Talk:Circumcision

Category:Violence against men

Looking over the category description and pages categorized with it, this does not seem to be the kind of article that belongs there. This seems more about the medical procedure. Perhaps the cat belongs on one of the other pages linked in the various culture-related sections? EvergreenFir (talk) Please {{re}} 04:57, 8 July 2014 (UTC)

Agree, category not supported. Zad68 05:11, 8 July 2014 (UTC)

Conversely we have another article devoted to the surgical procedure and this one IS SUPPOSED to be, and one day may become the "flagship" overview article mentioning all pertinent aspects of the varieties of circumcision in all its horror and its joy.When children and adults have a body part involuntarily and sometimes forcibly cut off for cultural reasons this ought to be mentioned here. That it is not tells us a great deal about the ongoing weakness of the wikipedia model in the face of a concerted cabal --— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 15:57, 8 July 2014 (UTC)

WP:NOTAFORUM
The following discussion has been closed. Please do not modify it.
Evergreen, cognitive dissonance dictates that you do not want to believe what was done to you (I presume you are circed because your profile says you are American). Nevertheless a lot of people believe circumcision to be a violent act. You could argue that up to 2/3 of the world's men who aren't circumcise would argue it was a violent act.Tremello (talk) 17:21, 11 July 2014 (UTC) Any excision of a body part which is cut off against the consent of the chopped person is a human rights violation, an act of violence, and an act of rape, by definition, as here it involves a sexual organ. However there is a concerted cabal working this article, who, for some reason, cannot accept this reality or countenance it being mentioned in the article, and work to ensure that the benign false useful picture of circumcision here described is not interfered with. It may be a cultural thing where editors to whom circumcision represents a covenant with their deity, cannot have its uglier aspects or diminishing popularity given any space here. --— ⦿⨦⨀Tumadoireacht Talk/Stalk 17:55, 11 July 2014 (UTC)

Notice: Please do not use Wikipedia article Talk pages to air your personal opinions about the article topic. There are plenty of Internet chat forums for that purpose, this is not one of them. Especially do not use Wikipedia article Talk pages to make personal attacks against or theorize about personal aspects of other editors. Continuing to do so may result in sanctions per WP:NPA and WP:TPG. Zad68 19:22, 11 July 2014 (UTC)

Zad it night be best if you handed over the blanking and blocking decisions on discussion of this topic to another editor, ideally one who is not so heavily invested in this article in its current state. as you are. The omission of key information about circumcision over a long period now from this article is a phenomenon that cannot go unremarked or quickly hidden forever. Please attempt instead to discuss the cogent points raised concerning human rights, mutilation, violence and rape.--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 21:39, 11 July 2014 (UTC)

Zad was correct in hatting that discussion as it was FORUM. We must discuss the the article itself. The word violence is not used once in the article. There's no support for it based on the current article. The category is already on Forced circumcision which is a much better fit for it. EvergreenFir (talk) Please {{re}} 22:37, 11 July 2014 (UTC)

Is that a typo or did you wish to say that Zad$Zachariah hated the discussion ? or halted the discussion?. The discussion was, im either mode of Zachariah, mostly concerned with the article and its current oddly unbalanced editorial state.I suggested that Zad&Zachariah recuse himself from admin functions such as blanking out discussions on this article for the reason stated. we have still to hear from Zad^Zach. on the subject of this suggestion We must work to ensure that the rape and human rights violation aspects of circumcision, alongside the disease, disfigurement,and death caused by circumcision get the mention and weight appropriate to them in this, the flagship article on the subject. This article is not supposed to be confined to, or chiefly concerned with, the medical aspects alone of the primarily cultural act of this variation of cutting off bits of the penis. I appeal to editors and administrators of whatever belief system who have still managed to retain objectivity in this contentious subject to come forward to assist in this process of correction and rebalance.--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 22:22, 16 July 2014 (UTC)

Not a typo. Referring to the template Zad used: {{hat}}. Note, you are going pretty far in asking someone to recuse themselves because you disagree with them. EvergreenFir (talk) Please {{re}} 22:37, 16 July 2014 (UTC)

Tumadoireacht per WP:TPG I will not use this article Talk page to respond to non-article related points, but will on your User Talk. Zad68 02:24, 17 July 2014 (UTC)

Add "see also: Forced circumcision" or soemthing to the effect. — Preceding unsigned comment added by 92.1.65.57 (talk) 07:40, 29 July 2014 (UTC)

Semi-protected edit request on 21 July 2014

The opening paragraph for the page on Circumcision contains the statement "Circumcision does not appear to have a negative impact on sexual function.". This is not true, and it should be noted that fully removing the foreskin removes approx 20,000 or so nerves, and there are countless cases of this effecting sexual function. I'd like to have this corrected. IAmAWhale (talk) 09:05, 21 July 2014 (UTC)

Not done. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:09, 21 July 2014 (UTC)

2014 practice guideline

In JAMA [1] which discusses circumcision.Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:35, 21 July 2014 (UTC)

Removed

"The first medical doctor to advocate for the adoption of circumcision, was the eminent English physician, Jonathan Hutchinson. A study he published in 1855 appeared to demonstrate that circumcised men were significantly less vulnerable to such disease. Hutchinson became a notable leader in the campaign for medical circumcision for the next fifty years, publishing A plea for circumcison in the British Medical Journal (1890), where he contended that the foreskin "...constitutes a harbour for filth, and is a constant source of irritation. It conduces to masturbation, and adds to the difficulties of sexual continence. It increases the risk of syphilis in early life, and of cancer in the aged.""

