is surely clearly stated in the very first sentence (“with almost 70% of these being Muslim”).

On age-grading, it is simply a fact clearly stated by the sources that prevalence is age-graded in the UK and Australia as a result of earlier declines in child incidence. There is no controversy I am aware of about this fact (it is just the way the demography works), and the text does not seek to draw any further conclusion. There is no synthesis. The same falling incidence is of course true for New Zealand and Canada, as clearly stated in the History of Circumcision article and many sources, but having already deleted the Canada reference in response to your objection I would be happy to delete NZ as well rather than pile on yet another citation if you believe mentioning it in the text is “misleading”.Johncoz (talk) 01:48, 27 April 2008 (UTC)

Johncoz, although there are a few remaining issues, I would certainly agree with your statement (that "the draft text does a substantially better job than the existing section"). As far as I'm concerned, the Australia sentence is now okay. I refer to my comments above about the Eurasia sentence. Jakew (talk) 11:27, 27 April 2008 (UTC)

I'm not sure if I'm following the whole discussion (is there a draft somewhere that's being edited?) but I have another suggestion: how about saying "In n₁ countries the rate is over 80%; in n₂ it's between 20% and 80%, and in n₃ it's below 20%." (replacing the n's with numbers), or else "In some countries the rate is over 80%, and in some of the others it's less than 20%". (I haven't consulted the source. Blackworm, these are draft sentences that may need some work and indicate nothing about my beliefs.) The reader could refer to the main article on the topic to get the details i.e. which countries.

Re synthesising two sources about falling rates: I think it is possible to synthesise them: I think you can say that the rate has fallen in both countries. That takes a subset of the information of each source. ☺ Coppertwig (talk) 17:24, 27 April 2008 (UTC)

Jake I have concocted a table as requested after reconciling the WHO map with the mainprevalence of circumcision article, the Majority Muslim countries table and external sources (eg atlas) where required. It's quick and dirty but has the info. The good news is that it fully verifies the accuracy of the Eurasia sentence. On the downside(s)the Majority Muslim countries table is inexplicably missing Albania and Kyrgyzstan, however there is an even better table at Islam by country, and I propose to link to that; and the prevalence article it turns out has many major omissions (eg China Taiwan), which I have noted in the table.

The draft is on my user page. Johncoz (talk) 17:48, 27 April 2008 (UTC)

[←outdent] Could we bring the draft to this talk page? It may help alleviate confusion. Thanks, AlphaEta 20:05, 27 April 2008 (UTC)

Sure. Here's a copy of the current draft text. I'll leave the master with references on my user page as a convenient location for edits and change control.

Estimates of the proportion of males that are circumcised worldwide vary from one-sixth[3] to a third.[4] WHO has estimated that 664,500,000 males aged 15 and over are circumcised (30% global prevalance), with almost 70% of these being Muslim.[1] Excluding majority Muslim countries and Israel, prevalence in Latin America[5] and Eurasia[1] is generally less than 20%[6] with the notable exceptions of the Philippines, which has a prevalence greater than 80%,[7] and South Korea, which is approaching that level.[8] Estimates for individual countries include Spain[7], Columbia[9] and Denmark[10] less than 2%, Finland[11] and Brazil[7] 7%, Taiwan[12] 9% and Thailand[7] 13%.

WHO estimates prevalence in the United States and Canada at 75% and 30%, respectively.[1] Prevalence in Africa varies from less than 20% in some southern African countries to near universal in North and West Africa.[5] The circumcision rate has declined sharply in Australia since the 1970s, leading to an age-graded fall in prevalence, with a 2000-01 survey finding 32% of those aged 16-19 years circumcised, 50% for 20-29 years and 64% for those aged 30-39 years.[13][14] Prevalence in the UK is also age-graded, with 12% of those aged 16-19 years circumcised, and 20% of those aged 40-44 years.[15]

Johncoz (talk) 22:17, 27 April 2008 (UTC)

There appears to be broad agreement that the current draft text is superior to the existing section. That being the case, I will now make the change.

There is a continuing discussion about the Eurasia sentence. The current status of that discussion is summarised (by jakew and myself) at the NOR noticeboard. Johncoz (talk) 18:24, 28 April 2008 (UTC)

More deceptive figures.

The World Health Organization (WHO) stated that studies of three trials provide compelling evidence that male circumcision provides a 50–60% reduction in HIV transmission from female to male.

This is a relative risk reduction. In absolute terms it reduces the risk from 0.3% per sexual contact to 0.12-0.15%. So an absolute risk reduction of less than 1/5th of 1%. Big fucking whoop. HIV is not nearly as easy to spread as American propaganda over the last 20 years has implied to children, and it is despicable to claim this as a valid medical pretext for circumcision. --76.222.55.11 (talk) 19:28, 25 April 2008 (UTC)

Please see WP:TALK. I can only suggest that you write to the WHO and explain your concerns. Jakew (talk) 21:57, 25 April 2008 (UTC)

There's a valid point in there. We find it normal to repeat that "male circumcision provides a 50% reduction in HIV..." without discussing absolute risk, but then we say "more circumcised men reported having been diagnosed with genital warts compared with uncircumcised men (4.5% and 2.4%)" instead of something absolutely frightful and unacceptable derived from the exact same information, like "being circumcised increased reporting of genital warts by 87.5%." It's spin; it's right there in the sources' presentation of the data (especially circumcision advocates like the WHO), and it's sometimes right here in our rewording of sources. How does one cut through it? By consistently taking the same spin as the sources? Blackworm (talk) 22:46, 25 April 2008 (UTC)

What you call "spin", Blackworm, is the interpretation of data as it appears in reliable sources. Obviously our coverage needs to be close to that interpretation, because our role is to express "significant views that have been published by reliable sources", not to express the view of Wikipedia editors who have their own personal interpretation of data that have been published in reliable sources. Jakew (talk) 23:50, 25 April 2008 (UTC)

When reporting the WHO's recommendation, I agree with Jake that we should keep the relative percentage as reported in the citation. However, I think Blackworm has salvaged a valid point from the original post. Reporting the relative risk as indicated by the WHO does not preclude us from adding absolute risks for each individual, randomized, controlled trial:

• In Kisumu, Kenya, "the 2-year HIV incidence was 2.1% (95% CI 1.2-3.0) in the circumcision group and 4.2% (3.0-5.4) in the control group (p=0.0065)...."
• In South Africa, "There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) [0.85%] in the intervention group and 49 (2.1 per 100 person-years) [2.1%] in the control group...."
• In Rakai district, Uganda, "the modified intention-to-treat analysis, HIV incidence over 24 months was 0.66 cases per 100 person-years [0.66%] in the intervention group and 1.33 cases per 100 person-years [1.33%] in the control group...."

Does this serve as a possible solution? AlphaEta 00:53, 26 April 2008 (UTC)

I think it's an excellent solution to the problem of the presentation either RR or absolute risk. Since Jake seems to concede above that the text is the interpretation of the WHO (and not editors here), it would follow that we must make must that clear throughout. We could do something silly like preface the entire section with "Everything below is the view of the WHO." I would rather, though, use the data referenced by the WHO, see the data consistently separated from the WHO's statements, and presented as neutrally as possible, exactly as AlphaEta does above. Then, we can state the WHO's conclusions and recommendations (e.g., mass male circumcision).

I will begin to look at the sources and see how to properly integrate them into the above suggested edit, making minor revisions as necessary. Jake, would you like to help? Is there anything in the above you find to be accurately sourced, with a source you know? Blackworm (talk) 01:26, 26 April 2008 (UTC)

I agree it is worth preparing a draft. An extraordinary number of people (who are not statistically savvy) come away with the impression that for instance there is a 50% chance of contracting HIV if one is uncircumcised. The same thing happened with HRT some years ago. Providing absolute risks as an adjunct is a good way of helping to clarify this without distorting the data.Johncoz (talk) 02:07, 26 April 2008 (UTC)

Blackworm, you've misunderstood. I'm not saying that the text is the interpretation of the WHO specifically; I'm saying that it is the interpretation in the sources (this is also true of the trials themselves. To quote examples from the abstracts linked above: "a reduction in the risk of acquiring an HIV infection of 53%", "a protection of 60%", "estimated efficacy of intervention 51%").

I'm not convinced that quoting absolute figures is useful to the reader, since they depend upon the prevalence of the disease, which varies dramatically by population. Relative risk is somewhat more useful in general statements, and since secondary sources generally focus on these figures, it makes sense for us to do the same. I would suggest adding detailed information about the individual trials to medical analysis of circumcision. Jakew (talk) 11:24, 26 April 2008 (UTC)

[edit conflict.] Sorry, in case it's not clear, I'm referring to ideas for the edits presented in the previous discussion section as well. Blackworm (talk) 02:10, 26 April 2008 (UTC)

Possibly the meaning of relative risk could be made clearer to the reader by using a phrase like "approximately half as many circumcised men contract HIV ... as compared to circumcised men". (This sentence would probably need some work to make sure it's accurate etc.)☺ Coppertwig (talk) 14:13, 26 April 2008 (UTC)

Jake, I haven't misunderstood anything. The statement above says "the WHO [...] compelling evidence [...] provides ..." Yes, WHO, we know; circumcision is compelling and a provider of great things. Let's present the data, including absolute risk in the trials, then the WHO can tell us how this data is "compelling evidence" and how males in Africa should be lined up and circumcised on a "nominally voluntary" basis. Presenting an interleaved mix of WHO circumcision advocacy and data is why people are coming here saying this article reads like a circumcision brochure.

Our job here is to have the reader understand the topic. The relative risk is important, since it's the goal of these studies to find it, but the absolute risk is too, to put the relative risk in context. We do this already for penile cancer, for example, where even the 200%-2100% relative risk increase we state ("3 to 22 times") isn't enough for medical organizations to recommend circumcision as a preventative option, due to the very tiny absolute risk. Let the reader decide.

Coppertwig, your suggested edit extrapolates the results of these trials to all men. It seems you believe that it is a fact that circumcision reduces all males' chances of contracting HIV by 50%, and we should present it as such without attribution of the view. I disagree. Blackworm (talk) 18:40, 26 April 2008 (UTC)

Reading the HIV article I have noticed they use a similair quote "A meta-analysis of twenty-seven observational studies conducted prior to 1999 in sub-Saharan Africa indicated that male circumcision reduces the risk of HIV infection" sourced to Weiss, H.A.; M.A. Quigley, R.J. Hayes then balance it with "However, a subsequent review indicated that the correlation between circumcision and HIV in these observational studies may have been due to confounding factors." sourced to Siegfried, N., Muller, M., Deeks, J., Volmink, J., Egger, M., Low, N., Walker, S. and Williamson, P.. Concerning the importance we seem to be placing on this I find this new source illuminating. Garycompugeek (talk) 20:09, 26 April 2008 (UTC)

I think the newer randomized controlled trials make those results obsolete. Basically, they're just saying we don't know; but after the RCT's we're much more certain. ☺ Coppertwig (talk) 21:04, 26 April 2008 (UTC)

You're correct, Coppertwig. Siegfried et al. said this about the RCTs then underway: "Although the positive results of these observational studies suggest that circumcision is an intervention worth evaluating in randomised controlled trials, the current quality of evidence is insufficient to consider implementation of circumcision as a public-health intervention. Therefore, the results of the three randomised controlled trials underway will provide essential evidence about the effects of male circumcision as an intervention to prevent HIV infection." Jakew (talk) 21:42, 26 April 2008 (UTC)

Because the OP was allowed a soapbox moment to highlight the relatively low risk of contracting HIV per sexual encounter, I request that the same luxury be afforded to me so that I may point out how this risk actually translates into new cases in the field. According to UNAIDS, 2007 saw 1.7 million new cases of HIV in sub-Saharan Africa (this staggering number is actually much improved from 2001). Multiple studies conducted in the 1980's and 1990's indicated that approximately 80% of new HIV infections in Africa are the result of heterosexual contact.[31], [32], [33] If this holds true, then 1.36 million people acquired this disease last year as a result of a "low risk" encounter! More recently, researchers have suggested that perhaps the estimate of heterosexual acquisition was overstated.[34] For the sake of argument, let's say only 40% of new cases in Africa are the result of heterosexual encounters. This still means that 680,000 people contracted a virus that leads to an incurable illness. Furthermore, the areas most greatly affected by HIV lack sufficient stocks of anti-retrovirals and other treatments to keep AIDS at bay. Yes, HIV is nowhere near as easy to contract as herpes and other viral STDs, but it is far from a propaganda effort to suggest that heterosexual spread is a real threat. I shall now step down from the soapbox and promise not to make a habit of it. Please check my math and let me know if there are errors in my extrapolations. Kindest regards, AlphaEta 03:25, 27 April 2008 (UTC)

Based on the above responses from my previous post I do not believe the general thrust of my meaning was understood. Based on the data I believe that circumcision can decrease chance of HIV transmission in any orifice, not propaganda. The point was if the one source was cancelling out the other sources perhaps we should only use the follow up sources of the controlled trials? Another point, to keep things in a balanced perspective, is Only WHO and UNAIDS seem to be advocating it as a way to fight HIV. The major medical schools of thought seem to believe this alone is not justification for circumcision leading us to believe there are better methods to avoiding HIV. I know we source this at the end of the original WHO statement but it seems to get diluted in the article. Garycompugeek (talk) 19:15, 28 April 2008 (UTC)

Gary, only two policy statements have been issued/revised since the publication of the three RCTs. One of these was the joint WHO/UNAIDS statement, and the other was the AUA statement. For obvious reasons, we can't know how any other medical organisations view the issue until they issue their new policies. Jakew (talk) 19:37, 28 April 2008 (UTC)

Be Bold

There are many well thought out suggestions above, and some I feel might be too complicated for the reader. Overall I urge Johncoz to make the changes that he feels are correct and let the wiki process do the rest. Remember the article belongs to the encyclopedia not Jakew and final decisions lay with the community. Garycompugeek (talk) 12:44, 26 April 2008 (UTC)

As you may have gathered, I am new to the Wikipedia community. But my understanding of the protocol for a substantial change to a "controversial" topic is that it should be discussed on this page first and if there is disagreement, reasonable steps should be taken to reach a consensus. (And yes, I am trusting in the fact that the article does not belong to any individual or group). I have no doubt that the wiki process will further improve whatever emerges out of this discussion, but in the meantime I am in no special hurry. Johncoz (talk) 18:55, 26 April 2008 (UTC)

Speed is not of the essence and I have surmised your caution. By all means please take your time. Please view this as encouragement for you seem to have consensus forming. Garycompugeek (talk) 20:01, 26 April 2008 (UTC)

Plastibell

The passage on Plastibell technique does not describe the technique, unlike the Gomco and Mogen passages. This is both unbalanced and creates the exceedingly odd impression of non-surgical surgery (the foreskin just "comes away" after some days). The Plastibell article does have an accurate description but had no citation, which I have now fixed with a reference to a British Medical Journal article. I propose that we replace the existing text with the following:

With the Plastibell, the adhesions between glans and foreskin are first divided with a probe. Then the foreskin is cut longitudinally and the Plastibell placed over the glans and covered over by the foreskin. A ligature is tied firmly around the foreskin, crushing the skin against the groove in the Plastibell, and the excess skin protruding beyond the ring is trimmed off. The remnant foreskin and clamp come away in three to seven days.

And use the same BMJ reference. The proposed text is 74 words; by comparison the Gomco passage is 102 words. Plastibells are now used in the majority of infant circumcisions in the developed world. The change would make the external link redundant —- so it could be deleted. If anyone wants to quickly compare the three pieces of text, I have placed them here. Johncoz (talk) 23:52, 28 April 2008 (UTC)

I think this is a good description, and your rationale for the addition makes sense. I can only say be bold. Jakew (talk) 11:23, 29 April 2008 (UTC)

I concur. This is a nice addition to the article. Well done! AlphaEta 14:04, 29 April 2008 (UTC)

Well done. ☺ Coppertwig (talk) 23:50, 29 April 2008 (UTC)

How about a treatment of circumcision techniques in the developing and undeveloped world, where the majority of circumcisions are performed? What do barbers performing circumcision in Turkey use, for example? How about among tribes in Africa? Do we want to know? Blackworm (talk) 05:44, 30 April 2008 (UTC)

I think we do want to know, though reliable sources are difficult to find with the exception of the regular carnage in South African "circumcision schools". The issue is actually on my to-do list and I would be happy to collaborate in the future on putting something together. Johncoz (talk) 05:54, 30 April 2008 (UTC)

Neutrality

I'll add this for Jakew, who deleted my tag, even though I fully explained my editing it in in the extra information (so apparently he didn't check the History). Anyone visiting this talk page can clearly see that there are neutrality disputes. Comments about the page being too "anti-circumcision" or too "pro-circumcision" are everywhere. From what I can see, the debate still stands. I, as a person new to the Circumcision page, cannot see the logic in trying to pass this off as written from a "neutral" point of view when the neutrality is being discussed on the talk page. The tag advises readers that the article is thought by some to be biased; until the whole issue is sorted out, that tag is to stay. Cervantes de Leon (talk) 01:43, 30 April 2008 (UTC)

Every controversial topic will have people that complain about neutrality, so, if that were the standard, they would all be tagged. What we can't have are people coming and putting tags on stuff just because they don't like what's presented in the article. This article is already better sourced than almost all Wikipedia articles, precisely because it is controversial and many people from both sides of the argument have gone over it; therefore it's reasonable to believe that it should be considered neutral. If you can't come up with specific POV problems in the article, then your tag simply becomes an objection to the article in general and that is POV. The way, the truth, and the light (talk) 01:52, 30 April 2008 (UTC)

I agree with The way, the truth, and the light. If you're going to have a tag, the tag should have a link to the specific section of the talk page, and the specific section should state precisely what needs to be fixed in the article to make it NPOV. This section doesn't do that, so the tag is not appropriate. Besides, I think the article is fine. Debate about POV on the talk page is normal and healthy and is part of what keeps the article neutral IMO. Besides, opinions will always vary as to what is neutral. ☺ Coppertwig (talk) 02:04, 30 April 2008 (UTC)

• I'd like to be able to say that medical associations whole-heartedly recommend circumcision. Unfortunately, they don't (for political and other irrational reasons). - The way, the truth, and the light 17:19, 12 April 2008
• It doesn't really make an argument for either side, and is essentially a cop out by the AAP to avoid admitting that circumcision is a good idea. The way, the truth, and the light 18:24, 12 April 2008

Needless to say, I don't believe this user is in a position to comment neutrally on this article, despite the fact that that user's side can betray whatever POV they wish and be met with deafening silence from the administrators listening, rather than the blast of WP:RULES and administrative threats anyone apparently opposing that POV receives. Blackworm (talk) 02:29, 30 April 2008 (UTC)

I don't think editors' POVs has anything to with this issue, and the whiff of conspiracy theory you introduce does not help clear the air. The issue here is about drive-by tagging. The aim, after all, is to produce the best possible article, and the application of tags must apply to the content of the article, not the content of its talk page. I look forward to reading any suggestions Cervantes de Leon may have about strengthening this article's NPOV. Johncoz (talk) 03:29, 30 April 2008 (UTC)

What you call conspiracy theory, is documented in the last few archives of this Talk. Again, the fact that the POV tag is always added by editors who perceive a pro-circumcision slant, and immediately removed by editors who express a pro-circumcision slant, should say something about the true level of neutrality of the article. Blackworm (talk) 04:39, 30 April 2008 (UTC)

With respect, I think you've missed my point. Even if the "conspiracy theory" were a fact, drive-by tagging is not the way to deal with the perceived problem. (For the record, I am opposed to routine circumcision and deeply skeptical about mass circumcision in sub-Saharan Africa as a public health measure.) Johncoz (talk) 05:31, 30 April 2008 (UTC)

But "drive-by" implies the user adding the tag leaves the discussion. This was not the case here, with either of the editors who added the tags. Here, the issue is that any tagging "defaces" the article, and apparently editors are held to an illogical standard whereby they must prove the article is unbalanced before they are allowed to tag the article to indicate that they dispute its balance. I see absolutely nothing wrong with this article being perpetually tagged as having its neutrality disputed, if that reflects the reality in the discussion page. Others insist the article is balanced, and by untagging the article are acting as if they insist there is no neutrality dispute -- despite clear evidence that there is. Blackworm (talk) 20:17, 30 April 2008 (UTC)

The relevant policy, to which Jakew referred, is WP:DRIVEBY and states: "Drive-by tagging is strongly discouraged. The editor who adds the tag must address the issues on the talk page, pointing to specific issues that are actionable within the content policies, namely Wikipedia:Neutral point of view, Wikipedia:Verifiability, Wikipedia:No original research and Wikipedia:Biographies of living persons. Simply being of the opinion that a page is not neutral is not sufficient to justify the addition of the tag. Tags should be added as a last resort." (emphases added) Johncoz (talk) 02:18, 30 April 2008 (UTC)

WP:DRIVEBY is not policy. That page also states, In general, you should not remove the NPOV dispute tag merely because you personally feel the article complies with NPOV. Rather, the tag should be removed only when there is a consensus among the editors that the NPOV disputes have indeed been resolved. Blackworm (talk) 02:29, 30 April 2008 (UTC)

The guideline about removal of tags presumably applies to those tags that have been correctly added in the first place (ie in accordance with the guidelines I quoted). In other words, drive-by deletion is no more valid than drive-by addition. In both cases, the action should be discussed on the Talk page first in relation to the specific issues in dispute, and an attempt made to reach consensus for either action. This is particularly so with articles as controversial and exhaustively worked over as this one. Johncoz (talk) 02:47, 30 April 2008 (UTC)

"...until the whole issue is sorted out...." I admire your optimism! Unfortunately, this is a highly polarized issue, and as such, it is unlikely that any one of us will ever be completely satisfied with the neutrality of this article. To simply say that the article is not neutral provides insufficient substance for debate (for either side). We must base our discussion on specific recommendations and reliable sources. If you have any particular concerns, they can be addressed on this talk page. Since I've joined this discussion (about three weeks ago), consensus building been notably civil. Kindest regards, AlphaEta 03:38, 30 April 2008 (UTC)

Tag removed, point taken. In retrospect I am beginning to think that I should have simply kept my mouth shut... Cervantes de Leon (talk) 05:13, 30 April 2008 (UTC)

Do not despair Cervantes de Leon. If you have looked over histories you will see that I have raised this issue and placed tags after making additions to the article and talk page. Logic and perseverance is the key. Any desire to improve the encyclopedia is commendable and regardless of the subject's controversy lets remember not to WP:BITE. Garycompugeek (talk) 15:11, 30 April 2008 (UTC)

Paragraph in lead

In the 4th paragraph of the lead, we currently include three arguments made by 'opponents' of circumcision and one source. We also include one argument made by 'advocates' of circumcision and four sources. What I propose to do is to cut down the 'advocate' sources, so that we cite only one (I suggest Schoen), and to add a small amount of text to describe two other arguments that he makes. The result should be a) a better balanced paragraph, and b) a net reduction in sources (and hence article length and load time). Any thoughts? Jakew (talk) 12:48, 30 April 2008 (UTC)

Would you mind providing more detail here? How about a draft version of the paragraph so that the details of your changes can be considered? Beejaypii (talk) 13:18, 30 April 2008 (UTC)

Sure. I'm proposing to change this:

• Opponents of non-medical circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure.[10][11][12][13]

To something like this (as a rough draft):

• Opponents of non-medical circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure, with few complications and no effects on sexual health.[10]

(See 'Discussion and conclusions' in Schoen's paper.)

As you can see, the result is that we dedicate an equal number of references to both 'sides', and a roughly equal number of words. Jakew (talk) 13:30, 30 April 2008 (UTC)

I agree with the thrust and reasoning of Jakew's draft. However, I think a slight rewording of the Schoen position is required if we are not to misrepresent. I suggest "a worthwhile public health measure, with a low complication rate if "properly done" and no adverse effects on sexual performance."

Second, regardless of the wording we need to change non-medical (which actually implies ritual) to non-therapeutic.Johncoz (talk) 14:50, 30 April 2008 (UTC)

I think the following version would be more balanced (I'm incorporating Johncoz's suggestions here too):

• Opponents of non-therapeutic circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure, consider it to have a low complication rate when "properly done", and consider it to have no effect on sexual performance.[10]

Isn't this more balanced? What do the editors here think? Beejaypii (talk) 16:08, 30 April 2008 (UTC)

I think there are rather too many "consider it"s. If we were to add them to 'opponents', we'd have something like: "condemn infant circumcision as being medically unjustified, consider it to be an infringement upon individual bodily rights, and consider it a cause of sexual impairment". In my view, this adds bulk without much benefit, as it is quite obvious that these are arguments. I'd suggest that we could also remove the quotes around "properly done" - they aren't needed for two words. Jakew (talk) 16:18, 30 April 2008 (UTC)

Just to elaborate slightly, when I read the above, I can't help but notice the different language structure. We say what opponents think in straightforward terms, but when it comes to an advocate it is as though the author is desperately trying to distance himself from it as far as possible (I'm not saying that's the case, this is just my impression as a reader). That seems to be the function of "consider it" at every opportunity, and the apparent scare quotes. As a style of writing, this is reasonable enough, but coming so soon after the description of the opposite position, the contrast is striking. This doesn't seem very balanced at all. In the presentation of the views of opponents, I think it is perfectly clear that we're simply listing a few arguments they make, not endorsing them. I tried to copy the same presentation style for the views of advocates, and I think that's quite reasonable. However, let's distance ourselves (or not) equally from both positions. Jakew (talk) 16:42, 30 April 2008 (UTC)

The current construction uses "condemn" and "regard". The easiest solution is to alter both to claim, since that is the actual status . Adjusting for reasons of symmetry and style, this could give us:

"Opponents of non-therapeutic circumcision claim infant circumcision is an infringement upon individual bodily rights that is medically unjustified and a cause of sexual impairment.[9] Advocates of circumcision claim it is a worthwhile public health measure that has no adverse effect on sexual performance and a low complication rate when "properly done".[10]

Are we getting close? Johncoz (talk) 17:00, 30 April 2008 (UTC)

That's looking much better, but let's delete the quotes around "properly done", so that it reads "...a low complication rate when properly done". Jakew (talk) 17:17, 30 April 2008 (UTC)

Agreed. On reflection they look like scare quotes (which was not my intention) and hence editorialising. Johncoz (talk) 17:21, 30 April 2008 (UTC)

Jakew, I don't agree that it is "perfectly clear that we're simply listing a few arguments they make". In the first part of the paragraph, describing the stance of circumcision opponents, each of the arguments; "medically unjustified", "infringement upon individual bodily rights", and "cause of sexual impairment" is represented by a phrase which is functioning as a complement of the verb condemn, there's no ambiguity there. However, in the "advocates" part of your version, though the first argument "a worthwhile public health measure" is fulfilling an equivalent function with respect to the verb regard, the other two arguments, "with few complications and no effects on sexual health" are functioning as post-modifiers of the noun phrase "a worthwhile public health measure". It's like the difference between "X condemns Y because X think it's A, and thinks it's B, and thinks it's C" compared with "X regards Y as A, which has characteristic B, and has characteristic C". This is why I've added the "consider it"s: to show, without ambiguity, that "few complications" and "no effects on sexual health" are arguments of advocates, and to replicate, as closely as I have been able at this attempt, the structure of the "opponents" part of the paragraph, whilst at the same time trying to avoid clumsy ( to my idiolect at least) phrasing such as "while advocates of circumcision regard it as a worthwhile public health measure, as having few complications and as having no effects on sexual performance.[10]". Perhaps that example is not so bad after all. How about this version:

• Opponents of non-therapeutic circumcision condemn infant circumcision as being medically unjustified, an infringement upon individual bodily rights, and a cause of sexual impairment,[9] while advocates of circumcision regard it as a worthwhile public health measure, as having a low complication rate when properly done, and as having no effect on sexual performance.[10]

You may have tried to "copy the same presentation style for the views of advocates" but I think you should have tried to replicate the grammar and semantic style. As for the scare quotes, I was simply incorporating the change suggested by Johncoz as he wrote it, so please be assured that they were only "apparent" scare quotes. By the way, I never suggested that your version endorsed any of the arguments, I implied that it was not balanced.

Finally, you have suggested that my writing gives you the impression that I, "the author" am desperately trying to distance myself as far as possible from circumcision advocacy. I don't understand what you are trying to achieve with such a suggestion, and I think it's counterproductive. I will continue to assume good faith and not respond in kind. Beejaypii (talk) 18:18, 30 April 2008 (UTC)

Beejaypii, I think that Johncoz's suggestion of 17:00, 30 April 2008 is the best so far (minus the quotes). It seems the most balanced and least awkward. Are you happy with it?

As for my comments about the impression I received, I was trying to show why the paragraph seemed poorly balanced, not to criticise you personally. I included my parenthetical remark to help make that clear. Evidently I didn't make it clear enough, and I'm sorry if you were offended. Jakew (talk) 18:28, 30 April 2008 (UTC)

I accept your explanation for the personal criticism I perceived, and I wasn't offended (I don't offend easily), it was more a combination of surprise, disappointment, and irritation.

I think that Johncoz's suggestion is getting there. However, doesn't Schoen simply claim that there's a "lack of effect of circumcision" on "sexual performance", not the more specific "no adverse effect"? Beejaypii (talk) 18:50, 30 April 2008 (UTC)

(unindenting) I'm not particularly fussed about the inclusion of "adverse". The full par from Schoen is:

Moreover, about 70 million circumcised US males currently attest to the lack of effect of circumcision on either emotional health or sexual performance, and no objective studies indicate otherwise. As a matter of fact, evidence indicates that women in Middle America have a sexual preference for circumcised men, mainly from the standpoint of aesthetics and hygiene.

The second sentence seems to imply a benefit effect. And indeed, Schoen and his co-thinkers (ie the most prominent "advocates") regularly make claims outside of the peer-reviewed context about the positive benefits of circumcision on sexual performance. Johncoz (talk) 19:11, 30 April 2008 (UTC)

I don't believe it neutral to characterize circumcision as being properly done, and similarly object to the non-neutral language used here. One could argue that "properly done" is the advocates' view, but then consider the statement circumcision opponents reject circumcision when done improperly, for example when there is no immediate medical need. Further, "properly done" is far too vague and may simply be defined as "done in such a manner as to minimize complications," making the logic circular. I suggest removing the phrase "when properly done" altogether. The quotes originally around "properly done," in fact, served the purpose of properly attributing the view to the advocates, and Jakew's objection to them now causes the statement to violate WP:NPOV.

"Sexual impairment" should be changed to "reduced sexual pleasure." Most circumcised men and their partners would deny that the men are "sexually impaired" and thus reject the criticism, when the true criticism is that, for example, these men will never know what it is like to have 7-15 more square inches of sexually sensitive skin a normal penis has.

Also, the phrase "among many other reasons" should probably be added to the statements of both sides, since the debate on circumcision consists of many other aspects besides the few listed. It is unfortunate that attempts to expand on the circumcision controversy (or indeed to present circumcision as controversial at all) have been blocked by editors here, and we are stuck with a rigid limit of half of one sentence to summarize all the positions of all circumcision opponents, while entire sections continuously extol the purported benefits of the cutting without the context a discussion of the controversy would provide. Blackworm (talk) 19:52, 30 April 2008 (UTC)

Perhaps an altogether different approach would be better balanced. Great controversy exist regarding circumcision. Proponents view it as either a religious and cultural obligation and/or health benefit while opponents challenge the medical benefits and view circumcision as barbaric genital mutilation. Garycompugeek (talk) 21:10, 30 April 2008 (UTC)

I'm not calling for a comprehensive treatment of the controversy in the lead. I'm calling for it to appear somewhere. By the way, the words "mutilation" and "barbaric" are, to my understanding, banned from this article as somehow inherently violating WP:NPOV, even when correctly attributed or quoted. Blackworm (talk) 22:01, 30 April 2008 (UTC)

Blackworm, the current proposed text of the paragraph is not supposed to be neutral but represent the main claims made by advocates and opponents as reflected by two prominent (dare I say iconic) representatives (Schoen and Milos). In that light, I think the rendering of Schoen is fine, since it cleaves very closely to the wording of the source. With Milos, you are probably correct about reducing sexual pleasure being closer to the source.

Garycompugeek, the problem is that many who oppose routine infant circumcision would nonetheless reject a charactarisation of "barbaric genital mutilation". The current strategy for this paragraph seems safer for a lead summary.

There is, however, a bigger issue. Less than 10% of males globally have been circumcised for non-religious reasons (according to WHO). This clearly makes non-therapeutic medical circumcision a distinct minority position. So we probably need to re-balance our now overly balanced formulation. Taking all this into account, I arrive at the following draft:

"Opponents of non-therapeutic circumcision claim infant circumcision is an infringement upon individual bodily rights that is medically unjustified and adversely affects penile sensitivity and sexual pleasure.[9] Advocates of circumcision claim it is a worthwhile public health measure that has no adverse effects on sexual performance and a low complication rate when properly done.[10] Globally, fewer than 10% of males have been circumcised for non-religious reasons."

