Talk:Circumcision

'Foreskin-based medical and consumer products' section

Is there any particular reason why this section is here? It seems only tangentially related to circumcision, and would fit much better in foreskin. Jakew (talk) 19:59, 25 September 2008 (UTC)

No, because it only deals with foreskins that have been cut off - by circumcision. Foreskins can't be used for these products if they're still attached to the penis, which is what the foreskin article deals with. --Pwnage8 (talk) 20:53, 25 September 2008 (UTC)

That shouldn't matter, Pwnage8. The products are not circumcision products, they are foreskin products. Are fur-related items under fur or skinning? You cannot get the fur without skinning the animal, but we are interested in the product not the procedure—here too. -- Avi (talk) 20:58, 25 September 2008 (UTC)

They are products made from human tissue obtained through circumcision of male infants, as discussed specifically in the sources. Not "tangential" at all. The reader interested in reading about male circumcision should be made aware of the marketable for-profit products of circumcision. Blackworm (talk) 21:21, 25 September 2008 (UTC)

So why isn't fur discussed in skinning according to you? They are marketable foreskin products. Blackworm, can you provide a logical basis for differentiating between fur/skinning and foreskin/circumcision, please? -- Avi (talk) 21:24, 25 September 2008 (UTC)

The lead paragraph of the skinning (stub) article says that skinning is done "mainly as preparation for consumption of the meat beneath and/or use for the fur." So if you want an analogy, let's put the following in the lead paragraph of circumcision: Male circumcision is also performed in order to obtain infant foreskins for use in commercial and medical products, such as anti-aging skin creams. Then you can delete the section. Do we have agreement? Blackworm (talk) 21:36, 25 September 2008 (UTC)

Blackworm, are you aware of any reliable sources stating that the purpose of circumcision is to produce foreskins for use in these products? None of the sources in the article seem to state this, as far as I can tell, so it seems to be a poor analogy. There's a difference in the degree of relevance between the reason why X is done and something that sometimes happens to be done with the byproducts after X is performed. Jakew (talk) 21:52, 25 September 2008 (UTC)

I'm aware of reliable sources stating that foreskins from circumcised babies are used in commercial products. That's enough for me to feel quite comfortable in opposing your and Avi's attempt to remove this information from circumcision. Blackworm (talk) 22:09, 25 September 2008 (UTC)

It isn't accurate to say (or imply) that circumcisions are done to "harvest" foreskin for commercial uses, but I get the point. I think the section is kind of interesting, and I contributed a couple of sentences to it, but I'm not particularly concerned whether it is retained or removed. AlphaEta 22:13, 25 September 2008 (UTC)

Perhaps not, but it is accurate to say that male circumcision results in medical and consumer products that would not exist without male circumcision. Once there is a product based on something (anything), then there is a market for that something. Why should we suppress discussion of the raw materials of the market created by male circumcision (i.e., severed infant foreskins) and the processed consumer products created from those materials (e.g., wrinkle creams for women)? We must have a neutral POV on this, correct? Blackworm (talk) 22:24, 25 September 2008 (UTC)

I think the current verbage is neutral, and the section is interesting, but with respect to removal or retention, I'm not particularly compelled to argue either way. I just wanted to chime in since Blackworm and I are the primary contributors to the section. In other words, I have nothing useful to contribute at this time.... AlphaEta 22:40, 25 September 2008 (UTC)

I find the section fascinating. I had know idea about it until it was added to this article. I think It should be mentioned here as a direct result/byproduct of circumcision. Garycompugeek (talk) 22:16, 25 September 2008 (UTC)

Indeed, but some people would apparently prefer if you remained ignorant of this information. Blackworm (talk) 22:24, 25 September 2008 (UTC)