References

The first sentence is not supported by ref as it does not say he was first. We do not use primary sources from the 1890s typically. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:52, 21 July 2014 (UTC)

It is supported. "As early as 1855, English physician Jonathan Hutchinson advocated circumcision...Hutchinson’s theories formed the basis for an ongoing discussion in western medical literature about the preventive potential of male circumcision." I'd say that was pretty clear. The source from the 1890s is for the passage quoted in the text!Noodleki (talk) 17:05, 21 July 2014 (UTC)

Instead of using SIECCAN's pamphlet, we'd be better off mentioning Hutchinson and citing Darby 2003 directly, that sounds OK to me. I strongly disagree with citing Hutchinson's own publications from 1855 and 1890 and using them as primary sources, the article needs to continue to use up-to-date secondary sources that interpret the historical primary sources for us and put them in context. Zad68 17:18, 21 July 2014 (UTC)

His 1855 publication (venereal disease comparative rates) is mentioned by all secondary sources. The quotation from 1890 is a good summation of his view. Darby seems to have put up his work on [2] where he has this quotation.Noodleki (talk) 18:00, 21 July 2014 (UTC)

But that's just the thing--Gollaher is the most complete and detailed history source (240+ pages) we're using and does not mention Hutchinson 1855--I certainly can't find it if he does. The one quote they do have from Hutchinson is from a 1900 source. Of the Victorian-era adoptors of the procedure, Gollaher talks about Sayre a lot more than Hutchinson. That's really the issue with primary sources, you can't tell by looking at them alone whether your use of them is with due weight. If the article is going to quote anybody it should be Sayre rather than Hutchinson. So, yes, a mention of Hutchinson could be added, and if we really must have a quote (and honestly because of how difficult it is to manage due-weight issues with quotes from individuals, I'd prefer not to) Sayre should be quoted. Zad68 19:45, 21 July 2014 (UTC)

Glick has a great big section on him, as does Darby. There's also the issue of precedence, (15 or so years).Noodleki (talk) 20:49, 21 July 2014 (UTC)

...as do they both have significant discussion of Sayre--I already said I agree a mention of Hutchinson should be added, and probably should be about the same weight as Sayre.. Zad68 21:29, 21 July 2014 (UTC)

There was equal weighting before. So, restore, with sources to Glick and Darby?Noodleki (talk) 09:52, 22 July 2014 (UTC)

Well we can't put back in exactly what was there before due to some of the issues Doc James pointed out, although they're easily fixable. We're pretty close on this: we both agree that Hutchinson could use a mention, it can be done without the use of Victorian-era primary sources, and should be with about the same weight as Sayre. Our disagreement is over whether we should paraphrase the secondary sources, or have a direct quote from Hutchinson. I think the advice at WP:QUOTE is correct where it talks about the pitfalls of using direct quotes, and a quote isn't necessary in this case where we have an accessibly-written secondary source. So how about:

In 1855, motivated in part by an interest in promoting circumcision to reduce masturbation, English physician Jonathan Hutchinson published his findings that Jews had a lower prevalence of certain venerial diseases.(Darby 2003, p. 262) Hutchinson went on to advocate circumcision for health reasons for the next fifty years, eventually earning a knighthood.(Darby 2003, p. 262-) In America, one of the first modern physicians to advocate the procedure was Lewis Sayre, a founder of the American Medical Association. In 1870, Sayre began using circumcision as a purported cure ...(etc. as currently there)

Sound good? Zad68 13:39, 22 July 2014 (UTC)

yes thxNoodleki (talk) 17:55, 22 July 2014 (UTC)

 Done Applied to article... per WP:WEIGHT I had to do a bit of tweaking to not make it sound like Hutchinson got a knighthood solely for his work in this area--I read for example this biography on him which does not even mention his association with circumcision. But, a good addition, thanks. Zad68 20:12, 22 July 2014 (UTC)

"appear"

"Circumcision does not appear to have a negative impact on sexual function."

Considering the obvious and common-sense anatomical fact, that the foreskin HAS a sexual function, as it is highly innervated, produces lubrics and protects the glans and provides elasticity of the penis inside the female organ, this is an incorrect sentence. Also considering that sexual function includes psychosexual functioning, there is both logical (trauma and resulting impotence at least in grown up men) and empirical evidence disproving the sentence.

Change into: "The impact of circumcision on sexual function remains disputed."

A meta-analysis of studies on negative impacts: [3] Preconscious (talk) 11:50, 25 July 2014 (UTC)

Agree that it is a very blunt statement in the lead at present. I would support changing the sentence to "The impact of circumcision on sexual function remains disputed." --TBM10 (talk) 13:11, 25 July 2014 (UTC)

Although editors often bring their own very strong personal feelings about article topics to Wikipedia, per Wikipedia content policy we do not base article content on them, see WP:NOR among others. The current article content is extremely well-supported with up-to-date sourcing. See WP:MEDRS for the Wikipedia's guidelines for biomedical content. Zad68 13:44, 25 July 2014 (UTC)

The fact remains, however, that the current statement does remain disputed. --TBM10 (talk) 16:40, 25 July 2014 (UTC)

I don't like the addition of "disputed" wording as it is vague (who is disputing? what are they disputing?, etc). Per WP:LEAD, that sentence needs to be a summary of the text; I count 6 sources that say there is no relationship, and one to one small medical association reporting case reports (which are not a high quality of medical evidence). The wording as it stands appears appropriate given the WP:WEIGHT of reliable sources. Yobol (talk) 17:00, 25 July 2014 (UTC)

"Disputed" is putting it mildly! Circumcision (or cutting off bits from the head of the penis to call a spade a spade) is not a medical phenomenon but a cultural and anthropological one. There ARE well documented acknowledgements in Jewish and other traditions of both the pleasure reducing intention and result of cutting off most of the pleasure receptors on the tip of a sexual organ. Therefore constantly gurning and referencing the lack of secondary medical sources on the subject is both counterproductive and misleading. The historical, psychoanalytic, psychological and psychiatric literature on both victims and perpetrators of circumcision needs to be included for this article to maintain the currently wrongly awarded "good article" status. The sale of foreskins harvested from circumcision and sold at about 200 dollars USA each at current rates (and the most interesting cosmetic and medical and med research purposes they are put to) needs to be mentioned, as does forced circumcision in several cultures worldwide and the deaths and disease fron some forms of circumcision where the perpetrator takes the baby's penis in his sometimes hepatitic mouth during the procedure. I hope that the editors who are so soi-disant stringent on the medical front can apply the same objectivity to correcting these lacks. The recent and decent tightening up of the law in Britain for those who attempt to cut bits off baby girls' genitals is also beginning to focus on the the parallel practice of cutting bits off baby boys. The worldwide decline in popularity in circumcision also weirdly goes unmentioned in this very poor article. Has no editor with the resources to do so got the courage to buck the trend here, damn the torpedoes, and add these glaringly missing bits to the article ? --— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 20:36, 25 July 2014 (UTC)

