Circumcision study flaws: Difference between revisions

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'''Circumcision study flaws''' are numerous. The medical literature relating to circumcision is influenced by the authors' religious and cultural views.<ref>{{REFweb
'''Circumcision study flaws''' are numerous. The medical literature relating to circumcision is influenced by the authors' religious and cultural views.<ref>{{REFweb
  |url=https://circumcision.org/cultural-and-medical-bias/
  |url=https://circumcision.org/cultural-and-medical-bias/
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  |first=
  |first=
  |accessdate=2020-08-02
  |accessdate=2020-08-02
}}</ref> Moreover. the circumcision status of male authors impacts their views.<ref name="hill2007">{{REFjournal
}}</ref> Moreover, the circumcision status of male authors impacts their views.<ref name="hill2007">{{REFjournal
  |last=Hill  
  |last=Hill  
  |first=G.
  |first=G.
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  |issue=3
  |issue=3
  |pages=318-323
  |pages=318-323
|doi=
}}</ref> <ref name="boyle2012>{{REFjournal
}}</ref> <ref name="boyle2012>{{REFjournal
  |last=Boyle
  |last=Boyle
  |first=Gregory J.
  |first=Gregory J.
  |author-link=
  |author-link=Gregory J. Boyle
  |last2=Hill
  |last2=Hill
  |first2=George
  |first2=George
  |author2-link=
  |author2-link=George Hill
  |etal=no
  |etal=no
  |title=Circumcision‐generated emotions bias medical literature
  |title=Circumcision‐generated emotions bias medical literature
|trans-title=
|language=English
  |journal=BJU Int
  |journal=BJU Int
|location=
  |date=2012
  |date=2012
  |volume=109
  |volume=109
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  |pages=E11
  |pages=E11
  |url=https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2012.10917.x
  |url=https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2012.10917.x
|archived=
|quote=
  |pubmedID=22313504
  |pubmedID=22313504
|pubmedCID=
  |DOI=10.1111/j.1464-410X.2012.10917.x
  |DOI=10.1111/j.1464-410X.2012.10917.x
  |accessdate=2020-08-02
  |accessdate=2020-08-02
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==Review of the circumcision literature==
==Review of the circumcision literature==


Bossio ''et al''. (2014) conducted a comprehensive review of the circumcision literature. They reported that most research was concentrated on finding a benefit for non-therapeutic circumcision and there were large gaps in the knowledge of the sexual health correlates of male circumcision, including:
Bossio ''et al.'' (2014) conducted a comprehensive review of the circumcision literature. They reported that most research was concentrated on finding a benefit for non-therapeutic circumcision and there were large gaps in the knowledge of the sexual health correlates of male circumcision, including:
* penile sensation
* penile sensation
* sexual functioning
* sexual functioning
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  |etal=no
  |etal=no
  |title=A review of the current state of the male circumcision literature
  |title=A review of the current state of the male circumcision literature
|trans-title=
|language=English
  |journal=J Sex Med
  |journal=J Sex Med
|location=
  |date=2014-12
  |date=2014-12
  |volume=11
  |volume=11
Line 74: Line 64:
  |pages=2847-64
  |pages=2847-64
  |url=https://www.researchgate.net/profile/Caroline_Pukall/publication/266564315_A_Review_of_the_Current_State_of_the_Male_Circumcision_Literature/links/59ed438a0f7e9bfdeb71aec7/A-Review-of-the-Current-State-of-the-Male-Circumcision-Literature.pdf
  |url=https://www.researchgate.net/profile/Caroline_Pukall/publication/266564315_A_Review_of_the_Current_State_of_the_Male_Circumcision_Literature/links/59ed438a0f7e9bfdeb71aec7/A-Review-of-the-Current-State-of-the-Male-Circumcision-Literature.pdf
|archived=
|quote=
  |pubmedID=25284631
  |pubmedID=25284631
|pubmedCID=
  |DOI=10.1111/jsm.12703  
  |DOI=10.1111/jsm.12703  
  |accessdate=2020-08-02
  |accessdate=2020-08-02
}}</ref>
}}</ref>