No one is trying to supress information, Blackworm, but the proper place for foreskin-related products is in foreskin, not circumcision. Other than sensationalism, I cannot think of a reason why products should be listed under the process used to get the raw materials, as opposed to the material itself. Again, notwithstanding irrelevant arguments such as sensationalist wording in opening paragraphs, fur products belong under fur, not skinning. Wigs belong under Hair, not Haircuts. Woolen fabric belongs under Wool, not Shearing, etc. As I said, other than some form of emotional attachement, why is this any different? -- Avi (talk) 23:08, 25 September 2008 (UTC)

Indeed, why is it? Jayjg ^(talk) 23:55, 25 September 2008 (UTC)

Because the circumstance (I couldn't resist) make this special. This is human material being refashioned. It makes it interesting and notable as to "how?" and "from where?". Garycompugeek (talk) 00:02, 26 September 2008 (UTC)

So is head hair when being used to make a wig, but it still does not belong in haircut, but hair, Gary. -- Avi (talk) 00:04, 26 September 2008 (UTC)

As opposed to wigs? In any event, it will be as interesting in the foreskin article as here, and far more relevant. Jayjg ^(talk) 00:05, 26 September 2008 (UTC)

Oh, and Gary, we discuss fertilizer in urine see (Urine#Other uses), not Excretion: quod erat demonstrandum :-) -- Avi (talk) 00:07, 26 September 2008 (UTC)

I think it's notable in both articles. Garycompugeek (talk) 00:53, 26 September 2008 (UTC)

Yes, but that's just an assertion, not an argument, so it carries no weight. Jayjg ^(talk) 01:02, 26 September 2008 (UTC)

(ec) I agree with Gary. I think the foreskin products are interesting and notable and should be mentioned in this article; and can also be mentioned in the foreskin article. Arguments for mentioning them here include that around the time of circumcision, a mother may sign a form giving permission for her baby's foreskin to be used for such purposes, therefore the existence of such products is sometimes part of the whole procedure surrounding circumcision; and that "circumcision" or "circumcised" are mentioned in at least 3 of the references talking about this product, making it notable in this context. Perhaps the same arguments cannot necessarily be made about wigs, fur etc. I think intuitively that this information is interesting and relevant to the topic of circumcision, and I don't see convincing reasons to exclude it: merely analogies without accompanying explanations. Another argument is that many readers of this article may be people considering having their baby circumcised, and I think they would be interested to know that there may be a possibility that they could sign a form and have their baby's foreskin used in this way. I would delete the part about the price of the product, though: that seems relatively trivial and probably time-dependent. One way to do it might be a short mention in this article (at least a sentence, I would say) and perhaps a longer mention in the foreskin article, with of course a link from here. The reason for putting the longer mention in the foreskin article is that while some of the refs mention "circumcision", I think more of them use the word "foreskin"; some mention "foreskin" but do not mention "circumcision", I believe. ☺ Coppertwig (talk) 01:15, 26 September 2008 (UTC)

(<-)Coppertwig, so the fact that the uses of blood are discussed in the blood article and not in bleeding or exsanguination, uses of intestines are discussed in Gastrointestinal tract and not in disembowelment, urine are discussed in the urine article, and not in urination or excretion, and the uses of semen are discussed in the semen article, and not in ejaculation, and the uses of fur are discussed in the fur article, and not in skinning, and the uses of wool are discussed in the wool article, and not in shearing, etc. etc. is irrelevant? If people want to know how the foreskin is used, they would naturally go to the foreskin article, not circumcision, the same way no one would go to urination to learn how urine is used. -- Avi (talk) 01:49, 26 September 2008 (UTC)

Ah! You're thinking that the people who would be interested in this information would begin by asking "I wonder how the foreskin is used". That might apply to wool, urine, etc.; but in this case, I think many of the people who would be quite interested in this information would not even have thought of the idea that the foreskin would be used for anything at all. They might begin with the question, "I wonder what it's like to have a baby circumcised?" or "I wonder what happens when a baby is circumcised?" Simply listing a number of examples of how other articles are arranged, without saying anything about why they are arranged that way, doesn't convince me; and I notice that you haven't addressed the two things I pointed out as possible differences between the case of circumcision and those other examples. I think the important thing to include in this article is a statement of the fact that foreskins are used; the details of how they're used can perhaps be in another article, with a link from here. Regards, ☺ Coppertwig (talk) 02:10, 26 September 2008 (UTC)