Johncoz (talk) 01:57, 1 May 2008 (UTC)

Your suggestion mixes up two unrelated issues, Johncoz. It's like saying, "globally the majority of humans do not have fresh, clean water, so fresh clean water is a distinct minority position." The problem is, of course, that having fresh clean water is not itself a position at all - we cannot assume that people have actually decided to have (or not to have) clean water, and even if they have we can't know their thought processes. Similarly, we can't assume that people being circumcised or not, or having circumcised their son(s) or not, will have a position one way or the other, or indeed that they will have a position at all. Jakew (talk) 11:33, 1 May 2008 (UTC)

I agree with Jakew that needlessly complicates the statement further. Move the last sentence to the Prevalence section and I will support the rest. Garycompugeek (talk) 12:37, 1 May 2008 (UTC)

There were no assumptions. The paragraph is about medicalised non-therapeutic circumcision. It summarises the arguments for and against, and estimates its global incidence. Seemed straightforward to me. But I'm happy to move it, if that's the consensus. Johncoz (talk) 12:58, 1 May 2008 (UTC)

Ok, removing that statement and again making the number of claims equal, how about this?

• Opponents of non-therapeutic circumcision claim infant circumcision is an infringement upon individual bodily rights that is medically unjustified and adversely affects sexual pleasure.[9] Advocates of circumcision claim it is a worthwhile public health measure that has no adverse effects on sexual performance and a low complication rate when properly done.[10]

Jakew (talk) 21:19, 1 May 2008 (UTC)

Fine by me Johncoz (talk) 21:29, 1 May 2008 (UTC)

I think the phrase "has no adverse effects on sexual performance" is problematic. The source does not claim that circumcision has "no adverse effects", it claims that "about 70 million circumcised US males currently attest to the lack of effect of circumcision on either emotional health or sexual performance" (which is, incidentally, a logically unimpressive argument in my opinion - it's basically: lots of US males have been circumcised therefore it has no effect). So, the source claims a "lack of effect" but not "no adverse effects": a phrase which, though logically correct, implies that there could be non-adverse effects, i.e. neutral or positive effects, whereas the source effectively rules this out with the unqualified "lack of effect". Furthermore, Johncoz, when the source states that "evidence indicates that women in Middle America have a sexual preference for circumcised men, mainly from the standpoint of aesthetics and hygiene." this is akin to suggesting that circumcision is good because evidence indicates that some women think it is, hygienically and aesthetically (another unimpressive argument in my opinion) and makes no claims about effects on sexual performance. Beejaypii (talk) 16:32, 2 May 2008 (UTC)

We could probably cite an alternative source, in which Schoen makes his arguments more clearly. For example, in this paper, Schoen states:

• "Anecdotally, some have claimed that the foreskin is important for normal sexual activity and improves sexual sensitivity. Objective published studies over the past decade have shown no substantial difference in sexual function between circumcised and uncircumcised men.8 Indeed, circumcised men were found to have more varied sexual activity, and a study in Middle America showed that women preferred circumcised penises, mainly for reasons of improved hygiene.9"

If we cite this source instead, and replace "performance" with "function", it would seem to be a fair summary. Would you agree? Jakew (talk) 16:42, 2 May 2008 (UTC)

I almost agree. I think we would also need to add "substantial" before "adverse effects". I think it's an important nuance. What do you think? Beejaypii (talk) 16:51, 2 May 2008 (UTC)

Fine with me. Jakew (talk) 17:02, 2 May 2008 (UTC)

Actually, at second reading, I think this source is also problematic. Schoen again does not claim "no adverse effects", he claims "no substantial difference in sexual function". Is that the same thing? And "more varied sexual activity" does not tell us anything about whether the effects of circumcision are positive, negative or neutral, it simply tells us that it can result in "more varied sexual activity", and such behaviour could, for example, be interpreted as a quest for sensations lost through circumcision. Beejaypii (talk) 17:15, 2 May 2008 (UTC)

I'd hazard a guess that Schoen isn't suggesting such an interpretation, Beejaypii. Nevertheless, will "no substantial effects" (ie., without "adverse") alleviate your concern? Jakew (talk) 17:20, 2 May 2008 (UTC)

And I would hazard a guess that Schoen chose his words very carefully. Anyhow, I think "no substantial effects" is faithful enough to the source material. Are you going to make the change or shall I? Beejaypii (talk) 17:35, 2 May 2008 (UTC)

Ok. All done. Jakew (talk) 18:27, 2 May 2008 (UTC)

The words "properly done" aren't in the source, and further violate WP:NPOV unless quoted. The word "advocate" or "advocacy" is not in the source. The complication rate being "low" is not in the source. I believe this needs more work. Blackworm (talk) 18:51, 2 May 2008 (UTC)

You are correct Blackworm, these words/phrases are not in the source (well, the new source at least - they were in the original source). As for the reference to advocates (and, for that matter, opponents), perhaps we could avoid both these terms. Also, I can't find infringe in the Milos paper, but violate is there, and I think the direct quote "interferes with normal sexual functioning" is better than the more narrow interpretation "adversely affects sexual pleasure". What do you think of this:

Some oppose infant circumcision, believing that, amongst other things, it violates individual bodily rights, is medically unjustified, and "interferes with normal sexual functioning."[9] Others advocate infant circumcision, believing, for example, that it has multiple medical benefits, no substantial effects on sexual function, and a low complication rate when properly done.[10]

We will need to restore the original pro source, and retain the current one, for this version - both are referenced. Beejaypii (talk) 21:32, 2 May 2008 (UTC)

I like your version better, though it doesn't address "properly done." It also seems to suffer from the same kind of imbalance Jake refers to above (author distancing themselves from one position, use of scare quotes). I don't see any reason for the quotes there. Unlike "properly done," there is a qualifier ("believing that"), thus it is clear that it is a belief. We should also present Schoen's view that another reason to circumcise males is because women prefer it. I suggest:

Some oppose infant circumcision, believing that it violates human rights, is medically unjustified, and interferes with normal sexual functioning, amongst other negative consequences. Others advocate infant circumcision, believing that it has multiple medical benefits that outweigh any risks or harms, that it has no substantial effect on sexual function, that women prefer it, and that it has a low complication rate when performed by an experienced operator.[10] Thoughts? Blackworm (talk) 17:29, 5 May 2008 (UTC)

"Excluding majority Muslim countries ..." and NOR

The sentence "Excluding majority Muslim countries and Israel, prevalence in Latin America[115] and Eurasia[81] is generally less than 20%[116] with the notable exceptions of the Philippines, which has a prevalence greater than 80%,[117] and South Korea, which is approaching that level" has been under discussion, most recently at NOR/N. It seems unlikely a consensus can be formed to support the current construction, although there is no dispute over its accuracy.

Consequently, I have drafted an alternative that circumvents the perceived problem: "Prevalence is near universal in the Middle East and Central Asia, but is generally low across the rest of Eurasia, being primarily a function of Muslim adherence, with the notable exceptions of the Philippines and South Korea. Prevalence in Latin America is universally low." Supported by two references: WHO for the first sentence and Drain for the second. Johncoz (talk) 20:53, 1 May 2008 (UTC)

I think this is a tremendous improvement, Johncoz, but a small problem remains: the WHO document, as far as I can tell, doesn't actually mention Eurasia. The document does support the statement when "Eurasia" is replaced with "Asia", but it doesn't make any general comments about the prevalence in Europe (I don't know whether this is due to lack of solid data, or whether it is a simple oversight). I would propose instead something closer to the breakdown in the WHO source, such as "Prevalence is near universal in the Middle East and Central Asia, but is generally low across the rest of Asia. In Europe, circumcision is generally associated with religion or immigration. Prevalence in Latin America is universally low." Jakew (talk) 21:16, 1 May 2008 (UTC)

The problem, Jake, is we don't actually say what the prevalence is in Europe in your formulation. I would say the WHO map supports the statement "generally low across the rest of Eurasia", and constitutes as valid a verifiable source - without OR - as a prose statement. Johncoz (talk) 22:31, 1 May 2008 (UTC)

Johncoz, the source doesn't describe the prevalence either, and interpretation of maps is best left to sources. That's why we need to either a) find another source, or b) state what the source actually says. Jakew (talk) 22:50, 1 May 2008 (UTC)

Here's a possibility from Drain et al.: "Only 4 of 18 (22%) developing countries in Europe and Central Asia had a high male circumcision prevalence". We could express that as something like "In Europe, few developing countries have a high male circumcision rate." Jakew (talk) 23:08, 1 May 2008 (UTC)

Jake, we do not need to interpret the map, we are reading it. Of the 38 countries that can be identified, 32 are yellow ie prevalence of <20%, while six are orange ie prevalence 20-80%. None is red (>80%). This in not an interpretation, it is a fact taken directly from the map and requires no other ability than to be able to count (Just as reading a sentence presupposes the ability to read). It is not even necessary to know the names of the countries or other extraneous data. (At an even simpler level, anyone who simply looks at the map can see that excluding the Mid-East and Central Asia, Eurasia is overwhelming yellow).

And talking about "developing countries in Europe" (whatever they are) still does not say anything at all about European prevalence as such, which we all agree is "generally low", as shown on the map. Johncoz (talk) 23:29, 1 May 2008 (UTC)

Johncoz, we've been over this before, both on this page and at WP:NOR/N, and while it would be misleading to say that a consensus emerged, it is clear that there is significant disagreement with the notion that one can make anything more than the simplest statement about a map.

If you want to say something about European prevalence as a whole, then find a source that makes such a statement. If not, let's use what is available. Jakew (talk) 23:35, 1 May 2008 (UTC)

Jake, what we have discussed over the past week is the legitimacy of reconciling the map with other data (specifically the proportion of various populations who are Muslim) to support the original construction. I have conceded that correlating these two sources should be abandonded, since most see it as OR, specifically a violation of WP:SYN. What is proposed here is something much more straightforward, namely reading our source (the map) and making the "simplest" of statements. I honestly do not understand the objection, and which content policy it is based on. Johncoz (talk) 23:57, 1 May 2008 (UTC)

I think it's OK to count the number of countries on a map. I think that's within what Blueboar meant by ". If the map is published by the WHO, then it is not OR for us to bluntly state what is shown on the map." at WP:NORN. ☺ Coppertwig (talk) 02:30, 2 May 2008 (UTC)

Coppertwig, as I read that discussion, I asked if others thought that my impression ("if China is listed as <20%, we can state that, but we shouldn't interpret or try to generalise from the data as a whole") was reasonable, and Blueboar agreed that we could make blunt/straightforward statements, but "Avoid any analysis...". (We also discussed the synthesis problem, which dominated the discussion.) I may be mistaken, but that is my understanding.

The apparent problem here is that we disagree on what constitutes "interpreting" or "analysing" a map. There's some confusion caused by WP:NOR's use of the terms "primary" and "secondary" source, but what is clear, I think, is that we should cite a source for interpretation or analysis of data (ie., it should be the source's interpretation or analysis, not ours).

I think it's safe to say that we all agree that a statement about a single country is a straightforward statement. However, I think that problems occur when one starts counting countries. In addition to the possibility of errors, discussed previously, one problem is deciding which countries to count. Do we count those in a continent (and if so, what definition is used, and how well are the boundaries defined)? Do we count, say, those intersecting the Greenwich meridian? As I see it, while there's nothing inherently wrong with making this decision, it is fundamentally interpretive.

Also - and it helps to imagine the map as a table here - if counting rows that meet certain criteria isn't analysis, then is calculating a mean analysis? How about a confidence interval for that mean? Is it acceptable to calculate summary statistics for two continents and use, say, a t test to compare the two? Although there seems to be broad agreement about making statements about a single row, it seems very hard to decide where interpretation or analysis begins once one starts thinking about groups of rows, and I think it makes sense to err on the side of caution.

Finally, it is incredibly difficult to source a general statement about the overall prevalence in Europe, and when a statement is so hard to source I think it makes sense to ask why that might be, and whether we should be cautious. I can only speculate, but one reason may be that there is insufficient data to be confident (for example, consider "Our findings ... support the notion that the prevalence is low in Europe" (emph added) PMID 17881413). WHO indicate that the map represents estimates ("National prevalence of male circumcision was estimated using DHS data where available. For other countries, estimates were made from other published sources"), after all. Should we be make a more confident statement than any of our sources? Jakew (talk) 11:58, 2 May 2008 (UTC)

None of which stopped us actually listing the 32 identifiable low prevalence European countries, (and 6 medium prevalence) in the Prevalence of circumcision article, based solely on the WHO map. Johncoz (talk) 13:27, 2 May 2008 (UTC)

These are what I would call blunt or straightforward statements about the map. It's like saying, "Shakespeare wrote 'Give thy thoughts no tongue'": there's a 1:1 relationship to a "statement" in the source (sorry - I couldn't resist this example in the context of NOR discussion). But if we say "In Shakespeare's plays, X sentences begin with the word 'give'", it's no longer a straightforward statement, and we're now asking the reader to perform some research in order to verify the statement (and again, the research is no more than counting). If you think of the map as a table, for each country listed in prevalence of circumcision we're basically quoting a single row of that table. This doesn't involve making a decision about which groups of rows to select and performing any computations on those groups. Jakew (talk) 13:48, 2 May 2008 (UTC)

I agree with Johncoz and Coppertwig and don't think this is the big deal extrapolating from it. The fact is circumcision rates are low in Europe and the map supports that statement. Garycompugeek (talk) 14:16, 2 May 2008 (UTC)

The standard for Wikipedia is verifiability, not truth, and we're not concerned with determining facts for ourselves (and indeed, due to our editing model, we can't). Instead, we are concerned with finding reliable sources about a subject, and summarising what they have concluded about a subject.

Here are some verifiable statements:

• WHO states that in Europe, circumcision is generally associated with religion or immigration.
• Drain et al. state that in Europe, few developing countries have a high male circumcision rate.
• Klavs et al. report data supportive of the notion that the prevalence is low in Europe.

All of these are directly verifiable. I'm also attributing each statement to make it clear who is performing each analysis. Compare with the following, which correctly attributes each and every interpretation:

• WHO state that prevalence is near universal in the Middle East and Central Asia. WHO also present a map showing circumcision prevalence by country, and we, Johncoz, Coppertwig and Garycompugeek, have agreed that this map shows that the prevalence is generally low across the rest of Eurasia.

See the problem? Jakew (talk) 16:03, 2 May 2008 (UTC)

Actually, Jake, I don't. Here is WHO map. Apart from a small orange splot on the Balkans, Europe is overwhelmingly entirely yellow, ie low prevalence. All but the totally colour blind can see that at a glance. To say so is to make a blunt factual statement about what the map shows and does not involve any interpretation or analysis. Johncoz (talk) 20:07, 2 May 2008 (UTC)

Johncoz, if you read the above statement you'll see that it already includes your name. I know that you believe it to be true, but that doesn't stop it from being an analysis. Even if I were to add my own name, the problem would still be the same: we need to be able to cite someone else's interpretation or analysis, not ours. Jakew (talk) 21:06, 2 May 2008 (UTC)

Jakew please don't semanticlly bandy words. Your analogy is poor. Our job as editors is to interpret the data and list sources to back up those interpretations. If all we ever did we was quote scientific data much of our readers would be unqualified to understand and/or interpret it. You throw analysis and synthesis as roadblocks because this does not support your POV. This discussion is getting unnecessarily tedious for you seem to be alone in your position. Garycompugeek (talk) 21:25, 2 May 2008 (UTC)

You're incorrect, Gary. Our job is not to interpret data. It is to report on published interpretations of data, as is clearly stated in WP:NOR: "All interpretive claims, analyses, or synthetic claims about primary sources must be referenced to a secondary source, rather than original analysis of the primary-source material by Wikipedia editors." There is a significant difference there, and it is very important. Jakew (talk) 21:34, 2 May 2008 (UTC)

Jake, while I admire your tenacity, the fact remains circumcision prevalence in Europe, as shown on the map, is "generally low". An educated reader (without specialist knowledge) would be able to verify this simply by looking at the map. This makes it a bare fact, a blunt statement, an accurate description about what the map shows. And I really cannot fathom why you would want to challenge this, even after rereading your arguments. Look at the map again - Europe is overwhelmingly in yellow! Johncoz (talk) 22:35, 2 May 2008 (UTC)

Of course, I don't speak for Blueboar. That's my opinion/interpretation.

Jake, let me draw your attention to the following segment of WP:SYN: "Summarizing source material without changing its meaning is not synthesis; it is good editing." What blunt statements do you think we could make about the European part of that map, Jake? How does it serve the reader to avoid saying that Europe is generally yellow on that map? I think we can say that most European countries have less than 20% prevalence. Policies need to be applied with balance and common sense. ☺ Coppertwig (talk) 22:54, 2 May 2008 (UTC)

Coppertwig, I'm quite aware of that part of WP:SYN, and as you may note, I have proposed several secondary sources, and I have summarised each of them. The difficulty with non-prose sources, such as tables or maps, is that they lend themselves poorly to summarising, or - more accurately - it is very difficult to summarise data without analysing it. That's why secondary sources are so important.

I would say that something like "WHO estimate that prevalence is less than 20% in France" is a blunt statement about the map.

Here's how I see the problem. A number of editors insist on the inclusion of a specific claim about the prevalence of circumcision in Europe. The claim is based upon the editors' own analysis of source material, and is not the interpretation of a reliable source. Extensive searches have been unsuccessful in identifying a source that would support the exact claim. Although verifiable secondary sources have been proposed that have commented on the prevalence of circumcision in Europe, these have been rejected on the apparent basis that they don't state what the editors wish to state.

Now I don't feel comfortable about saying "well, it's obviously right, so presumably it hasn't occurred to anyone". Sure, that's possible, but there may be a very good reason why nobody has made such a claim. For example, maybe there's too little data. A possibility (and this is just a possibility) is that parts of the WHO map are based on estimates that the authors considered to be of very poor quality, and as such they did not feel sufficiently confident in their data to make a general statement about Europe in the text. Maybe they didn't intend for their map to be used in such a way. We don't know. We can't know. Wikipedia could give the wrong information, and lose a lot of credibility, if we make a statement that isn't fully supported by the facts. Our core policies are designed to protect the encyclopaedia from that, and when it proves difficult to make a statement adhere to these policies, that's usually (albeit not always) a sign that we need to stop and reconsider. Maybe the statement doesn't belong in a tertiary source. Maybe we ought to modify it.

So we serve the reader by being cautious and precise, and making sure that all statements are verifiable. We also avoid the risk of a wrong statement, or presenting data as being more certain than it is.

It's not as though there aren't alternatives here. There are. And I'm afraid that I don't understand how the reader suffers by us saying (for example) "Klavs et al. report data supportive of the notion that the prevalence is low in Europe" rather than "the prevalence is low in Europe". The only apparent "problem" is that we're not making a more definite statement, but nobody has yet explained why we should. Jakew (talk) 23:56, 2 May 2008 (UTC)

Jake, some comments

• It is completely out of scope to speculate on why reliable sources present the data the way they do. That is a real Pandora's box. The map is a reliable source, full stop.
• Wikipedia cannot "lose credibility" if it accurately summarises the data in a cited reliable source, in this case the map.
• The low prevalence of circumcision in Europe is a verifiable conclusion taken directly from the source - no reasonable person can deny this. Johncoz (talk) 00:33, 3 May 2008 (UTC)

No, Jake has a good point. It's perfectly valid for Wikipedians to discuss (on the talk page) reasons why a source may or may not be reliable. It seems reasonable to suppose that the reliablity of the data may vary from one part of the map to another. How about Jake's proposed sentence about Klavs et al.?. (Where is the full reference to Klavs et al?) If we can say that, we don't need to reference the map. However, the word "notion" has dismissive connotations. How about "Klavs et al. report data suggesting that the prevalence is low in Europe" or "Klavs et al. report data consistent with a low prevalence in Europe"? (When we get the reference and see what they actually say we might find better words.) ☺ Coppertwig (talk) 00:52, 3 May 2008 (UTC)

My understanding is the WP policy determines the category of "reliable source" by publication status, not content (which would require an independendent evaluation of its "truth"). If sources conflict, then we balance our coverage proportionately. In any case, the WHO map is a reliable source by any definition, and as regards Europe there is no source that contradicts our summary of it (though some sources contradict data for particular countries, eg Slovenia). Johncoz (talk) 01:20, 3 May 2008 (UTC)

Johncoz, it shouldn't be terribly surprising that no sources contradict the claim, because no sources make the claim either. We'd have the same problem if an editor wished to cite, say, the NHANES dataset in support of a claim that circumcision protected against heart disease (if the claim hasn't been made in the literature, there's no way of finding alternative views). What's being proposed here is that we ignore WP:NOR's requirement for a secondary source for interpretive claims. We can't consider such a proposal unless we're willing to think about the consequences of doing so, and to do that we have to consider issues such as whether the map is reliable enough to support our claim. Jakew (talk) 11:27, 3 May 2008 (UTC)

Coppertwig, the abstract for Klavs et al. can be found at PMID 17881413. To quote: "Our findings ... support the notion that the prevalence is low in Europe". I've also listed two other possible sources in my post dated 16:03, 2 May 2008. Jakew (talk) 11:27, 3 May 2008 (UTC)

Coppertwig why does it "seems reasonable to suppose that the reliability of the data may vary from one part of the map to another." to quote you? As Johncoz states above that philosophy leads to pandora's realm. The WHO map source is superior to Klavs reference. Garycompugeek (talk) 03:32, 3 May 2008 (UTC)

Wait a second: the Klavs study is only about Slovenia, so it isn't much use -- unless perhaps in its introduction it summarizes other studies? I assume the map may be based on various sources from various countries; if there were one Europe-wide or worldwide survey we probably would have heard of it. Various sources will probably vary in quality. However, if we're making a general statement that prevalence is low in most of Europe, the precise level of reliability for each country is not that important. OK, I'm back to my earlier position: we should be able to make a "blunt" statement describing the map, such as "the WHO map shows low (<20%) prevalence in most of Europe". ☺ Coppertwig (talk) 13:19, 3 May 2008 (UTC)

Coppertwig, I'm afraid that I don't have the full text of the Klavs study - I just found that quote when using Google Scholar to find some possible sources. But the wording ("supports the notion") suggests that the prevalence is thought to be low in Europe but that there is no way to be sure. The levels shown on the map are estimates (as the legend states), and it may be that the estimates for Europe are poorer than those for elsewhere (which may be why WHO comment in the text on - I think - every continent but Europe). In fact, there's no rational reason why we should believe that the map is "better" than the Klavs study, since it is possible that both are just representing "best guesses" about Europe in different ways. If the map were a prose source, we could probably judge the level of confidence from the wording in the text, and retain the nuances of language in our summary. Unfortunately, it isn't a prose source.

Bearing this in mind, and temporarily setting WP:NOR aside, let's explore what we could say about the WHO map:

• The proposal being discussed is: "Prevalence is ... generally low across the rest of Eurasia". This is problematic because it states more than the map does (it doesn't capture the fact that these are estimates).
• Now consider: "Prevalence is ... estimated to be generally low across the rest of Eurasia". This is problematic because the reader needs to know who made the estimate.
• Now consider: "WHO estimates that prevalence is ... generally low across the rest of Eurasia". This is problematic because the implication is that WHO have stated as much.
• Now consider: "WHO presents a map of estimated prevalence levels, in which the level is shown to be generally low across the rest of Eurasia". This is getting better, but the sourcing problems are now beginning to become apparent.
• Finally, consider: "WHO presents a map of estimated prevalence levels, from which the level is judged by Wikipedia editors to be generally low across the rest of Eurasia". In this statement, it is absolutely clear: a) what the source is, b) what statements about confidence are made in the source, c) what the source says and doesn't say, and d) who is interpreting the map. Now, because of that clarity and transparency, we've found a statement that is unsuitable for inclusion in the article. And that's indicative of a problem.

So again, what's wrong with any of the following statements? "WHO states that in Europe, circumcision is generally associated with religion or immigration. Drain et al. state that in Europe, few developing countries have a high male circumcision rate. Klavs et al. report data supportive of the notion that the prevalence is low in Europe." Jakew (talk) 14:27, 3 May 2008 (UTC)

What's wrong with this statement: "WHO presents a map of estimated prevalence levels, in which the level is shown to be generally low (< 20%) across the rest of Eurasia"? (assuming we've already mentioned the parts where the WHO map is orange or red). That's not a judgement by Wikipedians: it's a clear yellow colour on the map that anyone can see.

The only problem with the statements you suggest is that (a) Klavs may be looking at Slovenia only and extrapolating to Europe, and (b) without the Klavs statement, we're not providing sufficient information about Europe. ☺ Coppertwig (talk) 15:55, 3 May 2008 (UTC)

I would think that, if we were to ignore NOR, the statement you quote is probably the least bad of the available options.

As for your comments about Klavs, I have some questions for you. First, how do we know that WHO aren't extrapolating from limited data? Second, is extrapolating from limited data a bad thing (that is, when it happens, is it better for the reader to know or not)? Third, if the only interpretive source that provides "sufficient" information has to extrapolate on the basis of one country, then might that say something about the available data, and more to the point, if the reader was provided with statements with such limitations, might (s)he reasonably make a conclusion for him/herself about both the prevalence in Europe and the amount and reliability of data available? Fourth, should "sufficient information" be judged by the availability of reliable secondary sources, or should it be judged by what we wish to say? Jakew (talk) 17:25, 3 May 2008 (UTC)

Ah. Maybe the WHO map is based on Klavs (for the European part). Now you've got me leaning towards your Klavs statement again. (I don't agree with you that we would be violating NOR in the version I suggested.) ☺ Coppertwig (talk) 20:28, 3 May 2008 (UTC)

I'd guess that both are based on a common source, possibly Drain (WHO's ref 53). But I'm only guessing, of course. Jakew (talk) 20:35, 3 May 2008 (UTC)

I have no problem with Coppertwig's formulation: "WHO presents a map of estimated prevalence levels, in which the level is generally low (< 20%) across the rest of Eurasia, ..." and continuing "and states that "there is generally little non-religious circumcision in Asia, with the exceptions of the Republic of Korea and the Philippines." Johncoz (talk) 20:44, 3 May 2008 (UTC)

BTW, their prevalence data for most of Europe cannot be based either on Klavs (published a year later, this Feb) or Drain, which does not deal with most of Europe. It is clearly projected from DHS estimates of Muslim pop., supplemented by some other unknown sources Johncoz (talk) 20:56, 3 May 2008 (UTC)

... which is why I said "other unknown sources". Whatever their methodology, our job is to accurately represent their conclusions Johncoz (talk) 21:35, 3 May 2008 (UTC)

Not quite, no. Our job is to accurately represent the conclusions of reliable sources. However, that doesn't mean that we have to represent every single reliable source (which is sometimes impossible). In particular, when a source itself summarises some information, but not all, then there is no obligation that says "we must try to extract this information in any way we can from this particular source". It may be better to summarise a different source instead. Jakew (talk) 21:56, 3 May 2008 (UTC)

Drain do report some findings re Europe, Johncoz, which they summarise as: "Only 4 of 18 (22%) developing countries in Europe and Central Asia had a high male circumcision prevalence". By the way, you might find it interesting to take a look at the number of DHS surveys that have been performed in European countries. Jakew (talk) 21:03, 3 May 2008 (UTC) (edited 21:20, 3 May 2008 (UTC))

This is not really relevant to the wording (could we agree on that, please), but for the record I said for "most of Europe". As it turns out, their text statement misrepresents their own data. Here is their table, in which you can see that no European countries have high prevalence. The countries they deal with are Moldova, Russia, Ukraine, Georgia (all low prevalence), Bosia, Macedonia, Albania and (confusingly) "Yugoslavia". It is the last that clearly misled the WHO authors into misclassifying Slovenia, for instance. Johncoz (talk) 21:16, 3 May 2008 (UTC)

I have revised the draft with its citations here. The text says: Circumcision is near universal in the Middle East and Central Asia. WHO presents a map of estimated prevalence in which the level is generally low (< 20%) across the rest of Eurasia, and states that "there is generally little non-religious circumcision in Asia, with the exceptions of the Republic of Korea and the Philippines".[1] Prevalence in Latin America is universally low.[2] Is this acceptable? Johncoz (talk) 21:51, 3 May 2008 (UTC)

I'm afraid that I'm not comfortable with citing the map, for reasons discussed at length. Once we agree on the sourcing, I suspect that the wording will be relatively easy to agree. Jakew (talk) 21:56, 3 May 2008 (UTC)

But Jake, we devote an entire subarticle to prevalence in which we happily cite the map literally hundreds of times without caveat. The WHO document is a "reliable source", by any reading of WP policy, and that includes the map. There is no ground that I can see for rejecting the current formulation. Johncoz (talk) 22:04, 3 May 2008 (UTC)

Johncoz, I have been thinking about the prevalence article, and I think that we do need to make some changes. As a minimum, I think we need to make it clearer that the WHO estimates are estimates. I'm not entirely sure of the best approach yet, and if you want to open a discussion at that article's talk page, I'll look forward to discussing it with you.

On the subject of this article, even though you disagree that making general statements about the map violates NOR, you must surely agree that WP:NOR#Primary, secondary, and tertiary sources prefers an interpretive source. Besides, this is a logical approach that naturally follows from the principle of NOR: since this article must compress information into a comparatively small space, it makes sense to summarise sources that have already compressed information, rather than compressing a larger amount of information ourselves. So if we had two prose sources, one of which said "Prevalence in country X is N1. Prevalence in country Y is N2...", and the other gave an overview, we'd prefer the latter. Jakew (talk) 22:43, 3 May 2008 (UTC)

On the prevalence article, I did foreshadow exactly that ("For a general article on circumcision it should provide a short snapshot of the findings in the main prevalence article (which also needs some work).") at 20:03, 24 April, and would be more than happy to collaborate. On sources, of course I would prefer a succinct summary from a reliable and unchallenged secondary source. However, we have what we have, partly because the low prevalence in Europe is an accepted fact, I suspect. So, we do the best we can with the reliable source we have, clearly flagging it as an estimate. Might I suggest that my current formulation is more agreeable to your position than the existing text, so we make the substitution. Then, if you wish to pursue an alternative formulation after we do over the prevalence article, we will revist the matter. Johncoz (talk) 23:06, 3 May 2008 (UTC)

Johncoz, this isn't a choice between your proposal or the existing text. There are other options. Will you please examine the last paragraph of my post dated 14:27, 3 May 2008? Jakew (talk) 23:13, 3 May 2008 (UTC)

I have read it, Jake, more than once. But its muddiness only makes sense if one wanted to avoid all mention of the WHO map (which apparently you do). The map however is our best source for overall estimates (which are what is required for this "snapshot") and its use in the way suggested does not violate any WP guidelines. Like it or not, it qualifies as a reliable source, and it is not contradicted by any other source at the level of generality we are citing it. Johncoz (talk) 23:32, 3 May 2008 (UTC)

You will never be able to satisfy Jakew on this Johncoz. I believe you still have consensus regardless of one editor. Garycompugeek (talk) 03:50, 4 May 2008 (UTC)

Muddiness is a good word, Johncoz. The feeling that I get from the prose sources is that this is a muddy issue, and I think that it's a mistake to try to "protect" the reader from this through over-clarification. I also, as you know, have some serious concerns about this usage of the map, though I recognise that you don't share this viewpoint.

There is, of course, another possibility here, which is worth discussing. It's not ideal, but it may be an acceptable compromise. It includes a reference to the map and a quoted opinion from which the reader can get a feel for the level of certainty.

• Prevalence is near universal in the Middle East and Central Asia.[WHO] WHO states that "there is generally little non-religious circumcision in Asia, with the exceptions of the Republic of Korea and the Philippines".[WHO] In Latin America, prevalence is universally low.[Drain] WHO presents a map of estimated prevalence in which the level is generally low (< 20%) across Europe,[WHO] and Klavs et al. report findings that "support the notion that the prevalence is low in Europe".[Klavs]

Thoughts? Jakew (talk) 11:38, 4 May 2008 (UTC)

Great, I hope we can get consensus on that. A minor point, not enough to break consensus over: Because of the geographical proximity of Asia and Europe, I would move Latin America out from between them, probably putting it at the end. ☺ Coppertwig (talk) 13:18, 4 May 2008 (UTC)

Surely excluding Muslim-majority (or even -minority) countries surely makes statements about Asia meaningless. For that matter, identifying incidence as proportions of national populations is also rather meaningless given the vast disparities in the latter. There are, after all, some 160 million Muslims in Pakistan, 154 million in India, 127 million in Bangladesh, 15 million in Malaysia and 204 million in Indonesia. Masalai (talk) 05:54, 7 May 2008 (UTC)

Wording about Jewish law.

This is only a small point, but I thought that it would be better to bring it to the talk page before making any change that may have religious implications that I may be unaware of. One sentence about Jewish law reads:

Under Jewish law circumcision is a mitzva aseh ("positive commandment" to perform an act) and is obligatory for Jewish males.

This strikes me as unnecessarily ponderous. The same thing could be more simply expressed as:

Under Jewish law circumcision is a commandment (mitzva aseh) and is obligatory for Jewish males.

'Positive commandment" commandment to perform an act" is implied in the word 'commandment'. Michael Glass (talk) 11:26, 4 May 2008 (UTC)

Sounds good to me. It may still be a bit redundant: don't "commandment" and "obligatory" mean the same thing? ☺ Coppertwig (talk) 13:13, 4 May 2008 (UTC)

For some clarification, mitzvos come in two forms, requirements to perform an action (positive commandments/mitvos aseh) and injunctions against various actions or states of being (negative commandments/mitzvos lo sa'aseh). The translation of mitzvah as commandment is pretty much accepted, so the positive qualifier, to me, seems to be necessary to be precise. Perhaps a more streamlined sentence would be

“Under Jewish law circumcision is a mitzva aseh (positive commandment) and is obligatory for Jewish males.”

