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Proposed RfC: Is is OK to say "significantly reduces", if "significant" in the source might refer to statistical or clinical significance

There's some disagreement about the word "significantly" in the sentence "male circumcision significantly reduces the risk of HIV infection among heterosexual men in sub-Saharan Africa". The word "significant" is used in the source, but the word is mentioned as "careful language" here: Wikipedia:Manual of Style/Medicine-related articles#Careful language.

One source, the WHO, mentions:

Data from three RCTs conducted in different countries showed a 59% (44%–70%) reduction in HIV incidence (efficacy) among circumcised men ages 15–49 years (11–13). The protective effect was seen soon after circumcision. The protective effect was confirmed in extended post-trial follow-up to six years of men in two of the three RCTs (in Kenya and Uganda) (27, 28). The estimated impact over the six years was a 66% (51%–76%) reduction in risk, which is close to the result of the “as-treated” analysis of the three RCTs. [1]

The second source is Siegfried et. al uses the term "significant", although some editors question if it could be statistical or clinical significance:

Three large RCTs of men from the general population were conducted in South Africa (N = 3 274), Uganda (N = 4 996) and Kenya (N = 2 784) between 2002 and 2006. All three trials were stopped early due to significant findings at interim analyses. We combined the survival estimates for all three trials at 12 months and also at 21 or 24 months in a meta-analysis using available case analyses using the random effects model. The resultant incidence risk ratio (IRR) was 0.50 at 12 months with a 95% confidence interval (CI) of 0.34 to 0.72; and 0.46 at 21 or 24 months (95% CI: 0.34 to 0.62). These IRRs can be interpreted as a relative risk reduction of acquiring HIV of 50% at 12 months and 54% at 21 or 24 months following circumcision. There was little statistical heterogeneity between the trial results (chi(2) = 0.60; df = 2; p = 0.74 and chi(2) = 0.31; df = 2; p = 0.86) with the degree of heterogeneity quantified by the I(2) at 0% in both analyses. We investigated the sensitivity of the calculated IRRs and conducted meta-analyses of the reported IRRs, the reported per protocol IRRs, and reported full intention-to-treat analysis. The results obtained did not differ markedly from the available case meta-analysis, with circumcision displaying significant protective effects across all analyses. We conducted a meta-analysis of the secondary outcomes measuring sexual behaviour for the Kenyan and Ugandan trials and found no significant differences between circumcised and uncircumcised men. For the South African trial the mean number of sexual contacts at the 12-month visit was 5.9 in the circumcision group versus 5 in the control group, which was a statistically significant difference (p < 0.001). [2]

The options are:

• A : keep the word "significantly"
• B : remove the word "significantly" and just state plainly "male circumcision reduces the risk of HIV infection"
• C : say specifically "prevention of 17 HIV infections per 1000 people over two years in the region", as that's the specific number referred to in the full text of the Siegfried et al.

Thoughts anyone??Stix1776 (talk) 16:13, 14 April 2022 (UTC)

Seems misleading since you're leaving out the what the second citation says. You'd have to add: "The second source is Siegfried et. al which states: "The results obtained did not differ markedly from the available case meta‐analysis, with circumcision displaying significant protective effects across all analyses." MrOllie (talk) 16:41, 14 April 2022 (UTC)

@MrOllie: Please forgive me as it wasn't intentional. I don't recall this source being mentioned in the dispute discussion before, but I may be wrong. If there's no other issues, I want to ask your permission to delete your last comment before I make this RfC go live (maybe in 2 days).Stix1776 (talk) 17:05, 14 April 2022 (UTC)

Please don't ever delete one of my comments. MrOllie (talk) 17:09, 14 April 2022 (UTC)

It's too bad, as I'll have to move this all into a new section. But OK.Stix1776 (talk) 18:01, 14 April 2022 (UTC)

Yes, "significant" is used in both sources in several places, and most everyone would consider a 59% reduction a clinically significant reduction, as well as being a statistically significant reduction on meta-analysis. I think it meets lay, clinical, and statistical criteria for calling it significant. |→ Spaully ^~talk~  20:07, 14 April 2022 (UTC)

If you mean you should start the RFC in a new section, yes you should, if you really think it must be held at all now that you have read the second source. But please don't move my comments either - talk pages should be a record of discussion as it happened. I'll also note that the RFC statement I was replying to has since been edited. MrOllie (talk) 20:18, 14 April 2022 (UTC)

Option A is the best choice of the three. 59% is an estimate of the reduction in seroconversion — and will vary between studies — while "significant" accurately reflects the results of top-quality studies in the context of high risk areas. KlayCax (talk) 00:52, 17 April 2022 (UTC)

Thank you very much Spaully. I do appreciate outside editors adding their voice to a dispute. In regards to the "significant" in the study, I'm genuinely not sure if it's referring to statistical significance or significant as a synonym for strong. I'm a pretty sciency person, although I'm neither a doctor nor an epidemiologist. I feel 70% confident that they're referring to statistical significance, as it's what referred to throughout the full text, but I'm not going to pretend that I'm sure on this. Note I added in statistical detail into the paragraph above. I'm going to take a card from MrOllie's playbook and ask the folks at WT:MED. If they think it means "strong" then I might drop this. If they think it means "statistically significant", then I should be OK with the word "significant" as long as it's "statistically significant" in the text.

FYI KlayCax, the RfC is just a proposal and isn't official yet, although thanks for your input. Stix1776 (talk) 09:03, 17 April 2022 (UTC)

May I point out the discussion at | WT:MED. There's a lot of editors that think this is likely statistical significance and/or clinical significance. Talking "significant" literally, when the reader will likely interpret "significantly" as meaning "greatly" can be dangerous. Alexbrn suggests a exact answer of "prevention of 17 HIV infections per 1000 people over two years", which I find more exact and honest than "significantly" in the article. I'm changing Option C to his suggestion. Frankly, I'm OK with that interpretation, if you people would like to save everyone the trouble of a RfC. Stix1776 (talk) 13:21, 18 April 2022 (UTC)

Dispute Tag

1. "There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice". I'm not seeing this in the source, which again is Jacobs et al (2012), or Bolnick (the textbook author). Feel free to correct me with the quote. Also this clearly fails WP:RS/AC as "consensus" is never mentioned.
2. Sexual effect in this diff [3]. The removal of newer clinical practice guidelines (from the Canadian Urological Association) with an text from an older, 2013, study that states "the highest quality evidence indicates that circumcision has no impact on sexual function, sensation, or pleasure". WP:MEDDATE is pretty clear that research from over 5 years ago shouldn't be considered over newer research. As I've stated previously WP:AGE MATTERS. There is newer and more nuanced research here [4], [5] as well as a plethora of older policy statements with more nuance.
3. The removal of the word "controversial" here [6], even though it's listed in multiple high quality sources, including Calcagno (2007), World Health Organization (2007), the BMA advice to doctors [7], and likely other sources.
4. "Male circumcision significantly reduces the risk of HIV infection" (this diff [8]). Someone needs to find the text that supports this, as I'm not seeing it. I'll be happy to remove this when someone shows me the source. Also "significantly" came with the MEDRS failing Council of Foreign Relations source.
5. "In these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure" is just a hodgepodge of WP:SYNTHESIS with different articles combined to create a novel conclusion not written in any source. I've requested the source text quote multiple times and I've never gotten it. It's clear intent was to block wording of "informed consent" and "rights of the child" that are well sourced. SN Social Sciences is not medline indexed, or even a medical journal, and really shouldn't be in a medical article per WP:MEDRS.
6. "while formerly common in many English speaking nations during the first half of the 20th century, rates have declined significantly in the UK and Australia" [9] removing well sourced material, without explanation, because the editor doesn't like it clearly goes against WP-NPOV and WP:PRESERVE. Editors can't just remove sourced content that they don't like.
7. "Public health advocates of circumcision consider it to have a net benefit". Morris is the only author of this source, and he didn't state there's more than one person advocating. How is this plural? I tried to fix this, but it was returned in this revert [10]. Also there's multiple medical bodies and researchers that disagree [11] [12] [13], yet these get removed while only keeping the pro infant circumcision mentions. (see this dif [14])
8. "Outside of these areas with high HIV/AIDS prevalence, the positions of the world's major medical organizations differ on the routine circumcision of minors; the World Health Organization, UNAIDS, and American medical organizations generally hold the belief that it carries moderate prophylactic health benefits that outweigh small risks". I can see how the AAP said this, but I read the WHO source [15] up and down and I'm not seeing this. Reverted here [16]. The source statement does not say that WHO or UNAIDS promotion circumcision "carries moderate prophylactic health benefits that outweigh small risks". The wording is dishonest OR.Stix1776 (talk) 00:29, 12 February 2022 (UTC)
9. @Alexbrn: regarding this edit [17], how does Nursing Ethics, A Medline Indexed journal, fail MEDRS?Stix1776 (talk) 10:14, 5 February 2022 (UTC)
10. Also Alexbrn, regarding this edit [18], you changed the meaning. Would you prefer each medical organization listed out? "Both the British Medical Association (BMA) and the British Association of Pediatric Surgeons (BAPS) have expressed that there is “rarely a clinical indication for circumcision”", "Canadian health organizations have largely opposed routine NC over the last 30 years. In 1989, the Canadian Pediatric Society commented that the evidence pertaining to STDs and UTI was not “sufficiently compelling to justify a change in policy” and revisited in 1996 [ 5 ] . This policy has discouraged neonatal circumcision since the 1970s. This position is also supported by the College of Physicians and Surgeons of British Columbia (CPSBC) position, released in 2009, which definitively states that the routine circumcision of neonates “is not recommended” and may even have human rights implications". Is listing it better?
11. “No major medical organization recommends circumcising all males, and no major medical organization recommends banning the procedure“, is not written in the source, and other editors have spotted this. @MrOllie:, can you quote what's in the source to back this up? Stix1776 (talk) 13:24, 11 February 2022 (UTC)
12. "Throughout society, circumcision is often considered for reasons other than medical need. Public health advocates of circumcision consider it to have a net benefit, and therefore feel that increasing the circumcision rate is an ethical imperative...", dating back to 2012, was removed here [19]. Attempts to restore it were met with edit warring [20].Stix1776 (talk) 11:57, 19 April 2022 (UTC)

ThanksStix1776 (talk) 08:13, 5 February 2022 (UTC)

• After looking at the latest version of the article I am becoming extremely concerned about WP:V issues and apparent WP:SYNTHESIS. Statements should generally be backed by one, maybe two citations. More than that is often a tell of synthesis. Regarding "European medical organizations generally hold the belief ..." the first citation (of 5!) was to a 2010 "Manual for early infant male circumcision under local anaesthesia" by the WHO. How does this source WP:VERIFY the claim about the 44 Nations of Europe and the "beliefs" of their medical organizations? This article is a WP:GA which means editing should be careful and diligent. Alexbrn (talk) 10:40, 5 February 2022 (UTC)

I think that listing the actual sourced position of each medical body with quotes and citations is fine. I'll get on this when I have a moment. But I've listed multiple OR concerns above and you have nothing to say about it?Stix1776 (talk) 02:58, 6 February 2022 (UTC)

I am most concerned with what I see as the most serious problems, like the use of unreliable sources. With regard to PMID:33719736, it is not a review as WP:MEDRS wants but a novel philosophical/theoretical paper. Alexbrn (talk) 03:21, 6 February 2022 (UTC)

I'm not seeing anything in MEDRS that says you can't use theoretical papers. If there's nothing in MEDRS that supports your understanding of the policy, can you at least ask WT:MED. I'm happy to go with the opinion of outside editors. Wouldn't [21] or [22] or [23] be acceptable?Stix1776 (talk) 07:53, 6 February 2022 (UTC)

See WP:MEDASSESS. The Earp source is a primary source - essentially just an opinion piece. We want better. the three sources you list are clinical guidance, a position statement and a review - so much better. You really don't need to go to WT:MED for obvious matter likes this. Alexbrn (talk) 08:37, 6 February 2022 (UTC)

You're not pointing out the part where it says that theoretical papers can't be used. And you ignored my direct question. — Preceding unsigned comment added by Stix1776 (talk • contribs) 11:38, 6 February 2022 (UTC)

MEDRS says what ARE reliable sources, and that primary sources should be avoided. There is a near infinity of types of source that are unsuitable obviously, so an exhaustive list is not possible. When we have reams of top-quality sources on circumcision I am at a loss as to why editors want to scrape up poor ones. I directly answered your question. Alexbrn (talk) 12:19, 6 February 2022 (UTC)

The ignored question was "Wouldn't [24] or [25] or [26] be acceptable?"

WP:MEDDEF defines a prime source as follows:" A primary source is one in which the authors directly participated in the research and documented their personal experiences. They examined the patients, injected the rats, ran the experiments, or supervised those who did. Many papers published in medical journals are primary sources for facts about the research and discoveries made". Earp is clearly summarizing other sources so this is secondary. Can't you either 1) ask uninvolved editors, 2) find a similar case, or 3) find text in Wikipolicy that supports you? I keep requesting that we bring this to mediation or ask outside editors, and those calls are ignored.

Finally you're splitting hairs over edge cases, while there are clear failures of WP:MEDRS that you're not looking at. If you're genuinely not POV pushing against the sources and wikipolicy, why not look at those clear mistakes that I have posted? Stix1776 (talk) 12:06, 11 February 2022 (UTC)

Per this diff [27], @Alexbrn:, I've asked your repeatedly. In what fashion are editors allowed to add non American medical bodies to this article?? Stix1776 (talk) 12:48, 11 February 2022 (UTC)

In good ways. Cramming novel material into the lede is not a good way. See WP:LEDE. If you want to improve the article, work on the body: the lede can then summarize it. Alexbrn (talk) 12:53, 11 February 2022 (UTC)

To absolutely disconnect this from your original edit and the unanswered questions. How can we add non American perspectives to the lead when your removed them? Stix1776 (talk) 13:06, 11 February 2022 (UTC)

You wrote "Pedantic" instead of "Paediatric" by the way. Graham Beards (talk) 13:08, 11 February 2022 (UTC)

The lead is suppose to summarize, not list individual bodies. I support mentioning the WHO on HIV, but we shouldn't be going org by org for others. I have returned the very long standing summary statement to the lead (see my comments further up the talk page). MrOllie (talk) 13:09, 11 February 2022 (UTC)

The disruption on this article has grown to the point where I wonder if a WP:GAR is necessary. Stix1776 you seem to be going at it like a bull in china shop. This push to alter the lede without paying any attention to the body is not good. Alexbrn (talk) 13:22, 11 February 2022 (UTC)

Stix1776, please stop going back and adding material to earlier posts, it makes this discussion nearly impossible to follow. If you have a question for me ask it at the end of the section and I will respond there. - MrOllie (talk) 13:27, 11 February 2022 (UTC)

Very supportive of WP:GAR. Alexbrn, please stop with the personal attacks, though. Stix1776 (talk) 00:33, 12 February 2022 (UTC)

The sentence below should point out that the WHO only recommends circumcision for adolescents and adult males and does not make a recommendation for infants.

Change: "Consequently, the World Health Organization (WHO) recommends consideration of circumcision as part of a comprehensive HIV prevention program in areas with high rates of HIV; the effectiveness of using circumcision to prevent HIV in the developed world is unclear.[12][14]"

To: "Consequently, the World Health Organization (WHO) recommends consideration of circumcision for adolescents and men, but not infants; as part of a comprehensive HIV prevention program in areas with high rates of HIV; the effectiveness of using circumcision to prevent HIV in the developed world is unclear.[12][14]"

Infants should not be included by generality when the WHO did not include them in the report recommendations. — Preceding unsigned comment added by 2600:1700:D591:5F10:E1E9:9A0A:FFCD:74AA (talk) 08:53, 20 February 2022 (UTC)

I also support WP:GAR. Anyone want to do the honors? Prcc27 (talk) 16:56, 20 February 2022 (UTC)

It would of course be much better to make efforts to repair the article. I also think it would be sad indictment if an article was de-listed because of unchecked disruptive editing (which is largely what has happened). For that reason, I think there would also need to be a review of editor conduct. I am unsure whether circumcision falls under DS via the indirect route of Gamergate, but if not I think this is a topic area which needs discretionary sanctions. Alexbrn (talk) 17:02, 20 February 2022 (UTC)

It does seem incongruous to have a dispute tag on a GA article. I agree that repairing the article is ideal, but the discussion has been so contentious I do not see consensus in sight. An RfC is an option, but that would not change the reality, viz., the article has slipped below Good Article standards. I note the following from good article reassessment under Community reassessment, When to use this process:

Requesting reassessment during a content dispute or edit war is usually inappropriate. Wait until the article stabilizes and then consider reassessment. If significant instability persists for more than a couple of weeks, then reassessment on the grounds of instability may be considered.

Since instability has persisted for more than a couple of weeks, requesting a good article community reassessment seems warranted. Mark D Worthen PsyD (talk) [he/him] 19:01, 20 February 2022 (UTC)

I do appreciate the effort that Mark D Worthen PsyD put into reassessment. Frankly, I agree 100% with his summary. I wasn't aware that the lead was too long, but I do agree that it's something that needs to be trimmed. I do also agree with Alexbrn that this article needs a an addition of discretionary sanctions. I'm actually surprised that it doesn't have this already. I do also support a review of editor conduct that Alexbrn suggests, although I don't know how to request this in Wikipedia.

Lastly I wanted to ask editors here if they're interested in having a good article or just getting their point of view across? I continuously ask for mediation or another dispute process, and this is repeatedly ignored.Stix1776 (talk) 10:35, 29 March 2022 (UTC)

Further revision talk

Lead wording on medical community's positions:

The present wording in the lead is as follows.

The WHO, UNAIDS, and American medical organizations generally hold the belief that the elective circumcision of minors in developed countries carries prophylactic health benefits that outweigh small risks, while European medical organizations generally hold the belief that its medical benefits are not counterbalanced by risk. In these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure. There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice.

I suggest that it should be replaced with:

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness relating to the elective circumcision of minors in developed countries. [The rest of the paragraph's wording being moved into the body with revised wording.]

The revised wording in body being:

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness relating to the elective circumcision of minors in developed countries. The WHO, UNAIDS, and American medical organizations generally hold the belief that the elective circumcision of minors in developed countries carries prophylactic health benefits that outweigh small risks, while European medical organizations generally hold the belief that its medical benefits are not counterbalanced by risk. Discussions and disputes over prophylactic efficacy, consent, group rights, and religious freedom have been brought up in these cases. [The original accidentally and unnecessarily duplicates "[bio]ethics" two times.] There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice.

(The bold above being modified.)

Penile cancer in lead:

The present wording in the lead is as follows.

It also decreases the risk of rare cancer of the penis.

I suggest that it should be replaced with:

It also decreases the risk of penile cancer.

Having "cancer of the penis" rather than "penile cancer" seems simply loquacious. I have no strong feelings on whether "rare" should be included or not. It is an extremely rare form of cancer (even severe complications resulting from circumcision appear to be way more common than phimosis-induced penile cancer.) Whatever fits editoral discretion.

World Health Organization in "elective" body section:

The present wording in the "elective" section of the body is as follows.

According to the World Health Organization, "there are significant benefits in performing male circumcision in early infancy".

I suggest it should be replaced with:

According to the World Health Organization [blockquote if real]: "There are significant benefits in performing male circumcision in early infancy, and programmes that promote early infant male circumcision are likely to have lower morbidity rates and lower costs than programmes targeting adolescent boys and men." [end blockquote]

"Minor issues (that I have no strong opinions on)"

• Whether to put the fact that penile cancer is "rare" in the lead
• Whether to add that "the WHO holds the belief that it carries prophylactic health benefits that outweigh small risks" in the lead.

Editors opinions:

I see all of these changes as substantive improvements to the status quo. But because these edits have been challenged by Stix1776, let's get a consensus on the talk page from recent, active editors on here. MrOllie, Alexbrn, Prcc27, Stix1776, OntologicalTree, Dimadick, Jayjg, and Markworthen, Praxidicae, how do you feel about the changes? KlayCax (talk) 17:55, 13 April 2022 (UTC)

I agree that all of these are improvements to the article. MrOllie (talk) 22:14, 13 April 2022 (UTC)

1. I do not think it is necessary to remove the nuances between American/certain international organizations vs. European organizations. I’m okay with “There is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice” being removed from the lead, albeit I’m open to keeping it if we simply remove the word “all”.
2. I do not see why we need to remove “rare”.
3. I am concerned that expanding on this may be WP:UNDUE. Didn’t PEPFAR quit circumcising infants in Africa due to studies showing that there were higher complications rates for circumcising younger boys? I am against this wording unless we also touch on this in the article. Prcc27 (talk) 23:19, 13 April 2022 (UTC)

The nuances between international health organizations (such as WHO and UNAIDS) and American (and to less extent Anglospheric) medical organizations are not being removed. That information is simply being moved into the "elective" section of the article. Both "in these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure" and "there is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice" clearly don't belong in the lead.

Ironically, preserving these parts in the lead gives the article a more pro-routine circumcision lean.

As for accusing me of haing a supposed pro-circumcision bias, anyone who reads my previous edits on here can see that it is ridiculous. I've contributed to parts of the article that portray routine circumcision in an negative light. See here and here for just two examples. The consistent assumption of bad faith is getting to the point of absurdity.

Literally everything in the lead right now will remain so in the body. That isn't "censorship" or an example of bias. I'm continuously failing to see why "in these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up, leading to ethical discussions surrounding the procedure" and "there is a consensus across all major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice" is in the lead, or how removing it imposes bias in the article at all. I'm failing to see what this dispute is even about. KlayCax (talk) 15:37, 18 April 2022 (UTC)

FWIW, I agree that the suggested changes are largely improvements. Your wording on the WHO paragraph is a better replacement for the first two sentences, though I would agree with Prcc27 that keeping “There is a consensus across major medical organizations that the elective circumcision of minors should be legal, within the purview of medical professionals, and to some extent should yield to parental choice” (with/without all) also seems pertinent to the lead.

For the sake of 1 word, "rare" prior to either penile cancer or cancer of the penis seems reasonable to keep as otherwise it might be interpreted as a stronger indication for routine circumcision than it it. |→ Spaully ^~talk~  10:40, 14 April 2022 (UTC)

Wow how cool of you to place this in another section. Please note the previous section and how little space actually exists in the lead regarding ethics and medical policy disagreements. This is clearly has nothing to do with "trimming the lead" and everything to do with KlayCax's clear POV with circumcision. I've seen too many edits where KlayCax unabashedly lies and misrepresents the sources [28] [29] to portray circumcision positively to believe that they genuinely care about the quality of this article. Why insist on removing every small source fact critical for circumcision unless you have a serious POV problem?? If you really care about cutting down the lead, why not cut where most of the actual text takes place???

Regarding the word "rare", why not just remove the cancer reference as so many medical bodies don't recommend circumcision for penile cancer. The RCOF calls penile cancer "extremely rare" and doesn't recommend the procedure for medical reasons [30]. The European Urological Association specifically does not recommend circumcision for penile cancer [31]. The British Medical Association and the Royal Dutch Medical obviously don't recommend preventative circumcision for any reason. The WHO also calls it "extremely rare" [32].

Even the most positive source for circumcision to prevent penile cancer, the AAP, is very lukewarm:

It is difficult to establish how many male circumcisions it would take to prevent a case of penile cancer, and at what cost economically and physically. One study with good evidence estimates that based on having to do 909 circumcisions to prevent 1 penile cancer event, 2 complications would be expected for every penile cancer event avoided. However, another study with fair evidence estimates that more than 322,000 newborn circumcisions are required to prevent 1 penile cancer event per year. This would translate into 644 complications per cancer event, by using the most favorable rate of complications, including rare but significant complications. The clinical value of the modest risk reduction from circumcision for a rare cancer is difficult to measure against the potential for complications from the procedure. In addition, these findings are likely to decrease with increasing rates of HPV vaccination in the United States. [33]

If your interests genuinely have to do with trimming the lead, why not cut out the entire cancer reference?? Stix1776 (talk) 15:53, 14 April 2022 (UTC)

Please strike the personal attacks from the above. This (as well as the outing attempts and unfounded sockpuppetry accusations) are really getting out of hand. MrOllie (talk) 16:29, 14 April 2022 (UTC)

@KlayCax: I literally broke down the statistics in the article in the previous section, as well as quoted MOS:LEAD, " "It should identify the topic, establish context, explain why the topic is notable, and summarize the most important points, including any prominent controversies". You clearly desire to remove the tiny bit of the lead that refers to ethics. I've asked you multiple times where the OR word salad of "in these situations, questions surrounding prophylactics, bioethics, group rights, and religious freedom have been brought up" comes up in the source, and you refuse to answer.