Exactly Coppertwig. I had no idea such a relationship existed, however my interest in this topic revealed the connection. Garycompugeek (talk) 02:38, 26 September 2008 (UTC)

I agree with those saying this section needs to be restored. Avi, some things on that list of topics you mentioned aren't procedures and they don't have an end product. Of the procedures you mentioned: the skinning article is more like a stub. The wool and the uses of wool are obvious and it is also a vast subject - which means that the sheering article would be too long. Adding a short section in the circumcision article is fine. Avi you took it out with the explanation "per talk" as if there was consensus to remove it. Tremello22 (talk) 19:46, 29 September 2008 (UTC)

Tremollo, I did not delete it, but moved it up in the article to the procedures sections. Being that this article is a somewhat contentious one, I would consider it a personal favor if you were to look at what I have written in both the article and the talk page before assuming that I am trying to suppress anything. Thank you. -- Avi (talk) 00:53, 2 October 2008 (UTC)

I am new to this discussion and have read this section with interest. I do not find the metaphors listed above persuasive arguments. What I would like to point out, and something that you missed, is that circumcision is controversial and one aspect of that controversy is that it is in income stream for docs and hospitals as well as a source of very specialized tissue having a certain value. This adds valuable information to the controversy. I agree that the list of post-excision foreskin uses should be mentioned here and and pleased that information remains, even if not in its own section. (Dan Bollinger (talk) 03:12, 28 October 2008 (UTC))

The information hasn't been removed, Tremello, and calling for its restoration is therefore somewhat puzzling. The same sources are now cited, along with others, in a new paragraph at the end of the 'Modern circumcision procedures' section. See the following section for the rationale. Jakew (talk) 20:09, 29 September 2008 (UTC)

Re-writing the sections

After thinking about Coppertwig's point, I can see that there should be some mention of what is done with the foreskin after circumcision. For example, in Judaism, it is buried, and forbidden to be used. So I am going to edit the "Modern circumcision procedures" by adding a paragraph about post-circumcision foreskin treatment in which it is stated that some foreskins are used by the medicinal industry, foreskins from a bris milah are buried, and if there are other special dispositions they are listed there. Specific examples such as $130 skin cream belongs in the foreskin article. This way, immediately in the procedures section there is a link to disposition, and we do not have $130 sensationalism. -- Avi (talk) 03:47, 26 September 2008 (UTC)

• Change to this article
• Addition to Foreskin article

--Avi (talk) 03:49, 26 September 2008 (UTC)

This seems an acceptable compromise, and at least we don't have an entire section of dubious relevance. Let's keep an eye out for a reliable secondary source that summarises this info, though. If one can be found we can cite that instead. Jakew (talk) 11:15, 26 September 2008 (UTC)

Not dubious to me Jake. I thought we agreed to keep the section. We can drop the price since that is irrelavant and I like Avi's addition to Modern circumcision. Garycompugeek (talk) 17:21, 26 September 2008 (UTC)

Avi, it is not acceptable for you to label anything which you wish to suppress "sensationalism," as I've seen you do in the past. This information, i.e. the foreskin market and parts of the penis being viewed and used as "raw materials" greatly informs the debate on circumcision. (Jakew labels the foreskin severed by circumcision a "byproduct," but that is a POV -- what isn't a POV (i.e. is verifiable) is that the foreskin severed by circumcision is being made into products.) I do not believe any other human body parts (tissue, with nerves, blood, pain receptors, etc., not hair) are extracted from humans who do not give their consent, then bought and sold and used to make consumer products; thus any analogies with "fur" or "hair" are falling on deaf ears in my case. Circumcision and circumcision advocacy is the mechanism which creates these for-profit products, as specifically mentioned in the sources, and I strongly object to your attempts to suppress this material here. If the facts about what are being done with severed foreskins upset you, write a letter to your politician -- labeling neutral information from reliable sources "sensationalist" and using that as a rationale for keeping the information far away from information on circumcision (i.e. this article) is not WP:NPOV and therefore not acceptable. Blackworm (talk) 18:07, 26 September 2008 (UTC)