Bossio ''et al''. made three recommendations:
Bossio ''et al.'' made three recommendations:
 
1. That more rigours and consistent methodology be used.
 
2. Empirically rigorous studies of the physiological effects of neonatal circumcision are needed.


3. Psychosocial factors, including [[Sexual effects of circumcision| sexual correlates of circumcision]], should be studied.<ref name="bossio2014" />
# That more rigours and consistent methodology be used.
# Empirically rigorous studies of the physiological effects of neonatal circumcision are needed.
# Psychosocial factors, including [[Sexual effects of circumcision| sexual correlates of circumcision]], should be studied.<ref name="bossio2014" />


To carry out the recommendations of the authors it would be necessary to violate the [[human rights]] of more boys who would be permanently injured by non-therapeutic [[circumcision]].
To carry out the recommendations of the authors it would be necessary to violate the [[human rights]] of more boys who would be permanently injured by non-therapeutic [[circumcision]].
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  |last=Goldman
  |last=Goldman
  |first=Ronald
  |first=Ronald
  |author-link=
  |author-link=Ronald Goldman
  |etal=no
  |etal=no
  |title=Circumcision policy: A psychosocial perspective
  |title=Circumcision policy: A psychosocial perspective
|trans-title=
|language=
  |journal=Paediatrics & Child Health
  |journal=Paediatrics & Child Health
  |location=English
  |location=English
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  |pages=630-3
  |pages=630-3
  |url=https://academic.oup.com/pch/article/9/9/630/2648566
  |url=https://academic.oup.com/pch/article/9/9/630/2648566
|archived=
|quote=
  |pubmedID=19675851
  |pubmedID=19675851
  |pubmedCID=2724127
  |pubmedCID=2724127
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  |last=Boyle
  |last=Boyle
  |first=Gregory J.
  |first=Gregory J.
  |author-link=
  |author-link=Gregory J. Boyle
  |last2=Hill
  |last2=Hill
  |first2=George
  |first2=George
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  |pages=316-334
  |pages=316-334
  |url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf
  |url=http://www.salem-news.com/fms/pdf/2011-12_JLM-Boyle-Hill.pdf
|quote=
  |pubmedID=22320006
  |pubmedID=22320006
|pubmedCID=
|DOI=
  |accessdate=2020-07-31
  |accessdate=2020-07-31
}}</ref> claims that circumcision reduces the risk of HIV by 60 percent. The statement shows only limited understanding of the functions of the foreskin. While it recognizes the protective function, it does not recognize the immunological function or sexual function, and shows only limited understanding of the erogenous function. The RACP places parental preference above child human rights. Nevertheless, public hospitals in [[Australia]] have banned performance of non-therapeutic circumcisions<ref>{{REFnews
}}</ref> claims that circumcision reduces the risk of HIV by 60 percent. The statement shows only limited understanding of the functions of the foreskin. While it recognizes the protective function, it does not recognize the immunological function or sexual function, and shows only limited understanding of the erogenous function. The RACP places parental preference above child human rights. Nevertheless, public hospitals in [[Australia]] have banned performance of non-therapeutic circumcisions<ref>{{REFnews
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  |url=http://www.circinfo.org/news_2018.html#fall
  |url=http://www.circinfo.org/news_2018.html#fall
  |title=Foreskins rule! Australians rush to abandon circumcision
  |title=Foreskins rule! Australians rush to abandon circumcision
|trans-title=
|language=
|last=
|first=
|author-link=
  |publisher=Circumcision Information Australia
  |publisher=Circumcision Information Australia
|website=
  |date=2018
  |date=2018
  |accessdate=2020-03-31
  |accessdate=2020-03-31
|format=
|quote=
}}</ref> The RACP needs to update this backward-looking, outmoded statement.
}}</ref> The RACP needs to update this backward-looking, outmoded statement.


