(usually remedied by pressure to the area and dressings like usual), and that is only 1% of all circumcisions. More significant complications are a lot rarer.
100% suffer loss of the most erogenous part of the penis (the foreskin). The other negative effects of circumcision have never been properly studied, so they can't be confidently stated. Meatal stenosis alone could effect more than 20% of those circumcised. Not to mention the psychological damage.
But it needs to be viewed contextually alongside FGM. To equate the two is foolish.
I recommend this great essay by Brian Earp, a bioethicist who studies genital cutting. He addresses this conception directly.
That first link seems to be behind a paywall, so I can't really engage with that. On psychological damage, I found this study that seems to refute that, but I haven't read through it beyond the abstract and skimming the whole body of it. Additionally, a lot of the claims rely on doctors not using proper anesthetic, citing studies from over twenty years ago. Searching around, pretty much all of the hospital website pages on circumcision state they use some form of anesthesia. I can't speak as to the situation at every hospital, of course.
The essay was really cool, and definitely upended some of my thoughts on the matter. The biases on viewing male circumcision in the best of lights vs. female circumcision in the worst definitely caught me off guard, as I hadn't really thought about that at all. However, there were still some things that didn't seem quite right. For instance, Earp mentions 400 deaths because of circumcision in South Africa. According to this article the leading causes of death were dehydration, malnutrition, and sepsis rather than being solely the fault of circumcision. I'm sure circumcisions were responsible for some of the deaths, but the exact proportion is unclear (unless it's listed somewhere else I can't find), so it feels dishonest to write all the deaths off as caused by circumcision. Additionally, given the relative secrecy of the initiation rituals specified, isn't it possible that some of those sepsis deaths were caused by non-circumcision related wounds? Again, the article is unspecific and if you've got any additional details on the matter that would be dope.
That refutes nothing. First of all, the sample size was 20. They measured stress markers in subjects hair, and found no significant difference. But nowhere does anybody claim that every traumatic experience would leave a measurable glucorticoid difference in adulthood. That's why the authors don't even make the claim that their study proves the absence of trauma.
Searching around, pretty much all of the hospital website pages on circumcision state they use some form of anesthesia. I can’t speak as to the situation at every hospital, of course.
IIRC, around half of hospitals/practitioners today use no anesthesia during circumcision. Of course they would not advertise their lack of adequate anesthesia. Additionally, nothing short of general anesthesia is capable of adequately reducing the pain, which is not safe for use in infants. Therefore, circumcision of infants is torturesome 100% of the time, even when local anesthesia is used.
According to this article the leading causes of death were dehydration, malnutrition, and sepsis rather than being solely the fault of circumcision.
This is being pretty nit picky IMO. If you die from complications arising from a surgery, I believe that it's still fair to claim that the surgery was the cause of death. Just as if someone dies from a blood clot resulting from COVID-19, their death certificate might list "blood clot", but the virus is still responsible for their death. I don't think that's dishonest at all.
isn’t it possible that some of those sepsis deaths were caused by non-circumcision related wounds?
The authors do say "Thus, our findings provide evidence that male circumcision does not promote psychological trauma." You bring up a good point about sample size, but I'm having trouble finding research that is both recent and statistically substantial.
I also can't find anything definitive on proportions of anesthesia used during circumcision today, with the closest thing I can find being this study from Turkey in 2017, which deals with primarily 3-6 year olds and shows what appears to be universal use of anesthetic. I don't entirely understand the idea that only general anesthesia can properly stop pain during circumcision, as from what I can gather nerve blocking anesthetics stop all sensation apart from pressure, which can still upset infants of course.
Just as if someone dies from a blood clot resulting from COVID-19, their death certificate might list “blood clot”, but the virus is still responsible for their death.
Yeah, but in that case the blood clot is directly resulting from COVID-19, whereas malnutrition is typically not a direct side effect of circumcision. The sepsis is of course a result of improper wound care, and it's sensible to blame that on the circumcision. Still, given the apparent secrecy of the initiation rites I don't see how we can conclusively say all infections are resulting from circumcision barring some intimate knowledge of the rituals. Ritual scarring is a common practice in Africa, alongside any manner of potential injures that could occur as a young boy proving his manhood.
At the end of the day circumcision absolutely sucks and should not be done without good medical reason IMO. I'm just saying that in most cases it seems less damaging on average compared to FGM, while still being capable of being just as bad or even worse depending on the severity. Earp makes a good point in saying that our own individuality makes it impossible to say which practice is objectively worse, but that doesn't mean it can't skew in a fashion where one is generally more severe than the other.
Among the 74 physicians questioned, 57 (76%) used no analgesia, and of the 17 who used analgesia, only 3 (4%) used dorsal penile nerve block anesthesia.
The issue is that all this data is from over twenty years ago, prior to a wave of recommendations made by various medical associations for universal use of local or topical anesthetic. That's part of why this is all so hard to talk about properly, because so much of the data is either decades old or too general to draw conclusions from. I did find this press release claiming 97% percent of relevant training programs teach effective pain relief techniques for circumcision, and that's from fourteen years ago. Given the scale of medical advances made since then in all manner of fields, I don't think it's unreasonable to suppose that anesthetic use has advanced somewhat in the same time period.
This obviously isn't to discount the many (and overwhelming majority if we're looking at total performed in history) non-anesthetized and traumatic circumcisions of the past, but to show that despite the senseless and dangerous nature of male circumcision-as-default it has been made safer and more comfortable, something that I'm not sure can be said for the female counterpart.
I don’t think it’s unreasonable to suppose that anesthetic use has advanced somewhat in the same time period.