The article as written discusses the "circumcised foreskin" near the top of the article, so you should have nothing to fear, Blackworm. Also, your own opinion as to what is bought/sold after medical procedures is exactly that, your own opinion. I understand that you do not like the comparisons to urine, semen, blood, and fur, since it counteracts your emotional belief. However, this is wikipedia, not Blackwormapedia, and thus we need to discuss these issues as respectfully and as neutrally as possible, as Coppertwig and Gary have done in this discussion. -- Avi (talk) 18:17, 26 September 2008 (UTC)

Uh, no, it's not my own opinion -- severed foreskins from circumcisions are sold as consumer products, just like the reliable source says. Please strike out that part of your response. The rest of your response is similarly irrelevant. I believe your, Jayjg's, and Jakew's responses are disrespectful too, in the extreme -- but then coming from such diametrically opposed points of view it isn't surprising that we both feel that way (I believe the penile foreskin is a part of the human male body, while you apparently agree with Jakew that it is a "byproduct"). Blackworm (talk) 18:29, 26 September 2008 (UTC)

I've reviewed the changes Avi made and can abide by them, although I'm not sure the uses and disposal of foreskins severed by circumcision belong in the "procedure" section. I suppose it's all right for now, until we add more information, and create a new section to explore these details. I've added some more material related to this as well. Also, with regard to analogies to other articles, one example of an article on a procedure which deals extensively with the products of that procedure is seal hunting. As the procedure is controversial, it makes much more sense that the facts surrounding the controversy be explored in greater detail, as is the case here. The consumer products are not the seals, which were always there, but the dead seals, killed by seal hunting. The consumer products are not the foreskins, which were always there, but the severed foreskins, severed by male circumcision. Blackworm (talk) 21:41, 26 September 2008 (UTC)

Avi, I appreciate the flexibility and creativity you showed in listening, compromising, and also adding additional interesting material. It's delightful to finally be involved in a discussion at the same time as you (and to boldly split infinitives...); I was already thinking of saying that before you started agreeing with me – honest! (Not the part about the infinitives, though. Or the flexibility etc. Not the part after "Now, here's the plan.")

Would you please provide a more complete citation for the Yoreh Deah reference? I think we need a page number or section number (chapter and verse?),^{(16:10 28 September 2008)} I think we also need (or at least it would be useful to have) a quote in Hebrew and a translation of the quote into English; the translation can be by a Wikipedian. All that can go in the footnote. See Wikipedia:Verifiability#Non-English sources. I'm not sure if the part about burying the foreskin has an English translation in Wikisource. Here's another possibly useful reference: "After circumcision, Jews traditionally bury the foreskin." [1] (From Abraham to America By Eric Kline Silverman.) The bit about burying the foreskin needs to be reworded: the Wikipedia article must not itself assert that anyone "must" do something. The exact rewording may depend on what precisely the source says. How about inserting "Under Jewish law," at the beginning of the sentence? Do all major groups of Jews recognize this law? ☺ Coppertwig (talk) 13:38, 27 September 2008 (UTC)

Coppertwig, the way sections are referenced in the Shulchan Aruch is exactly how I have given it: Which Work (Yoreh Deah, Oruch Chaim, Even Ha'Ezer, or Choshen Mishpat) and then Chapter and Section ("Seif" in wikisource). So the requirement for burying the foreskin is in Chapter 265, Section 10, which has not been translated in wikisource just yet, I've just added it. Page numbers are not the proper way to reference this, as there have been multiple printings, each with the exact same words, but different layouts. This is the way all the responsa reference Shulchan Aruch, and anyone with a copy (and almost every Orthodox Jeish home will have one, and every shul, yeshiva, and kollel will have multiple copies) can find it immediately with that reference. It is eminently reliable and easily verifiable in print if necessary. -- Avi (talk) 02:49, 28 September 2008 (UTC)