Certainly Tumadoireacht you are not suggesting to add content that is unsourced, poorly-sourced, or violates WP:WEIGHT, or to violate Wikipedia behavior policies regarding such things as edit-warring or tendentious editing, right? Your use of a Wikipedia article Talk page to air your personal opinion is once again noted. Zad68 21:27, 25 July 2014 (UTC)

Zad - your propensity to duck the issues raised by contributions on this page and instead accuse those whose intent is to improve the article of "airing' personal opinions is odd. Let us instead try to find ways of improving the article without resorting to such unwwiki like aspersions. I raised 16 points in my last contribution. You chose to ignore them all and instead describe the suggestions for improvement as "personal opinion". As you well know the "weight argument refers to how much mention is given to aspects of a subject and NOT to whether they get mentioned at all at all. i ahve stopped editing this article some time ago as I have observed that any edit that does not conform to a particular view of circumcision quickly gets reverted by any one of a small and concerted team of editors. Surely you do not intend to continue to stand over such a partial and selective article which is so in contrast to other encyclopedias and other wiki encyclopedias in its omissions ?--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 17:40, 26 July 2014 (UTC)

The use of article Talk pages to air personal opinions is disallowed per WP:TPG; it's not "odd" to point that out and it's perfectly in line with Wikipedia behavior. Are you saying you do not intend to ever abide by WP:TPG? Your understanding of "weight" is not in line with WP:WEIGHT, please refer to that policy document for more information.

And, Tumadoireacht, the edit summary you provided for your comment (diff) that you addressed to me was, "pewsonal makes me newvuss". What exactly did you intend to communicate to me with that? I'd be happy to pursue your concerns further but I want to make sure I understand all the information you intended to communicate before I do. Zad68 02:30, 27 July 2014 (UTC)

Of course personal opinions are not the thing. But the "oddness" as i clearly stated above was rather in the transparent tactic of repeatedly ignoring cogent critique of the article and instead attempting to characterize such critique as "personal opinion" This, from an admin, has the potential to inhibit many would-be contributors. Hence personal/nervous. The "surely it is not your intention" line of chat is camp and inappropriate. By the way the use of "your use of a talk page .... again...has been noted" is not a good way to address a fellow editor - noted by whom? (the passive verb is particularly silly) noted where ? and for what purpose? I hope no other editor is intimidated by seeing such peculiar statements trotted out. Please revise your reading of the WP policy on weight given to particular aspects of a subject. I have given you the relevant sections from that policy in the past. Attempting to shut out facts from the article DOES constitute an ongoing imposition of personal opinion which is at odds with core WP values. Please reconsider your position,statements, reversions, and actions.--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 12:06, 27 July 2014 (UTC)

But you didn't write "personal/nervous" you wrote "pewsonal makes me newvuss". And your reply here indicates that when you were writing "me" you were not indicating yourself, but rather putting those words in my mouth, while mocking me? Zad68 02:48, 28 July 2014 (UTC)

Question is, if it appears or if there are studies that don't prove it. (I linked a meta-analysis of studies that do and there are dozends if not hundreds of others that imply an impact, do you want to cite them all?) It appears, that if you cut away a part of the genital organ it results in a decrease of sexual function. This is, what should "appear" to any common sense. If you can disprove this obvious assumption through any statistical methods and what psychological theories are involved to explain a compensation of the loss of foreskin, is another subject. which you could include as "Discussion on sexual function". BWT, I don't feel invited to invest any time in searching for links, if former contributions WITH sources are deleted at will. Preconscious (talk) 14:59, 26 July 2014 (UTC)

Hi Preconscious, first you need to review WP:MEDRS, English Wikipedia's standards for biomedical content. As Yobol mentioned the article currently carries a half-dozen high-quality secondary sources such as MEDLINE-indexed systematic reviews and review articles. Per WP:MEDREV individual primary sources aren't used to counter the conclusions of high-quality secondary sources, and in this case there are a lot of them, all saying the same thing. Honestly, even just one of the secondary sources in use would be enough to support the simple assertive statement the article carries. There are many similar kinds of statements along the lines of "Intervention X has effect Y" throughout many other articles on English Wikipedia that are cited to just one good-quality secondary source; six is really overkill, but the number of references has grown over time because our readers demand it. Zad68 02:30, 27 July 2014 (UTC)

Zad: "The current article content is extremely well-supported with up-to-date sourcing." - Not in this case. "appear" is not exactly well-supported, you ignore common sense at best. In terms of general outlines, this article is a rather poor exegesis of a very limited scale of studies with almost no logical argument or overarching sense of the difficulty and diversity of the issues at stake. I have read better and this is, why I'm intervening. I bet there is a Wikipedia-policy on common sense used as argument. Preconscious (talk) 15:06, 26 July 2014 (UTC)

Preconscious, the trouble with "It is obvious that..." and "It is common sense..." is that, most often, those phrases are exactly equivalent to "In my opinion"--this is a form of original research which is disallowed, see WP:OR. To answer your question I bet there is a Wikipedia-policy on common sense used as argument: there is, in a way: see WP:BURDEN. In a nutshell, if you feel something is "common sense", you can add it to an article without a source, or with a poor-quality source, but per WP:BURDEN if that content is challenged it is up to you to support it with reliable sourcing and demonstrate compliance with other policies, and if you can't, the challenged content cannot stand--this is policy. Zad68 02:30, 27 July 2014 (UTC)

I would suggest to consider reading and implementing the links from the well-organized, less sophistic and more informative German wikipedia article on "Zirkumzision", where the issue of sexual pleasure and function is disputed more scientifically (most of the links are in english) I would offer to translate the German section on Sexual Function if implemention (and further discussion) is granted: Zirkumzision - Auswirkungen auf die SexualitätPreconscious (talk) 15:20, 26 July 2014 (UTC)

Preconscious, actually the sourcing standards of English Wikipedia are much more stringent than German Wikipedia, so most all of the sourcing used there could not be used here. Here is something interesting: English Wikipedia's sourcing and article content standards have gotten to be sufficiently well-respected that the English Wikipedia's Medicine Wiki-project is actually publishing our best-quality article content as review articles in peer-reviewed medical journals. Also, English Wikipedia's articles (including this one, actually) are being translated and exported to other-language Wikipedias. If you are interested in medical articles and have a native command of German, you might consider joining the Medical Tranlsation team to help translate and export English Wikipedia's articles, let me know if interested. Zad68 02:30, 27 July 2014 (UTC)

Zad, 1. Sexual function is not biomedical content. It is primary psychological and philosophical. One can see, what happens, if biomedicine or empiricist sociology feels competent to judge sexual satisfaction from questionaires.