Note that you reverting to defend your deletion of sourced material in the body. Can you please explain your reasonings for the deletion or why you think they shouldn't stay. Clearly this is POV pushing.

The NPOV edit you're so proud of [34], deleted text from the body to the lead, only to have it disappear forever. Moving text from the body to the lead, to later "trim" the lead, seems to be an editing tactic of yours.

Please can we have some mediation for all the controversy in this article.

That this is regularly ignored speaks volumes of the confidence of KlayCax and defenders.Stix1776 (talk) 11:29, 19 April 2022 (UTC)

The new wording of "major medical organizations hold [widely] varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness relating to the elective circumcision of minors in developed countries" addresses and improves upon that point. Doesn't it? That doesn't violate the spirit or wording of MOS:LEAD in anyway.

If anything, it more properly "summarize[s] the body of the article". (Summary of MOS:Lead). Literally nothing in the current version is being deleted.

"Penile cancer" was included in the lead under previous WP: Consensus. I had no contribution to it. If you want to start another RFC/discussion to revert the previous consensus, feel free. Again, I fail to see how it justifies a blanket reversion of the edit published.

Prophylactics refers to the debate within the science community over its efficacy in the prevention of pathologies, religious freedom and group rights refer to its intersection with those subjects, and bioethics refers to the debate over whether it is ethical to perform (usually routine) in given situations. All of which are repeatedly and extensively sourced throughout the article. See Cagaanan, 2011; Pinto, 2012; Cohen-Almagor, 2020 for a few examples.

You're misreading who made that edit. I added those parts unto the article. I got outvoted by other editors and those additions were removed under WP: Consensus by other editors. I was using it as an example (out of many) that I've contributed to on here that portrays routine circumcision in a more negative light. Accusing me of a pro-circumcision WP: NPOV is an ad hominem and easily disproven through my own edits. All of your concerns are not being ignored. I responded above — and again — now. KlayCax (talk) 14:53, 19 April 2022 (UTC)

Remove section on things like Tuli?

The opening sentence of this article mentions that this article is specifically about the "medical procedure" of removing the foreskin. I'm wondering why there is talk in this page on cultural and religious removal of the foreskin? As an example the Philippine Tuli ritual? Is this article about both medical and non-medical removal of the foreskin? If so, shouldn't the opening sentence say that? If not, then shouldn't discussions of things like Tuli be in a separate article about the non-medical removal of the foreskin?

Herro56 (talk) 13:33, 27 April 2022 (UTC)

Breast implants are also medical procedures that have cultural purposes. The procedure is medical, even if the impetus for it is not. EvergreenFir (talk) 15:12, 27 April 2022 (UTC)

What do you mean by the procedure being medical? What makes something like Tuli a medical procedure?

The article linked under "medical procedure" defines it as "a course of action intended to achieve a result in the delivery of healthcare". Rituals like Tuli aren't intended to be some sort of healthcare. It's a rite of passage. Herro56 (talk) 18:51, 27 April 2022 (UTC)

All circumcisions are medical procedures, whether they are carried out by a doctor in a hospital, religious leader in a place of worship, or anyone else, as at a fundamental level they are all a form of surgery. However not all circumcisions are carried out for medical reasons. I can think of several other medical procedures that can be carried out for health, or religious, or cultural reasons.

Tuli (rite) is a separate article, about the cultural impetus for the procedure. There are also other articles, like Brit milah, and Lebollo la banna for other religious and cultural specific reasons for the practice. You can find those listed under Category:Circumcision. Sideswipe9th (talk) 21:19, 27 April 2022 (UTC)

The article on surgery defines it as: "an invasive technique with the fundamental principle of physical intervention on organs/organ systems/tissues for diagnostic or therapeutic reasons". Ritual circumcision isn't done for diagnostic or therapeutic reasons, is it? Medical circumcision is done for those reasons, isn't it? So how is it a surgery if it's not done for those reasons?

If you want to say something like 'all invasive procedures are "surgeries"' - whether or not they are done for "diagnostic or therapeutic reasons" - then wouldn't that mean that other forms of ritual body modifications are "medical procedures"? Scarification is an example that comes to mind. That is also often a rite of passage and involves cutting into the skin. Is it a "surgery" and therefor a "medical procedure"? Herro56 (talk) 01:29, 28 April 2022 (UTC)

Terminology is not necessarily going to be 100% in alignment between different Wikipedia articles. This is a consequence of how we follow the wording of sources as they describe different topics rather than coming up with our own centralized definitions. MrOllie (talk) 01:33, 28 April 2022 (UTC)

So what's the terminology here? And where is it from?

What I think is going on is that this terminology is based on going to sources specifically discussing medical circumcision and then incorrectly applying that description for all forms of circumcision. E.g. I see some references to pediatrics reference books at the start. Are they discussing ritual circumcision or only medical circumcision? My guess is it's only talking about the latter.

And I'm betting that you're not going to find a source that talks about Tuli as a medical procedure - it certainly doesn't seem to be described as such in the Tuli article. Herro56 (talk) 02:48, 28 April 2022 (UTC)

That is one definition of surgery, however it is not the only definition of the word. Several non-therapeutic surgeries exist, of particular relevance to this discussion, due to the inherent link to genitalia, includes not only circumcision, but also female genital mutilation, and surgery performed on intersex children.

Non-therapeutic male circumcision of children - practical guidance for doctors, British Medical Association 2019, page 11: There are clearly risks inherent in any surgical procedure: for example, pain, bleeding, surgical mishap and complications of anaesthesia. With NTMC there are associated medical and psychological risks, although it is generally considered a low-risk procedure. Usually risks of surgery are offset by the medical benefits that ensue – where there are no clear medical benefits, some other justification is needed for exposing children to this risk. While this does not refer to Tuli nor any other ritualistic based circumcision by name, Tuli would be considered as part of this guidance due to it involving a non-therapeutic circumcision of a child for cultural reasons.

Male circumcision: Global trends and determinants of prevalence, safety and acceptability. World Health Organisation 2008, PDF page 8, numbered page 3, in the introduction: Male circumcision is one of the oldest surgical procedures known, traditionally undertaken as a mark of cultural identity or religious importance. Again doesn't mention Tuli by name, however like with the BMA guidance it would be considered as part of this guidance due to it occuring under "mark of cultural identity".

Post-traumatic stress disorder (PTSD) among Filipino boys subjected to non-therapeutic ritual or medical surgical procedures: A retrospective cohort study, Gregory Boyle and Samuel Ramos, Annals of Medicine and Surgery, 2019, a paper that focuses entirely upon the effects of circumcision amongst youth in the Phiillippines, including those who undergo Tuli. While it doesn't describe it as a medical procedure, it does describe it as a non-therapeutic surgery. You may be interested to note that boys subject to Tuli suffer from a heightened rate of PTSD symptoms than those who underwent a medical circumcision (69% versus 51%) Sideswipe9th (talk) 03:18, 28 April 2022 (UTC)

Thanks for those sources. But I think that they show what the problem is. The argument made was that since Tuli is a "surgery", then it's a "medical procedure".

Those sources you provide say that it's a surgery, but a non-medical one. Notice the last one, it differentiates between: "non-therapeutic ritual or medical medical surgical procedure". It's saying that Tuli is not a medical procedure.

The BMA document also is working under a similar definition as I think should be used, here's how they define circumcision: "Male circumcision is the removal of part or all of the foreskin (prepuce) that covers the penile glans. If it is undertaken for any reason other than current physicalclinical need, it is termed non-therapeutic (or sometimes ‘ritual’) circumcision." - later on it discusses "Circumcision for medical purposes" as different than a ritual circumcision.

So these are sources that basically say that there are non-medicinal surgeries - and that ritual male circumcision is a non-medicinal surgery.

Why not use the definition provided by the BMA? "Male circumcision is the removal of part or all of the foreskin (prepuce) that covers the penile glans." That covers both medicinal circumcision (which is currently only covered by the opening sentence in the article) and also ritual circumcision. Herro56 (talk) 13:01, 28 April 2022 (UTC)

It's taken me a while to consider what you've written @Herro56:, as well as re-review the guidance from the BMA and WHO.

I've got two reasons for not liking the strict quotation from the BMA. One is that it's overly technical, while most are likely familiar with terms like foreskin and penis, they are less so with prepuce and penile glans. The second is that if we were to use it, I think we'd lose some specificity as to what type of procedure it is, in the opening sentence.

How would you feel if instead, we substituted "medical procedure" for "surgical procedure"? The opening sentence would then read Circumcision is a surgical procedure that removes the foreskin from the human penis., with the same citations as present. That brings us into line with BMA and WHO guidance, I suspect other major public health bodies that I can't seem to find relevant guidance for at this time, which differentiates between medical and non-medical circumcisions, and keeps it clear that regardless of the underlying reason for a circumcision (be it medical or ritual) the procedure is surgical in nature. Sideswipe9th (talk) 18:33, 29 April 2022 (UTC)

I agree with your thinking regarding not using the exact phrasing of the BMA, and my initial comment was just about the phrase "medical procedure".

I'm still not sure about the phrasing "surgical procedure" - since I still think that implies that it's done as a medical procedure - which in cases like Tuli it's not. I was looking at an anthropology article on circumcision and I don't think that they used that term at all, but I'll have to check it again.

But I tihnk "surgical procedure" is a better term - and the BMA source might call ritual circumcision a sugical procedure. So I think it's a good change that I'll be happy with. :)

I have some other more general comments regarding the article as a whole, since I feel like this article seems to be written almost exclusively about medical circumcision - but that's for a new topic and a later date. I'll have to think more about that and I'll maybe start a topic later when I've thought more about it. Thanks for the discusison! :) Herro56 (talk) 00:54, 30 April 2022 (UTC)

Awesome! I'll wait a day to see if @MrOllie and EvergreenFir: have any objections before making the change. Sideswipe9th (talk) 02:36, 30 April 2022 (UTC)

No objections. I removed it from the article as a part of a larger, more comprehensive edit on the lead. KlayCax (talk) 03:30, 30 April 2022 (UTC)

pro circumcison

I am pretty aghast at how strongly wikipedia recommends circumcision. There are so many sections in this article redundantly repeating the supposed health benefits of circumcison using dubious studies (and the same study sourced three different times). And nothing on Dr Kellogg's promotion of circumcison to prevent masturbation in boys? This article is a polemic on circumcison and it's a disservice to both Wikipedia and anyone reading it looking for an objective point of view. 2603:6000:B400:2EF1:AD31:5CD2:C2FD:C833 (talk) 14:58, 13 May 2022 (UTC)

Sexism and merging with female genital mutilation

This is clear sexism, as "female genital Mutilation" is clearly trying to sound dangerous, where as so is male genital mutilation, but the cirmumscion article for men is clearly biased about supporting it being illegalized for women but not for men.

So, to solve this issue, I propose we merge these articles into one, naming it "genital mutilation" and making circumcision redirect to here. 82.18.134.221 (talk) 21:31, 4 June 2022 (UTC)

This is addressed in the FAQ at the top of this talk page. MrOllie (talk) 21:33, 4 June 2022 (UTC)

where, and it doesn't seem to talk about sexism, nor about "female genital mutilation" 82.18.134.221 (talk) 08:37, 5 June 2022 (UTC)

Talk:Circumcision/FAQ#Page_name addresses the topic directly. Most reliable sources refer to circumcision as "circumcision"; thus, in accordance with WP:TITLE, Wikipedia does the same. Sideswipe9th (talk) 14:48, 5 June 2022 (UTC)

still is sexist 82.18.134.221 (talk) — Preceding undated comment added 16:07, 5 June 2022 (UTC)

Preferred wording in lead RfC

Version #1 (Revised):

Circumcision is associated with reduced rates of urinary tract infections and sexually transmitted infections. This includes decreased incidence rates of cancer-causing forms of human papillomavirus (HPV) and significant reductions of HIV transmission among heterosexual men within high risk populations. Neonatal circumcision also decreases the risk of penile cancer. Complication rates are higher when the procedure is performed on individuals that are older. A 2010 review found circumcisions performed by medical providers to have a typical complication rate of 1.5% for babies and 6% for older children, with few cases of severe complications. Bleeding, infection, and the removal of either too much or too little foreskin are the most common acute complications. Meatal stenosis is the most common long term complication. Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors. The World Health Organization (WHO), UNAIDS, and American medical organizations take the position that it carries health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. There is a consensus among major medical organizations to recommend circumcision as part of a comprehensive HIV transmission program in areas with high endemic rates of heterosexually transmitted HIV. [Note C]

Contained within Note C of Version #1:

There is a consensus among major medical organizations to recommend circumcision as part of a comprehensive HIV transmission program in areas with high endemic rates of heterosexually transmitted HIV. The World Health Organization does not recommend circumcision for HIV prevention in men who have sex with men; major medical organizations have differing perspectives on the prophylactic efficacy of using circumcision to prevent HIV in the developed world.

Version #2 (Original):

Circumcision is associated with reduced rates of urinary tract infections and sexually transmitted infections. For the latter, this includes decreased incidence rates of cancer-causing forms of human papillomavirus (HPV) and significant reductions of HIV transmission among heterosexual men within high risk populations. The WHO and UNAIDS recommend circumcision as part of a comprehensive HIV transmission program in areas with high endemic rates of HIV. The WHO does not recommend circumcision for HIV prevention in men who have sex with men; effectiveness of using circumcision to prevent HIV in the developed world is unclear. Neonatal circumcision also decreases the risk of penile cancer. Complication rates are higher when the procedure is performed on individuals that are older. A 2010 review found circumcisions performed by medical providers to have a typical complication rate of 1.5% for babies and 6% for older children, with few cases of severe complications. Bleeding, infection, and the removal of either too much or too little foreskin are the most common acute complications. Meatal stenosis is the most common long term complication. Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors. The World Health Organization (WHO), UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk.

— Preceding unsigned comment added by KlayCax (talk • contribs) 22:28, 12 June 2022 (UTC)

Version 1: (Note: I am the one who posted this.) The revision is a substantive improvement. KlayCax (talk) 17:21, 13 June 2022 (UTC)

Version 2: we need to give due weight to men who have sex with men and the developed world. Prcc27 (talk) 23:14, 12 June 2022 (UTC)

The lead can't authoritatively state it one way or another in those situations. There's simply a lack of consensus on the matter. (The AAP + a few other medical organizations say it does reduce the incidence of HIV/AIDS in developed countries; the WHO and European medical organizations state the opposite and/or state it's unclear.)

The revised wording specifically say that there's a consensus only "among heterosexual men within high risk populations". Perhaps it could be expounded upon in the notes, but "there is a consensus among major medical organization to recommend circmcision as part of a comprehensive HIV transmission program among heterosexual men in areas with high endemic rates of HIV" doesn't violate the concept of WP: Undue. The WHO/UNAIDS recommendations have been extensively critiqued by both anti-circumcision and pro-circumcision citations in the literature, alongside others.

The revised lead already specifies that consensus on the matter only applies in narrow circumstances. If anything, taking one medical organization's guidelines (which have been extensively criticized from both camps) and uniformly applying it throughout the article as the authoritative statement of the medical profession is an example of WP: Undue. The revised revision doesn't go beyond the consensus; the original gives an impression that there is a stronger scientific consensus on the matter than there is. KlayCax (talk) 17:15, 13 June 2022 (UTC)

You are mischaracterizing what we currently have. We do not focus on only one medical organization’s guidelines– we give due weight to multiple organizations. Prcc27 (talk) 22:02, 13 June 2022 (UTC)

It's not the fact that the World Health Organization is quoted. It's the fact that several other major medical organizations (such as the American Academy of Pediatrics and CDC) state that circumcision is prophylactic (including) for MSM in developed countries. It isn't that it's wrong. It's just that simply giving the WHO's opinion would indirectly imply that there's a consensus on the matter among major medical organizations.KlayCax (talk) 18:42, 17 June 2022 (UTC)

Note: I'm making a new RfC since this one was improperly filed. So perhaps this conversation could be moved once it's made.KlayCax (talk) 18:42, 17 June 2022 (UTC)

Note: This appears to be improperly filed. @KlayCax: please review the all of the text at WP:RFC for how to properly file an RfC to ensure that it gets added by bots to the correct lists. Sideswipe9th (talk) 18:05, 13 June 2022 (UTC)

I didn't realize. Thanks! KlayCax (talk) 15:01, 15 June 2022 (UTC)

No worries. When I saw it didn't have any of the headers or stuff, I figured you hadn't seen that. Once you've read through the text at RFC I'd recommend starting a new section to do it cleanly in, and dropping Prcc27 a message to let them know that it's been filed properly. Sideswipe9th (talk) 15:25, 15 June 2022 (UTC)

Thanks! I'll make a remade RfC. KlayCax (talk) 18:42, 17 June 2022 (UTC)

Why is Christianity in the header?

Excuse my ignorance, but as a Jewish man, does any major Christian denomination actually support or recommend circumcision? Why the heck is it in the header?OntologicalTree (talk) 23:05, 9 July 2022 (UTC)

• Please explain what you mean by “the header”. It looks like some of the minor sects of Christianity endorse it. Prcc27 (talk) 00:17, 10 July 2022 (UTC)

References broken

31 references show up in the article. Somewhere, the article gets broken and prevents the hundred plus references from showing on the article. 2600:1700:D591:5F10:996C:4877:C2EF:3A72 (talk) 04:12, 20 July 2022 (UTC)

Does it still show up as broken for you? KlayCax (talk) 18:27, 31 July 2022 (UTC)

Prevalence section here is larger than that referred here as the main article: Prevalence of circumcision

It should be an {{excerpt}} of Prevalence of circumcision#Present. — Guarapiranga ☎ 07:11, 8 August 2022 (UTC)

Suggested mergers and deletions

• Circumcision clamp + circumcision surgical procedure → circumcision

Both of these articles could easily be merged into circumcision without any significant problems. There doesn't seem to be an independent reason for them to exist.

• Ethics of circumcision + Circumcision and law + Circumcision controversies → TBD name (Suggested name: Cultural views on circumcision)

All of these could easily be merged into one, singular article. Or perhaps, similarly, merged into circumcision. No good reasons for them to exist as independent articles.

• Brit Shalom and Brit rechitzah → Circumcision

Fringe movement which even supporters state that presently "calling it a marginal phenomenon would be generous". Comes off more across as a promotional page than anything else.

• Intact America + Genital Autonomy America → Merged into Intact America or deleted entirely. The latter organization no longer even exists.

Don't meet standards of notability and has been overwhelmingly edited by users close to the organization. (As has been openly stated by those editing it.)

Merging content into this article could be tricky and might make this article too long. I oppose naming any combination of those articles “Cultural views on circumcision”– ethics and culture are two very different things. Not really sure how Circumcision and law would fit with the other articles.. I support merging IA and GAA. Prcc27 (talk) 00:46, 15 July 2022 (UTC)

I'm open to suggestions. I've thought of something like: Cultural, ethical, legal, and social views on circumcision.

I saw a post above saying that there was way too many articles surrounding this topic. And — honestly — I happen to agree with the notion.

Sorry for a late response. I've been busy with other articles and it didn't seem to "ping" on my watchlist. KlayCax (talk) 03:14, 31 July 2022 (UTC)

I think Circumcision and law should remain its own article. Ethics of circumcision + Circumcision controversies could become “Ethics and controversies of circumcision” Prcc27 (talk) 03:26, 31 July 2022 (UTC)

I’m not sure why you created Cultural views on circumcision.. I do not think it is the right way to merge pages. I think it would have made more sense to merge one article into the other, without creating an extra article. Prcc27 (talk) 03:56, 31 July 2022 (UTC)

Apologies, I didn't see your initial comment at the time. @Prcc27: I agree that the name should be changed. But I think we need to give it a more encompassing title that encompasses cultural, social, and ethical viewpoints, although I'm unsure what the ideal wording would be. The wordings of ethics of circumcision or circumcision controversies simply aren't broad enough for what I thin we need to be looking for. KlayCax (talk) 04:18, 31 July 2022 (UTC)

• I don’t agree with merging those articles into something more broad. I’m okay with consolidation when it is necessary, but adding culture to the mix would mean we would probably have to trim a lot of the ethics and controversies content, which I oppose. I think Religious male circumcision may actually be the more appropriate article to try to include cultural aspects. Prcc27 (talk) 04:36, 31 July 2022 (UTC)
  • Religious male circumcision wouldn't an ideal place to consolidate much of this. There's cultural, ethical, and social views on circumcision that aren't limited to just the religious imposition of the practice. (e.g. Historical Greco-Roman views on the beauty of the prepuce; African, American, Middle Eastern, et al. disfavor on the aesthetics of it.) There's a lot of things on ethics of circumcision and circumcision controversies that could be drastically trimmed while improving the subsequent quality of the article.KlayCax (talk) 05:18, 31 July 2022 (UTC)

The latter organization no longer even exists.
Neither does the Roman Empire; not a criterion for mergers and deletions. WP:N or else. — Guarapiranga ☎ 01:08, 1 August 2022 (UTC)

Tbc:

• Support:
  • Circumcision clamp + Circumcision surgical procedure → Circumcision
  • Ethics of circumcision + Circumcision and law + Circumcision controversies → Circumcision: ethics and law
• Oppose:
  • Brit Shalom and Brit rechitzah → Circumcision
    Brit rechitzah has already been merged into Brit Shalom, which I didn't oppose. Further merging it into Circumcision means diluting it and minimising a topic notable enought to be covered by various RS.
  • Intact America + Genital Autonomy America → Merged into Intact America or deleted entirely.
    As stated above, that an organization no longer even exists is not a criterion for exclusion from WP.

  — Guarapiranga ☎ 07:04, 8 August 2022 (UTC)

I don't have a very strong opinion about some of these suggestions. I only have some concerns about merging the Circumcision controversies, law and ethics pages into one article. Those pages are already long enough, which means that merging them would create either a very lenghty article (not necessarily too bad, if it's well taken care of, but still hard to navigate), or a normal sized article with a lot of information from the pages removed. Considering that circumcision is a heavily discussed topic, the existance of seperate pages with links to each other doesn't seem that bad, to me at least.

I also agree with User:Prcc27 that if any of the law, ethics or controversies articles are to be merged, they cannot be named Cultural views. This new page by User:KlayCax has potential to become an interesting page, but I don't think it can become the merging place of the law, controversies or ethics pages. Maybe that page could merge as a subcategory in circumcision? Piccco (talk) 18:30, 9 August 2022 (UTC)

OntologicalTree notification about it

Saw your post about the current WP: Fork situation @OntologicalTree: and I agree that there's way too many articles surrounding this subject.

Any particular suggestions? KlayCax (talk) 18:26, 31 July 2022 (UTC)

Prevention of STDs is highly disputed

Here are some of the sources I have for this:

• African HIV trials were found to be faulty and fraudulent.
• Being circumcised is a predictor of sexually transmitted disease.
• Having a circumcised partner is “strongly associated with HIV-1 infection” in Rwanda.
• A Ugandan trial shows a 61% relative increase in HIV infection among female partners of HIV-positive circumcised men. This link also debunks the famous African pro circ trials.