Would that be acceptable? -- Avi (talk) 14:22, 4 May 2008 (UTC)

Is there a source for this statement? Also, it doesn't seem that the view that it is obligatory for Jewish males is universal. We trust that the enduring Jewish values of ethics and education will lead more Jews to the realization that circumcision does not serve the best interests of the child or the community of Jews. [35], Judaism is divided on the matter of converts. Reform Judaism does not require it, Orthodox and Conservative movements do.[36] Perhaps a slight rewording would address this? Blackworm (talk) 17:23, 4 May 2008 (UTC)

I was talking from the Orthodox perspective. -- Avi (talk) 23:44, 4 May 2008 (UTC)

Source would be Genesis 17:12 (cf Leviticus 12:3). -- Avi (talk) 23:53, 4 May 2008 (UTC)

I don't think we should cite the Bible directly, at least not without a secondary source confirming the interpretation.

I still don't see any difference between "positive commandment" and "obligatory": it still sounds repetitive.

I did some web searches and found these [37] [38]

Based on what Avi and Blackworm said, how about "Under Orthodox Jewish law, circumcision is a mitzva aseh (positive commandment) and is obligatory for Jewish males." ? ☺ Coppertwig (talk) 03:14, 5 May 2008 (UTC)

A better source for the Orthodox law would be Shulchan Aruch, Yoreh Deah, 260:1. -- Avi (talk) 03:42, 5 May 2008 (UTC)

Thanks, Avi. I was hoping you could provide that sort of information. Here it is at Wikisource: wikisource:Shulchan Aruch/Yoreh Deah/260, "It is a positive commandment (mitzvah) for the father to circumcise is son. And this mitzvah is greater than all the other positive mitzvahs".☺ Coppertwig (talk) 12:08, 5 May 2008 (UTC)

From a cursory reading of Shulchan Aruch, it doesn't seem this source is universally accepted as "Orthodox Jewish law" (but it's close). The source makes no mention of Orthodox Jewish law, so we'd need a secondary source recognizing Shulchan Aruch as law, and then we can attribute the view to that source. But all this misses a point; the goal of the sentence in the lead should be to show circumcision's role in Judaism, not just Orthodox Judaism. (I'm not sure why Avi would wish to present the Orthodox perspective as representative of all Jews.) How about: In the Hebrew Bible, male circumcision is a commandment from God. That, at least, is immediately verifiable. We could perhaps follow it with a sentence on prevalence of circumcision among Jews (I believe one of the WHO sources estimated it at 98%).

In browsing the source, I also found this interesting item: We don't circumcise the son of a man without his knowledge but if the father refuses to circumcise his son the bet din [court] circumcises him against the fathers wishes.[39] This could possibly be summarized later in the text as, Shulchan Aruch, recognized by an overwhelming majority of Orthodox Jews as law, requires a father to circumcise his son, and if the father refuses, calls on the rabbinical court to circumcise against the father's wishes. It provides a nice contrasting view to that of medical organizations and many governments, serving WP:NPOV well. Blackworm (talk) 16:56, 5 May 2008 (UTC)

It should be noted, however, that since the destruction of the temple some 1930 years ago, I believe that there really has not been a rabbinic court authorized to be able to perform the circumcision, for technical reasons relating to being in the diaspora etc. And, I admit, I am not 100% certain that it has never been done; two millenia is a LONG time. As for the Shulkhan Arukh being one of the key links in the chain for Orthodox transmission over these millenia, I believe that is appropriately handled here Shulchan Aruch, but if necessary, we can get a source. I would contest, however that the "forced circumcision" not be placed in, although I do need to check the Shach and the Taz (primary commentators on the Shulkhan Arukh) there and see what they say. Thanks. -- Avi (talk) 18:40, 5 May 2008 (UTC)

If this law (and thus, Shulchan Aruch) was subsequently rejected by a substantial portion of Orthodox Jews (or the leaders?) then that merits mention too. Could you expand on your reasoning behind wanting to not present the law that states the rabbinate court must overrule the father's wishes and circumcise? Again, it seems a notable counterpoint to the view held by medical organizations and many governments. I don't see why it should be considered a "forced circumcision," as I see it as simply the common, everyday surrogate consent (a widely accepted concept) being assigned to the court, rather than to the parents. Blackworm (talk) 01:54, 6 May 2008 (UTC)

As I understand Avi's point, Blackworm, this "notable counterpoint" has not been invoked for some 2,000 years, for the very practical reason that said rabbinic court has not had the rather important property of existence. Hence, as "notable counterpoints" go, this seems fairly low on the list. And to propose including it alongside "active" (if that's the correct term) Jewish law seems to rather miss the point. Jakew (talk) 11:37, 6 May 2008 (UTC)

(<-)The Shulchan Aruch is still the baseline for almost all Orthodox tradition, Blackworm, but there exists the difference between the theoretical and the practical. Theoretically, a non-circumcised Jew may not take part in the Paschal lamb. However, as there has been no Paschal lamb for 1930+ years, it is practically a non-issue. Similarly, there are theoretical powers given to authorized rabbinic courts; however, I do not know of any incidents of forced circumcisions against the parents' wills, as I do not believe any rabbinic court in the diaspora has the legal authority to perform such action. However, under a theocratic government in the land of Israel (which last occurred 1930+ years ago) the court would be authorized to impose the circimcision, the same way it is authorized to perform capital punishment on idolators and eminent domain on people who do not pay their debts. So, while it is a legal truth, its presence in this article would be WP:UNDUE in my opinion since it has been a theoretical point for many centuries. -- Avi (talk) 13:48, 6 May 2008 (UTC)

Jake, as now I understand it, rabbinic courts still exist, but they do not currently have the authority to enforce this particular law on anyone (similar to the laws of a government in exile). Avi, you've convinced me that its mention in this article seems undue. It would be much better suited to circumcision and law, or perhaps history of male circumcision if the former has no treatment of the legal history of circumcision. Perhaps we should return to focusing on a good, sourced, lead paragraph statement (I probably shouldn't have introduced this tangent here). Blackworm (talk) 20:19, 6 May 2008 (UTC)

Circumcision Myths

I have noticed in reading History of male circumcision under the section "Male circumcision to prevent masturbation" many childhood myths. Aside from religious mandates it seems circumcision was as the forefront of preventing masturbation (This being what I was taught as a child). It was beleived the foreskin and clitoris provided pleasure during masturbation. Considering this is the english speaking wikipedia and that circumcision being one of the major drives behind in the US and other places to "control 'masturbatory insanity'" is it fair to regulate it to one section in an stub article? Garycompugeek (talk) 22:47, 5 May 2008 (UTC)

Prevention of masturbation was one of many reasons proposed for circumcision in the late 19th and early 20th centuries, but it doesn't seem to warrant major coverage. To give you an idea of its significance as assessed by one historian, in David L Gollaher's 253-page book, "Circumcision: A history of the world's most controversial surgery", the index lists two pages for "masturbation" (there is also some additional treatment under insanity). Jakew (talk) 23:11, 5 May 2008 (UTC) (edited 23:17, 5 May 2008 (UTC))

I disagree. It's frequently cited in sources. All it would take is a short list of reasons given, say from this source: In a recent historical survey, Dunsmuir and Gordon cite prevention or cure of impotence, phimosis, sterility, priapism, masturbation, venereal disease, epilepsy, bed-wetting, night terrors, "precocious sexual unrest" and homosexuality as among the contradictory benefits urged by Victorian and Edwardian physicians in Britain and the USA, without offering any firm suggestions of their own as to the relative weight of these factors. I suggest a list format by date, allowing us to add "cervical cancer, penile cancer, HIV, and other STDs" under the late 20th century heading. Blackworm (talk) 01:45, 6 May 2008 (UTC)

This is already covered in the history of male circumcision article. It would seem to be unnecessary to import it here. In addition, a list such as you suggest is blatantly an attempt to discredit medical analysis of circumcision by comparing it to obsolete fears about masturbation. The way, the truth, and the light (talk) 01:51, 6 May 2008 (UTC)

The reasons listed *are* the medical analysis of circumcision of the time, so I don't see how its neutral presentation is necessarily an attempt to discredit it. Present it, and let the reader decide whether it's discredited. There is substantial overlap between the analysis then and now, too. My seeking to present the entire analysis without focusing on masturbation was an attempt to be neutral, not the opposite as you accuse. Blackworm (talk) 02:02, 6 May 2008 (UTC)

So, in your view, does the current content of this article focus too much on masturbation? To quote:

• In the view of many practitioners at the time, circumcision was a method of treating and preventing masturbation.[109] It was also said to protect against syphilis,[110] phimosis, paraphimosis, balanitis, and "excessive venery" (which was believed to produce paralysis).[109] — Circumcision#Medical circumcision in the 19th century and early 20th century

Jakew (talk) 11:15, 6 May 2008 (UTC)

How could one sentence focus to much on masturbation. This issue is out of balance. As I have stated above this was a much weightier issue then you apparently want to give credence too. The way, the truth, and the light objects about any truth that does not paint circumcision in a beneficit light. True medical benefits of circumcision concerning transmission have only recently been acknowledged. The truth is we have followed blind ignorance and myth for much of circumcisions history. I propose a section of 'Circumcision Myths' and more weight given circumcision being done to prevent masturbation. Garycompugeek (talk) 12:44, 6 May 2008 (UTC)

A very poor idea, for several reasons. First, a section entitled "circumcision myths" is almost sure to violate WP:NPOV (and possibly WP:NOR), since it represents either a) the viewpoint of Wikipedia editors that statement X is a myth about circumcision, or b) the viewpoint of a reliable source that statement X is a myth (which is inherently problematic, because it excludes other reliable sources arguing that statement X has merit). Second, any such material is likely to be already included, under a less POV heading, and is given appropriate treatment. For example, the historical idea of circumcision to prevent masturbation is already included, as I've shown, in the appropriate section. Finally, as noted above, and as Blackworm's quote clearly shows, circumcision to prevent masturbation was but one of several reasons given at the time, and it would be inappropriate to give it more weight in the article.

Regarding your comments about The way, the truth, and the light, I suggest that you review WP:CIVIL and WP:AGF. Jakew (talk) 14:02, 6 May 2008 (UTC)

(edit conflict)

So you would have me believe that there are no misunderstandings concerning circumcision? There are myths on both sides of the issue. Concerning your last statement - I have been completely WP:CIVIL. "blatantly an attempt to discredit medical analysis of circumcision by comparing it to obsolete fears about masturbation" to quote The way, the truth, and the light, is not assuming good faith. In fact you accusing me of this is also not assuming good faith. Just because circumcision to prevent masturbation creates doubt about medical analysis is not a reason to exclude it. Garycompugeek (talk) 15:46, 6 May 2008 (UTC)

(Outdent.) I agree with Jakew that "Circumcision Myths" is inappropriate. Gary's first post here left the impression that the subject isn't addressed at all, and as Jakew points out, it is. The current edit seems fine to me. Jake, I don't believe the current content focusses too much on it; the source gives a good amount of attention to it, quoting the main advocating physician as listing it second in a list, and explaining at length how a great deal of other disease was attributed to masturbation at the time: Since the Enlightenment, doctors in Western Europe and America had identified masturbation as a cause of illnesses. In the course of the nineteenth century it was linked to madness, idiocy, epilepsy, and from these to a multitude of other psychological, behavioral, and pathological conditions. Again, I think the current edit on the topic is appropriate. Finally, I'd like to ask Jake why Gary's comments about The Way are incivil, but The Way's comments about me are not worthy of his reproach. Surely incivility and lack of good faith are not dependent on one's apparent position with respect to circumcision? If they are related in your eyes, Jake, perhaps you should keep the "policy reminders" to yourself rather than only attacking "one side" with them. Blackworm (talk) 15:20, 6 May 2008 (UTC)

Perhaps my childhood preconceptions are lending undue weight to this issue however I will not press it if no one else agrees. Garycompugeek (talk) 16:02, 6 May 2008 (UTC)

In answer to your question, Blackworm, I do think that TWtTatL's comment above was inappropriately worded, and I would suggest that a more civil phrasing might be something like "a list such as you suggest would only serve to discredit..." Ultimately, however, it's not as egregious as a statement that boils down to "you always object to statements that I perceive as factual yet do not support what I perceive to be your point of view", which cannot be rephrased as a comment about the subject, and is simply nothing more than an accusation of bad faith. In short, "you are a POV pusher" is far worse than "this seems to be POV pushing" (see Wikipedia talk:NPOV dispute#Consensus needed), and although not exactly the same, this seemed too close to the former. Jakew (talk) 16:36, 6 May 2008 (UTC)

Semantics. Bottom line is EVERYONE needs to assume good faith/be civil and remain focused on the issues at hand. This article is very contentious and draws ire easily. Garycompugeek (talk) 19:29, 6 May 2008 (UTC)

Getting back to the article, Gary, you said is it fair to [relegate discussion of masturbation] to one section in an stub article -- but it seems you missed the mention in this article in the section referenced above. Does this address your concern? Blackworm (talk) 20:22, 6 May 2008 (UTC)

Thank you Blackworm. Not exactly. I am happy that we mention it but feel it should illustrate one of the main reasons for circumcision for earlier time periods. I grew up being taught this so I may be giving undue consideration? Garycompugeek (talk) 20:58, 6 May 2008 (UTC)

If you are older, it's possible that your perspective differs from younger editors as far as the temporal relevance (i.e., whether it's "current," "recent," or "historical"). The WP term is "recentism" and it's a subject of some debate. I could see how hearing from editors that certain views one grew up with are "obsolete" would trigger the "WTF" reflex in that circumstance. I feel the same about the view that the word "uncircumcised" is a pejorative insult, for example (grew up with it, still see it now, read it in the dictionary, and yet have editors flatly denying the view and continuing to use the word in the article). Anyway I think you may be right about undue consideration, and keep in mind that you would be the welcomed exception to the rule if you actually questioned whether your upbringing and culture causes you to see undue bias (one way or another) with regard to circumcision. Blackworm (talk) 21:56, 6 May 2008 (UTC)

In reply to Garycompugeek's "So you would have me believe that there are no misunderstandings concerning circumcision?" Opposing the inclusion of a myth section is not the same thing as claiming there are no misunderstandings. I also oppose the inclusion of a myth section for reasons described well by Jakew, and I assume that misunderstandings exist. If a large enough number of people have the same misunderstanding to make it notable enough to include mention of here, then perhaps we're not talking about "a piece of information about which there is no serious dispute" (WP:NPOV). Even if there were some things that could quite legitimately be included in a "myths" section, there would undoubtedly also be things that some people think should certainly be included there while others think they should certainly be excluded. Putting, in effect, a strong assertion into a section heading leaves little flexibility. Talking about each case where it comes up in the article, on the other hand, allows words to be carefully tailored to each situation. Besides, a "myths" section would throw together bits of information from diverse aspects of the topic, rather than allowing each to link organically into the section in which it is relevant, enhancing the overall cohesion of information in that section.☺ Coppertwig (talk) 09:04, 12 May 2008 (UTC)

Vandalism

On checking the history I noticed that some anonymous moron has been vandalising the article. We have more to do with our time than reversing the work of vandals. I propose that the article be protected from editing by anonymous users permanently. What do others think? Michael Glass (talk) 09:09, 8 May 2008 (UTC)

I do not believe this would be possible going contrary to basic wiki policies. There are many controversial articles that draw much more vandalism than this article. If it gets out of hand an admin will protect for a given amount of time and/or block IP's. Garycompugeek (talk) 12:59, 8 May 2008 (UTC)

Kenya Report

I added this since Bailey's study let the WHO policies, on this: University of Illinois epidemiology professor. Dr. Robert Bailey's research in Kisumu, western Kenya reported that "infection rates were cut by 60% among men who were circumcised." Funded by the U.S. Institutes of Health and the Canadian Institutes of Health Research, it led the World Health Organization to include circumcision in its prevention policies.iht.com, Male circumcision as anti-AIDS weapon --Florentino floro (talk) 09:28, 23 May 2008 (UTC)

You added it to "Hygiene, and infectious and chronic conditions". Please look at the section entitled "HIV and other sexually transmitted diseases", where we already include coverage of the HIV issue, and document the three trials (including Bailey's). Jakew (talk) 11:21, 23 May 2008 (UTC)

Highly Biased Article

There are plenty of medical sources to refute most of what is trying to be presented in this article. The HIV argument is loaded with poor sampling methods from African dominated regions where lack of sexual protection is practiced- also in Scandinavia, where circumcision is bearly practiced, there is one of the lowest rates of sexually transmitted desease, while in the US, where there is much practice of circumcision, there is one of the highest rates of HIV in the Western world, not to mention impotencey. HIV has to do with sexual practices, not circumcision or lack of it. Circumcision also can have biases from within the medical world too becuae it is a money-making endeavor for certain doctors, while the pediatric society today clearly states that there is no medical benifit for the practice what so ever- it is simply a cultural preference. Circumcision also removes the frenulum, the male equivilent to the female clitorus, it turns a sensitive internal gland into a less sensitive external element, not to mention, it is a human rights violation of mutilation, which is completely against the law for females. Circumcision destroys the natural gliding mechanism of the intact organ. No where in the world of medical science do we ever hear of amputation of normal healthy tissue to improve upon what nature has created- it doesn't exist. This is a highly biased article that is not simply talking about what circumcision is, but rather promoating an agenda for it that is not at all proven by medical science to be benificial. The majority of men, documented to have had the proceedure later in life, overwhelming expressed regret, a lack of sensation, and loss of sexual variety. not to mention the need for artificial lotions to aid in self stimulation. This article needs to be flagged- it is highly biased Chiboyers (talk) 00:10, 29 May 2008 (UTC)

Feel free to add additional information if you can cite reliable sources. OhNoitsJamie ^Talk 00:13, 29 May 2008 (UTC)

I reverted an addition to the lead, on account of the fact that it gave undue weight to a single observational study from 1997. Additionally, presenting it as a "complete contrast" to the WHO, CDC, etc., statements was original research. To criticise reliable secondary sources (CDC, etc) one would need other secondary sources; see WP:MEDRS#Using primary sources to "debunk" the conclusions of secondary sources. This may be difficult, however, as prevailing scientific opinion (as may be verified through a brief browse of PubMed) seems to reflect the high-quality evidence (meta-analysis of RCTs) now available (see WP:MEDRS#Assess the quality of evidence available). Jakew (talk) 13:13, 29 May 2008 (UTC)

This Article Is Controlled By A Biased Agenda

I just cited a reliable source from the University of Chicago that was removed by this Jakew, a problematic poster that several people above have commented on. I can also provide further reliable sources that refutes that circumcision wards off desease, HIV/AIDS, and all other related myths. When this page has been noted by several people and tagged that there is a bias, and this Jakew takes it upon himself to remove the tag and change the page undemocratically, we have a problematic page governed by an agenda that wishes to suppress all views and factual evidence that is in contrast to a certain perspective that some favor. There are countless reliable sources from the scientific community that states that circumcision has no medical benifit what so ever. There are sources from the Jewish community that even questions the validity of this ancient ritual in the modern world. There is no fully agreed upon scientific position, in the Western World, what so ever that proves, without a doubt, that circumcision ever had any true benefit what so ever. The overwhelming testimonials from men that had circumcision done late in life express regret, loss of sensation, and a sense of mutilation. ALL of this can be sourced, which would be a waste of time to do as Jakew, and others of his perspective, will continually remove it and watch over this page in desperation to cover up FACTS and not allow a balanced discussion of this topic. Any logical person can see this article is unbalanced, and when a person has to removed valid sourced information to only promote one agenda, something is wrong. Look at how long this talk page is. If this article was correctly balanced, we would not have a need for so much talk- pages that have this much on Wikipedia are pages that continually have unbalanced articles attached to them. Putting effort on balancing a flawed article controlled by an agenda always is a wate of time when valid points not liked are continually removed and desperately argued against. Those who want a balanced perspective should look into the matter themselves, instead of having facts and knowledge repressed on Wikipedia by those with an unbalanced agenda.Chiboyers (talk) 15:23, 29 May 2008 (UTC)

Jake please try to work with other editors on the talk page before reverting everything YOU do not like. Garycompugeek (talk) 16:38, 29 May 2008 (UTC)

Please see this post in the above section, Gary. Jakew (talk) 16:45, 29 May 2008 (UTC)

Thank you Jake I didn't see your above post however I do not agree with your conclusions. Original research? The Title of the source article is "Research shows circumcision has little effect on spread of disease". Chiboyers post is from a respected peer reviewed source and placed after the WHO source to show balence and contradiction. Garycompugeek (talk) 17:08, 29 May 2008 (UTC)

Original research was but one of the problems I noted, Gary, and as I explained the problem is of presenting it as a "complete contrast" to the WHO's conclusions, for which one would need to cite a reliable source that contrasts the two. If that were the only problem, it could be addressed by rephrasing the text. However, I also noted some more serious problems, including use of the primary source to contradict the secondary sources, and undue weight problems caused by citing a single observational study. Given that there have been more than 40 observational studies and 3 RCTs, the majority of which have found a protective effect, we need to be careful that our coverage is representative (we've discussed this before; see eg., #HIV, #Dubious edits, and #new study). Jakew (talk) 17:22, 29 May 2008 (UTC)

Showing multiple sources to discredit the WHO source would be WP:UNDUE on the other side however one more blended as a meta would be perfect balance if it can be found. Still I find the source credible and its placement correlated properly to above statement. Minor word changing can be hashed out. We should not pick and choose sources but let the reader weigh content themselves. Garycompugeek (talk) 19:22, 29 May 2008 (UTC)

Gary, allow me to quote from WP:NPOV#Undue weight:

"NPOV says that the article should fairly represent all significant viewpoints that have been published by a reliable source, and should do so in proportion to the prominence of each. Now an important qualification: Articles that compare views should not give minority views as much or as detailed a description as more popular views, and will generally not include tiny-minority views at all. For example, the article on the Earth does not mention modern support for the Flat Earth concept, a view of a distinct minority."

Now, bearing this in mind, it is clear that the correct balance is that our coverage of various viewpoints is in proportion to the prominence of those viewpoints in reliable sources. That is, we would only give equal coverage to the ideas that circumcision was and was not protective if those views were equally prominent in the literature. So, let's take a look. (At the time of writing, PubMed lists 485 papers including the keywords "circumcision" and "HIV", so obviously this is just a selection.)

• A meta-analysis published in 2000 (preceding the RCTs) reported that "Twenty-seven studies were included. Of these, 21 showed a reduced risk of HIV among circumcised men, being approximately half that in uncircumcised men (crude RR = 0.52, CI 0.40-0.68)."[40]
• A systematic review published in March 2005 (also preceding the RCTs) stated that "[the] review includes a comprehensive assessment of the quality of all 37 included observational studies [...] Although most studies show an association between male circumcision and prevention of HIV, these results may be limited by confounding, which is unlikely to be adjusted for. [...] Therefore, the results of the three randomised controlled trials underway will provide essential evidence about the effects of male circumcision as an intervention to prevent HIV infection."[41]
• (The RCTs were then published.)
• WHO, UNAIDS, et al. state in their joint recommendations that "The partial protective effect of male circumcision is remarkably consistent across the observational studies (ecological, cross-sectional and cohort) and the three randomized controlled trials conducted in diverse settings. [...] The efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt."[42]
• The CDC state that "Several types of research have documented that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex."[43]
• The first meta-analysis of RCT evidence reported: "to summarize the protective effects seen in the trials, we conducted a random-effects meta-analysis of results of these three trials, following the recommendations of the QUORUM statement for reporting trials as appropriate [19]. There was no evidence of heterogeneity between the trials (P=0.86), and the summary rate ratio was 0.42 (95% CI 0.31–0.57; Fig. 2), corresponding to a protective effect of 58% (95% CI 43–69%), identical to that found in the observational studies (58%, 95% CI 46–66%) [14]." (Weiss et al., AIDS. 2008 Mar 12;22(5):567-74)

So, to consider WP:UNDUE, if we had space to do so in this article, it might be reasonable to include all of the primary sources (ie., individual studies). But we don't. If we were to include a few selected primary sources (and I'm not suggesting that we should), we'd need to include a representative selection, and per the above, that would mean mostly including studies that found a protective effect. But the thing is, there's actually no need to include primary sources at all, and we should prefer secondary sources where possible; see WP:PSTS, WP:V, WP:MEDRS#Some definitions and basics, and WP:MEDRS#Using primary sources to "debunk" the conclusions of secondary sources. So if we want to give an overview of the findings of observational studies, it would be far better to say something like "A meta-analysis published in 2000 reported that 21 of the 27 observational studies included showed a protective effect." But once we WP:MEDRS#Assess the quality of evidence available, it becomes clear that the RCT evidence is of such a stronger methodology that this information is largely outdated. It certainly doesn't belong in the lead, and the current text in the HIV section ("Before there were any results from randomized controlled trials, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV.") covers it perfectly well. Jakew (talk) 21:03, 29 May 2008 (UTC)

I don't like it Jake. PubMed is a great source but primarily American sources. The majority of the world male population is not circumcised and that majority is not in the US. Are we accurately reflecting world opinion or just American opinion? Garycompugeek (talk) 13:19, 30 May 2008 (UTC)

Gary, PubMed isn't just American. It's a database containing records for articles appearing in numerous journals, published in (according to PubMed) more than 80 countries. (To browse through some of those journals, go here.) As such, it's an excellent guide to the scientific literature. Jakew (talk) 13:35, 30 May 2008 (UTC)

I agree that PubMed is an excellent guide to the scientific literature however it is "primarily American sources" and as such maybe unbalanced concerning circumcision. This is not about PubMed but a valid peer reviewed source directly contradicts the WHO source. You contest that it is an extreme minority (world is flat) viewpoint because of PubMed however I maintain this viewpoint maybe more mainstream worldwide than you realize. Garycompugeek (talk) 14:08, 30 May 2008 (UTC)

I don't understand, Gary. Where do you get the idea that it is "primarily American sources" (is this a quote from somewhere?).

Also, no, it's not about PubMed per se (although Laumann's study can be found in PubMed). It's about two issues: first, whether Laumann does contradict the WHO source, and second, whether it is representative to include Laumann in the lead section.

The first issue is one of original research: since neither Laumann's study nor the news article currently cited in the article refer to the WHO source, it is merely the opinion of certain WP editors that it contradicts the WHO source. Furthermore, neither Laumann's study nor the news article actually refer to HIV/AIDS (the study does include HIV in Table 2 — 1.9 per 1000 in circumcised men and 5.4 per 1000 in uncircumcised men, though not statistically significant — but it is not discussed in the text).

As for an "extreme minority/Flat Earth" viewpoint, no, that's not what I'm saying. At the time Laumann's study was published (1997), there were only observational studies, and if you look at the first meta-analysis I cited above, you'll see that 21 of 27 observational studies included in that (2000) review found a protective effect. Put another way, 6 of 27 (roughly 20%) observational studies did not find a protective effect. So at the time, it wasn't an extreme minority viewpoint, but it was a minority viewpoint.

Now, of course, the situation is different. We not only have observational studies, but we have experimental evidence too (in the form of RCTs). And if you read the systematic review I cited, you'll see that although it expressed doubts about the reliability of observational studies, it emphasised the importance of RCTs (consistent with WP:MEDRS#Assess the quality of evidence available). Jakew (talk) 14:47, 30 May 2008 (UTC)

Jake I'm not saying this is the end all conclusion and to be frank, as I've stated before after reading lots of raw data, I agree and understand that a circumcised penis is less sensitive/tender making it harder to contract VDs. (castration would go even further but no one seems to be recommending that) I digress, the point I'm trying to make is unless this is the only source in the World dissenting then sure lets leave it out otherwise we can reword it a bit and leave it in as GOOD balance. Garycompugeek (talk) 17:03, 30 May 2008 (UTC)

Gary, while I have no problem with including it where there is space to do so (eg. medical analysis of circumcision), there is a serious problem of undue weight in including it in this article, and in particular with including it in the lead section, where space is even more limited. To give this study an appropriate amount of weight, we would need to include it alongside discussion of other observational studies, in addition to the secondary sources that have summarised them. In the current version of the lead, we dedicate a paragraph to the WHO & CDC, which are secondary sources summarising multiple observational and RCT studies. We then dedicate a second paragraph to one of the 40 or so observational studies that is among the relatively few that found no effect. Jakew (talk) 17:35, 30 May 2008 (UTC)

• • • Nonsense, I can provide even many more valid medical sources, not just U of C, that demonstrates that there is absolutely no proven scientific position between circumcision and HIV/AIDS prevention. Lack of safe sex is the overwhelming conclusion for the spread of HIV/AIDS, as is the case with Africa. I can even provide countless studies of men who have experienced circumcision later in life discussing the effects of a loss of frenulum, the general lack of a fuller sensitory experience and the overall need to have to have more aggressive sexual experiences in order to achieve sensual pleasure. The desire for more circumcised men to participate in anal sex as a response to the need of having to have more pressure placed on the shaft to feel gratification, vs. those who are not and achive great satisfaction from the just arousal of the frenulum alone. I can provide research that demonstrates that the masterbatory practices of those who are not circumcised are far more gentle in their approach to receiving stimulation, and I can even provide research that examines how circumcision has altered sexual interaction bewteen men and women; a circumcised man needs more agressive back and forth motions to arouse the shaft vs the uncircumcised male who will feel great pleasure from a rolling internal motion that is both stimulating to her g-spot and his frenulum, thereby also keeping a closer-bonding contact with her clitorus, vs, the more "banging" needed motion by the circumcised man, causing a conflict between what gives him pleasure and what gives her pleasure. I can provide materials that discussed how the glandular head looses its glass-like surface from being altered into an external element- I can also provide alternative sourcing that says circumcision has caused more penile cancer at the location of the circumcision scar, than in any man who is left intact. I can also provide overwhelming evidence in the greater numbers of Americans who are choosing to not "buy into" the myths about circumcision which was at a height in the 1970's at nearly 90% occurance and, today, American circumcision is at only about 40%. I can provide studies that examined the cultures of Italy, France and Spain, noted for their attention towards love-making, and those cultures general lack of circumcision. We can go on and on- not to mention that circumcsion was promoted by US hospitals throughout the 20th century based on almost no scientific/sexual research into the medical and sexual effects of the practice- and that the U.S. has the highest impotency rate in the Western world, today, where circumcision was greatly practiced. I am not trying to make anyone feel bad here, but even on the most general surface of the subject, one has to question why a history of genital mutilation is not accepted for females and deemed "barbaric", but in the case of a male, it was accepted as OK- that very position alone is disturbing- one is actually going to blindly follow the myth that a male needs bodily modification of natural healthy tissue in order to be "improved". My goal here is not to spend my time, day in and day out, like Jakew, watching over this article to promote a particular agenda- my goal was that this article needs to be flagged for a bias, and that it is inaccurate to present a pro-circumcision argument as a medical fact , that is all I have to say, and I will move on from this subject nowChiboyers (talk) 22:31, 29 May 2008 (UTC)

FLAGGING IS A MUST

JAKEW REMOVED SOURCED MATERIAL BASED FIRST ON A LIE OF ORGINIAL RESEARCH, THEN HE BACK-STEPPED AND SAID THAT IT IS A SINGLE CASE STUDY WHICH IT WAS NOT, THEN HE TRIED TO ALTER THE STATEMENT TO ONLY SAY VENERIAL DEASEASE, WHEN IT CLEARLY STATES BACTERIAL AND VIRAL. MANY PEOPLE HERE HAVE COMPLAINED THAT THE ARTICLE IS BIASED- AND PROMOTING INFORMATION THAT HAS NOT BEEN CONCLUSIVELY ACCEPTED BY THE SCIENTIFIC WORLD AS A PROVEN FACT. THIS IS A COMPLETELY BIASED ARTICLE THAT MUST BE FLAGGED TO WARD OFF THE AGENDA BY JAKEW AND OTHERS LIKE HIM. THIS ARTICLE HAS A ONE-SIDED SLANT, PERIOD! I WILL NOT ACCEPT VALID SOURCED MATERIAL BEING REMOVED BASED ON ANY EXCUSE ONE CAN FIND TO REMOVE IT BECAUSE IT GOES AGAINST THE MYTH THAT SOME PEOPLE WANT TO PERPETUATE. ANY REMOVAL OF A FLAG AT THIS POINT CONSTITUTES VANDALISM- JAKEW DOES NOT OWN OR CONTROL THIS ARTICLE, AND I DO NOT APPRECIATE HIS SNEAKINESS TO REMOVE MATERIAL WHEN HE THINKS PEOPLE ARE NO LONGER LOOKING, AND HIS CLEAR AGENDA OF SLANTING THIS ARTICLE TOWARDS GENITAL MUTILATIONChiboyers (talk) 15:43, 31 May 2008 (UTC)

Assuming you are not a straw puppet, you should know that such behaviour will only make those who may agree with you have a much more difficult time making this article neutral instead of clearly advocating male circumcision as it does now. Blackworm (talk) 18:40, 31 May 2008 (UTC)

When several people have commented on a bias, and flagging is removed, and certain people continue to remove and/or change statements to positions that they don't want to hear- then something unethical is happening here with this article, and a more bold statement has to be made. Put valid sources that say one position for circumcision, put others that say an alternative, and let people choose what they want to embrace, but it is a fact that medical science has NOT proven that circumcision has any, or ever had, any true medical benifit what so ever.I can load the article with tons of completely alternative views from medical science that argues for a completely different position than the one now for circulmcision, and the one source that I added, already was removed and altered.When even others commented on it as a good source and valid. I have seen articleslike this before that are controlled by one person or a few with an agenda, and it is a waste of time to added valid sourcing and points to it- it must remain flagged.Chiboyers (talk) 21:34, 31 May 2008 (UTC)

First of all, Chiboyers, can I encourage you to read a previous discussion on this talk page? Since this earlier discussion touched on some closely related points, it might be a good idea to familiarise yourself with it. You can find it at #Neutrality.