I have amended the text to read "should" instead of "must" and added "According to halakha..." which should cover which branches do what. -- Avi (talk) 02:51, 28 September 2008 (UTC)

And lastly, I would be remiss for leaving out that it is a pleasure to work with you as well . Of course, you know that I greatly respect your ability and judgment -- Avi (talk) 03:04, 28 September 2008 (UTC)

Severed foreskins

This couching of circumcision in language like "removed" instead of "cutting" or "severing" or "amputating" seems a result of emotional attachment to male circumcision, but is not reflected in reliable sources. Please see pages 31 and 50 of [2], Circumcision in Man and Woman: Its History, Psychology and Ethnology, a 2001 book on circumcision (all circumcision, not only the male circumcision discussed in this article and incorrectly and non-neutrally labeled "circumcision"). Other Google Scholar searches on other terms such as "amputation" and especially "cutting" (still no idea why that is suppressed) will reveal that the terminology is well reflected in reliable sources. Blackworm (talk) 21:53, 26 September 2008 (UTC)

Removed is also used in literature (http://www.jimmunol.org/cgi/content/abstract/160/1/60 for example). So restoring "shocking" terms is also evidence of an emotional attachment to circumcision and foreskins, I reckon. 8-) -- Avi (talk) 21:56, 26 September 2008 (UTC)

• http://www.springerlink.com/content/r5639303326050kt/
• http://www.jhc.org/cgi/reprint/38/12/1847

Just some other examples of "removed" in the literature. -- Avi (talk) 22:01, 26 September 2008 (UTC)

That the word "severed" is shocking to you is irrelevant. The word "severed" means, [3] to put or keep apart : divide; especially : to remove (as a part) by or as if by cutting; : to become separated. It is used in reliable sources to describe the severed foreskin. It is both more accurate and more informational than "removed" as the latter word says nothing about how it was removed, and also carries an implication that the foreskin is not a part of what it was "removed" from, i.e. the penis, which in this case is disputed. (I realize every attempt is made here to frame the foreskin as a separate "byproduct" of the body to be "removed," and not a part of the penis that is often "severed," but clearly reliable sources contradict that.) Plenty of words and phrases used in this article are shocking to me ("circumcision," "uncircumcised," "benefits," (to some extent, compare its antonym, "harms") "removal of too little skin," "more humane [not to use anaesthetic]," etc.) and yet I have no rationale to oppose them merely based on the terms, because those terms are used in reliable sources. The thing is, for so long editors here have only acknowledged one side's emotional attachment to the subject, and have organized and written the entire article in that perspective, avoiding all recognition that the idea of circumcision itself is shocking to many. That double standard must change, Avi. Blackworm (talk) 22:12, 26 September 2008 (UTC)

Per Google hits, "removal" seems preferable for the first sentence of the article. Google hits: "circumcision severing" 14,400; "circumcision severance" 27,500; "circumcision removal" 928,000. (Not all hits involve relevant uses of the words.) See also discussion at Talk:Circumcision/Archive 41#Circumcision is, of course, surgery. Blackworm, I think you have a good point that the word "removal" could be taken as implying that the foreskin is not part of the penis; "severance" seems better to me in that regard. "Severance" would apply even if it is considered that crushing with a clamp isn't "cutting". It would resolve the possible ambiguity in "removal" (i.e. retraction). "Severance" would be accurate whether the procedure involves surgery or any other situation (done by barbers; forced circumcisions, or whatever). However, I'm impressed by the preponderance of Google hits and support the use of the word "removal", which after all doesn't seem to me to have any very serious problems. Besides, "severance" is a less common word and might be confusing to some people. ☺ Coppertwig (talk) 03:16, 27 September 2008 (UTC)

