Talk:Circumcision/Archive 69

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Archive 65 Archive 67 Archive 68 Archive 69 Archive 70 Archive 71 Archive 75

Lead text moved to sub-paragraphs

All content besides definition has been moved from the lead/header text to the relevent sub-paragraphs. No content has been changed or removed. — Preceding unsigned comment added by Okotoimako (talkcontribs) 10:45, 23 December 2011 (UTC)

I reverted this change because it created an inadequate lead that merely served as a dictionary definition. Per WP:LEAD, "The lead serves as an introduction to the article and a summary of its most important aspects." Jakew (talk) 11:14, 23 December 2011 (UTC)
Yes contravenes WP:LEAD --Doc James (talk · contribs · email) 11:47, 23 December 2011 (UTC)

Wikipedia promotes the World Health Organization's opinions in the second and third paragraphs of the Introduction, without citing any authoritative opinion to counterbalance it. The citation from the Royal Dutch Medical Association in the fourth paragraph hardly offsets the WHO theories advocated as "strong evidence" in the opening paragraph. In context to its advocacy of the WHO theories, Wikipedia uses a very weak citation from the KNMG,i.e., "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision.", which indicates an ignorance of the KNMG's core statement, "There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene." To keep the Introduction in its current version establishes Wikipedia's advocacy of the controversial WHO hypotheses. — Preceding unsigned comment added by Mock The Knife (talkcontribs) 17:06, 23 December 2011 (UTC)

See the above section. Jakew (talk) 17:20, 23 December 2011 (UTC)

NPOV dispute -- Second and Third Paragraphs of the INTRODUCTION above Contents

There has been no attempt to address the imbalance of viewpoint in the opening paragraphs. The second paragraph establishes the World Health Organization as the ultimate authority on the demographics of worldwide circumcision, so that by the third paragraph too much weight has been given to WHO's controversial AIDS theory, and no counterbalancing authority is cited to offset it. The phrase "strong evidence" that introduces the AIDs theory very clearly violates the neutral point of view, i.e., "strong evidence" states seriously a contested assertion as fact.

Wikipedia's endorsement of the AIDs research as "strong evidence" states its opinion of the research as fact, violating the neutral point of view. The AIDS studies in Africa have been critiqued and disputed on many grounds, most recently in the December 2011 Journal of Law and Medicine. see Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns Gregory J Boyle and George Hill December 2011 Journal of Law and Medicine http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf

The Royal Dutch Medical Society rejected the AID's theory when it issued its finding in 2010 that "There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene." Mock The Knife (talk) 17:06, 24 December 2011 (UTC)

There is scientific consensus that strong evidence exists. As explained previously, the existence of a small number of individuals expressing a minority point of view does not change that. Jakew (talk) 18:28, 24 December 2011 (UTC)

Archiving rate

Garycompugeek apparently wants to slow down the archiving rate of the Talk: page, which, for the past six months, has been set to 1 week. For the six months before that it was actually set to 5 days. The reason it's set so short is because the Talk: page generally quickly fills up with WP:NOTFORUM violations, typically from new account anti-circumcision activists, or from the many sockpuppets of TipPt or Joe Circus. Is there a consensus here to slow it down? Jayjg (talk) 17:04, 28 December 2011 (UTC)

I think a week is perfectly reasonable. It's not as though this is an obscure article that people rarely look at, after all. I'd oppose increasing it to a month. While I'd prefer not to increase it at all, I'd be willing to compromise on a fortnight, with the understanding that it may need to be reduced again if the talk page becomes unmanageable. Jakew (talk) 17:17, 28 December 2011 (UTC)
Obviously, a constant archiving rate of one week is sometimes going to lead to current debate material being archived prematurely (e.g. the table of search methods used to establish weight and associated criticism). I support a compromise change to a fortnightly archiving frequency. I'm going to restore the thread with the table because I last updated it on the 24th - four days ago. Any objections? Beejaypii (talk) 20:26, 28 December 2011 (UTC)

I dislike having to go through the archives because a discussion has dragged on, and commenting on a thread in the archives is for posterity. Let us try two weeks and see if it is better, I simply set it to one month because that seems to be the most common denominator. Garycompugeek (talk) 15:13, 29 December 2011 (UTC)

I also prefer the current one week archiving period, but am willing to test a two week archiving period, with the understanding that it will be switched back to one week without further discussion if the page starts filling again as it so often has in the past. Jayjg (talk) 15:56, 29 December 2011 (UTC)

Completely agree. We may even need to reduce it to less than one week if subjected to a lot of nonsense, as we have been in recent months. Jakew (talk) 16:17, 29 December 2011 (UTC)
And, of course, this change is not retroactive, so Gary, please stop trying to restore to this page dead discussions that have already been archived. Jayjg (talk) 17:05, 29 December 2011 (UTC)
Jayjg, Beejaypii added to the table 4 days ago as this[[1]] shows. Why are you edit warring on a talk page about archived discussions? If myself or any other editor wants to discuss anything pertaining to the article, who are you to set a time limit? Please self revert immediantely. Garycompugeek (talk) 17:30, 29 December 2011 (UTC)
I'm not sure why Beejaypii was adding to someone else's table, when he should have been making his own table. In any event, there was no on-going discussion of the material, and no likelihood that any consensus would form regarding changing the lede. Instead, what would inevitably happen is this:
  1. Beejaypii would propose shortening or in some way discrediting any material seen as favorable to circumcision, particularly in the lede.
  2. You would wholeheartedly agree with whatever Beejaypii proposes.
  3. Some IP editor, new editor directed here from an anti-circumcision discussion board, or sock of TipPt or Joe Circus would show up and agree.
  4. No-one else commenting would agree to the change.
  5. Interminable conversation on the topic.
  6. Rinse, repeat.
If you like, I can set up a template for this conversation, with parameters for the specific material Beejaypii finds too "pro-circumcision" this time, and an auto-signature for your inevitable concurrence with whatever Beejaypii says. I might even be able to work out some sort of randomized name for the inevitable IP/sock that shows up too. Perhaps Jakew could create a bot that every couple of days would add standard comments in the conversation - for example

The lede still gives UNDUE weight to the pro-circumcision material X. Beejaypii

Agree completely with whatever he said. Garycompugeek

This article will never improve as long as it relies on JUNK SCIENCE!!!. Joe Circus sock59

How does that sound? Jayjg (talk) 17:55, 29 December 2011 (UTC)
I found it quite amusing to read. My perspective is quite different. New editor comes to page and complains about pages neutrality or pages name disparity from Female genital mutilation. Jake reverts and points to some obsure archived thread that goes on for decades discouraging said editor and if the poor editor has the nerve to question or complain more Jayjg generally bites their head off. If things continue to go south Avi generally shows up to back both of you up. Want to talk about gaming the system? Jakew's edit count of 1305 [[2]] by far exceeds anyone elses, ex Avi 561, Tip 556, Jayjg 233, Garycompugeek 173, Beejaypii 104. Garycompugeek (talk) 17:54, 30 December 2011 (UTC)
Not sure what edit counts have to do with anything (they certainly have nothing to do with my comment), but TipPt's actual edit count on the article is almost 700, once you include his various socks (User:Zinbarg etc.) and IPs. Jayjg (talk) 00:23, 1 January 2012 (UTC)

Before this thread degenerates any further, I've created a new section below combining the table in question with an adaptation of other, related comments I contributed recently. I hope other editors are prepared to engage in the debate. Beejaypii (talk) 01:36, 30 December 2011 (UTC)

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Description of the RFC

When Beejaypii initiated the RFC above, he used the following opening sentence:

A debate has been taking place about whether apportioning significantly more of the lead of the current version of the circumcision article to one aspect (HIV prevention) of the main article topic relative to all other aspects is justified.

I've modified it to the more neutral:

A debate has been taking place about whether the weight apportioned to HIV prevention in the lead of the current version of the circumcision article is appropriate.

WP:RFC states quite clearly that a brief, neutral statement of the issue should be included. The word "neutral" is both linked and italicized for emphasis. Beejaypii, please don't abuse the RFC process in this way in the future. Thanks! Jayjg (talk) 17:23, 16 January 2012 (UTC)

What's more neutral about that? Beejaypii (talk) 17:29, 16 January 2012 (UTC)
Your sentence was worded in a way to echo your complaint, that the article is "apportioning significantly more of the lead of the current version of the article to one aspect (HIV prevention) of the main article topic relative to all other aspects". The neutral sentence indicated the issue in the more neutral way, whether the weight given to HIV is appropriate. If you find this difficult to understand, please review your comments above about "common sense". Jayjg (talk) 17:38, 16 January 2012 (UTC)
It does not seem appropriate for an admin, in particular, to employ sarcasm (quote: 'If you find this difficult to understand, please review your comments above about "common sense"'). Do you dispute that the article is apportioning significantly more of the lead to the HIV aspect than any other aspect, currently (if you assert that's no neutral)? Beejaypii (talk) 17:52, 16 January 2012 (UTC)
I was not employing sarcasm at all; I was hoping you would remember your previous commitment to the principle of "common sense", and begin applying it in this case too. Do you dispute that the modified sentence is shorter, easier to understand, and more neutral? Jayjg (talk) 17:55, 16 January 2012 (UTC)
Unless you disagree that the article is apportioning significantly more of the lead to the HIV aspect than any other aspect, currently, then I don't understand how you can claim that my version was not neutral in some way. In which case it's not a question of less or more neutral, it's a question of why you edited my version. And the question still remains about why you edited my version instead of addressing your concerns in an additional comment, especially in view of the fact that you did not raise these issues when I added additional comments to the previous RfC which you instigated? Perhaps an RfC should only have one description when it suits your purpose, and not when it doesn't? Would you like diffs for the previous RfC to illustrate? Beejaypii (talk) 18:19, 16 January 2012 (UTC)
It's a question of framing, Beejaypii. RFCs are supposed to be presented in as neutral a fashion as possible, but the request was framed in terms of your own arguments. Jayjg's edit presented the issue without framing in terms of your point of view "apportioning significantly more of the lead to the HIV" or the opposite "is there sufficient emphasis to provide due weight to this highly significant issue". Jakew (talk) 18:23, 16 January 2012 (UTC)
In what way is "apportioning significantly more of the lead to the HIV..." not neutral? Do you dispute that's the situation in the current version of the article lead? "is there sufficient emphasis to provide due weight to this highly significant issue" is not the debate, it's whether there's a way of even ascertaining due weight to the extent that justifies significantly more of the lead apportioned to one issue. And the question remains of Jayjg's inconsistent approach with respect to his edit of my description. Beejaypii (talk) 18:44, 16 January 2012 (UTC)
What inconsistent approach? Jayjg (talk) 19:17, 16 January 2012 (UTC)
And why not just express your concerns in an additional comment instead of editing my comment? Beejaypii (talk) 17:30, 16 January 2012 (UTC)
Because there should be one neutral description of the RFC that all editors read when they first come here to understand the problem. Jayjg (talk) 17:38, 16 January 2012 (UTC)
Is that a policy? Beejaypii (talk) 17:40, 16 January 2012 (UTC)
You now need a policy to have one neutral RFC question? Jayjg (talk) 17:43, 16 January 2012 (UTC)
Sorry, let me be more specific: where's the policy which supports you editing another user's RfC description instead of adding your own comment? Beejaypii (talk) 17:47, 16 January 2012 (UTC)
Where's the policy that allows you to add a non-neutral RFC question? Where's the policy that states you personally own the RFC? Jayjg (talk) 17:53, 16 January 2012 (UTC)
The bit about "one" description? Additionally, you haven't explained why your version is more neutral. Beejaypii (talk) 17:41, 16 January 2012 (UTC)
I have indeed explained why my description is more neutral, above. Are you again asking questions that have already been answered? Are you actually claiming your version is more neutral? Jayjg (talk) 17:43, 16 January 2012 (UTC)
What aspect of creating an RfC with a description which can then be added to by any other editor with additional comments (as opposed to editing another user's comment) implies ownership? And you still have not explained why my description was not neutral. Beejaypii (talk) 18:02, 16 January 2012 (UTC)
I have indeed explained why your comment is not neutral, in comment of 17:38, 16 January 2012 (UTC) above. But if you're still having difficulty understanding this, please review Jakew's comment of 18:23, 16 January 2012 (UTC) regarding "framing" to understand better why your framing of the RFC was not neutral. Jayjg (talk) 18:42, 16 January 2012 (UTC)
Yes, again, what aspect of creating an RfC with a description which can then be added to by any other editor with additional comments (as opposed to editing another user's comment) implies ownership? And why didn't you insist on one RfC description in this way when you instigated the previous RfC and I added comments to that description (as opposed to editing your original comment)? Beejaypii (talk) 18:47, 16 January 2012 (UTC)
Did you attempt to change the previous RFC's description? I don't recall you doing that. Jayjg (talk) 19:17, 16 January 2012 (UTC)

@Beejaypii: Arguing about the framing of the RfC is pointless. The explanation for the change has been clearly given, and if there is a problem understanding that explanation the best strategy would be to forget about it—not all problems can be solved. Continuing to ask for policies and what-have-you shows a lack of understanding about Wikipedia's procedures (not bureaucracy). This page should focus on the issues. Johnuniq (talk) 22:19, 16 January 2012 (UTC)

Perhaps when a contribution of yours is simply changed by another editor without prior discussion you might see things differently. Especially when that user has seemingly overridden the following from WP:RFC, with reference to the summary:
  1. "Include a brief, neutral statement of the issue below the template, and sign it with ~~~~ (name and date) or ~~~~~ (just the date)." - Jayjg removed my signature here
  2. Which is a cause for concern in view of "(For your question to be displayed correctly, the first date stamp must precede any such sub-section headings or tables.)"
  3. "You can also do your best, and invite others to improve your question or summary later." - kind of implies that someone simply changing it without prior discussion isn't the way to go.
Beejaypii (talk) 02:27, 17 January 2012 (UTC)
And guess what, the RfC's posting seems to have messed up, yet it was ok when it was first posted. Possibly because Jayjg removed the time stamp here.
Beejaypii (talk) 02:39, 17 January 2012 (UTC)

I've restored the original description of the RfC because of the technical problems indicated. I'm open to suggestions about possible neutrality issues. Beejaypii (talk) 03:46, 17 January 2012 (UTC)

I've restored the neutral description, because "technical problems" are no reason to have an inappropriate RFC description. I've added my signature for now, to deal with any technical issues; feel free to replace it with your own signature if you prefer. The text, however, must remain neutral, in accord with WP:RFC. Jayjg (talk) 04:18, 17 January 2012 (UTC)
Please explain why you feel that my description is inappropriate or not neutral. Simple assertions that it is are not explanations. Beejaypii (talk) 11:38, 17 January 2012 (UTC)
Wikipedia:Drop the stick and back slowly away from the horse carcass... Jakew (talk) 12:30, 17 January 2012 (UTC)
Wow I have never seen editors go to such lengths to disparage another editors comments. Jakew and Jayjg have been Beejaypi's biggest opponents in this HIV debate yet apparently see no conflict of interest in editing his comments creating the RFC or explaining what was not neutral about it. Garycompugeek (talk) 17:32, 17 January 2012 (UTC)
"Wikipedia:Drop the stick.." And that's what you just did is it Jakew? I have not had a rational explanation of what was wrong with my description, which suggests neither you nor Jayjg can provide one (as does your attempt above to get me to drop the point). Beejaypii (talk) 21:54, 17 January 2012 (UTC)

Problematic methodology used to establish sub-topic weight (generally, and with respect to HIV information in the current lead)

A debate has been taking place about whether the weight apportioned to HIV prevention in the lead of the current version of the circumcision article is appropriate. The proposed methodology/methodologies for establishing relative weight of aspects of the topic have been discussed, as have aspects of some of the policies and guidelines governing such issues on Wikipedia. An impasse appears to be have been reached and outside input is sought. A new sub-thread titled RfC comments has been created for the purpose. Jayjg (talk) 04:22, 17 January 2012 (UTC)


Because there has been some confusion about which discussion threads are active or not, I'm bringing together material from two related discussions in this new section to clarify the situation.

Here's the latest version of the table (recently bot-archived four days after the last edit to it) which was originally introduced by Coppertwig with this edit, where he invited "others to edit it and add to it."

source type percentage method method weakness(es)
books 20% First ten "Google Books" results for "circumcision", percentage of books for which specific "Google Books" searches showed that the book mentions HIV or AIDS. This is just verification of the co-occurrence of one term together with either of two other terms in 10 results out of over 50000.
books 2% Google Books search for "circumcision hiv" as fraction of search for "circumcision"
literature reviews (any time) 29% PubMed search for "circumcision hiv" as fraction of search for "circumcision". Using "limits" restrict to reviews. Only demonstrates the fraction of biomedically related sources which reference the term "HIV" from amongst sources of the same kind which reference the term "circumcision". Also suffers from similar newsworthiness problems as the news search results below.
literature reviews (since RCTs) 57% PubMed search for "circumcision hiv" as fraction of search for "circumcision". Using "limits" restrict to reviews published after 1 Dec 2005. Only demonstrates the fraction of biomedically related sources which reference the term "HIV" from amongst sources of the same kind which reference the term "circumcision". Also suffers from similar newsworthiness problems as the news search results below.
"reliable source" books
recent books (since RCT's) 6% Since 2005. Google Books search for "circumcision hiv" as fraction of search for "circumcision"
scholarly articles (since RCT's) 50% Since 2005. Google Scholar search for "circumcision hiv" as fraction of search for "circumcision" "circumcision restoration" gives 40%. "circumcision fruit" gives 52%. "circumcision chocolate" gives 9%. Also, "circumcision hiv" since 2008 gives 36% (why choose 2005 in particular?)
news articles (since RCTs) 41% Google News search for "circumcision hiv" as fraction of search for "circumcision". Search from 1 Dec 2005 to present. Just a test of recent newsworthiness. Says nothing about the importance of HIV to the topic of circumcision compared to non-controversial, established aspects of the topic.
web pages

In addition to what the search results and criticism offered in the table above suggest, it does seem that the principle of performing PubMed and other searches to establish the relative importance of a sub-topic to a main topic is fundamentally problematic.

Firstly, only sub-topics which are currently newsworthy and being discussed will return significant results: non-controversial sub-topics, whose principles are widely accepted, simply won't be the focus of much discussion and won't return significant results. These kinds of searches do not, therefore, provide an indication of the relative degree of importance of a sub-topic by comparison with another sub-topic where one or more of those sub-topics is currently newsworthy and one or more of the others isn't. And even when comparing two newsworthy sub-topics, these searches still don't provide an indication of the relative degree of importance they have to the main topic.

Secondly, in terms of execution, the search principle lends itself well to searches for sub-topics which can be comprehensively referenced via a single term (as is the case with "HIV", which is an unambiguous and highly prevalent abbreviation) but is much more difficult to perform where a concept may be referred to using a variety of words/phrases, as is the case with foreskin restoration for example, which, to cite a few possibilites, could be referred to as "restoration of the foreskin", "uncircumcision", "restoring the foreskin", "preputial restoration", "foreskin restoring", "restore the prepuce" and even highly contextual variations such as "restore what they've lost", etc.

Thirdly, a search for co-occurring terms reveals nothing about the nature of the relationship between the concepts represented by those terms, aside from an indication, via prevalence of co-occurrence in sources, that there is some relationship.

Finally, why just use PubMed as a dedicated journal search facility, with its biomedical restrictions, why not other academic search facilities such as ScienceDirect? After all, not all sub-topics of circumcision are necessarily medical, e.g. history and religion for starters. Any attempt to establish relative importance of a sub-topic must take as many aspects as possible into account surely? Beejaypii (talk) 01:16, 30 December 2011 (UTC)

It seems there are significant problems involved in trying to justify dedicating a large portion of the lead (currently over 25%) to the HIV issue. The HIV issue is a sub-topic of a sub-topic (medical aspects) of the main article topic, and even within that sub-topic it does not have as direct and intrinsic a relationship to the surgical procedure as other medical aspects. Therefore, and based on closer examination of what seems to be seriously flawed methodology used to justify the weight apportioned to HIV in the lead thus far, I again suggest reducing the HIV coverage in the lead, to this concise summary:

Additionally, strong evidence that circumcision reduces the risk of HIV infection in heterosexual men has led to the WHO recommending circumcision, with respect to that population, as an additional HIV prevention strategy, with the proviso that it should always be considered as part of a comprehensive HIV prevention package.

In particular, I think we need to keep in mind that the main topic of this article is the medical procedure circumcision, with its procedural, historical, religious, cultural (to name a few) sub-topics, as well as sub-topics of those sub-topics. So, any objections to the change I propose? Beejaypii (talk) 01:56, 31 December 2011 (UTC)

Please see previous discussions. Jakew (talk) 09:28, 31 December 2011 (UTC)
I assume you're referring to discussions I haven't been involved in (otherwise your request makes little sense) which deal with the criticism of the term co-occurrence search methodology I've introduced into the table above. If that is indeed the case, would you mind pointing me to those discussions? Beejaypii (talk) 12:13, 31 December 2011 (UTC)
No, Beejaypii, I'm referring to previous discussions in which you've proposed to shorten the HIV material, and others (including myself) have rejected that proposal.
As for your criticism of the "co-occurrence" methodology, I think you've overstated your case somewhat, but I basically agree with your fundamental point that such methodologies are inexact. I've already agreed said so, in Talk:Circumcision/Archive 68#Weight of HIV in lead, where I wrote: "it's a fairly crude methodology". But I continued "it's among the best available", and that's the important point: while a perfect indicator of due weight would be wonderful, we only need a rough estimate. After all, those of us reasonably familiar with the literature should have a good idea of the relative importance of various topics, and we only need the figures to help quantify that. And since we don't have anything better, these data will have to suffice. Jakew (talk) 13:29, 31 December 2011 (UTC)
I also wonder what has changed from the relatively recent discussions we've had about shortening the amount of space given to HIV in the lede. As I recall, the last two times you proposed changing the lede, Garycompugeek inevitably agreed with everything you said, and no-one else did. What has changed since then? Based on the weight given to HIV in recent medical literature about circumcision, the lede should probably devote more space to HIV than it currently does. Jayjg (talk) 00:28, 1 January 2012 (UTC)
Jayjg your attempts to marginalize my comments are quite ineffective. Do you not typically agree with anything Jakew and Avi says? Is it because you are just a puppet or do you have similar viewpoints? Garycompugeek (talk) 13:55, 5 January 2012 (UTC)
I'm not attempting to "marginalize" your comments, I'm just noting the fact that they are invariably just "rah rah" cheers for those of Beejaypii (and occasionally, of any other editor who appears even slightly anti-circumcision). If anyone has "marginalized" your comments, it is you, by dint of their inevitable contents. Jayjg (talk) 15:01, 9 January 2012 (UTC)
Jayjg if you think "rah rah" cheers is not a marginalizing characterization you are sadly mistaken. I'll not respond further to this thread as it has no value to the article. Garycompugeek (talk) 15:23, 10 January 2012 (UTC)
Jakew, why refer me to previous discussions that I was actually involved in? Additionally, why refer me to discussions which did not include a detailed analysis of the methodology criticised in the table and accompanying post by me above? The debate has obviously moved forward and those discussions do not provide answers to the points I've made.
If the methodology in question is good enough to be applied, please demonstrate its use to justify 25% of the lead dedicated to the HIV issue. In other words, please provide specific counter arguments to the points I've made.
How can "those of us reasonably familiar with the literature" be confident that the "good idea of the relative importance of various topics" that we "should have" is not influenced by our own prejudices? What are the safeguards? Your assertion sounds like an argument in favour of the POV of yourself and others in the current context.
Jayjg, if you think "the lead should probably devote more space to HIV than it currently does", and if you're confident about that (your use of 'probably' suggests some doubt on your part), please provide arguments supporting your opinion, or at least explain what you mean by "[b]ased on the weight given to HIV in recent medical literature about circumcision". In particular I'd be interested to know how you've ascertained the weight given to HIV and how that pertains to assessing the weight of the HIV issue relative to the main article topic in relation to the relative weight of all other sub-topics to the main article topic. Beejaypii (talk) 03:24, 1 January 2012 (UTC)
Beejaypii, the reason why I referred you to those discussions was because you asked whether there were objections to your proposal to shorten this material. Since several people (including myself) have previously explained their objections to doing so, doing so again seems an inefficient use of time. Jakew (talk) 11:19, 1 January 2012 (UTC)
Indeed, this constantly re-asking essentially the same questions is an extremely "inefficient use of time". That's why I'm going to respond here minimally, while noting my previous reasoning and objections, which Beejaypii can assume will never change unless he produces some actually new and convincing material or arguments, which he so far has not. Jayjg (talk) 16:43, 1 January 2012 (UTC)
Jakew and Jayjg, if all my arguments above have already been countered, produce the evidence. If my arguments are unconvincing, counter them. Beejaypii (talk) 02:32, 2 January 2012 (UTC)
This has already been done, which is why this is an "inefficient use of time". There is no way of measuring the exact importance of HIV to circumcision, but a review of the recent literature (particularly medical) indicates that it is of significant importance. It is therefore quite obvious that the lede should at least mention the topic, and any editor who suggests removing it entirely, or that it is a "compromise" to even mention it, can be dismissed out of hand, because the arguments put forward for removing it entirely are neither policy-based nor rational (e.g. "JUNK SCIENCE!!!", "it's only relevant to Africa!!!", "an article criticized the WHO's position!!!"). Now, whether one-tenth, one-quarter, or one-third of the lede should be devoted to the topic can never be decided in a purely mathematical way. Rather, editors must examine the different proposals, and see which prose seems to best summarize the topic. From that perspective, proposals designed solely to minimize the amount of text devoted to the topic – as opposed to proposals designed to best summarize the topic - will never achieve consensus, regardless of their purported rationales. Jayjg (talk) 20:11, 4 January 2012 (UTC)
"This has already been done..." Not it hasn't. Produce the evidence.
'...this is an "inefficient use of time"' Depends on your point of view. It's a very easy assertion to make in the course of a debate, but vague and difficult to quantify. It's also what you conclude from your own, unsubstantiated "already been done" assertion.
"...the lede should at least mention the topic." There's a difference between mentioning it and devoting a quarter of the lead to it. Also, there are other sub-topics not mentioned in the current lead at all which one could make the same assertion about.
"...any editor who suggests removing it entirely..." Which obviously doesn't include me.
"(e.g. "JUNK SCIENCE!!!", "it's only relevant to Africa!!!", "an article criticized the WHO's position!!!") Why are you quoting other editors' arguments at me? What's that got to do with my comments in this thread?
"...can never be decided in a purely mathematical way." Sorry, hasn't that been my argument? Glad to see the message has got through.
"...see which prose seems to best summarize the topic." And try to ensure the aspects summarised are relevant enough to the main article to be included, and that the summary is appropriate for the lead, and so on.
"...proposals designed solely to minimize the amount of text devoted to the topic..." Which proposals are you talking about?
Beejaypii (talk) 13:10, 5 January 2012 (UTC)

I agree with Beejaypii's proposal. His logic is quite sound and Jake's is quite week. I am making a compromise (a rare bird around here) for I did not want any mention of HIV in the lead and feel its Wp:UNDUE for reasons stated above. The paragraph summarizes the sources well. Garycompugeek (talk) 15:55, 31 December 2011 (UTC)