This doesn't even cover the known phenomena of circumcision causing risky sexual behaviour due to the man thinking he's immune to STDS. Prevention of STDs is also just one of many myths that have been propagated by this article. Tiggy The Terrible (talk) 20:28, 13 August 2022 (UTC)

This is already conveyed with Major medical organizations hold widely variant perspectives on the bioethics, cost-effectiveness, and the prophylactic efficacy related to the elective circumcision of minors. The World Health Organization (WHO), UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk in the article. KlayCax (talk) 19:29, 27 August 2022 (UTC)

@KlayCax: the line you mention seems to be very small and well buried, and isn't given enough weight considering the vast number of studies & official statements that could be cited there. I'd say it should be first, and we should line up both the for and against claims immediately after - if they are in the lead at all. Personally I think that section is too long and too in depth. a lead should be byte sized, according to the wiki documentation. It should highlight the issues involved without actually addressing them, since it's supposed to lead you deeper into the article rather than be the be all and end all. In my mind we should cut down the second two massive paragraphs, and place their content elsewhere. Tiggy The Terrible (talk) 09:38, 1 September 2022 (UTC)

We can't use lower quality sources like this to try to undercut the WHO. Single trials and stuff like the 'Doctors Opposing Circumcision' opinion piece in the JLM don't even meet WP:MEDRS. MrOllie (talk) 10:35, 1 September 2022 (UTC)

@MrOllie: How about the metastudies & other studies I added to the page that you revoked? Can you tell me why you think that we shouldn't lead with the line that points out these benefits are disputed? Also, I'm noticing a lack of any mention that most circumcisions are involuntary in the heading. Saying they are elective makes it seem like adults are getting it done to themselves. Tiggy The Terrible (talk) 16:53, 1 September 2022 (UTC)

They don't meet MEDRS. The only metastudy I see, the one by Van Howe, has been discussed extensively in the talk page archives, feel free to read them - rehashing this yet again isn't a good use of time. Reliable sources generally do not call medical procedures on minors 'involuntary' - Tonsillectomy is mostly done on children. You'll note that no one labels that an involuntary procedure. MrOllie (talk) 17:00, 1 September 2022 (UTC)

@MrOllie: I'm a little bit confused by what you are saying because infant circumcision is, by definition, involuntary - and I can cite you quite a few valid studies that describe it that way. Here is another. Here is a third. It wasn't hard to find these, and I'm sure I can find articles and all sorts calling it this if you like. I do have several studies noting no real HIV benefit, like this one. Could you link me to the Van Howe discussion? I can't find it, but it seems very random to not include that metastudy that the European Journal of Epidemiology calls "comprehensive" in the previous link. It seems very odd to exclude it, so a reason would be good. Tiggy The Terrible (talk) 18:22, 1 September 2022 (UTC)

Yes, there are a lot of fringe articles that you can find in this space. But we're not going to use them here, nor will we adopt their POV pushing language - nor are we going to undermine the well established consensus of mainstream medical science based on a few people publishing in questionable journals. Please read WP:MEDRS carefully - you are going to have to stick to it if you want to edit medical articles on Wikipedia. No number of links to papers that do not meet that standard will do any good here. There are many discussions on Van Howe in the talk page archives. Use the search box toward the top of this talk page. MrOllie (talk) 19:04, 1 September 2022 (UTC)

@MrOllie: This article here is the European Journal of Epidemiology, and it backs up the Van Howe metastudy. Calling it comprehensive. Is the European Journal of Epidemiology not authoritative enough? I could not find a vote in my search that would indicate consensus. Just a lot of arguing. However, I'm happy to exclude that one meta study. The problem is there are a great number of other studies finding the same thing that seem to have been excluded. For example, the one above - which is not on there, as far as I can see. Tiggy The Terrible (talk) 19:49, 1 September 2022 (UTC)

It is a single study. Again, have a look at WP:MEDRS, this is covered there. MrOllie (talk) 19:56, 1 September 2022 (UTC)

@MrOllie: My point was simply that that it reviews that metastudy. I have other metastudies, Such as this one from the Lancet. Or this one that found the link was not significant in gay men. We should also discuss the inclusion of a section on ethics. For example: using this article from The American Journal of Bioethics "Under most conditions, cutting any person’s genitals without their informed consent is a serious violation of their right to bodily integrity. As such, it is morally impermissible unless the person is nonautonomous (incapable of consent) and the cutting is medically necessary" Tiggy The Terrible (talk) 20:30, 1 September 2022 (UTC)

I'm more or less done repeating myself - none of these links pass WP:MEDRS for one reason or another. And even if they did muster bare acceptability, we cannot use lower tier sources to undermine the WHO. I'm done responding here until a third party chimes in. MrOllie (talk) 20:41, 1 September 2022 (UTC)

Possible inaccurate citations/information throughout the article

I just removed a statement that stated:

The overall prevalence of circumcision in South Korea has increased markedly in the second half of the 20th century, rising from near zero around 1950 to about 60% in 2000, with the most significant jumps in the last two decades of that time period. This is probably due to the influence of the United States, which established a trusteeship for the country following World War II.

It goes on to cite the World Health Organization. But nothing within the citation claims that!

The strikethrough text itself appears to have been an unreferenced statement inserted by an IP editor on March 22, 2005. (Although earlier statements with similar wording existed.) I couldn't find any consensus within the literature on this statement — along with multiple citations already present within the article stating the exact opposite.

Such as p. 256-257 of Bolnick, Koyle & Yosha (2012) :

...[in] South Korea... where the operation became very popular in the second half of the twentieth century... while these authors attributed this to American influence, this seems unlikely since the age of circumcision matches more the practice in the Philippines and elsewhere in southeast Asia. Quoted anedoctal evidence mentions that the Korean Army favored the procedure during the Korean War, and also that many popular newspaper and magazine articles promoted circumcision in the 1950s.

Despite its impressive length this article (and other articles related to circumcision suffer from substantive problems:

• Quoting NPOV-pushing (both pro and con; see folks like Brian Morris, Marilyn Milos, et al. All of which should have raised red flags to almost anyone who is aware of this subject.) sources instead of respectable medical assocations. (AAP, WHO, British Medical Association, Danish Medical Assocation, et al.)
• Labeling inaccurate/disputed information as objective fact (Claiming that there's a consensus that South Korea picked up circumcision from the United States, claiming that Kellogg was a promoter of routine circumcision, et al.)
• Articles that are obvious cases of WP:REDUNDANTFORK or WP:POVFORK. (See Circumcision clamp, Intact America, Genital Autonomy America, Brit Shalom, Intaction, et al. for just a small sample of this.) The vast majority of these articles are reductant forks which almost always receive no traffic, often times due to being Wikipedia:Orphans, and are simply mirrors of wording already present on other articles on the subject.

I could keep going on and on. But this article probably needs to be downgraded to start. It has massive issues throughout and this isn't something that can be easily solved in a night. I'm aware that the main article achieved GA-status (before getting demoted) a few months ago. But I'm under the conviction that promoting it in the first place was a mistake: this article(s) needs major, major improvements.

Thanks, KlayCax (talk) 07:26, 2 September 2022 (UTC)

Re: Major medical organizations overwhelmingly support the legality of circumcising minors.[25][54]

I read the two sources cited for this https://link.springer.com/chapter/10.1007/978-1-4471-2858-8_1 and https://link.springer.com/article/10.1007/s43545-020-00011-7 neither of them represent overwhelming support. There is guidelines for the procedure when a medical necessity but that is no different when an amputation is required. Even the first abstract writes "That is, circumcision confers some medical benefit but not enough to call for its routine application."

There is a recognition of the possible legality of circumcision in respective countries, though they come with various caveats and actual doubt as to whether religious justification would actually hold up, if for example in the EU it is brought to the European Court of Human Rights.

The second source is an advocacy and lobbying piece. Again made clear in the abstract "The final part of the article includes a proposal for humane male circumcision that considers religious sentiments and the rights of the child, aiming to strike a reasonable balance between competing interests. I hope the proposal will be debated in parliaments in the western world."

It also cites a BMA piece "The British Medical Association (2004) is supportive of allowing parents to make choices for their children" despite it being published in 2021, the most recent guidance BMA guidance is from 2019 https://www.bma.org.uk/media/1847/bma-non-therapeutic-male-circumcision-of-children-guidance-2019.pdf and while it doesn't outright condemn the religious/cultural practice, it certainly isn't "supportive of allowing parents to make choices for their children" for circumcision. From the 2019 guidelines:

"Furthermore, the harm of a person not having the opportunity to choose not to be circumcised or choose not to follow the traditions of his parents must also be taken into account, together with the damage that can be done to the individual’s relationship with his parents and the medical profession, if he feels harmed by an irreversible non-therapeutic procedure."

This page has much wider problems, such as after the initial description it is immediately followed by a justification: "Circumcision is associated with reduced rates of sexually transmitted infections and urinary tract infections. This includes decreasing the incidence of cancer-causing forms of human papillomavirus (HPV) and significantly reducing HIV transmission among heterosexual men within high risk populations".

If the page on domestic abuse followed the description with "beating your wife has been found to lower divorce rates and increase offspring education outcomes by 30%" it would be wildly inappropriate even if those statistics were somehow true.

But I just went in depth with at least those two sources which are referenced repeatedly, the second of which being openly lobbying is clearly inappropriate. Trying to falsely claim major medical organisations support your point of view isn't acceptable. BeardedChimp (talk) 04:20, 10 September 2022 (UTC)

The "overwhelming ..." claim is not supported by the sources; I have restored the text as it stood in the GA. Your "wife beating" comment is WP:SOAP, and unhelpful. Bon courage (talk) 08:28, 10 September 2022 (UTC)

Regarding you restoring the GA wording, I think saying that no major medical organization recommends a ban, does not capture the nuances. The Royal Dutch Medical Association for example, seems to think a ban is justified (albeit they worry about unintended consequences). Prcc27 (talk) 15:16, 10 September 2022 (UTC)

My suggestion would be, to move the Royal Dutch sentence in that paragraph to immediately follow the no major medical organization recommends a ban sentence. However, I do worry that might be WP:SYNTH. Thoughts? Prcc27 (talk) 15:35, 10 September 2022 (UTC)

The current version starts with the most generally agreed positions and then moves to the more specific, with the RDMA position at the end as most specific. That's how we should keep it, especially since moving it up implies that the RDMA is a 'major medical organization', which would definitely be synthesis. MrOllie (talk) 15:45, 10 September 2022 (UTC)

Legality citation needed

There are two sentences in the article which require citations. Otherwise, I feel like they need to be deleted: “Even among critics of the practice, there is an agreement that any such legislation would lead parents who insist on the procedure to turn to poorly trained practitioners instead of medical professionals[citation needed], would further the stigmatization of or encourage the persecution of minority groups[citation needed].” The first sentence is backed by the Royal Dutch Medical Association (KNMG) source, but the KNMG view is already referenced later on in the paragraph, so we need an additional source for this to remain. Furthermore, we would need to reword one of the sentences, as it is redundant to state this twice in the same paragraph. Prcc27 (talk) 16:09, 10 September 2022 (UTC)

If nobody provides new sources or demonstrates which current sources back up these claims, I will be removing these sentences from the article as soon as tomorrow for violating WP:OR. Prcc27 (talk) 22:46, 12 September 2022 (UTC)

Trials paragraph POV

I have some WP:POV concerns regarding the paragraph about the trials. “The circumcised group had a substantially lower rate of HIV contraction than the control group, and hence that it would be unethical to withhold…” Issue #1: we should not state an ethical view as factual. “…the treatment in light of overwhelming evidence of prophylactic efficacy” issue #2: non-therapeutic circumcision is considered prevention, not “treatment”; also, it is POV to exaggerate and say the evidence is “overwhelming”. At best, the evidence is “strong”. Prcc27 (talk) 02:38, 15 September 2022 (UTC)

Note to other editors that this is (and my first comment below) is a rediscussion of this.

Sharma, et al. (2021) states: MC is... strongly supported by the data from three large RCTs conducted in Africa right before that. It directly mentions the three RCT trials as part of the "overwhelming evidence" for circumcision in high risk contexts.

Scientific American (2008) states: all three trials were stopped early due to the overwhelming evidence of circumcision's protective effect.

Thomas, et al. (2011) states: Overwhelming evidence, including three clinical trials, shows that male circumcision (MC) reduces the risk of HIV infection among men.

Lie and Miller (2011) states: Only after the results of three RCTs were available was the public health community convinced that there was sufficient evidence to initiate provision of circumcision services in high prevalence areas

Holmes, Bertozzi, & Bloom (2017) states: Circumcision of adult males is 70 percent effective in reducing transmission from females to males based on three RCTs... (very strong evidence).

Piontek and Albani, (2019) states: Randomized controlled trials have demonstrated circumcision results in a 50–60% reduction in risk of acquiring HIV infection in heterosexual males. In three clinical trials performed in sub-Saharan Africa, uncircumcised men were randomly assigned to one of two groups. One group was offered immediate circumcision (treatment group) and those in the other group (control group) were offered circumcision at the end of the trial. All participants received HIV testing and counseling, condoms, and safe sex counseling. All three trials were stopped early due to the overwhelming evidence that circumcision offered a protective effect against HIV, and it was felt to be unethical to ask the control group to wait to be circumcised.

World Health Organization (2020) states: The evidence that circumcision reduces the risk of HIV infection in men is strong. Results come from diverse settings, span 32 years (1986 to 2017), and are very consistent... Data from three RCTs.

We've had multiple RfC's on this matter: all with a uniform consensus that it's not undue. What is undue is promoting fringe perspectives. KlayCax (talk) 22:16, 18 September 2022 (UTC)

You even admitted that “strong” and “overwhelming” isn’t a contradiction. Why are you fighting so hard for using the latter term? Prcc27 (talk) 23:06, 18 September 2022 (UTC)

Photo cropping

The photo File:Covenant of Abraham.JPG was cropped on 17 May 2020, with the new version uploaded by the original uploader (Chesdovi), saying "cropped, per talk". I don't know what talk that was referring to; I didn't easily find such a discussion. The caption in the article had included some descriptive details: "with a Mogen shield (on the table, next to the scalpel)". I just removed that part of the caption, because there is no Mogen device, scalpel or table visible in the cropped version. My impression is that the cropped version contains a lot less information than the uncropped one, so I would prefer the uncropped one. In the cropped version, all we see is the back of a man's head and a baby that is wearing a diaper and having its shirt pulled up by someone else's hands. I don't see anything in the picture that even identifies that what is happening is circumcision (in contrast to the uncropped version, which shows the instruments that will be used in the process). Which version do others prefer? —⁠ ⁠BarrelProof (talk) 21:37, 10 October 2022 (UTC)

No, Wikipedia can't refer to circumcision as "genital mutilation" in Wikivoice.

@GenoV84:. We can't blanketly refer to circumcision as "genital mutilation" in Wikivoice. This has already been discussed repeatedly on the circumcision talk page and various RfC's ad nauseam: with a repeated consensus that it shouldn't be referred to as such in Wikivoice. As Martha Nussbaum famously summarized in Sex and Social Justice (1999):

Although discussions sometimes use the terms 'female circumcision' and 'clitoridectomy', "female genital mutilation"... is the standard generic term for all these procedures in the medical literature... The term 'female circumcision' has been rejected by international medical practitioners because it suggests the fallacious analogy to male circumcision.

Blanketly changing "circumcision" to "child abuse" and "genital mutilation" is WP: Activism, WP: NPOV, and WP: Fringe. KlayCax (talk) 22:06, 11 October 2022 (UTC)

Similarly, changing "circumcision" to "male genital mutilation" and "abuse" in the estimates of sexual violence page is a violation of WP: NPOV. (As previous RfC's have additionally stated). We've had a RfC/debates like this ad nauseam over the past ten years: with the same conclusion time after time. KlayCax (talk) 22:46, 11 October 2022 (UTC)

@KlayCax: If you have read the edit summaries of my latest edits on the article Circumcision controversies, you already know that the reason for reverting your repeated removal of the same content wasn't due to the language used in that paragraph; in fact I didn't contend the changing of words, but rather your unjustified, persistent, deliberate removal of sourced content and relevant informations supported by the academic sources cited in the article. GenoV84 (talk) 01:15, 12 October 2022 (UTC)

Btw, the appropriate talk page to discuss about the aforementioned edit warring is Talk:Circumcision controversies, not this one. GenoV84 (talk) 01:16, 12 October 2022 (UTC)

Btw, the appropriate talk page to discuss about the aforementioned edit warring is Talk:Circumcision controversies, not this one. I think either is fine. But I'll repost this thread on there. Whether it should be referred to as "mutilation" in Wikivoice affects a multitude of articles surrounding circumcision. KlayCax (talk) 01:42, 12 October 2022 (UTC)

That's why I brought the conversation to the main article on the subject. KlayCax (talk) 01:47, 12 October 2022 (UTC)

RFC lead Wording

First aspect

Wording choice A: (Move major medical organizations positions in developing nations into a note)

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors. [Within note] The World Health Organization, UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. [/End Note]

Wording choice B: (Completely eliminate major medical organizations positions in lead)

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors. [No note] The World Health Organization, UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk. [/No Note]

Wording choice C: (Status quo)

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors. The World Health Organization, UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk.

Second aspect

Wording choice D: (Modified lead)

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors in developed countries.

Wording choice E: (Status quo)

Major medical organizations hold widely varying perspectives on the prophylactic efficacy, bioethics, and cost-effectiveness related to the elective circumcision of minors.

— Preceding unsigned comment added by KlayCax (talk • contribs) 12:37, 17 May 2022 (UTC)

Semi-protected edit request on 15 October 2022

The existing page states "Circumcised men are presently estimated to constitute around 38% of the world's population.[9][21][39][40] ". This is badly worded and is incorrect as worded. The figure is about one third of men, not one third of the world's population. The quoted sentence should read: "Circumcised men are presently estimated to constitute around 17% of the world's population.[9][21][39][40]" 180.150.36.246 (talk) 08:21, 15 October 2022 (UTC)

Resolved

Bon courage (talk) 08:23, 15 October 2022 (UTC)

Requested move 10 October 2022

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this discussion.

The result of the move request was: Not moved by a unanimous consensus. No such user (talk) 10:17, 17 October 2022 (UTC)

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Circumcision → Male circumcision – This article only covers the topic of male circumcision. Please note that female circumcision also exists. Due to that, I propose that "Circumcision" should become a disambiguation page. Male circumcision is only common in the US, Australia and Canada when regarding first world countries, and the term "circumcision" is therefore equally associated with both the male and female version in a large part of the world. 12u (talk) 20:53, 10 October 2022 (UTC)

• Male circumcision is not just an American thing. Prcc27 (talk) 15:34, 10 October 2022 (UTC)
  • Yes, please see Circumcision#Prevalence and Prevalence of circumcision for details. There are places with higher rates than the United States. —⁠ ⁠BarrelProof (talk) 17:30, 10 October 2022 (UTC)
    • I misformulated. Thanks for correcting me, I have now updated the request reason. However, the links you referred me to does in fact verify that male circumcision is uncommon in many English-speaking countries, and the term "circumcision" can therefore be ambiguous. 12u (talk) 18:59, 10 October 2022 (UTC)

Talk:Circumcision/FAQ addresses this briefly. It's been brought up repeatedly and consensus has been "no". --jpgordon^{𝄢𝄆𝄐𝄇} 19:08, 10 October 2022 (UTC)

• Not again. The answer is "no", not least by pretending, as the OP does, that there are two "types" of circumcision (male/female), is to downplay female genital mutilation. Bon courage (talk) 19:25, 10 October 2022 (UTC)
  • I am not attempting to downplay female genital mutilation; circumcision is genital mutilation, both for males and females. However, male genital mutilation could also refer to castration and other procedures, please see Genital_modification_and_mutilation#Males. We need to keep the "circumcision" term in order to disambiguate. 12u (talk) 06:14, 11 October 2022 (UTC)

    By creating an equivalence between a slight (even beneficial) surgical procedure and the horrific brutality of FGM, that's what would happen. See the FAQ too. Bon courage (talk) 06:19, 11 October 2022 (UTC)

I checked the FAQ now by your request, and found this recent comment which supports my statement. Let's not pretend that male circumcision is any less horrific. In Norway it is considered a religious practice with no health benefits. (reference) 12u (talk) 07:46, 11 October 2022 (UTC)

Looks like some silly activism was recently added; that's been cleaned up. Anyway, consensus is well settled and this move is not going to happen. If you want more views I suggest advertising this RM at WT:MED (where this has also been discussed before). Bon courage (talk) 07:53, 11 October 2022 (UTC)

• Oppose. "Circumcision" is the name commonly used by the sources, and an additional qualifier is not necessary. - MrOllie (talk) 12:15, 11 October 2022 (UTC)
• Strongly oppose. This subject has already been repeatedly broached before.There's consistent consensus that it shouldn't be changed. As Martha Nussbaum has stated: Although discussions sometimes use the terms 'female circumcision' and 'clitoridectomy', 'female genital mutilation' (FGM) is the standard generic term for all these procedures in the medical literature... The term 'female circumcision' has been rejected by international medical practitioners because it suggests the fallacious analogy to male circumcision.

This would be WP: Activism and a violation of WP: NPOV. KlayCax (talk) 18:29, 11 October 2022 (UTC)

• Oppose. The word on its own overwhelmingly refers to male circumcision. When it is used to refer to FGM then "female" is invariably added to it. -- Necrothesp (talk) 12:33, 12 October 2022 (UTC)
• Oppose my understanding is that "circumcision" in common vernacular refers to male circumcision. This is also longstanding precedent on this talk page. No dab please. Draken Bowser (talk) 14:00, 12 October 2022 (UTC)
• Oppose per WP:CONCISE and WP:COMMONNAME. Though a hatnote pointing to Female genital mutilation might be useful. Rreagan007 (talk) 18:04, 14 October 2022 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Anti-circumcision bias

Does this article come across as bias to anyone else?

Sections in the article frequently devolve into what seems like rants against the practice rather than an objective accounting. The summarization of the existing literature also seems skewed in an anti-circumcision way. As a Jewish person, it seems heavily skewed towards a liberalistic and Anglo-American perspective; other cultural and religious perspectives are totally ignored.OntologicalTree (talk) 17:17, 15 June 2022 (UTC)

Those are not “rants”. We give due weight to controversies and significant minority viewpoints. Religious perspectives would probably belong in the respective religion sections. Also, if anything, I think the lead may give UNDUE weight to religion. This was a concern even before the religion section in the lead was recently expanded. Prcc27 (talk) 18:25, 15 June 2022 (UTC)

That's fine, but I can't see how it's not problematic to implicitly privilege a certain metaphysical view of the world (in this instance: materialistic naturalism combined with Anglo-American liberalism) throughout the article. Why does the ethical section not mention the Jewish, Islamic, and Christian perspectives on the rite, while highlighting a view of autonomy that would be rejected throughout a majority of the world outside of Western Europe and North America. Muslims are a significant portion of circumcised men and the article barely mentions it. OntologicalTree (talk) 23:08, 9 July 2022 (UTC)

I don't think that is an intentional bias by editors, @OntologicalTree:. I highly suspect that it's related to the fact that the nature of Wikipedia currently tends to appeal towards users that are 1.) College-educated 2.) Relatively young (18-40) 3.) White 4.) Western 5.) Irreligious and/or Christian, et al. All groups more likely to oppose the continued perpetuation of the practice. (See Wikipedia:Who writes Wikipedia? for more information.) I disagree with your implication (on this and a few other posts made by you) that there's a malicious intent here — you shouldn't assume good bad by other editors — but I agree that there's NPOV problems on the present circumcision-related articles. It's a side effect of the current editor base. KlayCax (talk) 04:36, 31 July 2022 (UTC)

The article deals with the topic of circumcision. The fact is that worldwide most men are circumcised not as adults but as children. Statistically most of them for religious (Islam, Judaism, others) or pseudo-medical reasons (e.g. phimosis, which is not fundamentally pathological in children, but physiological, i.e. natural). For this reason, the article, in whatever form, actually describes a widespread human rights violation against male children. The alleged right of religious adults to have their sons (or daughters!) circumcised for non-medical reasons is not covered by universal human rights, on the contrary. For this reason, there will always be non-neutral points of view in this article. One simply cannot have a neutral position on human rights violations against children. Religions have been founded long before the Universal Declaration of Human Rights and have always changed their rites over time. I personnally don't like the section title "Anti-circumcision bias" which indicates that circumcision was the norm which is not the case for most countries. Furthermore, there are rare medical indications for circumcision and adult men have all rights to be circumcised for whatever reason. This is why intactivists do not speak against circumcision generally, but focus on the medically not indicated circumcision of minors which is forbidden as a matter of law. No physician has the right to cut off intact organs from a child's body without medical urgency (and there is none). No parent has the right to have someone cut off intact organs from their child's body without medical urgency (and there is none). Ulf Dunkel (talk) 12:20, 14 October 2022 (UTC)

This is just disruptive WP:SOAP. Please confine contributions to this page to suggestions for improvement using high-quality sources. Bon courage (talk) 12:25, 14 October 2022 (UTC)

I am sorry but this is the Talk page where I replied to a question by @OntologicalTree. And I am not aware that WP section titles in articles and talk pages did ever have to be based on high-quality sources. Therefore I allowed myself to question the section title "Anti-circumcision bias". Why didn't you criticize the OP for his WP:SOAP, if any? Ulf Dunkel (talk) 13:00, 14 October 2022 (UTC)

Probably because I wasn't watching the page. See WP:TPG for what a Talk page is for and cease the advocacy - go to reddit or something for that. Bon courage (talk) 13:06, 14 October 2022 (UTC)

Ulf Dunkel doesn't seem to be doing WP:SOAP. He is not doing Advocacy, propaganda, or recruitment, opinion, etc. He seems to be delivering facts as they exist in the wild. He seems to be talking about human rights. He seems to be talking about human culture/religion and statistics. What he wrote can be verified and if it is correct, can be copied and pasted into the article. Vmelkon (talk) 03:59, 6 November 2022 (UTC)

Not sure how the religious perspectives would relate to ethics.. I do not know why the article gives less weight to Islam, but my guess would be that maybe Islam does not stress the “importance” of circumcision as much as other religions. Prcc27 (talk) 00:04, 10 July 2022 (UTC)

Islam (which by far makes up the majority of religious and cultural circumcisions in the world) definitely needs more representation within this article. However, I don't have a great deal of knowledge about the issue within the Muslim world/theology so I'm afraid that I can't contribute much to the issue. @OntologicalTree:@Prcc27: KlayCax (talk) 04:36, 31 July 2022 (UTC)

How is anti-circumcision an "Anglo-American" perspective? Religious circumcision notwithstanding, the USA has one of the highest rates of circumcised adults in the world. (Roughly 80.5% of adult men residing in the USA have been circumcised: Prevalence of circumcision.) By contrast, the practice of circumcision is very rare throughout most of Europe, (including Russia,) Latin America, and most of east Asia, (including China and Japan,) and that is the case even if one does take into account religious circumcisions performed in those places. Masquarr (talk) 07:57, 12 September 2022 (UTC)

You're right, it's just the opposite. In the world the white American POV is pro-mutilation. Mhannigan (talk) 05:29, 3 October 2022 (UTC)

Talk page: Should prophylactic and religious circumcision be referred to in Wikivoice as "genital mutilation" and "abuse"?