The above is an odd approach, Coppertwig. Must we use the same term consistently, universally, and throughout? There is no rationale for Avi's changing "severed foreskin" to "removed foreskin."[4] Here are some much more relevant Google search statistics: "severed foreskin"[5] has 2140 hits, while "removed foreskin"[6] has 1750 hits. Blackworm (talk) 04:08, 27 September 2008 (UTC)

NPOV requires that we document points of view, but not that we share them. POVs should generally be described with a detached tone. For example, if a judge described a convicted murderer as a "brutal sociopath", then instead of saying "Smith was a brutal sociopath", we say (for example) "the sentencing judge described Smith as a 'brutal sociopath'". (I'm assuming, for the sake of argument, that it is judged important to note this description. If not, we might say something else, like "the judge sentenced Smith to life imprisonment".) Other sources may use language to express viewpoints in more subtle ways. A proponent of circumcision might say "as a result of this beneficial procedure, tissue is available for burn victims". An opponent might describe the same fact by saying "after the child has been cruelly mutilated, the amputated foreskin can become available for burn victims". If the fact (let's presume that it is a fact) is important, then the language used by the sources is unimportant, and we should choose the most neutral term. If the language used by the source is also important, then it's probably wise to quote or otherwise attribute any inflammatory or otherwise non-neutral language. "Severance" does have certain non-neutral connotations, so I would recommend "removal". Jakew (talk) 13:02, 27 September 2008 (UTC)

I think "removal" lends itself to "take from not apart of" ie John had a wart removed. Garycompugeek (talk) 13:43, 27 September 2008 (UTC)

I think it could just as easily be "John had a leg removed", Gary. A quick search of Google Scholar reveals several examples: "...physicians must remove a limb from a patient to prevent the spread of disease...", "...remove a limb such as a leg or an arm...", "...sufferers from BIID who attempt unsuccessfully to remove a limb themselves...", "Remove a limb following irreparable trauma to the extremity...", "A child undergoing a single surgery to remove a limb..." Jakew (talk) 13:58, 27 September 2008 (UTC)

Who would say, "John had a leg removed?" They would say, "John had his leg amputated" or "John lost his leg." And according to Google there's over 800 occurances of "amputated a limb," but don't you think it would be a bit disingenuous to list a handful here? You have no evidence that the word "severance" has non-neutral connotations. Please Jakew, abide by policy. Blackworm (talk) 19:35, 27 September 2008 (UTC)

Jakew -- did you even CHECK this? "Amputate a limb" in Google Scholar, 182 hits. "Remove a limb" in Google Scholar, 48 hits. Please stop assuming the term you prefer is the most common or the most neutral term. Blackworm (talk) 19:39, 27 September 2008 (UTC)

I think you may have misunderstood my point, Blackworm. I didn't say that it was the most common term, and I'm not sure how one could determine neutrality of a term by frequency of use. My point was merely that "removed" can apply as easily to a leg as to a wart. Jakew (talk) 19:52, 27 September 2008 (UTC)

So how would you determine neutrality then? By WP:CONSENSUS? Is there a consensus on "severed" vs. "removed," Jake? If not, and considering my rationale for my edit, and Avi's rationale for his edit partially reverting mine, what is the proper way the article should read right now, Jakew? Let's settle that first, okay? Blackworm (talk) 21:31, 27 September 2008 (UTC)

(ec!) In my comment above I was only talking about the first sentence of the article; I hadn't looked at the changes to the procedures section yet. I favour using "removal" in the first sentence and "severed" in the procedures section. "Severed" seems to me to be a reasonably neutral term and is preferable for some reasons I gave above; and the phrase "the removed foreskin" sounds awkward to me: perhaps "removed" is not often used as an adjective, or is it because the cluster of consonants vdf is hard to pronounce? There are advantages for NPOV and style to using different terms in different places in the article. As a compromise, I suggest avoiding both terms by saying instead "the foreskin after circumcision". It's great to have you back, by the way, Jake. ☺ Coppertwig (talk) 14:07, 27 September 2008 (UTC)

