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=== American bias ===
=== American bias ===
Because the United States circumcises so many of its male infants, [[circumcision]] is often said to be an American cultural value, and it is accepted as “normal.” Cultural bias on this issue may be most obvious when considering the practice of female circumcision in Africa. Americans regard the practice with horror, the way Europeans, who do not cut the genitals of male or females, regard American circumcision.<ref name='CRC 2011-03-06'>{{REFweb
 
{{Citation
|Title=
|Text=Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice. It is important to acknowledge that researchers' personal biases and the dominant circumcision practices of their respective countries may influence their interpretation of findings.
|Author=Siegfried ''et al''.
|Source=
|ref=<ref>{{REFjournal
|last=Siegfried
|etal=yes
|title=Male circumcision for prevention of heterosexual acquisition of HIV in men
|journal=Cochrane Library
|volume=3
|date=2003</ref>
}}
 
Because the United States circumcises so many of its male infants, [[circumcision]] is often said to be an American cultural value, and it is accepted as “normal.” Cultural bias on this issue may be most obvious when considering the practice of female circumcision in Africa. Americans regard the practice with horror, the way Europeans, who do not cut the genitals of male or females, regard American circumcision.<ref name="CRC2011-03-06">{{REFweb
  |last=
  |last=
  |first=
  |first=
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}}</ref>
}}</ref>


American bias in favor of circumcision could be attributed to a number of different factors. The history of circumcision in America goes back more than a century, when it began as a way to curb [[masturbation]] in boys and men.<ref name='Stay Free!'>{{REFweb
American bias in favor of circumcision could be attributed to a number of different factors. The history of circumcision in America goes back to the Nineteenth Century, when it began as a way to curb [[masturbation]] in boys and men.<ref name='Stay Free!'>{{REFweb
  |quote=The operation should be performed by a surgeon without administering an anesthetic...
  |quote=The operation should be performed by a surgeon without administering an anesthetic...
  |last=McLaren  
  |last=McLaren  
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  |url=http://www.ibiblio.org/stayfree/10/graham.htm
  |url=http://www.ibiblio.org/stayfree/10/graham.htm
  |accessdate=2011-03-06
  |accessdate=2011-03-06
}}</ref> Thereafter American doctors began on a quest to medicalize the practice of circumcision as a preventer of a myriad of diseases, and that endeavor continues to this day. There is a huge bias in favor of non-therapeutic and therapeutic circumcision in the American medical literature.<ref name="fleiss1999">{{REFbook
}}</ref> Thereafter American doctors began on a quest to medicalize the practice of circumcision as a preventer of a myriad of diseases, and that endeavor continues to this day.  
 
===Media bias===
 
Another factor that plays a role in instilling bias in favor of circumcision in America is the local media. American television and theater treats the presence of the [[foreskin]] with ridicule and disdain, and praises circumcision as "clean" and "healthy," and news outlets are always ready to publish the latest "study" (usually conducted by American "researchers") that shows circumcision might have some kind of "benefit." Editors may also believe that American audiences, who already believe circumcision is beneficial, will want to read stories reinforcing their cultural assumptions. By contrast, a study showing no benefit (or even negative findings), may not be considered "news" by editors if their audience is expected to have little interest. Tabloid-type media especially may not want anything other than simplistic stories. Discussions carefully evaluating the validity of conflicting findings may be off-puttingly complex and not especially interesting to the reader who already believes circumcision as healthy, and see no need for further debate. These stories therefore might be less likely to be published.
 
===Medical literature bias===
 
There is a huge bias in favor of non-therapeutic and therapeutic circumcision in the American medical literature.<ref name="fleiss1999">{{REFbook
  |last=Fleiss
  |last=Fleiss
  |first=Paul  
  |first=Paul  
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}}</ref>
}}</ref>


Another factor that plays a role in instilling bias in favor of circumcision in America is the local media. American television and theater treats the presence of the [[foreskin]] with ridicule and disdain, and praises circumcision as "clean" and "healthy," and news outlets are always ready to publish the latest "study" (usually conducted by American "researchers") that shows circumcision might have some kind of "benefit." Editors may also believe that American audiences, who already believe circumcision is beneficial, will want to read stories reinforcing their cultural assumptions. By contrast, a study showing no benefit (or even negative findings), may not be considered "news" by editors if their audience is expected to have little interest. Tabloid-type media especially may not want anything other than simplistic stories. Discussions carefully evaluating the validity of conflicting findings may be off-puttingly complex and not especially interesting to the reader who already believes circumcision as healthy, and see no need for further debate. These stories therefore might be less likely to be published.  
Fleiss (1999) reported strong bias in the American medical literature regarding male circumcision. He reported:
 
* Bias against studies critical of circumcision.
* Bias in the type of studies that are performed.
* Bias in the acceptance of studies before peer review.
* Bias in peer reviewers.
* Proliferation of a false analogy between circumcision and immunization.
* Bias in studies associating HIV infection with circumcision status.
* Bias in studies regarding penile cancer.<ref name="fleiss1999" />


{{Citation
American researchers who have written studies critical of male circumcision usually have had to publish in the foreign medical literature.
|Title=
|Text=Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice. It is important to acknowledge that researchers' personal biases and the dominant circumcision practices of their respective countries may influence their interpretation of findings.
|Author=Siegfried ''et al''.
|Source=
|ref=<ref>{{REFjournal
|last=Siegfried
|etal=yes
|title=Male circumcision for prevention of heterosexual acquisition of HIV in men
|journal=Cochrane Library
|volume=3
|date=2003
}}</ref>
}}


== Religious bias ==
== Religious bias ==