2. This is why this article contains large parts of cultural science. 3. "that the English Wikipedia's Medicine Wiki-project is actually publishing our best-quality article content as review articles in peer-reviewed medical journals." - this article is not "wikipedia's medicine Wiki-Project" it has to stand alone for its reputation and quality. 4. "Also, English Wikipedia's articles (including this one, actually) are being translated and exported to other-language Wikipedias." - Also other scientific articles are translated and exported to english wikipedia. Check bias. 5. Again, anyone else than Zad who has both, control and competence of this article and thinks, the sentence on sexual function does not represent the pluralistic research, (the argument is, that it "appears" not to be existent, which is disproved by the sources, if they are acceptable can be discussed one by one). I offer to translate some arguments from different scientific studies proving the logical presuppositions, that something happens if you remove a part of a sexual organ. 6. I also offer a translation from German into English of parts of Hegel, if that helps you, Zad. Or from Marx or Kant or Virchow or other primary sources, that seem to inhibit primary philosophical standards in the discussion of the content and structure of this article. Preconscious (talk) 18:08, 27 July 2014 (UTC)

Zad, In fact, what the current sentence actually does, Zad, is the following: to disprove individual factual evidence with statistics.

This is not scientific, it is dishonest sophistry. It is FACT, that circumcision causes in a (disputable) range of persons dysfunctions up to penile loss and in rare circumstances death. As the article includes cultural circumcision, this is even increased through ritual circumcision with a high incidence of penile loss, necrosis and death. Other factual evidence consists about loss of sensitivity and pleasure. It does not matter in the first range, if in a statistical survey this can be measured or not. The fact exists, that it happens (see complication rate). And the sentence suggests against all evidence, that complications don't happen, that there is no single case of sexual dysfunctioning through circumcision. In effigie, the sentence discriminates against persons who suffered such impairment (up to penile loss) and declares their complication as non-existent. That you need this sentence so much testifies heavy subconscious doubts that seek for denial. Preconscious (talk) 18:47, 27 July 2014 (UTC)

I cannot speak for Zad's subconscious or its needs and should not in any case, but up to that Preconscious you have made some well thought out points. Would you like to propose a better wording than the current one ? --— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 00:42, 28 July 2014 (UTC)

Preconscious, please do not personalize this discussion and focus only on the article content. Don't make comments about editors.

You may feel Sexual function is not biomedical content but the sourcing disagrees with you. What we do here is summarize the best-available sources, we do not advance our own arguments, and we do not synthesize our own conclusions from primary sources, so translating primary sources to support an argument you are making would not be a good use of time. The word "appears" is exactly what several of the sources cited in the article use, please review the sourcing provided and you'll see they support the current content. Complication rates and the rare catastrophic outcomes are already covered in the article, in both the lead and the body, not sure how you missed that, please review carefully. Zad68 02:40, 28 July 2014 (UTC)

Zad, There is a sentence in this article that is effectively FALSE. If it is cited in scientific studies, it stays false. Science is not religion, which is, why it is open to corrections. I don't know, who is in charge here and how, but my argument has been made from several angles and if you ignore all of them, I can only document this and see if I can find assistance on a higher level. This "personalization"-argument is rather funny sophistry, as you seem to be in charge of editing - which is why any argument discussed is governed by a person at the moment. Preconscious (talk) 07:49, 28 July 2014 (UTC)

Preconscious, your statement There is a sentence in this article that is effectively FALSE. If it is cited in scientific studies, it stays false. is at the heart of the content issues you're having here. You appear to be saying that you don't care what the sourcing says; you know the truth. Fundamentally, we disregard what individual editors might believe is "The Truth" (again see WP:NOR) and instead we summarize the conclusions of the best-available sources. (Although if you can get your views published in a high-quality source, we can cite that source.) Please read this essay, WP:Verifiability, not truth. Zad68 13:36, 28 July 2014 (UTC)

No, you know the truth, which is why you are blocking it. I'm not making a statement about the sources you cite, I'm making a statement about the sources you don't cite and about how you cite the source which makes the quotation FALSE as contradicting any factual evidence of any single complication. Why do you need this sentence as it is? Alternatively quote the study, where it "verifies" that there is not a single complication caused by circumcision. Which is what your sentence says. If it helps, please read this essay, as obviously this is not about medicine, but about science: https://en.wikipedia.org/wiki/Science_of_Logic. Preconscious (talk) 16:03, 28 July 2014 (UTC)

Once again I request that you please stop personalizing this content issue. Your statements Alternatively quote the study, where it "verifies" that there is not a single complication caused by circumcision. Which is what your sentence says. indicate you're not reading or understanding what the article or sources say. Zad68 21:52, 28 July 2014 (UTC)

Van Howe Meta-Analysis

I would like to see Van Howes meta-analysis cited. Van Howes meta-analysis is at the same time a higly profound critique of several kinds of bias, mainly sampling bias and lead-bias. He critisizes John Hopkins study for selective misrepresentation of collected material: "Why would Tobian and the research group from John Hopkins collect samples from the penile shaft and glans but only report the result of the glans?"

In "urinary tract infections" - For nonspecific urethritis Van Howe concludes a lower risk for intact men.