Can Wikivoice state that prophylactic and (religious/Jewish) religious circumcision is "genital mutilation", "sexual violence", and "abuse"?

Ongoing discussion on the circumcision controversies talk page. Disputed parts in bold.

Circumcision controversies page:

In Classical and Hellenistic civilization, Ancient Greeks and Romans posed great value on the beauty of nature, physical integrity, aesthetics, harmonious bodies and nudity, including the foreskin (see also Ancient Greek art), and were opposed to all forms of genital mutilation, including [Jewish religious] circumcision — an opposition inherited by the canon and secular legal systems of the Christian West and East that lasted at least through to the Middle Ages, according to Frederick Hodges.

Estimates of sexual violence page:

Historical and documented forms of sexual violence against male patients include the involvement of medical staff in the practice of male genital mutilation [circumcision] in the United States.

See the talk pages on both articles. GenoV84 states it doesn't violate WP: NPOV. I disagree. KlayCax (talk) 01:42, 12 October 2022 (UTC)

@KlayCax it's funny how it's only genital mutilation when you do it to a girl. Tiggy The Terrible (talk) 13:53, 6 November 2022 (UTC)

The title of this Article should be changed to "Male genital mutilation"

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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The title of this Article should be changed to "Male genital mutilation" and the first lines should say something similar to the "Female Genital Mutilation" Article says "Male genital mutilation, also known as Male circumcision". The first section of the article should be what the procedure is. Then followed immediately by information about how it originated, why, and how uncommon the practice is throughout the World with statistical information to show that.

Unless done for a legitimate medical reason such as Phimosis, Male Circumcision is Genital Mutilation. It is an unnecessary practice that originated out of delusional, barbaric religious fanaticism.

A new study from October of 2022 has also called in to question the claims of Circumcision aiding in a reduction of HIV transmission as the article claims in saying "Circumcision is associated with reduced rates of sexually transmitted infections and urinary tract infections. This includes decreasing the incidence of cancer-causing forms of human papillomavirus (HPV) and significantly reducing HIV transmission among heterosexual men within high risk populations." Zoboili (talk) 03:08, 16 January 2023 (UTC)

See the FAQ. We're not going to change the name. MrOllie (talk) 04:04, 16 January 2023 (UTC)

The FAQ is meaningless because it provides no references, sources or citations for the "consensus" it refers to. The actual solution to this supposedly common (also not cited) reference to the procedure as "circumcision" is to create a redirection from "circumcision". This should be put to a vote and if it has been before, it must be cited.

You also have no right to stifle discussion on changing it because things change over time. Even if there was a vote at one point, there is absolutely no logical reason there could not or should not EVER be another. Zoboili (talk) 04:06, 16 January 2023 (UTC)

Nothing has changed, please don't waste community time on useless processes. MrOllie (talk) 04:07, 16 January 2023 (UTC)

Provide citations to the consensus on the FAQ and stop deleting people's posts that adhere to Wikipedia's guidelines for this kind of contentious article.

"The subject of this article is controversial and content may be in dispute. When updating the article, be bold, but not reckless. Feel free to try to improve the article, but don't take it personally if your changes are reversed; instead, come here to the talk page to discuss them. Content must be written from a neutral point of view. Include citations when adding content and consider tagging or removing unsourced information."

My post was a suggestion with verifiable information to back it up. Deleting it completely goes against the principles of Wikipedia. Zoboili (talk) 04:10, 16 January 2023 (UTC)

WP:POINT EvergreenFir (talk) 04:09, 16 January 2023 (UTC)

It is not a disruption to make a suggestion. It is also not a disruption or "making a point" to call out a user for acting in bad faith.

"The subject of this article is controversial and content may be in dispute. When updating the article, be bold, but not reckless. Feel free to try to improve the article, but don't take it personally if your changes are reversed; instead, come here to the talk page to discuss them. Content must be written from a neutral point of view. Include citations when adding content and consider tagging or removing unsourced information."

My post was a suggestion with verifiable information to back it up. Deleting it, as MrOllie did, completely goes against the principles of Wikipedia. They deleted it because apparently it has been permanently decided that the article's name shall never be changed; despite there not being any sources for these decisions. Zoboili (talk) 04:12, 16 January 2023 (UTC)

This is disruption [35] - don't damage the FAQ. MrOllie (talk) 04:23, 16 January 2023 (UTC)

Are you suggesting that requiring sources is vandalism? What a ridiculous action. You are disrupting the intention of the site, not me.

WP:POINT Zoboili (talk) 04:26, 16 January 2023 (UTC)

Yes, placing spurious cite needed tags on FAQ/talk page content is disruption, which is a form of vandalism. MrOllie (talk) 04:28, 16 January 2023 (UTC)

What defines "spurious" the same thing that defines "vandalism" in this case? Your own disagreement? I placed them in the proper locations, directly after the statements and subjects in question that should be cited. Regardless of my personal stance on this topic, the article should be cited. Zoboili (talk) 04:30, 16 January 2023 (UTC)

No, citation needed tags do not go on talk page content which you happen to disagree with. MrOllie (talk) 04:31, 16 January 2023 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

"Rare" penile cancer

I removed "rare" penile cancer again from the lead. I don't think there needs to be much write-up about this — since a similar conversation has already occurred on the foreskin talk page. However, I wanted to tag everyone involved in the previous conversation in case there was any concerns. Thanks. @Prcc27: @Bon Courage: @Piccco:. KlayCax (talk) 07:26, 3 December 2022 (UTC)

Penile cancer is far from being the main justification for circumcision. One could argue, that it is WP:UNDUE to include it in the lead at all. I think putting “rare” or “relatively rare” clarifies, that the main prevention concerns for circumcision are UTIs and STIs, and that penile cancer prevention is only a concern to a lesser extent. Prcc27 (talk) 00:44, 4 December 2022 (UTC)

World Health Organization stance on circumcision

Hi, @Neveselbert:. Why did you state that Elsevier Health Sciences's Material Child Nursing Care, 7th Edition violates the tenets WP:MEDRS?

It's sourced from:

"The World Health Organization recognizes male circumcision as an important intervention in reducing the risk of heterosexually acquired HIV in men. The organization recommends early infant circumcision for newborn males weighing more than 2500 g and without medical contraindication."

A call for universal neonatal circumcision — with the exception of contraindication cases — has been the official policy of the WHO since 2010. KlayCax (talk) 06:15, 17 December 2022 (UTC)

That is not what the source says. The WHO has never called for "universal neonatal circumcision". ‑‑Neveselbert (talk · contribs · email) 06:20, 17 December 2022 (UTC)

@Neveselbert:. Like any procedure/healthcare treatment, the WHO's recommendations and guidance exempts those with contraindications, including male infants who weigh under 2.5 kilograms. (e.g. Low birth weight.) "Universal" in this case means "given normative health". All of this was explained to the reader in the original context.

e.g. As of 2022, the World Health Organization recommends universal infant circumcision of male neonates, provided that there are no contraindications for the procedure

As for Elsevier Health Sciences: it meets the criteria of WP:MEDRS in spades. It's an official textbook from a well-respected publisher. KlayCax (talk) 06:40, 17 December 2022 (UTC)

No, it doesn't. The WHO has never called for it to be done on a universal basis. ‑‑Neveselbert (talk · contribs · email) 06:41, 17 December 2022 (UTC)

Universal means that they universally recommend routine circumcision to the parents of all healthy male neonates. Of course there's exceptions for hemophilia, low birth rate, et al. The original edit stated: As of 2022, the World Health Organization recommends universal infant circumcision of male neonates, provided that there are no contraindications for the procedure

That's a near verbatim quote of the Elsevier Health Sciences textbook. KlayCax (talk) 06:49, 17 December 2022 (UTC)

This is nonsense. See Talk:Circumcision/Archive 83#Suggest one-word change, to clarify the WHO's position. ‑‑Neveselbert (talk · contribs · email) 06:51, 17 December 2022 (UTC)

It's not an inherent contradiction. Many European medical organization oppose the circumcision of neonates and children — even in areas of high HIV/AIDS prevalence — but have also participated in voluntary medical male circumcision efforts. All the WHO is stating is that they support males being voluntarily circumcised.

If Peter (the WHO) likes: (supports)

1.) A: "Walking" (e.g. Voluntary medical male circumcision efforts) 2.) "Running." (Circumcision of neonates) Is that a contradiction? No. KlayCax (talk) 07:01, 17 December 2022 (UTC)

Again, they have never advocated for it on a universal basis on those who are unable to consent. ‑‑Neveselbert (talk · contribs · email) 07:03, 17 December 2022 (UTC)

They view it as parents assenting (although it doesn't fit the definition of consenting) to the circumcision during the neonatal period.

Of course they don't support rounding up people and forcefully circumcising them.KlayCax (talk) 07:05, 17 December 2022 (UTC)

Elsevier Health Sciences's Material Child Nursing Care, 7th Edition states: The organization recommends early infant circumcision for newborn males weighing more than 2500 g and without medical contraindication. It's hard to get more explicit than that. WP:MEDRS is passed.

This doesn't mean that the WHO is right. It just means that they presently hold that position, as of 2022. KlayCax (talk) 07:07, 17 December 2022 (UTC)

No, it's not "passed" at all. Unless you can provide a source from the WHO itself confirming they recommend "universal neonatal circumcision"? ‑‑Neveselbert (talk · contribs · email) 07:12, 17 December 2022 (UTC)

Again, I didn't mean that they stated all men should be circumcised. Of course there's exceptions. Perry et al. (2022) states "the organization recommends early infant circumcision for newborn males weighing more than 2500 g and without medical contraindication". Do you just want that quoted verbatim instead? Elsevier Health Sciences is one of multiple WP:MEDRS-compliant sources which have stated similar. (My academic resource states the same.)

A lot has changed since Jacobs & Grady & Bolnick (2012) published.

It's okay if the article states things that occured past the year it was published which contradict it. KlayCax (talk) 07:48, 17 December 2022 (UTC)

So you can't provide a source from the WHO itself confirming? ‑‑Neveselbert (talk · contribs · email) 07:50, 17 December 2022 (UTC)

As for Of course there's exceptions., the exception being that the supposed "benefits" are nowhere near enough to recommend doing it routinely. ‑‑Neveselbert (talk · contribs · email) 08:14, 17 December 2022 (UTC)

Sorry for the late response, Neveselbert. I contracted a bad cold and was sick for a few days.

So you can't provide a source from the WHO itself confirming? Manual for early infant male circumcision under local anaesthesia (2010) is widely viewed as a recommendation for universal circumcision from multiple reliable sources. (Along with other statements published by them.) At the very least, the statement No major medical organization recommends circumcising all males is not universally agreed upon by reliable sources. (My Up-To-Date guidance states the WHO does recommend it.) The exception being that the supposed "benefits" are nowhere near enough to recommend doing it routinely In developed countries?

I agree. But this article isn't about what is the ideal policy. It's about what's currently policy.

The WHO has recommended infant circumcision (at least in areas of high HIV prevalence) since 2010. KlayCax (talk) 14:41, 22 December 2022 (UTC)

The 2010 PDF does not explicitly recommend the practice, stating The decision to have a newborn male circumcised is very personal and should be made after careful consideration of the risks and benefits and cultural, religious, and personal preferences. Therefore, the statement No major medical organization recommends circumcising all males is broadly accurate. As for In developed countries?, of course, though even in developing countries there is no consensus for a routine recommendation among the young. The WHO may have indicated such a recommendation in areas of high HIV prevalence, but this is still not explicitly stated by policy. ‑‑Neveselbert (talk · contribs · email) 16:11, 22 December 2022 (UTC)

Many of the primary resources related to the World Health Organization have suffered link rot since the site transferred to a new domain in 2020. Because of this, it's almost impossible for many of these things to be primary sourced. (Luckily, it's not a requirement for WP:MEDRS - and if anything, it's discouraged - and it's harder to find a higher quality source than official guidelines published by Elsevier Medical to doctors.)

The World Health Organization now recommends that male circumcision be offered as an HIV prevention intervention... and recommends neonatal circumcision... should be an important component of prevention campaigns since "neonatal circumcision is a less complicated and risky procedure than circumcision performed in young boys, adolescents or adults [and] countries should consider how to promote neonatal circumcision in a safe, culturally acceptable and sustainable manner." - Acceptability of Infant Male Circumcision as Part of HIV Prevention and Male Reproductive Health Efforts in Gaborone, Botswana, and Surrounding Areas (2009); published in AIDS and Behavior. though even in developing countries there is no consensus for a routine recommendation among the young The statement is exclusively about the World Health Organization. It doesn't claim that there is a consensus in the matter. is broadly accurate Elsevier Health Sciences (2022) guidelines explicitly disputes Jacobs & Grady & Bolnick's interpretation.

At the very best, Jacobs & Grady & Bolnick's interpretation is disputed in reliable sources, and contradicted by Elsevier (from official 2022 guidelines).

That's heavily problematic. KlayCax (talk) 18:17, 22 December 2022 (UTC)

Perhaps a WP:RFC would be in order here? ‑‑Neveselbert (talk · contribs · email) 18:19, 22 December 2022 (UTC)

I tend to strongly oppose WP: RFC's whenever possible: it's a measure of last resort. I think it's entirely possible to work this out without one.

I'm okay with both statements - As of 2022, the World Health Organization recommends universal infant circumcision of male neonates, provided that there are no contraindications for the procedure and No major medical organization recommends circumcising all males being removed from the article. Since Jacobs & Grady & Bolnick (2012) contradicts the first (although I argue it's outdated) and (Perry et al., 2022) Elsevier Health Sciences contradicts the other. Perhaps a note could also be added explaining the differing interpretations of the WHO's position. KlayCax (talk) 18:28, 22 December 2022 (UTC)

The problem with removing the latter statement is that it's been included in the article for a long time, indeed for much if not most of the period since 2010, so I do believe an RFC would be advisable here. ‑‑Neveselbert (talk · contribs · email) 19:12, 22 December 2022 (UTC)

I'll start one if you feel it's necessary, @Neveselbert:.KlayCax (talk) 19:04, 24 December 2022 (UTC)

The article's image for anti-circumcision protestors

The current image in the article makes opponents of routine circumcision come across as kooky. (e.g. It gives off major "crazy guy with a sign on a street corner" vibes)

Is there any better pictures we could use? If not, I think it should be removed from the article entirely. KlayCax (talk) 19:00, 24 December 2022 (UTC)

I’m very open to replacing the photo. But for now, we should have at least something in ethics section. I don’t have strong feelings about the current photo, and in all honesty, it could be worse (think Bloodstained men kooky worse). Prcc27 (talk) 01:41, 25 December 2022 (UTC)

I'm also open but not overly concerned with the status quo. There are more options at Commons: https://commons.wikimedia.org/wiki/Category:Anti-circumcision. Firefangledfeathers (talk / contribs) 01:45, 25 December 2022 (UTC)

I'm also not really concerned about this. People seem to protest about everything, so I don't think protesting is necessarily looked down upon. Maybe this is more up to everyone's personal interpretation. Piccco (talk) 18:58, 25 December 2022 (UTC)

"Christian circumcision" in the article

I've recently noticed that significant parts of the present article directly state or otherwise imply that circumcision is a common religious rite for Christians.

To anyone with knowledge surrounding this topic or Christian theology in general: this is a massive red flag surrounding the article's accuracy.

Anglophonic and Filipino circumcision

Citations surrounding this seem to be poorly worded statements from an array of authors stating that circumcision is a common prophylactic, cultural, or social practice in areas where Christians live.

However, it should be obvious that this does not make it automatically a rite that is performed because of Christianity. Anglosphere circumcision is predominately performed out of a belief that it's prophylactic against disease ("e.g. healthier that way") or as a cultural thing. (e.g. "To fit in" or "to look like dad".) Filipino circumcision predated the arrival of Catholicism to the islands.

None of these instances of circumcision are considered "religious obligations" or anything of the like.

Coptic circumcision

The present article also seems to suggest that circumcision is considered a religious obligation in Coptic Christianity. This seems to be primarily based on a poorly worded (or just straight out incorrect) sentence from Robert S. Ellwood in The Encyclopedia of World Religions (2008). (Although not mentioned by Ellwood, it appears to be referring how many Copts see it as an important social and cultural rite.)

"It is obligatory among Jews, Muslims, and Coptic Christians."

Stating that the Coptic observance of circumcision is religious in nature is similarly incorrect.

Similar to how Anglophonic and Filipino circumcision is not linked to religious observance: they're not circumcised because they're Coptic Christians, they're circumcised because it's a part of Coptic culture. That's a profound and meaningful difference. No branch of Coptic Christianity obligates circumcision for religious reasons — and circumcision outside of immediate medical necessity is (to quickly summarize a complex topic) outright prohibited after baptism. The sentence also has other obvious problems. Male circumcision is only considered obligatory (exempting profound circumstances) in Judaism and certain Islamic schools of thought. It is not mandatory (to my knowledge) among any Protestant Christian denomination, in Coptic Christianity, and in certain Islamic schools of jurisprudence.

I'm not sure how this was published by Ellwood (2008). I'm not familar with his works or him. But this sentence is a massive, egregious error, despite being published by a reliable publisher (and an apparently well-respected in the field of religious studies) author. Not sure what's the exact Wikipolicy in cases such as this, but it seems obvious to me that it should be left out entirely.

Other sources on the matter:

It's also contradicted by a multitude of sources dating back to the 19th century. For example, Anecdota Oxoniensia. Semitic Series: Volume 7 (1895) states:

Circumcision on the eighth day is customary, but not obligatory; on the other hand, the Coptic church forbids [cultural] circumcision after baptism.

Among many other sources with similar statements up to the 2010s.

Additional note:

Katherine Hunting in Hunting (2012) seems to make another, similar problematic error surrounding Christian observance of circumcision.

Neonatal circumcision is the general practice among Jews, Christians, and many, but not all Muslims

I'm not sure what the statement "neonatal circumcision is the general practice among... Christians..." comes from. But — from an historical, theological, and international perspective — it's similarly incorrect: a majority of Christian adherents around the world are not (and historically have not been) circumcised. Predominately, only those in Africa, the Phillippines, and the Anglosphere are; none for religious obligation. KlayCax (talk) 11:26, 16 November 2022 (UTC)

Tagging @SonoCat:. KlayCax (talk) 11:26, 16 November 2022 (UTC)

The gospel is pretty clear, as were the Church fathers, that Christians have no spiritual need of genital surgery. The Catholic Church forbids mutilation and amputation (at least for spiritual reasons), on pain of hellfire. The Copts are the singular documented exception that I know of, but of course -- in Anglophone settler societies which happen also to be Christian -- circumcision has been widely adopted for cultural, quasi-medical (non-spiritual) reasons. The Christian faith defined itself on this very point, of opposition to compulsory forced circumcision of infant males. This is all recorded in the book of Acts, Paul's epistles, writings of the Church fathers, etc. "But Christians don't circumcise!" my treating clinical psychologist declared to me. I shrugged. Everybody knows this, and yet, and yet ... Prunella Vulgaris (talk) 00:28, 4 January 2023 (UTC)

Unreliable or problematic sources in article

I've noticed that a substantive portion of citations in the article (and other articles related to circumcision) relate to sources which are either:

• Problematic for NPOV reasons (Both pro-circumcision and anti-circumcision)
• Outdated information
• Disproportionately focus attention on minor sources/or are WP: Fringe.

Unreliable or problematic "pro-circumcision" sources (e.g. Possible NPOV issues):

• Brian Morris — Biologist and pro-routine circumcision activist whose metastudies conclusions have been widely disputed. (e.g. "The benefits to risk ratio exceeds 100 to 1" for starters) Possible NPOV issues in his conclusions and WP: Fringe. Many of his current citations within the article could be replaced with citations from major, reputable medical sources.
• Several other pro-circumcision sources with similar problems to the previously mentioned. Not much to add here: beyond the fact that they have similar issues.

Problematic "anti-circumcision" sources (e.g. Possible NPOV issues):

• Marilyn Milos — Anti-circumcision activist. Possible NPOV issues in his conclusions and WP: Fringe. (Now removed from the article)
• Dan Bollinger — Anti-circumcision activist and Vice President of Intact America; several Wikipedia articles have cited his discredited claim that "117 individuals die every year" (or a similar number in the United States) Possible NPOV issues in his conclusions and WP: Fringe.
• Robert Darby — Historian who is anti-circumcision who has made several disputed claims surrounding circumcision. Possible NPOV issues.
• Ronald Goldman — Anti-circumcision psychologist who keeps getting re-added unto the "psychological effects" section. Many of his points are WP: Fringe or have problematic NPOV issues if given without context.
• Gregory Boyle — Anti-circumcision psychologist whose rejection of a link between HIV and circumcision (in high context areas) seems unquestionably repeated. Instance of WP: Fringe and possible NPOV issues.

Unreliable or problematic for other reasons (e.g. Are outdated, promote other fringe perspectives, et al.):

• Grafton Elliot Smith — Hyperdiffusionist historian whose archeological theories have long-time fallen in disrepute. Also falls under WP: Fringe.
• Peter Charles Remondino — Physician; article gives outdated and disproportionate information to his views on circumcision.
• Sami Aldeeb — Claim that "the Islamic tradition of circumcision was derived from the Pagan practices and rituals of pre-Islamic Arabia" is certainly not universally agreed upon by scholars. This part was recently added by an editor. But I can't seem to find the specific edit in which it was added unto. This viewpoint is certainly a case of WP: Fringe.
• Another citation in the article also appears to promote the fringe claim that the Islamic God is a lunar deity. (I only found his article behind a paywall. So I'm not sure he actually states that: but it's definitely problematic regardless.) Similar problems with WP: Fringe.