Maybe someone should propose a RfC to get greater input.Doc James (talk · contribs · email) 05:01, 1 January 2012 (UTC)
The "logic" of using results of intersection of search results is bizarre: Google Books search for "Islam" 30,500,000 results; "Circumcision" yields 2,520,000; together 109,000 results (about 4% of circumcision and 0.3% of Islam), so using the logic posed about, one should remove Islam from the lead before HIV since the relationship appears statistically an order of magnitude weaker. This of course would be preposterous, given that many (most?) circumcisions are following the precepts of Islam rather than for HIV or anything else that ails you. Just another statistical argument that amounts to nada, like virtually the entire thread above. Carlossuarez46 (talk) 22:41, 2 January 2012 (UTC)
I agree with you about the search methodology. However, I'm not sure what your stance is in relation to this discussion topic: are you arguing that dedicating roughly 25% of the current lead to the HIV sub-topic is justified or not? Beejaypii (talk) 07:38, 4 January 2012 (UTC)
The lead should identify what the topic is, why it's important (or at least notable), and do a quick summary of the major points to be delved into. Perhaps the lead on HIV can be shortened to the simple first statement "strong evidence..." and leave the rest for details, but some may claim that the bald statement without some further clarification is biased in which case the additional statements are added to provide balance - and if that takes up space, well - WP is full of space. Carlossuarez46 (talk) 17:09, 4 January 2012 (UTC)

Arbitrary break 1

I also have stated that search results seem a peculiar way to justify material inclusion especially for the lead which should simply summarize the article's sections. Why are we sensationalizing one particular heavily controversial section? Proponents of the current lead have statistical nonsense on their side while those of us in favor of removing or reducing HIV's prominence from the lead have policy and strong logic on their side. Garycompugeek (talk) 14:53, 5 January 2012 (UTC)

We're not "sensationalising", Gary, we're [[WP:LEAD|"explain[ing] why the topic is interesting or notable, and summari[sing] the most important points". And, since "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources", we're attempting to give emphasis to material that is given considerable emphasis in reliable sources. Jakew (talk) 16:09, 5 January 2012 (UTC)
In what way do HIV/circumcision sources demonstrate that HIV is so important to the topic of circumcision that a lead coverage of 25% is justified in the circumcision article? Beejaypii (talk) 18:31, 5 January 2012 (UTC)
We've already had that discussion. Jakew (talk) 18:38, 5 January 2012 (UTC)
It should be easy for you to answer my question then. Beejaypii (talk) 18:44, 5 January 2012 (UTC)
One obvious reason is that circumcision is done for different reasons in different countries and cultures - it would be very Judeo-Muslim or Anglo-American centric to not mention the number one reason it is being introduced to people in traditionally non-circumcising areas or cultures. If you were writing an article Circumcision in Saudi Arabia, the HIV angle is probably of minimal to no importance at all. But we're not writing that article here, we need to be more global and obviously the HIV angle is notable in the lead absolutely consistent with policy. Carlossuarez46 (talk) 23:41, 6 January 2012 (UTC)
You seem to be answering the question "why should HIV be mentioned in the lead?" What I want to know is what justification is there for 25% of the lead (the current situation) being dedicated to this issue? Beejaypii (talk) 15:25, 7 January 2012 (UTC)
Which has already been answered: since reliable sources give it considerable weight, so should we. Asking the same question over and over again isn't constructive. Jakew (talk) 16:01, 7 January 2012 (UTC)
You keep claiming the question has been answered without substantiating that claim. If it's been answered, answer it. It's easy. I'm quite prepared to point editors to specific, previous comments if I think a question has already been answered. Why aren't you prepared to do that in this case? Beejaypii (talk) 17:33, 7 January 2012 (UTC)
See Jayjg's comment here, for example, which explains why that it isn't even meaningful to ask for a source-based justification of a precise percentage. Yet oddly you continue to demand such justification. Stranger still, your proposal would represent (at a guess) 8-10% of the lead, but you have failed to provide any source-based justification indicating that this should be the percentage. This would seem inconsistent with the position that such justifications should be required. Jakew (talk) 18:24, 7 January 2012 (UTC)
Your comment is based on the erroneous presumption, on your part, that a request for a demonstration of the effectiveness of a methodology equates to advocating that methodology. Additionally, my position is not that "such justifications should be required"; my position is that such justifications are not possible, which is why I presented my earlier suggestion for the lead summary of the HIV issue in the following way:
It seems there are significant problems involved in trying to justify dedicating a large portion of the lead (currently over 25%) to the HIV issue. The HIV issue is a sub-topic of a sub-topic (medical aspects) of the main article topic, and even within that sub-topic it does not have as direct and intrinsic a relationship to the surgical procedure as other medical aspects. Therefore, and based on closer examination of what seems to be seriously flawed methodology used to justify the weight apportioned to HIV in the lead thus far, I again suggest reducing the HIV coverage in the lead, to this concise summary:

Additionally, strong evidence that circumcision reduces the risk of HIV infection in heterosexual men has led to the WHO recommending circumcision, with respect to that population, as an additional HIV prevention strategy, with the proviso that it should always be considered as part of a comprehensive HIV prevention package.

In particular, I think we need to keep in mind that the main topic of this article is the medical procedure circumcision, with its procedural, historical, religious, cultural (to name a few) sub-topics, as well as sub-topics of those sub-topics.
My stance is basically that the methodology used to justify a significant portion (one quarter) of the lead dedicated to a sub-topic of one aspect (medical) of the main article topic is bogus. Therefore, an approach which does not seek to significantly emphasise a single sub-topic, relying on concise summaries and appropriate detail, seems fair and sensible.
I asked for justification for 25% of the lead dedicated to the HIV issue earlier. Your first response was "We've already had that discussion." After further prompting, and the intervention of another editor, you stated "...since reliable sources give it considerable weight, so should we." - basically supporting the methodology in question. Then you begin your next response by advocating the comments of another editor (Jayjg) which attack the methodology in question (?) - a paradox I also addressed in my original response to that editor - and you try to imply that I'm the one who's advocating that methodology because I asked for a demonstration of its applicability.
I'm arguing that it's not possible to demonstrate that the HIV issue is so important to the topic of the surgical procedure male circumcision that a significantly greater proportion of the lead should be dedicated to that issue than any other sub-topic. Therefore, a non-emphatic approach should be adopted - which seems to be the most neutral approach under the circumstances. You seem to be striving to support the unsubstantiated emphasis on the HIV issue extant in the current lead. Demonstrate why that emphasis, relative to other aspects and sub-topics, is substantiated. Beejaypii (talk) 09:49, 8 January 2012 (UTC)
As others have explained to you previously, policy requires that we follow the emphasis given in reliable sources: "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources". So there really isn't room for discussion about that: your belief that we should adopt "an approach which does not seek to significantly emphasise a single sub-topic" is contrary to policy. The question remaining is, do reliable sources give significant emphasis to HIV? The answer is, quite clearly, yes. Jakew (talk) 10:35, 8 January 2012 (UTC)
Could you explain your interpretation of "emphasis in reliable sources"? As far as I can see, the HIV/circumcision sources have little reason to discuss aspects of the article topic which are not pertinent to the HIV issue. Are you interpreting that to mean those aspects not mentioned are therefore not important? All those sources really indicate is the importance of circumcision to the topic of HIV transmission prevention, not the relative importance of HIV to the topic of circumcision. And as far as working contrary to policy, I think the approach I'm advocating, in the absence of a valid means of establishing relative weight, is in keeping with the spirit of the policy:
An article should not give undue weight to any aspects of the subject but should strive to treat each aspect with a weight appropriate to its significance to the subject. For example, discussion of isolated events, criticisms, or news reports about a subject may be verifiable and neutral, but still be disproportionate to their overall significance to the article topic. This is a concern especially in relation to recent events that may be in the news. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements. WP:UNDUE
Again, unless you can demonstrate that the HIV issue deserves weight amounting to 25% of the lead according to it you are working against policy. Beejaypii (talk) 14:21, 8 January 2012 (UTC)
You're making a fundamental error of logic there, Beejaypii. Since absence of evidence is not evidence of absence, not demonstrating something would not indicate working against policy. Secondly, I am absolutely astounded at your implication that the "spirit of the policy" is such that one can effectively ignore it by picking holes in every proposed method to ascertain the significance according to sources, then protesting that there is no "valid means of establishing relative weight". That's like arguing that since speedometers have limitations, the spirit of the laws dictating speed limits is such that one should drive as fast as one likes. The best way to adhere to the spirit of the policy is to try to judge weight using the best methods one can find, as even flawed methods are likely a better approximation than pretending that all issues have equal weight.
In any case, plenty of evidence has already been provided indicating that sources give HIV considerable weight. These include the various searches shown above, as well as my observation back in July that "8 of the 20 (40% of) items on the first page of [PubMed reviews] results [for circumcision] refer to HIV in the title"[3].
If you wish to assert that the proper weight is less than what is currently given, you cannot escape the onus of proof. Find a better method of determining the weight given by reliable sources and propose it. Until then there doesn't seem to be a case for changing it. Jakew (talk) 15:47, 8 January 2012 (UTC)
"You're making a fundamental error of logic there, Beejaypii. Since absence of evidence is not evidence of absence, not demonstrating something would not indicate working against policy"
I'm not sure what you mean there. Would you explain exactly how you are applying that here please: which "evidence" do you regard as "absent" and which "absence" do you regard as not "evidenced", and how does that relate to the point you're trying to make. I'm always a little suspicious when someone involved in a debate begins resorting to these kinds of aphorisms instead of addressing the details of the debate directly - it can often serve to confound rather than to clarify.
"If you wish to assert that the proper weight is less than what is currently given, you cannot escape the onus of proof."
I'm arguing that we cannot ascertain the proper weight in this case. Therefore, we should strive to ensure that one aspect is not apportioned a percentage of the lead which is out of proportion to the amount of the lead dedicated to any other aspect. We can do that by summarising the aspect in question concisely, in keeping with the treatment of other aspects in the lead. I think that amounts to following, as far as is reasonably possible in this case, the policy requirement to strive to avoid giving undue weight to any aspect of the subject. You, on the other hand, are striving to ensure that one aspect (HIV) continues to dominate the lead relative to all other aspects, to the tune of 25% coverage. The onus is on you to prove that such a considerable apportionment of the lead to that one aspect is warranted. You have not done that, and ignoring difficult criticisms of the methodology you advocate is no substitute.
Your assertion about the various searches and the PubMed searches seems to deliberately ignore all the points I've made in the table at the beginning of this thread, and the comments I posted beneath it. If that's going to be your strategy I'll simply make the points again as the debate continues.
And fundamentally, you seem to be confusing prevalence of discussion of the main topic (circumcision) in relation to the subtopic (HIV) in sources focussing on one aspect of the main topic (medical), with prevalence of a viewpoint that the subtopic (HIV) is significantly more important than any other subtopic of circumcision. Beejaypii (talk) 20:00, 8 January 2012 (UTC)
I was referring, Beejaypii, to your claim that "unless you can demonstrate that the HIV issue deserves weight amounting to 25% of the lead according to it you are working against policy", as I'm sure was perfectly obvious.
Regarding your claim of undue weight, undue weight is, by definition, where something is given greater weight than is appropriate. Thus, in order to make such a claim, you would have to demonstrate that the appropriate weight for that topic is smaller. But by saying that "we cannot ascertain the proper weight in this case", you've actually contradicted your own argument: if you cannot say what the proper weight should be then you have no way of knowing that the weight given is undue. What you are essentially saying is "I am ignorant about the appropriate amount of weight". That's not an argument for changing it. Jakew (talk) 21:40, 8 January 2012 (UTC)
You said 'I was referring, Beejaypii, to your claim that "unless you can demonstrate that the HIV issue deserves weight amounting to 25% of the lead according to it you are working against policy", as I'm sure was perfectly obvious.' - I actually asked "Would you explain exactly how you are applying that here please: which "evidence" do you regard as "absent" and which "absence" do you regard as not "evidenced", and how does that relate to the point you're trying to make." Your response amounts to a simple reproduction of an extract of my post, which doesn't explain your use of the phrase "Since absence of evidence is not evidence of absence, not demonstrating something would not indicate working against policy." Instead of relying on that aphorism, explain what you actually mean, because it isn't obvious to me, and you're the one who made the assertion.
As for the rest of your post, it ignores what I said previously "I'm arguing that we cannot ascertain the proper weight in this case. Therefore, we should strive to ensure that one aspect is not apportioned a percentage of the lead which is out of proportion to the amount of the lead dedicated to any other aspect. We can do that by summarising the aspect in question concisely, in keeping with the treatment of other aspects in the lead. I think that amounts to following, as far as is reasonably possible in this case, the policy requirement to strive to avoid giving undue weight to any aspect of the subject." In contrast, you are basically asserting that in the absence of a means of ascertaining relative weight (demonstrate the application of such a means if you disagree about that absence) it is acceptable to apportion weight to a particular aspect disproportionately to the weight apportioned to all other aspects, even without being able to demonstrate why it is acceptable to do so. I repeat my previous assertion: you are the one who is striving to ensure that one aspect (HIV) continues to dominate the lead relative to all other aspects, to the tune of 25% coverage. The onus is on you to prove that such a considerable, exclusive apportionment of the lead to that one aspect is warranted. Beejaypii (talk) 14:52, 9 January 2012 (UTC)
Actually, Beejaypii, you are the person who keeps claiming that "25%" is an inappropriate amount of the lede to devote to HIV, so you must prove that some other percentage is appropriate. What percentage is that, and how do you know? Jayjg (talk) 15:01, 9 January 2012 (UTC)
It's not the figure which is important, it's the percentage relative to the portion of the lead attributed to one aspect as compared to the proportion dedicated to other aspects. In the case in point, the 25% apportioned to the HIV aspect is disproportionate to the % apportioned to other aspects (I assume you agree with that, percentage-wise at least?). If you like I can create another table, breaking down the current lead, sentence by sentence, proposition by proposition; that will not support your stance that the HIV aspect deserves significantly greater coverage in the lead than any other aspect of the main topic however. My stance, as I've repeatedly explained, is that we cannot ascertain the relative weight of different aspects of the article topic (if we can, show me how), therefore, a concise treatment of each aspect mentioned in the lead is the approach which avoids any one aspect being emphasised unduly, as far as we can know. Unless you and Jakew (and others) can demonstrate why the HIV aspect deserves a significantly greater portion of the lead than any other aspect of the topic you are effectively promoting an unsubstantiated POV. My POV, on the other hand, is not that any particular aspect is less or more important than another, it's that we cannot ascertain whether that is the case or not, and a concise summary of each aspect included in the lead (though there are other discussions about which aspects should actually appear in the lead, and which aspects should be covered in the whole article even) is therefore the most neutral approach in the absence of evidence. Apportioning a significantly greater portion of the lead to any particular aspect in the absence of evidence is not a neutral approach. Beejaypii (talk) 16:32, 9 January 2012 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────Beejaypii, obviously the percentage is important to you, otherwise you wouldn't keep repeating (and protesting) that "the 25% apportioned to the HIV aspect is disproportionate". It's also obvious that a lede cannot mention every point mentioned in the article - I've never seen an FA lede that did so, for example, since it would make most ledes far too long: therefore, "a concise summary of each aspect" seems impractical, not to mention a violation of WP:LEDE. WP:LEDE advocates summarizing the "most important points" of the article in the lede (not "each aspect"), and states that "the emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources" - not at all what you're advocating in your comment. Now, can you show us what formula you used to calculate that "the 25% apportioned to the HIV aspect is disproportionate", and explain what the actual percentage should be? Jayjg (talk) 17:23, 10 January 2012 (UTC)

"Beejaypii, obviously the percentage is important to you..." I don't know what you mean. Important to me? The percentage of 25% is roughly the amount of the lead apportioned to the HIV aspect. In this article lead that is disproportionate to the % dedicated to any other aspect. Do you dispute that? I'm not making a global assertion about article leads in general, such that 25% of any article lead dedicated to any one aspect of an article topic is disproportionate. You do realise that don't you?
"It's also obvious that a lede cannot mention every point mentioned in the article" Er, where did I claim it should?
'...therefore, "a concise summary of each aspect" seems impractical,' Now I understand, whether intentional or not, your "It's also obvious..." statement, above, is a straw man.
"the emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources" I assume you have sources according to which HIV is more important to circumcision than any other aspect then?
'Now, can you show us what formula you used to calculate that "the 25% apportioned to the HIV aspect is disproportionate", and explain what the actual percentage should be?' The 25% is the % of the text, by word count, of the lead apportioned to HIV (roughly) - no formula required to ascertain that. I don't know what the percentage should be - point is that it's not possible to ascertain (if it is, show me how) - but in this article that 25% is significantly greater than the % apportioned to any other aspect of the article topic. Therefore, I'm advocating the most neutral approach, which is not to apportion a significantly greater portion of the lead to any one particular aspect in the absence of evidence supporting such relative emphasis, which seems a more neutral than campaigning for one aspect of the article topic to be apportioned significantly more of the lead than any other aspect, in the absence of evidence supporting such relative emphasis. Can I also draw your attention to the wording at the top of WP:LEAD, in the "style-guideline" template: "This guideline is a part of the English Wikipedia's Manual of Style. Use common sense in applying it; it will have occasional exceptions." Beejaypii (talk) 19:57, 10 January 2012 (UTC)
The approach you advocate is not only contrary to WP:LEAD, it is also contrary to WP:UNDUE, which clearly states that an article "should strive to treat each aspect with a weight appropriate to its significance to the subject". That is not the same as "should strive to give each aspect equal weight", except in the situation where all aspects are equally significant. To justify your approach, therefore, one would have to demonstrate that this is such a situation. Jakew (talk) 20:45, 10 January 2012 (UTC)
Are we going to start quoting single phrases from policies in isolation now? For example, I can argue that WP:UNDUE also states, in the very first sentence, "as far as possible without bias." Perhaps we can have a long debate about what "as far as possible" means next. I can also point out that strive is closely synonymous with try, which implies the possibility that one might fail under some circumstances (yet more evidence of room for common-sense). Additionally, I've already quoted from the template at the top of WP:LEAD above: "Use common sense in applying it; it will have occasional exceptions." But all this will get us nowhere. Demonstrate a way of assessing the relative importance of different aspects of the topic. And, more specifically, demonstrate that the HIV issue is more important than any other aspect and deserves to be apportioned more of the lead than any other aspect, because that's the state of affairs you are trying to defend. Beejaypii (talk) 21:31, 10 January 2012 (UTC)
I have already provided evidence indicating that the issue is highly significant to circumcision, which to my mind is more than adequate, but actually your demand is an attempt to shift the burden of proof. As the person attempting to gain consensus for your proposed change, the onus is upon you to show that HIV should be given less weight. Jakew (talk) 21:43, 10 January 2012 (UTC)
"I have already provided evidence indicating that the issue is highly significant to circumcision" You haven't provided evidence that HIV has greater relative significance than any other aspect of circumcision. The fact that the HIV issue is one of the aspects actually mentioned in the lead (and my concise, alternative version qualifies in that respect) reflects significance. The HIV aspect is apportioned significantly more of the lead than any other aspect in the current version of that lead. You have not provided evidence indicating why that should be the case.
"which to my mind is more than adequate" Are you prepared to provide arguments in support of that, or do you intend to just leave it at as unsubstantiated assertion (which may as well be simple POV)? In other words, why is it "more than adequate"?
"...your demand is an attempt to shift the burden of proof." An unspecific assertion. Where did the burden of proof lie, in your opinion, and where have I shifted it to?
"As the person attempting to gain consensus for your proposed change, the onus is upon you to show that HIV should be given less weight." Another unsubstantiated assertion. Could you explain why you believe that to be the case? Beejaypii (talk) 09:12, 11 January 2012 (UTC)
Most importantly, because if you can't demonstrate why it should change, then there's no reason why it shouldn't be left as it is. Jakew (talk) 10:21, 11 January 2012 (UTC)
Beejaypii and myself have repeatedly shown that we object to the prominence of HIV in the lead, a sub topic of a topic and nothing to do with the medical act of circumcision which happens to be the title of this article. First you tried to use search results as justification which I think most of us feel was statistical nonsense and now you say you disagree with Beejaypii's logic but you haven't backed that assertion up with any meaningful logic of your own. Garycompugeek (talk) 16:30, 11 January 2012 (UTC)
Your objection is noted, but unless it is accompanied by evidence showing that sources give HIV less emphasis than is presently given, that's little more than WP:ILIKEIT. Jakew (talk) 17:14, 11 January 2012 (UTC)
Your like the king of strawmen Jake. We've already established there is no mathematical formula to ascertain prominence from one source to another. We have to use logic and common sense to summarize the article lead. Garycompugeek (talk) 20:16, 11 January 2012 (UTC)

"I LIKE IT"??? That would indicate a misreading of Wikipedia:Arguments to avoid in deletion discussions because WP:ILIKEIT doesn't apply to any of the logical points in this discussion. To the average schmuck who reads the article, they come away with the impression that Wikipedia encourages circumcision. That's why scholars never quote Wikipedia in their research, because it's so unreliable in its objectivity. Encyclopedia Britannica remains the model for excellence. Wimp O'pede (talk) 19:31, 11 January 2012 (UTC)

Since you appear not to have grasped the analogy, the principle behind WP:ILIKEIT is that personal preferences alone are not a good basis for editing Wikipedia. Thus the fact that Gary and BJP object to the current lead is not by itself relevant unless they can make a persuasive argument. Jakew (talk) 20:11, 11 January 2012 (UTC)
You didn't answer my question above. You stated "As the person attempting to gain consensus for your proposed change, the onus is upon you to show that HIV should be given less weight." Why? Surely the burden of proof applies equally to any content on Wikipedia. You seem to be saying that because something is already in the article it's not subject to the same burden of proof. The burden of proof does not fall on one side or another; it's distributed equally.
Additionally, my stance has consistently been, throughout this debate, that it is not possible to ascertain the relative importance of the HIV issue (or any issue), as compared to other aspects. Therefore, we cannot evidence the apportionment of a greater portion of the lead to one issue than any other issue. Under such circumstances, to be as neutral as possible as far as we know, we shouldn't apportion a significantly greater portion of the lead to any one issue. To apportion significantly more of the lead to a single issue in the absence of a way of demonstrating that such relative emphasis is warranted is not neutral.
To put it simply, I'm arguing for no significant, unsubstantiated relative emphasis on any aspect of the article topic in the absence of a way of substantiating said emphasis. You seem to be arguing for significant, unsubstantiated relative emphasis accorded to one aspect of the topic. Beejaypii (talk) 20:27, 11 January 2012 (UTC)
How do you reconcile your position that "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects" with WP:UNDUE, which states that articles "should strive to treat each aspect with a weight appropriate to its significance to the subject" and with "the emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources"? Jakew (talk) 21:18, 11 January 2012 (UTC)
If you examine WP:UNDUE you'll see a template at the top which states "This page documents an English Wikipedia policy, a widely accepted standard that all editors should normally follow. Changes made to it should reflect consensus." I've reproduced the Wikilink of normally for obvious reasons.
Additionally, with respect to the bit you quote beginning "should strive...", and as I pointed out in a post above (21:31, 10 January 2012 - roughly 24 hours ago) - in response to a similar question from you - strive is closely synonymous with try, implying room for failure (and the aforementioned Wikilink to WP:COMMON supports room for manoeuvre with regard to the policy in general I think). How do you reconcile your attempts to defend significantly greater emphasis apportioned to one aspect in the lead (emphasis compounded by the fact that actual mention in the lead itself constitutes emphasis with respect to aspects not mentioned in the lead) with "strive to treat each aspect..."? The HIV issue in the lead currently receives the greatest emphasis of any aspect of the article topic, yet no method of ascertaining the validity of that emphasis is available. That's not a common sense, as neutral as possible, approach. Beejaypii (talk) 22:00, 11 January 2012 (UTC)
I'm quite well aware of these points, Beejaypii. You seem to be implying that this is in some way an exceptional situation. If that is indeed your intent, please explain why this article is an exception: why can this policy be applied to other articles but not here? Alternatively, if circumcision is much the same as other articles in terms of the ability to determine relative importance of aspects, then aren't you effectively saying that these statements in the policies are meaningless, in the sense that there is no way to implement them?
As to your question, I don't see any contradiction between treating each aspect with weight according to its significance and giving one aspect more weight than others (I would think that the latter would follow naturally from the former in many cases). And since I don't subscribe to your belief that it is impossible to determine which aspects are more significant, I don't see what needs to be reconciled. Jakew (talk) 22:27, 11 January 2012 (UTC)
"You seem to be implying that this is in some way an exceptional situation." No, I've been describing why certain aspects of certain policies cannot be applied to the letter in the case of this article (but the policies allow for a common sense approach where necessary anyway). I could only speculate about whether this is exceptional or not.
"please explain why this article is an exception: why can this policy be applied to other articles but not here?" As I state above, I have not asserted that this article is an exception: that would be an assertion about the applicability, to this article, of certain aspects of the policies concerned relative to their applicability to articles in general. We can speculate about that, but that's about it. In order to answer the question we would have to subject a sizeable, representative sample of similarly contentious articles to the same kind of analysis we've undertaken here. My arguments have been about the specific case of applying aspects of certain policies to this article (and, again, I'm compelled to point out that those policies allow room for manoeuvre and common sense).
"And since I don't subscribe to your belief that it is impossible to determine which aspects are more significant, I don't see what needs to be reconciled." Ok, how have you ascertained that the HIV issue is more significant than any other aspect to the extent that significantly more of the lead dedicated to it is justified? I assume you have a rational basis for your belief that it's possible to ascertain that? Are you prepared to expose your arguments to scrutiny? The fact that the HIV issue appears in the lead at all is to apportion weight to that aspect of the topic, but how do you justify the disparity between that aspect and all other aspects in the lead? And if you can't justify it, on what basis do you insist on maintaining the version of the lead we have currently? It's quite simple: demonstrate why the HIV issue deserves significantly more emphasis than any other issue in the lead, otherwise that emphasis is not substantiated and we have to assume that the HIV issue does not deserve more emphasis than any other issue in the lead because that's the most neutral we can be under such circumstances. Beejaypii (talk) 19:15, 12 January 2012 (UTC)
You seem to have evaded my questions, Beejaypii. Jakew (talk) 19:44, 12 January 2012 (UTC)
"You seem to have evaded my questions..." - an unsubstantiated claim (and somewhat cryptic I would say), which even you don't seem confident about ("seem"?). By contrast, you HAVE completely avoided addressing any specific aspect of my response, which means I've had to post this additional message pointing that out. You could have just addressed your specific concerns, providing me with something concrete to respond to, couldn't you? Or am I supposed to guess what you are thinking? Beejaypii (talk) 10:31, 13 January 2012 (UTC)
They're straightforward enough questions, Beejaypii: is there something special about circumcision that makes it impossible to apply these policies or not? If this article is a special case that warrants unusual treatment, then why is that (or is this merely an example of special pleading)? If, on the other hand, you're effectively saying that these policies cannot be applied anywhere, then I think such an argument isn't really worthy of discussion at all. Jakew (talk) 11:05, 13 January 2012 (UTC)
Your questions are not straightforward. You've presented a choice between "is there something special about circumcision that makes it impossible to apply these policies or not?" (misrepresenting the actual situation, which is about the extent to which certain aspects of these policies can be applied to the letter to this article, not the binary can the policies can be applied or not) and "you're effectively saying that these policies cannot be applied anywhere." (a conclusion you've drawn from your own misrepresentation of my position - straw man). So, you've presented a mutually exclusive choice between A: It's impossible to apply these policies to this article (to reiterate: misrepresenting my position as an all or nothing assertion) and B: It's impossible to apply these policies anywhere. You are just affirming a disjunct (again), and disallowing the possibility that it's not possible to apply certain aspects of these policies to the letter in the case of this article, which is actually my argument (to reiterate: straw man). Additionally, you ask "If this article is a special case that warrants unusual treatment, then why is that...?" As I've pointed out repeatedly, I cannot know whether it's a "special case" without evaluating similar discussions around similar aspects of other articles, involving the same policy considerations. And what do you mean by "special case" anyway? Is it really special to examine the extent to which a policy is applicable in a specific case, bearing in mind that policies allow for a common-sense approach and flexibility? And what do you mean by "unusual treatment"? It's just a vague assertion. I would argue it's unusual to support significantly greater relative emphasis on one aspect of a topic than any other aspect, in the lead, without demonstrating why that relative emphasis is due (unless one is POV pushing of course). Basically, in arguing that certain aspects of certain policies (policies which allow for flexibility and common-sense remember) cannot be applied to the letter to aspects of the lead of this article, why am I required to comment on the applicability of aspects of those policies to any other article? Go to the relevant policy talk pages if you want those discussions. Beejaypii (talk) 15:42, 13 January 2012 (UTC)

Arbitrary break 2

Beejaypii, WP:LEDE states that the "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources", mirroring WP:UNDUE, which states that articles "should strive to treat each aspect with a weight appropriate to its significance to the subject", but you (Bejaypii)) insist that for Circumcision "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects", that the article is an "exception", an article in which we may only "strive" to follow policy and guideline but must accept the inevitable "failure" to do so. Why? Jayjg (talk) 15:50, 13 January 2012 (UTC)

You've selectively quoted from policies and in doing so have ignored, for example, the advice at WP:UCS (which I recently pointed out) which is linked to from the template at the top of WP:NPOV (which, of course, contains WP:UNDUE), and you have ignored the advice at WP:LEDE which states "Use common sense in applying it; it will have occasional exceptions." (something I also pointed out previously). What you have done is present policies as if they are more restrictive than they actually are by quoting passages from those policies in isolation. Therefore, my arguments are not contrary to policy in the way you are implying. You've also done the same thing in quoting from my contribution earlier: you quote "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects." I wrote:

...it is not possible to ascertain the relative importance of the HIV issue (or any issue), as compared to other aspects. Therefore, we cannot evidence the apportionment of a greater portion of the lead to one issue than any other issue. Under such circumstances, to be as neutral as possible as far as we know, we shouldn't apportion a significantly greater portion of the lead to any one issue. To apportion significantly more of the lead to a single issue in the absence of a way of demonstrating that such relative emphasis is warranted is not neutral.