Sure I'm not trying to say it cannot be used and understood in a proper sentence. I'm trying to point out what the word itself means in general terms. [[7]]:moving or being removed, relocation, dismissal. This leaves room for ambiguity. A more direct term would state that what we are "removing" was attached to something else. Garycompugeek (talk) 14:15, 27 September 2008 (UTC)

"removed" would be used when you are taking something (such as an organ) out of the body I reckon, severed implies it was cut out/off, therefore it is more accurate to say "severed". I don't think using severed is "shocking" - I think people know what circumcision entails. Also, I think removed is often used when the thing being removed is bad and needs to be removed - i.e "we removed the tumor" or "we removed the abscess" So in a way "removed" is less neutral. Tremello22 (talk) 20:26, 27 September 2008 (UTC)

(<-)I took out all adjectives so everyone can relax :) -- Avi (talk) 02:31, 28 September 2008 (UTC)

Why must we put no adjective, rather than describe it as "severed," Avi? What rationale do you have for that edit? Blackworm (talk) 04:25, 28 September 2008 (UTC)

Because the use of of any of the terms is engendering complications, be it "removed" or "severed" or "circumcised" or whatnot, so since the sentence is no re-written as to obviate the need for any adjective, there should be no more problems. Unless, of course, someone is not interested in building an encyclopedia, but instead is trying to push some sort of agenda in which one term or the other would be useful in adding an emotional charge to the article. But of course, we all know that is not allowed in wikipedia. -- Avi (talk) 04:38, 28 September 2008 (UTC)

Pure nonsense. You are denying a forms of expression you don't like based on your own narrow, unsourced, original research. You are the one appearing to push an agenda by attempting to ban language used in reliable sources based on nothing more than your fiat. When this is made clear to you, you take more steps acting like some neutral party ("everyone relax"), with an air of invoking some administrative privilege, but with a result that still bans the neutral language you don't like. Now, when that is exposed as nonsense, you break into this wild attack in which you accuse me of pushing an agenda because I described a foreskin cut off the rest of a penis "severed." Completely ridiculous and disrespectful, Avi. You have no sources, no rationale, nothing. I am trying to build an encyclopedia, what are you trying to do? Where is your proof that the word "severed" is considered too biased to describe the piece of the foreskin separated by cutting from the penis? You have none. Abide by policy, and self-revert your rationale-less edit. No one objects to "removed," it's in the the first sentence of this article; similarly no one should object to "severed foreskin." "The edit has 'complications'" -- seriously Avi, in the face of someone asking you for a rationale, that doesn't cut it and I think you know it. Blackworm (talk) 07:15, 28 September 2008 (UTC)

In a nutshell, unless you are imagining some company making skin cream out of attached foreskins, or feeding the foreskin to the calf with the rest of the person, your continued perseverance in trying to sensationalize the article is not in compliance with WP:NPOV. -- Avi (talk) 07:30, 28 September 2008 (UTC)

Pure original research. You have no rationale to oppose the phrase "severed foreskin." Blackworm (talk) 17:23, 28 September 2008 (UTC)

The exact same rationale you use to oppose "removed foreskin," Blackworm . And since I was able to have the article disseminate the same information without using any such adjective, I have followed the wiki way here. Further attempts to re-introduce unnecessary contentious verbiage would appear, at face value, to be disruptive editing. -- Avi (talk) 18:57, 28 September 2008 (UTC)