I'm not suggesting that these sources be prohibited entirely altogether throughout the article. But if there's another possible citation for the sentence: I'm under the conviction that these sources should be replaced altogether. I'm sure there's others I missed: but these are the most glaring examples. KlayCax (talk) — Preceding undated comment added 11:59, 8 August 2022‎ (UTC)

This has been much discussed before and the bottom line is that otherwise golden-standard sources cannot be ruled out because of personal/activist objections to individual authors and because they don't like the science. For obvious reasons, if this was allowed any science could be torpedoed by activist fussmaking. Alexbrn (talk) 05:56, 7 September 2022 (UTC)

I don't agree to the alleged NPOV issues here. Even the wording "pro-circumcision activist" vs. "anti-circumcision activist" do not do justice to the problem that circumcision on minors is done without any medical indication in most cases and thus isn't covered by the Universal Declaration of Human Rights. There cannot be a neutral view on violations of human rights. Ulf Dunkel (talk) 12:41, 14 October 2022 (UTC)

The allegedly discredited claim by intactivist Dan Bollinger that "117 individuals die every year" refers to an external link which leads to a single NY Times paywall article. This isn't much of a reference proving he has been discredited. The original study of Bollinger found a percentage which gives this estimated number of 117 deaths: "This study finds that approximately 117 neonatal circumcision-related deaths (9.01/100,000) occur annually in theUnited States, about 1.3% of male neonatal deaths from all causes." Publicly available sources who tried to refute this study are made by proven circumfetishists like Jakes Waskett and Brian Morris. Furthermore, a human rights violation cannot be diminished by quantity as human rights are personal rights. Even if no child would die from circumcision (which is not the case), it would still be a human rights violation in each single case where the "surgery" was made without medical indication and medical urgency. Ulf Dunkel (talk) 12:48, 14 October 2022 (UTC)

Gregory Boyle is (or was) a distinguished professor of psychology. Robert Darby was an eminent medical historian. Dan Bollinger is (or was) active in a group called Doctors Opposing Circumcision - surely of relevance to anyone spruiking the (ahem) health benefits of non-consensual penile surgery (e.g. Wikipedia's Circumcision page). Ronald Goldman is a diligent compiler of medical studies in support of his "post-traumatic" model of neonatal genital harm. Now, why should we have to reinvent the wheel -- revisiting studies that go back several decades, to the early 1960s even -- when these brilliant minds have done that work for us? If you insist, we will. Prunella Vulgaris (talk) 00:34, 4 January 2023 (UTC)

Lead wording

There has been an overgoing, almost years-long dispute on the wording of this part of the lead. With one side stating that there is a consensus in the literature that circumcision definitely reduces STD's in certain contexts and reduces the incidence of urinary tract infections. The other saying that there is no consensus and that the lead should merely state that there is an "association" between circumcision and UTI/STD prevalence. A small minority of editors have gone further: stating that circumcision increases the incidence of STD's and UTI's: citing various sources.

Version #1:

Circumcision reduces rates of sexually transmitted infections and urinary tract infections.

Version #2:

Circumcision is associated with reduced rates of sexually transmitted infections and urinary tract infections

The RfC question:

• Is circumcision merely "associated with" reducing STD's/UTI's? Or does it definitely reduce forms of both, given certain contexts?
• Is version #1 or #2 a better description of consensus?

Note that this is not a discussion on whether circumcision in developed nations is appropriate, ethical, or should be routine. (Or whether risks outset these metrics.)

Rather, it is asking on whether there a general agreement among sources that circumcision definitely reduces UTI's and certain STD's in certain contexts?

A very similar RfC discussion is ongoing on the circumcision and HIV page. So editors here might want to check that out as well. Thanks! KlayCax (talk) 19:40, 7 October 2022 (UTC)

• Version 1, Scientific consensus (here, and with circumsion and HIV) seems to be that circumcision definitely reduces UTIs and STIs in certain contexts.--Ortizesp (talk) 21:53, 7 October 2022 (UTC)
• Version 2 The sources currently in the article use the term “associated”. Deviating from this wording would violate WP:OR. Prcc27 (talk) 03:15, 8 October 2022 (UTC)

  That's incorrect.

  Multiple sources within the article presently definitely state that it reduces the rates of UTI's and certain STD's. In no way would it violate WP: OR. KlayCax (talk) 04:47, 8 October 2022 (UTC)

  Many of the sources say “associated”, so that should continue to be reflected in the article. Prcc27 (talk) 05:38, 8 October 2022 (UTC)

• Version 2. Suits more of the sources and is a more logical statement.  — SMcCandlish ☏ ¢ 😼  21:54, 9 October 2022 (UTC)
• Version 2 makes the same point, but more carefully and I think it sounds more natural. It is also the version preferred by the clinical decision support I'm subscribed to, which is always reassuring. Draken Bowser (talk) 13:45, 12 October 2022 (UTC)

  The claim is outlandish, pure and simple, and should be removed. Not reworded. See the work of Brian Earp, et al. Prunella Vulgaris (talk) 00:36, 4 January 2023 (UTC)

Adding a citation on the long term negative effects of circumcision.

I would like to add this to the lede as its a very reputable source. https://www.nature.com/articles/s41443-022-00619-8 Tiggy The Terrible (talk) 13:54, 6 November 2022 (UTC)

 Not done Not a reliable source, and even if it were WP:LEDEBOMBING would be bad. Bon courage (talk) 14:00, 6 November 2022 (UTC)

The suggested source is as reliable as anything else on the Circumcision page. (By way of comparison, leading bioethicist Brian Earp has roundly debunked e.g. all of the WHO-sponsored science in support of VMMC in Africa). Gregory Boyle and others have also published on the long-term (lifelong, cumulative) psychosexual sequelae of neonatal circumcision. Ronald Goldman is another published expert in the field, with much to say. Other recent peer-reviewed publications suggest that we simply don't know the extent -- probably large -- of lifelong complications and psychosexual harms. The Global Survey of Circumcision Harms is another relevant document.

Reference to such material is especially important, given the leading "angle" of the wikipedia Circumcision page emphasising a prophylactic health benefit. That's like saying: amputation of baby toes would prevent all future toenail infections from occurring: YES there is a gross health benefit, but this has to be weighed against costs and inherent harms of the procedure (amputation of healthy, functional tissue is inherently harmful): arguably there is (less than) zero net health benefit to preemptive foreskin amputation. Furthermore, medical ethics and human/children's rights must be weighed against any ostensible medical benefit.

In its opening gambit (written from a quasi-medical perspective) the Wikipedia entry for Circumcision gets it quite wrong: Not all forms of male circumcision remove the entire foreskin. On the other hand, many routine circumcision procedures amputate all of the foreskin, and the frenulum besides. Robert Darby et al. have devised a typology of male genital surgeries, analogous to that employed by the UN, WHO etc. in relation to the four types of FGM.

When so and so cites "30%" or whatever men are circumcised, they fail to distinguish e.g. sub incision and other forms of penile surgery. To do so wrongly gives a false sense of security to those subject to particularly severe forms of cutting in Anglophone medical contexts. Most "circumcised" men (e.g. Muslims) aren't cut quite so severely as that!

Research from Australian circumcising doctors (and research from their opponents as well) demonstrates that -- by and large -- the medical rationale is the least significant factor in parental choice of irreversible genital surgery for their children.

I've been researching the issue for about ten years, please get in touch if you feel this Wikipedia page stands in need of a substantial, major revision. (To me conspicuous parts of it read as though it'd been written by circumcision fetishists the likes of Brian Morris, who has precisely zero relevant medical expertise.)

Par for the course, pretty much, on this taboo topic. A quasi-medical whitewash. Prunella Vulgaris (talk) 00:22, 4 January 2023 (UTC)

The suggested source is as reliable as anything else on the Circumcision page - It really isn't. See WP:MEDRS for how we evaluate medical sources on Wikipedia. MrOllie (talk) 00:24, 4 January 2023 (UTC)

You set the bar too high, because the study isn't a "medical" resource per se; its findings are rather more sociological in nature. I think you may have mistaken circumcision itself for some kind of "medical" procedure? LOL. This is precisely the failing of the Circumcision page as it stands.

If only Robert Darby (medical historian) and Dan Bollinger (medical doctor and bioethicist) weren't blacklisted from discussion here!! The fact that their insights seem to have been banned, gives pause for grave concern over Wikipedia's integrity, and freedom from bias, at least in relation to this topic.

But then maybe that's the overarching intention, to sanitise the topic by relying disproportionately on (ahem) medical wisdom, and thereby kill off any interest in countervailing factors (such as human and children's rights, bioethics, and even the law). Prunella Vulgaris (talk) 03:18, 4 January 2023 (UTC)

MEDRS definitely applies, see Wikipedia:Biomedical information. MrOllie (talk) 03:30, 4 January 2023 (UTC)

Do most major medical organizations actually take a stance on the ethics of circumcision?

A few months ago the statement in the lead:

Major medical organizations hold widely variant perspectives on prophylactic efficacy related to the elective circumcision of minors.

Was changed into:

Major medical organizations hold widely variant perspectives on prophylactic efficacy and cost-effectiveness related to the elective circumcision of minors.

As a compromise wording. But I honestly can't find many major medical organizations that take an official position on the matter at all — and it's not found in any sources.

Supportive:

• American Medical Association (source)
• World Health Organization, arguably. (See WHO sources in article.)

Neutral:

• British Medical Association (source)
• American Academy of Pediatrics, arguably. (source)
• World Health Organization, arguably. (See WHO sources in article.)

Against:

• Danish Medical Association (source)
• Royal Dutch Medical Association (source)

Papers — among both supporters and critics of routine circumcision — generally comment on a "neutral stance" of major medical organization's as well. I can't find many organizations that actually come out and explicitly state it is ethical (outside of the American Medical Assocation/WHO) or unethical. (Outside of a few Dutch medical organizations.) KlayCax (talk) 22:26, 1 January 2023 (UTC)

@Prcc27:. KlayCax (talk) 00:52, 4 January 2023 (UTC)

@Prcc27: What is the statement "major medical organizations hold widely variant positions on the ethics of circumcising minors" based on?

It's not found in Jacobs & Grady & Bolnick (2012). The only major medical organization positions that I can find that explicitly state a position on the ethics of minors are the American Medical Association in 2010 and Royal Dutch Medical Association in 2011. Both medical organizations have automatically expiring policies after five or ten years and both are arguably non-major. There's been ethical discussions in the academic literature. That's different from major medical organizations. The claim is unsourced. KlayCax (talk) 01:12, 4 January 2023 (UTC)

There was consensus to give due weight to controversies like bioethics. There is more than one source, not sure if the Bolnick source is where the bioethics claim comes from exclusively or not. Also, I personally do think AMA and KNMG are major medical organizations. Prcc27 (talk) 03:14, 4 January 2023 (UTC)

There was an agreement to have a mention of ethics in the lead. There was no consensus to ever attach it to the statement "major medical organizations".

Adding it was immediately opposed by other editors at the time. (Including @Bon courage:, me, and others.) We already have an ethics statement in the lead, @Prcc27:. It's the part that says "major medical organizations" that's undue. not sure if the Bolnick source is where the bioethics claim comes from exclusively or not It's not mentioned in any source. Reliable sources — from both supporters and critics — state that most major (and minor) medical organizations have not made any statements favoring or opposing the ethics of circumcising minors.

The sentence is not found in any citation currently in the article. The sources about the matter that I could find state that a majority haven't published statements on the ethics of it. KlayCax (talk) 03:55, 4 January 2023 (UTC)

• Where is the ethics statement in the lead..? Without the “bioethics” sentence, there does not seem to be one. Please review WP:Canvas, before tagging users in discussions they are not actively involved in. Prcc27 (talk) 04:17, 4 January 2023 (UTC)

I added an ethics mention for the lead a few months back, per request. Without the “bioethics” sentence, there does not seem to be one. The lead states right after: There are varying cultural, ethical, and social views on the practice. I tagged Bon Courage because he was previously involved in the conversation.

The AMA statement was also a comment - not a policy paper - and their current leadership has made no similar comments. How can we say that major medical organizations hold "widely varying views" if: 1.) Even American medical organizations hold an official "neutral view" on its ethics and there's none with current policy positions that officially state it is ethical 2.) Official ethical opposition is limited to two Scandinavian (arguably non-major) medical organizations say it is not ethical 3.) The vast majority of reliable sources (from both supporters and opponents) state that major medical organizations have predominately stayed out of it.

The current wording is a sloppy WP: Synth, factually incorrect, and not sourced from any of the citations in the article. KlayCax (talk) 04:43, 4 January 2023 (UTC)

@Prcc27:. If you can find a current policy paper from a major medical organization that currently and explicitly states that electively circumcising minors in developed countries is ethical: feel free to readd. It's not found in any present source in the article. This includes Jacobs & Grady & Bolnick (2012). I'm (or anyone else) is not objecting to ethics in the lead. It's the major medical organization part that's unsupported and contradicts reliable sources. KlayCax (talk) 23:31, 4 January 2023 (UTC)

Ethical mentions are WP: Due and are (and should remain) mentioned in the lead. KlayCax (talk) 23:31, 4 January 2023 (UTC)

Seven issues with first paragraph alone

Seven issues with the first paragraph alone:

1. Circumcision is only a “procedure” (embedded link to surgery as medical specialisation) in cases performed in a clinical setting. What proportion of global circumcisions are thus performed? What proportion are performed in non-clinical settings? 2. If it is a medical procedure, then why not use medical parlance: amputates, etc. instead of the euphemism “removes the foreskin” (and what about the frenulum? the extent of foreskin ”removal” is highly variable). According to my OED, the only pertinent definition of “removal” is: “the act of taking away entirely.” This is clearly not the case for, e.g. traditional cultural forms of circumcision which only remove a portion of foreskin. According to my New Oxford American Dictionary (Apple Mac OS) the only pertinent definition of “removal” is: “the action or taking away of something unwanted” – extremely misleading in the context of non-consensual, non-therapeutic foreskin amputation. Who says the foreskin is "unwanted"? Typically not the owner of the mutilated (to use the correct medical term) penis. 3. “the most common form of the procedure” -- needs citation 4. “anaesthesia is generally used” -- needs citation 5. It is NEVER “usually elective” in cases of neonatal/juvenile circumcision; rather, in all such cases it is clearly a non-consensual (and non-therapeutic) surgical intervention; at very least this requires clarification; that consent is issued by proxy, and not by the victim/survivor/”beneficiary” of penile surgery himself, especially among neonatal foreskin ”donors” 6. It is (or medico-ethically, should be) a LAST RESORT not “an option” for cases of phimosis … 7. It is pointless to give a neat summary/description of the procedure here. In neonatal cases, the child must be forcibly restrained, and his foreskin torn from the glans to which it is fused. Alas one of our most widely-read descriptors of this procedure has been effectively banned (Marilyn Milos gives an influential account of her experience as a paediatric nurse, but it seems because of her activism she is blacklisted here)

There are wildly different forms of male circumcision (and of male genital cutting more broadly). What unites them all, if anything, is a systematic disregard for human and children's welfare and rights, and the intentional decimation of human sexual potential and the capacity for pleasure.

Circumcision long predates the medical paradigm, and persists despite the failure of medical rationalisations. In Australia, the research (both for and against the practice) strongly suggests that a medical rationale is the least of all factors driving parental choice to circumcise. Why does Wikipedia so strongly insist on its dubious (to say the least) medical credentials? Any reader of Robert Darby's history of anglophone "medical" circumcision would rightly scoff. And to my knowledge, there is no better medical history than that of Darby.

Frankly, this page is a discredit to Wikipedia ... and I'm only at paragraph one. But if this is precisely how Wikipedia operates (an acronym - NPOV - eliminating the works of any scholar who happens also to be an activist) then what hope is there for a balanced perspective? The world's most prolific bioethicist (and critic) in matters of genital surgery, Brian Earp, doesn't warrant so much as a footnote? There's something terribly wrong with this picture, which gives a misleading account of the (putative) ethical acceptability of male circumcision. Prunella Vulgaris (talk) 19:47, 4 January 2023 (UTC)

I’m not sure if most sources say “removal” instead of “amputation”, but I am open to the “amputated” wording, and I believe the AAP used that kind of language in an old policy statement. Prcc27 (talk) 22:33, 4 January 2023 (UTC)

removal : rubbish, waste, defective organs (e.g. ruptured appendix), unsightly stains and spots. Not applicable to healthy, functional body parts - unless, of course, one's cultural norms tend to dictate the superfluousness, unsightliness, dirtiness, undesirability of the male prepuce (to use the appropriate medical term, instead of that most misleading of euphemisms, "foreskin"). Prunella Vulgaris (talk) 23:44, 4 January 2023 (UTC)

It's used by the National Health Service in the UK: The foreskin is removed just behind the head of the penis using a scalpel or surgical scissors.

It's also the definition used by the Canadian Urological Association, AAP, CDC, et al. Removal doesn't have a negative connotation.

Removal of the frenulum isn't circumcision. It's frenectomy. Ethical and legal issues are already covered in depth.KlayCax (talk) 23:53, 4 January 2023 (UTC)

“amputation of the prepuce, either in whole or in part, up to and including the frenulum” would accurately cover just about all known forms of male circumcision.

For the record, my own frenulum was "removed" as a matter of routine neonatal circumcision. I suggest you familiarise yourself with Darby-Svoboda's typology of male genital cutting, which I am happy to provide. You will find that many circumcised males, particularly in Anglophone medical contexts, have also been subject to frenectomy; and that such outcomes are quite intentional on the part of the circumcision provider. Is it possible to have a frenectomy without circumcision? I think not!

To complicate matters – including statistics on global prevalence – other forms of customary or routine male genital cutting (e.g. Filipino super-incision, which does not destroy either part or whole of either foreskin or frenulum) may have been erroneously included under the rubric of “male circumcision.” Pro-circumcision researchers have a vested self-interest in exaggerating global prevalence (i.e. it makes them feel better about belonging to a minority of sexually mutilated human beings). Accordingly, such statistics must be regarded with a high degree of circumspection. Prunella Vulgaris (talk) 08:18, 5 January 2023 (UTC)

PS I'll bet my PhD in English that "removal" does carry said negative connotations (e.g. something "unwanted" as given in dictionary definition provided above). By what authority do you claim otherwise?

The UK-NHS notion that "the foreskin is removed just behind the head of the penis" describes only one of many possible circumcision procedures. Providers themselves often advertise a range of foreskin-cutting techniques and outcomes. American doctors in particular, are known for more aggressive procedures, and the styling of "tightly" circumcised penises.

More traditional but still extant forms of circumcision -- which target only the overhanging portion of the prepuce (e.g. African puberty rites, Hebrew customs prior to about 150 AD) -- don't fit the UK-NHS model at all. Its definition may be authoritative, but it is by no means accurate or comprehensive -- par for the course, I'd warrant. Prunella Vulgaris (talk) 08:31, 5 January 2023 (UTC)

This is all WP:OR. We can't just make up our own definition on the talk page. MrOllie (talk) 14:38, 5 January 2023 (UTC)

AAP (1999) said that circumcision produces “amputation of the foreskin.” I don’t really think the definition is made up or WP:OR. Whether it is WP:DUE or not is the question. Prcc27 (talk) 20:22, 5 January 2023 (UTC)

Ethnocentrism, cultural bias, exclusivity

The emphasis on male circumcision as a “medical” procedure is wholly unjustified. Not only does Wikipedia ignore the fact that the procedure is, literally, “the world’s most controversial surgery” (Gollaher 2000), one which predates the advent of modern or even ancient medicine by countless aeons; it also ignores the fact that – even in former British colonies such as Australia, where no professional medical body has ascribed a single therapeutic benefit since 1971 – parental choice to circumcise male children is motivated by anything but medical necessity. According to a study by circumcision providers themselves (Xu & Goldman 2008), “hygiene” and “family tradition” outstripped “medical reasons” by a factor of 3 and 2, respectively. Circumcision opponents go even further, observing that: “few parents have any clear reasons for wanting their sons circumcised and produce them only when challenged. The most common justifications turn out to be the supposed need to look like the father or peers and not to be teased in the proverbial locker room. If ‘health benefits’ are mentioned at all, they enter as an afterthought or when other arguments fail” (Darby 2005).

The Wikipedia entry for male circumcision turns all of this on its head. From its opening gambit, ostensible medical benefit is vigorously promoted as the underlying rationale for the procedure. No history, no cultural context; just a bald regurgitation of the culturally myopic pro-circumcision lobby’s desperately evidenced claims. This, to any informed reader, must smack of cultural bias.

Unlike their North American counterparts, neither Jews nor Muslims nor First Nations people from Africa or Oceania, submit their sons to circumcision for medical reasons. That’s a significant swathe of the world’s circumcising population. What would they make of Wikipedia’s wholly ethnocentric approach, not just to male circumcision, but to its traditional female counterpart? The underlying assumption – that male and female forms of genital cutting are anything but equivalent – makes sense only to a Westerner steeped in Judeo-Christian tradition.

In its pedantic adherence to authoritative forms of institutional knowledge, Wikipedia runs the risk of collaborating with, i.e. facilitating, neo-imperialism. A loose coalition of leading bioethicists and cultural anthropologists has comprehensively critiqued US- and WHO-sponsored programs to circumcise e.g. sub-Saharan Africa – precisely on account of their glaring ethnocentrism. Black foreskins have been highly prized by the medical establishment since Victorian times; see Remondino (mentioned elsewhere on this page) for details. The global foreskin harvest, driven by recent advances in biotechnology such as iPSC (induced pluripotent stem cells), demands ever more intensive bioethical scrutiny, not less.

Wikipedia must ensure that its holdings of knowledge are culturally safe, and appropriate.

NB full citations available upon request. Prunella Vulgaris (talk) 20:35, 5 January 2023 (UTC)

@Prunella Vulgaris: You are definitely in the place to drop the citations. There is never a need to offer them by request, as no conversation here will advance without them. Consider starting with your few best ones and tie them to points. Alternatively and preferred, just starting editing the wiki article as you wish and cite your sources. Bluerasberry (talk) 21:09, 5 January 2023 (UTC)

On ethnocentrism in hegemonic (WHO-sponsored) genital-cutting regimes:

(2012), Seven Things to Know about Female Genital Surgeries in Africa. Hastings Center Report, 42: 19-27. https://doi.org/10.1002/hast.81

Earp BD, Johnsdotter S. Current critiques of the WHO policy on female genital mutilation. Int J Impot Res. 2021 Mar;33(2):196-209. doi: 10.1038/s41443-020-0302-0. Epub 2020 May 26. PMID: 32457498.

Fish, M, Shahvisi, A, Gwaambuka, T, Tangwa, GB, Ncayiyana, D, Earp, BD. A new Tuskegee? Unethical human experimentation and Western neocolonialism in the mass circumcision of African men. Developing World Bioeth. 2021; 21: 211– 226. https://doi.org/10.1111/dewb.12285 Prunella Vulgaris (talk) 04:49, 7 January 2023 (UTC)

From its opening gambit, ostensible medical benefit is vigorously promoted as the underlying rationale for the procedure. The article never states that medical reasons are the primary reason. It states the opposite. It reads: "It is usually elective, performed as preventive healthcare, a religious rite, or cultural practice." and that Muslims make up at least 50% of circumcised individuals. Similarly, the article states that: Major medical organizations hold widely variant perspectives on the prophylactic efficacy and cost-effectiveness of circumcising minors. That's remarkably far from a ringing endorsement.

Unlike their North American counterparts, neither Jews nor Muslims nor First Nations people from Africa or Oceania, submit their sons to circumcision for medical reasons. That’s a significant swathe of the world’s circumcising population. We repeatedly and directly state that in the article. Again, what are you objecting to?

In its pedantic adherence to authoritative forms of institutional knowledge Then we need major medical organizations to state it. The fact that medical organizations in non-circumcising cultures overwhelmingly state that circumcision doesn't predominately affect sexual function (to respond to your post above) is why we can't state it.

makes sense only to a Westerner steeped in Judeo-Christian tradition. Judeo-Christian tradition? Christianity has no doctrine of circumcision and Jews make up a miniscule portion of the global circumcised population. Many Christian cultures have been outright hostile to the continued practice of circumcision: both religious and in a prophylactic sense. Most Western circumcision is secular.

The global foreskin harvest, driven by recent advances in biotechnology such as iPSC (induced pluripotent stem cells), demands ever more intensive bioethical scrutiny, not less. As someone in the urology field, the vast majority of neonatal foreskins are incinerated as medical waste. They're not being routinely "harvested". They're cell lines from a miniscule portion (50 or less) of neonates.

As for the final part: Wikipedia can't do activism or express a POV in terms of ethics. Articles just report what the world is. Not what we'd like it to be. KlayCax (talk) 00:17, 6 January 2023 (UTC)

The Circumcision article lacks intelligent structure, design or plan. It begins -- in media res -- with the post-hoc medical rationalisations for a Stone Age custom that wasn't even, to begin with, yet religious. Exact motivations for the procedure are similarly obscure, although I have indicated (with evidence) they are not primarily medical in nature (even in developed nations with advanced medical infrastructure).