As abstract in "Sexually trandmitted Disease" insert: "Van Howe's meta-analysis of 91 selected articles comes to the conclusion, that there is no overall significance for "Clamydia, gonorrhea, genital herpes, and human papillomavirus", "Syphillis showed mixed results", while "intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection." He points at the obvious fact, that studies of general populations make positive impacts of circumcision highly unlikely."

In the section on HIV implement insert: "Van Howe decided against including the three African trials into his meta-analysis concerning STD and Circumcision. He mainly points at the neglected lead bias, the time, where circumcised men are unable and/or not advised to have sexual intercourse (4-6 weeks). This most significant methodological flaw was not avoided or critisized by the major funding organisations nor by the high-quality articles citing the studies. He also argues, that 20% of infections in the Sub-Saharan setting "are not spread through sexual contact". The biological argument is classified by Van Howe as hypothetic at best and disproved in the case of the Lagerhans-cell-theory. He argues, that the Lagerhans-cells rather prevent infections and explain the lower transmission of STD in intact men. "

If you again decide to delete this detailed quotation of a high quality meta-analysis I would insist on a qualified discussion why it was deleted´and why Van Howes Meta-analysis should not be implemented in the article.

References

Preconscious (talk) 14:18, 26 July 2014 (UTC)

Preconscious, the journal that published the Van Howe article you are mentioning is not even MEDLINE-indexed. See WP:MEDRS for English Wikipedia's standards for reliable sourcing for biomedical information. The questioning of the utility of the results of the African HIV RCTs is indeed already mentioned in the article, see the Modern times subection of the History section. In fact an article by Van Howe (one that is MEDLINE-indexed) is already mentioned there, so an article by Van Howe is already in use to support content along the lines you are describing. Zad68 02:30, 27 July 2014 (UTC)

I just won 10 Dollars as I bet, that Zad would pull a sophistic argument. I will enter the sophistic argument by citing the same source MEDRS you are quoting, but the section on independet sources: "Many medical claims lack reliable research about the efficacy and safety of proposed treatments or about the legitimacy of statements made by proponents. In such cases, reliable sources may be difficult to find while unreliable sources are readily available. Whenever writing about medical claims not supported by mainstream research, it is vital that third-party, independent sources be used."

So the simple discussion is about quality of the article. As you say, there already is an article cited by the same author, so his quality is out of question. It is MORE up to date. (See guidelines for MEDRS up to date). And, most of all, Van Howes critique is essential for the public opinion on the STD-Debate. Why would you really want to withhold this information? Preconscious (talk) 17:53, 27 July 2014 (UTC)

Your comments are off-target, I am afraid. I am not sure why you are quoting from WP:MEDRS about "reliable sources may be difficult to find"... the sourcing in use is reliable per WP:MEDRS and easily available so I don't see how that passage you are quoting is relevant. Zad68 02:44, 28 July 2014 (UTC)

Yes, yes, just follow WP:MEDRS...appropriately...and other editors generally will not have any problems with your edits at this article. Flyer22 (talk) 02:49, 28 July 2014 (UTC)

Stay scientific in your argument and stick to the topic and other users will not have any problems with your edits at this article. What in Van Howes study prevents you from listing it? Van Howes meta-analysis is not a primary source (which could be even used in some cases according to WP:MEDRS) and the rest is up to the discussion, as there are only guidelines in Wp:MEDRS. Van Howes article provides an up to date critique of methods applied in high-standard-sources you cite here. This has to be respected. Van Howe questions the very scientific method of the sources as he points to the obvious fact that they don't include lead time bias. Why would you really want to disclose this fact to the public? Preconscious (talk) 08:58, 28 July 2014 (UTC)

There are high-quality sources that say X, if a lower-quality source (as discussed earlier) disagrees we don't concern ourselves with it. Why would it improve an article to base content on lower-quality sources when high-quality sources are available? Zad68 13:36, 28 July 2014 (UTC)

Where in Wikipedia WP:MEDRS does it say, that ISRN urology should not be used as a source? It is in the NLM Catalogue, which pretty much makes it a medliine-indexed source, doesn't it? http://www.ncbi.nlm.nih.gov/nlmcatalog/?term=ISRN+Urology Also Van Howes article is in PubMed. http://www.ncbi.nlm.nih.gov/pubmed/?term=ISRN+Urology+van+howe Preconscious (talk) 15:59, 28 July 2014 (UTC)

You should probably read the links you provide, where it says the journal is "Not currently indexed for MEDLINE." In cases where red flags such as lack of MEDLINE indexing, you can see if there are any positive citations in journals of undisputed reliability. The only citation I see where that article is discussed in any detail is this review article, which states in part, Van Howe "(1) failed to include results of all relevant studies, especially data from randomized controlled trials, (2) introduced bias through use of inappropriate control groups, (3) altered original data, in the case of human papillomavirus (HPV), by questionable adjustments for “sampling bias,” (4) failed to control for confounders through use of crude odds ratios, and (5) used unnecessarily complicated methods without adequate explanation, so impeding replication by others...Meta-analyses, when well conducted, can better inform public health policy and medical practice, but when seriously flawed can have detrimental consequences. Our critical evaluation leads us to reject the findings and conclusions of Van Howe on multiple grounds." So no, this is not an article that has gained any positive traction in the medical literature, so should not be used, per WP:MEDRS. Yobol (talk) 16:48, 28 July 2014 (UTC)

A review by the very same authors which obvious flaws were uncovered by Van Howe. One can tell the racket, that he suggests. Of course, most medics in the US have performed circumcision and most will seek to suppress feelings of guilt. Add political pressure, as the Pepfar is funding mass-circumcision. Many issues at stake that should turn any scientist deeply suspicious against such "reviews" and the prior studies involved.