To put it simply, I'm arguing for no significant, unsubstantiated relative emphasis on any aspect of the article topic in the absence of a way of substantiating said emphasis. You seem to be arguing for significant, unsubstantiated relative emphasis accorded to one aspect of the topic.

Again, I'm compelled to ask you to present evidence that the HIV issue deserves significantly more emphasis in the lead than any other aspect. If you cannot do that then my argument that it is not possible to ascertain such relative importance stands and I therefore have to ask on what basis do you argue that the HIV aspect should continue to be apportioned significantly more of the lead than any other aspect? Demonstrate why that aspect deserves significantly more emphasis than any other aspect in the lead. And if you cannot, demonstrate why attributing one issue significantly more of the lead than any other issue is more neutral than not doing so in the absence of evidence supporting such emphasis. Beejaypii (talk) 17:09, 13 January 2012 (UTC)
In what way would "common sense" dictate that the letter of the policies should not apply? If we should make this article an example of an "occasional exception", then what basis is there for doing so? What is so special about this article that unusual treatment is needed? Jakew (talk) 17:30, 13 January 2012 (UTC)
"In what way would "common sense" dictate that the letter of the policies should not apply?" It's surely common sense not to try to apply aspects of a policy to the letter when to do so depends on the availability of a method of ascertaining relative weight of different aspects of the topic to the extent that significantly more weight can justifiably be attributed to one (or more) aspects of the article topic relative to all other aspects in the lead, i.e. it's common sense not to try to do something (apportion relative weight having established it as due in the lead) in the continued absence of a valid way of doing it. And in the absence of a way of apportioning due relative weight the next best thing is to apportion similar weight, not apportion significantly greater weight to one aspect without substantiating it.
"What is so special about this article that unusual treatment is needed?" Again, I can only speculate (and your question begs the question of how "unusual treatment" is defined), however, it may not necessarily be just the article itself, but a combination of some aspect(s) of the nature of the article topic combined with aspects of the editing situation associated with it. To cite one possible example, editors arguing for the unsubstantiated and significant relative emphasis of one aspect of the article topic in the lead may be unusual, to some extent, but then again it may not - it seems to me that examination of a suitably large sample of other, similarly contentious article content discussions around emphasis apportioned to aspects of article topics in article leads would have to take place in order to answer the question substantively, if similar enough article content discussions even exist. But this is to digress: the central questions relate to the extent to which aspects of particular policies can be applied, to the letter, to this article, not speculation about issues around the application of those policies to other articles, or articles in general - those are issues for policy talk pages surely. Beejaypii (talk) 18:50, 13 January 2012 (UTC)
This is why we need to consider whether circumcision is an exception, Beejaypii. Is circumcision unusual in the sense that there is an "absence of a valid way of [determining relative weight]"? Or would applying the same test of "validity" mean that it is effectively impossible to apply WP:UNDUE to any article? If so, is such a test consistent with common sense? I think the problem is that you're demanding a way to perfectly quantify the relative weight of different aspects as an insurmountable problem. But WP:UNDUE doesn't require perfection; it requires that we "strive" (ie., try) "to treat each aspect with a weight appropriate to its significance to the subject". So in the absence of a perfect instrument, common sense would dictate falling back onto less perfect methods, including rough approximations and rules of thumb or, indeed, editorial judgement. There's certainly room for discussion to find the best, most appropriate, method, but refusal to use any method whatsoever seems contrary to the intent of the policy. Jakew (talk) 19:49, 13 January 2012 (UTC)
"This is why we need to consider whether circumcision is an exception, Beejaypii." What is? What aspect of my post are you referring to with the word 'this'?
'Is circumcision unusual in the sense that there is an "absence of a valid way of [determining relative weight]"? Or would applying the same test of "validity" mean that it is effectively impossible to apply WP:UNDUE to any article?' (still cannot see which part of my post 'this' referred to). You express that as if it's a matter of applying the whole policy or not; it isn't, the policy includes links to WP:COMMON and WP:Ignore all rules, allowing for flexibility. You are suggesting that if an aspect of a policy cannot be applied perfectly to one article then we have to try to establish whether that is true in general. Why do we have to do that here, and how would one do that anyway, and how do you square that with the policy advice about common sense and "ignore all rules"? Additionally, the degree of applicability of a policy will surely vary on a case by case basis because there's surely a complex relationship between articles and policies: articles vary in the extent to which different aspects of different policies are even relevant (is the section of WP:UNDUE titled aesthetic opinions particularly relevant to the current version of this article for example?), and they also vary, surely, with regard to the complexity involved in applying relevant aspects of policies (whichever they happen to be in each case, and to what extent).
You suggest I'm demanding a perfect instrument, yet you are effectively arguing that because a policy cannot be applied to the letter (though the policy allows for that via a direct reference to WP:COMMON and an indirect one to WP:Ignore all rules, via the aforementioned link) one then needs to examine the applicability of the aspect which cannot be applied to the letter, in the case of one article, to other articles. Again, if that's a valid discussion shouldn't it take place on relevant article talk pages?
As for the perfect instrument you speculate I'm demanding, I haven't demanded that at any point. What's your justification for that assertion?
As for your quote from WP:UNDUE, I notice you omitted to include the bit which directly precedes your selection: "An article should not give undue weight to any aspects of the subject..." Which sets me thinking: there's an apparent lack of opposition, on your part, to the fact that the article does not give much weight to the HIV issue. Do you find that situation acceptable in the article as a whole but not in the lead?
"...refusal to use any method whatsoever seems contrary to the intent of the policy." Firstly, I have not refused to use any method whatsoever; I've argued that a reliable method does not exist - not the same assertion. However, I will admit that "not exist" would be better expressed as "does not appear to exist." Secondly, insistence on using an invalid method in defence of significant emphasis on one aspect of the article topic is definitely contrary to the intent of the policy I would say. Thirdly, if you have a method, demonstrate its use to justify significantly more of the lead apportioned to the HIV issue than any other issue (and if it's applicable to weight in the lead it should also be applicable to weight in the article as a whole I think). If you cannot then we should do something about the HIV issue's significant emphasis in the lead until such a time (if ever) a demonstrably reliable method is found. Beejaypii (talk) 22:54, 14 January 2012 (UTC)
The reason why I say you're demanding a perfect instrument, Beejaypii, is that your rejection of the various methods of assessing weight only make sense in that context. If one demands a perfect instrument or nothing, then it makes sense to reject instruments because of imperfections (it makes less sense insist upon giving equal weight instead, but we'll overlook that). On the other hand, if one is "striving" to assess weight, accepting that one cannot do so perfectly, then one would accept that the evidence, imperfect though it is, indicates that HIV is of relatively high significance to the subject.
Since we appear to be going around in circles again, my inclination is to regard this discussion as finished unless new evidence or arguments are presented. Jakew (talk) 11:01, 15 January 2012 (UTC)
Demonstrate your imperfect evidence (whatever that means) that the HIV issue is significantly more important to circumcision than any other aspect of the topic. Isn't "relatively high" significance accounted for by the very presence of the HIV issue in the lead? What's the justification for significantly more of the lead being dedicated to that aspect than any other? Beejaypii (talk) 12:19, 15 January 2012 (UTC)
Beejaypii, you've already been shown why HIV is a particularly significant topic in relation to circumcision, above. In response, you've brought forward arguments as to why you think the methods for determining that were imperfect. You've then been asked what method you would use to determine the correct weight to provide, but have refused to do so, instead insisting that all topics be given equal weight, because it is (in your view) impossible to find an exact method for determining weight, in defiance of the specific instructions of WP:LEDE that "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources". It is you who insist we cannot follow WP:LEDE here, but have still failed to provide a compelling reason why this article must be the exception to it. You have two choices here - explain why the Circumcision article is the exception to WP:LEDE, where "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects", or provide your own methodology for determining the correct amount of material regarding HIV to use in the lede. Jayjg (talk) 17:03, 15 January 2012 (UTC)
"Beejaypii, you've already been shown why HIV is a particularly significant topic in relation to circumcision, above." Really? Where? If you mean I've been exposed to counter arguments, I've answered them. If you have confidence I've "been shown why HIV is a particularly significant topic in relation to circumcision" show me a reliable methodology used to establish that, then show me the methodology you advocate to support significantly more of the lead apportioned to the HIV aspect than any other aspect. Just vaguely referring to me having been 'shown' above seems like an effort to avoid specific arguments and implies an assumption of the greater validity of one side of the debate on your part.
"You've then been asked what method you would use to determine the correct weight to provide, but have refused to do so..." Really? Where?
"...instead insisting that all topics be given equal weight, because it is (in your view) impossible to find an exact method for determining weight..." Hyperbole: use of the word 'insisting', effectively implying an extreme position on my part. I've argued that we do not have a reliable system for ascertaining relative weight and that, therefore, we should rely on concise summaries of each aspect included in the lead because significantly more emphasis on any one aspect is not substantiated.
'...in defiance of the specific instructions of WP:LEDE that "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources.' More hyperbole: use of the word 'defiance', with all its negative connotations, effectively implying, again, an extreme position on my part. Furthermore, we can all cite selectively from policies in support of our stance. Here's mine, for what it's worth: "The lead section 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." So, that's "briefly summarize" and "stand on its own as a concise version of the article." Is roughly 25% of the article dedicated to the HIV aspect?
"It is you who insist we cannot follow WP:LEDE here..." Nope, I've argued we cannot follow certain aspects of it to the letter in this case, and I've set out my arguments in support of that stance. And bear in mind, as I've already pointed out, WP:LEDE includes the advice, in a template at the top, to "use common sense" because it will have occasional exceptions. Also, let's not forget that WP:LEDE is a guideline.
"...but have still failed to provide a compelling reason why this article must be the exception to it." I think my whole argument has been about why we cannot establish relative weight and substantiate a significantly greater portion of the lead to one aspect (i.e. we cannot apply certain aspects of WP:LEDE to the letter). If you don't find my reasons "compelling", demonstrate how we can substantiate significantly more of the lead dedicated to the HIV aspect than any other aspect.
"You have two choices here - explain why the Circumcision article is the exception to WP:LEDE..." I've presented my arguments about why certain aspects of WP:LEDE cannot be applied to the letter this article. What to you mean by "the exception"?
'...where "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects', or provide your own methodology for determining the correct amount of material regarding HIV to use in the lede.' I clarified my "it is not possible" position recently, just last night in fact. In the absence of a reliable methodology, I suggest not apportioning significantly more of the lead to any one aspect, because under the circumstances that represents considerable, unsubstantiated relative emphasis on one aspect.
Again, if you support significantly greater emphasis on the HIV aspect than any other aspect in the lead explain how you substantiate it. Beejaypii (talk) 19:36, 15 January 2012 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────Beejaypii, at the very top of this section is a large table in which editors attempted to determine what weight reliable sources accorded to HIV vis-à-vis circumcision, in accord with WP:LEDE: "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources". The editors who developed that table (and others) agreed that this indicated that HIV was, relatively speaking, a significant topic in circumcision, and one that should be therefore accorded more weight in the lede than others, per WP:LEDE. You, however, argued that the methods used were flawed, and that the "25%" of the lede (a figure you repeated many times) given to HIV was inappropriate - that, in fact, there was apparently no way of accurately deciding how much of the lede should be devoted to HIV, and that we must therefore assign equal weight to every topic discussed in the article, despite the fact that this violates both WP:LEDE and common sense (since the lede would, at that point, be far too long).
When confronted with these points, you continually dissect the comments of those you respond to, without actually responding to their fundamental points. This results in your asking at times fairly absurd questions - for example, when reminded that "Beejaypii, you've already been shown why HIV is a particularly significant topic in relation to circumcision, above", you respond "Really? Where?", as if the table had never been created, as if you didn't know that it was at the top of this section. You then go on to simply repeat that the methodology is (in your view) not reliable, and without such a "reliable methodology" we cannot follow WP:LEDE's dictum that "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources". Despite being reminded of it, you continually ignore the point made long ago that There is no way of measuring the exact importance of HIV to circumcision, but a review of the recent literature (particularly medical) indicates that it is of significant importance... Now, whether one-tenth, one-quarter, or one-third of the lede should be devoted to the topic can never be decided in a purely mathematical way. Rather, editors must examine the different proposals, and see which prose seems to best summarize the topic.
Similarly, your response to "You've then been asked what method you would use to determine the correct weight to provide, but have refused to do so..." is "Really? Where?" You apparently ignore comments such as "Now, can you show us what formula you used to calculate that "the 25% apportioned to the HIV aspect is disproportionate", and explain what the actual percentage should be?", despite the fact that you both responded to it and even quoted it.
Moreover, you claim that you are not advocating defying WP:LEDE, nor are you engaging in special pleading regarding the lede of this article, but that you have merely "argued we cannot follow certain aspects of it to the letter in this case" – something that is fairly obviously a distinction without a difference. You have further insisted that in the special case of the circumcision article we must use "common sense" instead of WP:LEDE's dictum, despite the fact that you constantly reject the common sense points and arguments of others, insisting on some sort of mathematically exact "reliable methodology" instead.
The bottom line is this; the consensus here for the past several years has been that HIV is a significant topic in circumcision, and should therefore be given more weight in the lede than some of the other topics this article discusses (as mandated by WP:LEDE). You have been presented with various arguments and search results indicating why editors here believe this to be the case. You have rejected those results and responses, and insisted that for this article we "we cannot follow certain aspects" of WP:LEDE. If you wish to convince others here, you must either explain why the circumcision article is the exception to WP:LEDE, where "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects", or provide your own methodology for determining the correct amount of material regarding HIV to use in the lede. Jayjg (talk) 21:15, 15 January 2012 (UTC)

It looks like this argument is going in circles, and I don't get the sense that either side is going to convince the other. This does seem like an important issue given how much discussion it has had, so perhaps a request for comment could be made, both sides could state their case, and the community could vote on it? --kyledueck (talk) 00:24, 16 January 2012 (UTC)
A good solution! Wikipedia needs Big Jim to step up to the plate on this article. — Preceding unsigned comment added by 188.95.153.254 (talk) 02:11, 16 January 2012 (UTC)
RfC instigated. Beejaypii (talk) 14:19, 16 January 2012 (UTC)


Because Jayjg is now using his post above to try to discredit me on my talk page (as well as removing my comments from his talk page and leaving his own points appearing to be unanswered by me, here for example - something I choose not to do at my talk page) I feel I can justifiably respond in my defence, beginning with this bit:

'Beejaypii, at the very top of this section is a large table in which editors attempted to determine what weight reliable sources accorded to HIV vis-à-vis circumcision, in accord with WP:LEDE: "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources"'

Yes, using demonstrably flawed methodology. My criticisms in this respect, which also appear in the table. Have not been specifically addressed once in this debate.

"The editors who developed that table (and others) agreed that this indicated that HIV was, relatively speaking, a significant topic in circumcision, and one that should be therefore accorded more weight in the lede than others, per WP:LEDE."

I also developed that table, adding room for criticism in the form of an additional column (or was the table always supposed to be one-sided?), and carrying out searches which had been omitted up till that point, which is in accordance with the editor who created the table’s advice: "I'm starting the table; I invite others to edit it and add to it"

"You, however, argued that the methods used were flawed, and that the "25%" of the lede (a figure you repeated many times) given to HIV was inappropriate - that, in fact, there was apparently no way of accurately deciding how much of the lede should be devoted to HIV, and that we must therefore assign equal weight to every topic discussed in the article, despite the fact that this violates both WP:LEDE and common sense (since the lede would, at that point, be far too long)."

I cited the 25% because it happens to be the % in this article, but the principle is the significant difference between that particular % and that apportioned to any other aspect of the article in the lead. I explained this to you here and here. You have either failed to grasp or apparently refuse to acknowledge those explanations.

"When confronted with these points, you continually dissect the comments of those you respond to, without actually responding to their fundamental points."

Anyone can claim another editor “continually” does this or “continually” does that. Substantiate it. You are demonstrably wrong on other points so there’s little reason to assume you’re correct here.

"This results in your asking at times fairly absurd questions - for example, when reminded that "Beejaypii, you've already been shown why HIV is a particularly significant topic in relation to circumcision, above", you respond "Really? Where?", as if the table had never been created, as if you didn't know that it was at the top of this section."

The way you phrased that assertion makes it sound as if a fact has been demonstrated to me, that’s why I responded like that. Not surprising really, given that the table in question includes serious criticisms of the methodologies used and, if anything, demonstrates how it has not been reliably established that HIV is a “particularly” important topic in relation to circumcision, which is a claim of higher relative importance than other important topics.

'You then go on to simply repeat that the methodology is (in your view) not reliable, and without such a "reliable methodology" we cannot follow WP:LEDE's dictum that "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources."'

Of course I repeat my assertions about the methodology, you simply assumed it WAS reliable in the way you stated “you've already been shown why HIV is a particularly significant topic in relation to circumcision, above” And, as you perfectly well know, WP:LEDE allows for a more flexible approach than you’re suggesting with your use of the word ‘dictum’.

"Despite being reminded of it, you continually ignore the point made long ago that There is no way of measuring the exact importance of HIV to circumcision, but a review of the recent literature (particularly medical) indicates that it is of significant importance... Now, whether one-tenth, one-quarter, or one-third of the lede should be devoted to the topic can never be decided in a purely mathematical way. Rather, editors must examine the different proposals, and see which prose seems to best summarize the topic."

So, you asserted that it’s been shown that the HIV issue is "particularly important" to circumcision on the one hand, and you assert that we cannot measure the "exact" importance but that it is of "significant" importance. Which is it, particularly or significantly? That’s a key difference in the context of this debate. Of course you can’t answer that, because you have no reliable way of ascertaining it, which has been my point entirely throughout this debate.

'Similarly, your response to "You've then been asked what method you would use to determine the correct weight to provide, but have refused to do so..." is "Really? Where?" You apparently ignore comments such as "Now, can you show us what formula you used to calculate that "the 25% apportioned to the HIV aspect is disproportionate", and explain what the actual percentage should be?", despite the fact that you both responded to it and even quoted it.'

I ignored a comment "despite the fact that" I "responded to it". That does not make sense. And I did not refuse to do anything; I responded by arguing the following:

The 25% is the % of the text, by word count, of the lead apportioned to HIV (roughly) - no formula required to ascertain that. I don't know what the percentage should be - point is that it's not possible to ascertain (if it is, show me how) - but in this article that 25% is significantly greater than the % apportioned to any other aspect of the article topic. Therefore, I'm advocating the most neutral approach, which is not to apportion a significantly greater portion of the lead to any one particular aspect in the absence of evidence supporting such relative emphasis, which seems a more neutral than campaigning for one aspect of the article topic to be apportioned significantly more of the lead than any other aspect, in the absence of evidence supporting such relative emphasis.[ http://en.wikipedia.org/w/index.php?title=Talk:Circumcision&diff=next&oldid=470644453 here]

How on earth can you represent that as "refused to do so"?

'Moreover, you claim that you are not advocating defying WP:LEDE, nor are you engaging in special pleading regarding the lede of this article, but that you have merely "argued we cannot follow certain aspects of it to the letter in this case" – something that is fairly obviously a distinction without a difference'.

Just POV assertions from you there. Not to follow something to the letter, something which includes references to common sense and Ignore all rules, is hardly defiant. I stand by my previous comment about hyperbole.

'You have further insisted that in the special case of the circumcision article we must use "common sense" instead of WP:LEDE's dictum, despite the fact that you constantly reject the common sense points and arguments of others, insisting on some sort of mathematically exact "reliable methodology" instead.'

I’ve asked repeatedly for a demonstration of a methodology which justifies significantly more emphasis on the HIV issues than any other issue in the lead. I didn’t request mathematical exactitude anywhere (show me where if you think I did). Demonstrate the methodology if you have one, or answer the criticisms in the table. That you shy away from doing so suggests you do not have confidence in the methodology.

'The bottom line is this; the consensus here for the past several years has been that HIV is a significant topic in circumcision, and should therefore be given more weight in the lede than some of the other topics this article discusses (as mandated by WP:LEDE). You have been presented with various arguments and search results indicating why editors here believe this to be the case. You have rejected those results and responses, and insisted that for this article we "we cannot follow certain aspects" of WP:LEDE. If you wish to convince others here, you must either explain why the circumcision article is the exception to WP:LEDE, where "it is not possible to ascertain the relative importance of [any issue], as compared to other aspects", or provide your own methodology for determining the correct amount of material regarding HIV to use in the lede. Jayjg (talk) 21:15, 15 January 2012 (UTC)

The HIV issue already has more weight in the lede than some of the other topics this article discusses”, just by its presence in the lead (some aren’t mentioned at all). The bottom line is what justification is there for it having significantly more weight than any other topic in that lead, because just "significant topic in circumcision" does not justify that. Beejaypii (talk) 02:00, 17 January 2012 (UTC)

Very well, I've taken the WP:BOLD step of cutting this Gordian Knot, by cutting out half of the paragraph on HIV. Instead of "over 25%" of the lede, it's now under 14% of the lede. Problem solved! Jayjg (talk) 03:38, 17 January 2012 (UTC)

Abitrary break 3

@Garycompugeek - yes, it is: Beejaypii is the one advocating removal of material based upon in. Since you apparently agree that such an effort is "peculiar", perhaps we can move beyond it. — Preceding unsigned comment added by Carlossuarez46 (talkcontribs)
No, I'm arguing that the methodology which has been used by other editors to justify a large portion of the lead dedicated to the HIV issue is bogus. If you read the whole thread you'll find this comment from me:
It seems there are significant problems involved in trying to justify dedicating a large portion of the lead (currently over 25%) to the HIV issue. The HIV issue is a sub-topic of a sub-topic (medical aspects) of the main article topic, and even within that sub-topic it does not have as direct and intrinsic a relationship to the surgical procedure as other medical aspects. Therefore, and based on closer examination of what seems to be seriously flawed methodology used to justify the weight apportioned to HIV in the lead thus far, I again suggest reducing the HIV coverage in the lead, to this concise summary:

Additionally, strong evidence that circumcision reduces the risk of HIV infection in heterosexual men has led to the WHO recommending circumcision, with respect to that population, as an additional HIV prevention strategy, with the proviso that it should always be considered as part of a comprehensive HIV prevention package.