Instead of this RRSS*, I suggest that the article on Capitalism be used as a model, with a logical format and structure, and including a brief summary of Criticisms, linking to a Wikipedia page of Criticisms in detail. As things stand, we have the equivalent of an article on Capitalism, without proper consideration of its history, typology, cultural and geographical variants, or any mention of Karl Marx (most of the leading circumcision critics are effectively blacklisted, on this very :talk page).

How's this for begging the question? The medical establishment doesn't have a problem with circumcision, because ... it's a "medical" procedure! It isn't harmful because ... doctors say it isn't! Not good enough, to countless victims of sexual mutilation, to whom Wikipedia adds insult to injury. We don't need medical organisations to confer authority, IF as critics argue, this is not a medical procedure at all, but rather a grim travesty of one (copious volumes have been written on the topic already; presumably none of which would pass Wikipedia's "medical" gatekeepers; but I shall have to marshal a few of them and give it my best shot).

Tissue engineering since the early 1990s has made a multibillion-dollar industry out of foreskins (not cultivated cell lines per se; foreskin fibroblasts etc. have only a limited shelf life and are not readily immortalised, to the best of my knowledge). Since circa 2006, foreskins have become "a hot commodity in science" (

Molly Glick. ‘Why Foreskin is a Hot Commodity in Science.’ Discover Magazine. 27 July 2021. Accessed 7 January 2023. https://www.discovermagazine.com/the-sciences/why-human-foreskin-is-a-hot-commodity-in-science ), especially with the advent of iPSC technology. The pioneers of iPSC point to the need for a much higher standard of informed consent on the part of cell donors (i.e. NOT parental consent in lieu). If you have evidence that fewer than 50 neonates have powered a multibillion-dollar biotech boom, then by all means please adduce. Because, accessing knowledge of Big Pharma's financial and other operations is well-nigh impossible to those of us outside the loop. (Industry-insider information is prohibitively expensive!). In an era of gene therapy, pre-emptive foreskin amputation deprives the individual of a potential future therapeutic benefit: forget treating UTIs; how about cures for cancer, infertility, Parkinson's etc. -- if we are to believe the scientific hype.

"Wikipedia can't do activism" ... then why a page on Karl Marx, Noam Chomsky, etc.? Let's just have the Capitalism page without any criticism of it whatsoever! I remind everyone that the topic at hand, properly considered, is that of non-consensual, non-therapeutic genital mutilation (to use clinically precise terminology, rather than this overloaded signifier, Circumcision). Only further question-begging allows escape from that harsh reality ("the world as it is. Not what we'd like it to be," as mentioned above).

The Circumcision article comes nowhere near a NPOV. If it did, it would treat male and female alike, for starters. And take a much broader, more comprehensive -- and more humane -- view of one of the enduring mysteries of our species. Western medicine alone is a poor guide to understanding the compulsion to sexually mutilate our children. But certainly, it has been a principal driver of the practice in modern (post-Victorian) times. Things can only get worse, if we do nothing to check the flow of innocent genital blood.

(*RRSS is my personalised boffin-code for "right royal shit show" -- please excuse the language. Honestly, I've never come across a worse-written, grossly misleading Wikipedia article, irrespective of my ethical and political leanings. To the well-informed, it's virtually unreadable.) Prunella Vulgaris (talk) 05:47, 6 January 2023 (UTC)

NPOV does not mean false balance. MrOllie (talk) 14:37, 6 January 2023 (UTC)

There is an emergent "global consensus" within bioethical and legal thought, on the malfeasance of non-consensual, non-therapeutic genital mutilation (citation to come).

Circumcision is not exclusively, nor is it even primarily, a medical phenomenon. It would be grossly inappropriate for medical doctors, especially those who profit from male circumcision, to govern public discourse on the topic.

False balance cuts both ways. Prunella Vulgaris (talk) 21:41, 6 January 2023 (UTC)

J. Steven Svoboda (2015) Growing World Consensus to Leave Circumcision Decision to the Affected Individual, The American Journal of Bioethics, 15:2, 46-48, DOI: 10.1080/15265161.2014.990760 Prunella Vulgaris (talk) 22:30, 6 January 2023 (UTC)

There's an "emerging world consensus" according to a commentary by the founder of anti-circumcision group Attorneys for the Rights of the Child. I wouldn't cite that in the article, just as I wouldn't cite the numerous other commentaries published alongside the target article "Ritual Male Infant Circumcision and Human Rights", the central thesis of which appears to be that circumcision is not a human rights violation. Firefangledfeathers (talk / contribs) 05:19, 7 January 2023 (UTC)

I say "Judeo-Christian tradition" of the west, because Christianity was the vehicle or gateway for Jewish influence on Victorian medicine. I am fully aware that the sacred texts of mainstream Christianity preach opposition to male circumcision. In Puritan North America, however, anti-sex tendencies inherent within Christianity probably engendered the adoption of drastic measures to curtail sexual freedom of expression. This historical context, at least partially, explains why the United States alone among former British colonies, continues to adhere to a Jewish custom adopted by Anglophone doctors in the Victorian age. See, e.g.:

Robert Darby (2005). A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain (Chicago: University of Chicago Press). Prunella Vulgaris (talk) 04:58, 7 January 2023 (UTC)

• The isolation of foreskin fibroblasts—a process for which, I do believe, Brian Morris holds relevant (typically undisclosed) patents and licencing agreements with pharmaceutical corporations such as Roche (citation needed)—is considered “the classic first step” in the derivation of human induced pluripotent stem cells or hiPSCs. [Fang, et al. Biological characters of human dermal fibroblasts derived from foreskin of male infertile patients. Tissue and Cell 49 (2017) 56–63.] But as one of the pioneers of iPSC has stated, in relation to the virtually limitless potential for foreskin cells to be developed into other organs and even so-called “embryoid bodies”: “Informed consent is a major ethical concern in derivation and applications of hiPSCs, and hiPSCs can be induced from somatic cells only if cell donors agree to take the cells from their bodies for derivation of hiPSCs. Cell donors in hiPSCs research have rights to know body parts from which their cells will be taken, the methods applied to derive the body cells, and the areas of hiPSCs research involving use of the donated cells.” [Zheng, Yue Liang. Some ethical concerns about human induced pluripotent stem cells. Sci Eng Ethics (2016) 22: 1277–1284, at 1281–1282.]

Are future prevalence estimates an actual instance of WP: Crystal?

@Prcc27:, why did you delete projections about future global circumcision incidence/prevalence from the article? Isn't this a clear instance where WP: Crystal does not apply?

Predictions, speculation, forecasts and theories stated by reliable, expert sources or recognized entities in a field may be included...

Seeing as how the vast majority of circumcisions are Islamic (anywhere from 50% to 70% of the total circumcised male population in the world) — rather than prophylactic — is it really that WP: Fringe or WP: Undue of a notion? From an international perspective: whatever Anglophonic medical organizations decide is relatively inconsequential to global circumcision incidence.

Even if all of the countries within the Anglosphere stopped it completely (bringing future incidence to 0%) — Australia, New Zealand, Ireland, the United States, and the United Kingdom — this is indisputably far offset by ongoing African and Islamic population growth. At least for the foreseeable future. (e.g. 2050. Where the projection ends.)

Jacobs & Grady & Bolnick (2012) is a reliable source/others have given similar projections. Others are from Jörg Albrecht (2021) and Basaran (2023). KlayCax (talk) 06:45, 8 January 2023 (UTC)

Would be interesting to see what those newer sources say; do you have a link? The 2012 source is old, so probably WP:UNDUE. Prcc27 (talk) 07:21, 8 January 2023 (UTC)

WP: Undue states Neutrality requires that mainspace articles and pages fairly represent all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources. How does that rule apply in this situation? It's not a fringe perspective. It's entirely in line with the literature. It's indisputable given the % of circumcisions performed for stated prophylactic, cultural, and religious circumcisions, along with where world population growth and demographic trends are going. Outside of the United States, Canada, and remnant continuation in Australia and New Zealand, prophylactic-justified circumcision is predominately uncommon throughout the world. It's obvious that the main trends in incidence relate to the percentage of Muslims in the global world population and African population growth. Even a theoretical total abandonment of circumcision within the Anglophonic world would barely make a notable change in rates.

Circumcision and the Community (2020; p.11) by Ahmad Zaghal and ‎Nishat Rahman (in 2020) for instance states: The reason for the rise in MC prevalence could be attributed to the rising number of Muslims worldwide and to the initiation of voluntary medical male circumcision (VMMC) programmes encouraged by the WHO and the joint United Nations agency programs... I'm not going to overload you with references that state similar. But the rise in circumcision incidence stated by Jacobs & Grady & Bolnick (2012) is in line with the literature. What makes you think it's a fringe perspective?

Given that Islamic/African circumcision makes up a large majority of circumcisions. (Even now.) It's not a WP: Fringe perspective to state it's going to be rising until 2050. The projection is entirely conservative, from multiple reliable sources, and is entirely in line with current demographic data. The other statements deleted are near-verbatim quotes from Jörg Albrecht (2021) and Basaran (2023). Both of which are under two years old, are from reliable publishers, and sourced. If you have a source that states that international circumcision incidence is dropping (outside of the Anglophonic world) feel free to add. It's just that — whatever the Anglophonic world does — it won't impact the overall rise in incidence. KlayCax (talk) 11:46, 8 January 2023 (UTC)

It doesn’t seem DUE to use an 11 year old source for projections. A lot can happen in 11 years, and if there are newer sources, those would be preferable. Also, a paragraph on projections would need to be concise. Prcc27 (talk) 16:27, 8 January 2023 (UTC)

Zaghal and Rahman (2020) (slightly over two years old) states similar. I have no objections to making it more concise.

WP: Due wouldn't apply here. It's not a fringe perspective to say it's rising in the academic literature. KlayCax (talk) 05:11, 9 January 2023 (UTC)

@Prcc27:. I made the sentence concise and provided a source from two years ago. Why did you delete? KlayCax (talk) 05:59, 9 January 2023 (UTC)

• The current consensus is that the 2012 source is UNDUE. The Zaghal and Rahman (2020) source could possibly remain in the article, but it wouldn’t be in the future section. @Piccco:, do you think the Zaghal and Rahman (2020) source is DUE? Prcc27 (talk) 16:32, 9 January 2023 (UTC)

  The two arguments from the Zaghal and Rahman (2020) quote seem a little more specific and not as vague as the 2012 quote. I guess that quote could have a mention in the prevalence section. Piccco (talk) 19:39, 9 January 2023 (UTC)

I think what may be a little undue about this subsection is not necessarily the date of the publication, but the usage of only one source that emphasizes only on the rising tendencies of the phenomenon.

The logic behind the prediction (the rise of muslim population in the past decades and the probable continuation of this tendency) seems substantial. What this source fails to do, however, is showcase the different tendencies for religious and non-religious/cultural circumcision and the different regional tendencies, mainly in the Anglophonic world.

Indeed, the prevalence of the procedure may have been steady in Africa and the Middle East (mainly due to Muslim & Jewish faith), but in other regions, where the procedure was prevalent in the past for non religious reasons, the tendencies seem to be a lot different in the past few decades. Mainly in Canada, UK, Australia and New Zealand, maybe also in the USA and South Korea(?).

The prediction itself may not be mistaken. It tries to predict the numbers on a global level. Its weakness, however, is that by emphasizing on the global scale it doesn't give a clear image about the different regional tendencies in other places of the world.

Also, I think the point about the positive recommendations by medical organizations, may be little vague too, considering that these policies are constantly altered, renewed etc.

The challenge with this type of information is that it is constantly changing and needs to be regularly checked and updated with the latest data. Piccco (talk) 18:18, 8 January 2023 (UTC)

National circumcision incidence and prevalence would have to be constantly changed and checked far more than international rates.

We have similar projections from other sources. Note that Zaghal and Rahman (2020) says similar. "The reason for the rise in MC prevalence could be attributed to the rising number of Muslims worldwide and to the initiation of voluntary medical male circumcision (VMMC) programmes encouraged by the WHO and the joint United Nations agency programs".

What this source fails to do, however, is showcase the different tendencies for religious and non-religious/cultural circumcision and the different regional tendencies, mainly in the Anglophonic world. Zaghal and Rahman (2020) could help with that. As for the other part: adding future circumcision rates of various countries raises its own problems.

Anglophonic prevalence appears to be decreasing. Although I'm uncertain if there's any current changes in current incidence. The nature of the United States — which compromises 333 million people out of the estimated 470 million in the core Anglosphere — healthcare system makes it notoriously difficult to calculate true circumcision incidence changes.

Meanwhile, the rest of the Anglophonic world (outside of Australia and Canada) has dropped non-religious circumcision long ago. KlayCax (talk) 05:11, 9 January 2023 (UTC)

Tissue disposal?

The question naturally arises, at least among certain sections of Wikipedia’s readership: What becomes of the amputated penile tissue? Across cultures the foreskin may be discarded, eaten, buried, sanctified as burnt offering, incinerated as medical waste, or collected for biotechnological ends (a lucrative output of cosmetics, engineered skin, and any number of biomedical research products). Obviously, nobody knows the fate of each and every foreskin, as there is extremely limited (typically zero) regulation of male genital-cutting practices.

(The only sources I can think of here would be anthropological texts, some of which may not pass some imagined “gold standard” of medical research for this topic? These same texts would also be of great benefit to understanding “origins” and “history” of male circumcision, to nominate two other sections sorely missing from this article.)

By including a few sentences on the fate of the amputated foreskin, something of the immense cultural, geographical and historical sweep of male circumcision would be conveyed. This information would help counter distortions generated by Eurocentric, Anglophone, and/or professional medical bias.

Caveat: the amputation and collection of healthy, functional tissue without knowledge or consent (e.g. in the case of neonatal circumcision) raises a number of ethical and legal concerns. Those could be addressed here, or in a separate section discussing said concerns more broadly. PS that’s not activism: just rudimentary jurisprudence and bioethics, on a firm foundation of scholarship, which have been routinely and actively suppressed from pro-circumcision arguments. Prunella Vulgaris (talk) 19:22, 10 January 2023 (UTC)

The question does not "naturally arise" any more than questions like "what happens to removed appendixes?". Seems a bit odd. In the UK the Human Tissue Act 2004 applies. Bon courage (talk) 02:58, 11 January 2023 (UTC)

The Danish College of General Practitioners - Mutilation Viewpoint

“The Danish College of General Practitioners has stated that circumcision should ‘only [be done] when medically needed, otherwise it is a case of mutilation’” has been included in this article for several years, and is now being removed by a couple of users. To Bon Courage’s last point, I would say that WP:MEDRS does not necessarily apply to an *ethical* viewpoint. And regardless of this source, wouldn’t this source be MEDRS compliant (assuming MEDRS even applies here)? What is the common practice as far as archived sources, and why is the archived version being completely disregarded? As I said before, this viewpoint is WP:DUE, since it is a significant minority viewpoint. Prcc27 (talk) 19:41, 11 January 2023 (UTC)

Seems like blatant cherry picking to extract this factoid out of that source, about GPs, especially when it relates what the actual Danish health authority's view was. Uneartheding some defunct web page from this minor group compounds the POV push. Bon courage (talk) 19:48, 11 January 2023 (UTC)

If I remember correctly, this was first put in the Wikipedia article, back when the webpage was still live, before the webpage was “defunct” and suffered from link rot. Prcc27 (talk) 00:12, 13 January 2023 (UTC)

It's not clear why we'd report on the view of this organization in particular - they are quite small, about 1/7th the size of the main Danish medical association. MrOllie (talk) 20:00, 11 January 2023 (UTC)

My penis isn't "mutilated". The quote is rude, outrageous and offensive. OntologicalTree (talk) 23:01, 12 January 2023 (UTC)

• It is an ethical viewpoint, whether or not you find it to be rude isn’t relevant to this discussion. Prcc27 (talk) 00:00, 13 January 2023 (UTC)

Unless your Circumcision was done to treat a Medical condition, it is. Zoboili (talk) 03:09, 16 January 2023 (UTC)

Ridiculous attempt to frame opposition as antksemitism in the lead

The lead contains the following bit "Campaigns of Jewish ethnic, cultural, and religious persecution have repeatedly included bans on the practice as an attempted means of forceful assimilation, conversion, and ethnocide,[29][32][33] including in the Maccabean Revolt.[34][35]"

This is a ridiculous attempt at poisoning the well . It was probably true historically but there is no indication whatsoever that modern campaigners against circumcision are doing so because they're anti-jewish, so this is just a bad faith insertion. Whoever inserted this was fully aware of what they were doing. 2A02:A420:43:5E1D:DCFC:5E82:5EF9:5C83 (talk) 04:29, 19 January 2023 (UTC)

I think the history section of the lead is WP:UNDUE, and I support removing the sentence referenced above. Prcc27 (talk) 01:34, 20 January 2023 (UTC)

It is important to summarize the main sections of the article, including the history section, and this is a major point in the history section. MrOllie (talk) 01:45, 20 January 2023 (UTC)

• The current wording makes it sound like this still applies today. At the very least, it should be reworded. Prcc27 (talk) 02:48, 20 January 2023 (UTC)

  Considering that we've seen both a resurgence of anti-semitism across Europe as well as efforts to ban circumcision in Europe in the last decade, I think it is still relevant. If anything, we should probably be summarizing more of the content relating to that in this article - right now it is all over at Circumcision and law MrOllie (talk) 02:57, 20 January 2023 (UTC)

Do the current sources in the lead even support the claim? If not, it should be reworded per WP:OR. Prcc27 (talk) 03:20, 20 January 2023 (UTC)

Yes, they do. MrOllie (talk) 03:23, 20 January 2023 (UTC)

• Where in the sources do they do that? The sources seem to give more weight to historical campaigns, rather than present-day campaigns. Prcc27 (talk) 04:51, 20 January 2023 (UTC)

  The citations already in the article include quotes. MrOllie (talk) 21:48, 20 January 2023 (UTC)

  Those quotes specifically reference “history”. Insufficient to draw conclusions about present-day from that. Prcc27 (talk) 23:18, 20 January 2023 (UTC)

  Good thing the sentence starts with 'Historically', then. Thanks for adding that. MrOllie (talk) 23:37, 20 January 2023 (UTC)

Personally, I don't have a very strong opinion about this, but I also think that the previous wording (by KlayCax, I think) that referred to it simply as 'campaigns' was maybe a little more neutral for the lead. Piccco (talk) 15:41, 21 January 2023 (UTC)

Female circumcision hatnote

It looks like we are going back and forth regarding the female circumcision hatnote. Is there any reason why we wouldn’t want to clarify to readers, that this article is about male circumcision only? Prcc27 (talk) 02:24, 24 January 2023 (UTC)

The opening sentence "Circumcision is a procedure that removes the foreskin from the human penis." seems to convey that idea rather succinctly, without engaging with the idea that male and having a penis are not necessarily synonymous or dealing with the fact that "female circumcision" and "male circumcision" are not "equivalent" procedures.

I don't think we need to "clarify" what should already be sufficiently clear. Mr. Swordfish (talk) 03:47, 24 January 2023 (UTC)

• That sentence does not redirect the readers to the appropriate article, if they are looking for more information on female circumcision, the hatnote does. Prcc27 (talk) 04:40, 24 January 2023 (UTC)

The context makes it obvious what the article is referring to. "Female circumcision" is an obvious point of view violation. OntologicalTree (talk) 15:16, 26 January 2023 (UTC)

It's mentioned in five references in the article. Are they POV violations? ‑‑Neveselbert (talk · contribs · email) 20:50, 26 January 2023 (UTC)

Pinging Neveselbert and OntologicalTree. Want to make sure you're aware of this discussion. Firefangledfeathers (talk / contribs) 21:17, 24 January 2023 (UTC)

We used to have a disambiguation page (it was deleted), which was able to provide a landing spot that could direct readers to the other article with the proper context to avoid equating the two. Perhaps we need that back. MrOllie (talk) 13:13, 26 January 2023 (UTC)

See Wikipedia:Articles for deletion/Circumcision (disambiguation). This is a WP:2DABS situation. ‑‑Neveselbert (talk · contribs · email) 20:48, 26 January 2023 (UTC)

Yes, it is unfortunate that ripple effects of that discussion have caused a problem here, but that is now the situation that we have. - MrOllie (talk) 22:52, 27 January 2023 (UTC)

Actually no, that page was only created 6 months ago. This edit changed the hatnote that was in place then to one linking to a disambiguation page that wasn't actually a disambiguation page. The hatnote in place before that date should be restored. ‑‑Neveselbert (talk · contribs · email) 23:16, 27 January 2023 (UTC)

Does anyone object to these lead improvements/changes?

Is version #1 (new) or version #2 (old) of the second paragraph in the lead better?

Prcc27 recently reverted edits that I made to the lead. Objecting to:

• The new version saying there's a consensus among major medical organization that consensual, adult circumcision reduces HIV/AIDS transmission in high-risk areas.
• Removing a reference to penile cancer being universally rare
• Broadening MSM/developed countries references to encompass other major medical organizations
• Trimming fat surrounding major medical organization's positions

Wording on HIV/AIDS:

Old wording:

and significantly reducing HIV transmission among heterosexual men within high risk populations. The World Health Organization (WHO) and UNAIDS recommend circumcision as part of a comprehensive HIV transmission program in areas with high endemic rates of HIV. The WHO does not recommend circumcision for HIV prevention in men who have sex with men; effectiveness of using circumcision to prevent HIV in the developed world is unclear.

New wording:

There is a consensus among major medical organizations that adult circumcision significantly reduces HIV transmission among heterosexual men within high risk populations. They take variant positions on the effectiveness of using circumcision to prevent HIV transmission among men who have sex with men and in the developed world.

While the specific mentions of the WHO/UNAIDS were steamlined into a sentence that encompassed other medical organziations. (British Medical Association, et al.)

Note that the newer version makes several improvements:

• It clarifies that there is only a consensus around adult circumcision only
• Identifies that major medical organizations have variant positions surrounding MSM and the strength of its prophylactic effect in developed countries. (Which isn't clear in the original wording.) Rather than the initial wording: which seems to incorrectly suggest that there's a unified consensus on MSM.
• The wording is much much concise, understandable, and easy to read.

Wording on Penile Cancer:

Old wording:

Neonatal circumcision also decreases the risk of rare penile cancer.

New wording:

Neonatal circumcision also decreases the risk of penile cancer.

Since the article takes a global perspective to circumcision — rather than local — saying that it is blanketly "rare" across the world is inaccurate.

Kandeel (2007), for instance, states: The incidence of penile carcinoma ranges widely internationally. In many low and middle-income countries, "where poor hygiene is combined with a low circumcision incidence, it compromises one of the most common malignant conditions in men. Similar statements can be found throughout the academic literature on penile cancer.

Position of medical organizations:

Old wording:

Major medical organizations hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors. The World Health Organization (WHO), UNAIDS, and American medical organizations take the position that it carries prophylactic health benefits which outweigh small risks, while European medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk.

New wording:

Major medical organizations hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors. [Details in body]

Trims down unnecessary wording for the lead. "Major medical organizations hold variant perspectives on the prophylactic efficacy of the elective circumcision of minors" makes the second sentence relatively unnecessary, with the lead already starting to verge on "two long" as is.

The large majority of these changes seem like obvious improvements to the article. Tagging recent talk page contributors on this page: @MrOllie:, @Prcc27:, @Bon courage:, @Piccco:, @Bluerasberry:, @Spaully:, @EvergreenFir:, @Doc James:, @Dashoopa:, @Markworthen:. If an agreement can't be found, then this is going to have to go to RfC. KlayCax (talk) 14:14, 23 January 2023 (UTC)

Generally, in pages like this one, the wording of the lead is almost always result of past discussions and consensus built previously by other editors, therefore fast and big changes may accidentally lead to small changes in meaning that may have not been agreed upon in the past. Not saying this is what happened here, but I believe the rv by Prcc27 was in good faith for that reason.

Now as for the suggested changes in those parts, I think, If we are to change the wording, maybe one that encompasses both the old and the new version could be a good solution. Just making some suggestions:

1) Major medical organizations agree that consensual adult circumcision performed in areas with high endemic rates of HIV significantly reduces HIV transmission among heterosexual men. They take variant positions on the effectiveness of circumcision for HIV prevention in men who have sex with men without strong recommendations; effectiveness (of circumcision for HIV prevention) in the developed world is unclear

2) Neonatal circumcision also decreases the risk of penile cancer in high-risk areas. I find this sentence to be precise.