Also, please read WP:DRIVEBY and WP:DT carefully. You have not yet stated why the tag is justified, with reference to applicable policies. You have made it abundantly clear in this and the above two sections that you have a strong opinion on the subject, and that you disagree with (for example) the World Health Organisation's assessment of the HIV evidence, but that does not necessarily mean that there is a problem with the article.

Please understand that nobody here is saying that the viewpoint that circumcision does not protect against HIV is wrong, just that it is a relatively uncommon view in the scientific community at present, and we need to take that into account. As a credible encyclopaedia, Wikipedia needs to give more weight to mainstream scientific views, and indeed WP:NPOV policy requires that we do so. At the same time, we're not claiming that the mainstream viewpoint is right, and if you examine the text that you tried to remove, you'll see that it simply states that the WHO, etc, state that X is so, which is different from claiming that X is actually true. Please note that our job is not to evaluate viewpoints, nor to offer rebuttals to those with which we may personally disagree, but simply to report on them, in proportion to their prominence.

Finally, since you indicate that you'd like to "load" this article with lots of "alternative" views to "argue" for a certain position, I'm somewhat concerned that this tag may not represent a carefully considered analysis of applicable policy. Jakew (talk) 22:28, 31 May 2008 (UTC)

• • • I never stated that I would "like" to load the article with alternative views. I said that I "can/could" do so with completely different and equally valid medical sources to present an alternative picture than the one this article has at the moment. Thereby, I was making a statement that the "selected" sources being used now are slanting the article in only one direction, and thus lacking neutrality. To present the information you cited in a suggestive manner of a "proven" medical fact agreed upon by the world medical community is grossly wrong, especially when it comes to European and Asian research that overwhelming shows no clear benefit to circumcision what so ever in preventing HIV/AIDS. Thus, there is no "common view" held by the world scientific community today that agrees that circumcision is a clear benefit to help prevent HIV/AIDS. I would also like to state some points from the "mathematic" community, of which no medical doctor is required to take course work in statistics. Professional statisticians have commented on the internal bias and lack of proper sampling methods in any of the statistics generated from these studies, and have even gone so far as to say that it would be a probable impossibility to derive any accurate stats in this matter- which would involve too many variables: economic class, social status, sexual promiscuity, sexual behaviors, environment, as well as no way of knowing if a person being tested is even telling the researcher the truth since sexual matters tend to be embarassing and people are prone to exaggerate and cover up the truth. Chiboyers (talk) 03:31, 1 June 2008 (UTC)

I think either the POV tag should be removed from the article, or else the POV tag should have a link to a specific section of the talk page, and that section should list the specific changes that would allegedly have to be done to make the article NPOV. Stating that there are sources refuting something and not actually providing the sources doesn't qualify as specifying such a change. ☺ Coppertwig (talk) 03:56, 1 June 2008 (UTC)

• • • That is not true, I can back everything I state by sourcing, and in fact, I began the task of sourcing the article with valid statements and citations to start the process of balancing, but Jakew removed even my initial efforts, first based on a lie saying it was original research, which Garycompugeek even had to revert because that was an out an out falsehood since it was coming from the University of Chicago, one of America's premiere medical research groups. Then, Jakew says it was only a single case study, which was also a lie, since it was an article backed by not only U of C, but also Professor Lauman, a leading sociologist Dr. Mead, and the American Medical Association. Then, Jakew tried to alter the statement to give it less weight once Gary called him for his actions- and then ultimately, when Jakew thought I walked away from this article, he removed the statement all together- sealing the reality that clearly we have an agenda occuring here with some trying to gloss over valid medical sourcing that is in conflict to their own personal agenda. From the preliminary expreinces I had with this article, and the obvious agenda occuring here, I will not waste my time putting great effort in balancing an article that those with an agenda will be constantly looking to destroy. Therefore, flagging is needed. Chiboyers (talk) 06:18, 1 June 2008 (UTC)

Well, this is slightly off-topic, but it seems that some clarification is needed.

First of all, the fact that the source you wanted to insert was published by the University of Chicago has nothing whatsoever to do with the fact that the way you wanted to use it was original research. The source in question mentions neither HIV (the first sentence does, however, read "Circumcision, once advocated as a means of reducing the spread of venereal diseases, has very little impact on their transmission...") nor the WHO recommendations. Hence, claiming that it is a "complete contrast" to the WHO recommendations, and claiming that it "concluded that circumcision has no significant effect on the prevention of HIV/AIDS" is completely unverifiable from the source itself: it is merely your own interpretation, and as such is original research.

Next, I pointed out that it was a single observational study. You protest that this isn't true because it was "backed" by the University of Chicago, the authors (one of which you misidentify - the authors were actually Laumann, Masi, and Zuckerman - not that it matters), and the American Medical Association. It's difficult to understand your reasoning here, and it's unclear what you mean by "backed by". Sure, it had authors, but that's the case with any study. Sure, these authors were affiliated with a university, but again that's quite common. Sure, it was published in JAMA, but that's the thing about studies: they tend to be published in journals. None of these things are unusual, nor do they refute the statement that it was a single observational study.

So, I corrected these problems in two parts. Firstly, I altered the statement here, "correcting the most obvious OR and inaccuracies (WP:UNDUE problem still remains)". In addition to the original research problems noted above, this also corrected the misrepresentation of the source, which actually referred to "a new study" (ie., singular), not "studies". Some time after, I removed the sentence, noting "rm single observational study from lead. see WP:UNDUE".

So to return to Coppertwig's observation, claiming that you have sources is somewhat different to actually providing them. What has happened so far is that you have tried to remove material with which you disagreed, then you tried to insert material that violates WP:UNDUE and WP:NOR, and failed to WP:AGF I've drawn your attention to these policies. None of which justifies the tag. Jakew (talk) 12:13, 1 June 2008 (UTC)

• • • I was notified that additional sourced work should be added, rather than remove unproven points, which I followed with and you removed. The sourcing that I added was valid and deserves a place within the article, even Gary said that he had no problem with the source, which was also going to be followed up with additional sourcing, but I will not go 5 steps forward working on blancing the article and 6 steps back to try to deal with your agenda of your removal of the work. I said that this article should have both pro and against valid sourcing, you are the one who wants only your position addressed. Moreover, you are trying to always discredit valid sourcing from points you don't like, but right now within the article, there are some major sourcing problems that I never removed- specifically, your point 122 that does not link to referencing any of the points you claim, probably since the link has changed over time. But if we are going to be technical to Wiki standards, I can't take your word for it that link once said what you claim- all of those points referencing that supposed link should be removed- they are not up to Wikistandards of sourcing, but you are making exceptions for your work.Chiboyers (talk) 16:27, 1 June 2008 (UTC)

• • • Some of the statements I made earlier don't even need additional sourcing for validation. For example, I said circumcision is bad becasue it changes the glass-like surface of the penile gland as well as removes the frenulum, which is the male equivalent to the female clitorus. Go see Frenulum of prepuce of penis. Look at the more vibrant coloring, and glass-like surface when the gland is left normal, and look what happens to it after it is altered by circumcision. Look at the complete removal of the frenulum in the circumcised example, and the difference in the non-circumcised example- and the known fact that the frenulum is one of the most sensitive and erogenous parts of the genetalia that is aroused by the lightest of touch. One would have to be in denile to not accept that circumcision is changing significantly a healthier glandular state, and that if one is removing a known highly erogenous element from the male member, there is, without a doubt, loss of highly sensitive tissue and additional pleasure sensors. Circumcision, religiously, was done as a sacrifice- sacrificing physical pleasure for what some thought was a higher mental and spiritual goal by removal of the most erogenous elements from the penis, the frenulum, that was going to easily draw one to focus on the body rather than on G-D.Chiboyers (talk) 06:40, 1 June 2008 (UTC)

Please review WP:NOR and WP:V. Jakew (talk) 12:13, 1 June 2008 (UTC)

• • • I do not need help as a PhD holder to understand what original research is- I am simply making a statement right above that demonstrates that some of the points I raised on this talk page are evident already on Wikipedia as well as raising some points for people to think and talk about. What I hold accountable to sourcing is what is placed within the article, not what is discussed on a talk page- and clearly the initial efforts at balancing with creditable and valid sourcing was removed unfairly from the article. If I wanted to add the point I raised above to the article, I could and would souce it with a valid citation, but I didn't add it to the article- I just highlighted here for awareness.Chiboyers (talk) 16:00, 1 June 2008 (UTC)

• • • The point we are fixating on at the moment is the HIV/AIDS issue- but there are others points relating to cicumcison too. A major one is that the penis is foremost a sexual organ for pleasure, and that well into the 20th century, American victorian sensibilities wanted to overlook its primary function. Prudish mothers felt unconfortable with washing their boys and having erections created when touching the frenulum- giving a sense to the mother that they were in "sexual situation" with their child. Also, an uncircumcised boy needs to be educated by his mother on how to roll back the foreskin while washing, again an uncomfortable issue for many of these mothers to talk about, not to mention that all uncircumcised boys begin to play with their foreskins early on, finding novilty in its movement. Catholics, for example, have major issues when it comes to masturbation, and they can even deem rolling a foreskin back as a masturbatory act- therefore not engaging in it and resulting in less hygene for some men. Therefore, in order to bypass all of this dyfunctionalism, the answer for years was cut the foreskin away, but at the cost of not reializing that after puberty, the penis is foremost a sexual organ for pleasure, and what they are cutting away in an immature child has very important functions on a mature man for his and her pleasure. Medicine wasn't doing research into the male genetalia as a sexual entity, for years they made unproven and unsophisticated claims about the benefits of circumcision- often looking at the issue and still looking at it superficially. And as current statisticians and socioligistist have stated, which I can source, medicine was not adding in all variables to make their claims properly. For example, if a Catholic does not want to roll back his foreskin while bathing, belieiving it is a sin, and then it shows up that uncircumcised men have a hygene issue- well that is not a problem of having a foreskin, that is a problem of a mental outlook an irrational issues- that would be liking saying a certain religious group believes that brushing their teeth is morally wrong and guilt striken by doing it, and then finding out that this same group has higher dental decay. America has serious issues still with sex today, not to mention pop culture's uncomfortablness with presenting the naked body. These points here are points that that American still needs to face- and it will be a process of time to fully unplug people from the myths about circumcision for medical benefits. Now, if one is doing siomething because of a religious traditon, tradition is simply tradition. Geisha girls had their feet bonded, and some African tribes elongate their earlobes and necks, one can do anything in the name of religion or culture, but don't cloak that into a "medical benefit", that myth needs to be debunked, and valid sourcing and research is there to do itChiboyers (talk) 16:00, 1 June 2008 (UTC)

In reply to Chiboyers: Please try to edit your talk page posts to be shorter. I'm sorry, but I didn't take the time to read your last section, as it appears to consist of unsourced statements about circumcision. Re "For example, I said circumcision is bad": please review the Wikipedia policy WP:NPOV. If one of your reasons for the POV tag is that you put a source into the article and it was reverted, then please post that source on the talk page in a section that is linked to from the POV tag. With no such link, I think the POV tag should be removed. I'm sorry if this message sounds abrupt. It takes time for new users to get used to the policies and guidelines and how things usually work in Wikipedian discussions. This article has been very extensively edited and discussed. Very often what looks like an improvement to one editor will not be accepted; since it's already a polished article, only the very best changes tend to be accepted. Please note the template at the top of this talk page which says "Please read this page and discuss substantial changes here before making them." Regards, ☺ Coppertwig (talk) 16:49, 1 June 2008 (UTC)

Your criticism seems one sided. Jake post huge swaths of text on here all the time without a peep out of you. Garycompugeek (talk) 18:05, 1 June 2008 (UTC)

• • • I thought that it was very clear already that this was a talk page, here to discuss any points related to this subject matter of circumcision, and I believe that I said already that I hold sourcing accountable for cited information within the article, not what is general talk on a discussion page. Flagging is needed for the article because valid sourcing from within the article stating an alternative postion in the medical world has already been removed. There is a bias controlling what is placed within this article, and as it stands right now, the article lacks neutrality. Chiboyers (talk) 17:04, 1 June 2008 (UTC)

Let's take a step back and ask ourselves why people keep coming to this page and saying its bias and slanted toward pro circumcision? Since I have been watching it not one such post complaining the opposite on the talk page. Why? Chiboyers, while I agree with you the page has many balance issues, you must lay out your concerns with solutions so that they may gain consensus. Garycompugeek (talk) 17:19, 1 June 2008 (UTC)

Thank you, Garycompugeek, although I don't quite follow what you're saying: I can't figure out what you mean by "such post" – sorry. Also, I disagree with this revert. Adding this new material doesn't have consensus. It's already been pointed out that it's a single observational study. It's outdated: the HIV randomized controlled trials contradict it, so it would have to be contextualized if it's used at all. It's too much fine detail for the lead. The footnote given is to a news-style report, not to the scientific journal article. Even quoting the journal article directly would go against the grain of WP:MEDRS. The article seems to be misquoted: the article says "has very little impact", perhaps implying that it has an impact, while the quote you edited in says "has no significant effect", implying that no statistically significant effect was found, which I'm not at all sure is an accurate representation of either the news-like item or the journal article. I suggest if you're keen on including this reference, that you try to put a carefully-quoted direct reference to the journal article into Medical analysis of circumcision somewhere, not in the lead there either, I suggest; I might or might not oppose such an edit if proposed there. Please present new material on the talk page for discussion before editing it into this page. ☺ Coppertwig (talk) 18:28, 1 June 2008 (UTC)

You are welcome. (for what i'm not sure - now you have me confused.) I did not introduce this into the article but have merely been backing up another editor just as you appear to be doing. I am not comfortable with the way anti circumcision views are routinely regulated to sub categories of this subject. Garycompugeek (talk) 18:42, 1 June 2008 (UTC)

• • • Well, Gary, now you have your answer why people who clearly see a bias and agenda here don't want to invest time posting on this this talk page or investing time into rounding up alternative valid sourcing. It will end up being all reverted by those with an agenda controlling this page. I especially love the comment above which wanted to silence me by saying I should "edit" my talk on this discussion page. Those who are most insecure have to "watchdog" this article day in and day out to make sure that only their "selected" sourcing is added and are afraid to see equally vaild sourcing from the alternative position. If the presence of one single source from an opposing position created this much drama, imagine what would happen if I added a great number of valid sourcing from medical science and mathemetical statisticians. This article IS lacking in neutrality.Chiboyers (talk) 15:09, 2 June 2008 (UTC)

Removing the tag doesn't have consensus either. See WP:NPOV_dispute: In general, if you find yourself having an ongoing dispute about whether a dispute exists, there's a good chance one does, and you should therefore leave the NPOV tag up until there is a consensus that it should be removed. This article isn't sacred; adding a tag to warn others that neutrality is disputed is not "defacing" despite the repeated label of drive-by tag removers against multiple editors feeling that there are issues. This article has multiple open WP:NPOV issues that have not been resolved through consensus, starting with the title, which should be Male circumcision, as discussed here and here. Chiboyers, I look forward to seeing you attempt to make this article neutral. Use good sources, and summarize neutrally. Be prepared for reverts, circular logic, misinterpretation of policy, administrative threats, intimidation, and endless "discussion" always ending with claims of "no consensus for change." Blackworm (talk) 15:33, 2 June 2008 (UTC)

User:Jayjg please assume good faith. This is the second time a banner has been placed by a concerned editor (that I have been watching) and the second time you have bit a new user. It seems quite silly for me to lecture a wikipedia administrator on basic wikipedian principals. This was obviously not a drive by and Chiboyers is certainly not trying to deface the article as you so brazenly put it. Garycompugeek (talk) 19:15, 2 June 2008 (UTC)

• • • Thank you Blackworm. I appreciate your interest in seeing more neutrality. When I placed the first U of C point in the intro, I thought that positioning it after the HIV/AIDS statement was a good location to have comparative analysis. Readers of the article would then have two alternating view points from medical science, and therefore, would have a fuller picture of the issue at hand. I am still concerned about alot of reverting of sourced work if I start to place cited points within the article, so what I will do, is begin by citing some links here on the discussion page- links may not even be the best sourcing available for the topic, but it has the advantage of everyones' immediate access to where the info is coming from, and a good start. I also like the idea of posting on the talk page, first, because it will allow for some discussion of where others may feel that the cited source best fits within the article. I will start a new section on this talk page called "Alternative Sourcing". Chiboyers (talk) 16:36, 2 June 2008 (UTC)

Alternative Sourcing

I will begin a process of adding links to this section, links that not only address the HIV/AIDS issue, but also links that would roundout the discussion of circumcision from a number of concerns:

1) Circumcision having little effect to ward off the spread of sexual desease (both bacterial and viral)-University of Chicago: [[44]]

2) Circumcision not proven to ward off HIV/AIDS as well as concerns of poor sampling methods in U.S. statistics: [[45]]

3) Testimonials of men circumcised as adults expressing general regret: [[46]]

4) Circumcision: a source of Jewish pain: [[47]]

5) Unnecessary circumcision: [[48]]

6) Pediatricians turn away from circumcision: [[49]]

7) Circumcision may cause urinary problems: [[50]]

8) Circumcision and HIV infection: [[51]]

9) Circumcision and cervical/penile cancer: [[52]]

I just added a few links to demonstarte that the benefits or need of circumcision is clearly contested from a number of different avenues and in no way a "proven" benefit for any medical concern - the most compelling research ,of course, even comes from published works that don't have weblinks attached to them.Chiboyers (talk) 18:36, 2 June 2008 (UTC)

Before you spend too much time citing partisan websites, Chiboyers, can I ask you to take a look at WP:V (in particular WP:V#Questionable sources and WP:V#Self-published sources) and WP:RS (as well as WP:MEDRS)? You may find the following advice in WP:V helpful: "Articles should rely on reliable, third-party published sources with a reputation for fact-checking and accuracy ... In general, the most reliable sources are peer-reviewed journals and books published in university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. As a rule of thumb, the greater the degree of scrutiny involved in checking facts, analyzing legal issues, and scrutinizing the evidence and arguments of a particular work, the more reliable it is." Jakew (talk) 17:56, 2 June 2008 (UTC)

Partisan websites like CNN and the University of Chicago? I'd say the WHO is more partisan, since they openly advocate mass male circumcision of infants and adults, resulting in semi-voluntary circumcisions in the army and police in Africa. There's no problem with sources 1), 5) (which is a re-publication), and 6) that I can see. The others can't be cited directly, but point to sources that can be. Blackworm (talk) 19:55, 2 June 2008 (UTC)

We've discussed the U of C source (#1) at length already, so it seemed unnecessary to comment on it. The CNN link (#6) hadn't been added at the time of my post (items 4 and above were added after I commented), but of course it is about the 1999 AAP policy, which we already cite directly in several places in the article. As for Denniston's 1992 article (#5), while we don't cite that, we do cite another of Denniston's opinion pieces, in which he makes similar arguments, as our ref 45. Jakew (talk) 20:14, 2 June 2008 (UTC)

Yes, indeed. The CNN source has other information too, e.g. "The United States is the only country in the world that routinely removes the foreskins of infant boys." How odd that we claim without attribution in Prevalence of circumcision that male circumcision is a part of "Western" culture, given that. I think we should trim the number of WHO advocate opinion pieces too. And Schoen's opinion pieces, given that he is perhaps the best known advocate of mass male circumcision after the WHO. Or is that sources advocating circumcision are "reliable," "scientific" and "neutral," and only sources opposing circumcision are "opinion pieces?" Blackworm (talk) 21:14, 2 June 2008 (UTC)

It's a little hard to understand your objection, Blackworm. I don't think we cite any WHO opinion pieces. We do, however, cite several opinion pieces in the article, which include, for example, Schoen's "Should newborns be circumcised? Yes", Denniston's "Circumcision and the Code of Ethics", and Milos' "Circumcision: A medical or a human rights issue?". I'm not proposing to remove these. Are you, and if so, on what grounds? Jakew (talk) 21:40, 2 June 2008 (UTC)

I'm proposing that if "opinion pieces" are to be limited to one (which seems to be your misguided view), we should limit the WHO's opinion to one instance. Of course, I do not believe that is an appropriate action, and thought that would be clear. Once you begin to see that the WHO is a source with opinions, and not an infallible provider of unquestionable truth, this parallel should become clear. I posit that the there is no clear line between "opinion" and "an attributed view," and we attribute plenty of views to WHO. Your position on this inevitably boils down to "the WHO is just -- BIGGER" (paraphrasing) -- my response is always, "it's not 100% of all opinion, like this article often makes it out to be." Blackworm (talk) 01:36, 3 June 2008 (UTC)

Blackworm, I don't think I've suggested that opinion pieces should be limited to one, and I'm not sure why you have that impression. In a sense, you're correct in that every viewpoint is also an opinion, but I think that's a rather simplistic viewpoint that overlooks the fact that, in WP, some opinions have more significance than others. In some cases this weight is because the type of source is highly rated within systems of evidence-based medicine. In others this weight is due to the fact that it represents the conclusions of an authoritative and significant body (for example, as you observed, WHO's conclusions have consequences, and this is also true of other significant medical organisations. These policy statements also have the benefit of being issued on behalf of the organisation's membership). When assessed either way, opinion pieces by individual authors aren't all that significant by themselves, though in some cases they can be representative of a more common viewpoint. I'm not saying that they should be ignored altogether — and we do cite opinion pieces where appropriate — but we need to think carefully about their significance and the amount of weight that they should be given. It is a mistake to say "it exists, and therefore it should be cited", because at the time of writing (according to PubMed), 4,063 circumcision-related articles exist, and it is completely impractical to cite them all. Jakew (talk) 13:23, 3 June 2008 (UTC)

• • • Some major factors leading to a general sense of a lack of neutrality within this article is certain portions not having qualifing statements. For example, the presentation of penile cancer statistics, HIV/AIDS statistics and hygiene sections with one-sided citations, unqualified, is suggestive of a "hard fact". When within many of these studies there may be statistical biases and poor sampling methods at work that several professionals and doctors have commented on, not to mention lacking in enough studies or large enough testing pools to even suggest "proof". For example, I can provide alternative valid sourcing that washing is just as good as a hygeine method for males than full circumcision. The presentation of several of these "hard fact" points are one-sided, and to not mention statistical uncertainty, in some form, which can be validly sourced, is suggestive of a deliberate overlook- especially when WHO is a known pro-circumcision group. There would also be a benefit to source some point within "cultures and religions" stating that not all within the Jewish community are accepting of circumcision as a tradition that should endure, instead of just saying that it is "Jewish Law" and a commandment, coming off as guilting some to "obligatory" follow it. There are plenty of other factors to determine Jewish identity, such as having a Jewish mother. Not to mention that Moses, himself, was never circumcised. One should not ignore valid citation that some within the community who also question its validity as a ritual, especially when one of the community's most outspoken proponants is a published doctor in that area of medicine. One should also exclude loaded words like "obligatory" that have biased rhetoric within them. Chiboyers (talk) 23:12, 2 June 2008 (UTC)

I completely disagree that there is a general sense of a lack of neutrality in this article. I will say now I think it's quite good, and quite improved in terms of balance since the first time I saw it. Your arguments re: methodologies require reliable sources, otherwise it will get tiresome very quickly around here, and with reason. Some editors will see you as wasting their time and possibly soapboxing. To put it bluntly, you're discussing the subject and not the article, which is inappropriate for talk pages (WP:TALK). Then again, I am of the opinion that calling POV tags "defacing," as stated in this edit summary is itself a form soapboxing, in the sense that it places the article on a kind of soapbox pedestal, that is not appropriate. This article is not a featured article nor even a good article -- there seems to be no community consensus that this tag removal on the basis that the tag is "defacing" is justified. What does it mean to say that the tags "aren't permanent?" Is that wording even based on policy? The tag is removed when the dispute is resolved. But then I can understand if it's difficult to see one's hard work at neutrality tagged as still unacceptable. In this case, though, it would reflect the clear lack of consensus regarding the existence of a POV dispute. I'm not going to tag, personally, because I don't want to hurt anyone's feelings and have discussion derailed again. I'd rather make my view known that's it's completely unacceptable here, and cite sources, as I did in the open debate over the title of this article. Blackworm (talk) 02:43, 3 June 2008 (UTC)

The Bottom Line

Unless there are either qualifing statements like "not all within this community accepts this"; "sampling methods have not been universally accepted as valid"; "the medical community is not in consensus"; "Other doctors take an alternative position"; or simply adding the additional validly sourced points of the opposing position- then this article will always be biased and lacking in neutrality. An article of this importance should strive to be at the level of a "featured article" or a "GA article", and, currently, this article IS still lacking in neutrality. One can not present the WHO statements in the manner of a "proven fact" "universally accepted by medicine" and just ignore that there is still substantial opposition from within the world medical community with published valid sources arguing against those results and questioning the validity of sampling methods. This article IS still lacking neutrality, we may be close to getting it where it needs to be, but we are not there yet- we need either some qualification, or some additional alternative sourced points.Chiboyers (talk) 05:12, 3 June 2008 (UTC)

Great! You can help improve this article. It would be helpful if you would provide references to the sources questioning the WHO position, and please suggest where to insert the specific wordings you've suggested above. You can also suggest specific wording to add, with references, regarding the other points you've raised in other sections. However, note that I spent a lot of effort shortening this article, so I might oppose any edit that lengthens it; if you want to add something, you could also suggest deleting something else to keep it from getting longer, though it's not necessarily impossible for the article to get a little longer. ☺ Coppertwig (talk) 12:49, 3 June 2008 (UTC)

• • • It seems attractive to make the effort at correcting some suggestively biased wording, adding some qualifing statements or nessessary sourced points, and I don't believe that lengthy writing is needed- just some tweeking that creates a more balanced presentation. However, already, I see that the U of C point was removed once again. Now, I can re-position that point in a different location, but I have also listed already a valid alternative source that even talks about HIV/AIDS specificaly and that should be placed within the intro to show balance. Right now, I do not have much faith that the effort at balancing will not be done in vain by those with a one-sided agenda to revert everything. For example, the U of C source was very valid and appropriate, but was constantly removed without even any attempts at re-locating it. It is not enjoyable to fix neutrality on biased articles because it is like asking a Republican to have consensus with a Democrat, and just like in politics where every year we hear that "We are going to bring the parties together", it does not happen in reality. I listed valid sourcing to draw from that others can use to cite some points for balance and I have already listed above how some qualifing statements can be used, and I already said how a loaded word such as 'obligatory' should be removed. It would be better for someone else to make those adjustments- if I do it, it will be reverted by Jakew- and I no longer have the time to go 5 steps forward and 6 steps backwards with reverting- you can handle it from this point forward. If you don't want to do it, than the article should be flagged for lack of neutrality which would direct a viewer to the talk on this discussion page, but I don't have much faith that that will be done either, or even if it is done, that it would stay flagged for very long- best of luck!Chiboyers (talk) 14:49, 3 June 2008 (UTC)

Thank you for your contributions. Please don't let this article sour you on Wikipedia. It will not always be this difficult to help out. This happens to be a very contentious article watched by many with strong views. Garycompugeek (talk) 16:36, 3 June 2008 (UTC)

Whatever changes you want to propose, please follow the request in the template at the top of this page and present the edits on this talk page for discussion before editing, specifying the precise words and where they would go. ☺ Coppertwig (talk) 16:55, 3 June 2008 (UTC)

Edit war

In the interest of stopping the current edit war I have been seeking a 3rd party opinions from disinterested admins. User:Black_Falcon was kind enough to respond here. I will agree to relocate the U of CH source if we relocate the WHO source. Neither belongs in the summary lead which I have been trying to bring down to basics, but for every pro listed a con should be there to balance if possible. Garycompugeek (talk) 16:56, 3 June 2008 (UTC)

I'm reverting for the following reasons.

• Black Falcon agrees that the material does not belong in the lead.
• New material should be presented on the talk page for discussion and only added after the details have been agreed on.
• I oppose this revert because most of the points which I had raised earlier here have not, as far as I can see, been addressed in any way.
• My point that it would need to be contextualized seems to have perhaps been replied to in a comment which I can't find right now, which stated something along the lines that it was balanced by coming right after the WHO material in the previous paragraph. My answer to that is that I don't see that as sufficient: some people might read or pay attention to only the last paragraph and not notice that it's contradicted by the paragraph before. I would prefer having it in a sentence with a word like "although" or something along those lines.

Since the person who had been asked for an outside opinion agrees that this source does not belong in the lead, please don't revert it back into the lead, but please present suggestions on this talk page, if you wish, as to where else in the article you think it might go.

By the way, Garycompugeek, I'm sorry I didn't specify what I was thanking you for earlier, because now I can't remember which of two things it was or whether it was both: let's suppose it was both, so I was thanking you for providing a reply in this interesting discussion, and I was also thanking you for encouraging Chiboyers to lay out the user's "concerns with solutions so that they may gain consensus", which I also encourage the user to do. ☺ Coppertwig (talk) 17:53, 3 June 2008 (UTC)

Coppertwig, these are not valid reasons to contribute to this edit war. Black Falcon suggested that all paragraphs starting with "The American Medical Association" be removed; you can't single out the one paragraph you don't like and remove it on that basis. Your second point is plainly false and contradicts WP:BOLD -- the notice on the top of this page hinges on what we consider "substantial" changes, i.e. it is a matter of opinion. The concerns have already been laid out. We cannot approach the topic as if we agree that it is an undisputed fact that male circumcision prevents HIV; Jakew's WP:OR claims of "scientific consensus" notwithstanding. It is even arguable that the reader is better served by a presentation of the historical medical arguments used for advancing and imposing male circumcision (i.e., as against masturbation, insanity, etc.), leading up to today's medical argument (HIV). As circumcision has been described as a "a solution in search of a problem," it behooves us to present that aspect of this topic. Blackworm (talk) 18:19, 3 June 2008 (UTC)

Blackworm, thanks for this source which you provided on Black Falcon's talk page, which provides an alternative perspective while commenting on the RCTs. I suggest that this be added at the end of the WHO paragraph (currently last paragraph) of the lead, with the wording "although the actual effect on a population would also depend on behaviour and other factors." (By "other factors" I mean things like female-to-male tranmission.)

I further suggest that the WHO paragraph be deleted from the lead altogether. This information is already represented in the body of the article, and is represented in summary in the lead in the phrase "health advantages" in an earlier paragraph. I can't think of any way to represent the HIV information in just a few words: it's too complex. I suggest that the reference you provided be added at the end of the first paragraph of the HIV section with the words "The actual effect on a population would also depend on behavioural and other factors."

Re reverting: people are welcome to invoke my "self-revert" policy if they wish. The concerns I raised above when I objected to the re-addition of this material earlier have still not been addressed. I don't expect this edit war to continue now that an outside opinion agrees that the material doesn't belong in the lead. ☺ Coppertwig (talk) 18:46, 3 June 2008 (UTC)

I would disagree with removing the WHO paragraph, as it fulfills some important functions of the lead, namely to "establish context, summarize the most important points, [and] explain why the subject is interesting or notable". Even if one personally believes that circumcision has no effect on HIV transmission, one cannot deny that the WHO recommendations have raised the importance of circumcision as an issue, and (as Blackworm has noted) that the recommendations have had an impact on people's lives. I would not be opposed, however, to restructuring the paragraph so that the focus is on the recommendations themselves rather than trying to summarise the HIV issue as well. To facilitate this, and to allow the paragraph to be more focused, it would help to remove the CDC. Jakew (talk) 19:03, 3 June 2008 (UTC)

I disagree. The WHO and CDC are meta together nicely. Please relocate the WHO statement with CDC or add the U of Ch source or blackworms source to achieve parity. Garycompugeek (talk) 19:13, 3 June 2008 (UTC)

Jakew, you have some good points about the WHO material fulfilling more than one function in the lead – I hadn't thought of it that way. OK, how about we leave the WHO paragraph in the lead, append to it the wording I suggest above with the source Blackworm provided, and also include the same information in the HIV section? ☺ Coppertwig (talk) 19:49, 3 June 2008 (UTC)

I think that would be a mistake, Coppertwig. The paragraph is about what WHO, UNAIDS, etc conclude, and if we cite another source as well, it becomes a disorganised mess ("WHO, UNAIDS, and CDC state that X, and three individuals, in a Letter to the Editor, state Y"). The paragraph (and the preceding paragraph) is about the conclusions of medical organisations. If we were to take the previous paragraph and add a sentence stating that "However, Clark et al. state that 'Neonatal male circumcision is medically necessary and ethically imperative'[53]", it would give undue weight to Clark et al, and would take the focus away from what medical organisations have concluded. Similarly, we should keep the WHO paragraph about the conclusions of those organisations, not about those organisations plus a randomly selected Letter to the Editor that doesn't even mention those organisations. Jakew (talk) 20:02, 3 June 2008 (UTC)

Thanks, Jake. I knew I didn't have to worry about thinking through that sort of argument because I could rely on you to bring it up. Seriously. LOL. ☺

We could report only what the major organizations say, but taken to extremes that could leave out significant viewpoints. I think we do cite letters to the editor elsewhere in the article.