In particular, I think we need to keep in mind that the main topic of this article is the medical procedure circumcision, with its procedural, historical, religious, cultural (to name a few) sub-topics, as well as sub-topics of those sub-topics.
Pay attention, in particular, to the last bit, where I'm basically calling for a common sense approach based on consideration of the topic as a whole with its various sub-topics.
Feel free to argue for 25% of the lead dedicated to a sub-topic (HIV) of one aspect (medical) of the main article topic. I look forward to seeing your reasoning. Beejaypii (talk) 15:25, 7 January 2012 (UTC)
Actually, as has already been pointed out, it is you who keep bringing up the "25% of the lead dedicated to HIV", and arguing it is inappropriate, so it is you who must explain what percentage is appropriate, and how you have calculated this. Jayjg (talk) 15:04, 9 January 2012 (UTC)
It's not the figure which is important, it's the percentage relative to the portion of the lead attributed to one aspect as compared to the proportion dedicated to other aspects. In the case in point, the 25% apportioned to the HIV aspect is disproportionate to the % apportioned to other aspects (I assume you agree with that, percentage-wise at least?). If you like I can create another table, breaking down the current lead, sentence by sentence, proposition by proposition; that will not support your stance that the HIV aspect deserves significantly greater coverage in the lead than any other aspect of the main topic however. My stance, as I've repeatedly explained, is that we cannot ascertain the relative weight of different aspects of the article topic (if we can, show me how), therefore, a concise treatment of each aspect mentioned in the lead is the approach which avoids any one aspect being emphasised unduly, as far as we can know. Unless you and Jakew (and others) can demonstrate why the HIV aspect deserves a significantly greater portion of the lead than any other aspect of the topic you are effectively promoting an unsubstantiated POV. My POV, on the other hand, is not that any particular aspect is less or more important than another, it's that we cannot ascertain whether that is the case or not, and a concise summary of each aspect included in the lead (though there are other discussions about which aspects should actually appear in the lead, and which aspects should be covered in the whole article even) is therefore the most neutral approach in the absence of evidence. Apportioning a significantly greater portion of the lead to any particular aspect in the absence of evidence is not a neutral approach. Beejaypii (talk) 16:32, 9 January 2012 (UTC)
So is circumcision "special", in your assessment that it is impossible to ascertain due weight, or should WP:UNDUE always be interpreted to mean the exact opposite of what it actually says? Just curious. Jakew (talk) 16:54, 9 January 2012 (UTC)
I've no idea whether circumcision is "special". I would have to collect data from the analysis of similar issues across a suitably large sample of article content discussions, at the very least, in order to even come close to providing any kind of substantiated answer to that question. Additionally, I believe you've formulated a logical fallacy of the Affirming a disjunct type: you've presented a mutually exclusive choice between circumcision is "special" because it is impossible to ascertain due weight and WP:UNDUE should always be interpreted to mean the exact opposite of what it actually says. But that's rather academic anyway, because the second of those two propositions is an example, I believe, of Begging the question, assuming, as it does, that WP:UNDUE HAS been "interpreted to mean the exact opposite of what it actually says." If you'd like to reformulate your query using non-fallacious arguments I'll try to respond. Beejaypii (talk) 21:22, 9 January 2012 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── Beejaypii you will not convince the gatekeepers with logic. They will simply obstruficate with circular logic and false dichotomies. This will ONLY be settled by following dispute resolutions. Garycompugeek (talk) 15:42, 10 January 2012 (UTC)

Well, it certainly won't be "settled" by making drastic changes that have no consensus. Nor will it be "settled" by making personal attacks on those you disagree with. Jayjg (talk) 16:26, 10 January 2012 (UTC)
Actually, the false accusation of a "personal attack" is, in fact, a personal attack itself. Wimp O'pede (talk) 16:48, 10 January 2012 (UTC)
Something of a moot point, though. Jakew (talk) 16:59, 10 January 2012 (UTC)
Yes, particularly when one editor accuses other editors of being "gatekeepers" who "simply obstruficate with circular logic and false dichotomies". I wonder, is the false accusation of a false accusation of a personal attack also a personal attack? And it's odd how yet another "new" editor has shown up on this Talk: page to "fight the good fight". Jayjg (talk) 17:06, 10 January 2012 (UTC)
No doubt its one of our banned editors, run a checkuser and block the sock. Garycompugeek (talk) 16:59, 11 January 2012 (UTC)
Trimming one paragraph in lead is drastic!? I think not. I was being bold and showing my support for Beejaypii's proposal. This talk page is worse than the political bickering in the American Congress. Dialog seems pointless and dispute resolutions seem to be the only alternative. If Beejaypii does not take this to the next level then I will. Garycompugeek (talk) 16:59, 11 January 2012 (UTC)
In future, Gary, please note that, per WP:CONSENSUS: "In discussions of textual additions or editorial alterations, a lack of consensus results in no change in the article." Jakew (talk) 17:11, 11 January 2012 (UTC)
Thanks for that spiffy definition Jake. The next sentence from WP:CONSENSUS reads "Consensus on Wikipedia does not mean unanimity (which, although an ideal result, is not always achievable); nor is it the result of a vote." and that means you cannot hold an article hostage simply by disagreeing, you actually need to use logic that others can follow. Garycompugeek (talk) 20:21, 11 January 2012 (UTC)
Ample logic has been provided by Jake, me, and others, and has been met with a wall of WP:ICANTHEARYOU. Jayjg (talk) 20:40, 11 January 2012 (UTC)
No Jayjg. The logic has been provided by Beejaypii and myself, you and Jakew seem to be practicing WP:ICANTHEARYOU and WP:ILIKEIT. Garycompugeek (talk) 14:01, 12 January 2012 (UTC)

Exactly right. In my line of work, it's a Defence mechanism we diagnose as psychological projection, a very persistent personality trait. Wimp O'pede (talk) 16:23, 12 January 2012 (UTC)

Please be advised that "diagnosing" traits in other editors is likely to be considered a personal attack. Jakew (talk) 16:32, 12 January 2012 (UTC)

My point was that the editors who accused others of a wall of "I can't hear you" and "I Like it" were actually accusing themselves via a well-known Defence mechanism we diagnose as psychological projection. In a lively discussion, it's fair to challenge others to evaluate their own logic and integrity, hopefully to reciprocate those qualities in their Interlocutors' well-reasoned arguments. Wimp O'pede (talk) 17:14, 13 January 2012 (UTC)

Your point was understood and, as noted, it is a personal attack, so don't do it in future. Jakew (talk) 18:22, 13 January 2012 (UTC)

RfC comments

  • We should remember that this article is not to be Anglo-centric nor Judeo-Islamic-centric. We have articles about Jewish and Islamic ritual circumcision and the article history of circumcision deals with the English-speaking world's adoption of the practice, so those can be treated summarily here and need not monopolize the lead. However, one of the biggest reasons for circumcision's introduction into areas not recognizing a cultural (mainly, but not exclusively, the English-speaking world, and a few countries occupied by them) or religious (mainly, but not exclusively, Islam and Judaism) duty to circumcise (both babies and adult men) are the arguments made recently about HIV prevention. Carlossuarez46 (talk) 18:13, 16 January 2012 (UTC)
We have an article about Circumcision and HIV too, so, presumably, that issue can also be "treated summarily here and need not monopolise the lead"? In which case, your justification for less emphasis on the religious aspects you mention and more emphasis on the HIV issue fails. Beejaypii (talk) 11:30, 17 January 2012 (UTC)
Because it's not the same topic: that was a discussion about the actual nature of the relationship of the HIV issue to circumcision mainly in terms of semantics. This one is about the possibility, or not, of establishing the relative importance of the HIV issue to circumcision compared with other issues using statistical methodologies. The first was about sense relationships, this is about statistical methodologies. Although, actually, the sense arguments probably strengthen the arguments against significantly more emphasis on HIV than any other topic in the lead. Beejaypii (talk) 03:12, 17 January 2012 (UTC)
So this one is a theoretical study of whether or not one can use a "statistical methodology" to determine the importance of HIV as an issue in circumcision relative to other topics in circumcision? Jayjg (talk) 03:58, 17 January 2012 (UTC)
My description was too concise. This RfC is about the extent to which it is possible (or not) to validly measure the relative importance of the HIV issue to circumcision and substantiate the claim that it deserves significantly more weight in the lead than any other aspect of the topic. Beejaypii (talk) 11:09, 17 January 2012 (UTC)

Condensing the first two sentences

Looking at the paragraph, it does have some degree of redundancy, and can probably be shortened and improved at the same time. I therefore propose to rewrite this:

  • There is strong evidence that circumcision reduces the risk of HIV infection in heterosexual men in populations that are at high risk.[1][2] Evidence among heterosexual men in sub-Saharan Africa shows a decreased risk of between 38 percent and 66 percent over two years[3] and studies have concluded it is cost effective in this population.[4]

As this:

  • There is strong evidence that circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in populations that are at high risk,[3] and studies have concluded it is cost effective in sub-Saharan Africa.[5]

Given the great difficulties in finding consensus for any changes to this paragraph, I would like to use a rough straw poll to see whether there is consensus for making this one change without reference to any other changes editors might or might not wish. So... Jakew (talk) 20:10, 17 January 2012 (UTC)

  • Support as proposer. Jakew (talk) 20:10, 17 January 2012 (UTC)
  • Support. The more concise version should help to alleviate some concerns that others have raised, while retaining much of the information. Great proposal IMO, and I appreciate that you're looking for common ground on what has become a very lengthy discussion. kyledueck (talk) 23:09, 17 January 2012 (UTC)
  • Neutral. It is better than it was however I do not prescribe to the conjecture that there is scientific consensus about the "strong evidence" circumcision reduces HIV transmission nor it's cost effectiveness. There is considerable controversy here and it should be documented. Garycompugeek (talk) 23:47, 17 January 2012 (UTC)
  • Neutral. Seconding Garycompugeek's comment here. There needs to be a change in the narrative of the paragraph to highlight the fact that there is a controversy surrounding how the WHO interpreted the data it collected, which it bases its recommendation on. Even though almost 1 in 10 professionals (using Jakew's own numbers) would dissent from the narrative of this sentence, it would still leave one with the impression that the evidence is solid and near-iron clad. I'm seeing a lot of gatekeeping going on with this paragraph and it doesn't seem to fall in line with the Wikipedia:Neutral point of view policy. Therewillbefact (talk) 07:19, 19 January 2012 (UTC)
  • Neutral I think the bit about cost effectiveness is somewhat incongruous, especially with the WHO recommendation bit retained (I know that's outside the bit this poll relates to but I think it's relevant), as in the version current at the time writing - is cost effectiveness really an issue that warrants a mention in the lead (partly a rhetorical question and I won't chase an answer)? However, I think that the version I just linked to resolves the emphasis issues adequately enough (and that includes the bit Jakew is conducting the poll for); and having expressed my reservations, and in the interests of conflict resolution and in the spirit of mutual compromise, I won't actually oppose that version. Nevertheless, I will remark that there is still some redundancy which could easily be addressed: "populations that are at high risk" could become "populations at high risk", (and in the WHO bit "part of a comprehensive program for prevention of HIV transmission" could become "part of a comprehensive HIV transmission prevention program"). Beejaypii (talk) 13:12, 19 January 2012 (UTC)
  • Neutral on grounds of irrelevance. Never mind the wording of the RFC; the lede as it stands needs radical condensation and also needs neutralisation of POV. It could (should) be boiled down to say, 25% of its current size and shorn of discussion and evaluative statements. The amount of material on the various merits and demerits of circumcision, whether concerning HIV and other health problems or not, does not matter; anyone who has more constructive and valuable material can add it according to taste and according to WP guidelines. But the lede is not where such material belongs. Incidentally, one thing that did bother me in reading the material in the body of the article, was wording that did not distinguish between the value of circumcision in reducing the risks associated with irresponsible sexual practices (which seems to be fairly well established), and the value of circumcision as a prophylactic measure, which it is not in any normal commonsense degree. Persons trained in relevant disciplines might have no trouble drawing the appropriate conclusions from the studies, but laypeople reading a lot of that wording would be at serious risk of interpreting it as meaning that if you are circumcised, you can forget about HIV etc. Some of it even gave the impression that adult circumcision offered immediate benefits, which would be doubtful, to put it kindly. JonRichfield (talk) 20:17, 20 January 2012 (UTC)

Proposal to close RFC and archive

This talk page is huge. Since the material has been shortened, I can't see that letting the RFC run its full course serves any real purpose. I therefore propose to close it early and manually archive this section. If there are any objections I won't do this, and I'll wait a reasonable period (48hrs or so) to see whether anyone objects. Jakew (talk) 17:28, 23 January 2012 (UTC)

Circumcision and Masturbation?

Now, what in the world does circumcision have to do with masturbation? Maybe this rationale was thrown in to further justify this ancient, essentially hygenic, practice amongst those inclined to prudery, but surely it has no connection with that; if its intent was to abate that practice, then surely the profligate state of modern American and European males demonstrates that it has been an abysmal failure. — Preceding unsigned comment added by 173.29.79.236 (talk) 05:38, 20 January 2012 (UTC)

Primary sources

Per WP:MEDRS and WP:RS primary sources should typically not be used especially when good secondary sources are available. Thus removed some primary sources.Doc James (talk · contribs · email) 05:54, 20 January 2012 (UTC)

When did Steven Svoboda and Robert Van Howe become a medical association?

Tftobin (talk · contribs) added a paper by Svoboda and Van Howe (ref 207) to the "Australasia" subsection of the "Positions of medical associations" section. I'm somewhat perplexed by this, partly because Svoboda and Van Howe are both American, and partly because I had no idea that they had become a medical association... Jakew (talk) 09:59, 20 January 2012 (UTC)

Agree that it should be moved to another part of the article.Doc James (talk · contribs · email) 10:02, 20 January 2012 (UTC)
I've removed it, but I'm not opposed to adding it as a citation to the "Some have challenged the validity of the African randomized controlled trials, prompting a number of researchers to question the effectiveness of circumcision as an HIV prevention strategy" sentence. Jakew (talk) 15:59, 20 January 2012 (UTC)

Addition to sexual effects section

I'd question the reliability of the addition of George Hill's "The case against circumcision". This:

  • Is published in an obscure journal that is not indexed by PubMed.
  • Is labelled by the journal as a "debate article", not a review.

I'm not sure that this piece is sufficiently reliable for use as a source here. Jakew (talk) 10:17, 20 January 2012 (UTC)

Agree have not been able to find it on pubmed and thus unable to verify that it is a review.Doc James (talk · contribs · email) 14:43, 20 January 2012 (UTC)
Okay, removed. I'm uncomfortable about the reliability of this source. It also seems doubtful that a polemic article intentionally making a case against something (as the title indicates) would be likely to make a dispassionate, evidence-based review of the evidence. Jakew (talk) 16:04, 20 January 2012 (UTC)

Paragraph Three

An editor has admitted that the lead is about both Adult and Neonatal circumcision. It's important to make that distinction clear to the reader; otherwise, the lead implies that the adult studies in a promiscuous African tribal environment have evidentiary value for the efficacy of neonatal circumcision. Paragraph Three seems to have been dropped into the lead without proper thought or context. That's poor writing and scholarship, and, quite frankly, would receive a grade of "D" if it were a middle school term paper. We should be very cautious in highlighting an adult study that no national medical organization of doctors has endorsed as an argument in favor of neonatal circumcision. Wimp O'pede (talk) 16:39, 16 January 2012 (UTC)

As explained previously, the article is about circumcision at any age, not specifically about neonatal circumcision. Nevertheless, numerous sources have applied the findings of the HIV trials to neonatal circumcision: certainly there is no consensus that these data only apply to adult circumcisions. Jakew (talk) 17:01, 16 January 2012 (UTC)

I believe that the third paragraph needs to draw attention to the fact that the “strong” evidence its referring to – the test results garnered during the Sub-Saharan African trials -- are not as widely accepted on a global scale as it is presented in this article. No mention is made suggesting that information to the contrary exists. The fact that health professional have vouched against the validity of the “strong evidence” is something we should consider as well. Perhaps we can start by changing the narrative of “strong”, or in the very least providing an additional sentence or two describing that health professionals and stasticians would disagree with the innuendo. Perhaps glance at the following links for some perspective: http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00761.x/full

Quote that sticks out: "That the relationship between circumcision and transmission of HIV is at the very least unclear is illustrated by the fact that the US combines a high prevalence of STDs and HIV infections with a high percentage of routine circumcisions. The Dutch situation is precisely the reverse: a low prevalence of HIV/AIDS combined with a relatively low number of circumcisions. As such, behavioural factors appear to play a far more important role than whether or not one has a foreskin." - Royal Dutch Medical Association http://www.zimeye.org/wp-content/live_images/2012/01/44-419-1-PB.pdf The content above largely runs against the narrative of the third paragraph.

Being that validity of the three trials have been dismissed a number of times, the tone of the paragraph should be changed such that if someone were to read this article without conducting further research, they would understand that evidence contrary to what is written in the paragraph, the trials are controversial. As it is now, one would leave the impression that the evidence is iron-clad. It is actually controversial. The language of this paragraph needs to be changed. Perhaps we can collaborate to work in some of what other peer-reviewed journals are concluding? I think it would help produce an article with a more NPOV. Therewillbefact (talk) 05:19, 17 January 2012 (UTC)

The problem is that, while there are a handful of individuals who disagree, there is a global scientific consensus that circumcision does protect against female-to-male transmission of HIV. (Please go to Talk:Circumcision/Archive 68#Weight of HIV in lead, and scroll down until you reach my comment dated 18:37, 14 December 2011 (UTC). There you will see a rough sample of the 50 most recent reviews relating to circumcision; only 2 of the 26 with readily identifiable viewpoints about the association were negative.) Consequently we need to be very careful not to paint a misleading picture of the literature, because citing those who dispute the association would represent the situation as far of a controversy than actually exists. For further discussion of this, please see WP:UNDUE and WP:FRINGE. Jakew (talk) 09:27, 17 January 2012 (UTC)

I understand that we do not wish to blow things out of proportion with respect to giving others the impression that this controversy is larger than it is. However, using the information you just provided me with here, 2 out of the 26 most recent reviews -- that's roughly 8% -- would dissent from the narrative of the third paragraph's first sentence. The innuendo should still be altered to reflect that there are dissenting health professionals with plenty of credentials advancing their claims in peer-reviewed journals -- it would be less deceptive to the reader of this paragraph. On the same global scale you're referring to, a good number of health professionals have met these same studies with resistance. I respect your POV here, but being that a dissenting opinion has already been made by the Journal of Public Health in Africa, the Royal Dutch Medical Association, The Journal of Law and Medicine (Australia), The Public Health Association of Australia (among other publications) it is again deceptive not to integrate such content into the paragraph, or to even hint at the fact that such information is out there and that a controversy exists to some extent.

I wouldn't mind collaborating with you Jakew to make an adjustment to the rhetoric of this so that it is fair. I agree with you that it is important we do not give off the wrong impression to our readers. The number of dissenters, again, aren't exactly the dismal drop in the bucket you make it out to be. Perhaps we can mention the fact that the evidence is controversial to an extent? Perhaps we can start by omitting or changing "strong" in strong evidence (as "strong" would leave one with the impression that there is unanimous consensus)? Again, we need to have the content of the paragraph reflect reality. Why can't we mention that the Cochrane Review from 2003 that found insufficient evidence to support a circumcision intervention program to prevent HIV infection at the very least, for instance, if we have already worked in how the WHO recommends the surgical procedure in high-risk areas? Again, there is still a lot of one-sidedness going on with this paragraph. I'll be happy to work with you to make it a tad more fair. Therewillbefact (talk) 16:36, 17 January 2012 (UTC)

You're incorrectly attributing opinions to journals. This is incorrect: journals frequently publish critiques or rebuttal pieces, so it is usually unwise to attribute the opinion to the journal itself. The opinions have been asserted by individuals; let's not try to bolster them by attributing them to another entity. As I said, there is effectively a scientific consensus on this issue, and we must be extremely careful not to misrepresent the state of the literature. In particular, mentioning those who deny the association might create the impression that this is a widely held viewpoint. I am less strongly opposed to mentioning them in the body of the article, where there is more space than in the lead section.
Regarding the 2003 Cochrane review, it's out of date. The authors published an updated review in 2005, and the most recent update was published in 2009. We might cite the 2003 review when discussing the history of circumcision/HIV research, but it doesn't make any sense to do so now. After all, the reason why the authors of the 2003 review judged the evidence insufficient was that "observational studies are inherently limited by confounding which is unlikely to be fully adjusted for", and the conclusion stated "It would be prudent for consumers to await the findings of ongoing randomised trials before deciding on the balance between benefits and risks of male circumcision in the context of HIV infection." Since then, of course, the randomised controlled trials have been published, so the situation is completely different. And the most recent Cochrane review states: "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months. [...] Inclusion of male circumcision into current HIV prevention measures guidelines is warranted" Jakew (talk) 16:59, 17 January 2012 (UTC)

I will concede that I was referencing an outdated review there, thank you for drawing attention to it. My point is that you are still suppressing information if you do not draw attention to the fact that there is at least something of a controversy (which there very well is--albeit I understand that we do not want to overstate it) to the "strong evidence" in this paragraph. At the very least, it should be mentioned in the paragraph why professional health organizations in some Sub-saharan countries have met the WHO's routine circumcision recommendation with resistance. Why is this not even mentioned when the WHO stance is? Again, the "strong evidence" comment would leave a reader with the impression that it is unanimously accepted, which as you know it is far from unanimous. Given that almost 8% were dissenters, using your figures, it is still something worth integrating into this paragraph in one way or another. At the very least, there is merit for a change in the tone of the sentence. Either the narrative of the sentence should be changed, or it should be accommodated by a followup of why health organizations in sub-Saharan Africa have met this recommendation by the WHO with resistance. It seems very stange, given the the WHO is US-based, that the sub-saharan countries are the ones actually affected by this recommendation and there is no podium given to their rebuttal of this recommendation in the paragraph. Why are we giving the WHO a podium for their voice, but not one for the health organizations in the countries actually affected by this recommendation? Therewillbefact (talk) 17:29, 17 January 2012 (UTC)

It seems to me that this is broadly analogous to the people who deny that HIV causes AIDS. A paper denying the link between the two was recently published, but even so the HIV article still makes the definite statement that: "Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS)". It doesn't say "is a lentivirus that, according to a controversial theory, causes AIDS", and it's unlikely that it ever will. It doesn't say that it "might" cause AIDS. It asserts the scientific consensus on the issue, even though a small number of individuals believe otherwise. This is quite proper, according to the policies cited above, and doesn't "suppress" information in a meaningful sense.
As for the affected countries, I've just been browsing through Table 1 in Progress in scale-up of male circumcision for HIV prevention in Eastern and Southern Africa: Focus on service delivery, and it seems that most of the 13 targeted countries have policies and plans in place. It appears to be true, though (according to this paper) that countries are having trouble meeting their targets. Jakew (talk) 19:45, 17 January 2012 (UTC)

You are arguing that a small-but-sizable community that takes issue with the lack of scientific rigor in how three trials were carried out and interpreted is similar to a proportionally smaller community that has had its POV dismissed on a number of occasions. You are starting to make some stretches here. It is not exactly fair to compare those who question the WHO's interpretation of three trial experiments as a basis for more research as not akin to the phenomenon of AIDS denialism. AIDS denialists have been debunked many times over in scientific communities; their arguments have been rendered as unsubstantiated and without merit over the many years their POV has existed. The arguments made by those who question how the WHO interpreted its trials have not had their claims dismissed by professionals in the same manner either, for what it's worth.

Additionally, the number of professionals who would argue against the label of “stong” evidence is not the “extreme minority opinion” you make it out to be (these were your words). Using your own numbers, you mentioned they add up to roughly 8% of opinion-holders. This is hard to reconcile; as it is neither an "extreme minority opinion", nor a POV that has been addressed and debunked by professionals.

It is also worth noting that it is an increasingly emerging opinion. It is fairly recent – a large portion of the opinion pieces contending against the conclusions the WHO made (after conducting the three trials) were written around 2011. “How the circumcision solution in Africa will increase HIV infections” in the Journal of Public Health in Africa was published Oct. 2010. “Not a surgical vaccine…” in the Australian and New Zealand Journal of Public Health was published in October 2011. The Journal of Law and Medicine’s “Sub-Saharan African Randomized Trials into Male Circumcision” surfaced in late November 2011. Therewillbefact (talk) 08:33, 19 January 2012 (UTC)

Sorry, I can't agree. First of all, the degree to which arguments have been refuted is probably difficult to resolve, but consider, for example, the exhaustive and throrough response to Green et al. Or this response to a different article by Green et al. Or this and this response to Van Howe. I will agree, though, that the HIV/circumcision denial viewpoint may be held slightly more widely than the HIV/AIDS denial viewpoint; perhaps the 'vaccines cause autism' lobby would have been a better analogy. Jakew (talk) 09:55, 19 January 2012 (UTC)

You're grasping for straws now. What you have said is that almost 1 in 10 professionals believe vaccines cause autism. To my knowledge, this is an argument that has been made with respect to the HPV vaccine in particular. And again, just as with AIDS denialism, there happens that there is a wikipedia page devoted to the Vaccine controversy. The refutation pieces you have cited acknowledge a few opposing viewpoints, but I haven't seen anywhere near the comprehensive refutation that AIDS denialists or vaccines-cause-autism proponents have seen after reading the few pieces you've cited. Many arguments are still left untouched. I'd also argue that given the fact that you've provided a few papers that acknowledge an opposing POV in its infancy, it furthers supports my point that it controversial. They would had have no incentive to write those pieces otherwise. 98.225.99.245 (talk) 17:26, 19 January 2012 (UTC)

Please don't misrepresent my position. I haven't said that "almost 1 in 10 professionals believe vaccines cause autism". What I have said is that the two situations are "broadly analogous". And I think that's true, in the sense that a tiny minority of professionals (and a larger set of laypeople) believe these things. In the absence of surveys, I don't have an exact way to quantify the exact number, though I suspect that in both cases the figure is substantially less than 1 in 10.
Regarding rebuttals, your arguments seem rather inconsistent. You initially claimed that the existence of rebuttals was a difference between AIDS denialists and circumcision/HIV denialists: "[...] not akin to the phenomenon of AIDS denialism. AIDS denialists have been debunked many times over in scientific communities [...]". When I pointed out that rebuttals can also be found in the case of circumcision and HIV, you now say that the existence of rebuttals is evidence that an issue is controversial ("They would had have no incentive to write those pieces otherwise"). But surely that's also the case for rebuttals of AIDS denialists? That is to say, to apply your reasoning, couldn't one say that the existence of rebuttals of AIDS denialists is evidence that the statement that "HIV causes AIDS" is controversial, and therefore Wikipedia should describe this "theory" as such?
In any case, you're quite correct that both of these fringe theories have their own articles. That's entirely proper and acceptable under Wikipedia policy. But in the main articles about HIV and AIDS we're very careful not to misrepresent the shape of the literature. We don't give undue weight to these viewpoints by presenting a "controversy".
Please note that I'm not saying that this material doesn't belong anywhere in Wikipedia. There's no reason why it shouldn't be included in circumcision and HIV, where there is plenty of space. It may be appropriate to discuss it in circumcision controversies, too. Even in the body of the article we cite refs 126 and 127. But in the lead section, where we have (at a rough guess) fifty words, it seems difficult to mention any opposition without giving it undue weight and consequently misrepresenting the literature. Jakew (talk) 19:00, 19 January 2012 (UTC)

It is important that the lead in particular reflects reality is because it receives far more traffic than the pages you provided. I was using the empirical data you cited yourself to show you that you were shooting yourself in the foot with your own arguments (which was that the POV we've been discussing is analogous to AIDS denialism or the vaccines-prompt-autism POV, for the purpose of what we should integrate into the lead). There is far more merit to integrating the POV we've been discussing in the lead, and it is not the "extreme minority opinion" to anywhere near the extent that you make it sound like it is. Using your own numbers, it is far from the dismal drop in the bucket you make it out to be.

My point is that you've been making some pretty severe stretches in comparing what we've been discussing to other POVs that do not hold nearly as much weight and are far less accepted (proportionally) among professionals in their respective communities. I've only seen you toss around quantitative analysis only when it benefits your POV, and you've made unwarranted comparisons in trying to put your uncompromising editing preferences into perspective. Perhaps we can omit the adjective "strong" and the statistics that accommodate it, since the dissenting opinion (and again, not one that constitutes an "extreme minority opinion") is that circumcision did not even have a statistically significant impact on HIV transmission. But, for some reason, I feel like proposing anything along these lines to you is starting to become a futile effort on my part. You haven't been open to any compromises to the paragraph, to any extent, and you only condensed it after some editors in the talk page have taken issue with it.