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  |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf?sfvrsn=eaa32f1a_10
  |url=https://www.racp.edu.au//docs/default-source/advocacy-library/circumcision-of-infant-males.pdf?sfvrsn=eaa32f1a_10
  |title=Circumcision of infant males
  |title=Circumcision of infant males
|last=
|first=
|author-link=
  |publisher=Royal Australasian College of Physicians
  |publisher=Royal Australasian College of Physicians
|website=
  |date=2010-09
  |date=2010-09
  |accessdate=2020-07-31  
  |accessdate=2020-07-31  
  |format=PDF
  |format=PDF
|quote=
}}
}}


=== Canada ===
=== Canada ===
The [[Canadian Paediatric Society]] (2015) issued a new statement regarding non-therapeutic circumcision of boys. This statement was prompted by the three seriously flawed HIV studies of adult males in Africa, that have now been disproved,<ref name="boyle-hill2011" /> and caused the retirement of the excellent previous 1996 statement.<ref name="cps1996">{{REFjournal
The [[Canadian Paediatric Society]] (2015) issued a new statement regarding non-therapeutic circumcision of boys. This statement was prompted by the three seriously flawed HIV studies of adult males in Africa, that have now been disproved,<ref name="boyle-hill2011"/> and caused the retirement of the excellent previous 1996 statement.<ref name="cps1996">{{REFjournal
  |last=Outerbridge
  |last=Outerbridge
  |first=Eugene
  |first=Eugene
Line 195: Line 160:
  |pages=769-80
  |pages=769-80
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1487803/
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1487803/
|quote=
  |pubmedID=8634956
  |pubmedID=8634956
  |pubmedCID=1487803
  |pubmedCID=1487803
|DOI=
  }}</ref>
  }}</ref>


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  |pages=311-20
  |pages=311-20
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4578472/
|quote=
  |pubmedID=26435672
  |pubmedID=26435672
  |pubmedCID=4578472
  |pubmedCID=4578472
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  |accessdate=2020-07-31
  |accessdate=2020-07-31
}}
}}


The [http://www.cua.org/en Canadian Urological Association] (2018) issued a 24-page guideline on the care of the normal foreskin and neonatal circumcision. The statement is very comprehensive and covers treatment of various diseases and deformities as well as discussing non-therapeutic circumcision of boys in Canada. Our comments are restricted to the discussion of non-therapeutic circumcision.  
The [http://www.cua.org/en Canadian Urological Association] (2018) issued a 24-page guideline on the care of the normal foreskin and neonatal circumcision. The statement is very comprehensive and covers treatment of various diseases and deformities as well as discussing non-therapeutic circumcision of boys in Canada. Our comments are restricted to the discussion of non-therapeutic circumcision.  
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  |pages=E76-99
  |pages=E76-99
  |url=http://www.cua.org/themes/web/assets/files/g49_en_circumcision-new_logo_am.pdf
  |url=http://www.cua.org/themes/web/assets/files/g49_en_circumcision-new_logo_am.pdf
|archived=
|quote=
  |pubmedID=29381458
  |pubmedID=29381458
  |pubmedCID=http://www.ncbi.nlm.nih.gov/pmc/articles/pmc5937400/
  |pubmedCID=http://www.ncbi.nlm.nih.gov/pmc/articles/pmc5937400/
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  |url=http://www.cirp.org/library/legal/smith/
  |url=http://www.cirp.org/library/legal/smith/
  |title=Male Circumcision and the Rights of the Child
  |title=Male Circumcision and the Rights of the Child
|trans-title=
|language=
  |last=Smith
  |last=Smith
  |first=Jacqueline
  |first=Jacqueline
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  |date=1998
  |date=1998
  |accessdate=2020-02-04
  |accessdate=2020-02-04
|format=
|quote=
}}</ref> so it should be no surprise that the statement emphasizes the protection of the human rights of male minors and the reduction in the number of non-therapeutic circumcisions of children as much as possible. It finds no medical purpose for child non-therapeutic circumcision.
}}</ref> so it should be no surprise that the statement emphasizes the protection of the human rights of male minors and the reduction in the number of non-therapeutic circumcisions of children as much as possible. It finds no medical purpose for child non-therapeutic circumcision.