How about this: leave the lead as it is, but in the HIV section, at the end of the second paragraph, append: "Kalichman et al. point out that we cannot conclude the overall effect on HIV rates in a population without taking into account behavioural and other factors". Coppertwig (talk) 21:37, 3 June 2008 (UTC)

Well, I'm not opposed to including it somewhere (perhaps in this article), but I think we'd need to consider it in context of the original study and the authors' reply. Certainly I'd agree that predictions about the expected population-level impact are important, but the space in this article is somewhat limited, and I'm inclined to think that such content may be more appropriate for medical analysis of circumcision. Jakew (talk) 21:55, 3 June 2008 (UTC)

Jakew, this argument uncannily resembles my argument against Tannenbaum and Shechet's statement, "more humane not to use anaesthesia" -- in which you objected to my suggestion that we call it a "letter to the editor" in the prose (and yet suggest that wording above), and objected to my call to remove it because it contradicts all medical organizations (and yet suggest that that is a valid argument above). I hope you can see how I'm not impressed when your position seems to diametrically shift based on the apparent support or opposition to circumcision of the disputed sources. [AGF. -BW] Blackworm (talk) 20:23, 5 June 2008 (UTC)

The outside opinion did not believe the who/cdc source belongs in the lead either. If you wish to revert U of CH please take it with who/cdc to provide balance. Different properly sourced viewpoints make the article stronger. I do not believe either have their place in the lead but in the interest of balance have reverted. Garycompugeek (talk) 01:47, 4 June 2008 (UTC)

I oppose your action of reverting, Garycompugeek. You have not addressed the issues I raised earlier, and you have not addressed the reasons Jakew raised for not removing the WHO paragraph from the lead. You're also going against the outside opinion, and continuing to put the article into an unstable state rather than going back to the way it was (which had a sort of rough wiki-consensus for a long time, I think) until consensus can develop here on what to change it to. Please either self-revert, or post counter-arguments to the arguments that have been raised here, or both.

Do you really think a letter to the editor is notable enough to mention in the lead for providing balance against the positions of several major organizations? If that reference were included in the lead as you suggest, what would the wording be to go with it? (I withdraw the wording I suggested at 18:46, 3 June 2008, since it would be misunderstood as meaning that that's part of the position of those organizations.)☺ Coppertwig (talk) 02:18, 4 June 2008 (UTC)

Actually outside opinion says remove them both from lead. I have restored one to provide balance. Black Falcon also said it was not UNDUE. Perhaps you should read his reply again. I have no problem rehashing words in the source or exchanging one for the other (blackworms). Garycompugeek (talk) 02:30, 4 June 2008 (UTC)

You have not provided counter-arguments to the points I raised, nor have you done anything to improve the restored paragraph in order to address the points I raised, nor have you suggested specific wording for an alternative proposal. Please self-revert. Please don't restore material to which objections have been raised on the talk page without replying to those objections. ☺ Coppertwig (talk) 02:52, 4 June 2008 (UTC)

Your arguement lacks logic. To paraphrase you, if I raised 30 objections would you have to satisfy them? You have not satisfied my objections nor blackworms long standing ones. Your opinion is no more valid than mine. Garycompugeek (talk) 03:00, 4 June 2008 (UTC)

Gary, not only have you failed to address the points that Coppertwig and I raised, but you've also ignored the input you requested (to quote: "The addition of the source to the article does not give that particular position undue weight; however, adding it to the lead is more complex" [emph. added]). Please try to build consensus for this material instead of edit warring. Jakew (talk) 11:19, 4 June 2008 (UTC)

There is absolutely nothing wrong with the U of Ch source. I have stated I do not believe it belongs in the lead. I also feel the WHO/CDC source should be relocated. My position has never changed. I have supported Chiboyers addition to the lead to add balance but posit they should both be relocated. None of my objections have been appeased however I will discontinue reverting. I know this is not a Democracy however I don't understand how you can claim consensus when 3 editors express favor for the source and 2 do not. Garycompugeek (talk) 15:54, 4 June 2008 (UTC)

I apologize. I think I did the same thing I accused you of doing: I reverted without having answered your points. I think one of your points is that there should be balance or parity. I at least partially agree with this; though according to WP:NPOV there doesn't have to be parity (equal weight) in the representation in the article if there isn't equal weight in the sources. I'm sorry that I may not have been very good at noticing or absorbing your arguments. Would you please provide diffs of the other arguments or repeat the arguments (on my talk page if it would take up too much space here)? Blackworm's, too.

I don't think Jakew was claiming that there was consensus. At the moment we have a dispute, so there is no consensus about that material. What we need to do is discuss and try to reach consensus, according to the WP:CONSENSUS policy.

I have a suggestion: I suggest instead of either the U of C study or the letter to the editor, that as the last sentence of the WHO paragraph we put this, which is similar to a sentence from the HIV section: "Before the randomized controlled trials which prompted those organizations to take those positions, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV." with the same two references as the similar sentence in the HIV section. The advantage of this is that it's based on two review studies (meta-analyses), so it deserves far more weight than one observational study or a letter to the editor. ☺ Coppertwig (talk) 01:56, 5 June 2008 (UTC)

Apology accepted. Your meta also is fine with me. I'd like to take a step back though.

This paragraph - The World Health Organisation (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV. - is more about HIV/AIDS prevention and really should be relocated. Circumcision is notable without it. Lets break down the summary lead. We explain what circumcision is. We talk about its history and prevalence. We document the controversy. We summarize it's not recommended by major medical institutions. That's all we need. Bringing in the hotly contested HIV/AIDS into the summary in my opinion is UNDUE. I agree it is important and should stay in the article. Just not in the lead. Black Falcon was also of this opinion. Garycompugeek (talk) 12:28, 5 June 2008 (UTC)

Gary, as I understand it, you are proposing to move the WHO paragraph but not the preceding paragraph ("The American Medical Association"). Moving both would be problematic, but this would be especially so, for several reasons. First, while it may represent the recommendations of major organisations as of 1999, it would fail to reflect the more recent recommendations. Second, as noted above, the WHO recommendations are one of the main reasons why the subject is notable and interesting. Finally, although you claim that the HIV/AIDS issue is "hotly contested", you have not provided any evidence that this is so, nor have you given any explanation why this would be undue weight (and indeed, I cannot see how one could construct such an argument).

I should also note that you are misrepresenting Black Falcon's suggestion, which was to move the paragraphs 'starting with "The American Medical Association..."'. Jakew (talk) 12:53, 5 June 2008 (UTC)

Jakew, to quote, "the WHO recommendations are one of the main reasons why the subject is notable and interesting." I disagree with your assertion. In my opinion, the main reasons why circumcision is notable are such things as its thousands of years of history, its place within major religions, its global prevalence both current and historic (the fact that it directly affects, or has affected, a substantial minority of the male population of the world, probably numbering in the hundreds of millions currently), and the fact that it is a controversial topic (and the notability of these aspects is not compromised just because there aren't many recent scientific journals which focus on them, nor does the topicality of one aspect of a subject equate to notability of the whole subject in my opinion). Furthermore, The WHO recommendations consist of advice regarding the implementation of circumcision programs only as an "additional strategy" in the attempt to prevent/reduce the rate of heterosexual transmission of HIV. In fact, in relation to three of the randomised control trials, WHO acknowledge that "HIV incidence was considerably lower in the intervention (circumcised men) than in the control group (uncircumcised men), but nevertheless remained high overall (0.7 to 1.0 per 100 person-years in circumcised men)." So, we basically have a medical effect of circumcision which, only to some extent, and only as an additional strategy, may reduce the rate of heterosexual transmission - and this is being promoted as "one of the main reasons why the subject is notable"? As for whether this aspect of circumcision renders the subject interesting, surely that is highly subjective, personal, and largely POV. Beejaypii (talk) 14:18, 5 June 2008 (UTC)

Beejaypii, I think that you are missing the point somewhat in terms of your interpretation of their recommendations: while one might selectively use their text to argue that the effect is minimal, the fact is that they recommend that circumcision should form part of HIV prevention strategies, and that recommendation has already led to planning/implementation in several countries, and thus affects people. In addition to this, it can hardly be denied that the HIV recommendations have led to a great deal of scientific and media interest in the subject.

Having said this, please note that I said 'one of the main reasons', not 'the only reason'. I would agree with many of the other reasons you mention. Jakew (talk) 14:59, 5 June 2008 (UTC)

Ah yes.. I was, not intentionally. Let's move all three. I feel the policy statement fits into lead as a broad covering staement but I am willing to compromise. Are you? It's your POV WHO makes Circumcision notable. I strongly disagree. As far as the evidence about it contested, that would be the two sources we are talking about and I claim UNDUE because I of the reason I stated in my last post. It is UNDUE weight for the lead summary. Yes it makes waves in the HIV/AIDS prevention circles but not when trying to summarize what circumcision is. Garycompugeek (talk) 15:29, 5 June 2008 (UTC)

Gary, I believe it would be a mistake to move these paragraphs, in part because they serve to, in your own words, summarise the recommendations of "major medical institutions", and in part because the WHO paragraph helps to establish an important aspect of why circumcision is notable and interesting. Instead of simply stating that you disagree, perhaps you could explain why you disagree? For example, do you disagree that WHO's recommendations have led to the planning/implementation of circumcision programmes in individual countries? Do you disagree that it has led to interest in the subject from scientific journals and in the media?

As for the two sources under discussion, one is an observational study published approximately a decade before the WHO issued their recommendations (and about 8 years before the first RCT was published). The other doesn't refer to the WHO recommendations; instead it takes issue with the extrapolations from RCTs made by Kahn et al, and questions their predictions. It is evidence of the existence of an alternative view, but nobody has disputed the existence of this viewpoint, the question has been whether this viewpoint is prominent or whether it is that of a slim minority.

It remains unclear why you think it is undue weight to include this in the lead. Could you please explain your position in more depth, perhaps quoting the parts of that policy which you think apply? Jakew (talk) 16:32, 5 June 2008 (UTC)

Jakew, I'm not convinced the WHO/HIV issue is a main reason the subject of circumcision is notable. It may well be a main reason why the subject "medical analysis of circumcision" is notable, but here I think it's peripheral, belonging in the body of the article but not in the lead, at least not in such detail. The lead should "briefly summarize the most important points covered in an article in such a way that it can stand on its own as a concise version of the article" (wp:lead). I don't think the further advice given at wp:lead, "the relative emphasis given to information in the lead will be reflected in the rest of the text" is being adhered to in this article, and the inclusion of current paras five and six in the lead is the main reason. Notability of the subject is perfectly well established by paragraphs 2-4 of the current lead. Health advantages are mentioned near the beginning of the fourth paragraph, and the reader can easily access the HIV specific information by accessing the relevant sources or via the table of contents. I'm sure most of us with an interest in circumcision have our own view with regard to which particular aspect(s) of the subject is/are amongst the most important, and we know we don't all agree, so it might be wiser to accept a more concise "overview" type lead, without overspecific information, leaving the reader free to assess the relative merits of the information provided in the body of the article for themselves, and not misleading them, via the lead, into thinking that a substantial portion of the article is dedicated to the HIV prevention issue, which it is not. Beejaypii (talk) 17:11, 5 June 2008 (UTC)

Beejaypii has summed it up perfectly. Garycompugeek (talk) 17:40, 5 June 2008 (UTC)

Agreed. When the WHO-HIV statement was originally added to the lead, the editor placed it as the second paragraph, right below the definition, as if that is circumcision's most important aspect. That sad event is a grave warning that we cannot allow circumcision advocacy to set the tone of this article. Since then the paragraph has moved down to be the "last word" of the lead, which some may argue is even more non-neutral. Blackworm (talk) 20:43, 5 June 2008 (UTC)

Beejaypii, I'm puzzled by your statement. I don't understand how one can view the WHO/HIV issue as making medical analysis of circumcision notable, but not circumcision itself. Can you explain?

To address your other comments, I agree with your statement that we should "briefly summarize the most important points covered in an article in such a way that it can stand on its own as a concise version of the article", but it is unclear whether you consider this to be an argument for or against including the WHO/HIV issue. It is difficult to understand how it could be seen as an argument against.

Moving on, it's true that the relative emphasis in the lead is perhaps somewhat greater than in the text; this is largely due to this paragraph growing due to historical compromises, and would probably be addressed by removing the CDC source so that we can more briefly address the WHO (I'm inclined to agree with you that it would be desirable to reduce the length of the paragraph). Moreover, if you examine the section from which you quote, it begins "In general, the relative emphasis given to material in the lead should reflect its relative importance to the subject according to reliable sources" — according to PubMed, 275 papers referring to circumcision were published in the last full year (2007). Of these, fully 119 (or about 43%) also referred to HIV. Taking into account the fact that some of these papers may only refer briefly to HIV, it seems reasonable that one of the five paragraphs, or roughly 20% of the text of the lead, should be dedicated to this issue. Jakew (talk) 18:36, 5 June 2008 (UTC)

I'm quite certain WP:lead doesn't mention number of relative hits in a Pubmed search. Let's just use WP:common sense to realize WHO/CDC are talking about HIV/AIDS prevention not what circumcision is which befits the lead. Garycompugeek (talk) 20:02, 5 June 2008 (UTC)

Of course it doesn't mention the relative number of hits in a PubMed search! That's just a way of getting a rough measure of the relative importance of HIV to circumcision. As for what circumcision "is", that's a definition, which is basically the function of the first sentence. The lead needs to do more than just define the subject. To quote from WP:LEAD: "The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. ... The lead should be able to stand alone as a concise overview of the article. It should establish context, summarize the most important points, explain why the subject is interesting or notable, and briefly describe its notable controversies, if there are any. The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources. The lead should not "tease" the reader by hinting at but not explaining important facts that will appear later in the article. It should contain up to four paragraphs, should be carefully sourced as appropriate, and should be written in a clear, accessible style so as to invite a reading of the full article." Jakew (talk) 20:14, 5 June 2008 (UTC)

My apologies Jake that was sarcasm. It also says the lead shouldn't be more than 4 paras and we have 6. What do ya say we trim it down a little move the last two to their relevant sections? Garycompugeek (talk) 20:30, 5 June 2008 (UTC)

The last two are already summaries of the relevant sections, Gary. I don't think that 4 paragraphs is intended to be taken as an absolute limit, but if you're concerned by the number we could probably remove a couple of paragraph breaks. We could probably also reduce the word count a little while retaining the meaning. Jakew (talk) 20:38, 5 June 2008 (UTC)

Excellent then we can remove them from the lead. I was simply pointing out another good reason why they should not be there. Note I am compromising. I think para 5 sums up prevalent medical opinion befitting the lead but I am willing relocate it. I don't want to do it but I will. You can do this also Jake. I know you can. Please compromise. Garycompugeek (talk) 21:10, 5 June 2008 (UTC)

Gary, how do you get from "The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic." and "The last two [paragraphs] are already summaries of the relevant sections" to "then we can remove them from the lead"? I'm genuinely curious. Jakew (talk) 21:15, 5 June 2008 (UTC)

I'm not going to play word games with you Jake. Your inability to compromise is telling. You also seem to be alone in your opinion. Garycompugeek (talk) 21:33, 5 June 2008 (UTC)

Its a shame Jake, you would rather edit war than compromise. Garycompugeek (talk) 22:37, 5 June 2008 (UTC)

I'm impressed by Jakew's argument that the WHO-HIV thing is part of why circumcision is notable. I think that's correct: I think a significant percentage of people coming to read this page are probably doing so with the WHO recommendations or HIV prevention in mind.

I did two web searches to check the notability of the WHO recommendations. On a google search for "circumcision", of the first 20 pages, based on the titles, 4 (that's 20%) seemed to me to be connected with HIV prevention and/or the WHO recommendations. I also did a google news search for "circumcision"; in that case, based on the titles, 8 of the first 20 (that's 40%) seemed to me to be connected with HIV prevention.

When Jakew suggested removing paragraph breaks, I think he meant joining two paragraphs into one, not removing paragraphs. The paragraphs are rather short, so joining them is probably a good idea.

Garycompugeek, you said that circumcision is notable without it. That's fine: there can be more than one reason something is notable. The lead is supposed to summarize the article, so it should mention all major points, even if there is more than one such reason. I don't know whether the WHO/HIV thing is hotly contested or not (I haven't seen publications contesting it), but if it is, then that means it's notable and should likely be mentioned in the lead. You say that it's UNDUE in your opinion, but you don't explain what that opinion is based on. I say it's due weight based on the web searches I just did, among other things.

Please help keep the edit history of the article simple and tidy, and help this article contribute as respectably as possible to Wikipedia's image, by refraining from making new changes until after they've been discussed and agreed on on the talk page. ☺ Coppertwig (talk) 01:11, 6 June 2008 (UTC)

I will refrain Coppertwig. It's true there are no limts on notability. It's also true there are many notable things in the Circumcision artcile. Its up to us to decide what is the most notable. While you have commented on Jake's arguement you have neglected the finer points made by Beejaypii. He has pointed out that we mislead the reader into believing a substantial portion of the article is about HIV/AIDS prevention. Others feel this way also. My personal view about Circumcision for HIV/AIDS prevention is that this a terrible reason to amputate part of the most sensitive organ on your body. Practice safe sex. It works for me. Garycompugeek (talk) 02:25, 6 June 2008 (UTC)

• Hi Gary, I got caught up in some blocking mix up and wasn't able to respond till now, I find your last point very interesting, if HIV and circumcision is not even promoted to be full proof even by the pro-circumcision camp, what so-called value does it have at all then?- is there anyone intelligent out there with a circumcison really saying to themselves, "now I can engage in unsafe sex becuase I am protected", and is this "safety" propaganda even leading to the higher HIV rates in this country Chiboyers (talk) 06:44, 6 June 2008 (UTC)

Jakew and Coppertwig, I think the methodologies you are employing to ascertain the notability of the HIV prevention aspect of circumcision actually measure topicality, which does not equate to relative notability within the whole subject. There are notable aspects of circumcision, such as its long history, which probably aren't being discussed with high frequency in recent published sources because they are not topical or, currently, controversial. Your methods applied to such aspects of the subject would suggest they are not notable, which is false, so your methods are flawed. Furthermore, the advice in wp:lead states "The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources.", that's "according to reliable, published sources." not "in accordance with frequency of mention in recent reliable, published sources." Can you see the difference there? Beejaypii (talk) 12:42, 6 June 2008 (UTC)

Garycompugeek, feel free to try to suggest a shortened version of the HIV mention in the lead (this is difficult to do). Beejaypii, I think there can be different kinds of notability and the lack of notability by one measure doesn't necessarily mean something isn't notable. Chiboyers, your comment seems to me to be about circumcision itself rather than about article content. ☺ Coppertwig (talk) 12:57, 6 June 2008 (UTC)

(edit conflict) Beejaypii, I think we may be talking at cross purposes. I'm trying to answer the question "why is the subject of circumcision interesting or notable". Correct me if I'm wrong, but I think you're trying to answer a question more similar to "given that I'm interested in circumcision, what aspects of it are interesting or notable". In terms of these two questions, it seems to me that circumcision's long history is perhaps a relatively weak answer to the former, but a stronger answer to the latter.

In an ideal world, we might have multiple reliable sources which explicitly tabulate the relative importance of various aspects of circumcision, but let's be realistic here: we don't have these sources. In the absence of such sources, it's reasonable to try to get a rough idea of the relative importance through other methods. I would agree that these methodologies are not perfect, and I wouldn't pretend otherwise. As I stated above, they're intended as a "rough measure". If you have a better suggestion, I'd be keen to know what that is. Jakew (talk) 13:06, 6 June 2008 (UTC)

It is obvious that many of us object to HIV/CDC source in the lead. At issue is weather or not it is notable enough to be there. When I say it is hotly contested I mean by established editors contributing to this article. I feel we mislead the reader here and worry about the consequences. I believe Jake and Coppertwig probably feel the same way if we were to remove it. I'm not sure a mediator will help this matter since we had one for a slightly different reason but his take was to remove to U of Ch source and the HIV/CDC source. Mediation? Arbitration? Where do we go from here? Garycompugeek (talk) 13:41, 6 June 2008 (UTC)

Jakew, what gives you the impression that I'm trying to answer the question "given that I'm interested in circumcision, what aspects of it are interesting or notable"? I don't understand your point here.

So, you agree that your methodologies are not perfect. Well, you aren't agreeing with me, because I didn't say they weren't perfect, I said they were flawed. To reiterate: your method tells us about topicality and frequency of mention, it does not tell us about relative notability. Your method does not demonstrate that the WHO/HIV prevention aspect deserves disproportionate representation in the lead of this article, contravening advice given at wp:lead. And I am not obliged to suggest a better alternative to a flawed methodology which you have independently introduced, which is not documented in wikipedia policies or guidelines, and which you are using to support disproportionate representation, in the lead, of one aspect of the article topic.

If we don't have "multiple reliable sources which explicitly tabulate the relative importance of various aspects of circumcision" then we should accept that, and not rely on "rough measures" to try to get a "rough idea" (since when has that been a recommended approach on Wikipedia?). What I believe we should do, under the circumstances, is try to ensure that the lead complies with the advice that it should be able to "stand on its own as a concise version of the article", and if we try to do that we should be able to come up with a well-structured lead which does not, as the current lead does, provoke edit wars because disproportionate emphasis has been given to one particular aspect of the topic. In short, keep it all brief and concise and nobody will be reasonably entitled to get upset, and we can all then focus on the body of the article, where all the detailed information rightfully should be. Beejaypii (talk) 01:03, 7 June 2008 (UTC)

That was very well said, Beejaypii. Regarding Jakew's novel criteria for assessing notability, I am not impressed. He chooses to examine only one aspect of circumcision, namely medical aspects, by going to PubMed, to assess the notability of the WHO paragraph in a general article on circumcision. He then further limits the scope of his original "rough idea notability research" to the year 2007, the year of the results of the HIV RCTs. He then calculates that some forty-odd percent of year 2007 articles in PubMed and referencing circumcision, also reference HIV. From this, and after a completely arbitrary assessment (i.e. guess) at the strength of the link between the HIV reference and circumcision reference, asserts that "it seems reasonable that one of the five paragraphs, or roughly 20% of the text of the lead, should be dedicated to this issue." Assuming one would accept all of that original research, the conclusion that the statement about "this issue" -- namely, "HIV and circumcision in Western medicine in 2007" -- that of all the things said about circumcision and HIV, things he includes in his "evidence," the central theme and binding idea is that the WHO stated that circumcision reduced transmission of HIV. Did I see the words "WHO" or "reduced transmission" in those searches? Only 23 articles published in 2007 in PubMed mention the WHO, a dismal 8% of the articles in 2007. If you consider all PubMed articles forever, the percentage on a search for "circumcision HIV WHO" vs. "circumcision" is 99/4067, or 2.4%. In short, your argument is an invented, non-binding justification for imposing your own personal sense of "order" or "reasonableness" or whatever word you'd like to use, on all of the others here who disagree with you. What do they call editors like that? The mere idea of imposing your invented methodology on the editors here is insulting and disrespectful; the idea is flawed on its face. Further, even if one humours the attempt and follows it through to its mathematical conclusion, it fails to convince. Blackworm (talk) 06:47, 7 June 2008 (UTC)

Beejaypii, to address your points in turn, I received this impression largely because of your choice of words (for example, "does not equate to relative notability within the whole subject", as well as the distinction you wish to make between topicality - which is surely an aspect of notability - and notability). If I've incorrectly understood, then please accept my apologies and correct me.

While I recognise that you're under no obligation to propose a better methodology, there seems to be a problem here, because we both agree that we should follow the guidance of WP:LEAD that "The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources." It is therefore essential that we have a method of determining the importance to the topic according to these sources. Coppertwig and I have proposed "rule of thumb" methods that, while not perfect, give us usable information. If you reject these methods, then what alternative method would you propose to allow us to assess whether the guideline is being met? I very much doubt that the intent of the guideline is for us to simply ignore it as you suggest. Jakew (talk) 10:52, 7 June 2008 (UTC)

I think Jakew earlier suggested removing the mention of the CDC. I'm not sure why; however, the CDC is a U.S.-specific agency, so it seems less notable to me than the WHO. We can still discuss whether to remove the whole paragraph or not or what else to do, but meanwhile, can we get agreement on removing the CDC, which would shorten that paragraph slightly, helping slightly to address the problem of balance?

Beejaypii, what definition of notability are you using? I think notability as it applies to articles is defined in Wikipedia guidelines but I'm not sure that notability for stuff within articles is defined. It would be different, since a thing within an article wouldn't necessarily have the same degree of notability as something deserving a whole article, and because of the quantiziation of sources it won't scale smoothly.☺ Coppertwig (talk) 11:44, 7 June 2008 (UTC)

(edit conflict) Beejaypii logic seems flawless Jake and extremely difficult to argue with. We must employ logic and common sense to weight notability. Coppertwig is impressed with your argument but accepts it on flawed reasoning ie "I think a significant percentage of people coming to read this page are probably doing so with the WHO recommendations or HIV prevention in mind." Why? I highly doubt it. I also highly doubt that those who are circumcised feel safe to have sex with infected HIV persons, at least I hope they do not. What exactly are we trying to accomplish here? Yes circumcision slightly reduces transmission rates of infectious disease because of the tougher skin. Overall this is meaningless unless you refuse to practice safe sex. When it comes to HIV WHO wants to roll the dice and hope you don't crap out. (note the pun was intentional) Sorry I want full proof methods when it comes to do or die. What WHO is essentially saying is humans are too stupid to practice safe sex so circumcision will reduce transmission rates. Because of scientific research this should be documented in the article. Does it belong in the lead as something that makes circumcision notable? I think not. Garycompugeek (talk) 11:59, 7 June 2008 (UTC)

Gary, as Coppertwig has noted above, about 40% of Google news results appear to involve HIV prevention, which suggests that there is a significant level of interest in the subject. Your other points seem to be expressing your own opinion of the WHO's conclusions, and your disagreement with their position. Jakew (talk) 12:39, 7 June 2008 (UTC)

Of course its my opinion Jake. This is the talk page. This is where we express our opinions and explain our conclusions. It's my opinion WHO's position does not make circumcision notable and neither do search results. You are either completely rejecting or ignoring the bulk of Beejaypii's logic. This is why I find it very frustrating to debate with you Jake. At what point do you say "Is it possible I could be wrong?". I am far from flawless but will accept others logical arguments. I have proposed other avenues to solve this dilemma because I am confident of my position. Either give in. Come up with something logical that will sway us (dissenting editors) or agree to a dispute resolution. Garycompugeek (talk) 13:03, 7 June 2008 (UTC)

Per WP:TALK, "Article talk pages should not be used by editors as platforms for their personal views." Whether you, I, or any other editor agrees or disagrees with a source is completely irrelevant to the article, and there is no need for such views to enter the discussion. I have addressed Beejaypii's arguments above. Jakew (talk) 13:13, 7 June 2008 (UTC)

Perhaps I have been slightly soapboxing but only in the interest of explaining conclusions and applying to WP:common sense. Your addressment of Beejaypii's argument is completely unsatisfactory. I repeat myself "Either give in. Come up with something logical that will sway us (dissenting editors) or agree to a dispute resolution." Garycompugeek (talk) 13:28, 7 June 2008 (UTC)

(edit conflict)

Another thing I would like to make absolutely clear regarding search results. Search hits could be from anywhere but it does not mean they are all from peer review sources we would accept in this article. They also tend to repeat themselves in multiple article further skewing any statistics. Conversely due to our high standards of quality for this article (ruling out bias pages on both sides of the board) would leave you with very small percentage of applicable data. Garycompugeek (talk) 13:18, 7 June 2008 (UTC)

Yes, Gary. That was why I initially used PubMed rather than a plain Google search (PubMed is a database that indexes articles peer-reviewed journals). And as Coppertwig has shown, the same is true of news sources. Jakew (talk) 13:26, 7 June 2008 (UTC)

True but you do not accept all peer review sources do you Jake? Garycompugeek (talk) 13:32, 7 June 2008 (UTC)

Last but not least using your own search criteria for notability and/or inclusion Google news search on related searches to circumcision list "male circumcision", "mutilation", "procedure", "female", "hiv aids" and "old egyptian". I guess we should change the title to "Male Circumcision" and include a section on female circumcision plus discuss circumcision as genital mutilation. Garycompugeek (talk) 13:51, 7 June 2008 (UTC)

Discussed many, many times previously. Please see, for example, Talk:Circumcision and law#Neutrality. Jakew (talk) 13:55, 7 June 2008 (UTC)

I'm not advocating it Jake, merely trying to use your logic to prove a point. Garycompugeek (talk) 14:24, 7 June 2008 (UTC)

Sorry I messed up the formatting of my last message, but to be more explicit, here is the edit I propose: I propose changing "The World Health Organisation (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV." to a version not mentioning CDC, i.e. "The World Health Organisation (WHO; 2007) and the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007) state that evidence indicates that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV." The U.S.-specific CDC can still be mentioned in the article, but for brevity I suggest not in the lead. :-) Coppertwig (talk) 15:52, 7 June 2008 (UTC)

If the WHO paragraph is notable because the WHO is prominent and its recommendations have real world effects, as Jakew states, then it is those real world effects, if anything, that belong in the lead. On 18:16, 24 January 2008 (UTC) Jakew posted a link to a BBC article here stating that a state sponsored mass circumcision program is underway in Rwanda, described as "nominally voluntary" and "many in the armed forces will regard it as an order." Over four months later, that information is still not in this "balanced" article. Is it because it is difficult to summarize that information in a way that fits with this "circumcision brochure," as other editors have called it? Jakew sees the WHO's advocacy of circumcision as one of circumcision's most notable aspects, explains that this is because it has real world effects, but doesn't seem interested in including those real world effects in the article, pre-emptively stating his opposition to the appearance of material about those real world effects in this article, by immediately recommending it go into POV-fork subarticles. It's nonsensical. This article cannot continue to be a vehicle for circumcision advocacy. We have many editors, each in 1 on 1 conversations with Jakew attempting to get him to stop objecting to any changes he wouldn't personally make, in effect treating him as the arbiter of this article (WP:OWN). You can disrupt Wikipedia by blocking any edits you don't like, too, not just by editing. Please stop, Jake. Blackworm (talk) 16:07, 7 June 2008 (UTC)

Or you can just ignore all those other pesky editors who do not agree with your POV. Sorry if I seem jaded but I have been trying contribute to this article for months now and the one sentence I got into the article was the CDC reference to try and balance WHO and even that got twisted to look like support for WHO and now Coppertwig wants to remove that from the lead. Coppertwig, you have my support, go ahead and remove or relocate the CDC reference. Its not serving as the balance that I originally proposed anyway. Garycompugeek (talk) 18:31, 7 June 2008 (UTC)

Your suggestion seems very sensible, Coppertwig. Actually, we could reduce the word count further. Since we've already introduced the acronym WHO in paragraph 3, how about "WHO and the Joint United Nations Programme on HIV/AIDS (2007) state that..."? Jakew (talk) 16:47, 7 June 2008 (UTC)

Garycompugeek, I understand your frustration. Around March 2007 I spent tons of time trying to do something about what appeared to me to be a problem with Wikipedia:Attribution. The only thing I was allowed to add to the article, after weeks of discussion and some editwarring, was changing a period to a colon. I've had similar experiences with at least one article, and maybe even this one (I don't quite remember). But I think many people find that after a good bit of experience editing an article, they get a better feel for what fits with policies and guidelines and what other editors will accept, and have a better time getting stuff in. :-) Coppertwig (talk) 22:18, 7 June 2008 (UTC)

(Outdent.) Coppertwig, that assumes that policy is being followed, but here, it is alleged that policy is not being followed. Jakew's "rough consensus" theory of article development is not policy. An edit that goes unnoticed, or an edit whose shifting of the POV isn't immediately obvious cannot be said to have any kind of consensus. Most editors don't check this article and all circumcision-related articles daily, carefully and diligently reviewing all diffs for any material they deem should be immediately challenged. This "rough consensus" theory is ideal for use by such a fanatical editor, since all material immediately challenged and "boldly reverted" would never have any chance to sit for days. Thus all material the editor challenges never has this form of consensus, and if that theory is applied the fanatical editor effectively owns the article. Sorry, but I don't think that's how Wikipedia is supposed to work. Blackworm (talk) 09:08, 8 June 2008 (UTC)

Jakew, we may well agree that "The emphasis given to material in the lead should roughly reflect its importance to the topic according to reliable, published sources.", but what we don't agree on is that this advice should be interpreted as "The emphasis given to material in the lead should roughly reflect its importance to the topic in accordance with frequency of mention in recent reliable published sources."

Also, I think that the existence of this very debate here suggests that the advice in wp:lead is not being "ignored", and nor am I suggesting that we ignore it: I'm suggesting that it is being contravened largely because of the amount of disproportionate emphasis the HIV prevention aspect is currently receiving in the lead.

Furthermore, I suggest that you are the one ignoring advice given in wp:lead, namely that "The lead should be able to stand alone as a concise overview of the article." and "in a well-constructed article, the relative emphasis given to information in the lead will be reflected in the rest of the text." and "Avoid...over-specific descriptions, especially if they are not central to the article as a whole."

I believe that I am making suggestions as to how the lead of this article might be improved so that it complies with as much of the advice at wp:lead as is realistically possible. You seem to be attempting to comply with one aspect of that advice, whilst contravening others, using a flawed methodology which you have introduced, in order to ensure that the WHO/HIV information is especially prominent in the lead. Beejaypii (talk) 10:02, 8 June 2008 (UTC)

Beejaypii, I understand that you disagree with this interpretation, but what you haven't offered is a usable alternative interpretation. When considering the intent of the guideline, do you really think that this advice is intended to be ignored unless sources explicitly tabulate the relative importance of various aspects? Or do you think that it is intended that we try to get a rough idea of the importance given to the topic in these sources?