3) As for the positions of medical organizations, the sentence is not too big and I think they are worth a mention in the lead. Piccco (talk) 22:22, 23 January 2023 (UTC)

I do not see any good reason to go from stating the HIV paragraph in Wikipedia’s voice, to trying to analyze what the “consensus” is among major medical organizations. The original wording seems more concise and neutral, in my opinion, albeit I do not necessarily oppose the “adult circumcision” clarification, if that is indeed what the sources say. Furthermore, the new wording on HIV in MSM & the developed world seems to be WP:SYNTH/WP:OR. Penile cancer is far from being the main medical “justification” for circumcision, and without saying “rare”, or using Piccco’s wording, it would be WP:UNDUE (one could argue that even mentioning it in the lead at all is UNDUE). Finally, there was already a prior consensus that controversies should be covered in the lead, which is why the medical organizations’ positions is in the lead. Prcc27 (talk) 02:11, 24 January 2023 (UTC)

The consensus narrowly applies to VMMC programs in high-risk areas. The recent December 2022 RACP statement makes a similar statement. (On VMMC in high-risk areas) The dispute is in minors, the developed world, or in MSM. All of which are encompassed by the wording.

The other parts are not WP:SYNTH of WP:OR. The AAP 2012 report says it does apply to MSM/developed nations, the WHO implies that it does for developed nations (but not MSM), and the The British Medical Organization/couple other medical organizations state it doesn't apply to developed countries or MSM.

Controversies/disputes are still in the lead and unaffected. KlayCax (talk) 19:36, 26 January 2023 (UTC)

You cannot compare and contrast what the medical organizations say, and then say they take “variant positions”. That is WP:SYNTH. We would need a source that directly says that this is the case. Either way, for the lead we may just want to include what the majority viewpoint is (which would seem to be what the WHO says). Prcc27 (talk) 19:57, 26 January 2023 (UTC)

If the AAP says explicitly says yes and others explicitly say no in their given policy position statements... It's not an instance of WP: Synth or original research being violated. It's simply applying existing information onto to the text. None of that is problematic. What would be problematic is editors determining majority/minority viewpoints. KlayCax (talk) 20:29, 26 January 2023 (UTC)

WP:SYNTH: “Do not combine material from multiple sources to reach or imply a conclusion not explicitly stated by any source”. Also, we do need to know what the majority viewpoint is, to determine if it is DUE or UNDUE for the lead.. Prcc27 (talk) 21:59, 26 January 2023 (UTC)

@Prcc27:. The AAP + several others explicitly applies it to those situations. The RACP + a few others explicitly reject it for MSM/developed nations.

Both take explicit positions on the matter in their policy statements. Saying they don't take variant positions when it involves MSM, developed countries, and neonates is ridiculous. The statement is entirely reflected from sources. I'm not sure how you're getting original research from any of this.

Do they not take those positions?KlayCax (talk) 23:33, 26 January 2023 (UTC)

@KlayCax Seeing it again, it seems that this part of the lead refers specifically to the WHO programms that targeted high risk areas to regulate HIV rates. That's why it mentions only the views of the WHO. The views of other medical organizations are expressed below (in the part that you suggested to remove). That's why I suggested that we keep as it is. Currently, it seems that the views of both the WHO and major medical organizations have a sufficient and balanced coverage in the lead. Piccco (talk) 22:43, 26 January 2023 (UTC)

There's other VMMC-programmes being presently performed that are entirely unrelated to the WHO. (Including USAID, several by European medical organizations, et al.) It would be inaccurate to state that the programmes are exclusively being performed by the World Health Organization. The lead's talking about VMMC programs in general.

Since there's disagreement in the academic literature about whether circumcision in neonates/minors, MSM, or in developed nations has significant prophylactic effect, the fact that they have differing interpretations of the data should be expressed. (Without having to go into every individual position by every major med organization).

I oppose having the positions of individual medical organizations being removed.

I just think that the lead should simply state that there are variant perspectives on the matter. (WHO + UNAIDS + American + [probably] African/some Canadian v. European) seems to have implications that the "for" position is a majority one. Since the WHO is considered (the?) world's leading medical organization — it gives off the implication that it's the majority opinion. (Are we doing it by the aggregate # of medical organizations? # of people they represent? It's obvious how attempting to determine this is a WP: OR nightmare.)

I have no position on whether "penile cancer" should be included in the lead; staying out of the debate related to that completely. (Between @Bon courage:, @Prcc27:, and a few others below.) Outside of the fact that added "rare" presents a few problems. I'd honestly be okay with deletion. (Neutral on the matter.)

Note that the current lead doesn't mention that there is only a consensus on VMMC circumcision — simply vaguely mentioning "circumcision" — which is something that I think needs to be addressed. (If nothing else.) Are you alright with me adding that part if a consensus on the other stuff isn't reached within a week? KlayCax (talk) 23:33, 26 January 2023 (UTC)

@Piccco:. Tag. KlayCax (talk) 19:10, 27 January 2023 (UTC)

@KlayCax Sorry for the (somewhat) late response. I understand what you said above, but from what I see, the effeciency of circumcision in HIV reduction is already mentioned in the second sentense ...and significantly reducing HIV transmission among heterosexual men within high risk populations. This is presented here as a fact, something that it is widely agreed upon (clearly by medical organizations). Then the text simply continues to mention separetely the WHO programms. What you suggest seems to be a mixing of these two sentences, but, If I'm honest, I'm not sure if this is actually necessary, considering that the current version carefully avoids any type of SYNTH. If you want to mention adult or voluntary, however, I guess there'd be no problem.

The present sentence has SYNTH problems.

"Effectiveness of using circumcision to prevent HIV in the developed world is unclear" is an actual case of SYNTH and is contradicted by the available citations within the article. The updated December 2022 RACP statement states that it is clear that circumcision doesn't have a significant prophylactic effect in developed nations. The 2012 AAP statement says it is clear that it does (At least that's the notion that they implicitly make). They both de facto state the evidence is "clear". They just come to starkly differently conclusions about where it leads. That's one of the reasons why I believe the revised wording is a significant improvement. It fixes that issue.

And I'll definitely add VMMC once a consensus is reached on the other issues. (Asssuming @Prcc27:, @MrOllie:, and @Bon courage: are okay with it as well.) Several major medical organizations in Europe explicitly state that it should only apply to VMMC circumcision in areas of extraordinarily high HIV incidence/prevalence. (e.g. Basically Sub-Saharan Africa, Haiti, and Belize.) While stating that it should not be applied to neonates or other minors. KlayCax (talk) 02:25, 28 January 2023 (UTC)

Umm.. the RACP statement says “it is not clear that the findings from African studies, where the predominant mode of HIV transmission is heterosexual intercourse, can be extrapolated to Australia and Aotearoa New Zealand or other western countries, which have much lower rates of HIV infection and where the predominant mode of transmission is penile-anal sex among men.” I’m not sure which part of the RACP statement you’re referring to..? The RACP source actually seems to back up what is said in the lead. Either way, we would likely treat them as a minority viewpoint, if they contradicted the WHO. Prcc27 (talk) 02:48, 28 January 2023 (UTC)

As for MSM and the developed world, saying only that they take variant positions is maybe a little vague and it's not clear enough what these positions are. I don't know, I trully think that the current version is actually fine. Piccco (talk) 20:27, 27 January 2023 (UTC)

The present version simply states that some major medical organizations: "X list of medical organizations state it carries prophylactic health benefits which outweigh small risks, while Y list of medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk" I'm just unsure how this wording isn't conveyed in the previous sentence. Or why it's necessary to include. 1.) Stacking the WHO on the "pro side" (which is true) 2.) "Regionalizing positions" in the lead probably gives off implications to readers that are likely misleading. (Such as the WHO believing benefits > risks in developed countries is a strong majority opinion within the academic literature. For instance. Or that there aren't prominent supporters or critics of the practice in both areas.) KlayCax (talk) 02:25, 28 January 2023 (UTC)

I think that if we indeed make any changes to the wording, they should be carefully discussed and agreed upon by all editors. It makes sense that this discussion is complicated because there are distinctions that need to be made, like neonatal/minor circumcision and voluntary-adult, for example.

Another distinction is between efficiency/benefit and recommendations. Over all, when it comes to recommendations, it seems that routine circumcision for MSM and the developed world is not a recommendation. When it comes to efficiency, American organizations typically say it has some benefits that overwight the risk (though not enough to recommend routine circ.) and European say the opposite. Since the lead should equally represent modern views on a global scale, these are all things that should be clearly stated there and not just implied. That is why I was a little sceptical about the changes.

Then we also have the WHO; can we actually merge them with the rest of the organizations or should they have their own separate mention? Don't know what other editors think. Piccco (talk) 20:49, 28 January 2023 (UTC)

• For statements about consensus, WP:RS/AC is needed; the reference to "rare" penile cancer is POV and odd, as if there's some special sub-variety of penile cancer which is rare (whatever "rare" means in the context of cancer!). It's almost as if Wikipedia is trying to play down the risk reduction. Bon courage (talk) 03:10, 24 January 2023 (UTC)
  • It is not POV to say that penile cancer is rare. The AAFP, among others, have said the same thing [36]. Prcc27 (talk) 03:43, 24 January 2023 (UTC)

    Exactly, making USA = The World is POV. It's not that rare in developing countries. Bon courage (talk) 05:09, 24 January 2023 (UTC)

    • @Bon courage: Are you going to discuss this, or edit war? Other alternatives have been proposed on this talk page, including Piccco’s proposed wording, and my proposal to say “relatively rare” (in line with this source). Until consensus changes, the status quo should remain. We are trying to work towards a consensus and/or compromise. If you think the status quo is too contentious, the appropriate action would be to add a disputed tag. Prcc27 (talk) 05:38, 24 January 2023 (UTC)

      You're the one who's in danger of being blocked for edit-warring. Rather than use ancient sourcing and trying to decide editorial between Wikipedia editors, why not reflect modern sources? The world is more than America, and penile cancer is a more serious problem elsewhere. Bon courage (talk) 05:44, 24 January 2023 (UTC)

      • The current wording makes it seem as though penile cancer prevention is on the same footing as UTI & STI prevention. I think it would be better if it was not in the lead at all, unless the wording is clarified, per WP:DUE. Prcc27 (talk) 06:12, 24 January 2023 (UTC)

        Penile cancer is a profoundly debilitating disease, and not being circumcised is a risk factor. Follow the sources. In developing nations this is a big deal. WP:HOSTAGE tagging doesn't help. Bon courage (talk) 06:16, 24 January 2023 (UTC)

        • Something being sourced, does not automatically mean it should be included in the lead. If this is a big deal in developing countries, say that. The current wording makes it seem like it is a big deal, full stop, when it is actually very rare in many parts of the world. Definitely UNDUE. Prcc27 (talk) 06:26, 24 January 2023 (UTC)

          It's all in the body; the lede is a summary. The article has an entire section on cancer, so something is due. We don't privilege the African view (significant prevalence) or the US view (rare) in the lede. Some (no doubt American) editors seem to want the latter. Bon courage (talk) 06:36, 24 January 2023 (UTC)

          • Developed world vs. developing world is an important distinction. We make the distinction for HIV, so why not with penile cancer? Yes, the lead is a summary, which is exactly why I was concerned about the sentence being included at all. Prcc27 (talk) 07:01, 24 January 2023 (UTC)

            We do make the distinction (in the body). Just calling it "rare" does not make the distinction, and it actively misleading in a global context. If an aspect of the article has an entire sub-section, summarizing it in the lede is due. Bon courage (talk) 07:05, 24 January 2023 (UTC)

            It can be considered "rare" in a global context as it accounts for less than 1% of all cancers in men worldwide. ‑‑Neveselbert (talk · contribs · email) 16:21, 24 January 2023 (UTC)

            Source? Bon courage (talk) 16:35, 24 January 2023 (UTC)

            World Cancer Research Fund International. It's actually even lower at 0.4%. ‑‑Neveselbert (talk · contribs · email) 16:42, 24 January 2023 (UTC)

            You've just linked to a document tabulating "the most common cancers in the world". So it's among those. Bon courage (talk) 16:45, 24 January 2023 (UTC)

            Well, on a global scale penile cancer is indeed considered rare. The thing here is that its prevelance varies widely, as KlayCax quoted above, making it very rare in some places and more common in others. That's why I suggested the wording in high-risk areas, or something similiar, since it is concise and doesn't leave space for misconceptions. Any opinions? Piccco (talk) 23:44, 24 January 2023 (UTC)

            “If an aspect of the article has an entire sub-section, summarizing it in the lede is due.” That sub-section is actually about cancer in general (penile, prostate, and cervical). Also, let’s not assume that that sub-section is DUE.. Prcc27 (talk) 02:38, 25 January 2023 (UTC)

            Most men who develop penile cancer do not have any identifiable risk factors. ‑‑Neveselbert (talk · contribs · email) 16:24, 24 January 2023 (UTC)

            That may be your opinion, but it's not what our MEDRS source says. Bon courage (talk) 16:35, 24 January 2023 (UTC)

            Penile cancer is a relatively rare form of cancer and the exact cause of most cases is not known. Some studies have found that up to 70–80% of men who develop penile cancer do not have any known risk factors. ‑‑Neveselbert (talk · contribs · email) 16:44, 24 January 2023 (UTC)

            Well, it's not in the article so I'm not sure why you're raising it. But the abstract of our MEDRS source contradicts your view. Bon courage (talk) 16:46, 24 January 2023 (UTC)

            • Penile cancer being mentioned in the lead seems UNDUE. The lead only covers the most common circumcision risks, so why are we covering a relatively uncommon “benefit” in the lead? I don’t buy the argument that penile cancer’s debilitating nature means a mention in the lead has merit, we don’t mention circumcision deaths in the lead, and that’s pretty debilitating. Nevertheless, the “rare penile cancer” wording kept the peace for the most part, up until now. As Piccco noted above, penile cancer is rare when judging from a global perspective. I think that merits the “rare” reference per WP:DUE. I’m also open to “relatively rare”, since it is rare relative to whether you live in a developing country or developed country. I do not particularly like Piccco’s proposed wording, but would accept it as a compromise. I’m also open to the “current” wording, with a collapsible note explaining that it is rare, especially in the developed world. We need to find a compromise here, the status quo is not acceptable, and part of the consensus building process is trying to find something we can agree on. Prcc27 (talk) 02:34, 25 January 2023 (UTC)

              We're through the looking glass here. We have a detailed source saying it's rare in developed countries and not in developing countries. We say that. Globally, Neveselbert has produced a source placing it among the world's "most common" cancers. It isn't bowel cancer, but it's not a rare one like heart cancer either. We can't just assert it's "rare" in the face of these sources. This is basic NPOV. We should say nothing contentious in the lede; let the penile cancer article do the heavy lifting on prevalence, and include more detailed description about regional difference in the body (as we now do). Bon courage (talk) 05:51, 25 January 2023 (UTC)

              And Piccco shared a source which suggests it is rare, from a global perspective. And you have not addressed their comment. The sources say that it is rare, even if some of them note that developing countries have significantly higher rates. It makes sense to state the general global perspective in the lead, and explain that developing countries have higher rates in the body. Prcc27 (talk) 16:17, 25 January 2023 (UTC)

              If good sources say different things, it is a very bad idea to come down on one side. Put Piccco's source is a weak, non-MEDLINE journal, and they cherry pick it to leave out the "however" qualification which follows the comment picked. This all looks like a pretty desperate POV-push, even the Penile cancer article itself doesn't mention prevalence in the lede, and there are many other global qualifications one could pick out (like that it's psychosexually devastating, or that it's on the rise in Europe, for example). Bon courage (talk) 16:33, 25 January 2023 (UTC)

              The source I produced confirms that the cancer can be considered "rare" in a global context as it accounts for less than 1% of all cancers in men worldwide. Heart cancer is extremely rare, while penile cancer is understood to be relatively rare. ‑‑Neveselbert (talk · contribs · email) 18:02, 25 January 2023 (UTC)

              Your list of the most common cancers, yes. Are you proposing we say "relatively rare among the most common cancers worldwide", to be faithful to your source? Can't you see that being reductive in the lede is necessarily being misleading? Bon courage (talk) 18:12, 25 January 2023 (UTC)

              Just “relatively rare” or “relatively rare” with a collapsible footnote, would suffice.. Prcc27 (talk) 01:53, 26 January 2023 (UTC)

              When you're writing something so unclear in the lede it needs a "collapsible footnote" (whatever that is) to add explanatory commentary, then that's a writing failure. Best to say nothing and let the body do the explaining. I strongly oppose the addition of any single qualifier here and think it POV. Bon courage (talk) 06:17, 26 January 2023 (UTC)

              What are your thoughts on keeping the current wording exactly the same, with a collapsible footnote? KlayCax made a similar edit in the past, albeit I would suggest we make the footnote more concise. Prcc27 (talk) 02:53, 27 January 2023 (UTC)

  It's almost as if you are trying to play up the risk reduction. ‑‑Neveselbert (talk · contribs · email) 16:17, 24 January 2023 (UTC)

  Circumcision seems to eliminate the risk, so it would be hard to "play up" that! But we don't mention that in the lede. Do you think we should? We should keep things plain and neutral in the lede (you know: summary), and let the body do the explaining. Bon courage (talk) 06:21, 26 January 2023 (UTC)

  No, it is not a guarantee of protection, other factors such as HPV infection, smoking, and poor hygiene also play a role in the development of penile cancer. ‑‑Neveselbert (talk · contribs · email) 12:28, 26 January 2023 (UTC)

No one's disputing it. But this is an article on circumcision: not HPV infection, smoking, or poor hygiene.KlayCax (talk) 20:40, 26 January 2023 (UTC)

Which is precisely why claiming it "seems to eliminate the risk" is nonsense. ‑‑Neveselbert (talk · contribs · email) 20:51, 26 January 2023 (UTC)

I would definitely oppose any suggested wording that included that. The edit itself only mentioned that it reduced the risk of penile cancer in the aggregate. (Although the impact of the intervention would, obviously, vary significantly in the context in which it is applied.) KlayCax (talk) 23:33, 26 January 2023 (UTC)

These edits seem to be an improvement. Thanks. Mr. Swordfish (talk) 03:39, 24 January 2023 (UTC)

Foregen and the "ridged band"

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Articles have been sprinkled with assertations from a "foreskin regeneration organization" known as Foregen to argue that circumcision commonly causes psychological issues in circumcised men. Most of it was removed after @MrOllie: made several edits. That being said, until today they were still claims that it made about circumcision and the foreskin that were present in the article until today. I removed more citations from the group here. Are they actually a reliable source? OntologicalTree (talk) 00:58, 29 January 2023 (UTC)

Not to be crude: but as someone who was not circumcised and then became so as an adult due to conversion to Reform Judaism. I don't recall the supposed "ridged band" (or my foreskin in general) being sensitive in the least during the time that I possessed one. I'm sure other editors here who presently have one can make a similar observation to my own.

It's utterly absurd for editors to try and have the article claim, or at least promote the idea of, the structure being "critical to sexual function" based entirely off of a 25-year old paper by an anti-circumcision activist. It seems like an extraordinary statement for the article to make. One has to wonder why medical organizations predominately critical of circumcision have failed to make an even brief mention of the supposed "vital structure".

Looking up "ridged band" online on Google from the past year reveals that the term is pretty much exclusively used by three groups: Mens Rights Activists, anti-circumcision organizations, and incel forums. It shouldn't need to be said that attempting to weave it into the article as a widely accepted idea or indisputed fact is massively problematic. OntologicalTree (talk) 01:12, 29 January 2023 (UTC)

We edit Wikipedia based on reliable sources, not based on your anecdotal observations. What you experienced personally, is irrelevant to this talk page. Prcc27 (talk) 02:56, 29 January 2023 (UTC)

The comment wasn't about my personal experience in converting to Reform Judaism. It's about the article making claims that circumcised men don't have normal sexual function. I was simply stating that I know beyond a shadow of a doubt that it absolutely doesn't.

Relying on a source from an anti-circumcision activist from 1996 is a clear attempt to push an agenda. I'm not the only one who thinks so. @MrOllie: and other editors have explicitly stated that medical sources over 10-15 years+ should almost never be used. This isn't to mention the fact that a group known as Foregen is almost certainly not a reliable source, yet editors keep trying to add it on multiple pages.OntologicalTree (talk) 03:16, 29 January 2023 (UTC)

Foregen are clearly not a WP:MEDRS compliant source. The donation-driven 'research' they are conducting has little in common with actual medical research. MrOllie (talk) 03:40, 29 January 2023 (UTC)

I am not sure why you even created this section, if you are referring to edits made on the Foreskin article. Is there something specific you want to address about the Circumcision article? This is a talk page, not a forum. Prcc27 (talk) 03:57, 29 January 2023 (UTC)

The first part is my personal experience of the matter. I'm sorry if the second part was confusing. It's a paraphrase of what editors other than me have stated (Bon Courage, KlayCax and MrOllie) have said on this talk. The first two stated that search terms for the matter have shown that it's not used in reliable sources. MrOllie said Goldman and Foregen shouldn't be used. OntologicalTree (talk) 02:07, 30 January 2023 (UTC)

Again, what does this have to do with the Circumcision article? Are Foregen/Goldman sources currently being added to this article? If not, this discussion is not constructive. Prcc27 (talk) 05:13, 30 January 2023 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

FGM = Male circumcision analogy discussion on FGM page

Go to talk of female genital mutilation. OntologicalTree (talk) 04:18, 2 February 2023 (UTC)

Direct link: Talk:Female genital mutilation#FGM = Circumcision analogy. Alsee (talk) 17:02, 3 February 2023 (UTC)

Scientific misinformation on German "circumcision" page

The German page on Wikipedia has been misleadingly edited to to assert that there's an agreement that pleasure is significantly reduced in circumcised men among major medical organizations/the scientific community. I realize it might be a bit gauche to ask for responses on other language Wikis. But I'm not fluent in German and want assurance that everything is fixed (and worded) properly.

See discussion here. KlayCax (talk) 00:11, 27 February 2023 (UTC)

Die deutschsprachige WIKIPEDIA zum Thema "Beschneidung" benötigt sicherlich keine Korrektur von amerikanischer Seite. Vor allem dann nicht, wenn - wie im vorliegenden Fall - offensichtlich nicht mal ausreichend Deutschkenntnisse vorhanden sind, um die Diskussion im Artikel-Sprachraum führen zu können.

Inhaltlich ist weder die deutsche Perspektive auf des Thema Beschneidung "misleadingly", noch benötigen wir in der deutschen WIKIPEDIA Fremdsprachler, die uns zeigen, wie "fixed and worded properly" auf Deutsch auszusehen hat.

Fakt ist, dass beim Thema "Beschneidung" die deutschsprachigen medizinischen Fachgesellschaften bei gleicher Publikationslage zu einer anderen Bewertung als die entsprechenden amerikanische Organisationen kommen.

Wer die in Deutschland maßgebliche medizinische Leitlinie der DGKCH nicht lesen kann, möge sich von Artikeländerungen an der deutschsprachigen Seite fernhalten. Es wäre ein klarer Fall von "Cultural Bias and American Ethnocentricity", wenn versucht wird, auf die Deutsche WIKIPEDIA-Seite dergestalt Einfluss zu nehmen, dass die Bewertungen von amerikanischen Organisationen wie der AAP auch im Deutschen Sprachraum wichtiger sein sollen, als die der eigenen deutschen Fachgesellschaften wie die DGKCH.

Unterschiedliche Bewertungen medizinischer Themen wie der "Beschneidung" zwischen Europa und Amerika sind legitim. Sie bedürfen keiner Korrektur durch die amerikanische Seite, was letztlich nur einem fachlichen Paternalismus gleichkäme. Guido4 (talk) 00:30, 2 March 2023 (UTC)

If you can't read German, here is an English version of the reply:

The German WIKIPEDIA article on circumcision certainly does not need any "corrections" to align it with the American point of view on the matter. This holds especially true if the attempt comes from a side that does not even speak enough German to discuss the matter in the language that the article is written in.

From a German medical point of view on the matter of circumcision the article is not "misleadingly", nor do we need any teaching how to have it "fixed and worded properly" in German.

As it has been published by Frisch et al., European medical organizations evaluating the same scientific literature on the matter of circumcision have come to different conclusions than their American counterparts.