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  |archived=
  |archived=
  |title=Non-therapeutic circumcision of male minors
  |title=Non-therapeutic circumcision of male minors
|trans-title=
|language=English
  |last=Kruseman
  |last=Kruseman
  |first=Arie
  |first=Arie
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  |accessdate=2020-07-31
  |accessdate=2020-07-31
  |format=PDF
  |format=PDF
|quote=
}}
}}


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* {{REFweb
* {{REFweb
  |url=https://www.bma.org.uk/media/1847/bma-non-therapeutic-male-circumcision-of-children-guidance-2019.pdf
  |url=https://www.bma.org.uk/media/1847/bma-non-therapeutic-male-circumcision-of-children-guidance-2019.pdf
|archived=
  |title=Non-therapeutic male circumcision (NTMC) of children – practical guidance for doctors  
  |title=Non-therapeutic male circumcision (NTMC) of children – practical guidance for doctors  
|last=
|first=
|author-link=
  |publisher=British Medical Association
  |publisher=British Medical Association
  |website=www.bma.org.uk
  |website=www.bma.org.uk
  |date=2019
  |date=2019
  |format=PDF
  |format=PDF
|quote=
}}
}}


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  |author-link=
  |author-link=
  |last2=Masi
  |last2=Masi
  |first2=CM
  |first2=C.M.
  |author2-link=
  |author2-link=
  |last3=Zuckerman
  |last3=Zuckerman
  |first3=EW
  |first3=E.W.
  |author3-link=
  |author3-link=
  |etal=no
  |etal=no
  |title=Circumcision in the United States
  |title=Circumcision in the United States
  |journal=JAMA
  |journal=JAMA
|location=
  |date=1997
  |date=1997
  |volume=277
  |volume=277
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  |pages=1052-7
  |pages=1052-7
  |url=http://www.cirp.org/library/general/laumann/
  |url=http://www.cirp.org/library/general/laumann/
|archived=
|quote=
  |pubmedID=9091693
  |pubmedID=9091693
|pubmedCID=
|DOI=
|accessdate=
}}</ref> As a result, many Americans have never seen a human foreskin and most are profoundly ignorant of its care, purposes, and functions.
}}</ref> As a result, many Americans have never seen a human foreskin and most are profoundly ignorant of its care, purposes, and functions.


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  |last=Bollinger
  |last=Bollinger
  |first=Dan
  |first=Dan
  |author-link=
  |author-link=Dan Bollinger
|publisher=
  |website=https://www.academia.edu
  |website=https://www.academia.edu
  |date=2012
  |date=2012
  |accessdate=2019-10-23
  |accessdate=2019-10-23
|format=
  |quote=As they saying goes, follow the money. Now you know why neither the American Academy of Pediatrics, American Medical Association, American Academy of Family Physicians, or the American College of Obstetricians and Gynecologists haven’t condemned this unnecessary surgery, and why their physician members are quick to recommend the procedure to expectant parents.
  |quote=As they saying goes, follow the money. Now you know why neither the American Academy of Pediatrics, American Medical Association, American Academy of Family Physicians, or the American College of Obstetricians and Gynecologists haven’t condemned this unnecessary surgery, and why their physician members are quick to recommend the procedure to expectant parents.
}}</ref> Non-therapeutic circumcision of boys has become the proverbial ''Goose That Lays Golden Eggs'',<ref>{{REFweb
}}</ref> Non-therapeutic circumcision of boys has become the proverbial ''Goose That Lays Golden Eggs'',<ref>{{REFweb
  |url=http://www.read.gov/aesop/091.html
  |url=http://www.read.gov/aesop/091.html
|archived=
  |title=The Goose and the Golden Egg
  |title=The Goose and the Golden Egg
|trans-title=
|language=English
  |last=Æsop
  |last=Æsop
  |first=
  |first=
|author-link=
  |publisher=Library of Congress
  |publisher=Library of Congress
  |website=http://www.read.gov
  |website=http://www.read.gov
|date=
  |accessdate=2020-08-02
  |accessdate=2020-08-02
|format=
|quote=
}}</ref> so there is intense interest in keeping the Goose alive.
}}</ref> so there is intense interest in keeping the Goose alive.