I understand that you believe that WP:LEAD is being contravened, and that HIV is given disproportionate emphasis. I do not understand how you can judge the emphasis to be disproportionate, however, without having a means of assessing what the correct proportion ought to be (which brings us back to the previous point). However, Coppertwig and I have suggested ways of reducing the word count, and thus in turn the relative proportion of the lead.

I do not understand why you think I am ignoring the advice that "The lead should be able to stand alone as a concise overview of the article" - indeed, this advice seems to indicate that the HIV aspect should be mentioned. I do agree that the relative emphasis given to HIV could be reduced somewhat in the lead, and again I refer to the efforts to reduce the word count somewhat. I do not think that either the current or the proposed paragraph are over-specific - if anything, they serve as a very high-level overview - but I would welcome your proposals to address this. Jakew (talk) 11:07, 8 June 2008 (UTC)

Jakew, if the HIV aspect should be mentioned, and it's ok to do so in the form of a high-level overview, then we can do the same thing in the lead with other aspects of the topic too. Unfortunately, I can see that leading to further disputes over relative emphasis, but in the context of an unnecessarily expanded lead. Your territoriality concerning the lead of this article is the primary cause of disputes. You are not facilitating the process of improving the lead because you are pushing the aspect of circumcision which you, personally, want to see given disproportionate prominence in the lead, with scant regard for the structural quality of the article, and justified by a methodology, introduced by you without concensus and not documented in policies or guidelines, which cannot tell us anything indisputable about relative notability within the context of the main topic: because it cannot, conversely, demonstrate that a particular aspect is not notable. Furthermore (and this is a somewhat moot point in view of the failings of the methodology in question already described, but it raises further questions) can one guarantee that the search facility at Pubmed is bug-free and reliable? Should we really be relying on whatever code is involved in that search facility to ascertain (supposedly) relative notability of aspects of a topic in the way you are doing? Isn't this a very unscientific and makeshift way of trying to achieve what you're trying to achieve (at which it doesn't succeed anyway)? If your methodology is as useful as you claim, why don't you try getting it added it to the wp:lead guidelines as a recommended strategy, to be adopted in situations such as the one we have here? Beejaypii (talk) 13:34, 8 June 2008 (UTC)

Beejaypii, I don't see a particular problem with mentioning other aspects in the lead, and indeed we already do so. We discuss, for example, history, prevalence, and claims from advocates on both sides of the circumcision debate.

To review the history here, when I pointed out that the WHO recommendations were "one of the main reasons why the subject is notable and interesting", you objected that this was "highly subjective, personal, and largely POV". In order to be somewhat more objective, I then asked "For example, do you disagree that WHO's recommendations have led to the planning/implementation of circumcision programmes in individual countries? Do you disagree that it has led to interest in the subject from scientific journals and in the media?" These questions, as far as I can tell, went unanswered. Finally, I offered a reasonably objective way of assessing the rough significance of this aspect across multiple reliable sources, in an easily reproducible test that avoids giving too much weight to any individual source. Similarly, Coppertwig has used similar methods to show that this result is not limited to PubMed. You respond by stating that this method is flawed, yet do not offer a better method of determining the importance of material.

The clear intent of WP:LEAD, as documented in the first two paragraphs, is that the lead should summarise the significant aspects of a topic. In the absence of any method to determine significance, we would have to either a) rely upon subjective assessment (which you reject), or b) have no material whatsoever in the lead. Since the latter outcome is absurd, and since you reject the former, it follows that a method of determining relative significance is needed. Sure, the methods that Coppertwig and I have used aren't foolproof, but in the absence of anything else they serve as a reasonable basis for discussion (and I'm sorry to be blunt, but if the best objection to them is that there might be bugs in PubMed then they must be a pretty good basis).

In spite of having offered several different kinds of evidence in support of the significance of this paragraph, Coppertwig and I have attempted to address your concerns about relative emphasis by reducing the word count of the paragraph. Are you interested in working with us on this? Jakew (talk) 14:11, 8 June 2008 (UTC)

Arbitrary section break (third on page)

(ec) Wait: before we remove the CDC mention, I'd like to find out what sort of balance Garycompugeek was originally using it to add. I'd like the lead to say something about possible harmful effects of circumcision or about it not necessarily being a good idea to use circumcision as a preventive for HIV, if such balancing ideas can be justified from reliable sources with due weight.

Blackworm: I'm sorry, I haven't had time to fully absorb all of this discussion so I'm not sure if I follow what you're saying. I was mentioning rough consensus not as an argument that the article should take some particular form, but only as an argument for refraining from making certain edits for a few days while we discuss them, so as to maintain a dignified article history that looks as if changes have been made carefully, and that is easier to search through afterwards. ☺ Coppertwig (talk) 14:43, 8 June 2008 (UTC)

Coppertwig I was referring to this post "The CDC quotes "There are as yet no convincing data to help determine whether male circumcision will have any effect on HIV risk for men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner." [18] sourcing Koblin BA, Chesney MA, Husnik MJ. Garycompugeek (talk) 22:20, 12 April 2008 (UTC)" straight from the CDC arcticle. Garycompugeek (talk) 17:08, 9 June 2008 (UTC)

Jakew, I believe that your methods of ascertaining relative notability are not acceptable, and my best objection to those methods is not the point I make about possible bugs in the Pubmed search. In fact, lets take a look at what I actually wrote about your method in my last contribution, namely that it...

"...cannot tell us anything indisputable about relative notability within the context of the main topic: because it cannot, conversely, demonstrate that a particular aspect is not notable. Furthermore (and this is a somewhat mute point in view of the failings of the methodology in question already described, but it raises further questions) can one guarantee that the search facility at Pubmed is bug-free and reliable? Should we really be relying on whatever code is involved in that search facility to ascertain (supposedly) relative notability of aspects of a topic in the way you are doing?"

It seems pretty obvious that I, myself, don't see the point I make about the search facility as the main objection. What was it you said again:

"Sure, the methods that Coppertwig and I have used aren't foolproof, but in the absence of anything else they serve as a reasonable basis for discussion (and I'm sorry to be blunt, but if the best objection to them is that there might be bugs in PubMed then they must be a pretty good basis)."

Here, you effectively side-step my main objection to your methodology by implying that it's not the best point, without actually addressing it, and effectively promoting a lesser point I made (which I actually described as a "somewhat mute point" when I made it) to the top of the list, and the conclusion you draw is that the object of my critiques, your methodologies, are a "reasonable basis for discussion" because that newly elevated point may be the best one (please see straw man). And yes, your methodologies are a "reasonable basis for discussion", the discussion we've been having pretty much suggests that's a given, but so what, that doesn't make them any more valid.

You ask me if I'm interested in working with you and Coppertwig on this. Actually, I'm interested in working with any editor who is interested in taking part in this discussion and the changes to the article which result from it, but can we achieve concensus on a fundamental aspect of the current discussion first? Can we follow through, to a conclusion, the discussion of the methodology you have invented and employed, unsupported by Wikipedia policies and guidelines, to support disproportionate emphasis placed on a particular aspect of the article topic in the lead (and how about also addressing Blackworm's critique of that methodology, which he set out in his contribution beginning "Very well said..."?) Beejaypii (talk) 22:08, 8 June 2008 (UTC)

Beejaypii, I apologise for the "best objection" remark. This was unnecessary and I will, if you wish, strike it out.

If you look at the discussion above, you will see that both Coppertwig and I have acknowledged that there may be more than one kind of notability, and it follows from this that one may need to use multiple methods to establish the notability or significance of an aspect of the topic. So when you state that the method "cannot ... demonstrate that a particular aspect is not notable", I don't entirely agree. It might indicate that an aspect is not notable, but if that's the "wrong" answer (how would we tell if we're disallowing subjective assessment?) then we might be talking about another type of notability.

The problem, as I see it, is that there is (understandable) resistance to subjective assessments of relative significance, and yet there is also resistance to more objective measures. The resistance to the latter seems to be misguided, largely because it seems to be on the basis of mistaking evidence in support of an argument for significance for an absolute rule for determining significance. I don't believe there can be an "absolute rule", but when subjective assessments are rejected it is reasonable (and indeed, almost expected on WP) to present evidence in support of one's position.

Not only have I offered PubMed searches, but Coppertwig has also shown that there are similar results in Google News (and, although less suitable for locating reliable sources, plain Google). So that's three different kinds of evidence, all of which indicate that the HIV issue is significant. In addition to this, arguments have also been presented that WHO's statement (an obvious secondary source for the HIV issue) are also notable due to the prominence of WHO and thus the consequences of their recommendations.

Taken together, then, especially in light of lack of evidence to the contrary, it is hard to escape the conclusion that there is compelling evidence that the HIV issue ought to be covered in the lead. I do acknowledge, however, that more emphasis is given to this aspect in the lead than in the rest of the article, and I again point out that Coppertwig and I have been discussing a means of addressing this by reducing the number of words in the lead paragraph. Jakew (talk) 23:31, 8 June 2008 (UTC)

No argument has been presented for the notability of the WHO's position on circumcision in the lead section. If the WHO statements are "also notable," then at best they should come after the statements whose general notability you believe to have established, i.e. something along the lines of: The possible effects of circumcision on HIV transmission have been and continue to be examined. In 2007 the WHO recommended the procedure as a means to reduce HIV transmission, in contrast with most states' medical organizations, which do not recommend (but generally do not oppose) the procedure. In Africa, this has lead to state programs to circumcise males. I see that as neutral, notable, and general; it doesn't give the WHO (advocates) or its opponents too much "brochure"-space (if you'll permit), and it effectively summarizes the subject (circumcision and HIV) in proportion to its established notability. It references the time aspect (2007) of the "evidence" you have produced. It points out that most medical organizations still do not recommend the procedure. The above can replace the WHO paragraph, and the paragraph on the AMA. Thoughts welcome. Blackworm (talk) 00:58, 9 June 2008 (UTC)

And by the way, Jake, there is no onus on editors to come up with a methodology that YOU believe is "more objective" than yours. A more objective methodology may still be gravely flawed, as I believe yours is. Compromise and consensus with editors around you is the only way to go. Blackworm (talk) 01:09, 9 June 2008 (UTC)

(<<<outdent)Re "The possible effects of circumcision on HIV transmission have been and continue to be examined." Inserting this at the beginning of the paragraph would lengthen the paragraph. Would other editors see it as increasing too much the weight given to this topic? I think it would be OK to insert it. Actually, I think it's a good sentence. It introduces the paragraph nicely rather than leaving the reader to parse a list of names of organizations before figuring out what's being talked about.
I'm not sure that we can fairly state that medical organizations have a contrasting position: maybe they just haven't updated their positions yet after the WHO thing came out. Do we have reliable sources stating that there is such a contrast?
There is no onus on other editors to come up with a method Jakew finds convincing unless they wish to convince Jakew of something in the process of trying to reach consensus.
I think Jakew's point is not that an alternative method of establishing notability proposed by others is less objective, but that no such alternative method has been proposed. ☺ Coppertwig (talk) 01:24, 9 June 2008 (UTC)

Thank you, Coppertwig, for your reply. If we all accept that the WHO currently recommends circumcision, and medical organizations do not recommend circumcision (and do not oppose), clearly those are contrasting positions, regardless of whether and when other organizations will agree with the WHO. In fact, what calls for the "contrasting" language is neutrality, but we can address this differently by making the paragraph about what medical organizations say, rather than about circumcision and HIV. In that case, I would suggest the paragraph: Most states' medical organizations do not recommend (but generally do not oppose) male circumcision. However, in 2007 the WHO recommended it as a means to reduce HIV transmission. In Africa, this has lead to state programs to circumcise males. It removes the contrast language. Being about medical organizations and the real-world effect of their recommendations, rather than about circumcision's possibly link with HIV, there is no need for the first sentence you said you liked (sorry).

The WHO doesn't set the agenda for other organizations, the organizations are indeed aware of the WHO's recommendation (as the CDC source shows) and of the underlying studies. I suggest we let the reader decide whether the WHO's change in position in 2007 is too recent for other organizations to have had a chance to examine the same evidence and change their position along with the WHO. Blackworm (talk) 01:53, 9 June 2008 (UTC)

It occurs to me, Blackworm, that your proposal would have much the same effect as joining the last two paragraphs of the lead into one. As a general concept — covering the medical organisations in one paragraph — I think it's a good idea. However, I'm not sure about the exact wording, and I would like to understand why you feel that this wording is preferable to, say, simply joining the paragraphs. Jakew (talk) 12:46, 9 June 2008 (UTC)

It's less than half as long as the two existing paragraphs, as it doesn't have a level of detail inappropriate for the lead, and it additionally introduces the real world effects that make the HIV aspect notable. Blackworm (talk) 15:26, 9 June 2008 (UTC)

Hmm. On first glance, I can see three major problems. Firstly, "state" is somewhat ambiguous, and might be taken to mean US States. Secondly, the AMA report represents the literature as of December 1999, and so this needs to be dated in addition to the WHO statement. Thirdly, I'd prefer to stay closer to the source than "do not recommend (but generally do not oppose)". To address these issues would require a few more words, but perhaps not as many as the existing paragraphs.

How about something like this: "As of 1999, most medical organisations did not recommend routine infant male circumcision, and advised that parents should be given accurate and unbiased information to inform their choice. In 2007 the WHO recommended circumcision as a means to reduce HIV transmission, which has led to national circumcision programmes in several African countries." Jakew (talk) 17:19, 9 June 2008 (UTC)

(ec) Yes, I agree, we need to let the reader decide. I think it's difficult to summarize in a few words various states' medical organization policies, especially when we may only know a few of them. It might work to tack the HIV stuff at the end of the paragraph about medical organization policies (which I think needs to be edited so as not to mention only a U.S. organization).

On second thought, the sentence "The possible effects of circumcision on HIV transmission have been and continue to be examined." seems to me to have a problem. I'm not so sure we can say "continue to be examined": what does this mean? The RCTs were stopped early due to allegedly overwhelming evidence, so I suppose nobody's planning any more RCTs at the moment. I haven't thought of a good way to word it. ☺ Coppertwig (talk) 13:55, 9 June 2008 (UTC)

That sentence is gone from the above version. You'll notice the AMA paragraph to be replaced summarizes the various states' policies. Is that summary disputed? Blackworm (talk) 15:26, 9 June 2008 (UTC)

Hmm. Jakew, doesn't your suggestion involve a degree of spin? When you say "As of 1999, most medical organisations did not recommend..." doesn't your use of the simple past tense (did not recommend) suggest a completed action, ie something which was occurring but is not any longer? Is that in the source? I don't think so, I think the source tells us what the AMA said the situation was in 1999, but does not tell us how, or whether, it has changed in the meantime. Furthermore, by presenting information as "how things were", instead of "how the AMA described things as being" you set things up very nicely for the following sentence, "In 2007, the WHO recommended..", to play the "but here's how things are since more recently" role, and you've also retained the mention of the WHO in the text, along with the weight that adds, and you've managed to drop the reference to the AMA in the text, reducing the apparent weight of that side of the argument. Beejaypii (talk) 22:14, 9 June 2008 (UTC)

Firstly, Beejaypii, I do not appreciate your accusation of "spin", and I would be grateful if you would avoid making such claims in future. Not only is it unfortunate that you appear not to assume good faith, but some of your allegations are somewhat perplexing. For example, you state that I have "managed to drop the reference to the AMA, reducing the apparent weight of that side of the argument", yet if you had read Blackworm's comment dated 01:53, 9 June 2008, it would have been obvious that his initial draft wording dropped the reference to the AMA, presumably due to the desire for brevity. Perhaps it might be more productive to simply state your objections to the text, rather than attempting to weave them into a theory about another editor?

The AMA explicitly state in their statement that it "represents the medical/scientific literature on this subject as of December 1999" (typos in source corrected). Unless we wish to credit the AMA with the ability to predict the future (relative to 1999), the past tense would therefore seem to be appropriate. We also use the past tense when describing the WHO's 2007 statement ("the WHO recommended..."). The obvious alternative would be to use a direct quote with dated attribution, though of course this wouldn't help to reduce the word count. Jakew (talk) 23:20, 9 June 2008 (UTC)

Do we have a reference on which to base a statement about "most medical organizations"? If not, I dispute such a statement as unverified, and it could perhaps be replaced by something along the lines of "several major medical organizations". I don't even know how many medical organizations there are in the world; I assume at least one per country, which is a large number, and in that case I haven't seen references talking about the positions of a majority of them. Besides, "medical organizations" is vague and could be taken to include a very large number of very small, informal organizations. ☺ Coppertwig (talk) 09:53, 10 June 2008 (UTC)

Maybe "most major medical organizations". ☺ Coppertwig (talk) 11:02, 10 June 2008 (UTC)

Jakew, I made neither an accusation nor a claim, I asked a question: "...doesn't your suggestion involve a degree of spin." (by the way, nice word play in the first paragraph of your last contribution: "spin" and "weave". You haven't been reading my recent contributions to the Blackburn article, about the textile industry, have you?)

You are correct, I did not notice that Blackworm dropped the AMA reference, I acknowledge my mistake. You can stop feeling perplexed now.

Now lets look at your use of the past tense. Yes, we don't wish to credit the AMA with the ability to predict the future, but that doesn't seem to relate to the point I'm trying to make. You see, your phrase "As of 1999, most medical organisations did not recommend...", as I pointed out, suggests a state of play which has now ended, which may or may not be true, but we don't know and we don't have a source which tells us. To avoid suggesting a situation which has now ended, you would probably have to say "As of 1999, most medical organisations do not recommend...", again, this may or may not be true, we don't know, and we don't have a source which tells us. However, the statement "The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice.", is valid, and supported by a source. Do you see the point I'm trying to make here? Beejaypii (talk) 22:35, 10 June 2008 (UTC)

I think that we must be parsing the sentence differently, Beejaypii. I don't see the implication of a "a state of play which has now ended", as you put it. Nevertheless, your point seems to be that you prefer the current version (or "direct quote with dated attribution" as I put it above). As I indicated, I think that's an acceptable alternative. The disadvantage is that Blackworm expressed a (reasonable) desire to reduce the length, and the attributed version is slightly longer (39 vs 28 words if I count correctly). Jakew (talk) 23:12, 10 June 2008 (UTC)

(Outdent.) I could abide by Jakew's suggested edit, but then Beejaypii has brought up the spectre of WP:V. I suppose it was a foolish idea from the beginning to attempt to improve the lead by stating things pretty much all editors here agree on, instead of things which destroy the readability but are rendered bulletproof by hard, reliable, easily available sources. I wrote the AMA paragraph that I suggested we remove, and which Beejaypii says is valid and supported. But I suppose I had a moment where I saw some common ground we could agree on, and thought perhaps for a moment many of us could transcend our pedantry to improve both the flow and neutrality of the lead. Blackworm (talk) 06:05, 11 June 2008 (UTC)

RFC: Does WHO/CDC paragraph belong in LEAD?

Does the WHO/CDC paragraph make Circumcision notable?

Not in proportion to its current prominence in the lead. This is a clear case of recentism. Certainly if it does at all, its contribution is a tiny fraction of how the circumcision of females makes circumcision notable. The circumcision of females is not addressed at all in this article, which is one fundamental flaw that several other flaws flow from. Circumcision is not what this article says it is. Circumcision is the 1 a: the act of circumcising;[54] and circumcising means to cut off the foreskin of (a male) or the clitoris of (a female)[55]. Correct that flaw, and you see how dozens of other flaws have no flaw to stand on (pardon the pun). Blackworm (talk) 05:50, 12 June 2008 (UTC)

Blackworm, you're ignoring what I've pointed out to you previously: there is more than one definition of the word "circumcision". Any particular use of the word may happen to only be using one of those definitions. A Wikipedia article is, as I've explained to you before, centred around a topic, not around a word (see Wiktionary for that). Here, the topic is male circumcision. Male circumcision is one of the definitions of the word "circumcision", and that's how the word is being used here to refer to this topic. A Wikipedia article has no obligation to explore all topics that relate to all definitions of a word.

My opinion on the RfC is expressed in these posts above:

• ...google news search for "circumcision"; in that case, based on the titles, 8 of the first 20 (that's 40%) seemed to me to be connected with HIV prevention.
• The edit I'm suggesting, i.e. removing mention of U.S.-specific CDC
• before we remove the CDC mention, I'd like to find out what sort of balance Garycompugeek was originally using it to add.

☺ Coppertwig (talk) 13:18, 13 June 2008 (UTC)

While hoping to attract outside opinion to this debate I will never the less add my two cents. Sticking to the question of the RFC, (not that I don't agree there are many other issues) I feel the last paragraph of the lead dealing with WHO/CDC is mainly about HIV/AIDS prevention and a poor one at that (slight reduction in transmission of STDs when not practicing safe sex). There is plenty of evidence that the above benefit does not outweigh the negative effects of circumcision and I will quote a recently added source "There are some minimal advantages in some circumstances, particularly in some infectious diseases, but they're overwhelmingly balanced by disadvantages in other areas," from the AMA's Tasmanian President, Haydn Walters. As far as making an item notable based on search results... well there are so many reasons why that is not feasible I will not list them here but other editors and myself have tried to in the section Edit War. Garycompugeek (talk) 14:20, 13 June 2008 (UTC)

Edit war II

Please discuss changes on the talk page before editing. ☺ Coppertwig (talk) 13:44, 13 June 2008 (UTC)

Nameing Conventions

moved above post to this section

Veering off topic: Sorry if I'm beating a dead horse, but I think it would be a good idea to rename this article to "Male circumcision", with a redirect to here from "Circumcision". In doing the web searches on "circumcision" I saw a lot of stuff about female circumcision, so I guess "circumcision" is rather ambiguous. See Blackworm's argument on my talk page (archive). _{(I changed my mind; see my oppose rationale in the next section.10:57, 22 June 2008 (UTC))} ☺ Coppertwig (talk) 10:32, 14 June 2008 (UTC)

Yes, we have discussed this at length previously. I'm opposed to renaming, for reasons described, for example, here. Jakew (talk) 10:52, 14 June 2008 (UTC)

I have read that very lengthy discussion and am not convinced Jake. To be frank it doesn't end in any kind of consensus. Circumcision can be male or female and locale and subject generates POV of which. I agree with Coppertwig and Blackworm. This article should be renamed Male Circumcision. There should be a neutral article called Circumcision that briefly covers both and stubs to both male and female circumcision in more detail. Garycompugeek (talk) 13:08, 14 June 2008 (UTC)

I know that discussion didn't end in consensus, Gary, but it does contain lengthy discussion of the issues. There is very little ambiguity, since when "circumcision" (as opposed to "male circumcision" or "female circumcision") is used in sources, it generally means the removal of the penile foreskin. Moreover, the term "circumcision" (as opposed to "male circumcision") is the commonly-used term for the procedure. As such, the obvious name for the article is "circumcision", and what little ambiguity there is is resolved through the hatnote at the start of this article. Jakew (talk) 13:25, 14 June 2008 (UTC)

English sources typically but just because this is the English speaking Wikipedia does not mean we do not take the entire world into account. Sources about female circumcision do not state "female circumcision" in the article but quote circumcision as used here. Additionally circumcision is a verb. It does not take gender into account. Garycompugeek (talk) 14:06, 14 June 2008 (UTC)

We're using the English word "circumcision" here; it doesn't matter here what that word might mean in other languages, though we talk about the phenomenon everywhere in the world, not just English-speaking countries. Sources often say "female circumcision" in the title and just "circumcision" within the article, I think. I quoted one news source in one of those discussions, I think, that said "circumcision" in the title and meant female circumcision. By the way, "circumcision" is a noun; the verb is "circumcise". ☺ Coppertwig (talk) 14:23, 14 June 2008 (UTC)

Coppertwig I think we are trying to make the same point and I was referring to the act of circumcision or as you have put it correctly circumcise. Garycompugeek (talk) 19:25, 14 June 2008 (UTC)

Jakew, the first three sources referenced in the article use a gender-neutral definition of circumcision, or use disambiguating language, which some may eventually drop as it becomes clear that male circumcision is the topic discussed:

• Dictionaries. [56] 1. The act of cutting off the prepuce or foreskin of males, or the internal labia of females.
• A journal. [57] (via CIRP) Strabo's statement that the Hebrew priesthood imposed male and female circumcision for tyrannical and superstitious reasons supports Wilhelm Reich's theory of circumcision as a mechanism [...].
• Another journal: Title: Male Circumcision: A Gender Perspective[58]

The topic that should have the title, "circumcision" is the topic of circumcision, not the topic of male circumcision. The topic of male circumcision's article should be called male circumcision, per WP:TITLE policy. Blackworm (talk) 09:06, 15 June 2008 (UTC)

Blackworm, if you read my comment again, you'll see that I do not claim that the term "male circumcision" is never used, only that it is used less commonly than "circumcision" when describing this procedure. As such, not only do I acknowledge the existence of sources using "circumcision" to mean both circumcision and FGC, or using "male circumcision" instead of "circumcision", but I am quite confident that others exist in addition to those which you quote. Again, I refer to my comments in one of the many previous discussions about this, for example those of 23:07, 26 January 2008 and 13:56, 27 January 2008 in this thread. Jakew (talk) 10:38, 15 June 2008 (UTC) (edited 10:46, 15 June 2008 (UTC))

Coppertwig, Garycompugeek, Blackworm and Jakew, just thought I'd draw your attention to the fact that the documents referenced in the WHO/CDC/HIV paragraph of the lead use the phrase "male circumcision" extensively throughout their text. Perhaps these organisations consider there to be significant potential ambiguity, enough to justify continued use of the phrase throughout their own publications even when those publications actually contain it in the title. Beejaypii (talk) 12:21, 15 June 2008 (UTC)

I don't think it would make sense to have an article about both male and female circumcision (regardless of what such an article would be called). I don't think there's anything that can be said about both male and female circumcision: only about one or the other. If anyone finds several reliable sources that give a significant amount of information about circumcision-in-general (not a sentence about male circumcision and then a sentence about female circumcision, but a significant number of statements about "circumcision" meaning both) then maybe we could have such an article. ☺ Coppertwig (talk) 14:51, 15 June 2008 (UTC)

How can you advocate changing the name to "Male Circumcision" and not have a "Female Circumcision"? Circumcision in general will talk about both male and female circumcision briefly and pair down to their respective stubs in more detail. Garycompugeek (talk) 14:58, 15 June 2008 (UTC)

(<<outdent) Easily: the decision was made that the title of the article would be "female genital cutting". Female circumcision is a redirect to there. Give an example of a statement that can be made about "circumcision" meaning both male and female: I expect there are very few such statements. When several reliable sources are presented that each have several paragraphs of information about "circumcision" (meaning both; not a bunch of sentences that say on the one hand male circumcision this and on the other hand female circumcision that) then I'll start to think it might be notable enough for an article. An article that has little except a section on male circumcision and a section on female circumcision isn't much use: might as well just have the separate articles. ☺ Coppertwig (talk) 17:02, 15 June 2008 (UTC)

Title changes to female genital cutting should be discussed on that Talk page. Coppertwig, please refer to the first two sources I quote above for examples of statements made about "circumcision" meaning both male and female. Many, many other sources exist despite the near non-existence of the circumcision of females in the English-speaking world. We could always go over and try to change the soldier article to define it as "a male in an army" -- but I doubt this article's earlier editors' warped, irrational, policy-violating approach to the title of this article along with the criteria presented to justify it ("but Blackworm, 'male soldier' is used less commonly than 'soldier' when describing a male soldier") would be even considered seriously, much less adopted, anywhere but here.

Jakew's objection has no merit: he has not demonstrated his claim, nor is his claim meaningful. Even if sources overwhelmingly used "circumcision" as meaning the topic of male circumcision, that is about as surprising as sources treating "penis" as meaning the topic of the human penis. Yet, the penis article makes clear that a penis is not necessarily a human penis. That reflects the reality of the topic: "penis." Here, we do not reflect the reality of the topic: "circumcision." Jakew's criteria is invalid, and a misinterpretation of WP:UCN guideline anyway. WP:TITLE policy which I reference above easily trumps the misinterpretation of that guideline. The narrowing of the topic of circumcision implicit in some sources (mostly medical sources, since female circumcision is very rarely performed in a medical context) discussing male circumcision does not change what the topic is: male circumcision. Further, as Beejaypii points out, the most prevalent and international sources (WHO, international journals) repeatedly disambiguate this topic by using "male circumcision" to describe it. Anyway, as many pages of discussion show, Jakew will never accept a change in title of this article, nor will he accept the inclusion of the topic of the circumcision of females in this article. He insists on inconsistency and policy violation. Luckily, he is in the minority in this discussion. Blackworm (talk) 20:31, 15 June 2008 (UTC)

Blackworm, I have actually demonstrated my claim in previous discussions, and if you read my above comment again, you'll see that I provided a link to one of those discussions along with the timestamps of the comments.

I'm glad that you link to WP:TITLE, which says (to quote from the "nutshell"): "Generally, article naming should prefer what the greatest number of English speakers would most easily recognize, with a reasonable minimum of ambiguity, while at the same time making linking to those articles easy and second nature." Most of that advice, of course, reflects that in WP:UCN. In short, we should favour an "obvious" title provided that there is a reasonable minimum of ambiguity (which is not the same as "no ambiguity"). This leads us to two questions. First, given that the topic is the removal of the penile foreskin, what is the obvious (easily recognised & intuitively linked) title? What word or phrase would most readily spring to mind? The obvious answer is "circumcision". Second, how much ambiguity is truly present? If someone were to type in "circumcision", how likely is it that they would actually be looking for female genital cutting? I'd suggest that, while plausible, it is relatively unlikely, and this situation can be (and is) addressed through the hatnote (consistent with WP:MOSDAB). Jakew (talk) 20:57, 15 June 2008 (UTC)

Blackworm, the first source you quote is a dictionary; it provides merely a definition, not any statement about "circumcision". The second source provides a statement about "male and female circumcision" which could perhaps be construed to satisfy my criterion, but which also contains the word "and", implying that two concepts, not one, are being talked about; and the third seems to be about male circumcision. ☺ Coppertwig (talk) 21:41, 15 June 2008 (UTC)

Jakew, what exactly is a reasonable minimum of ambiguity in your opinion? Because personally, I would say the ambiguity of "circumcision" is not reasonably minimal. What do others think here? Furthermore, I think that the "obvious (easily recognised and intuitively linked) title" for an article about the removal of the penile foreskin is "male circumcision".

In my opinion, there's another question we should be asking here: if someone were to type in "circumcision", how likely is it that they would expect to retrieve an article encompassing both male and female circumcision? If it's likely, shouldn't we then have a single article called "circumcision" covering both forms of circumcision, or at least a disambiguation page linking to the current article, renamed as "Male circumcision", and to "Female circumcision" (which currently links to the Female genital cutting article, as I'm sure we're all aware)? Beejaypii (talk) 22:12, 15 June 2008 (UTC)

Beejaypii, it occurs to me that sometimes an "obvious" title may be slightly ambiguous, and conversely a completely ambiguous title may be so non-obvious that it is impossible to guess. As an extreme example, a completely unambiguous title would be "removal of the foreskin of the penis", but it would be so non-obvious that it would be all but useless. Finding the reasonable minimum of ambiguity involves, in part, weighing this against the "obviousness" of the title.

Since we've discussed the level of ambiguity before, allow me to quote from one of the comments in a previous thread (dated 23:07, 26 January 2008; see above for link):

• Here is the result of a Google search for "circumcision". (I'm using plain Google rather than Google Scholar in case general usage differs from scholarly usage.) Of the ten true search results I get on the first page (excluding the news results and paid links, etc), all of the results refer to the procedures affecting males. On the second page there is one result that appears to be about "female circumcision". On the third page there are two results that appears to be about "female circumcision". So of the thirty "most relevant" pages for "circumcision" (as judged by Google's algorithms), 27 (90%) are about the procedure affecting the male. [The following clarification is from a slightly later post:] Sorry, I'm making an assumption that I should have made explicit. Since Google have built their business on the quality of their information retrieval systems, and since their results have a reputation for being good, I'm assuming that these results are reasonably "good". That is, these results are roughly what people are looking to find when they type "circumcision". Do you think this is a reasonable assumption?

And I continued in 13:56, 27 January 2008:

• I would imagine that people typing "male circumcision" are looking for information about (male) circumcision. However, "male circumcision" seems to be used less frequently than "circumcision". Google returns 406,000 results for this exact phrase ("male circumcision"), whereas it returns 6,970,000 for "circumcision" (376,000 match the exact phrase "female circumcision"). Roughly speaking (and bearing in mind the fact that these are estimates based upon assumptions), "circumcision" seems to be used 17 times as often as "male circumcision", and in 90% of cases seems to have the same meaning.