If your knowlegde of the German language is not sufficient for reading the medical guidelines by the German Association for Pedriatric Surgery (Deutsche Gesellschaft für Kinderchirurgie, DGKCH), then please refrain from editing German medical articles. It certainly would be a case of "Cultural Bias and American Ethnocentricity" if a German WIKIPEDIA page is edited from an American party in a way that American Medical Organizations like the AAP are stated to have more importance than our own German medical associations, who have issued clear guidelines on the matter of circumcision that are legally binding for all doctors in Germany.

Diverging perspectives on medical issues like circumcision between the European and the American side are ok. They are not in need of a "correction" from an American side, which would just equal paternalism. Guido4 (talk) 09:54, 2 March 2023 (UTC)

HPV claim at beginning

Many studies do not come to the same conclusion as the cited one — the data from African studies do support a preventative effect on HIV but the same cannot be said of HPV. Many of the studies reviewed by the cited study sample only the glans, which they admit is a confounding factor. Many of them also rely on self-reporting of circumcision status, which confounds the results. In a newer review of circumcision and STDs, Van Howe writes on HPV: “With the studies of any type of HPV, sampling only the glans trended toward being a factor ( and ). Glans only studies had a summary odds ratio of 1.82 (95% CI = 1.05–3.14), while studies with complete sampling had a summary odds ratio of 1.17 (95% CI = 0.98–1.40). Patient report of circumcision status was a statistically significant factor ( and ) with studies relying on physical examination to determine circumcision status having a summary odds ratio of 1.14 (95% CI = 0.97–1.35) and studies with a reliance on patient report as summary odds ratio of 2.11 (95% CI = 1.24–3.59). When both factors are included in a multivariate model (sampling and ; physical examination and ), the summary odds ratio for complete sampling of the penis combined with circumcision status determined by physical examination is 1.08 (95% CI = 0.93–1.24), and for sampling only the glans combined with determining circumcision status by patient report is 3.21 (95% CI = 1.62–6.36).

With high-risk HPV studies, sampling only the glans trended toward being a factor ( and ). Studies that sample only the glans had a summary odds ratio of 1.86 (95% CI = 0.9964–3.46), while studies with complete sampling had a summary odds ratio of 1.10 (95% CI = 0.88–1.37). Patient report of circumcision status was statistically significant ( and ) with physical examination studies having a summary odds ratio of 1.08 (95% CI = 0.88–1.32) and patient report studies having a summary odds ratio of 2.16 (95% CI = 1.18–3.99). When both factors are included in model (sampling and ; physical examination and ), the summary odds ratio for complete sampling combined with physical examination determination of circumcision status is 1.01 (95% CI = 0.84–1.22), while the summary odds ratio with sampling only the glans combined with depending on patient report to determine circumcision status is 3.45 (95% CI = 1.60–7.42).” https://www.hindawi.com/journals/isrn/2013/109846/

These claims on HPV and other non-HIV STDs should be better supported, removed, or information should be added noting their their findings are controversial and not supported by all research. Yoleaux (talk) 00:27, 3 March 2023 (UTC)

Controversey

Noticeable lack of mention on controversy, possible bias? 80.233.22.222 (talk) 13:15, 28 February 2023 (UTC)

Re-read the article. It is mentioned several times, including a link to another article we have on that subject, Circumcision controversies. - MrOllie (talk) 13:19, 28 February 2023 (UTC)

It's 1/8th of the article. (~1000 words out of 8000) KlayCax (talk) 10:51, 3 March 2023 (UTC)

Jonathan Hutchinson's claims misrepresented

Our article currently claims that "renowned British physician Jonathan Hutchinson published his findings that Jews had a lower prevalence of certain venereal diseases in the city of London, particularly that of syphilis." This is false on two counts:

• Hutchinson only claimed that the rate of syphilis was lower, not plural venereal diseases. He presented data for both syphilis and gonorrhea. The gonorrhea rate was actually higher, but he ignored this, focusing only on the syphilis rate. The paper was "On the influence of circumcision in preventing syphilis".
• Hutchinson didn't claim that Jews had a lower prevalence of syphilis "in the city of London". He claimed that his Jewish venereal disease patients had a lower rate of syphilis than his non-Jewish venereal disease patients. He claimed nothing about the overall rate for the city of London.

Here is all the data presented in Hutchinson's paper if anyone cares:

The data from Hutchinson's paper

And here is Hutchinson's original paper itself for anyone that wants to read it. Both of my points above are already delineated in the second cited source for the sentence. Here's another secondary academic source that verifies both of these points: [37]. The other source for the sentence, Al-Salem 2016, is factually wrong and should be removed from that sentence. Nosferattus (talk) 00:34, 10 March 2023 (UTC)

Our article also says that "Hutchinson suggested that circumcision acted as an effective means against contracting sexually transmitted disease." Again, this is a complete misrepresentation (and an absurd claim). Hutchinson claims in his paper that circumcision merely lowers the risk of contracting syphilis: "The circumcized Jew is then very much less liable to contract syphilis than an uncircumcized person." Nosferattus (talk) 01:14, 10 March 2023 (UTC)

Botched, or not?

Since there is so much confusion (on these :Talk pages, and on the Circumcision controversies: Talk pages) as to the extent of foreskin removal, perhaps that deserves clarification - across cultures, clinical practices, and throughout history in respect of the same culture (e.g. Judaism) - but primarily as a matter of medico-legal definition. For example, the Wikipedia articles might (for public benefit) include expert opinion on what constitutes excessive shaft skin removal, i.e. the most common form of a "botched" circumcision:

"[...] the bad news is, I've told this to a lot of people and sometimes I get shocked looks and [they] say "Oh, that's me!" If you have an erection and your scrotum is pulled forward significantly on the shaft and there's hair on the shaft--any significant amount of pubic hair on the shaft--[the] fact is you had a botched circumcision as a child. And it's because there is no "cut here" line [on the penis] and [because] the doctors frankly don't understand the anatomy and how the penile skin system works, so that even major textbooks on how to perform a circumcision, I think, are absolutely flat wrong; that's the most common thing that I see [as an expert circumcision injury litigator]: excessive shaft skin removal."

David Llewellyn. "Common circumcision injuries and their causes." Intact 2022: 16th International Symposium on Child Genital Cutting. 27 August, 2022. https://www.youtube.com/watch?v=teK2FstXzN0&list=PLUiUHQRcs8VvDezDnDqpLVju_spLqqNlm&index=12 Prunella Vulgaris (talk) 04:57, 24 February 2023 (UTC)

I'm confused, you posted about expert opinion on a medical topic, but then you cited a lawyer. Please have a look at WP:MEDRS for minimum sourcing standards for a topic such as this. - MrOllie (talk) 05:04, 24 February 2023 (UTC)

It's because the urologists with vested interests in controlling this article, claim that circumcision entails removal of the foreskin, but NOT the frenulum and CERTAINLY NOT penile shaft skin -- yet these are both relatively common adverse outcomes of neonatal circumcision in clinical contexts, according to both Llewellyn (a highly successful expert litigator in this field, whose knowledge of penile anatomy is second to none), and the peer-reviewed Global Survey of Circumcision Harms dataset - i.e., as reported by adult survivors of (professionally unacknowledged) "botched" childhood circumcision procedures. It would be useful (to prospective parents and adult survivors, etc.) to clarify the medically "acceptable" extent of foreskin amputation, as well as list those features of a "botched" procedure (cf. Llewellyn's overview) that would potentially result in medical-malpractice litigation. Not by way of legal advice, but for clarification of some of the mystique surrounding the (ahem) medical procedure. Prunella Vulgaris (talk) 05:59, 12 March 2023 (UTC)

The myth of the "Ridged Band"

Editors are once again attempting to weave together fringe information into articles surrounding male sexual anatomy. Absurdly implying that circumcised men have lost sexually important parts of their own penis or are otherwise dysfunctional. Unsurprisingly, the same anti-circumcision lexicon and "researchers" are back again.

The notion of a "ridged band" comes from an anti-circumcision activist, John Taylor, in the 1990s. The article on the matter was utterly absurd, unsourced, and overfilling with outright false information. Claiming that this mythical structure is supposedly responsible for the majority of male sexual pleasure, is overwhelmingly sensitive, the whole typical lingo.

Per @Bon courage:

WP:MEDRS sources generally need to be secondary and recent. This is getting off-topic but yes, the term "ridged band" seems to have been taken up by John Taylor in the 1990s and became part of the circumcision activist lore (another vital anatomical structure that circumcision destroys!). Indeed on the front page of cirp.org viewers are encouraged to visit the "Ridged Band" web site. Yet, if we get up-to-date, the term seems to have no lasting mainstream currency and the only recent WP:MEDRS secondary independent source I can find (Cox et al. 2015. PMID 26185672) had this to say: The “ridged band” seems to be a name used for the concertinaed distal skin that becomes stretched for retraction over the glans. We consider that such a conformation is merely a matter of individual idiosyncrasy and not a universal feature. Furthermore, different illustrations of the so-called “ridged band” do not appear to show the same structure.. .So presenting it as a fact in Wikipedia, even identifying it (as something different even from the sources) on the opening image caption of our Foreskin article (before I zapped it) was, to put it mildly, problematic.

The AAP denies the notion of a "ridged band" as well. OntologicalTree (talk) 23:37, 10 January 2023 (UTC)

The concept is now covered in some medical textbooks.[38] so this offers some better sourcing to include. Don't think there is so much material is needs to be spun off into a standalone article. Bon courage (talk) 03:14, 11 January 2023 (UTC)

The term still seems relatively fringe. A quick glance of Google Scholar (search the term "ridged band" since 2015) shows that almost no reliable source mentions it. The ones that do almost exclusively bring it up surrounding the history of the routine circumcision debate. Essentially none bring it up in its own right. I also don't think that the source is making an argument for or against its existence. It simply seems to be reporting what Taylor and McGrath believed on the issue. That's a big difference. In a book about the issue of circumcision, it's not surprising to see it being mentioned. Note that the American Academy of Pediatrics also disputes the existence of it as well.

I'd also note that medical organizations hostile to circumcision have never mentioned the term as well. Surely one of the Nordic ones, which seem overwhelmingly hostile to circumcision, would have brought the concept up, right? However, none of them do. This strongly suggests that the concept is still fringe and doesn't belong in an article. OntologicalTree (talk) 03:52, 11 January 2023 (UTC)

As @Bon courage said, the term has some coverage in litarature making it worth a mention, but maybe not widespread coverage. As you suggested in your summary, the key points could merge in the foreskin article. I personally wouldn't really mind a merge. It was also proposed by @KlayCax. Tagging OntologicalTree Piccco (talk) 11:17, 11 January 2023 (UTC)

The implication that it would make is that circumcised men are missing important/sexually sensitive parts of their penis. That's an extreme claim. The reliable source quoted by @Bon courage: is simply showing what McGrath and Taylor believed. Not whether it's true. It makes no statement for or against the idea. The one's that do, including from the AAP, directly contradict their given claims. That's why it shouldn't be included in the article.

We've had multiple RFC's finding that sexual sensation is not changed (improved or worsened) by circumcision. (A logical implication of the supposed ridged band being sensitive.) Yet people keep wanting to beat the horse. I'm not blaming you, since you've only made a few recent edits: but this is getting absurd.

It may be true that @KlayCax: was okay with a merge, but @MrOllie: and other editors have strongly opposed any mention of the ridged band in general. As do I. I'm unsure why a relatively fringe notion among anti-circumcision activists should be treated the same as an AAP. It's undue and misrepresents the scientific literature.OntologicalTree (talk) 11:30, 11 January 2023 (UTC)

Well, we didn't say that we would necessarily include all the controversies and discussions there. But a more detaild mention of some anatomical features of the tissue, predominatly from the source given by @Bon courage and maybe a picture. I agree that some things about the page, like the image of a circumcised penis, were not very necessary. Piccco (talk) 11:46, 11 January 2023 (UTC)

BRITISH JOURNAL OF UROLOGY, Volume 77, Pages 291-295,

February 1996. The prepuce: Specialized mucosa of the penis and its loss to circumcision. J.R. Taylor, A.P. Lockwood and A.J. Taylor

https://doi.org/10.1046/j.1464-410X.1996.85023.x Prunella Vulgaris (talk) 22:47, 12 March 2023 (UTC)

Erogenous zone article

@Crossroads: keeps trying to have Wikipedia state that circumcised men are missing sexually sensitive areas of their body. This notion is inflammatory, discredited, and overwhelmingly contradicted by reliable sources. Per a recent December 2020 study:

Those studies found MC has no or minimal adverse effect on sexual function, sensation, or pleasure, with some finding improvements. A consensus from physiological and histological studies was that the glans and underside of the shaft, not the foreskin, are involved in neurological pathways mediating erogenous sensation. In contrast to the higher quality evidence, data supporting adverse effects of MC on function, sensation, or pleasure were found to be of low quality...

The American Academy of Pediatrics says similar. Why are we including WP: Fringe ideas? OntologicalTree (talk) 02:05, 11 January 2023 (UTC)

That study's claim that in some studies, it has benefits on sexual functions, sensation, satisfaction, and pleasure for males circumcised neonatally or in adulthood is itself inflammatory, discredited, and overwhelmingly contradicted by reliable sources. ‑‑Neveselbert (talk · contribs · email) 08:22, 11 January 2023 (UTC)

• If we're talking about PMID:33008776 this is not a high-quality journal (not MEDLINE-indexed), so this source should not be used and especially not for anything WP:EXCEPTIONAL. Bon courage (talk) 08:33, 11 January 2023 (UTC)

I seem to agree with @Neveselbert and @Bon courage. Also, the studies say that the genitals of circumciced men are sexually functioning and sensitive. This is true. That doesn't mean that those who still have a foreskin, can't find it erogenous. Also, this discussion should have been made in the erogenous zone page, this is not the page. Piccco (talk) 10:16, 11 January 2023 (UTC)

Claiming that circumcised men are missing sexually sensitive parts of their penis is an extraordinary claim. This is not to even bring up the fact that it directly contradicts the overwhelming majority of statements given by doctors on the matter. Nordic medical associations, which are obviously hostile to the existence of routine circumcision, don't mention it, nor does any of their policy papers. Why? Surely, if the ridged band was so important and so sensitive and inherently cut off in circumcision... one has to wonder why they have never mentioned it in any paper criticizing it.

We're apparently going to take it as a given that medical organizations in non-circumcising countries are unaware that the "most pleasurable part of the penis" (Any man here who is not circumcised can see how obviously absurd that notion is.) is being destroyed in circumcision. (Including the adults who underwent it!) The article presents a straight-up, utterly absurd notion. The source it is based upon was a 2007 one by a group of overwhelmingly anti-circumcision activists. Taking it at face value, the NSFW graphic shows that the glans is the least sensitive part of the penis, and even more so than the shaft, which is one absurdity stacked richly upon another. Note that the AAP (with some fancy words) has has called Sorrell's finding wrong or otherwise speculative.

The American Academy of Pediatrics and other medical organizations have explicitly discredited John Taylor's notion that the foreskin is sexually sensitive or that the ridged band is a legitimate structure. Yet we're somehow supposed to take a brief mention in a source (Just summarizing Taylor and McGrath's beliefs! Not even arguing for or against its existence!) as a proof to make the obviously extraordinary claim that circumcised men are missing a sexually sensitive part of the penis. It's blatantly obvious how absurd of a claim that is. OntologicalTree (talk) 11:17, 11 January 2023 (UTC)

Your assertion that "the claim that circumcised men are missing sexually sensitive parts of their penis is extraordinary and contradicts the majority of statements from doctors" is misguided. Just because medical associations in "non-circumcising countries" may not mention it, does not mean it is not true. Your assertion that the source for this information is "a group of anti-circumcision activists" is also misleading. The source, a study by Sorrell, was peer-reviewed and published in a reputable journal. ‑‑Neveselbert (talk · contribs · email) 12:49, 26 January 2023 (UTC)

Mentioning the foreskin was a longstanding part of that article but despite the fact it is mentioned in the source, OntologicalTree was coming through and removing it, basically expecting me to take their word for it. Apparently there's a lot more going on here than first seemed, but some of the arguments above are non-sequiturs - for example, that circumcised men can experience sexual pleasure, even to the same extent, doesn't mean the foreskin plays no role in uncircumcised men. Arguments about "anti-circumcision activists" aren't necessarily convincing because "pro-circumcision activists" also obviously exist and need to be weighted accordingly; additionally, as it is circumcision that is the intervention, the burden of proof that it is harmless lies on those promoting it, not the other side.

Here OntologicalTree added citations to Daily Dot and Cosmopolitan (seriously) to the very same article, which are obviously very poor sources on a MEDRS topic. Crossroads ^-talk- 19:44, 12 January 2023 (UTC)

The changes come across as provocative and outrageously offense to this circumcised guy. I can't imagine that many of them are coming from good faith.

People are attempting to fringe arguments into the article saying that my penis is damaged and dysfunctional. Of course people are going to push back against that. Of course people like me are going to revert it. "However, a systematic review (detailed in the next section) of histological correlates of sexual pleasure attributed erogenous sensation to the glans and underside of the shaft, not the foreskin, with the erogenous sensations claimed to arise from the frenulum actually stemming from stimulation of nearby genital corpuscles in the glans and shaft rather than the frenulum itself." OntologicalTree (talk) 23:00, 12 January 2023 (UTC)

Your characterisation of the changes as "provocative" and "outrageously offensive" is not an appropriate response. The information being presented is based on scientific research and should be evaluated based on its validity and credibility, not on how it personally affects you. The idea that the changes are not coming from a place of good faith is also unfounded. ‑‑Neveselbert (talk · contribs · email) 13:06, 26 January 2023 (UTC)

If routine circumcision entails no erotogenic tissue loss, then why the need for a novel frenulum-sparing circumcision technique? https://doi.org/10.7860%2FJCDR%2F2015%2F14972.6860

https://jcdr.net/article_fulltext.asp?issn=0973-709x&year=2015&volume=9&issue=12&page=PC01&issn=0973-709x&id=6860 Prunella Vulgaris (talk) 22:57, 12 March 2023 (UTC)

Morris, et al.

I notice that this article is still littered with references to the work of Brian Morris. (But curiously, all mention of his name seems to have been expunged from discussion here and on the Circumcision controversies :Talk page). Here are a few allegations that may be pertinent as regards probable bias. As published in a research footnote:

"While Morris is a prolific pro-circumcision activist, he is also a highly controversial figure who has been accused of academic misconduct. He has been accused of veiled self-referencing and citing his own letters to editors as evidence of published research (Earp 2013c; Svoboda and Van Howe 2013). It has been documented in the International Journal of Epidemiology that Morris has also been accused of disregarding the norm of confidentiality in the peer-review process and of pressuring journal editors to reject well-conducted studies if they suggest that circumcision may be harmful. Responding to one recent episode, a Danish sexual health researcher reported that Morris had been a ‘particularly discourteous reviewer who went to extremes to prevent our study from being published. In an email, Morris ... called people on his mailing list to arms against our study, openly admitting that he was the reviewer and that he had tried to get the paper rejected .... Breaking unwritten confidentiality and courtesy rules of the peer-review process, Morris distributed his slandering criticism of our study to people working for the same cause’ (Frisch 2013)."

Na'ama Carlin. Morality, Violence and Ritual Circumcision: Writing with Blood (London and New York: Routledge, 2023) p. 58

I will dig out the references if needed. NB, this book is by no means opposed to neonatal circumcision. But the author was compelled to point out Morris's dubious credentials in a footnote, in deference to academic honesty. Prunella Vulgaris (talk) 06:10, 12 March 2023 (UTC)

I agree that Morris is a problematic source. But none of the claims presently within the article are reliant on his statements. @Prunella Vulgaris:. KlayCax (talk) 02:25, 20 March 2023 (UTC)

Updated CDC positions

@Neveselbert:. The positions of major medical organizations have shifted significantly since 2012-2014. That's why some of the things discussed in the GA-discussion from 2013 were removed from the article. My Elsevier urology resource says that the World Health Organization presently recommends universal circumcision for neonates.KlayCax (talk) 14:33, 20 March 2023 (UTC)

Your resource clearly must have made a mistake because that makes absolutely no sense whatsoever. There is no medical indication for it in the vast majority of neonates and the WHO would have to recognise that. ‑‑Neveselbert (talk · contribs · email) 14:35, 20 March 2023 (UTC)

@Neveselbert: Maternal Child Nursing Care (ISBN: 9780323825870) published by Elsevier Health Sciences (5 March 2022), states that: The organization [WHO] recommends early infant circumcision for newborn males weighing more than 2500 g and without medical contraindication. Jacobs & Grady & Bolnick et al. is from 2012 (10 years beforehand) and therefore outdated. (ISBN: 978-1-4471-2857-1) Other academic resources in my urology program state the same. KlayCax (talk) 14:57, 20 March 2023 (UTC)

What is their reference for that? They make no mention of it being a universal recommendation in that quote. ‑‑Neveselbert (talk · contribs · email) 14:58, 20 March 2023 (UTC)

@Neveselbert:. Yes, I initially was unsure about this as well, and actually consulted one of the visiting professors in my urology residency program — who has worked with the CDC and WHO — about this a few months ago. (A statement similar to Maternal Child Nursing Care is in our textbooks.) They stated that the Material Child Nursing Care resource from 2022 was right: the WHO presently does recommend universal circumcision (outside of possible religious/cultural minorities that specifically reject it.) (The "non-universal quote" you're citing in the CDC link was a reference to the small minority of religions that forbid it. Apparently they didn't want to imply that minorities should be pressured into having themselves or their sons circumcised.) Similarly, the CDC reference was only exempting religious minorities as well. They recommend it's universal outside of that context. (Essentially, they were being culturally sensitive here.)

I know that Material Child Nursing Care isn't the only resource among a heavily reliable publisher making similar claims within the past 2-3 years. Since other academic resources we have + my urology professors say the same exact thing. KlayCax (talk) 15:20, 20 March 2023 (UTC)

Again, what is their reference? Your professors are not authorities and their interpretation of the WHO position cannot be relied upon. Neither the WHO nor the CDC have themselves reported to recommend it universally in cases where there is no medical indication, and unless you are able to actually provide evidence to the contrary other than hearsay and speculation from sources other than those two organisations, the text from the GA that states No major medical organization recommends circumcising all males remains accurate on account of the citations provided, per WP:V. ‑‑Neveselbert (talk · contribs · email) 15:28, 20 March 2023 (UTC)

Secondary sources are entirely reliable; Jacobs & Grady & Bolnick (2012) is one as well. (Maternal Child Nursing Care is a RS.) As for my professors: I'm well-aware that hearsay evidence is not citeable. I'm just stating that I'm confident that this is not a mere misquotation/misstatement. Others use similar wording. KlayCax (talk) 16:20, 20 March 2023 (UTC)

No, it's not reliable as neither the WHO nor the CDC themselves have validated the claims. Can you provide confirmatory citations to the WHO and CDC themselves or not? ‑‑Neveselbert (talk · contribs · email) 16:23, 20 March 2023 (UTC)

I also would want to see the direct links to what the WHO and CDC said. It is quite possible for secondary sources to misinterpret what the primary sources say. Prcc27 (talk) 19:26, 20 March 2023 (UTC)

I think it's quite clear that they have misrepresented the WHO/CDC position, intentionally or otherwise. Neither organisation has ever recommended "universal circumcision". I've searched both organisations' websites and found nothing close to what would amount to a routine recommendation, which would undoubtedly have created a media stir and contributed to widespread protest. There is no way that two organisations of their stature could make such a recommendation under the radar. ‑‑Neveselbert (talk · contribs · email) 16:19, 22 March 2023 (UTC)

So, I emailed the CDC asking if they could confirm whether this was indeed their position. In response, they told me that the agency does not comment on information from unofficial or non-CDC sources and that there are websites that state whether information that's circulating in the media is true or false. For example, Snopes.com is a site that report rumors or hoaxes. Clearly, this response would imply that they make no such recommendation, which they characterised in their response as possible online misinformation. ‑‑Neveselbert (talk · contribs · email) 13:33, 23 March 2023 (UTC)

Wikipedia users aren’t journalists, so I would take this with a grain of salt. Prcc27 (talk) 13:20, 24 March 2023 (UTC)

The claims made by KlayCax should be, absolutely. ‑‑Neveselbert (talk · contribs · email) 13:52, 24 March 2023 (UTC)