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  |last=Bailey
  |last=Bailey
  |first=R.C.
  |first=R.C.
|author-link=Robert C. Bailey
  |last2=Moses
  |last2=Moses
  |first2=S.
  |first2=S.
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  |last=Gray
  |last=Gray
  |first=R.H.
  |first=R.H.
|author-link=Ronald H. Gray
  |last2=Kigozi
  |last2=Kigozi
  |first2=G.
  |first2=G.
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  |pages=657-666
  |pages=657-666
}}</ref> it was announced in 2007 that the [[American Academy of Pediatrics]] (AAP) would take the lead, in association with the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] (ACOG) and the [[American Academy of Family Physicians]] {AAFP}, these being the three trade associations (stakeholders) whose members perform most of the non-therapeutic circumcisions, in developing a new circumcision policy for America.<ref>{{REFjournal
}}</ref> it was announced in 2007 that the [[American Academy of Pediatrics]] (AAP) would take the lead, in association with the [[American Congress of Obstetricians and Gynecologists| American College of Obstetricians and Gynecologists]] (ACOG) and the [[American Academy of Family Physicians]] {AAFP}, these being the three trade associations (stakeholders) whose members perform most of the non-therapeutic circumcisions, in developing a new circumcision policy for America.<ref>{{REFjournal
|last=
|first=
|author-link=
  |title=AAP reviews policy on circumcision
  |title=AAP reviews policy on circumcision
  |journal=Relias Media
  |journal=Relias Media
  |date=2007-06-01
  |date=2007-06-01
|volume=
|issue=
|pages=
  |url=https://www.reliasmedia.com/articles/103802-aap-reviews-policy-on-circumcision?v=preview
  |url=https://www.reliasmedia.com/articles/103802-aap-reviews-policy-on-circumcision?v=preview
  |accessdate=2020-08-02
  |accessdate=2020-08-02
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  |title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement
  |title=Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement
  |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf
  |url=https://www.doctorsopposingcircumcision.org/wp-content/uploads/2016/08/commentary-on-american-academy-of-pediatrics-2012-circumcision-policy-statement.pdf
|contribution=
  |last=Hill
  |last=Hill
  |first=George
  |first=George
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  |last=Blank
  |last=Blank
  |first=Susan
  |first=Susan
  |author-link=
  |author-link=Susan Blank
  |last2=Brady
  |last2=Brady
  |first2=Michael
  |first2=Michael
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  |last5=Diekema
  |last5=Diekema
  |first5=Douglas
  |first5=Douglas
  |author5-link=
  |author5-link=Douglas Diekema
  |last6=Freedman
  |last6=Freedman
  |first6=Andrew
  |first6=Andrew
  |author6-link=
  |author6-link=Andrew Freedman
  |last7=Maxwell
  |last7=Maxwell
  |first7=Lynne
  |first7=Lynne
Line 489: Line 416:
  |first8=Steven
  |first8=Steven
  |author8-link=
  |author8-link=
|last9=
|first9=
|author9-link=
  |etal=no
  |etal=no
  |title=Circumcision Policy Statement
  |title=Circumcision Policy Statement
  |journal=Pediatrics
  |journal=Pediatrics
|location=
  |date=2012-09-01
  |date=2012-09-01
  |volume=130
  |volume=130
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  |pages=585-6
  |pages=585-6
  |url=https://pediatrics.aappublications.org/content/130/3/585
  |url=https://pediatrics.aappublications.org/content/130/3/585
|archived=
|quote=
  |pubmedID=22926180
  |pubmedID=22926180
  |pubmedCID=
  |pubmedCID=
Line 515: Line 436:
  |title=Male Circumcision
  |title=Male Circumcision
  |journal=Pediatrics
  |journal=Pediatrics
|location=
  |date=2012-09-01
  |date=2012-09-01
  |volume=130
  |volume=130
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  |pages=e756-85
  |pages=e756-85
  |url=https://pediatrics.aappublications.org/content/130/3/e756
  |url=https://pediatrics.aappublications.org/content/130/3/e756
|archived=
|quote=
  |pubmedID=22926175
  |pubmedID=22926175
  |pubmedCID=
  |pubmedCID=