Anyhow, you mainly argue, that it is "not yet" discussed or cited. An article from only one year ago... well, even four authors of the "critical" review needed one year to publish their defense only in mid 2014. Again my argument is, that you retreat to sophistry and that you don't judge the article on its own.Preconscious (talk) 18:08, 28 July 2014 (UTC)

I'm sorry you feel a discussion of the correct application of WP:MEDRS of a proposed source through its acceptance/citation in the relevant peer-reviewed literature is "sophistry". As you have not actually addressed the crux of the issue (that this source is not MEDRS compliant because it is not MEDLINE indexed nor positively cited in the medical literature), I will assume you have no actual response to these points and no further discussion is necessary. Yobol (talk) 20:02, 28 July 2014 (UTC)

Compare the "weight" and emphasis in a more rounded picture of circumcision given in this poor but legible translation of the intro in the french wikipedia

Here is the French wikipedia article opening paragraph on circumcision(circonsion) - it gives a wider and more comprehensive picture, though is still saddled with that bizarre opening photo of the turbanned men sitting on a carpet 100 years ago.

Here we get context, and prevalence, popularity, and rationale from the beginning as any article ought to do. How and why do you think the English language version has been prevented from achieving such a basic standard of description?

Circumcision (latin: circumcisio "cut around") refers, in its most common form, the partial or total removal of the foreskin, leaving the glans penis exposed. According to the World Health Organization, in 2009, 661 million men over 15 years would be circumcised, approximately 30% of the male population mondiale1. Ritual circumcision has been practiced for cultural and religious reasons since ancient times. In Judaism, the brit milah ritual is called. Although not being mentioned in the Qur'an, circumcision is practiced throughout the Muslim world,it is most often considered a sunna. It is also practiced by members of some Eastern Orthodox churches. Some people practice circumcision without religious reasons but by tradition, social cohesion, identity or masculinité. In the Anglo-Saxon industrialized world, circumcision was promoted to harm as a means to prevent masturbation, a hygiene, and to reduce the risk of infection. The statement attributing circumcision health benefits has since been tempered by medical research, as well as the correlation between circumcision and masturbation. The practice of circumcision increased in the English-speaking world in the early twentieth century to become a routine operation on newborns, but following lively debate is steadily declining since the late twentieth century ........ Do we need to radically rethink the emphasis or "weight" of the english language intro -or indeed of the entire article ?--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 12:36, 27 July 2014 (UTC)

Disposal of cut off foreskins from circumcisions and the big silence here in this article on it

Here is the section in the foreskin article on use of foreskins from circumcision

"Foreskin-based medical and consumer products: Foreskins obtained from circumcision procedures are frequently used by biochemical and micro-anatomical researchers to study the structure and proteins of human skin. In particular, foreskins obtained from newborns have been found to be useful in the manufacturing of more human skin.[61]

Human growth factors derived from newborns' foreskins are used to make a commercial anti-wrinkle skin cream, TNS Recovery Complex.[62]

Foreskins of babies are also used for skin graft tissue,[63][64][65] and for β-interferon-based drugs.[66]

Foreskin fibroblasts have been used in biomedical research.[67"

Now circumcision produces all these foreskins. They do not fall off, run down a trouser leg and get collected by lab or cosmetic employees off the street. Labs buy them online from hospitals. Yet there is a concerted group of editors on this article who quickly revert any mention in the circumcision article of what is done with the foreskins cut off during circumcisions. A reader may wonder but will never know. Not from this article. Why do you think this is ? Is it like an article on trawler fishing making no mention of the catch disposal ? Should this omission be corrected ?--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 15:41, 27 July 2014 (UTC)

I agree, it is essential information and should be implemented in the article. Preconscious (talk) 17:56, 27 July 2014 (UTC)

Agree a mention of it belongs here, but there's already info at Foreskin#Foreskin-based_medical_and_consumer_products as well. Foreskin makes more sense if we're gonna keep the info in a parent article. If you feel there's a enough info, create an article for it and add {{main}} to the section here and on foreskin. EvergreenFir (talk) Please {{re}} 22:20, 27 July 2014 (UTC)

The selling of the cut off foreskins from circumcision is part of the process of circumcision, as it arises solely from it and so needs a mention in this article. It would be good to describe what other non- and pre-clinical disposal methods are favoured in various cutting cultures - I understand that some bury the cut off skin? refs anyone ?--— ⦿⨦⨀Tumadoireacht ^Talk/_Stalk 01:00, 28 July 2014 (UTC)

Sure, if up-to-date, high-quality sourcing can be found that supports the content and demonstrates compliance with WP:WEIGHT. But, this suggestion sounds familiar. Didn't you propose this exact same thing about a year and a half ago, here? The issue at that time was that the content was bits of trivia strung together, and the sourcing was poor, so there was no consensus to add it. I looked for good-quality sourcing and didn't find it at that time. But Tumadoireacht you've had a year and a half to work on that since then, so surely by now you have found up-to-date, high-quality sourcing? Links please (for medical journal articles a PMID would be sufficient, of course). Thanks... Zad68 02:11, 28 July 2014 (UTC)

Tumadoireacht, you know the deal by now. Flyer22 (talk) 02:49, 28 July 2014 (UTC)

Insert section as "Circumcision as source for cosmetic and medical use of foreskins" Add redirect to Foreskin#Foreskin#Foreskin-based_medical_and_consumer_products.

Preconscious (talk) 08:52, 28 July 2014 (UTC)

Biological explanations

"There are plausible explanations based on human biology for how circumcision can decrease the likelihood of female-to-male HIV transmission. The superficial skin layers of the penis contain Langerhans cells, which are targeted by HIV; removing the foreskin reduces the number of these cells."

Modify into:

"Explanations based on human biology for how circumcision can decrease the likelyhood of female-to-male HIV transmission remain disputed. The superficial skin layers of the penis contain Langerhans cells. If these cells are involved in the transmission or prevention of HIV-infections remains disputed. Langerhans cell#HIV"

Delete the following passage or provide plausible explanation and sourcing: "When an uncircumcised penis is erect during intercourse, any small tears on the inner surface of the foreskin come into direct contact with the vaginal walls, providing a pathway for transmission."