I did not want to have to draw attention to this, but I feel like I don't have much of an option at this point. You've made so many edits to the circumcision entry that you outnumber the times any other editors have made edits on it by a vast margin - and your edits consistently reflect a bias in favor of emphasizing the benefits of circumcision, and downplaying any risks or adverse consequences that accommodate the procedure. Anyone reading the editing history for the circumcision entry (or your own discourse in this talk page) will observe this. This runs against what is expected out of editors in the Wikipedia:Neutral point of view policy. You aren't supposed to cite quantitative analysis only when it benefits a slanted POV, and it speaks volumes that you've consistently blown things out of proportion by making comparisons of what we've been discussing to other issues that are neither as widely-accepted nor well-refuted among professionals in their respective domains. Please do not read this as a personal attack, that is not my intention. I wanted to let you know that you have had - and still have - a propensity to make edits that all fall into the same narrative. This is not a sustainable editing practice for a daily powerhouse editor. Therewillbefact (talk) 20:26, 21 January 2012 (UTC)

Primary research

We do not use primary sources such as this for controversial content per WP:RS and WP:MEDRS

In a 2007 study, Sorrells et al., using monofilament touch-test mapping, reported the foreskin is the most sensitive part of penile anatomy, and foreskin lost to circumcision has twice the fine touch sensitivity of any remaining penile anatomy. They also found that "the glans of the circumcised penis is less sensitive to fine-touch than the glans of the uncircumcised penis."[6] In a 2008 study, Krieger et al. found that 'compared to before they were circumcised, 64.0% of circumcised men reported their penis was "much more sensitive," and 54.5% rated their ease of reaching orgasm as "much more" at month 24'. In contrast, they also found that '6–7% reported that their penis was “somewhat less” or “much less” sensitive' and 10.2% reported that it was "somewhat less" or "much less" easy to achieve orgasm.[7]

Thus removed.Doc James (talk · contribs · email) 05:26, 20 January 2012 (UTC)


We use primary sources on content per WP:NOR and WP:MEDRS.

WP:NOR " A primary source may only be used on Wikipedia to make straightforward, descriptive statements of facts that any educated person, with access to the source but without specialist knowledge, will be able to verify are supported by the source."

WP:MEDRS "Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above (see: Wikipedia:No original research)."

The articles you removed clearly state the authors finding that can be reasonably checked by editors with no specialist knowledge.

1 In Sorrells 2007 the author states "When compared with the most sensitive area of the circumcised penis, several locations on the uncircumcised penis, which are missing from the circumcised penis, were significantly more sensitive (Table 2)." Table 2 shows a 2:1 ratio of sensitivity. Also: "The most sensitive location on the circumcised penis is the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision were more sensitive than the most sensitive location on the circumcised penis."

2 I haven't checked the second article, but it clearly states the results of the article and does not draw inference. The only reason for removable would be if you verified the data presented was incorrect.

A majority of the citations in this article rely on primary sources. It appears the most active editors allow this to slide for pro-circ material, but jump all over it for con-circ material. We should present both sets of data as there is no clear consensus in the global medical community about the dominant view. I've found there is general consensus in Europe against circumcision, neutral or cultural choice circumcision views in the US, and pro-circ view in Africa due to the HIV epidemic. 174.28.162.94 (talk)

I have never added a primary source to this article and secondary sources need to be used regardless of the content. If we where to bring this article to either GA or FA review articles would be needed. The key bit is "may occasionally be used with care" They are used more than just occasionally here. Doc James (talk · contribs · email) 06:29, 20 January 2012 (UTC)
I find the editors of this article have no problem with pro-circ primary sources, with a few of the most active removing con-circ sources for reasons that they violate themselves in the article( e.g. "The evidence strongly suggests" removed from my post but inserted in the main article). There is a clear bias by two very active contributors in this article against present a full view of the pro's and con's of circumcision and a clear stated bias in defending the article against what one labels "activists". If a primary source is informative, reliable and meets the criteria for stating the authors intent, lets leave it in.174.28.162.94 (talk) —Preceding undated comment added 06:48, 20 January 2012 (UTC).
Consensus is to use secondary sources especially if the topic is controversial.Doc James (talk · contribs · email) 07:03, 20 January 2012 (UTC)
Consensus is to use primary sources when they are informative and reliable. You can clearly see this on this and other controversial articles. Also, its very hypocritical of you to remove the primary citation that showed a change in glan sensitivity, while leaving the primary source right above it that showed no change in glan sensitivity.174.28.162.94 (talk) 07:10, 20 January 2012 (UTC)
Thanks missed that one and removed it. That however is not consensus. Primary sources are rarely WP:DUE. Take a look at schizophrenia for a controversial topic that uses no primary sources... Doc James (talk · contribs · email) 07:18, 20 January 2012 (UTC)
Lets go ahead and actually get "consensus" before removing any more of these primary research links. Its a pain to add them back in and they are really quite informative, especially when presented in a neutral manner, in a controversial topic. This teaches the data around the controversy so people are aware of them. Also FYI the content "Reports detailing the effect of circumcision on erectile dysfunction have been mixed. Studies have shown that circumcision can result in a statistically significant increase,[56][57] or decrease,[58][59] in erectile dysfunction among circumcised men, while other studies have shown little to no effect.[60][61][62]" is also an aggregation of primary sources (but leave it in for now).174.28.162.94 (talk) 07:29, 20 January 2012 (UTC)
No a 20 person study is simply not notable. Feel free to get outside input on this. I agree that much of this article is poor. Adding further primary research articles however just makes it worse. Doc James (talk · contribs · email) 07:31, 20 January 2012 (UTC)

(undent) Have fixed the concern you have raised using a recently published review article that is freely available. What was there before was WP:OR. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2788411/?tool=pubmed Doc James (talk · contribs · email) 07:50, 20 January 2012 (UTC)

I appreciate your zeal, but lets not go on a mission to strip all the primary sources out of an article until we've discussed it with the other editors. I'm not sure which 20 person study you are talking about, but the aggregate content I listed cited 7 papers. Simply having an aggregate of these papers is extraordinarily useful. I publish in IEEE (aerospace and engineering), and having wiki aggregates of reliable primary sources has been immensely helpful in review a full spectrum of knowledge, and pointed me to papers I wouldn't have found otherwise. This is consistent with the goals and practices of encyclopedic knowledge and has presidence in many wikipedia articles.174.28.162.94 (talk) —Preceding undated comment added 08:04, 20 January 2012 (UTC).
The problem is combining the results of many primary sources is WP:SYNTH and WP:OR. Writing here is a little different than writing in academia. I do not think anyone here would deny that replacing content support by primary research with that supported by review articles is an improvement. If we are to get this article to FA that is what we must do.Doc James (talk · contribs · email) 09:22, 20 January 2012 (UTC)
I'm not seeing this synthesis or original research. If articles state that "X" is true, and others say "not X" is true, you are allowed to state, that some articles indicate X, other articles indicate not X. There is no synthesis, only aggregation. In order to have synthesis you must draw a conclusion from the aggregation as stated:
" If one reliable source says A, and another reliable source says B, do not join A and B together to imply a conclusion C that is not mentioned by either of the sources."
Drawing a conclusion not consistent with the articles is synthesis. — Preceding unsigned comment added by 174.28.162.94 (talk) 10:53, 20 January 2012 (UTC)
I'd say it's borderline synthesis, possibly okay in some situations, but only with great care to adhere to other policies. But the main issue here is not synthesis but, rather, the fact that primary sources are being relied upon rather than a secondary source. We tend to be more tolerant of primary sources in the sub-articles, simply because there's more space, but in this main article we should primarily rely on secondary sources. Jakew (talk) 12:38, 20 January 2012 (UTC)

In an article like this, where there is so much on-wiki and off-wiki activism against the procedure, it is particularly important that we hew closely to WP:MEDRS, WP:NOR and WP:PRIMARY. That means using only reliable, secondary sources, and only review articles for any medical content or conclusions. Jayjg (talk) 17:25, 20 January 2012 (UTC)

I agree we should adhere to WP:MEDRS, WP:NOR and WP:PRIMARY. All of these allow for primary sources when presenting the conclusion as the author and using these secondary to the primary source. WP:MEDRS states that such sources should be included but not over emphasized. WP:DUE states that minority views should be acknowledged. Furthermore, some of the revisions, such as the several describing impact on circumcision on female sexuality are not controversial. These complement the secondary sources.
I have found no evidence in WP:MEDRS, WP:NOR and WP:PRIMARY that a "controversial" topic should limit peer reviewed primary sources where they add useful content to the article. I have found evidence in WP:NOR,WP:MEDRS and WP:DUE that such content should be included. I suggest you should re-evaluate your personal policies about primary sources in an article with some controversial content because they are not consistent with Wikipedia policy. Reaching consensus as a minority group does not override the general wiki
Also, I've consulted a mediator and primary source aggregation is not considered original research. In fact, if they are a significant view point, an article needs to mention them. I suggest you refer to WP:SYNTHNOT when determining what is and what isn't synthesis by wiki consensus standards. (e.g. "SYNTH is when two or more reliably-sourced statements are combined to produce a new thesis that isn't verifiable from the sources. If you're just explaining the same material in a different way, there's no new thesis." and "coming up with summary statements for difficult, involved problems" has been described as "the essence of the NPOV process".").
I'd like to hear from other people who have not yet had a chance to voice there opinion before restoring the content. The views of jayjg, jakew and Jmh649, the most active members in the past few days appear to have been stated. Gsonnenf (talk) 19:21, 20 January 2012 (UTC)
Actually, you have not "consulted a mediator", and no-one has concluded that "primary source aggregation is not considered original research". Moreover, WP:PRIMARY and WP:MEDRS are quite clear that primary sources (and primary studies) should generally be avoided for exactly this reason - that editors insist that one specific study is very "significant", and therefore must be included, regardless of whether or not the secondary literature agrees. Please re-read WP:PRIMARY and WP:MEDRS. In addition, you should be extremely hesitant about even suggesting "restoring the content" without consensus to do so. And finally, regarding who should comment here, it is axiomatic that more experienced editors will have more familiarity with the policies and their meaning. Jayjg (talk) 19:29, 20 January 2012 (UTC)
I would expect better from you than to make up claims about what I have done. I asked a question and a mediator answer it. Both he and I concluded "primary source aggregation is not considered original research" demonstrating that your vigorous assertions are nonsensical. WP:SYNTH demonstrates its not original research.
I feel several of you have taken a view that this article is yours and that your opinions should be weighted higher than any 'outsider'. I also feel that those wanting to become involved, who do not share your POV, are driven away by edit wars, and adamant assertions of consensus and wiki lawyering that are dubious at best. I do most of my edits anonymously and have never experienced such a reprisal or such a bizarre interpretation of WP:NOR WP:MEDRS. I believe this article and its editors should go to formal mediation. Hopefully the editors who have been driven off by the hostile environment will give the article a second chance. Gsonnenf (talk) 20:56, 20 January 2012 (UTC)
I do not see why some have problems with review articles? There are lots of reviews on this topic. Pubmed will limit you search to reviews by a simple click of a button. They are much preferred by the editing community...Doc James (talk · contribs · email) 21:34, 20 January 2012 (UTC)
Gsonnenf, the question you asked was a contextless and inaccurate one, and the person who responded (who is not a moderator, by the way), gave his own personal opinion regarding that vague question. WP:MEDRS and WP:PRIMARY are quite clear: Wikipedia articles should be based on reliable, published secondary sources and, to a lesser extent, on tertiary sources. Rather than trying to justify using poor sources, instead find good sources. Regarding the rest, comment on content, not on the contributor. Jayjg (talk) 21:44, 20 January 2012 (UTC)
The question was not inaccurate, it was addressing the issue of aggregation being original research which was debated. WP:MEDRS gives clear guidelines for including primary sources which I already discussed. It feels like WP:TAGTEAM and WP:OWNER are going on in this article and talk page. I am asking other editors for their opinions, as we have already stated ours several times.
Now to clarify my position, There are several studies that have not yet been mentioned in a review because 1. they are new and 2. Most recent review articles focus on HIV and not primarily on sexual effects. The 2007 Sorrells study is important because it features a method that measures sensitivity of the lost foreskin. Prior studies only studied glan sensitivity. The O'hara and 3 other studies conclude that circumcision causes a reduction in lubrication during intercourse. These two work in adjunct to several secondary sources and provider the reader with important information and justification. These articles are not controversial and including them as "studies" is certainly not original research and is appropriate under all the above mentioned WP guidelines.Gsonnenf (talk) 00:11, 21 January 2012 (UTC)
Your first paragraph included negative statements about editors, not article content, so I didn't read further. Per policy, comment on content, not on the contributor, especially if you want your comments to be read. Jayjg (talk) 02:19, 22 January 2012 (UTC)
Oh, and now that the board in question has the full context of the issue, this is what the "moderators" are saying:

This is illegitimate SYNTHESIS, and a MEDRS violation. Fifelfoo (talk) 02:09, 21 January 2012 (UTC)

IMO, primary sources should only be used rarely and with great care. The best use for them is to provide an illustration to something already covered in a secondary source. The idea that it's OK to use them if a secondary source can't be found is all wrong. One big problem with using primary sources is that they often require interpretation, which we're forbidden from doing, and that it can be hard to judge all of the externalities, such as their reliability and relevance. On a well-developed topic like circumcision there's very little reason to use them.   Will Beback  talk  02:26, 21 January 2012 (UTC)

It is synthesis. TFD (talk) 07:12, 21 January 2012 (UTC)

It is what SYNTHESIS is, it is precisely what synthesis is. MEDRS explicitly states that data should not come from primary medical sources, but from field reviews. Wikipedians cannot aggregate cases, case studies, or primary points of research in relation to medical research. Fifelfoo (talk) 02:52, 21 January 2012 (UTC)

Moreover, they are sticking to their views, despite your hectoring them on the board and on their talk pages. Funny what an accurate description of an issue and a little context can do. Jayjg (talk) 17:38, 22 January 2012 (UTC)
Jayjg, I'm sorry that you don't support discussion to find why people have there beliefs and that you refer to discussion as "hectoring". Though I find it odd you are watching the talk pages of people who are supposedly neutral to this conversation. I was wondering did you post a discussion somewhere asking other people to comment like you did here? http://lists.wikimedia.org/pipermail/wikien-l/2007-December/087744.html Gsonnenf (talk) 17:57, 22 January 2012 (UTC)
Ah yes, another example of Avi's corollary to Risker's LawFace-smile.svg. If you have evidence that Jayjg is currently involved in canvassing, please bring it to ArbCom. Unfortunately, it is documented that there is both historical and current off-wiki canvassing by intactivists to violate Wikipedia rules and guidelines regarding this article, and hightened supervision is necessary to protect the integrity of the project. -- Avi (talk) 18:15, 22 January 2012 (UTC)
How many times is that five-year-old e-mail, irrelevant to this topic, going to be waved around by various editors hoping to distract attention from the actual issues at hand? Jayjg (talk) 21:09, 22 January 2012 (UTC)
To be brutally frank, as often as possible, Jay; wikipedia is unfortunately very political. However, as you say, that is a classic ad hominem fallacy, as it has no bearing on this discussion, and can be (and should be) ignored for the fallacious Ignoratio elenchi it is so typical of. -- Avi (talk) 21:16, 22 January 2012 (UTC)
That's a sad truth. Jayjg (talk) 21:44, 22 January 2012 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────Getting back to the actual topic at hand, in addition to the many good reasons already given for adhering to policy here, particularly WP:SECONDARY and WP:MEDRS, we must remember that this is a general overview article on the topic of circumcision, including its medical aspects. It is therefore even more important that we rely on the broad and reliable overviews/summary views provided by reliable secondary sources (in this case review articles), rather than including primary material. If there is any place for individual medical studies, it would be in the more detailed Medical analysis of circumcision article, and they really should be avoided even there, in favor of a fuller exposition of what the review articles say. Jayjg (talk) 21:44, 22 January 2012 (UTC)

Good points. These tie in with WP:DUE as well. There are relatively large numbers of primary sources, and it's frequently difficult to judge their significance, and in particular the significance of the issues studied (consider, for example, PMID 9783972). By sticking to secondary sources, we reduce (but do not eliminate) this problem, by allowing those secondary sources to act as a filter. If an issue is discussed in secondary sources, especially multiple secondary sources, it's much more likely to warrant inclusion. Jakew (talk) 22:16, 22 January 2012 (UTC)

Outside canvassing again

Apparently the usual off-wiki anti-circumcision canvassing has been going on, this time at Reddit. That's why we've seen a sudden influx of new or rarely used anti-circumcision accounts/IPs (in addition to the almost-boring-in-their-predictability socks, like User:Wimp O'pede). We should expect the typical outcomes of this (lots of policy-violating content changes and edit-warring), as we've already been seeing. Jayjg (talk) 20:14, 20 January 2012 (UTC)

Jayjg your attitude is extremely bad and the opposite of assume good faith. This does not give you free license to chase everyone off who feels this page is not neutral. There are always going to be people against circumcision but that doesn't make them activist just as it doesn't make you an activist for pro-circumcision. Labeling others points of view in a derogatory manner or tone simply adds fuel to the fire in this already hot inferno. We do have an RFC going on so newcomers appearing on the page should be expected. Garycompugeek (talk) 20:50, 20 January 2012 (UTC)
Actually, Gary, RFC participation depends on an editor browsing through RFC pages and (essentially) finding something interesting. Consequently, RFC participants tend to be fairly active Wikipedians. Jakew (talk) 20:54, 20 January 2012 (UTC)
Also, WP:AGF is not a suicide pact, as has been stated on Wikipedia many times. Gary, the Reddit call to arms was in its "intactivists" section - note the word activist embedded in that term. So yes, they're activists. Every time some off-wiki campaign draws new editors or sockpuppets here for anti-circumcision activism, and someone calls attention to it, you pop up insisting that we "assume good faith" about them, and criticizing the whistleblower. We're not idiots, though; please don't act as if we were. Rather than insisting that we assume good faith about obvious socks and activists drawn here from off-wikipedia, perhaps you should think of ways of dealing with the problem. Jayjg (talk) 21:37, 20 January 2012 (UTC)

Thanks to you guys, the article doesn't even mention how the AAP Circumcision Policy Statement includes "amputation of the foreskin" as part of the definition of circumcision. In fact, the integral and defining term "amputation" does not appear anywhere in the article.

Since you, Jayjg and Jake Waskett, are largely in control of this article, it's you being pro-circumcision rather than other people being anti-circumcision. You are so pro-circumcision that you refuse to let the article discuss it in accurate and neutral terms as defined by the AAP. So to leave a pre-emptive warning, poisoning the well against newbies is just despicable in terms of proper editorial procedure. --78.35.239.207 (talk) 22:55, 20 January 2012 (UTC)

I agree with the above comment. Gsonnenf (talk) 00:18, 21 January 2012 (UTC)

Per WP:MEAT: "Do not recruit your friends, family members, or communities of people who agree with you for the purpose of coming to Wikipedia and supporting your side of a debate." Note that it doesn't say, "unless you feel that existing editors are really biased". Perceived bias on the part of other editors is completely irrelevant, and is no excuse whatsoever. Jakew (talk) 11:05, 21 January 2012 (UTC)
Hmm, in the past couple of days 5 different IPs from three different continents have shown up to revert and edit-war anti-circumcision material into this article, and insult editors on the Talk: page. Must be an entirely random coincidence. Jayjg (talk) 02:17, 22 January 2012 (UTC)

I've done a bit research concerning the people editing this article. The only one who's actually been found guilt of WP:MEAT is jayjg. http://lists.wikimedia.org/pipermail/wikien-l/2007-December/087744.html . I am rather appalled by this his hypocrisy. Also I find your statement saying these new people are "border line socks" an attack on the new users such as me. This is rather hypocritical, as you are the first to cry foul when someone criticizes you.Gsonnenf (talk) 17:01, 22 January 2012 (UTC)

So basically you've found an email from five years ago and about a completely different article. Does it have any relevance whatsoever to this article, or is it merely a vague attempt at deflection? Jakew (talk) 17:24, 22 January 2012 (UTC)
It appears to be more a "blatant" attempt at deflection than a "vague" one. Jayjg (talk) 17:29, 22 January 2012 (UTC)
I did see about it on Redit. Noobs not welcome? Robert B19 (talk) 17:45, 22 January 2012 (UTC)
Thanks for being honest, it's a welcome change. As noted above, WP:MEAT states the following: "Do not recruit your friends, family members, or communities of people who agree with you for the purpose of coming to Wikipedia and supporting your side of a debate." Jayjg (talk) 17:49, 22 January 2012 (UTC)
Robert, you are welcome here if you want to review the article and make the article the best it can be. If you are here as an activist, or to support any particular position in the controversy, you should probably turn around. Being from reddit doesn't disqualify you, coming here with intentions to support a cause does. Gsonnenf (talk) 18:26, 22 January 2012 (UTC)

I am the user who was soliciting for help outside of Wikipedia on Reddit, and I will assume full responsibility for it. I actually did not know I was acting out of line until reading this, but it is something that I apologize for. I've deleted what I could to hedge against having any more users on our end joining in on this discussion, and will cease from doing it again down the road.

I made an effort to neutralize the amount of bias in the not-NPOV, B-grade entry for circumcision that exists courtesy of users like Jayjg and Jakew, who have over the years used networks of their own to shape the narrative of the circumcision entry by colluding with other editors. Jayjg and Jakew have deleted content posted by other users in this talk page, have been unwilling on many instances to compromise with their slanted editing preferences until meeting resistance by a moderator, and have stepped out of line with their arguments by making overblown generalizations in this talk page without bothering to acknowledge their missteps. As the most active users on the page for almost a decade, they have had a large pervasive influence on the quality of the content in the entry, and I set out to try to level the playing field.

Getting back to the outside canvassing on my end, I will admit to what I have prompted here, and will abstain from doing it again going forward. I apologize to all users for my actions here and any undue grievances I may have caused anyone. Therewillbefact (talk) 19:15, 22 January 2012 (UTC)

We should only be here to reflect the best available evidence as found in the form of review articles recently published (last three to five years) which are indexed in pubmed (a lose proxy for reliable journals).Doc James (talk · contribs · email) 19:20, 22 January 2012 (UTC)
"Setting out to improve the article" is a wonderful idea when performed in accordance with our core principles, rules, and guidelines. "Setting out to level the playing field" indicates a combat mentality--one that is in direct discord with the aforementioned policies and guidelines. Hopefully, Therewillbefact, you have a better understanding of the difference now, and can engage in discourse with your fellow editors about this, one of our most contentious articles in all of Wikipedia. Focusing on content, and not contributor, is absolutely key. Yes, you have an opinion, as does Jake, as does Doc, as does Gsonnenf, as do I, as does Jay, etc. While our opinions certainly shape our thoughts as we edit, as long as we stick to the best sources, saying no more and no less than what they do, and refraining from overstating positions in opposition to their prevalence in the field, and being careful not to make any synthesis or statement --even if true-- that is not stated in sources, we should be on safe ground. -- Avi (talk) 20:35, 22 January 2012 (UTC)
And Therewillbefact, I hate to have to ask this, but what the heck are you going on about? "until meeting resistance by a moderator"? What moderator? There are no "moderators" here. And "stepped out of line with their arguments by making overblown generalizations in this talk page without bothering to acknowledge their missteps"? I can't make any sense of that at all, except that you apparently think you (or someone else) is right about something, and Jakew and/or I am wrong about that thing. In addition, your opinion regarding the quality of this article "not-NPOV, B-grade entry" is, quite frankly, arrant nonsense, the product of a combination of unfamiliarity with Wikipedia and activist bias. And finally, in the past 4½ years there have been almost 4,900 edits to this article, of which I have made 66. That's 1.4% of the total edits to this article, and during that period I have been the 12th most active editor of the article - not even in the top 10! Hardly the "large pervasive influence" you claim in your conspiratorial view. Now, instead of using the page for calumnies, aspersions, defamation, and character assassination, do you think you could focus instead on trying to discuss article content, and in particular suggest changes that will (for a change) comply with things like WP:MEDRS? Jayjg (talk) 21:36, 22 January 2012 (UTC)
I believe Therewillbefact was referring to this when he made the moderator claim : http://en.wikipedia.org/wiki/Wikipedia:Requests_for_arbitration/West_Bank_-_Judea_and_Samaria . You did ask the question, so please no ad hom. complaints. As I understand, JakeW is actually the most posted person on this topic with over 10% of edits. 67.0.75.137 (talk) 22:05, 22 January 2012 (UTC)
Again, what possible relevance does that have to this article? Is this article about the West Bank? Jakew (talk) 22:08, 22 January 2012 (UTC)
I was about to ask that. I know that the predominant religions of WB/J&S are Islam and Judaism, both of which require circumcision as a religious sacrament, but that is really stretching it. I'm sure we were not focusing on editors instead of content Face-smile.svg -- Avi (talk) 22:12, 22 January 2012 (UTC)
It obviously has nothing whatsoever to do with that, since Therewillbefact actually linked his comment to a current section on this Talk: page, not some old unrelated page. 67.0.75.137/Gsonnenf is just trying to smear editors; it's really getting quite WP:DISRUPTive. Jayjg (talk) 23:16, 22 January 2012 (UTC)

Can Someone Please explain to me?

Why is it that the UN and feminists use the term, circumcision for males and "genital mutilation" for females? Like this is any different? — Preceding unsigned comment added by Trumpy (talkcontribs) 13:02, 21 January 2012 (UTC)

They believe it is, as do the vast majority of sources and citations. -- Avi (talk) 18:17, 22 January 2012 (UTC)

Violence of Circumcision

The British Medical Association (BMA) states that "it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks."[154] Milos and Macris (1992) argue that circumcision encodes the perinatal brain with violence and negatively affects infant-maternal bonding and trust.[18]

This aspect of circumcision deserves more coverage. Chevara (talk) 17:18, 23 January 2012 (UTC)

Hi Chevara, welcome to wikipedia, your input is certainly welcome. As it turns out, the BMA recommendation is already included in the article. The source Milos and Macris appear on pubmed http://www.ncbi.nlm.nih.gov/pubmed/1573462 and is a secondary source, a recommended attribute for use in this article. Please review the article, if you find sections that can benefit from information presented in the paper, feel free to point them out. Gsonnenf (talk) 17:37, 23 January 2012 (UTC)
Actually the entire paragraph above is quoted from the article, Gsonnenf. Jakew (talk) 18:11, 23 January 2012 (UTC)
Well then, let me revise my statement to "If you have anything additional you feel should be included, we welcome your suggestions." Gsonnenf (talk) 18:19, 23 January 2012 (UTC)

Plagiarism

Hello,

I think we may be guilty of wp:plagiarism in quite a few places in this article. Specifically the following taken from the guidelines page:

N Copying from a source acknowledged in a well-placed citation, without in-text attribution

  • Inserting a text—copied word-for-word, or with very few changes—then citing the source in an inline citation after the passage that was copied, without naming the source in the text.