Jakew (talk) 22:53, 15 June 2008 (UTC)

What you've shown, Jake, is meaningless. It seems extremely likely that articles say "male circumcision" once, or use "the circumcision of males" or "the removal of the foreskin" or some other disambiguating language, and then repeat the established central idea as "circumcision" for brevity in the rest of the article.[Jake correctly points out below this isn't what is measured. -BW] The fact that female circumcision is taboo and obscure in the West further explains your data. As a perfectly analogous Google search for "penis" would also show, by your argument, that the penis article should change its definition of penis to indicate that a penis is a "human penis." Since that is absurd, your argument is absurd. Your Google searches do not prove your claim or are even evidence for it. Further, as you argued in female genital cutting, the more popular term is not necessarily the most neutral term. I do not know why you abandon and oppose the principle you so eloquently argued there, here. Blackworm (talk) 00:02, 16 June 2008 (UTC)

Blackworm, you appear to misunderstand. The above figures are the number of articles containing each phrase, not the number of times the phrase occurs. Your analogy is faulty because you fail to understand the difference between words and concepts. In the case of "penis", there is a single concept (the male reproductive organ). In the case of "circumcision", there is a word that can describe several concepts, including the removal of the penile foreskin, the removal of the internal labia (according to one of the dictionary definitions you cite), or the removal of the clitoris (according to another). Finally, I neither abandon nor oppose the principle you mention: calling the removal of the penile foreskin "circumcision" is not in any way non-neutral. Jakew (talk) 10:33, 16 June 2008 (UTC)

Also -- I didn't trust your research so I verified it. Indeed, the page which is linked as #5 in a Google search for "circumcision" (CIRP) has "female circumcision" on it. So does the page linked as #8 -- "How is Female Circumcision Trivialized?" is the phrase. So does #10, NOCIRC, when they write at the top that their goal is to provide information "about circumcision and genital cutting of male, female, and intersex infants and children." I hate to have to question and verify your findings, Jake, only to see the basic facts you use shown to be incorrect. Blackworm (talk) 00:17, 16 June 2008 (UTC)

Blackworm, it would have been helpful if you had provided a link to your search results. Presumably you did not use the link I provided in my original message - I don't know what the results for that search were in January, but as of today, #5 is at www.bbc.co.uk, #8 is at www.timesonline.co.uk, and #10 is at besttreatments.bmj.com. Alternatively, could you provide a link to the pages you name, so that I can evaluate them to see whether they are about "female circumcision" or whether they merely contain incidental mention of the phrase? Jakew (talk) 10:33, 16 June 2008 (UTC)

Sorry Jake, of course you're correct about how search results appear. I suspect you are using google.co.uk, where I am using google.com. Search results seem to be localized. The three links focus on male circumcision, and contain information on female circumcision. Again, though, this argues backwards -- one would expect most searches on the word "penis" to be about human penises, but that doesn't mean that an article on the topic of the human penis could be properly named "penis." A human penis is not what a penis is, just like male circumcision isn't what circumcision is. Blackworm (talk) 15:41, 16 June 2008 (UTC)

Coppertwig, I have no idea why we throw out the dictionary for this article. I don't think your statement, "it provides merely a definition, not any statement about 'circumcision'" is logical at all. Someone who knows what circumcision is (according to its dictionary definition) comes to Wikipedia and is surprised to learn that what he or she "knows" isn't true at all. It makes no sense.

I agree that we should consider reasonable ambiguity. I believe that reliable sources demonstrate again and again that the ambiguity is reasonable. Even the WHO seems to agree by stating "male circumcision" over and over in its documents.

I don't understand why you seem to state your support for the renaming of this article to "male circumcision," and yet seem to argue against that position in discussion. If I'm not understanding you properly, could you please re-iterate the reasoning behind your support of changing the title to "male circumcision," or declare your opposition to the renaming?

I cannot see how you can possibly argue that the word "and" in "male and female circumcision" implies two topics in the source I quoted -- if you noticed, in the remainder of the sentence I quoted, the word "circumcision" is used again, and it is clear the author uses "circumcision" in that instance to mean "male and female circumcision."

You ask, given that the topic is the removal of the penile foreskin, what is the obvious (easily recognised & intuitively linked) title? The clear answer is "male circumcision." If you argue that "circumcision" is the answer, I can see that point of view, but you have not addressed "minimum ambiguity" with that example. In your second question, you write: Second, how much ambiguity is truly present? If someone were to type in "circumcision", how likely is it that they would actually be looking for female genital cutting? In this part, your second question ("how likely is it") cannot provide any clue as to the answer to the first question ("how much ambiguity is truly present"). That is an error. Referring again to my "penis" example, if the article were about the human penis, and most people typing "penis" were interested in reading about human penises, that would still not indicate that an article about human penises could be titled "penis" with a reasonable minimum of ambiguity. Female circumcision is obscure in the English speaking world, and indeed more people are interested in reading about the circumcision of males (it being generally legal, and widely performed in the English-speaking world, in contrast to the circumcision of females); but many, many English speakers recognize that the topic of circumcision encompasses the circumcision of both males and females. The ambiguity is not at a reasonable minimum. Blackworm (talk) 23:50, 15 June 2008 (UTC)

Blackworm, I'm not throwing out the dictionary, but I'm making a distinction between on the one hand a definition, which is an assertion about what a word means, and on the other hand a statement about a topic, which provides information about the real world. A definition provides no facts. To write an encyclopedia article, we need a certain amount of facts. I concede: we have one sentence (the second ref you quote) which provides information about circumcision-in-general. We would need several sources with perhaps several paragraphs each to be able to write an encyclopedia article.

I'm not arguing against changing the name of this article to "male circumcision". I weakly support changing the name to "Male circumcision" with "Circumcision" being a redirect to "Male circumcision", for the reason that a web search on "circumcision" brings up many female circumcision articles and that I've seen one article with "circumcision" (or a form of the word, I forget) unqualified in the title but meant female circucmcision. However, I oppose the creation of an article on the topic of circumcision-in-general unless I'm convinced that there is sufficient source material for it, which I'm not convinced of currently (and perhaps not even then – there may be other reasons not to). Blackworm, would you consider it an improvement to change the name to "Male circumcision" while keeping "Circumcision" as a redirect, or is your sole or primary purpose in renaming this page in order to be able to establish an article on circumcision-in-general?

I think the last paragraph of your message is in reply to Jakew or somebody, not me. ☺ Coppertwig (talk) 13:35, 16 June 2008 (UTC)

Thank you for clarifying, Coppertwig. Yes, I would consider it a large improvement to change the title to "male circumcision" and redirect "circumcision" to it. Blackworm (talk) 15:41, 16 June 2008 (UTC)

For what it's worth, I would also consider it an improvement because I do not consider the ambiguity of "circumcision" to be "reasonably minimal". Beejaypii (talk) 17:58, 17 June 2008 (UTC)

Consensus reflects changing this article's title to "Male Circumcision". Garycompugeek (talk) 18:05, 18 June 2008 (UTC)

I haven't withdrawn my objections; I just don't see much point in going around in circles. Jakew (talk) 18:18, 18 June 2008 (UTC)

Noted. However consensus does not say all editors must agree and common sense dictates you can never please everyone. Why do you feel your opinion outweighs the majority? Garycompugeek (talk) 18:33, 18 June 2008 (UTC)

I don't feel that my opinion outweighs those of others, Gary, but it appears that, so far, there is no consensus to make such a change (please remember that consensus does not mean "majority vote"). If you wish to gain a consensus, there are methods for gaining outside input on a proposed move (for example, see requested moves). Jakew (talk) 18:44, 18 June 2008 (UTC)

Requested move

The following is a closed discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the proposal was no consensus, not moved. 199.125.109.78 (talk) 05:53, 23 June 2008 (UTC) Circumcision → Male Circumcision — remove gender ambiguity —Garycompugeek (talk) 19:27, 18 June 2008 (UTC)

Survey

Feel free to state your position on the renaming proposal by beginning a new line in this section with *'''Support''' or *'''Oppose''', then sign your comment with ~~~~. Since polling is not a substitute for discussion, please explain your reasons, taking into account Wikipedia's naming conventions. This poll is an attempt to gain consensus through discussion, and not to find a majority view.

• Oppose. Per WP:TITLE, "Generally, article naming should prefer what the greatest number of English speakers would most easily recognize, with a reasonable minimum of ambiguity, while at the same time making linking to those articles easy and second nature." One can get a reasonable idea of the term people would recognise, would use for searches, and would intuitively use for linking by examining the frequency of use. Google returns 7,560,000 hits for "circumcision", compared with 452,000 for "male circumcision" (there are 504,000 for "female circumcision"). As we can verify by examining the hits on the first page of results for "circumcision", most results are primarily or entirely about the removal of the penile foreskin. From this, we may conclude that a) the term "circumcision" is used approximately 17x as often as "male circumcision", and b) that when it is used there is very little ambiguity: with a few exceptions, "circumcision" usually means removal of the penile foreskin. (The term "female circumcision" is more frequently used to refer to female genital cutting, and redirects to that article.) Per WP:TITLE and WP:UCN, then, the obvious title is "circumcision". While I acknowledge that there is a small amount of ambiguity, per WP:MOSDAB, the "recommended practice is to use a hatnote on the article for the primary meaning to link directly to the secondary meaning", which is done. Jakew (talk) 19:49, 18 June 2008 (UTC)
• Oppose. Wikipedia is not an institute for language reform. This is enough to oppose, but the usage of "female circumcision", implied by this, is indeed both controversial and probably ceasing to be standard usage. Septentrionalis PMAnderson 21:02, 18 June 2008 (UTC)
• Support. I decided to try another google search, but this time not searching for the bare words and phrases "circumcision", "male circumcision", "female circumcision". I've tried to devise a set of searches which give some idea about how frequently these terms are used as the subjects of sentences. I've combined them with the word "is", e.g. "circumcision is", "male circumcision is", and "female circumcision is". The google search results are as follows: there are 291,000 hits for "circumcision is", 68,300 hits for "male circumcision is", and 68,100 for "female circumcision is". Furthermore, the third hit on the first page of the "circumcision is" search is about female circumcision, as is the sixth. I'm bracing myself to be shot down in flames here, but I'm going to tentatively suggest that unless we can explain why there would be a statistically significant difference between "circumcision", "male circumcision" and "female circumcision" in terms of how these terms function as the subject of the verb to be, then the efficacy of the simple word and clause search which has been used thus far to demonstrate why the title of this article should not be changed to "male circumcision" has perhaps been called into question. From the search counts I've already cited, I conclude that the term "circumcision" is used no more than approximately 4.2 times as often as the phrase "male circumcision", and probably less in view of the presence of female circumcision related hits on the first page of the "circumcision is" search. The ambiguity is therefore not minimal. Beejaypii (talk) 23:04, 18 June 2008 (UTC)

Comment. Beejaypii, since the results for "male circumcision is" and "female circumcision is" would be duplicated in the results for "circumcision is," then in order to compare "male circumcision is" and "[some word other than "male" and "female," or no qualifier] circumcision is" we must subtract those two totals from the 291000 hits, leaving 154600 hits, or a factor of 2.3 -- not 4.2. Definite a case of "reasonable ambiguity," per WP:TITLE policy. Blackworm (talk) 08:14, 19 June 2008 (UTC)

• Support. Circumcision can be male or female. "English sources typically but just because this is the English speaking Wikipedia does not mean we do not take the entire world into account. We cannot pretend it does not exist. Sources about female circumcision do not state "female circumcision" in the article but quote circumcision as used here. Additionally the act of circumcision or to circumcise is a verb. It does not take gender into account." Garycompugeek (talk) 01:18, 19 June 2008 (UTC)
• Oppose. Circumcision still basically means male circumcision. Female circumcision is a controversial, vague and politically motivated neologism and not standard English; Male circumcision is unambiguous (agree on that part) but apart from that has similar problems. Andrewa (talk) 03:16, 19 June 2008 (UTC)

Comment.. I feel the same way about "Male Circumcision". Regardless of our POVs the encyclopedia must remain neutral and simply report facts. There is "Female Circumcision" whether we like it or not and that lends to the argument name change to "Male Circumcision". Garycompugeek (talk) 18:19, 19 June 2008 (UTC)

I don't see the logic of that at all. If Male Circumcision is a controversial, vague and politically motivated neologism and not standard English, it's hardly a good article title. No change of vote. Andrewa (talk) 17:59, 20 June 2008 (UTC)

Except that it isn't, and neither is "female circumcision." See below. I don't expect you to change your vote, though. Blackworm (talk)

I respect your views on the matter, but what I was trying to clarify was the logic. Garycompugeek had said he agreed with me, but that didn't seem to be reflected in the conclusion reached, so I wondered whether there was a misunderstanding... possibly on my part. Disaqree with your edit summary, but it's certainly a battle at times. Andrewa (talk) 19:19, 20 June 2008 (UTC)

Correction, I'm not sure what you mean by "Female circumcicion" not being standard english (look it up in any standard english dictionary) but assumed you did not agree with the practice of female circumcision as I do not agree with anytype of body mutilation. If I mistook your meaning I apologize. Regardless of controversy there is male and female circumcision and our article titles should demonstrate that fact. Garycompugeek (talk) 12:46, 21 June 2008 (UTC)

• Support. Circumcision is performed on males and females. The whitewashing of the common term "female circumcision" from Wikipedia begins in the female genital cutting article (the true neologism and demonstrably not the most common term used), continues to circumcision (which defines "circumcision" as strictly applicable to males, in contradiction to reliable sources), and extends (or Jakew has so attempted) to every circumcision-related article (circumcision and law, prevalence of circumcision, medical analysis of circumcision, sexual effects of circumcision). The most prominent sources, such as the WHO, recognize the non-neutrality and ethnocentrism of using "circumcision" to refer to male circumcision, which is why they routinely use the phrase "male circumcision," as do most journals. This whitewashing on Wikipedia, relative to reliable sources, is evidence of a non-neutral embrace of both recentism and activism (pro-male circumcision activism, combined with anti-female circumcision activism), and is thus a violation of WP:NPOV] policy. I find myself calling loudly for this article's title to be changed for the same reason another editor opposes it: Wikipedia is not an institute for language reform. You may feel that female circumcision should be called "female genital mutilation" (cause "that's just what it is") and you may feel that male circumcision is "just, well, circumcision, no big deal, whatever..." But that's your POV. Others exist, even if all others who don't seem to share that exact opinion are shunned around here. This New York Times article (2008) shows what I'm talking about. The article says, "Over the course of that Sunday morning, more than 200 girls were circumcised, many of them appearing to be under the age of 5. Meanwhile, in a nearby building, more than 100 boys underwent a traditional circumcision as well." Finally, circumcision as applicable to males and females was used in a very respected medical journal article almost 100 years ago: S.L. Kistler, Rapid bloodless circumcision of male and female, and its technic, Journal of the American Medical Association, Vol. 54, 28 May 1910, p. 1782-3. It doesn't seem a particularly exception article for that usage, either. Which is the "neologism" again? Blackworm (talk) 07:57, 19 June 2008 (UTC)

I don't follow you at all. Looking through the Google Scholar search on the three terms FC, FGC and FGM I find that most all articles refer to FGC and FGM -- and so I wonder how FGC could be a neologism if it is the most common term currently used, and has 1.6 Million hits on Google. I agree with you that how we feel about it is of little importance, and that Wikipedia as a means of reform should be avoided. The reason you should oppose the change is because "Male Circumcision" as a term is the Neologism (almost all of the google scholar articles I found used the term "Circumcision" a,d almost none of them used the term "Male Cirumcision". Current (last 10-20 years) research articles do not use the term male and female circumcision. Maybe that was true in 1910, it sure isn't now. Atom (talk) 14:21, 22 June 2008 (UTC)

• Support. The Webster's dictionary defines circumcision as a procedure done on males and females and that's what all English speakers understand it to mean. There are no grounds for opposition to this move because this is not an issue of whether male or female circumcision is worse than the other; the issue is whether circumcision is done to males and females. Jookieapc (talk) 04:49, 21 June 2008 (UTC)
• Oppose. I changed my mind, for the following reason. While I still think it would be a slight improvement to have this article named "Male circumcision" with "Circumcision" being a redirect to it if it remains a redirect, nevertheless I now realize that what would probably happen in practice is that it would not stably remain a redirect but a variety of people would keep coming along and trying to be helpful by changing the redirect into a disambiguation page or a short article, leading perhaps to edit wars and to instability in the way readers would be able to find this article, and being a disservice to the reader who, in the majority of cases I believe, would have to find the right link and do another page load before arriving at the desired information, and who in many cases might abandon the search before arriving at this article. One might argue whether it's of much importance to serve the reader who would abandon the search for the sake of a few extra seconds; I argue that it is. People doing web searches often spend only fractions of a second considering a specific link, and I would much prefer that the reader's reaction be "Oh, an informative Wikipedia article; maybe Wikipedia is useful after all" than "Oh, another short or content-free (i.e. disambiguation page) Wikipedia page; Wikipedia is a waste of time."
  It's not clear to me whether or not Wikipedia needs an article on the human penis specifically as opposed to an article on penes of mammals, but I'm convinced that it is good to have an article on male circumcision, and that we have a carefully edited and well-organized one here. I believe that the majority of people searching for such information will use "circumcision" as the search term (whether in the Wikipedia search box or in a search engine), and I want them to be able to find it as effortlessly as possible; the long page load time is already one barrier. Therefore, all things considered, I prefer keeping the current title, "Circumcision".
  I didn't intend to start a whole thread or a whole discussion. Someone inserted the section heading "Nameing Conventions" above my comment, which I had placed on this page at Blackworm's request. ☺ Coppertwig (talk) 11:01, 21 June 2008 (UTC)

Comment.. That someone was me Coppertwig. Your logic for flip flopping is quite flawed. Do you seriously believe others will cease trying to change the names of this article and female genital cutting? We are trying to impose a reality check here. In reality there is male and female circumcision. Its a fact. It's not going to go away whether we like it or not. It's is not our place to pass judgment. Just report clear unbias fact. Garycompugeek (talk) 12:46, 21 June 2008 (UTC)

I agree with you that there is male and female circumcision, although female circumcision is not always referred to by that phrase. I suppose people will likely continue to try to change the names of the articles. I agree that it's not our place to pass judgement. I don't understand where you think there's a flaw in my logic. ☺ Coppertwig (talk) 14:44, 21 June 2008 (UTC)

Coppertwig if you agree with me why the opposition? This discussion started out with me agreeing with you the title was ambiguous. As for clarity I was referring to searching for information about circumcision. What you expect to find depends on your POV. Sure male circumcision is more common than female circumcision but the very fact of its existence create ambiguity to the single term. Garycompugeek (talk) 15:49, 21 June 2008 (UTC)

If you tell me which parts of my rationale above you have difficulty following, or which parts you agree with and which parts you disagree with, I might be able to explain more fully those parts of my arguments. ☺ Coppertwig (talk) 17:26, 21 June 2008 (UTC)

That was the point of my previous post Coppertwig. Are you belittling me or did you not read and understand it? Garycompugeek (talk) 19:26, 21 June 2008 (UTC)

I assure you, I had no intention of belittling you; I'm sorry for any misunderstanding along those lines. I'm having difficulty following your argument. You said my argument was "flawed", but I don't see anywhere in your posts where you seem to me to be pointing to any specific part of my argument. I agreed with the things you said, but don't see them as indicating any flaw in my logic; my logic still looks logical to me. I don't understand this sentence in one of your posts: "As for clarity I was referring to searching for information about circumcision." I don't know what earlier comment of yours it's referring to, and I'm not sure what "as for clarity" means. If I have trouble following your argument that may be my problem, though I hope you'll try again explaining and that I'll catch your meaning this time. One problem may be that when someone (e.g. me) disagrees with an argument, they can have trouble even understanding it; people formulate concepts differently in their minds so the same words may not mean quite the same thing to different people, and it can be hard to pin down where the misunderstanding lies. For example, to me, if the logic of an argument is flawed, it should be possible to identify a specific part of the argument where the flaw lies. Maybe you think of flaws in arguments in some different way. Or maybe the difficulty in understanding is something else entirely, with neither of us realizing what's causing it. Maybe it would help if someone else tries explaining to me what you're trying to say.☺ Coppertwig (talk) 01:13, 22 June 2008 (UTC)

I will assume good faith Coppertwig no apologies necessary but I do appreciate your reply. This logic seems faulty "nevertheless I now realize that what would probably happen in practice is that it would not stably remain a redirect but a variety of people would keep coming along and trying to be helpful by changing the redirect into a disambiguation page or a short article" and I do not understand your conclusion. I mean no offense and respect your opinion. Sorry if I came off a little hard. Garycompugeek (talk) 20:38, 22 June 2008 (UTC)

Thank you for AGF, Garycompugeek – I appreciate it. Do you mean that you think people would not change the redirect into a disambiguation page or short article? See also my reply to Fyslee. I apologize for any less-than-civil wording or punctuation in my comments – I'm trying to avoid such but am not perfect. ☺ Coppertwig (talk) 01:13, 23 June 2008 (UTC)

Not flip-flopped: called on his bluff and true colours shown. Blackworm (talk) 12:15, 22 June 2008 (UTC)

• Oppose We should focus on the content and accessibility of the 'circumcision' and 'female genital cutting' articles rather than the titles themselves. In a perfect encyclopedia everything would be perfectly named. Wikipedia can't be any more organized/structured than the real world. In this real world, alteration of male and female genitals does frequently take place regardless of the many reasons and many opinions for or against. In western society alteration of males has traditionally been called 'circumcision'. We should leave this article with that name and put a redirect from 'Male circumcision' to the article. Alteration of female genitals in western culture has been called a variety of things, but only rarely by a few been called 'circumcision'. It has been called Female Genital Mutilation, Female Circumcision and Female Genital Cutting primarily. The wikipedia article on the subject discusses it quite thoroughly. There certainly is no clear agreement on which title is 'best'. What is most important is that 1) The article goes into details to explain the many perspectives 2) The article is accessible (can be found by people who are interested). Because of the politics involved we will never have an article title that everyone will agree with. Reading the literature and research (at least on the english language) on both the female and male topics it is clear that regardless of perspective most english speaking people do not call what is done to females 'circumcision'. Hence changing the article to be called 'Male circumcision' to differatiate from a future renaming of the Article on Female Genital Mutilation to be called 'Female Circumcision' that will never happen is folly and unnecessary. Since most people use the terminology 'circumcision' as applying to males, and the term "female genital cutting' for females. We should leave the articles named that and redirect all other names people might use to those articles. Atom (talk) 15:45, 21 June 2008 (UTC)

• Oppose There are thousands of years of history behind circumcision referring to the removal of the foreskin. "Female circumcision" is a recent coinage, probably devised to allow Western audiences to relate to a practice that is not common in the West. --Groggy Dice T | C 13:56, 22 June 2008 (UTC)

Comment Groggy Dice, according to my dictionary, the English language word circumcision dates from around the 13th century. Also, "female circumcision" is not a recent coinage (unless by "recent" you mean "almost a century ago"), as Blackworm has demonstrated in the discussion below with his reference to a JAMA article from 1910 titled Rapid bloodless circumcision of male and female, and its technic. Furthermore, what we are trying to establish here is whether or not the word circumcision is sufficiently ambiguous to justify renaming this article "Male circumcision", with a disambiguation page at "Circumcision". A test of prevalence of the terms "male circumcision is" and "female circumcision is", within the set of occurrences of the phrase "circumcision is", via google web searches, has already been suggested by me in the discussions below. The current results of such searches are: "circumcision is" 290,000; "male circumcision is" 61,700; and "female circumcision is" 47,300. This suggests that, of all the articles webpages which refer to circumcision, in proportion to the prevalence of the very common English language construct, NP is (NP meaning noun or noun phrase), approximately one sixth also refer to "female circumcision", and a little over one fifth also refer to "male circumcision". This suggests that the word circumcision is significantly ambiguous. Consider this advice from wp:title:

Convention: Please, do not write or put an article on a page with an ambiguously named title as though that title had no other meanings. If all possible words have multiple meanings, go with the rule of thumb of naming guidelines and use the more popular term.

In view of that advice, and in view of the fact that the title "Circumcision" appears to be ambiguous, whereas "Male circumcision" is not ambiguous, the article should be renamed "Male circumcision".

One might argue that disambiguating language (such as "male" in the phrase "male circumcision") might still be used even when there's very little possibility of ambiguity, and this is true, to some extent. Let's perform an equivalent search test with the phrases "penis is" and "male penis is" to test that. The phrase "penis is" returns 2,530,000 hits, but "male penis is" returns only 13,800, suggesting that, though disambiguating language may be used where ambiguity is virtually non-existent, it's uncommon. This perhaps strengthens the evidence I provide above for significant ambiguity of the the word circumcision. Beejaypii (talk) 17:33, 22 June 2008 (UTC)

The idea is at least 170 years old. "An account of what he calls the circumcision of females as well as of males by some of the African tribes is given by Bowman in his 'Description of the Coast of Guinea,' English translation 2nd edit pp. 179, 180, 329, 414."Penny Cyclopaedia of the Society for the Diffusion of Useful Knowledge -- published 1837). What to do when demonstrable falsehoods (female circumcision" being a neologism, as now two editors who oppose this move have asserted) are the basis for objections to making article content and organization neutral? (I'm assuming these two editors will not change their votes.) So far, the opposition stands on that, and also a fear that things may "go further" (paraphrasing). It's nonsense. We are erring by admission (at least, Coppertwig's admission) on one side on one POV, not because the actual, current proposal under debate isn't good, but for fear of a slippery slope, or that people may eventually shift the POV "too far" the other way. That is clearly anathema to WP:NPOV, and I'm disillusioned by the lack of quality of the arguments of the opposition to this move. Blackworm (talk) 04:52, 23 June 2008 (UTC)

• Support for two articles (Male circumcision and the current redirect to Female genital cutting) and suggest that the current title of this article be used for a disambiguation page, with links to the appropriate articles dealing with various aspects of the subject. Disambiguation solves the problems and provides better service to readers without giving undue weight to "female circumcision". -- Fyslee / talk 16:41, 22 June 2008 (UTC)

• Suggested text: Circumcision usually refers to Male circumcision, but is sometimes used to describe Female genital cutting. (This text is certainly open to revision and enlargement, which can be done after making the disambiguation page.) -- Fyslee / talk 16:41, 22 June 2008 (UTC)

Could you explain how that would provide "better service to readers" in your opinion? In my opinion it would be worse. As a reader, I want to be able to type in a simple, convenient search term such as "circumcision" and arrive immediately at an informative article; I don't want to have to go through disambiguation pages unnecessarily. Hatnotes (as in this case) and pages with names like "Circumcision (disambiguation)" are used in order to reduce the amount of time readers spend navigating disambiguation pages. ☺ Coppertwig (talk) 17:54, 22 June 2008 (UTC)

Coppertwig, when you type in "circumcision" and "arrive immediately at an informative article", do you expect that article to deal exclusively with "male circumcision", and, more to the point, would everybody? Beejaypii (talk) 18:18, 22 June 2008 (UTC)

Coppertwig, you say that "Hatnotes (as in this case) and pages with names like 'Circumcision (disambiguation)' are used in order to reduce the amount of time readers spend navigating disambiguation pages". I may have misunderstood, or you may not have expressed what you actually meant to, but you seem to have claimed that disambiguation pages are used to reduce the amount of time spent navigating disambiguation pages. Is that what you meant? And if it is, what do you mean? Beejaypii (talk) 18:18, 22 June 2008 (UTC)

Coppertwig, by a "service to readers" I mean that readers are not directed (by a redirect from Circumcision) directly to this article about Male circumcision. It would be a disservice to force many of them to take an undeclared detour. Since a growing and significant (currently) minority of readers may be looking for the neologism Female genital cutting article (even though the redirect "Female genital mutilation" is by far the most used expression, yet we favor a neologism....hmmm...), they will have to backtrack or by other means find it. By using a disambiguation page, we are giving them the option, and we are educating them to the fact that the term "circumcision" is used in more then the traditional way. We can also list "See also"s on that page. Time spent is a non-issue. We wikilink alot and wikilinking "wastes" no more time than disambiguating. I have never heard wasted "amount of time" used as an argument against disambiguation pages, but of course that doesn't mean it isn't used, it just isn't considered a relevant argument most of the time. I also support that we continue to use the existing redirects (Female genital mutilation and Female circumcision). Since "circumcision" is the umbrella term of all these various articles, it is logical that it become a disambiguation page, much like the Subluxation page. -- Fyslee / talk 19:39, 22 June 2008 (UTC)

Thanks for your reply, Fyslee. I agree with you that it's good to avoid forcing a reader to take a detour. That's what I mean when I talk about wasted time. Maybe you see some difference I don't see between taking a detour and wasted time, or maybe there's something I don't understand in your comment.

This is how I see it: it's about optimizing searches. Every time a reader is forced to follow one more link before getting where they want, there's a good chance they'll give up the search and go to some other website to try to get their information. This is partly because the reader doesn't know whether they're going to get any useful information at all or just a string of disambiguation pages, stubs and other disappointments.

Suppose three-quarters of the people typing in "circumcision" are interested in male circumcision, and one-quarter are interested in female circumcision. Let's compare two options: the current system, or making "Circumcision" a disambiguation page. Under the current system, three-quarters of the readers get where they want immediately with no extra links to follow, and one-quarter get the hatnote at the top of the page and have to follow one extra link to get where they want. Therefore, the average number of extra links per reader is one-quarter. With the disambiguation page, every reader typing in "circumcision" gets to the disambiguation page and has to follow one link to get to where they want, so the average number of extra links per reader is one, which is four times as many as under the current system -- definitely worse. Even if different proportions of readers are assumed, it's still worse than the current setup.

When I mentioned pages with "(disambiguation)" in the title, I meant that, for example, having a page called Derivative (disambiguation) rather than having a disambiguation page titled Derivative can save readers time. This is how it works: this naming convention is used when there is one meaning of the phrase that is used more often than all other meanings put together. Suppose three-quarters of the people typing in "derivative" want the math article Derivative, and one-quarter want one of the other articles listed on the derivative disambiguation page. Then, it saves readers detours to name the math article simply "Derivative". In that case, three-quarters of the readers go immediately where they want. One-quarter follow the hatnote to the disambiguation page and then follow another link to the page they want, making two extra links to follow per reader; the average number of extra links to follow per reader is therefore one-half. If, on the other hand, the disambiguation page were named "Derivative", then every reader typing in "derivative" would have to follow one extra link, making the number of extra links (or detours, if you will) one, which would be twice as many as with the current system for "Derivative". I believe that the people who wrote the guidelines took such factors into account and that that's why they wrote here "When there is a well known primary meaning for a term or phrase, much more used than any other ... then that topic may be used for the title of the main article, with a disambiguation link at the top." as well as the section Disambiguation links which describes the use of hatnotes as a method of disambiguation. ☺ Coppertwig (talk) 01:13, 23 June 2008 (UTC)

• Oppose. Per JakeW and Groggy. -- Avi (talk) 16:43, 22 June 2008 (UTC)
• Support. This article is clearly about male circumcision, and there clearly is such a concept as female circumcision in common use. There is no reason why this male viewpoint should dominate the 'namespace'. --Nigelj (talk) 19:20, 22 June 2008 (UTC)

Discussion

Any additional comments:

Regarding the comments of Beejaypii above, the additional searches suggest that the relative frequency of usage in constructions of the form "X is..." is somewhat less than the overall 17:1 ratio. It is difficult to know why there should be such a difference, though the evidence basically confirms that the term "circumcision" is used more frequently than "male circumcision". It is erroneous, however, to infer that the term "circumcision" is ambiguous. "Circumcision", "male circumcision", and "female circumcision" are distinct terms (just as "baked alaska" is distinct from "Alaska"), and we cannot determine that the first is ambiguous from the frequency of usage of the last two. To determine whether "circumcision is" is ambiguous, we must exclude "male circumcision is" and "female circumcision is". If there were significant ambiguity in the term "circumcision", we would expect to find a large number of results that were about female genital cutting. Here is the result of such a search. If we examine the results, we can see that all (if I am not mistaken) of those on the first page are discussing the removal of the penile foreskin. Jakew (talk) 11:31, 19 June 2008 (UTC)

Wouldn't you have to discount those results from your search which also refer to male circumcision in a disambiguating way in some manner? Let's examine the pages returned on the first page of your search results. The second page returned includes "male circumcision" in the title, the fifth seemingly includes the phrase "male infant circumcision" in the text (the search results indicate this, we'd apparently need a subscription to the linked website itself to delve further), the sixth has the phrase "Circumcision in men" at the very beginning of the main text (an obvious disambiguation), we apparently can't examine the text of the seventh link without paying for it, the ninth includes the phrase "male and female circumcision" in the title, and the title of the tenth search result is "your son's circumcision" (and further examination of the page in question in this case reveals a reference to a leaflet titled "circumcision in men"). Beejaypii (talk) 17:44, 19 June 2008 (UTC)

Not to mention the absurd first words of the hatnote of this article: "This article is about male circumcision." If it's about male circumcision, it should be called "male circumcision," per WP:TITLE. The hatnote used to say, For the practice sometimes referred to as "female circumcision," see female genital cutting. After Jakew and his supporters argued for fifteen pages that that statement was neutral, and not at all implying that female circumcision isn't really circumcision, they finally agreed to change it to the current form, hiding the clear non-neutral POV the earlier authors of this article title and article organization enforce on it, and all circumcision-related articles. Blackworm (talk) 18:15, 19 June 2008 (UTC)

Beejaypii, I think you must be under the mistaken impression that the search excludes "female circumcision" but not "male circumcision". If you look at the search again, you'll see that it excludes the exact phrases "male circumcision is" and "female circumcision is". The purpose of this is not to exclude pages where it is possible to determine the meaning from context - indeed, this would be counterproductive, since the intent is to determine what is meant when the term "circumcision" is normally used. The purpose is to differentiate between the current ("circumcision") and proposed ("male circumcision") titles. Jakew (talk) 18:32, 19 June 2008 (UTC)

You're wrong to think that I am under the impression that your search excludes "female circumcison" but not "male circumcision". I understand how you formulated your search and have done so since I first examined that particular contribution of yours.

I'm glad to hear that your purpose was not "to exclude pages where it is possible to determine the meaning from context", because if that had been your purpose you would have failed to achieve your goal: that would be impossible to achieve without a search engine fluent in English.