Argument: If the explanations are plausible or not is not subject to the article, it is subject of studies cited. If you cite, please see: WP:MEDRS The Langerhans-cell-theory is not accepted by vast parts of science, in contradiction it is suggested, that Langerhans cells are killing HIV-Viruses, which explains the LOW infection rate (1 per 1000 intercourses). If there are more tears in an intact penis than in a circumcised remains highly suggestive. Prove it or delete it. Preconscious (talk) 09:24, 28 July 2014 (UTC)

The current article content for both of those statements is well-supported by high-quality sourcing. Wikipedia cannot be used as a reliable source for itself, and again please see WP:NOR. Zad68 13:36, 28 July 2014 (UTC)

I don't cite Wikipedia as a source, I insist on linking the section in another article, where it matters. Since when does wikipedia prohibit proper interlinks? And the statement is doubted by high-quality sourcing, which a user could see at the redirected link. I then insist on citing here in addition to the above sentence: "[...] Langerin prevents HIV-1 transmission by LCs. HIV-1 captured by Langerin was internalized into Birbeck granules and degraded. Langerin inhibited LC infection and this mechanism kept LCs refractory to HIV-1 transmission; inhibition of Langerin allowed LC infection and subsequent HIV-1 transmission. Notably, LCs also inhibited T-cell infection by viral clearance through Langerin. Thus Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function."

Please also justify, how information here is blocked by persistent sophistry. How do you keep your arguments free of sophistry and therefore scientific in its true sense, which means self-sceptical and not fact-oriented, where facts might be manipulated by perception, bias or lobby-groups? If you cannot explain, why this wikipedia-article is blocking diversification of information, I will open a case, as I don't see you willing to discuss or cite counterevidence. The current "methodology" is prohibiting sources (cochrane, ISRN, Nature, and others) at will with vague and suggestive hints at WP:MEDRS. Preconscious (talk) 15:41, 28 July 2014 (UTC)

References

Preconscious - Please end your comments after your signature with {{reflist-talk}} if you are going to use references on the talk page. I have added it to this comment. Cheers. EvergreenFir (talk) Please {{re}} 19:40, 28 July 2014 (UTC)

A review of the source easily shows that the item from de Witte is a letter to the editor, and so is near the bottom of the source quality ranking per WP:MEDRS, see WP:MEDASSESS. It also does not mention "circumcision" anywhere in it. The sources the article currently uses are the most-preferred and address the effect of circumcision on HIV transmission directly. Zad68 21:48, 28 July 2014 (UTC)

Modern Times (Hutchington)

"In 1855, motivated in part by an interest in promoting circumcision to reduce masturbation, English physician Jonathan Hutchinson published his findings that Jews had a lower prevalence of certain venerial diseases.[73] While pursuing a successful career as a general practitioner, Hutchinson went on to advocate circumcision for health reasons for the next fifty years,[73] and eventually earned a knighthood for his overall contributions to medicine.[74]"

Delete "While pursuing a successfull career as a general practitioner" and "and eventually earned a knighthood for his overall contributions to medicine." It is highly suggestive and does not help the understanding. Hutchingtons findings are questioned by the fact, that jewish women and jewish men were equally underreperesented in Syphilis-statistics and that he ignored a main factor: anti-Semitic prohibition of cross-culture prostitution, i.e. of christian prostitutes with jews. In: Van Howe, that is blocked here from citing.

I also wonder, why John Harvey Kelloggs is not mentioned in this section, as he was one of the first supporters of circumcision (1888). "Kellogg worked on the rehabilitation of masturbators, often employing extreme measures, even mutilation, on both sexes. He was an advocate of circumcising young boys to curb masturbation and applying phenol to a young woman's clitoris." John Harvey Kelloggs#Masturbation Prevention — Preceding unsigned comment added by Preconscious (talk • contribs) 09:38, 28 July 2014 (UTC)

"Human immunodeficiency virus"

Insert: "In cross-country comparisons, higher national circumcision-rates do not correllate with a lower HIV-rate." Sources: https://en.wikipedia.org/wiki/Circumcision#mediaviewer/File:Global_Map_of_Male_Circumcision_Prevalence_at_Country_Level.png together with the map about HIV-infections: https://en.wikipedia.org/wiki/HIV/AIDS#mediaviewer/File:AIDS_and_HIV_prevalence.svg Preconscious (talk) 09:47, 28 July 2014 (UTC)

This suggestion is based on original research, you are interpreting a primary source of data and drawing your own conclusions from it. Zad68 13:36, 28 July 2014 (UTC)

Your suggestion, that a map on HIV or Circumcision would be a primary source of Data is not well justified. A map on HIV is a meta-analysis in itself, containing loads of primary sources from all countries. If the maps are implemented in both wikipedia-articles, what is wrong with showing them, when the article draws conclusions about interrelations between circumcision and HIV? What would the article be afraid of? Evidence? If it is only my conclusion, would you then agree to implement the map on HIV in the named section without comment, as it matters to grasp the subject? Preconscious (talk) 15:33, 28 July 2014 (UTC)

"A map on HIV is a meta-analysis in itself" --- Um, what? No, that is patent nonsense. Please review Meta-analysis, as you clearly do not understand the meaning of that word. Yobol (talk) 16:49, 28 July 2014 (UTC)

→Please review semantics if you should mistake this comparison as plain equation. It is not a primary source either. Nonetheless maps are used by wikipedia articles for illustration. Anyhow, what exactly is it with this specific map that you can't show it? Preconscious (talk) 20:50, 28 July 2014 (UTC)

Everything can be used as a primary source for itself, even if that thing is a secondary source for something else. Your use of the data to draw a conclusion from it that isn't stated by the source is original research using the data as a primary source. Zad68 21:41, 28 July 2014 (UTC)

Looks like an attempt at WP:OR. So oppose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:02, 28 July 2014 (UTC)

The method applied by now is not editing constructively at the moment, but blocking nervously. I offered to revise and suggested only applying the HIV-Map to the article. So any user can decide for his own, what to make with the picture. You can then find a cochrane study proving or disproving anything. I don't care. I think it is for the benefit of the user, if you have not only a circumcision map but also an HIV-map in the section, where the interrelation of HIV and CC is relevant. Why would one censor the wikipedia-map, if not for being scared and having no argument? Preconscious (talk) 08:15, 29 July 2014 (UTC)

"strong evidence"