Lets go ahead and get these fixed. The solution should be easy, all we have to do is attribute quotes and virtual quotes to the authors in the text. Gsonnenf (talk) 16:49, 23 January 2012 (UTC)

Why do you "think we may be guilty of wp:plagiarism in quite a few places in this article"? Jayjg (talk) 19:58, 24 January 2012 (UTC)
Most notably here: "There is strong evidence that circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in populations that are at high risk,[12]." This is a direct quote from an author where he is cited with an inline citation, but not named in text. There's a couple other places, I'll do a bit of review. I don't have access to quite a few of the papers though. Gsonnenf (talk) 17:59, 25 January 2012 (UTC)
It's not a direct quote: it's heavily paraphrased. The closest sentence in the source reads "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." Jakew (talk) 18:14, 25 January 2012 (UTC)
That looks like "or with very few changes" clause to me. What is the problem with attributing it to him? Gsonnenf (talk) 19:25, 25 January 2012 (UTC)
The first five words are the same, but that's hardly a case of "very few changes" (interestingly, this seems to be a case of convergence on the same terms: prior to this edit we cited a different source in support of that sentence fragment; this may suggest that it's simply the most natural way to express this information). If you like we could rephrase as "Strong evidence shows that", but it really doesn't seem necessary given that it's only a small part of the sentence. By the way, I think Nandi Siegfried would probably prefer the pronoun "she". Jakew (talk) 19:53, 25 January 2012 (UTC)
It seems to me that either formulation is fine, but perhaps you should change it to your proposal, to deal with any concerns? Jayjg (talk) 21:07, 25 January 2012 (UTC)
Can't say it seems necessary to me, but I've done so anyway. Jakew (talk) 21:46, 25 January 2012 (UTC)

Recent additions

67.0.71.114 (talk · contribs), 174.28.162.94 (talk · contribs) and DukeTwicep (talk · contribs) have recently edited the article, changing the text re Sorrells et al. The original text reads:

  • In a 2007 study, Sorrells et al., using monofilament touch-test mapping, found that the foreskin contains the most sensitive parts of the penis, noting that these parts are lost to circumcision.

This is verifiable, since the authors state: "In conclusion, circumcision removes the most sensitive parts of the penis [...]. The most sensitive regions in the uncircumcised penis are those parts ablated by circumcision."

The edits changed this to read:

  • In a 2007 study, Sorrells et al., using monofilament touch-test mapping, reported the foreskin is the most sensitive part of penile anatomy, and foreskin lost to circumcision has twice the fine touch sensitivity of any remaining penile anatomy.

This is problematic. Since the source does not state that the foreskin has twice the fine touch sensitivity, this claim is original research. Jakew (talk) 17:19, 19 January 2012 (UTC)

A second edit to the 'sexual effects' section is also problematic. Here are some of the problems:

  • It begins by saying "Evidence strongly suggest that circumcision causes a reduction in vaginal lubrication during intercourse with a female partner", but this assessment appears to be original commentary. We shouldn't say that the evidence "strongly suggests" such a thing - that's a matter of judgement. We could, perhaps, say that "Some studies have suggested that..."
  • All of the studies are primary sources. Per WP:PSTS and WP:MEDRS we should generally avoid these.
  • One study (by Bensley and Boyle) is listed twice.
  • The following sentence ("Reports on its impact on female sexual response has ranged from no change in general sexual satisfaction, to reduction in likelihood of female orgasm") suffers from the same primary source problem, and is somewhat skewed. Kigozi et al reported "The overwhelming majority of women (97.1%) report either no change or improved sexual satisfaction after their male partner was circumcised".

I would suggest that, given the problems associated with this material, it is best removed. Jakew (talk) 20:43, 19 January 2012 (UTC)

Good points. I've restored the previous for now. Jayjg (talk) 23:43, 19 January 2012 (UTC)


This content was twice removed, first because it was claimed not to be in the article, which was then shown to be in the article. Then removed for WP:MEDRS, WP:NOR. etc. But the statement is not original research. Please review the following:

WP:NOR " A primary source may only be used on Wikipedia to make straightforward, descriptive statements of facts that any educated person, with access to the source but without specialist knowledge, will be able to verify are supported by the source."

WP:MEDRS "Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above (see: Wikipedia:No original research)."

In Sorrells 2007 the author states "When compared with the most sensitive area of the circumcised penis, several locations on the uncircumcised penis, which are missing from the circumcised penis, were significantly more sensitive (Table 2)." Table 2 shows a 2:1 ratio of sensitivity. Also: "The most sensitive location on the circumcised penis is the circumcision scar on the ventral surface. Five locations on the uncircumcised penis that are routinely removed at circumcision were more sensitive than the most sensitive location on the circumcised penis." The statement added to Wikipedia is a clear summary of the authors conclusion and contains no original research. If someone can find a secondary source on the sensitivity of the foreskin (not glan), please add this as the dominant citation. In the female dryness summary, all the papers explicitly state an increase in female dryness as data and conclusions. These comply to the letter and spirit of the primary source guidlines.

A great deal of citations in this article are primary sources, and these are justifiably there. Lets not selectively remove content based on editor preference for pro-circ or con-circ. Lets present the available data and let people draw there own inferences. 174.28.162.94 (talk)

This is something of a moot point now that the sentence has been removed entirely. However, for future reference, please note that we may not include our own analyses of data presented in sources: if a source does not explicitly make a point, then neither should we. You may think it straightforward to compute a ratio, but actually that's questionable. For example, you took one point on the foreskin (the most sensitive) and extrapolated from it to "foreskin lost to circumcision" (by implication, the entire foreskin). Alternatives might have been to use the least sensitive point, or the mean value. As another example, it's customary to establish that there is a statistically significant difference between measurements as part of the process of comparing them; the authors asserted significance when points were compared collectively, through a mixed model, but did not comment on individual comparisons. Consequently it's not as simple as computing a ratio. Finally, an unstated assumption in your analysis is that the scores correspond linearly with sensitivity: that is, that twice the score implies half the sensitivity. I don't intend to debate these points with you; I'm just using them to illustrate the fact that what might seem to be a straightforward statement is often not the case. It's best to err on the side of caution and stick to the authors' own interpretation. Jakew (talk) 11:08, 20 January 2012 (UTC)
Its not a moot point as it is under discussion and will the wider community has a chance to comment on it, not just the 2 or 3 most vigilant members. Your example does not fall under the wiki definition of synthesis. I think you are being a bit pedantic and in general topics are expected to be summarized. The author refers to the chart to demonstrate the quantitative analysis. I could see you changing it from twice the sensitivity to the measured values. I encourage you to read the article to get a better understanding.174.28.171.127 (talk) 15:42, 20 January 2012 (UTC)

I understand why the edits made were out of line, but why was the original content omitted here (referring to "In a 2007 study, Sorrells et al., using monofilament touch-test mapping, found that the foreskin contains the most sensitive parts of the penis, noting that these parts are lost to circumcision.")? This was originally in the entry before it was poorly-edited and then subsequently deleted altogether. As mentioned above, the original text was verifiable. Therewillbefact (talk) 05:52, 26 January 2012 (UTC)

It was deleted because it was one of several primary sources. Jakew (talk) 09:48, 26 January 2012 (UTC)

Hygienic alternatives

This article needs a discussion of modern and traditional hygienic alternatives such as medical, or in some families parental, retraction of the foreskin at an early age and certain personal hygiene practices often taught in families from cultures that do not automatically practice circumcision. -98.69.193.71 (talk) 03:56, 20 January 2012 (UTC)

Hygienic alternatives? Do you mean washing?86.184.68.15 (talk) 18:27, 26 January 2012 (UTC)

STI section

I think many of the recent edits to this section are a great improvement. However, I think that this sentence poorly represents the literature:

I preferred this sentence, which was until recently in the lead:

Any objections to changing it? Jakew (talk) 10:12, 20 January 2012 (UTC)

No change away.Doc James (talk · contribs · email) 10:16, 20 January 2012 (UTC)

Tftobin (talk · contribs) has added some dubious material to this section. The first problem is that "increasingly being called into question" appears to be original research (the cited sources give no indication that there is a trend over time), and is obviously non-neutral. The second is that it gives undue weight to fringe views, as discussed previously. The third is that the first source is a news article, not a review. The fourth is that "Another study has shown an increase of HIV infection among circumcised men in Malawi" is a reference to a primary study. The fifth is that the cited source for this isn't even a peer-reviewed study, but, rather a news article about it (hence unsuitable for use as a source).

To rectify these problems, I intend to remove this material and, instead, add the Svoboda and Van Howe citation to the "Some have challenged the validity of the African randomized controlled trials, prompting a number of researchers to question the effectiveness of circumcision as an HIV prevention strategy" sentence. Jakew (talk) 13:23, 20 January 2012 (UTC)

We must stick with review articles thus removed.Doc James (talk · contribs · email) 14:42, 20 January 2012 (UTC)

There is a specialized medical book, "Genital Autonomy," from a recommended publisher ( Spring-Verlang ) that Tftobin's article referenced. Medical book series with good editorial oversight ( such as those from Springer ), are a recommended second source by wp:medrs. I've used a similar Springer book about internal ballistics and found it an excellent resource. I encourage anyone with access to this book to give it a read and see what is presented. Gsonnenf (talk) 16:07, 23 January 2012 (UTC)

This is an example of a questionable source. In fact, it's difficult to think of a less appropriate source than the proceedings of an anti-circumcision conference. Jakew (talk) 16:16, 23 January 2012 (UTC)
The above statement is ironic, considering that the recommendation of consultants to a CDC meeting was being cited as evidence that the benefits of circumcision outweigh the risks, above, in the controversy regarding circumcision paragraph. Tftobin (talk) 19:09, 26 January 2012 (UTC)
Not at all Jakew. Its also not the proceedings of a conference. The book is a compilation of articles put together by the fine editors at Springer press, a highly respected academic publisher. The conclusions they reach are valid professional conclusions. In the same way a HIV researcher may recommend circumcision because his research suggests it limits HIV transmission, these professionals reached the conclusion that they would not recommend circumcision and present their professional research supporting this. I'm quite sure Springer press has no interests other than professional considerations. Gsonnenf (talk) 16:43, 25 January 2012 (UTC)
The first editor (Denniston) seems to disagree with your assertion that it's not the proceedings of a conference. He begins his Amazon.com review: "As one of the three editors of the Proceedings of this Conference in England [...]"[4] Jakew (talk) 17:28, 25 January 2012 (UTC)
Ah, the summary was not clear on the conference. i still find it a valid and valuable source for the above stated reasons. Gsonnenf (talk) 17:45, 25 January 2012 (UTC)
In future, please don't waste other editors' time by making false claims. Jakew (talk) 18:11, 25 January 2012 (UTC)
beg to differ not a waste of time to keep an open mind on the edits needed Chevara (talk) 04:18, 26 January 2012 (UTC)
It's "not a waste of time" to waste other editors' time by making false claims? Jayjg (talk) 23:15, 26 January 2012 (UTC)
What was the reason for removing this sentence from the lead? (referring to "Whether it is of benefit for women is disputed[7][8] and whether it is of benefit in developed countries and among men who have sex with men is undetermined.") Therewillbefact (talk) 04:43, 27 January 2012 (UTC)
It was a tautology/redundant; the lede already states it reduces the risk in heterosexual men in populations that are at high risk, and is cost effective in sub-Saharan Africa. "Heterosexual men" excludes "women" and "men who have sex with men", and "Sub-Saharan Africa" excludes "developed countries" (among other places). Space in the lede is at a premium, so we should try to restrict material there to what we actually know, and haven't already said in other words. Jayjg (talk) 04:59, 27 January 2012 (UTC)
Alot of what we do as wiki editors is review each others work. Claiming "waste of time" is a bit uncivil as other seems to value the over all discussion on this valuable secondary source. I think the second sentence reflects the attitude of the article and general medical community wp:due and should be included. Gsonnenf (talk) 18:52, 28 January 2012 (UTC)
Your response did not address the points raised in mine about it being a tautology/redundant. Jayjg (talk) 01:32, 29 January 2012 (UTC)
There is always a trade off between redundant and clarity. Clarity is more important than eliminating redundancy in this case. Gsonnenf (talk) 05:14, 29 January 2012 (UTC)
Are you saying that "heterosexual men in sub-Saharan Africa" could be misinterpreted as "homosexual men in developed countries"? If so, it's not due to any lack of clarity, but rather a failure to read. Jakew (talk) 10:17, 29 January 2012 (UTC)
Indeed. As already noted, "heterosexual men" excludes "women" and "men who have sex with men" - it's difficult to be more clear than that. Jayjg (talk) 18:00, 29 January 2012 (UTC)

Medical cost benefit

The following statement has sources comparing monetary costs, to utility cost, which is very strange.

  • Medical cost-benefit analyses of circumcision have varied. Some found a small net benefit of circumcision,[38][39] some found a small net decrement,[40][41] and one found that the benefits and risks balanced each other out and suggested that the decision could "most reasonably be made on nonmedical factors."[42]

Citation [38] compares the monetary cost of performing the operation to the monetary cost of not having the operation. Some of the others look at the cost/benefit with respects to the patients health. I don't think the "monetary cost benefit" should be included in "medical cost-benefit", but should certainly be included some where. Any suggestions? — Preceding unsigned comment added by Gsonnenf (talkcontribs) 18:17, 23 January 2012 (UTC)

What are you talking about? Ref 38 concludes "Multiple lifetime medical benefits of neonatal circumcision can be achieved at little or no cost". Jakew (talk) 18:21, 23 January 2012 (UTC)
The quote refers to "monetary" cost, not utility cost, as indicated by the results: "Postneonatal circumcision was 10 times as expensive as neonatal circumcision ($1,921 per infant vs $165 per newborn), and was medically indicated for 9.6% of uncircumcised males. Cost benefits of circumcision resulted from prevention of infant urinary tract infection, balanoposthitis, phimosis, HIV infection and penile cancer. Assuming initial neonatal circumcision cost to be $200, the future health care cost offset (avoided) was calculated as $183 (range $93 to $303 in 95% of simulations)."
This is different than the other articles which talk about utility cost/benefit ( benefits/cost to someones health ). Gsonnenf (talk) 18:32, 23 January 2012 (UTC)
Yes, "cost" refers to monetary cost, while "benefit" refers to medical benefit. That's why I was a bit perplexed by your statement ("compares the monetary cost of performing the operation to the monetary cost of not having the operation").
For the time being I've rewritten the sentence to encompass financial and medical comparisons, since most of the cited studies do both.
We could consider making the first sentence about studies comparing medical costs and benefits, removing ref 38 and substituting 53 and/or 104. Then we could cite several of the same studies again (since many make economic evaluations), as well as PMID 20224784 and, perhaps, PMID 20090910. Jakew (talk) 19:13, 23 January 2012 (UTC)
Ah we must have semantic differences then. Cost and benefit, as I've experienced it, are two poles taken with respects to a particular variable, not necessarily monetary. (e.g. cost in time ( physical therapy vs. surgery ) , cost in life quality (e.g. chemotherapy), cost in payload budget (e.g. satellites), benefit to estimated quarterly earnings (e.g. business ) ).
I think it would make sense to separate economic factors from medical factors. There is also source aggregation going on in this sentence in case anyone wants to address that. Gsonnenf (talk) 19:40, 23 January 2012 (UTC)
Can't find a "medical cost benefit" section on any other surgical operation. Chevara (talk) 04:03, 26 January 2012 (UTC)
Right, it warrants a sentence or two, not an entire section. Gsonnenf (talk) 16:53, 26 January 2012 (UTC)
Am I missing something? What's the point of "medical cost benefit"? for insurance companies? Chevara (talk) 22:08, 26 January 2012 (UTC)
The article has exactly two sentences on benefits vs. costs. Costs and benefits are weighed for all medical procedures. Decisions on whether or not to perform a given procedure are typically made based on those cost-benefit analyses. Jayjg (talk) 23:21, 26 January 2012 (UTC)
A search of Wikipedia shows no similar cost effective statements for any other medical procedure. Support your assertion that "Decisions on whether or not to perform a given procedure are typically made based on those cost-benefit analyses." Chevara (talk) 06:05, 27 January 2012 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── Perhaps you are unfamiliar with concepts like "Comparative effectiveness research" or "Quality-adjusted life year" - please see the linked articles. You might also want to review a couple of representative journal articles to start: Implementing Evidence-Based Health Policy in Washington State (N Engl J Med 2009; 361:1722-1725), Cost-effectiveness of repeat medical procedures: kidney transplantation as an example (Med Decis Making. 1997 Oct-Dec;17(4):363-72). Ben Bernanke wrote a whole section on this topic in his book Principles of Microeconomics p. 352. You might also want to review the Wikipedia article on Healthcare rationing in the United States. Jayjg (talk) 20:18, 27 January 2012 (UTC)

One could edit those articles with a cost-effective theory on circumcision. It doesn't belong in this article. Chevara (talk) 22:15, 28 January 2012 (UTC)
Are you suggesting that studies of the cost effectiveness of circumcision are somehow unrelated to circumcision? Jakew (talk) 22:24, 28 January 2012 (UTC)
There is no other surgery article on Wikipedia that includes such a claim. Chevara (talk) 22:33, 28 January 2012 (UTC)
Could you express your objection to this obviously relevant and neutrally presented material in terms of policy? Jayjg (talk) 01:22, 29 January 2012 (UTC)
Jayjg asks an excellent question. I am, however, mystified by your claim that no other surgery article discusses cost-effectiveness. As counterexamples, see Tonsillectomy#Controversy over indications, Essure, Spinal cord stimulator#Cost effectiveness, and Urethrotomy#Controversy. Jakew (talk) 10:52, 29 January 2012 (UTC)
None of the links use "cost effective" in the lead with the exception of Essure which compares two surgical alternatives. Your other links are not comparable to the explicit pro-circumcision argument, "cost effectiveness of circumcision vs condoms" in the lead because Tonsillectomy is surgery for an actual condition, spinal cord stimulator is extremely expensive and indicated for an actual condition, and urethrotomy too is for an actual disease, not to mention all are quite expensive. "Cost effectiveness" of circumcision in the absence of a disease is a strange argument, most certainly inappropriate in the lead, if not the article itself. Chevara (talk) 17:29, 29 January 2012 (UTC)
Chevara, you still haven't stated exactly which text is problematic, much less any policy-based reasons for it being so. Please do so. Jayjg (talk) 17:58, 29 January 2012 (UTC)
I'm a bit perplexed by this, too, because we don't compare the cost-effectiveness of circumcision with that of condoms in the lead.
Regarding your other points, Chevara, you originally stated that there aren't any cost-effectiveness analyses presented for other surgical operations. When I proved that wrong, you attempted to change the subject by talking about whether surgery is performed in the presence of a pre-existing condition, or whether it is expensive. Neither of these points seem particularly relevant. Jakew (talk) 18:28, 29 January 2012 (UTC)
You left out the digression in which Chevara also apparently claimed cost-benefit analyses aren't done for medical procedures, but when shown entire Wikipedia articles (among other sources) on the subject, stated the information should go in those articles instead. The phrase moving the goalposts applies here. Jayjg (talk) 19:54, 29 January 2012 (UTC)

Controversy

The controversy around this procedure is notable and deserves a section. As controversies deal more with social and culture issues they do not need to be referenced exclusively to reviews and articles such as this would be useful.Doc James (talk · contribs · email) 14:51, 20 January 2012 (UTC)

There is a lengthy "Ethical, psychological, and legal considerations" section that is essentially the "Controversy" section. Jayjg (talk) 17:28, 20 January 2012 (UTC)
I agree with Doc but have had a difficult time implementing it. It took me many months just to get the fact that there is controversy surrounding circumcision in the article because some editors wish to brush it under the rug and deny its existence. Garycompugeek (talk) 17:43, 20 January 2012 (UTC)
I will try here is a bit... Doc James (talk · contribs · email) 17:57, 20 January 2012 (UTC)
That's fine, but keep in mind the article already has (and has had for years) an almost 1,000 word "Controversies" section already, titled (more informatively) "Ethical, psychological, and legal considerations". "Controversies" is rather generic and uninformative, and those kinds of sections tend to gather a grab-bag of random material. Jayjg (talk) 18:29, 20 January 2012 (UTC)

Other conditions that have a well known controversy movement include obesity Obesity#Size_acceptance and ADHD ADHD#Controversies. We do have a review article that describes circumcision as the most controversial surgery of all times.Alanis, MC (2004 May). "Neonatal circumcision: a review of the world's oldest and most controversial operation.". Obstetrical & gynecological survey. 59 (5): 379–95. PMID 15097799.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help) Doc James (talk · contribs · email) 18:40, 20 January 2012 (UTC)

I have added a line of text... Doc James (talk · contribs · email) 19:14, 20 January 2012 (UTC)

I think the controversy is more than just ethics, psychology and legal. Doctors have published questioning the cost/benefit from a medical perspective as well. Gsonnenf (talk) 15:53, 23 January 2012 (UTC)

Also, avoiding the term "controversy" as the section heading may be misleading to the unwary reader. Robert B19 (talk) 18:09, 24 January 2012 (UTC)

Sorry, I don't understand. Can you explain why is would mislead anyone to label a section that is about ethical, psychological and legal issues "Ethical, psychological, and legal considerations"? Jakew (talk) 18:40, 24 January 2012 (UTC)
If the sub-section is focused on controversy, which what everyone in this talk is suggestion, labeling it Ethical, psychological, and legal considerations would be misleading. Gsonnenf (talk) 18:53, 28 January 2012 (UTC)
Doc James: Without input from other editors, Jakew has made a drastic change to the content in the paragraph. Please see his revision here. His submission to the talk page regarding the edit can be found under Talk:Circumcision#Rewrite_of_controversies_paragraph. Therewillbefact (talk) 21:11, 28 January 2012 (UTC)
"Controversy" is a vague term. "Ethical, psychological, and legal considerations" is a specific description of the section's content. Vague headlines are "misleading", accurate descriptions are not. Also, Jakew has not made any change to the content in the paragraph added by Doc James. Please make more accurate Talk: page statements. Jayjg (talk) 01:30, 29 January 2012 (UTC)
He made a significant edit to an important controversy-related paragraph in the lead and heavily altered its weight in the lead paragraph. If "controversy" is too misleading or ambiguous for the purpose of the lead for you Jayjg, I would have been happy to compromise to have the rhetoric reflect reality. Perhaps we could have described that there are opposing viewpoints, particularly with respect to the talking points that do not violate undue or fringe theories for the purposes of the lead. Please refer to the rest of my response under Talk:Circumcision#Rewrite_of_controversies_paragraph and we'll continue the discussion there. Therewillbefact (talk) 00:25, 30 January 2012 (UTC)
I think Jayjg's point was that the discussion in this section isn't about the lead at all, but, rather, what are now various subsections of the circumcision#Society and culture section. Jakew (talk) 11:49, 30 January 2012 (UTC)
I understood that, which is why I tried moving this discussion over to Talk:Circumcision#Rewrite_of_controversies_paragraph... Therewillbefact (talk) 17:08, 30 January 2012 (UTC)

Merit to acknowledging a world-wide decrease of circumcision rates

I would like to hear what thoughts are with respect to incorporating how circumcision rates have declined worldwide in recent years in the article, as shown in the last two sentences of the abstract here: http://www.ncbi.nlm.nih.gov/pubmed/21452153

Would it be inappropriate to integrate how health professionals have not reached a consensus with respect to the effectiveness of the procedure on a global scale -- and that this is reflected in the decreasing number of annual circumcisions performed on a global scale, as explained in the citation above? I think this might be appropriate for mention in the fourth paragraph in the lead. Thoughts? Therewillbefact (talk) 21:20, 22 January 2012 (UTC)

I'm struggling to make sense of this statement, or more specifically how to reconcile it with the fact that large-scale programmes have begun in the last few years (in Africa, for example) in which millions of males are being circumcised for protective reasons. I wonder whether there may have been a problem in translation? Jakew (talk) 21:26, 22 January 2012 (UTC)
I have read neither citation yet, but unless at least one of them explicitly makes the linkage between the consensus, or lack thereof, amongst professionals and falling rates, for us to do so would be classic original research. -- Avi (talk) 21:27, 22 January 2012 (UTC)
It does make the claim, but it's difficult to imagine how it could be established. I wonder what primary sources that statement was based on. Jakew (talk) 21:38, 22 January 2012 (UTC)

We should consider the fact that circumcision is primarily recommended as a procedure to prevent HIV transmission in high-risk areas, this is far from a world-wide platform. Also keep in mind that we are discussing an aggregate figure here, meaning that we are looking at the number of procedures performed global scale. Yes, the number of annual procedures has increased in Africa -- but a reduction in circumcision rates has undoubtedly occurred in many other parts of the world, as reflected in the US, Canada, Australia, and the UK for instance. We're trying to look at the whole picture here. Therewillbefact (talk) 22:19, 22 January 2012 (UTC)

The quote seems fairly reasonable from what I've read and I'm sure we could find many supporting primary sources if we 'needed' too. It seems to make 3 claims.
  • World circumcision has decreased.
  • Studies show it helps prevent HIV.
  • Circumcision has decreased, despite studies on HIV prevention, because there is not consensus on the cost/benefit of circumcision. (There is certainly a debate in the academic community, where some believe the benefits of increased HIV resistance is offset by the cost on sexual function, psychology, ethics, and change in sexual practice. )
I would recommend rephrasing slightly, while still keeping the intent of the author. The sentence is a bit awkward as sentences from abstracts tend to be. Perhaps something like this:
  • "World circumcision has decreased as a protective practice because of improved hygiene and the lack of unanimous consent on the usefulness of protective circumcision, despite recent studies demonstrating a role in HIV prevention.[x]"
Gsonnenf (talk) 22:36, 22 January 2012 (UTC)
As written, it seems to be saying that rates of circumcision have decreased everywhere, but you may be right that they mean that the global average has decreased. It's difficult to be sure without looking at the full text (as I said, there may be a problem in translation). Also, another question is whether the article is acting as a secondary source for this particular piece of information, or whether it's a primary source for a hypothesis. Jakew (talk) 22:41, 22 January 2012 (UTC)
I think we must be missing some context. 68% of all circumcised individuals are Muslims, and the world Muslim population is actually growing rapidly - it has tripled in size since 1970. Jayjg (talk) 23:21, 22 January 2012 (UTC)
To my knowledge, the Shafiite school of Muslim thought is the only one that regards circumcision as necessary. So while your argument may be valid if all Muslims had the procedure performed on them, we know this is far stretch from reality.
If any of you have empirical evidence that suggests global circumcision rates aren't decreasing worldwide, I'd be happy to take a gander at it. It is important that we do not rely on conjecture here. Therewillbefact (talk) 23:47, 22 January 2012 (UTC)
"we know this is far stretch from reality"? The vast majority of Muslims are circumcised, and circumcise their sons. That is reality. It's not clear to what extent urologists from the Università Cattolica del Sacro Cuore, or a urology journal, would be considered reliable sources on the subject of worldwide circumcision rates, and we need to understand better what this paper is saying and on what it is based. Jayjg (talk) 23:57, 22 January 2012 (UTC)
If the vast majority of Muslim men are circumcised, there should be an ample amount of quantitative data to accommodate your claim. Please cite something to put the proportion of circumcised-to-uncircumcised men among Muslims into perspective. I agree with you, the vast majority of Muslim men are very likely circumcised, but you did not even bother to make a distinction of how many of them are likely to be circumcised. You've only defended your surmise with a statistic regarding Muslim population expansion over the past four decades. Just as a reminder, our discourse here should be one regarding worldwide circumcision rates. The Muslim population constitutes between a fifth and a quarter of the global population. Therewillbefact (talk) 00:31, 23 January 2012 (UTC)
I'm not sure what you're saying - you demand a citation for something on which you agree with me, that the "the vast majority of Muslim men are very likely circumcised"? To what end? And while the Muslim population does constitute only 20-25% of the world population, as I've already pointed out it constitutes 68% of the circumcised population, so any reduction in worldwide circumcision rates would necessarily imply a similar reduction in Muslim circumcision rates. In any event, I have merely explained the basis for my caution, and the main point remains unanswered. Jayjg (talk) 03:15, 23 January 2012 (UTC)
Oh, and regarding the world Muslim population the most recent good estimates, are that "Globally, the Muslim population is forecast to grow at about twice the rate of the non-Muslim population over the next two decades – an average annual growth rate of 1.5% for Muslims, compared with 0.7% for non-Muslims" ("The Future of the Global Muslim Population, Projections for 2010-2030", Pew Research Center, January 27, 2011). If the Muslim population is growing at twice the rate of the non-Muslim population, and Muslims already comprise almost 70% of all circumcised individuals, and the WHO itself uses an estimate of 100% Muslim circumcision for its calculations ("Male circumcision: global trends and determinants of prevalence, safety and acceptability", World Health Organization, 2007, p. 7) then it seems an extremely odd claim that global circumcision rates are declining. Jayjg (talk) 03:45, 23 January 2012 (UTC)
We shouldn't question an authoritative second source simply because of an untested back of the envelope calculation. If there is another second source that apposes this, we will need to include both. It would be important to let the user community know that there are several authoritative point of views regarding this. Gsonnenf (talk) 05:37, 23 January 2012 (UTC)
We do, however, need to establish whether the source is authoritative. At one end of the scale, the authors might have collected primary source data allowing them to estimate national circumcision rates, standardised these data by time period, applied population estimates to estimate global rates, and finally reached a conclusion. This would be a highly reliable secondary source. At the other end of the scale, it might be a simple guess on the part of the authors, based on no sources (and hence primary). As pointed out above, the claim seems at first glance a little surprising, and in accordance with Wikipedia:Verifiability#Exceptional claims require exceptional sources we should investigate further to find out how reliable the source is for this particular statement. Jakew (talk) 09:08, 23 January 2012 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── If, upon further research, we can't come to a more definitive conclusion regarding the validity of this citation in suggesting a 'worldwide' decrease of circumcisions, then it doesn't belong in the lead. I'll agree with Jakew on that one. Regardless of whether the 'global' reduction figure is solidified and subsequently incorporated into the lead - there is still room for some effective adjustments to be made. We can still certainly shape the lead to reflect reality as we know it today.