I agree that the rate today is probably higher than the 24% that it was in 1995, but keep in mind that a significant number of doctors practicing medicine today graduated from medical school before ~1980 (including the family doctor who cut me).
something that I’m not sure can be said for the female counterpart.
All of the societies in the world which practice FGC also practice MGC, and they use the same level of medical technology on both sexes.
https://www.academia.edu/8817976
In this African context, genital cutting (of whatever degree of severity) is most commonly performed around puberty, and is done to boys and girls alike. In most cases, the major social function of the cutting is to mark the transition from childhood to adulthood, and it is typically performed in the context an elaborate ceremony. Increasingly, however, African, Middle Eastern, Indonesian, and Malaysian genital alterations (again, of both boys and girls) are being carried out in hospital settings by trained medical professionals—and on infants as opposed to teenagers—on the model of male circumcision in the United States.
100% suffer loss of the most erogenous part of the penis (the foreskin). The other negative effects of circumcision have never been properly studied, so they can't be confidently stated. Meatal stenosis alone could effect more than 20% of those circumcised. Not to mention the psychological damage.
I recommend this great essay by Brian Earp, a bioethicist who studies genital cutting. He addresses this conception directly.
That first link seems to be behind a paywall, so I can't really engage with that. On psychological damage, I found this study that seems to refute that, but I haven't read through it beyond the abstract and skimming the whole body of it. Additionally, a lot of the claims rely on doctors not using proper anesthetic, citing studies from over twenty years ago. Searching around, pretty much all of the hospital website pages on circumcision state they use some form of anesthesia. I can't speak as to the situation at every hospital, of course.
The essay was really cool, and definitely upended some of my thoughts on the matter. The biases on viewing male circumcision in the best of lights vs. female circumcision in the worst definitely caught me off guard, as I hadn't really thought about that at all. However, there were still some things that didn't seem quite right. For instance, Earp mentions 400 deaths because of circumcision in South Africa. According to this article the leading causes of death were dehydration, malnutrition, and sepsis rather than being solely the fault of circumcision. I'm sure circumcisions were responsible for some of the deaths, but the exact proportion is unclear (unless it's listed somewhere else I can't find), so it feels dishonest to write all the deaths off as caused by circumcision. Additionally, given the relative secrecy of the initiation rituals specified, isn't it possible that some of those sepsis deaths were caused by non-circumcision related wounds? Again, the article is unspecific and if you've got any additional details on the matter that would be dope.
That refutes nothing. First of all, the sample size was 20. They measured stress markers in subjects hair, and found no significant difference. But nowhere does anybody claim that every traumatic experience would leave a measurable glucorticoid difference in adulthood. That's why the authors don't even make the claim that their study proves the absence of trauma.
IIRC, around half of hospitals/practitioners today use no anesthesia during circumcision. Of course they would not advertise their lack of adequate anesthesia. Additionally, nothing short of general anesthesia is capable of adequately reducing the pain, which is not safe for use in infants. Therefore, circumcision of infants is torturesome 100% of the time, even when local anesthesia is used.
This is being pretty nit picky IMO. If you die from complications arising from a surgery, I believe that it's still fair to claim that the surgery was the cause of death. Just as if someone dies from a blood clot resulting from COVID-19, their death certificate might list "blood clot", but the virus is still responsible for their death. I don't think that's dishonest at all.
Possible? I suppose, but I highly doubt it.
The authors do say "Thus, our findings provide evidence that male circumcision does not promote psychological trauma." You bring up a good point about sample size, but I'm having trouble finding research that is both recent and statistically substantial.
I also can't find anything definitive on proportions of anesthesia used during circumcision today, with the closest thing I can find being this study from Turkey in 2017, which deals with primarily 3-6 year olds and shows what appears to be universal use of anesthetic. I don't entirely understand the idea that only general anesthesia can properly stop pain during circumcision, as from what I can gather nerve blocking anesthetics stop all sensation apart from pressure, which can still upset infants of course.
At the end of the day circumcision absolutely sucks and should not be done without good medical reason IMO. I'm just saying that in most cases it seems less damaging on average compared to FGM, while still being capable of being just as bad or even worse depending on the severity. Earp makes a good point in saying that our own individuality makes it impossible to say which practice is objectively worse, but that doesn't mean it can't skew in a fashion where one is generally more severe than the other.
I found some data on anesthesia use.
http://cirp.org/library/pain/lander/
http://cirp.org/library/pain/wellington/
https://www.deepdyve.com/lp/wiley/newborn-circumcision-should-not-be-performed-without-anesthesia-Jv03okKBWD
The issue is that all this data is from over twenty years ago, prior to a wave of recommendations made by various medical associations for universal use of local or topical anesthetic. That's part of why this is all so hard to talk about properly, because so much of the data is either decades old or too general to draw conclusions from. I did find this press release claiming 97% percent of relevant training programs teach effective pain relief techniques for circumcision, and that's from fourteen years ago. Given the scale of medical advances made since then in all manner of fields, I don't think it's unreasonable to suppose that anesthetic use has advanced somewhat in the same time period.
This obviously isn't to discount the many (and overwhelming majority if we're looking at total performed in history) non-anesthetized and traumatic circumcisions of the past, but to show that despite the senseless and dangerous nature of male circumcision-as-default it has been made safer and more comfortable, something that I'm not sure can be said for the female counterpart.
I agree that the rate today is probably higher than the 24% that it was in 1995, but keep in mind that a significant number of doctors practicing medicine today graduated from medical school before ~1980 (including the family doctor who cut me).
All of the societies in the world which practice FGC also practice MGC, and they use the same level of medical technology on both sexes.
https://www.academia.edu/8817976