In the HIV-section you write "strong evidence". As the link to the Circumcision and HIV is there, one would think, that the Cochrane study linked there would be important for the unexplained judgement of "strong": "A 2003 systematic review from the Cochrane Collaboration was more cautious. This review of 35 observational studies concluded that while there was an association between circumcision and HIV prevention, the evidence was insufficient to support changes to public health policy.[28] A 2005 review of 37 observational studies expressed reservations about solidity of the conclusion that could be drawn because of possible confounding factors." — Preceding unsigned comment added by Preconscious (talk • contribs) 10:11, 28 July 2014 (UTC)

Cochrane itself uses the word "strong". Do you not agree the current article content summarizes the source accurately? I'm not getting the impression that you're reading the sources here. Cochrane is perhaps the most-preferred kind of source. Zad68 13:36, 28 July 2014 (UTC)

If you cite "strong", cite correctly. If you don't cite, don't cite. If you need help with citing, I will gladly inform you about the rules of objective citing. I cited a cochrane study above. So either you accept Cochrane is good, then implement the Cochrane study cited above which states no reliable evidence. Or you stick to your study of preference.

And no, cochrane is "perhaps" not the most-preferred kind of source, especially not when a high level of personal involvement in sexual issues is at stake. In 1935 you would have yielded a Cochrane-evidence for racist theses. Meta-analyses as such are not preferrable once it comes to understanding. They are in selection biases as easy as manipulated as a conventional survey, especially if manipulated as will for lobbying.

They might be useful for general estimates about costs and insurances and general attitudes. Which is, why cochrane is insurance and public-health-politics. But it remains statistics. And relying on it includes the attitude, that the majority is right. Which is especially unscientific. And especially in medical science, that has especially not been the most outstanding model for science in the past 3000 years (despite some outstanding progresses). Which is noted by critical physicians who tend to found pharma-independent journals and distrust any pimped study on the market that is trying to blur fact and fiction with statistics. Awareness about the temporality of "science" in medicine is taught in better universities, medics know about trends from yesterday today counting as unscientific. The poor methodology and the evident methodological flaws of the MAJORITY of studies in Medline-sources on circumcision has been critisized by Van Howe, as they are all funded without meeting basic standards of avoiding obvious biases. And none of them seeks to mention or explain the cross-country comparison-"paradox". Preconscious (talk) 15:23, 28 July 2014 (UTC)

I see a lot of hand waving above, but Cochrane reviews are considered the highest quality evidence. We generally do not point to out-dated reviews when newer ones supplant them, so your suggestion that we need to use out-dated information is not reasonable, and will not gain traction. If other article use out-dated information, it is a reason to improve the other article by removing it there, not make this article worse by adding it here. Yobol (talk) 16:53, 28 July 2014 (UTC)

I agree to the argument, that there is a more current cochrane study that might speak of strong evidence. Please cite then correctly from the study. Otherwise its prone to suspicion of POV, as the rest of the article tends to rather euphemistic language. In any case: would it not further your argument, to mention this development of opinion making process and list the three cochrane studies in dispute? Preconscious (talk) 21:08, 28 July 2014 (UTC)

What are the exact PMIDs of the Cochrane articles you are looking at? The Cochrane Review from 2009 says "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men". The Cochrane Summary from 2013 says "Results from three large randomised controlled trials conducted in Africa have shown strong evidence that male circumcision prevents men in the general population from acquiring HIV from heterosexual sex." They both use the results of the three large RCTs that were conducted through 2008. Are you actually suggesting we use one from 2003 to weaken the conclusions from the ones from 2009 and 2013?? Zad68 21:36, 28 July 2014 (UTC)

No, I suggested to cite the passage. And not adopt the finding precautiously without quotation marks. As the study you cite right know relies totally on the three trials, and as all these three trials have neglected lead bias and all of them were stopped early and none of them provides long-term insights and none of them explains the transmission process biologicalls, there should be reason to stay cautious and only cite it. At the moment the article adopts the findings unsceptically. Which is a rather superstitious bueraucratic procedure, that has nothing to do with checking and understanding medical knowledge in process. The more, as the entire text of the study is not available to the common user and only abstracts are online.Preconscious (talk) 07:47, 29 July 2014 (UTC)

Importance of Article

It is related to this article, to ensure, that the editors and admins are aware of its importance. I don't know, if they have been to Africa. In Africa, despite the colonial and post-colonial progresses to eradicate smallpox and reduce other diseases, there is an incredibly frustration and a load of (sometimes occult) conspiracy about racist medical intervention.

Vaccination campaigns are under permanent suspicion of sterilizing women. It is not, that African societies are not used to medical fraud. In some regions "homeopaths without borders" are present, in most regions you have herbalists and quacks. But that is the situation: HIV is considered as a western bio-weapon or myth by many and western medicine is countered with suspicion and especially vaccinations. If now, for some reason, circumcision is at first advertized as the new 60% reliable-vaccine against HIV, and then later on, after millions of Africans were bribed into circumcision, a proofreading of incomplete studies shows that the orginal database was flawed or that other factors are far more important in the spread of HIV/AIDS, it will have an effect on other therapies including Retroviral therapy. In short, if by now after millions of circumcisions the HIV-rates are not dropping significantly, it has not only an effect on opinion about circumcision in Africa, but vast parts of Africans will also put this into a general conspiracy theory and accompany it with vaccinations. So the result of flaws in circumcision-studies will in the end cause distrust against vaccinations against polio and other diseases.

Therefore I call for a policy of citing pro-circumcision studies only after having read and understood them, and quoting them in the best scientific way: sceptical. The current practice here is a simple publication-hierarchy, where studies are true, if they are cochrane. This is bureaucracy and not knowledge. And it seems to me that it is against the method of cochrane itself to "believe" in it for publication reasons, as its oulines always call for a critical questioning of studies - also of its own findings. I'm not against citing cochrane, I'm voting for respecting critique of methods also if not cochrane and logical critique, which in history has often provided better results than data-mining (compare homeopathy, which could be disproved by the logic of any 13-yrs. student while empiric research multiplies into thousands of studies by now). Preconscious (talk) 08:10, 29 July 2014 (UTC)