We could mention that in countries such as the US, the UK, New Zealand, Australia, and Canada, for instance, the number of circumcisions have have generally reduced. There's also no reason why we couldn't reference those figures you provided, Jayjg, to describe how circumcision rates in Muslim countries are moving in near-lockstep with their growing population. We could also include any additional relevant information we determine to be appropriate for briefly putting large-scale regional circumcision rates into perspective. Thoughts? Therewillbefact (talk) 10:34, 23 January 2012 (UTC)

At a brief glance, I couldn't find support for your assertion about the US, etc., in the source you cited. I don't know if I overlooked something, or whether you meant to cite another document.
Regardless, I'll agree for the sake of argument that it might be possible to find a source making such an assertion. That said, it partly depends on the source: from memory I can think of three sources, one asserting that US rates are stable, and two others asserting that US and Australian rates are rising. This may reflect different choices of time period: the 50-year trend may be different from the 10-year trend. It might also, in some cases, reflect simple disagreement among sources.
Personally, I'm not opposed in principle to including some information about trends in the article, assuming of course that good sources can be found and presented neutrally, but I wonder whether the lead is the right place for this information. I'm not confident of finding strong secondary sources (there are few reliable sources on prevalence, let alone its derivative), and what information there is may be complicated to summarise in a few words. Jakew (talk) 11:18, 23 January 2012 (UTC)
My thinking here is that since we've integrated professional opinions in the lead (how the WHO has recommended circumcision in high risk areas, and also how no existing professional association of physicians recommend routine circumcision), it might be of benefit to show readers what the general trends have been in the areas these professional opinions are being applied to. Therewillbefact (talk) 17:26, 23 January 2012 (UTC)
However, the only reason the statement from the (relatively small) Royal Dutch Medical Association is in the lede is because it was the strongest (apparently) anti-circumcision statement that editors could find from any medical body. (Before that, it was a similar statement from the American Medical Association, but as it was from 1999, and therefore missed all the big HIV/AIDs studies, it got so long in the tooth as to be embarassing, even for its most ardent defenders). It's not really a ringing endorsement for having it there, or for adding similar ones. Rather, one should figure out what (if anything) to add to the body of the article, and then decide if it should be summarized in the lede. Jayjg (talk) 18:56, 23 January 2012 (UTC)
I do think that the lead neglects to acknowledge a controversy that exists over whether circumcision is an appropriate treatment for many cases of the conditions that are described in the second paragraph of the lead ("balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and urinary tract infections"). There is no mention of a controversy among health professionals regarding the merits of circumcision as an appropriate treatment option for the conditions I just listed in very many cases; nowhere is it mentioned in the lead that health professionals - in numbers that justify controversial figures - would oppose to circumcision as appropriate for many cases of phimosis, as well as balanitis xerotica obliterans, for instance. Here's another regarding phimosis. And here's another, and another, and another. I would be happy to provide more citations should you believe that highlighting this controversy would fall in line with fringe or undue figures for the purpose of what to include in the lead. We should draw attention to the controversy that does exist over whether circumcision is an appropriate procedure for many of the cases of the conditions, being that are they are comprehensively provided in the second paragraph.Therewillbefact (talk) 07:25, 24 January 2012 (UTC)
Unless I'm greatly mistaken, none of the sources you cite contradict the statement in the article ("Circumcision is also used therapeutically, as one of the treatment options for [...]" [emph added]). Many of the sources you cite describe circumcision being used to treat these conditions among some of their patients; the last source you cite explicitly states "The standard practice for preputial disorders remains circumcision". The source you cite for balanitis xerotica obliterans is perplexing, because it states: "The preferred treatment for BXO has been circumcision, which will remove all the affected tissue."
I would agree that there is controversy over whether circumcision is the preferred treatment for many of these conditions, and it would simply be incorrect to state that it is the only treatment, but since the article does not make either of these statements, I don't see where the problem lies. Jakew (talk) 09:38, 24 January 2012 (UTC)
I noticed that the source for ("balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and urinary tract infections.[11]") is not index by PubMed. I have seen no articles from Clin Ped Emerg Med (journal from [11]) in Pub Med either. The source also says circumcision is a last resort option to phimosis, only recommends a circumcision consultation for reccurent UTI, posthitis and balanoposthitis. The source does recommend balanitis xerotica obliterans where it is the preferred treatment.
Overall, I'm going to have to say its a poor source and the sentence itself is slightly misrepresented of the source. I can see acknowledging it as a medical procedure, but we need proper sources, and should make sure to acknowledge if its routine or a last line of defense, much the way articles referring to pharmaceutical treatments do.Gsonnenf (talk) 17:16, 24 January 2012 (UTC)
I think the mistake you're making is to look at whether the source recommends circumcision in particular circumstances. But that isn't the issue here. The issue is whether the source documents that circumcision occurs for these reasons. By weak analogy, imagine a source on road traffic accidents, containing both statistics and recommendations. It would hardly misrepresent the source to say that a number of deaths occurred, even though the source will doubtless take the position that the number of deaths should be lower.
As for the source itself, it doesn't seem to say anything particularly surprising. It's reasonably easy to find other sources confirming it. Bhattacharjee, for example, says: "Most paediatric urologists recommend circumcision for acquired phimosis, paraphimosis, recurrent balanitis and in boys with recurrent urinary tract infections." And Holman and Stuessi state: "Medical indications for this procedure include phimosis, paraphimosis, recurrent balanitis and posthitis (inflammation of the prepuce)." So there doesn't seem to be any real doubt that it is used, at least sometimes, for treating these conditions. Jakew (talk) 18:33, 24 January 2012 (UTC)
"World circumcision has decreased as a protective practice because of improved hygiene and the lack of unanimous consent on the usefulness of protective circumcision, despite recent studies demonstrating a role in HIV prevention.[x]" Gsonnenf, I agree with your sentence for the article. It's objective and honest. Robert B19 (talk) 18:21, 24 January 2012 (UTC)
Robert B19, I think you would find it helpful to review Wikipedia's three core content policies, WP:NPOV, WP:NOR, and WP:V. The process that should be followed is to a) find out what reliable sources say on a topic, b) summarize their view in the article, and finally c) summarize that still further in the lede, if warranted. The process is certainly not what you seem to be recommending here, which is a) decide what you think is an important TRUTH™, b) put it in the lede, and c) find a source to support it. Jayjg (talk) 19:55, 24 January 2012 (UTC)
Since the majority of circumcisions have NOTHING to do with HIV prevention (especially if one believes that the rates are declining - what from some higher % before HIV was even noted?), so such a sentence is not only false, but misleading as well. Carlossuarez46 (talk) 06:55, 25 January 2012 (UTC)
I don't see any wp:npov, wp:pov, wp:v in Roberts statement. Lets stop biting people and wiki lawyering! He has read the thread, therefore knows its from a secondary source. Its NOT original research, its a slightly shortened version of the source sentence that conveys the exact same meaning. It is verifiable because it comes from an PubMed secondary source! Robert was agreeing its a decent summary. Lets stop the wiki lawyering, especially when there is NOTHING to wiki lawyer as in Roberts sentence! Gsonnenf (talk) 16:59, 25 January 2012 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────If Robert has read the thread, then he'll know there are a number of issues with the source. As has already been pointed out, among other issues, it's making a problematic claim, we haven't seen the detail (just an abstract), and the authors are not experts on worldwide circumcision rates. WP:RS and WP:REDFLAG are obvious concerns. Jayjg (talk) 20:59, 25 January 2012 (UTC)

I have to agree with Gsonnenf. Quibbling over the inclusion of a reliable source is exactly why Wikipedia has flagged this articles objectivity. Robert B19 (talk) 17:09, 28 January 2012 (UTC)
Please respond directly to the issues raised. Thanks. Jayjg (talk) 01:24, 29 January 2012 (UTC)
The source does not produce an exceptional claim. It should be included unless we find a non-synth reason that it shouldn't be included. Also JakeW, please do not remove neutrality templates when there is an obvious neutrality discussion going on here. Gsonnenf (talk) 18:57, 28 January 2012 (UTC)
Not only is the source not reliable for the claims it make, and not only have we still not seen what the source actually says on the topic, but the source quite obviously makes an exceptional claim, as noted above. Please make more accurate and relevant Talk: page statements, and please don't insert inappropriate tags. Jayjg (talk) 01:24, 29 January 2012 (UTC)
It just seems all wrong. I LOLed at the idea of a wiki lawyer arguing this case. My comment was based on common sense and liberal values, not a detailed familiarity with wiki rules. Robert B19 (talk) 03:57, 30 January 2012 (UTC)
It helps to understand that we do have a responsibility to our readers, and the various policies are intended to support that. Jakew (talk) 10:31, 30 January 2012 (UTC)

Relative RIsk

This sentence, "Researchers have reported that the risk of penile cancer is greater in never-circumcised men than in men who had been circumcised at birth; estimates of the relative risk include 3[115] and 22.[116]", should explain what RR means in this context, point to the relative risk article, or both. As is, the casual reader won't know what those numbers mean. Perhaps someone could change it, I cannot. Randomnonsense (talk) 23:35, 30 January 2012 (UTC)

Good point. Done. Jakew (talk) 09:26, 31 January 2012 (UTC)

RACP position update (2010 version)

The RACP position has been updated as of September 2010, and the 2004 version is no longer on the website of the RACP. As such, I have updated the citation with the new version, and have brought the executive summary in its entirety, without any textual decorations that are not evident in the original text. The position has not changed dramatically, and remains that the existing medical evidence for positive results is offset by potential complications, and it still does not recommend routinge infant circucision, but it leaves the decision to the parents. However, the RACP's text seems somewhat less emphatic. Where it used to be "there is no medical indication for routine neonatal circumcision," it now is "After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons." However, I believe that the entire executive summary may be a bit much for the footnote, and perhaps we can prune some things. On the other hand, as this article is contentious in the extreme, we may be better off leaving the unadulterated text in the footnote. Thoughts? -- Avi (talk) 05:16, 1 February 2012 (UTC)

Australian Medical Association position

To reflect the AMA, we bring have a quote from a 2007 news article from Haydn Walters, former head of the Tasmanian Branch of the Australian Medical Association, supporting a ban on non-medical or non-religious circumcision. Does this reflect the opinion of the Tasmanian AMA, let alone the AMA as a whole? More recently, in 2010, the AMA had an article published in its journal, MJA, which was very supportive of circumcision as a preventative measure against HIV (see PMID 20854234 Full text). Albeit an editorial, is it any more "editorial" than Professer Walters's statement? Should it be included for balance, or, what I think more appropriate, have neither of them as they are personal opinions and not the official positions of the medical bodies. -- Avi (talk) 05:51, 1 February 2012 (UTC)

Doing somewhat more research, I find no position statement on circumcision by the AMA. There are two articles, a warning against unecessary circumcision dated 2004, and the 2010 article recommending infant circumcision to prevent the spread of HIV listed above. The only official policy statement by the AMA that references circumcision is their position statement on Female Genital Mutilation, where they state rather clearly: "The AMA rejects the euphemism "female circumcision", sometimes used to describe the various forms of female genital mutilation, because the use of this phrase trivialises the severe and often irreparable physical and psychological damage occasioned to girls and women by these practices." This is another instance of where a national body indicates that the term "circumcision" is exclusive to males, for what it is worth. -- Avi (talk) 05:58, 1 February 2012 (UTC)

I think we can safely remove Walters' statement. If we consider the hypothesis that Walters was voicing AMA policy, it seems extremely unlikely. Why did they choose to make it public via the head of a local branch? Why did they not document their official policy in the time that has elapsed since? It seems much more probable that Walters was speaking for himself, perhaps speculating that his position might receive support. The section is entitled "Positions of medical associations", not "Positions of minor representatives of medical associations". Jakew (talk) 09:14, 1 February 2012 (UTC)
It was added by User:Blackworm on June 11, 2008 - and written in a much less NPOV way at the time.[5] You subsequently NPOVd it, but that didn't fix the fundamental issue. It might well be worthwhile to look for other such personal opinions presented as official positions. Jayjg (talk) 22:42, 1 February 2012 (UTC)

Removed as a personal opinion inappropriate for the section, if not the article. -- Avi (talk) 00:37, 2 February 2012 (UTC)

Primary sources again

User:Tftobin has started to add material from primary sources again,[6][7] despite a rather lengthy discussion recently explaining why, per WP:MEDRS, this article needed to stick to using review articles for any medical information. Tftobin, is there something about WP:MEDRS that you find confusing or to which you object? Jayjg (talk) 23:26, 31 January 2012 (UTC)

Just as I may want to think about systematic reviews, you may wish to think about the impression you leave with a new (attempted) contributor. Issuing a citation for a 'three-revert rule', for my first undo, presumes that my 'behavior indicates that you intend to continue to revert repeatedly.' as you put it. This violates the presumption of good faith, and creates a hostile atmosphere. It is very heavy-handed, and not exactly encouraging of open discourse. Your intent may not be to repress, but that is certainly what is being conveyed.Tftobin (talk) 14:34, 1 February 2012 (UTC)
Actually, you reverted twice, Tftobin. Your original edit was reverted by Yobol, which you then reverted once (reverted by me), and then a second time (reverted by Jayjg). Rather than attempting to force the change, it would have been preferable to understand why it had been reverted, asking here on the talk page if necessary.
Incidentally, to clear up some apparent confusion[8][9], we cite peer-reviewed papers in medical journals. PubMed is a database of citations and abstracts, and for convenience we often link to these, but the citation is always to the journal article. (This is a subtle distinction, but an important one.) Now, some of the papers indexed by PubMed are suitable for use as sources, and others are not. Wikipedia generally prefers secondary sources, such as reviews (ideally systematic reviews, though narrative reviews are also acceptable), rather than primary sources. The study which you've been adding is a primary source, documenting specific data among one group of participants in Zambia. A secondary source would take this source and others, and would place the information in context. A systematic review would systematically obtain and review data on the early resumption of sex following circumcision, and would be able to provide data about what was typical across different study populations. Jakew (talk) 14:50, 1 February 2012 (UTC)
Thank you, Jake, for the clear explanation. I had inquired on your talk page. In the future, if there is one, I will ask here.Tftobin (talk) 15:25, 1 February 2012 (UTC)
Would an article published in the International Journal of Epidemiology, and also published in a peer-reviewed journal be acceptable? Tftobin (talk) 02:45, 3 February 2012 (UTC)
"Also published"? I don't understand what you mean. The International Journal of Epidemiology is a peer-reviewed journal that publishes both reviews and primary research articles, so the best answer is that some articles published in Int J Epidemiol are suitable for use as sources. If you want to identify a particular article, I'd be happy to comment on it. Jakew (talk) 09:19, 3 February 2012 (UTC)
Is every source you cite peer-reviewed, or have any of them been primary research articles? Tftobin (talk) 12:56, 3 February 2012 (UTC)
The question isn't meaningful. You've presented it as though sources are either a) peer-reviewed or b) primary research, but never both. In fact, most primary research articles are peer-reviewed. What we're looking for is articles that are a) peer-reviewed, and b) secondary sources.
I'll try to answer anyway. Most sources cited in this article are peer-reviewed, and most are secondary. That said, there are a few non-peer-reviewed sources, eg., a web page by the American Cancer Society [ref 117] that's cited in the penile cancer section. There are also a few primary sources (eg., refs 115 and 116 in the same section). Many of these were inserted some time ago, when the standards for sourcing were lower. We're looking to replace them with more suitable sources, but unfortunately it won't happen overnight. Jakew (talk) 13:27, 3 February 2012 (UTC)
So, in essence, their are two tiers of standards. One is grandfathered. To give you more information, the article in mind has been published in a place which says that every article is peer-reviewed. From what I can see, it appears to be a primary source. Was that Schoen article which recently disappeared from the controversy section a secondary source? Thanks. Tftobin (talk) 14:55, 3 February 2012 (UTC)
In some contexts, Schoen's article would have been considered a secondary source (since he did summarise other sources), though not very strong one (since its purpose was to advocate for a point of view, rather than to dispassionately survey the literature). In the context in which it was cited, however, it was a primary source, since the focus was his point of view. That was the main reason why it was replaced. Jakew (talk) 15:56, 3 February 2012 (UTC)
Thank you, Jake. Tftobin (talk) 16:20, 3 February 2012 (UTC)
Jake, you seem to understand some finer points which I am unable to grasp yet. I'm asking for your help. What makes the article "http://whqlibdoc.who.int/publications/2007/9789241596169_eng.pdf" secondary? How do I find where it was peer-reviewed? I would guess that you would consider "http://www.medscape.com/viewarticle/753060" to be primary? If it was secondary, how could one find out? There seems to be a wall, where if you want to probe peer-reviewed sites, they require paid subscriptions to enter. If true, do others buy a subscription? Or are those who are unable simply left out of the activity? Thanks. Tftobin (talk) 17:43, 4 February 2012 (UTC)
The WHO article you mention is not, as far as I know, peer-reviewed, but it is an acceptable source per WP:MEDRS#Medical and scientific organizations. The article by Frisch et al is indeed a primary source. As a general rule of thumb, primary sources in medicine are those that directly include patients in an experiment or otherwise observe their characteristics. In contrast, secondary sources digest other sources (usually primary), analyse them together, and make conclusions that are hopefully more meaningful than those that can be drawn from a single, isolated study.
As for your other question, I usually use a combination of PubMed and Google Scholar to identify papers. If I need the full text of a paper I've found emailing the authors to ask for a PDF can be successful. Failing that, friends who work for universities can often obtain papers. If necessary I'll take a trip to my local medical library. If all else fails, I've been known to buy a paper online. Jakew (talk) 18:07, 4 February 2012 (UTC)
I appreciate the fact that you answered. The answer, rather than adding clarity, confuses me more. Wikipedia:Circumcision accepts primary sources, but only from a list of medical and scientific organizations per WP:MEDRS#Medical? When I used PubMed, I was told it was not an acceptable source, because the article was primary. The WHO document is OK, though primary, because it comes from a source listed in WP:MEDRS, but the Danish article is not, because it comes from the International Journal of Epidemiology, which is not a WP:MEDRS sanctioned source? Honestly, I am not trying to be difficult, or to give anyone a tough time. I am just trying to understand, and there seems to be some complex set of conditions which make some primaries OK, and others not OK, which is not easy to explain, and even harder to understand. Thanks. Tftobin (talk) 19:49, 4 February 2012 (UTC)
Tom, Int J Epidemiol is perfectly acceptable per WP:MEDRS, since it's a peer-reviewed journal. Most articles indexed by PubMed are also peer-reviewed. Some other sources, such as World Health Organisation documents, are also acceptable even though they're not peer-reviewed, because they're considered to be highly reputable.
Being peer-reviewed (or being published in a similarly reputable manner), however, is not enough by itself. A separate issue is the kind of article. Wikipedia prefers the type of article that summarises the results of research conducted by others. Please understand that the PubMed source you cited wasn't rejected because there's anything wrong with PubMed; it was rejected because it was the wrong kind of article. Similarly, there's nothing wrong with Int J Epidemiol.
So what we're looking for is an article of the right kind (secondary) and published in a suitable form (mostly peer-reviewed, with a few exceptions). Please, take a look at WP:MEDRS. It explains most of this in a very clear, readable style (much better than my attempts to explain, I'm sure), and it doesn't take very long to read. Jakew (talk) 20:58, 4 February 2012 (UTC)
I've read WP:MEDRS. It seems to be saying that it depends on the quality of the primary or secondary resource. Would it be permissible to use the aforementioned Danish article? Would it be permissible to quote from the Google Scholar article authored by Brian J Morris, Jake H Waskett, and Ronald H Gray, since it is secondary, even though not all of the authors are medical? I don't want to step on toes. I also don't want to repeatedly from sources which don't meet the standards here. I am truly trying to see if I understand where the boundaries lie, so I can submit with confidence, or not at all. Tftobin (talk) 00:17, 5 February 2012 (UTC)

Circumcision

Seriously,a human being is born with a foreskin. Is the absolutely unnecessary tradition of removing this part of a male anatomy a complete insult to evolution? It seems to me that generations of medical "experts" have been bending over backwards to justify this ridiculous procedure,even though they know it's all nonsense! I'm English,uncircumcised and so bloody glad to be. Jasont3671 (talk) 00:52, 30 January 2012 (UTC) Jasont3671 (talk) 00:52, 30 January 2012 (UTC)

Hi Jasont3671, welcome to Wikipedia. Unfortunately, personal anecdotes are not very effective for bringing about change in the content of an entry. This is to ensure that entries reflect reality instead of the opinions of a few editors. If you wish to give your views some credence for the purposes of affecting this entry, you are more than welcome to discuss it in this talk page with citations from reputable sources to advance your claims. We most prefer sources that are indexed by pubmed.com. Therewillbefact (talk) 01:22, 30 January 2012 (UTC)

Out of curiosity, is there a

infobox available, as there is with the violence against women infobox? If not, this might be a good place to begin with one, as this is the Western male version of FGM, with similar origins and aims (limited medical use aside). 69.5.157.1 (talk) 01:13, 31 January 2012 (UTC)

Circumcision generally isn't considered to be a form of violence, so your suggestion would be rather inappropriate. Jakew (talk) 09:27, 31 January 2012 (UTC)
I would respectfully disagree. When someone takes a blunt object, and uses it to separate two previously joined parts, that might be considered violent by most, if they thought about it. Tftobin (talk) 13:08, 3 February 2012 (UTC)
To paraphrase, you're essentially saying that "if I were given the chance to persuade people of my obviously right point of view, most people might agree with it". That's not the same thing as most people actually regarding circumcision as violent. Jakew (talk) 13:18, 3 February 2012 (UTC)
I'll thank you not to put words in my mouth. If you do, please put more correct ones. What I am saying is, if more people knew the medical procedure, and how the blunt object is used to tear the synchea, it might be considered violent, since it results in tearing apart two structures which were previously one. I treat you with courtesy, at least in here. Is it unrealistic to expect the same? Tftobin (talk) 14:51, 3 February 2012 (UTC)
However you wish to put it, you're considering a hypothetical scenario rather than the real world. Jakew (talk) 15:45, 3 February 2012 (UTC)
Beg to differ. This is the exact real world scenario with infant circumcision. Tftobin (talk) 16:18, 3 February 2012 (UTC)
When you start a sentence with "if more people knew..." you are presenting a hypothetical scenario. Jayjg (talk) 16:44, 3 February 2012 (UTC)
True, and a valid point. "If more people knew" is hypothetical. That an infant often endures the act of a blunt object separating the head from the foreskin by tearing the synchea is not hypothetical. Hence, something violent is happening. Tftobin (talk) 00:46, 4 February 2012 (UTC)
We've established that you believe that circumcision is violent, Tom. However, the issue is whether circumcision is generally considered to be an act of violence. Jakew (talk) 09:02, 4 February 2012 (UTC)
Generally considered by whom? Because male circumcision is a ancient religious practice that was very popular in Western Culture it would never be found as "abusive" or "violent" by a Westerner. They see it as normalised. However, Tftobin makes an excellent point that by its very definition it *is* an act of violence. More to the point it's an act of genital mutilation. It's merely being protected by "religion." The only reason Female Circumcision isn't referred to as such is because it was never an instrumental part of religious practice in the west.Celynn (talk) 09:10, 4 February 2012 (UTC)
This isn't the place to argue about whether it is or isn't violent. It's a place to hold constructive discussions about improving the article, consistent with our content policies. See WP:NOTAFORUM. Jakew (talk) 09:49, 4 February 2012 (UTC)
This treads close to 'a point was raised, which may be legitimate, but I don't want to discuss it'. Perhaps it is time that other participants coming at it with a fresh outlook took a look. Tftobin (talk) 17:16, 4 February 2012 (UTC)
I assure you, Tom, I love to debate, and it's taking considerable self-control to not discuss it. But this simply isn't the place to do so. Jakew (talk) 17:54, 4 February 2012 (UTC)
Would there be any harm, in having two other Wikipedia participants discuss it? Tftobin (talk) 19:40, 4 February 2012 (UTC)
The sole purpose of this talk page is to discuss improvements to the article, not our opinions about circumcision. --jpgordon::==( o ) 22:54, 4 February 2012 (UTC)
Exactly so. Tftobin, please review WP:NOTAFORUM. Jayjg (talk) 01:34, 5 February 2012 (UTC)
Pardon me. I had thought there was a context, since User talk:69.5.157.1 was discussing the possibility of an article about violence against men. My mistake. It won't happen again. — Preceding unsigned comment added by Tftobin (talkcontribs) 15:53, 5 February 2012 (UTC)
Might be a wee misunderstanding. When you wrote, "Would there be any harm, in having two other Wikipedia participants discuss it?", I interpreted "it" as meaning the question of "does circumcision equal violence" -- not "should there be a violence against men" page, to which my answer would be "sure, go dig up some good reliable sources and write an article". --jpgordon::==( o ) 19:28, 5 February 2012 (UTC)
...but please don't discuss it here - this is the Talk: page for discussing proposed changes to the circumcision article, not creating entirely new articles on different topics. Jayjg (talk) 22:33, 5 February 2012 (UTC)

"Many circumcisions are performed during adolescence for cultural or religious reasons"

This line originally said "most," but was recently changed by an editor.[10] We are supposed to go by reliable sources here, not what editors think is true, per WP:Verifiability. If the editor has a source as good as the one this line is supported by showing something different, then the editor should provide the source and decide on the best way to include the conflicting reports. Not change sourced material based on personal opinion. 31.193.138.223 (talk) 22:02, 3 February 2012 (UTC)