You said:

To determine whether "circumcision is" is ambiguous, we must exclude "male circumcision is" and "female circumcision is". If there were significant ambiguity in the term "circumcision", we would expect to find a large number of results that were about female genital cutting. Here is the result of such a search. If we examine the results, we can see that all (if I am not mistaken) of those on the first page are discussing the removal of the penile foreskin.

In my opinion, you made a mistake there: significant ambiguity would actually be indicated by a large number of results either about female circumcision, or about male circumcision but including disambiguating language. A large number of such results were indeed returned. Beejaypii (talk) 22:40, 19 June 2008 (UTC)

Could you explain what you mean by "disambiguating language", Beejaypii? To clarify, I am not asking you to explain what the term means, but how you distinguish between it and the normal, slightly redundant contextual information appearing in English prose that allow the reader to easily determine what is meant. For example, while it is possible that the person who wrote "your son's circumcision" may have meant "your son's (as opposed to your daughter's) circumcision", how do we know that it was intended to disambiguate, and not, say, something slightly redundant like "your son's penis"? To express the problem another way, if we deem every reference made by the author to males or penes to be disambiguating language, and exclude these sources accordingly, then how are we to assess what the authors mean by "circumcision" in the few documents that remain? Jakew (talk) 23:27, 19 June 2008 (UTC)

Jakew, if we were able to exclude sources where the context tells us whether "circumcision" refers to male or female circumcision, and if there are still any sources left after we do that, we wouldn't be able to assess what the authors mean by circumcision precisely because the term is ambiguous.

Let's take a step back a little bit here. Comparison of the number of results returned by searches for the phrases "circumcision is", "male circumcision is" and "female circumcision is" should give us an idea of the relative prevalences of the disambiguating phrases "male circumcision is" and "female circumcision is" within the set of all occurences of the ambiguous and inclusive phrase "circumcision is". Furthermore, there should be no significant difference in the likelihood of "male circumcision" or "female circumcision" functioning as the subject of the third person singular present tense form of the verb to be, i.e. is, in articles which discuss them. And we don't need to examine context when considering the search results for "female circumcision is" and "male circumcision is" because we already know which type of circumcision they refer to. Your search method, excluding "male circumcision is" and "female circumcision is" doesn't tell us anything useful unless we examine a substantial portion of the results returned in order to see what the context is in each case, because the context could still include "female circumcision" without that expression actually being used: phrases such as "circumcision of females", "both types of circumcision, male and female" could be used, to cite just two examples.

I suggest that the results of the search methodology I proposed provide us with a useful guide to relative ambiguity, and the results returned when that methodology is put into practice demonstrate that the ambiguity of "circumcision" is considerable. Beejaypii (talk) 18:28, 20 June 2008 (UTC)

I must admit that I had to read your comment several times before it made sense, Beejaypii. However, I think I've worked out the source of the problem. Correct me if I'm wrong, but you are assuming that "circumcision" is ambiguous (which seems to beg the question), and consequently view phrases such as "male circumcision" or "your son's circumcision" as disambiguating language. In contrast, I'm trying to make as few assumptions as possible. I'm simply assuming that the terms "circumcision", "male circumcision", and "female circumcision" exist, and the purpose of the search is to isolate the first so that we can assess whether it is ambiguous in common usage. I agree with you that it is necessary to examine the results of the search. Jakew (talk) 20:57, 20 June 2008 (UTC)

Jakew, do you think that the results of the search method I propose provide us with a useful guide to relative ambiguity or not? And if your answer is "no", which I suspect it will be, please explain why. Beejaypii (talk) 00:46, 21 June 2008 (UTC)

There are so many flaws in your argument, Jakew, that a complete deconstruction is impossible. I'll focus on what you said in your support, above, replacing "circumcision" with "penis" and "male circumcision" with "human penis," in order to prove, by your flawed reasoning, that "penis" should be defined in Wikipedia as "an external sexual organ of male humans" instead of the (correct) "an external sexual organ of certain biologically male organisms."

Google returns 87,400,000 hits for "penis", compared with 194,000 for "human penis" (there are 4 hits for "non-human penis"). As we can verify by examining the hits on the first page of results for "penis", most results are primarily or entirely about the human penis. From this, we may conclude that a) the term "penis" is used approximately 450x as often as "human penis, " and b) that when it is used there is very little ambiguity: with a few exceptions, "penis" usually means the human male sex organ.

— Analogous (flawed) argument for naming an article about the human penis, "penis," instead of properly defining penis as both human and non-human as the learned folks at that article have done.

This ignores, of course, the logical leaps involved in your "verifications," for example the invented criteria of "first page hits" "mostly" talking about male circumcision. They mostly talk about the circumcision of males because the circumcision of males is 1000 times more frequent than the circumcision of females, and probably hundreds of thousands of times more frequent in the West. Given that, one would expect thousands of articles on circumcision of males for every article on circumcision of females -- but even that ratio, which is not observed, would not show that "circumcision" only applies to males. We lead the reader to believe that, here, and it is a non-neutral, normative organization of material. Look at the references section of this article -- rife with references to "male circumcision." Look at the titles of the journal articles, and the text in those articles, which discuss "male circumcision." Look at the definition of "circumcision" in any dictionary. Look at how female circumcision and male circumcision are discussed in the literature, often discussed together and in the same sociological context, and compared and contrasted. Your wild claims about "distinct terms," as well as your several absurd analogies ("baked Alaska" indeed), don't hold up to any scrutiny. Blackworm (talk) 18:03, 19 June 2008 (UTC)

The analogy with "human penis" etc., is faulty, as I explained here. Jakew (talk) 18:32, 19 June 2008 (UTC)

Hardly! In the case of "circumcision," there is also single concept, which involves the cutting and removal of certain parts of human genitals, usually for cultural, traditional, and religious reasons. Since these genitals are different for males and females, we can further explore the subtopics of the circumcision of males ("male circumcision"), and the circumcision of females ("female circumcision"). The New York Times article I quote above shows this, as does the 1910 JAMA article. Your refusal to admit that a single concept exists, in light of reliable evidence indicating just that, is not excusable. Blackworm (talk) 18:48, 19 June 2008 (UTC)

In the above section, Blackworm, Coppertwig asked you, "would you consider it an improvement to change the name to "Male circumcision" while keeping "Circumcision" as a redirect, or is your sole or primary purpose in renaming this page in order to be able to establish an article on circumcision-in-general?" Your comments now seem to indicate that the latter is the case. I assure you that if I see evidence of a single concept, as opposed to a single word with a primary and (occasionally) a secondary meaning, I will take it into account. Jakew (talk) 20:19, 19 June 2008 (UTC)

So you deny that the NYT and JAMA articles are evidence of a single concept? Unbelievable. Blackworm (talk) 20:48, 19 June 2008 (UTC)

I haven't been able to locate the text of the JAMA article, so I can't comment about that. As far as I can tell, though, the NYT article is entirely consistent with two senses of one word, and does not imply that there is a single concept of "circumcision". Jakew (talk) 21:15, 19 June 2008 (UTC)

You mix "meanings," "concepts," and "senses" and it obfuscates the issue. The NYT say, to paraphrase: "Girls were circumcised. Boys were circumcised as well." Why would they mention boys if it were a separate concept? The dictionary I quote has ONE sense of the word "circumcise," i.e., "to cut off the foreskin of (a male) or the clitoris of (a female)."[59] Clearly circumcision is viewed as a single concept, your increasingly absurd objections and denials, as always, notwithstanding. As for the JAMA article, why do you need the text of the article? The title is Rapid bloodless circumcision of male and female, and its technic for crying out loud. Blackworm (talk) 21:28, 19 June 2008 (UTC)

I think that we must be reading the definition differently, Blackworm. When I read "to cut off the foreskin of (a male) or the clitoris of (a female)", I see a word that can mean i) to cut off the penile foreskin or ii) to cut off the clitoris, whereas you apparently see a word that means "the cutting and removal of certain parts of human genitals". Thus, to paraphrase your paraphrase, I read the NYT as saying "girls had their clitoris removed. Boys had their foreskin removed." Mentioning both in close proximity might indicate that the author felt that they were related concepts (in name at least), but it doesn't imply that they were regarded as a single concept. Hypothetically, if the NYT had said something like "circumcision is a single concept, which involves the cutting and removal of certain parts of human genitals, usually for cultural, traditional, and religious reasons", then I would agree that the author's clear intent was to express a single concept. Jakew (talk) 23:56, 19 June 2008 (UTC)

Pure insanity. The definition given above is one sense of the word -- the reliable source saw no need to subdivide it further and neither should you. Please read this page if you have trouble understanding what a sense of a word is. Or perhaps, the definition of "sense": 1: a meaning conveyed or intended : import, signification; especially : one of a set of meanings a word or phrase may bear especially as segregated in a dictionary entry. ONE meaning. ONE sense. Stop this nonsense, Jake, immediately. It is now disruptive. Blackworm (talk) 07:33, 20 June 2008 (UTC)

Actually, Blackworm, the source you cite used the word "or" to signify one of two meanings. You're obviously convinced of a single meaning, though. Jakew (talk) 11:22, 20 June 2008 (UTC)

Enough. Your positions are clear. Garycompugeek (talk) 13:12, 20 June 2008 (UTC)

I'm not letting that madness stand. Jakew clearly didn't read the page I linked, which indicates how senses are separated in the dictionary I linked. Dictionaries separate senses with separate entries for the senses. Consider for example the entry for castration, which lists the male and female senses separately: 2 a: to deprive of the testes : geld b: to deprive of the ovaries : spay. Note that despite the multiple senses, the castration article properly deals with the topic in general (male and female castration) instead of picking one particular aspect and labeling it according to the general topic, in an attempt to "tell" people that female castration isn't really castration. This fraud must end, Jakew. Blackworm (talk) 16:41, 20 June 2008 (UTC)

While you may think that the separation is significant, the source tells us that "The system of separating the various senses of a word by numerals and letters is a lexical convenience. It reflects something of their semantic relationship, but it does not evaluate senses or set up a hierarchy of importance among them."[60] (emph added) Jakew (talk) 16:49, 20 June 2008 (UTC)

Jake, think about what the quote says, and what you're saying. What the sentence you quoted means is that the enumeration and ordering of the different senses are a convenience. It doesn't mean the senses aren't separated. In any case, I've already shown you that multiple senses can be part of the same one topic (e.g. castration). The fact that there is only one sense for "circumcise" listed just makes my position bulletproof. You also haven't addressed the JAMA article Rapid bloodless circumcision of male and female, and its technic, and there are plenty of other sources talking about circumcision as a concept applicable to males and females. The denial of this view here creates a fallacy of definition, namely that the topic of circumcision as defined here is clearly too narrow. It's unfortunate that few have to patience to read this entire discussion and see the evidence for themselves, or to attempt to follow your convoluted logic to its illogical conclusion. Blackworm (talk) 17:37, 20 June 2008 (UTC)

Capitalisation

If this move were to go ahead, I'd suggest that the new name should be Male circumcision, not Male Circumcision as currently proposed in the move notice and at WP:RM#18 June 2008. See WP:NC#Lowercase second and subsequent words in titles. Andrewa (talk) 19:27, 20 June 2008 (UTC)

Agreed. Garycompugeek (talk) 20:02, 20 June 2008 (UTC)

The above discussion is preserved as an archive of the proposal. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

HIV part 2

I've reverted the addition of Thomas et al. to the HIV section. As was noted in December, this study is a single observational study, and there is no obvious reason why we should cite this study of the 40 or so observational studies to date. As noted recently, approximately 80% of observational studies found a protective effect, and the article ought to reflect that. If we were to cite a representative selection of observational studies, including Thomas as one of several, then there is no problem. There's space to do that in medical analysis of circumcision. Here, space is more limited, and to cite one non-representative study constitutes undue weight. Indeed, Thomas et al. noted that "Randomized clinical trials [then] currently underway should shed more light on this pressing topic", yet we do not even cite these RCTs directly. Instead, we cite secondary sources that summarise the trials. Similarly, we cite secondary sources that summarise observational studies. Jakew (talk) 11:07, 17 June 2008 (UTC)

You don't seem to neutral. If 80% observational studies found protective effect, why is the AIDS/STD section 100% on its protective effect? If nothing else there should be a paragraph devoted to skepticism for circumcision having a protective effect. I am not asking to remove any links to existing works, I think people should be given a full range of information, but the AIDS/STD section is completely one sided. The other 20% of the studies is more representative of those who will actually ever read this page, as most of the 80% is set in 3rd world countries. User:intactguy 21:15 17 June 2008 (UTC)

Since the publication of the randomised controlled trials, there is relatively little scepticism about the protective effect in the literature (try searching PubMed and you'll see what I mean - the overwhelming majority of authors now agree that there is a protective effect). Most published scepticism dates from before these trials were published. For example, as you'll see in the last sentence of the second paragraph of the HIV section, there was disagreement over whether the observational studies constituted strong enough evidence. As for your claim that the studies in developed nations found no difference, please see the section entitled "HIV Infection and Male Circumcision in the United States" in the CDC's factsheet. Jakew (talk) 21:31, 17 June 2008 (UTC)

You are acting like I am trying to have that information removed. Anyone who is truly looking at this from a scientific standpoint will never say case closed, so it is best to at least show another view. I said a "a few studies in developed nations", the studies done in developed nations aren't always as successful in showing a protective effect. As for the link you gave me, there is only one mention of a heterosexual study in the US, and "However, this association was not statistically significant [28]." Funny the CDC didn't mention the Thomas et al? intactguy 21:53 17 June 2008 (UTC)

I can't think of any meta-analyses that have reported an association between whether studies were performed in developed nations and their results. It's an interesting hypothesis, however. Anyway, I think your most recent edit to the article is an improvement, but two problems remain. First, the source you cite doesn't directly support the claim, and second, it doesn't distinguish between observational studies and RCTs. As a possible solution, we could add something to the sentence I mentioned above ("Before there were any results from randomized controlled trials, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV"), perhaps changing it to something like "Before there were any results from randomized controlled trials, reviews of observational data differed as to whether there was sufficient evidence for an intervention effect of circumcision against HIV.[refs] In one review, 21 of the 27 included studies found a protective effect.[ref:Weiss]" (addition in italics) Jakew (talk) 23:20, 17 June 2008 (UTC)

If a study does not find a statistically significant difference between two groups, that's a non-result. It proves nothing. It's quite easy to run a study that gets that sort of non-result: you just include a rather small number of subjects in the study. It's far more difficult to have a study that shows that if there is an effect, then it must be smaller than 30% (or whatever other percentage or amount); that would require a very large number of subjects and that sort of result is rarely achieved. It's quite impossible to have a statistical study that shows that there is precisely zero difference between two groups. Even if a study doesn't give a statistically significant result in itself, if combined with other studies in a meta-analysis it may contribute to a statistically significant result, giving a similar result to what would have been achieved if a larger number of subjects had been included in the original study. Therefore, there's no need for us to report such non-results of individual studies. ☺ Coppertwig (talk) 23:43, 17 June 2008 (UTC)

I disagree Coppertwig. The point intactguy is trying to make is the non-result. When one study says "yes this does blah blah blah..." and another says "does not find a statistically significant difference to blah blah blah.." we do not disregard it. These aren't separate control groups with expected failure rates but separate studies looking at the same thing. Garycompugeek (talk) 01:22, 18 June 2008 (UTC)

Gary, could you explain: with which part of Coppertwig's reasoning do you disagree, and why? Jakew (talk) 11:01, 18 June 2008 (UTC)

(edit conflict)

That was the point of my previous post Jake, could you explain which part of my statement about Coppertwig's statement you do not understand? Garycompugeek (talk) 16:18, 18 June 2008 (UTC)

The problem was that you didn't seem to address Coppertwig's reasoning at all, save to say that you disagreed. That's why I asked you to explain. As I understand, Coppertwig is making two points, firstly that a non-significant result is inconclusive, and secondly that since meta-analyses are available, which are the sum of the parts and more, there's little value in citing individual studies. It is unclear whether you disagree with either or both of these points, and on what basis. Personally, I agree with the second point, and partly agree with the first (a non-significant result can be a type II error, but on the other hand it can also indicate that the null hypothesis is actually true. Working out which depends on the context, statistical power, and so on). Jakew (talk) 16:41, 18 June 2008 (UTC)

Ahh clarity. Jake I was disagreeing to Coppertwigs last sentence "Therefore, there's no need for us to report such non-results of individual studies." While I agree meta is a nice way to formulate multiple sources it is not conducive to opposing controversy. Garycompugeek (talk) 21:35, 18 June 2008 (UTC)

I would say not finding a statistical difference does say something. And I was only mentioning that, because Jakew ask me to read the CDC factsheet, which wasn't enlightening. As for the lines I wrote, feel free to re-write it, what I am really looking for that the subject not be one sided. I agree we can't list all research done (Although I think it would be a good idea to have another page with all research done and results) in that section. As for the trials done in Africa, most agree it has its most value in high risk areas of Africa, and are unclear what that would mean for developed nations. Also, I think the 50-60% reduction may be a bit misleading, and should be put in context. The 50-60% makes good headlines, but it is relative risk, the absolute reduction in risk is less than 2%. Being circumcised in Southern Africa makes you 60% less likely to get AIDS than an uncut man, but in general you are only 2% less likely to get AIDS.intactguy 15:57, 18 June 2008 (UTC)

We do actually list a number of individual studies (though not all of them) in medical analysis of circumcision. Jakew (talk) 16:41, 18 June 2008 (UTC)

(unindenting) Coppertwig, would you be opposed to (slightly) expanding our coverage of the meta-analyses of observational studies? It seems to me that, by relying upon these secondary sources, we could accomodate the desire to show that some observational studies found no significant difference, yet we could also place these in an appropriate context and avoid reporting results (or non-results) of individual studies. I've suggested a possible sentence above - could it be adapted in any way? Jakew (talk) 20:37, 18 June 2008 (UTC)

It's OK with me to include your suggested addition "In one review, 21 of the 27 included studies found a protective effect.[ref:Weiss]". I looked at the abstract (Weiss 2000) and this seems to be a reasonable summary.

intactguy, you may think that not finding a statistical difference says something, and I might even agree with you in some situations, but many people think things say something – for example, a result which shows a difference although it is not statistically significant can be taken as weak evidence that there is a difference; however, generally when reporting scientific results standards such as statistical significance are normally used, and if the number of subjects was too small to be able to calculate any statistically significant result (not even that if there was a difference, it must have been smaller than a certain amount) then we would only be going on personal opinion as to what that might mean, not on scientific consensus. ☺ Coppertwig (talk) 01:14, 20 June 2008 (UTC)

Furthermore, if a study finds a difference which is in the expected direction and is rather large but not statistically significant, that is certainly not evidence that there is no difference. ☺ Coppertwig (talk) 01:55, 21 June 2008 (UTC)

Revision of the definition and revision to sexual effects section

According to the Webster's Dictionary definition and from the meaning of the Latin, I suggest "removal" be replaced with "cutting off". Removal is performed by cutting so cutting is the better word to use.

Circumcision is the cutting off of some or all of the foreskin (prepuce) from the penis or the internal labia of females.

In the sexual effects section I suggest reordered the content into a more coherent manner. At present the antecdotal reports are listed then the opposition is listed and then the evidence in favour of the antecdotal reports are listed. It would be more coherent to order this as <antecdotal reports>, <evidence of antecdotal reports> and then <studies not supporting the recent antecdotal reports>.

In my opinion it is also worth noting the Masters and Johnson study was released in 1966. The reference to this study is taken from an article released in 1999 which could be misleading. Specifically I want to add In a study published in 1966, ". Notice that the sentence following that one includes the date of release "In January 2007, The American Academy of Family Physicians (AAFP) stated..". Also the beginning quotation marks on the Masters and Johnson quotes are missing and should be added.

Masters and Johnson noted no difference in exteroceptive and light tactile discrimination on the ventral or dorsal surfaces of the glans penis between circumcised and uncircumcised men." In January 2007, The American Academy of Family Physicians (AAFP) stated "The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. [...] No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction." Jookieapc (talk) 12:10, 20 June 2008 (UTC)

(Note: I have modified the above to convert the angle brackets to HTML character entities, since they caused some of Jookieapc's comment to become invisible. Jakew (talk) 12:03, 20 June 2008 (UTC))

Several problems here. First, of the eight definitions cited, three state that circumcision is "cutting off" (or variations thereof) and four state that circumcision is "removal". Not all forms of circumcision require cutting (consider some of the clamps, for example), so "removal" is somewhat more generally applicable.

The second problem is that the article is about the removal of the penile foreskin, and the first sentence should define the subject of the article. There is no need to define every meaning of the word, and doing so is misleading.

The third problem is that the "sexual effects" section consists of the conclusions of three secondary sources, and needs to accurately represent those three sources. The actual ordering is: i) the assessment of the AAP, ii) the assessment of the AAFP, and iii) the assessment of Boyle et al. Please note that we are not quoting Masters and Johnson directly; we are quoting the AAP's assessment of the sexual effects of circumcision, and the fact is that they chose to cite M&J. Jakew (talk) 12:20, 20 June 2008 (UTC)

I agree with points 1. Even if 99.99% of male circumcisions are done by cutting the use of the clamp on occasions makes "removal" more encompassing.

On point two I agree as the article as it stands but as circumcision refers to male AND female circumcision in common language this article should either be moved or female circumcision added to it. See my comments in http://en.wikipedia.org/wiki/Talk:Circumcision#Redirect_to_Male_Genital_Cutting.3F

What do you mean by actual ordering? The first, and third sources are secondary sources but the secondary source is not. Of all the sources only one is 42 years old! That should be listed and not just excluded because AAP chose to include an old source. Also the third source has been truncated to hide the meaning of the sources statement which went on to state "an inevitable reduction in sexual sensation experienced by circumcised males". That should be ammended. We can't just add half of the sentence to soften the meaning. Jookieapc (talk) 13:21, 20 June 2008 (UTC)

Jookieapc, I'm afraid that I don't understand what you mean when you say "The first, and third sources are secondary sources but the secondary source is not". Could you rephrase?

None of the sources are 42 years old. The AAP's 1999 statement included the following words, which we quote:

a survey of adult males using self-report suggests more varied sexual practice and less sexual dysfunction in circumcised adult men. There are anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males. Masters and Johnson noted no difference in exteroceptive and light tactile discrimination on the ventral or dorsal surfaces of the glans penis between circumcised and uncircumcised men.

There is a single source for this quote: the AAP's 1999 document. That source, in turn, cites other sources, but these are not our sources. The AAP didn't comment on the date of this source (and presumably they would have done if they felt it important), and injecting this editorial comment serves only to undermine their assessment through original analysis of their statement.

Worse, Gary's recent edit introduces further problems. Firstly, it introduces the AAP's summary by stating 'In a study published in 1966, "..."', which is actively misleading because it implies that the quote is taken from the 1966 study, which is incorrect: it is actually a quote from the AAP. To correctly attribute the quote, one would have to say something like 'Citing a study published in 1966, the AAP continue, "..."', but of course this doesn't address the underlying problem. Additionally, there is no closing quote before "In a study published in 1966", making it appear as these are the AAP's words. Jakew (talk) 14:05, 20 June 2008 (UTC)

Jakew please don't act like you don't understand. The AAP quoted a source 42 years old and listed the date in their references section for the reader to find easily. The AAP reusing findings from the 60s doesn't somehow modernise those findings. Jookieapc (talk) 01:21, 21 June 2008 (UTC)

Jake I was reinstating Jookieapc's edit for I saw no reason not to include it. However if you feels it introduces ambiguity I have no problem with your proposed edit "Citing a study published in 1966". Garycompugeek (talk) 14:25, 20 June 2008 (UTC)

Gary, I'm puzzled why you should think that I was proposing that edit. As I clearly indicated, it would not address the underlying problem (ie., undermining the AAP's statement through original analysis of their statement). Please read my comment again. Jakew (talk) 14:35, 20 June 2008 (UTC)

In what way does stating the studies date undermine the AAP's analysis of their statement? Garycompugeek (talk) 17:28, 20 June 2008 (UTC)

Gary, the special treatment given to the date of the study implies that it is significant. Nowhere else in the article do we comment on the dates of studies cited by secondary sources (we don't comment on the date of the other source cited by the AAP, for example). The strong implication is that the date or age of the study is important, in spite of the fact that the AAP did not comment on it. The effect is to reduce the emphasis on what the AAP actually said. We should be discussing the AAP's analysis, not ours. Jakew (talk) 18:08, 20 June 2008 (UTC)

We quote study dates all over the place Jake. Readers find this helpful. It matters not what "place" source 1st, 2nd, 3rd, who cares, it is coming from. I find it noteworthy because of the difference of opinion of circumcision in different times. Just because the AAP didn't implicitly state the studies date means nothing either. We are not required to quote every source verbatim. Adding a sources date is hardly WP:OR or WP:SYNTH. Garycompugeek (talk) 18:56, 20 June 2008 (UTC)

Gary, can you show me an example of where we quote the date of a source cited by a secondary source? Jakew (talk) 21:19, 20 June 2008 (UTC)

I fixed this issue easily by quoting the 1966 Masters and Johnson book directly. Problem solved. Blackworm (talk) 20:59, 20 June 2008 (UTC)

Unfortunately, that's a step backwards, Blackworm. Now this reads as using a primary source (M&J) as a rebuttal to the preceding sentence in the AAP's quote ("There are anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males."). Please see WP:MEDRS#Using primary sources to "debunk" the conclusions of secondary sources. The AAP cited Masters and Johnson in their following sentence. I am puzzled as to why there should be such strong opposition to simply quoting what they say. Jakew (talk) 21:19, 20 June 2008 (UTC)

I am puzzled as to why you would want to hide the date of publication. It's not debunking anything. Change the order of the sentences, or start a new paragraph, or begin the section with M&J if you want, I don't care -- the material referenced is right there, accurate, and saying essentially the same thing the AAP said. I'm sorry that we are providing the fact that Masters and Johnson conducted their research over 40 years ago, and I'm sorry if you see that as weakening the brochure impact of the pro-circumcision statement. But it's a fact, and it's a fact that is relevant. Blackworm (talk) 21:31, 20 June 2008 (UTC)

I have no desire to hide the date at which M&J was published, Blackworm, and indeed where we cite it directly (eg here), I see no problem with it being dated (as indeed it is). However, in this particular context, "hiding" is not an issue because the AAP do not refer in their analysis to the date. Wikipedia policy strongly encourages the use of secondary sources in preference to primary sources, so that we can rely upon them to select and analyse what facts are important (according to the viewpoint of the author). In this article, where space is limited, that's especially important. Thus there is no reason to say "essentially the same thing the AAP said" when we can actually say what the AAP said, and we should certainly not do so in such a way that presents the primary source as though it contradicted the secondary source. As for whether it's relevant, if you have another reliable source that, for example, criticises the AAP for relying upon a study of this age, then please present it and let's discuss it. Jakew (talk) 21:47, 20 June 2008 (UTC)

Jakew failed to validate his assertion that "not all forms of circumcision require cutting (consider some of the clamps, for example)." When I pressed him on this, in this discussion, the best source he could come up with was an unreliable source which didn't even state what he wanted to claim. Circumcision is cutting. The word comes from the Latin "to cut." The word is etymologically related to the words incision, excision, and scissors. It's cutting, definitely -- however, "removal" sounds so much more friendly, like removing a cyst, or a tumor, or another foreign, undesirable body. That is the meaning intended here. Blackworm (talk) 19:18, 20 June 2008 (UTC)

Yes, that's the obvious intention with leaving "removal" in. A new born baby with some extra skin gets taken away for a simple "removal" procedure and comes back "fixed up", "normal", "clean".. Jookieapc (talk) 01:21, 21 June 2008 (UTC)

Imagine if what people call female genital mutilation or (to be nice, so it's said) female genital cutting were instead called female genital tissue removal. Imagine a huge international organization making that happen; actually changing the name of the concept and associating new ideas to it. Wow, that would be an interesting thing. Oh wait, it's already happened. But we disgress. Blackworm (talk) 02:08, 21 June 2008 (UTC)

Blackworm, I would like to point out to you again that the word "circumcision" is not the focus of this article: rather, that word is a name to refer to the focus of this article. The fact that "-cision" means or originally meant cutting is interesting but not binding on us.

Re the AAP/Masters&Johnson quote: I reverted back to what I believe is the original version. Jakew correctly points out that Wikipedia articles are supposed to rely on secondary sources if possible, and that the AAP did not mention the date. I looked through the above discussion again and the only reason I see that's been given for providing the date is that Jookieapc's opinion is that it's worth noting. Wikipedia articles are supposed to reflect the opinions of sources such as the AAP, not opinions of Wikipedians. It seems to me that explicitly stating the date in a sentence of the article would be undue weight here. ☺ Coppertwig (talk) 15:50, 21 June 2008 (UTC)

We provide the date for practically every other source. Jakew adds the date "(1999)" to the AMA statement in the lead, and moves it prior to the WHO statement, so that the WHO is seen as debunking it. No one bats an eyelash. Now, because we want the article to say "notes no difference" instead of what the original source says, which is "no clinically significant difference could be established," and because we want the ancient date of the study obscured, we invent bogus arguments that the directly summarized M&J statements are "debunking" the previous statement. It's bogus; the solution was given: move the sentence. You yourself argued that not finding a difference doesn't mean there is no difference. The sentence I wrote about M&J stands completely on its own, and could easily be moved to begin the section. It has nothing to do with the AAP, and the AAP's summary of the paper is clearly of inferior quality to quoting the paper directly. I suggest you think hard about the precedent you establish here -- it means any time any primary study is misused or misinterpreted by a group such as AAP or WHO, you insist on using the misinterpretation and burying the true study. Shall I start dismissing Jakew's arguments whenever he claims something is "worth noting?" You're sounding like him lately. It's saddening. Blackworm (talk) 21:30, 21 June 2008 (UTC)

More content on the procedure

The title of this article primarily relates to the procedure of [male] circumcision, not just the "circumcised" final product so I propose clearer information on the procedure itself. I propose we add photos or diagrams to the procedure section. —Preceding unsigned comment added by Jookieapc (talk • contribs) 01:26, 21 June 2008 (UTC)

Prevalence map

Re this addition of a map: I think such a map can enhance the article. However, I'm doubtful about the copyright status. Also, the figure caption should probably explain the colour-coding. ☺ Coppertwig (talk) 17:15, 21 June 2008 (UTC)

One-sided illustration

A photo that has been added to the "Ethical, psychological and legal considerations" section. The photo depicts promotional materials used by anti-circumcision activists, and the purpose of such these materials, obviously, is to promote the anti-circumcision position. Consequently, the effect (whether or not it was intended) of including a photograph of these materials is also to promote the anti-circumcision position.

Nigelj reverted the deletion, stating that "This is the section that discusses 'opponents' - it is perfectly right to illustrate with a small pic of a few opponents." This is erroneous, since the section is not about opponents, but "Ethical, psychological and legal considerations". The viewpoints of some opponents are discussed in this section, alongside those of others, but the section is not about opponents. Furthermore, opponents are not the focal point of the photograph, which - as noted - clearly illustrates the promotional materials used by the opponents. As such, the effective weight given to the arguments expressed in the slogans (eg., "Whose Body, Whose Rights? Let HIM choose") is drastically increased through the photograph, with the result that the section is biased away from neutral coverage. Jakew (talk) 18:40, 22 June 2008 (UTC)

Oh, don't be so silly: how can each and every photograph show a balanced viewpoint in and of itself? Just find some others that show some other POVs to achieve the necessary balance. This article desperately needs illustrations: it is one of the dullest-looking in WP, I think.

BTW, you have edited my edit comment above, I also mentioned that the section above already has an illuminated image of the Jewish ceremonial circumcision of Jesus, painted by Christians in the 1400s. That implies a distinctly other POV already, to my mind. --Nigelj (talk) 18:58, 22 June 2008 (UTC)

WP is not censored. There are plenty of other photos illustrating activism and political demonstrators across WP (see abortion, gay rights&opposition, Tibet, etc etc.) White-washing out an example of anti- neonatal circ protest is POV in itself. If you can find a picture that demonstrates the pro- viewpoint that would be relevent to the section, add away. --User0529 (talk) 19:03, 22 June 2008 (UTC)

WP is not censored, but it must conform to a neutral point of view, and that means not giving undue weight to one particular viewpoint. Jakew (talk) 19:07, 22 June 2008 (UTC)

Jakew, under what circumstances, in your opinion, could this photo be displayed in some Wikipedia article without violating NPOV? ☺ Coppertwig (talk) 19:59, 22 June 2008 (UTC)

According to the description, it illustrates a "[m]inor protest in front of Washington Convention Center in connection with the American Association of Pediatricians annual meeting". As such, it is probably most suitable for inclusion in the discussion of anti-circumcision protests and demonstrations in Genital integrity#United States. Jakew (talk) 20:49, 22 June 2008 (UTC)

Well, perhaps the image could also be placed in that article. Beejaypii (talk) 22:00, 22 June 2008 (UTC)

Good idea, done it! Beejaypii (talk) 22:18, 22 June 2008 (UTC)

I feel that way about the "family circumcision set" that accompanies the lead section, unduly emphasizing the tradition, long history, and "family values" aspect of cutting the foreskin off infant boys' penises with no anaesthetic. Blackworm (talk) 23:15, 22 June 2008 (UTC)

Thanks, Jake. ☺ Coppertwig (talk) 01:13, 23 June 2008 (UTC)

Jake your position for removing the picture because it is a violation of NPOV is illogical. By your logic only non controversial pictures may be added to articles and that is clearly not the case. We use pictures to illustrate all manner of points in articles. Garycompugeek (talk) 01:31, 23 June 2008 (UTC)