Yes, that was me. We need a more reliable source considering it is debateable whether most circumcisions are performed during adolescence. Pass a Method talk 11:44, 4 February 2012 (UTC)
Which sources debate it? Jakew (talk) 12:25, 4 February 2012 (UTC)
this and this one. Pass a Method talk 14:50, 4 February 2012 (UTC)
Can you quote the relevant passages, because I'm having trouble finding them? Jakew (talk) 15:04, 4 February 2012 (UTC)
most of these having been done during childhood, either soon after birth or prior to puberty 1st paragraph. 94% were circumcised in infancy Second paragraph in "Findings of the preliminary poll" section. Im sure there are more sources because its pretty unlikely that most circumcisions are performed after puberty which is what "adolescence" means. Pass a Method talk 15:17, 4 February 2012 (UTC)
You say that we need a better source for the "most" part of the line, but the source that is used - Bulletin of the World Health Organization (WHO) - is an excellent source. The "most of these" source you listed above even cites the WHO. Though not always accurate, I doubt that the WHO is giving inaccurate or conflicting information on this. I haven't read its source yet. We should read it and see exactly what it says about the topic of "most." It's likely that we have misread the line in the intro. I think that it may be trying to say that most circumcisions that happen in adolescence are for cultural or religious reasons, not that most circumcisions are done during adolescence. Like the sources you provided, I also believe that most circumcisions happen just after birth or at least before puberty (although I do point out that adolescence does not always equate to puberty). Either way, the information that most circumcisions happen just after birth/before puberty should be in the intro. It should be before the adolescence information. If the adolescence information is indeed referring to the time frame that most males get circumcisions in general, then it should be worded as "According to" and so on, so that both reports get representation and without confusing the readers. 107.22.79.57 (talk) 17:45, 4 February 2012 (UTC)
While it may be a reliabe source, reliable source can make mistakes. Although i dont feel strongly about this edit, it is unlikely the claim is true. Firstly, Muslims make up the majority of circumcisions and Muslims (per doctrine) get circumcised either as infants or as small children (before puberty). The next major groups are Jewish and Americanns. Per Jewish doctrine men must be crcumcised as babies. Most American males are also circumcised as infants. Therefore it is very unlikely this claim is true. We should therefore preferably seek another high quality source considering its a quistionable claim. My intital guess is that a vast majority of circumcisions happen at infancy or childhood, although im a little too busy to find the sources right now. Pass a Method talk 18:34, 4 February 2012 (UTC)
Read what I said again. I said that the WHO source is likely not even saying what you think it's saying. If you read the debated line again, you should be able to see that it may be saying that most circumcisions that happen in adolescence are for cultural or religious reasons, not that most circumcisions happen in adolescence. If so, if it's saying what I propose, then the text in the intro was simply worded badly by the person who added it and all you have to do is tweak the wording. This is why I said we should read the source to see exactly what it says about this piece of info. If it is claiming what you think it's claiming, then you should either add "most" back and then add the alternative report (using one or more of the sources you provided) beside it or remove the WHO source altogether and back the line with a source that says "many." My main issue is that changing text from "most" to "many" if the source says "most" is not right. I agreed that most circumcisions happen just after birth or at least before puberty. But I'm saying that Wikipedia text should be accurately supported by the sources. 107.22.79.57 (talk) 20:34, 4 February 2012 (UTC)
Ok, tweaked. I was thinking of tweaking it, but the sentence essentially repeats what the previous sentence said in a different way, so we might as well delete it. Pass a Method talk 21:21, 4 February 2012 (UTC)
I wouldn't say "many" is essentially the same thing as "most." I mean, that there's a difference is why you changed "most" to "many." And I didn't suggest that you remove the line altogether (I only suggested that you remove the source), but I'm okay with your having removed the entire line. I'm conflicted about what's left, though. All that's there about the topic now is "In some countries, circumcisions are more commonly performed during infancy." But if it's "most countries" and not "some," or rather "most circumcisions," we should add "most" with a source or two supporting it. But I'll leave that up to you guys. 107.22.79.57 (talk) 23:27, 4 February 2012 (UTC)
i will look for a source when i have time, im a bit busy now Pass a Method talk 23:52, 4 February 2012 (UTC)
Well, you already have a source for most circumcisions happening "either soon after birth or prior to puberty," so you could use that. But if you're looking for a source that only says "soon after birth" or "infancy," I understand. 107.22.79.57 (talk) 04:59, 5 February 2012 (UTC)

(unindenting) Unfortunately we can't use the "either soon after birth or prior to puberty" source, as it's self-published. But it seems likely that we should be able to find a reliable source on the subject. Here's what the WHO has to say:

  • Neonatal circumcision is common in Israel, the United States of America, Canada, Australia and New Zealand, and in much of the Middle East, Central Asia and West Africa, but is uncommon in East and southern Africa, where median age at circumcision varies from boyhood to the late teens or twenties. [...] There is no clearly prescribed age for circumcision in Islam, although the prophet Muhammad recommended it be carried out at an early age and reportedly circumcised his sons on the seventh day after birth (6). Many Muslims perform the rite on this day, although a Muslim may be circumcised at any age between birth and puberty. [...]The age at which circumcision is undertaken is determined by sociocultural and religious traditions, and it may occur from the neonatal period to the early twenties.[11] Jakew (talk) 09:38, 5 February 2012 (UTC)

Poor summary of controversies in the lead

The following sentence appears in the version of the lead current at the time of writing:

Specific controversies have included the health benefits and risks of the procedure,[19][18] ethical and legal considerations,[18] and the application of human rights principles to the practice.[20]

"health benefits", "risks of the procedure", "ethical and legal considerations" and "the application of human rights principles to the practice" are not "[s]pecific controversies". Additionally, "have included" implies something which occurred, and ended, in the past, which is misleading. Beejaypii (talk) 23:53, 5 February 2012 (UTC)

"Health benefits", "risks of the procedure", "ethical and legal considerations", and "application of human rights principles to the practice" are actually all quite specific, each covering a distinct topical area. Also, although I'm not an expert in grammar, I'm pretty sure "have included" is the present perfect tense, and therefore is a present (not past) tense. Regardless, what changes would you suggest? Jayjg (talk) 00:33, 6 February 2012 (UTC)
I think you've misunderstood. I'm not arguing that the items listed are not specific enough: I'm arguing that they are not controversies. A controversy involves at least two opposing positions. The phrases listed just refer to broad topic aspects.
I don't think it serves much purpose to start discussing syntax here, save to say that "present perfect" is not technically a tense but a combination of tense and "aspect", as the opening sentence of the article you linked makes clear. Additionally, your apparent assumption that the temporal reference included in the name of a tense (i.e. past, present, future) correlates closely and consistently with its temporal reference in a given example of usage is, though a common assumption amongst non-specialists, demonstrably mistaken. Why do you even try to formulate an argument about something you don't really understand ("...not an expert...", "...pretty sure..."), supported by a reference to an article you either haven't read or haven't understood, especially when you immediately distance yourself from that argument ("Regardless...")? It creates the impression of disagreeing just for the sake of being seen to disagree, which does not seem constructive.
My original point stands, and "have included" is misleading.
I suggest we revert back to the significantly more informative paragraph about arguments for and against, the one in this version of the lead. The current paragraph just simply asserts the existence of controversy, then provides a list of topic aspects which are erroneously described as "specific controversies", and it employs a misleading present perfect construct, implying that the "specific controversies" (which they obviously aren't) were once current but aren't any longer. And look how specific the HIV paragraph is: percentages, WHO position mentioned, cost-effectiveness mentioned, specific population and region of the world mentioned. I think it's time to put the POV tag back. Beejaypii (talk) 14:39, 6 February 2012 (UTC)

Done. Chevara (talk) 02:11, 7 February 2012 (UTC)

Disagree. The lead is supposed to be a summary, not a detailed exposition. As such, it correctly identifies the areas in which there is a controversy, and the rest is discussed in the body of the article where it can be discussed in detail. The entire lead is short; to expand the controversy section without expanding the rest of the lead would be WP:UNDUE as well. Yobol (talk) 15:14, 6 February 2012 (UTC)
Sorry. What do you disagree with specifically? I've made a number of points. Beejaypii (talk) 15:20, 6 February 2012 (UTC)
"I suggest we revert back to the significantly more informative paragraph about arguments for and against, the one in this version of the lead." Yobol (talk) 15:27, 6 February 2012 (UTC)
I see. It's just my suggestion that we revert back to the former version of the paragraph. So you're basically objecting to one of the potential outcomes of the discussions before those discussions have really taken place and arguments have been followed through to their conclusion?
"The lead is supposed to be a summary, not a detailed exposition." In what way was that former paragraph mentioned not a "summary" but a "detailed exposition"? And how does the current HIV paragraph stand in that respect? Just unqualified assertions on your part I'm afraid.
"...the rest is discussed in the body of the article where it can be discussed in detail." Same argument can be applied to aspects of the HIV paragraph, cost-effectiveness being a prime example.
"...to expand the controversy section without expanding the rest of the lead would be WP:UNDUE as well." That argument presupposes that the treatment of each aspect in the lead is currently finely balanced. It's just a way of saying that the lead is ok as it is (in your opinion) and therefore if we change something we'll have to change something else, which basically fails to address my specific criticisms of part of that lead.
"As such, it correctly identifies the areas in which there is a controversy..." What do you mean "correctly"? With what degree of accuracy? Also, areas of the topic are broadly referenced but described as "specific controversies", which is quite simply incorrect. Do you have anything to say about that?
Finally, just simply asserting that something is WP:UNDUE without specifically explaining why amounts to a broad, unsubstantiated assertion, and is of little value as an argument. Beejaypii (talk) 15:58, 6 February 2012 (UTC)
I am objecting to the proposal as I see no need for it and feel it would make the lead worse. If you did not want someone commenting on your proposal "before those discussions have really taken place and arguments have been followed through to their conclusion" you should have probably avoided making the proposal in the first place. Yes, adding details to the controversy section while leaving the health effects paragraph short would be placing more weight on the controversy than a discussion of the health effects, which would seem inappropriate here in a medical article (this isn't a controversy article). Yobol (talk) 16:06, 6 February 2012 (UTC)
I also disagree with the proposal to replace secondary sources with primary sources. Jakew (talk) 16:10, 6 February 2012 (UTC)
Anyone actually prepared to address the issues I've highlighted with respect to the paragraph in question?
"this isn't a controversy article..." It's not a financial article either Yobol, or a HIV article in fact, or an article about a part of Africa, but you don't seem to consider that a problem. Oh, and what's inappropriate about mentioning specific controversies in a medical article exactly (not one single controversy is currently mentioned, just phrases referencing aspects of the topic masquerading as such)? And Jakew, primary sources are not banned, nor are they universally preferable to secondary sourcessecondary sources universally preferable to primary. Perhaps you'd like to indicate why the primary sources in question are less preferable than preferable to the secondary sources the secondary sources you replaced with them with, or is your argument basically that they are primarysecondary sources so that's better, no matter what the comparative merits of their content and relevance to the paragraph in question? Additionally, primary sources aren't necessarily completely primary, nor are secondary sources necessarily completely secondary: it all depends what they are being used to substantiate. To argue as if they are is not a common sense approach in my opinion. It's difficult not to assume that you and others are striving to avoid any mention of any specific negative aspect of circumcision in the lead whilst concurrently trying to ensure that the HIV aspect is described with specific details. The POV tag should be reapplied, whether the article is intentionally POV or not, because it currently reflects the POV that specific controversies do not merit any description, but the HIV aspect deserves relatively detailed treatment, even down to financial considerations, in the lead. Beejaypii (talk) 20:12, 6 February 2012 (UTC)
There are plenty of specific controversial points listed, specifically that there is a medical risk-benefit controversy, ethical controversies and human rights controversies. As to your uninformed speculations about my intentions, you might do well to remember to focus on content, not the contributor. Yobol (talk) 20:30, 6 February 2012 (UTC)
"Health benefits", "risks of the procedure", "ethical and legal considerations", and "application of human rights principles to the practice" are all specific controversies, ones which are described in detail (including what the opposing positions are regarding them) in the article. Per WP:MEDRS, we are not going to replace secondary sources with primary ones. Per WP:LEDE, we are not going "summarize" in the lede material that is not actually used in the article. Jayjg (talk) 21:37, 6 February 2012 (UTC)
Sorry, but those phrases you list from the paragraph in question do not reference controversies. "Health benefits" are a type of benefits; "risks of the procedure" are types of risk; "ethical and legal considerations" are types of considerations; and "application of human rights principles to the practice" is the application of a particle set of principles to a particular practice. This is pretty basic semantics here. WP:MEDRS does not support your declaration: "we are not going to replace secondary sources with primary ones." That's an ill-thought out comment by you by the way. Sources have to be evaluated for suitability. It may be that more suitable secondary sources can be found. To declare that it will never happen, even though policies and guidelines don't actually prohibit it, comes across as a pre-emptive attempt to block a potentially valid edit from taking place before discussions have progressed and concluded. WP:LEDE doesn't clearly support your other declaration about material in the lead not used in the article. However, I'm sure there's plenty of controversy material in the article which can be summarised. The current paragraph, as it stands, doesn't even make sense, so it fails at summarising material which appears in the article, unless you can show me where "health benefits" are described as a controversy etc. I notice you fail to address my comments about the level of detail in the HIV paragraph. Beejaypii (talk) 23:31, 6 February 2012 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── The consensus established at this Talk: page was that we were going to abide by WP:MEDRS, which means relying on appropriate reliable secondary sources, and that we were also going to abide by WP:LEDE, which means that the lede summarizes the article, rather than introducing new material. Adding primary sources that are not even found in the article would be doing the exact opposite of that. The controversies described in this article are well and clearly summarized in the final sentence of the lede. Do you think its wording should be modified in some way to enhance the sentence's clarity? Jayjg (talk) 00:09, 7 February 2012 (UTC)

Re Beejaypii's observation: "have included" implies something which occurred, and ended, in the past, which is misleading. Beejaypii is correct: the present perfect is used when the time frame is not specific. From the lede's wording, we don't know which of the "controversies" still exist. If its current generalizations remain, the sentence should use the present perfect progressive which identifies the time frame, then the reader knows the controversies are unresolved. For example, "Specific controversies since 1951 (or in modern times) have included the health benefits and risks of the procedure,[19][18] ethical and legal considerations,[18] and the application of human rights principles to the practice.[20]" Without a time frame, the reader is led to believe the controversies were mostly in the past. http://www.myenglishteacher.net/present_perfect_progressive.html http://web2.uvcs.uvic.ca/elc/studyzone/410/grammar/ppvpast.htm Chevara (talk) 02:11, 7 February 2012 (UTC)
From your first link: "It is used to say that something started in the past, and it is still happening." (emphasis mine) Similar explanation in second link. They both note that the current wording suggests the controversies are currently ongoing, and not "ended" as you claim. As the grammar is correct, and tagging an entire article for grammar seems just a tad bit extreme, I will remove the tag. I suggest reading your own links before posting them to save everyone some time. Yobol (talk) 02:41, 7 February 2012 (UTC)
Tagging for a claimed problem with grammar or verb tenses is not just "a tad bit extreme", it's WP:DISRUPTIVE. It appears as if any excuse at all is being used to deface the article. If you think a different verb form is more accurate, then change the tense. Jayjg (talk) 03:23, 7 February 2012 (UTC)
If you do change the tense then please be careful that your changes are verifiable. The sources we cite don't support the statement that any of these controversies are current as of Feb 2012; only that they were current or had occurred in the recent past when they were written. I think it is best to aim for what might be termed "temporally ambiguous" wording, confirming that they have occurred in the past, while avoiding making an implication about whether they have ended. Jakew (talk) 09:05, 7 February 2012 (UTC)
Your acknowledgment that the wording was deliberate confirms Beejaypii's initial criticism of the sentence:
I think you've misunderstood. I'm not arguing that the items listed are not specific enough: I'm arguing that they are not controversies. A controversy involves at least two opposing positions. The phrases listed just refer to broad topic aspects.
I don't think it serves much purpose to start discussing syntax here, save to say that "present perfect" is not technically a tense but a combination of tense and "aspect", as the opening sentence of the article you linked makes clear. Additionally, your apparent assumption that the temporal reference included in the name of a tense (i.e. past, present, future) correlates closely and consistently with its temporal reference in a given example of usage is, though a common assumption amongst non-specialists, demonstrably mistaken. Why do you even try to formulate an argument about something you don't really understand ("...not an expert...", "...pretty sure..."), supported by a reference to an article you either haven't read or haven't understood, especially when you immediately distance yourself from that argument ("Regardless...")? It creates the impression of disagreeing just for the sake of being seen to disagree, which does not seem constructive.
My original point stands, and "have included" is misleading.
I suggest we revert back to the significantly more informative paragraph about arguments for and against, the one in this version of the lead. The current paragraph just simply asserts the existence of controversy, then provides a list of topic aspects which are erroneously described as "specific controversies", and it employs a misleading present perfect construct, implying that the "specific controversies" (which they obviously aren't) were once current but aren't any longer. And look how specific the HIV paragraph is: percentages, WHO position mentioned, cost-effectiveness mentioned, specific population and region of the world mentioned. I think it's time to put the POV tag back. Beejaypii
If I were to change the misleading tense of your sentence, it might imply acquiescence to the misleading nature of its entirety. Chevara (talk) 15:43, 7 February 2012 (UTC)
Would you care to explain why it "confirms" that criticism? By the way, if you want to refer to a previous post, just quote the timestamp. There's no need to waste space by repeating it in its entirety. Jakew (talk) 16:18, 7 February 2012 (UTC)
And what do you mean by "acknowledgment that the wording was deliberate"? Jayjg (talk) 18:22, 8 February 2012 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── Well, many of the points I've made have been ignored or misunderstood, and not for the first time on this talk page. No matter, I'll set them out again, but in stages this time, to avoid confusion. Let's start with these issues:

  • The supposed controversies listed in the current lead are not controversies: "Health benefits" are a type of benefits; "risks of the procedure" are types of risk; "ethical and legal considerations" are types of considerations; and "application of human rights principles to the practice" is the application of a particle set of principles to a particular practice.
  • The present perfect construct have included in "Specific controversies have included the health benefits and risks of the procedure,[19][18] ethical and legal considerations,[18] and the application of human rights principles to the practice.[20]" misleadingly implies that the "controversies" (see the preceding bullet point) which follow were current in the past but not any longer. Grammar is not the issue, it's the sense (semantics) of the chosen phrasing in the context in question which is the key.

Let's leave it there for the moment. Beejaypii (talk) 22:46, 7 February 2012 (UTC)

This change was discussed previously in "Rewrite of controversies paragraph" and the majority of users did not support the change. This change obviously did not meet the criteria of consensus and should be reverted.Gsonnenf (talk) 06:27, 8 February 2012 (UTC)
I fear you're mistaken. Consensus isn't based upon a simple majority, but for the sake of argument let's "count heads". Looking at the two discussions, I count four in favour of the change (Jakew (talk · contribs), Tftobin (talk · contribs), Jayjg (talk · contribs), and Yobol (talk · contribs)), and five opposed (Therewillbefact (talk · contribs), kyledueck (talk · contribs), Gsonnenf (talk · contribs), Beejaypii (talk · contribs) and Chevara (talk · contribs)). Even by that generous assessment, there's only the slightest majority opposing the change. Applying WP:MEAT, however, "In votes or vote-like discussions, new users may be disregarded or given significantly less weight, especially if there are many of them expressing the same opinion." I've made 14,410 edits, Tftobin has made 63, Jayjg has made 102,877, and Yobol has made 5,615. Therewillbefact has made 49 edits, kyledueck has made 78, Gsonnenf 438, Beejaypii 1,274 and Chevara 20. It should be clear from this that there is a strong association between inexperience with Wikipedia and opposing this change.
Returning to my initial point (and again quoting from WP:MEAT), "Consensus in many debates and discussions should ideally not be based upon number of votes, but upon policy-related points made by editors." In this case, the fact that MEDRS clearly states that "All Wikipedia articles should be based on reliable, published secondary sources" is fairly overwhelming. Jakew (talk) 10:12, 8 February 2012 (UTC)
I have no problem correcting sources to be WP:MEDRS, though changing the entire lead paragraph to something different that we find less informative is an issue when you only have minority support. Consensus does not go to the person with the most edits. Every person in this discussion likely believes they have the best points in the discussion. Declaring themselves winner of consensus because they think their points are the best is not consensus.
Also, be careful of WP:OWNER. As I understand it you have 13.5% of the edits on circumcision. Jayjg is #138 in total wikipedia edit counts. When you discount people because you don't think they are experienced, this can be offensive, drives users off and violates policy. People with moderate wiki edit counts are very capable of reading and interpreting policy and documentation, in fact many of us have been doing this for many years in our professional careers. Gsonnenf (talk) 11:31, 8 February 2012 (UTC)
Consensus notwithstanding, the paragraph doesn't even meet basic quality standards: it doesn't actually make sense. And MEDRS is a guideline, not a policy, by the way, and has the usual advice that "it is best treated with common sense, and occasional exceptions may apply." Additionally, it's a guideline about medical sources. Controversies associated with circumcision are not necessarily medical in many respects, so it's difficult to see how that guideline can be applied pedantically in this context anyway. Furthermore, MEDRS allows for the use of primary sources:
Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above (see: Wikipedia:No original research). When citing primary sources, particular care must be taken to adhere to Wikipedia's undue weight policy. Secondary sources should be used to determine due weight.
Given the advice from MEDRS about common-sense and the possibility of using primary sources, selectively and simplistically quoting from the guideline (e.g. "All Wikipedia articles should be based on reliable, published secondary sources") does not make sense: it's akin to reducing the guideline to a simple, 11 word assertion; it's significantly more complex than that, as it should be.
Are you prepared to comment on the points I make about the semantic issues with the paragraph in question Jakew? If nobody counters those points I think it will be reasonable to assume they are valid ones. Beejaypii (talk) 12:11, 8 February 2012 (UTC)
Ah, wp:medrs is only guideline? I had assumed it was policy because Jaysg and Jakew were treating it as policy. I certainly agree with you that wp:medrs should only apply to medical discussion and medical advice, and also with caution and common sense. Treating history, culture, social issues, etc as wp:medrs is obviously not appropriate. I've talked about application of wp:medrs before and how we need to use the entire policy, not just pieces. Gsonnenf (talk) 12:32, 8 February 2012 (UTC)
So, per "Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources" (and indeed per WP:NOR), we could not infer the existence of a controversy from these primary sources.
As for your points about the "semantic issues", your first point is concerned with the tense employed. I regard this as a moot point, since available sources do not support the use of the present tense. Your second point — that the items listed are not, strictly speaking, controversies — is trivial to address, and I've been waiting for your response to Jayjg's invitation to propose some changes to the wording. For example, we might change the language to read: "Specific controversies have involved [...]" If that's acceptable, please feel free to make the change. If it isn't, then do propose an alternative. Jakew (talk) 12:48, 8 February 2012 (UTC)
Beejaypii, Wikipedia guidelines should not be ignored without very good reason; thus far, none has been advanced. If you think the wording of the current paragraph is not explicit enough regarding the nature of the controversies mentioned in it, then (again) please suggest what wording should be added to make this more clear. Jayjg (talk) 18:22, 8 February 2012 (UTC)
Jayjg, Wikipedia guidelines should not be presented as far more restrictive than they actually are, which is what I drew attention to. To qualify that as ignoring the guideline in question is as simplistic as selecting one short quote from a whole guideline and behaving as if that quote represents a binding policy. Also, don't try to put words in my mouth please ("...you think [...] not explicit enough..."): I've argued consistently, on rational grounds, that the paragraph does not make sense. Finally, I don't have full access to two of the three sources currently used, so how can I assess their potential for use as substantiation for a hypothetical, properly cohesive paragraph? Beejaypii (talk) 01:17, 10 February 2012 (UTC)

I have been asked to provide my interpretation on WP:MEDRS and how it relates to this topic. We should try to use review articles and major textbooks for medical content regarding health effects. CheersDoc James (talk · contribs · email) 01:43, 9 February 2012 (UTC)

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  5. ^ Uthman, OA (2010 Mar 10). Van Baal, Pieter H. M., ed. "Economic Evaluations of Adult Male Circumcision for Prevention of Heterosexual Acquisition of HIV in Men in Sub-Saharan Africa: A Systematic Review". PloS one. 5 (3): e9628. PMC 2835757Freely accessible. PMID 20224784. doi:10.1371/journal.pone.0009628.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  6. ^ Sorrells, M.L. (2007). "Fine-touch pressure thresholds in the adult penis". BJU International. 99 (4): 864–869. PMID 17378847. doi:10.1111/j.1464-410X.2006.06685.x.  Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  7. ^ Krieger, JN (2008). "Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya". The Journal of Sexual Medicine. 5 (11): 2610–22. PMC 3042320Freely accessible. PMID 18761593. doi:10.1111/j.1743-6109.2008.00979.x.  Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  8. ^ Larke, N (2010 May 27 –Jun 9). "Male circumcision, HIV and sexually transmitted infections: a review". British journal of nursing (Mark Allen Publishing). 19 (10): 629–34. PMID 20622758.  Check date values in: |date= (help)
  9. ^ Eaton, L (2009 Nov). "Behavioral aspects of male circumcision for the prevention of HIV infection". Current HIV/AIDS reports. 6 (4): 187–93. PMID 19849961. doi:10.1007/s11904-009-0025-9.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  10. ^ Kim, HH (2010 Nov). "Male circumcision: Africa and beyond?". Current opinion in urology. 20 (6): 515–9. PMID 20844437. doi:10.1097/MOU.0b013e32833f1b21.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  11. ^ Templeton, DJ (2010 Feb). "Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men". Current opinion in infectious diseases. 23 (1): 45–52. PMID 19935420. doi:10.1097/QCO.0b013e328334e54d.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  12. ^ Larke, N (2010 May 27 – Jun 9). "Male circumcision, HIV and sexually transmitted infections: a review". British journal of nursing (Mark Allen Publishing). 19 (10): 629–34. PMID 20622758.  Check date values in: |date= (help)
  13. ^ Eaton, L (2009 Nov). "Behavioral aspects of male circumcision for the prevention of HIV infection". Current HIV/AIDS reports. 6 (4): 187–93. PMID 19849961. doi:10.1007/s11904-009-0025-9.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  14. ^ Kim, HH (2010 Nov). "Male circumcision: Africa and beyond?". Current opinion in urology. 20 (6): 515–9. PMID 20844437. doi:10.1097/MOU.0b013e32833f1b21.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  15. ^ Templeton, DJ (2010 Feb). "Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men". Current opinion in infectious diseases. 23 (1): 45–52. PMID 19935420. doi:10.1097/QCO.0b013e328334e54d.  Unknown parameter |coauthors= ignored (|author= suggested) (help); Check date values in: |date= (help)
  16. ^ Wiysonge, CS.; Kongnyuy, EJ.; Shey, M.; Muula, AS.; Navti, OB.; Akl, EA.; Lo, YR. (2011). "Male circumcision for prevention of homosexual acquisition of HIV in men.". Cochrane Database Syst Rev (6): CD007496. PMID 21678366. doi:10.1002/14651858.CD007496.pub2.