So if it's same rationale as me, why is mine wrong and yours correct? Why do you oppose "severed foreskin?" How is the foreskin not severed from circumcision, or under what circumstances is it inappropriate to refer to the segment or entirety of the foreskin that is cut off from the rest of the penis, as "severed?" You appear to have a great interest in removing "severed foreskin," judging by the effort you make to remove the language (multiple reverts), but you have not demonstrated any rationale. Is your interest in the matter similar to my interest in removing the word "uncircumcised"[8] (sometimes meaning "heathen") from the article,(read Jakew's[9] and your[10] responses to that), in your view? Since you raise WP:NPOV concerns on it, what connotations, in your mind (if not in any reliable sources, which so far you have failed to bring), does the word "severed" bring? I'm willing to be convinced by an argument, but all you have is assertion. Do you allow me to veto terms used in reliable sources because of a perceived potential emotional response provoked by the words, Avi? Or is that a privilege reserved to you, and those who agree with you? You haven't shown any rationale or applied any Wikipedia policy in changing my preferred adjective in this sentence to yours, or to the use of no adjective. Blackworm (talk) 20:45, 28 September 2008 (UTC)

More historical reading (full Talk sections): Prelude,[11] and extended discussion.[12] Blackworm (talk) 20:59, 28 September 2008 (UTC)

Speaking of historicity, Blackworm, it was I who first penned that sentence in the article. Your insertion of severed was the revision. Regardless, I found a neutral way to phrase the information, which somehow, disappoints you. I'm sorry that WP:NPOV doesn't please you in this case, but our goal here is not to please you or me, but to build an encyclopedia in accordance with wiki's core principles. It appears to me that in this particular instance you are the sole editor not wishing to have the article be more neutral. Why would that be? You have professed to desire to edit in accordance with wiki's guidelines. What has changed now? -- Avi (talk) 01:54, 29 September 2008 (UTC)

No, you seem to misrepresent the facts (there was no "insertion," it was a "replacement"), and make further personal attacks ("sole editor not wishing to have the article be more neutral"). At first, you penned "circumcised foreskin."[13] You apparently recognized the need for an adjective. Unfortunately, that adjective was somewhat confusing and imprecise, as it could be read to mean the remaining fragment of foreskin. My change was perfectly neutral, and had no such confusion: "severed foreskins." You objected to that wording, and changed "severed" to "removed,"[14] to which several editors have pointed possible out POV issues. I put "severed" back, you put "removed" back again.[15] For some unknown reason (do you see POV in both terms?), you then removed the adjective altogether,[16] leaving a sentence that conveys less information. Presumably, if "part or all" of the foreskin is (removed/severed) during male circumcision (see our definition), then the foreskin remaining on the penis may be referred to as the "circumcised foreskin," correct? Is that the one being used to make anti-wrinkle creams for women? Likely not. The current edit still has some of that potential confusion, for the "disposition of the foreskin" may mean the state of the remaining foreskin on the penis. Now, note that "removed" is used in the lead sentence of this article. Despite the POV issues with the word raised by several editors here (apparently banned from the definition: "(genital) mutilation," "(genital) cutting," "surgery,") I think we all recognize that we need to use some word, whether preferred by those supporting male circumcision or those opposing it, to convey the essence of circumcision, and thus there hasn't more than grumbling resistance to "removal." But, "removal" has high prominence already, and repeating it like a mantra (i.e. removing occurrences of any other terms) seems to reinforce, rather than dampen the POV issues editors here seem concerned about. What is the reason for that, Avi? I suggest we use a variety of terms to describe circumcision, as reflected in the sources. "Severed" is a neutral term, as the reliable sources show, and as several editors here agree. You have no rationale to insist on the deletion of the term, especially given your failure to provide sources backing up your claims of it being "shocking" terminology. Blackworm (talk) 03:43, 29 September 2008 (UTC)

You are repeating yourself, Blackworm, so I will as well. In a nutshell, there were issues with various terms, the sentence has been re-written to obviate the need for any terms, which is in accordance with wiki's policy of WP:NPOV. Simple enough, it appears. -- Avi (talk) 18:40, 29 September 2008 (UTC)

Prove that there is an issue with "severed." Your reasoning (i.e. your uncited assertion that "severed" has NPOV issues) was apparently not a valid rationale for me to oppose "uncircumcised,"(though I had a source[17], and an argument) according to you, thus I do not recognize it for "severed." What's simple enough is that you have no case to delete "severed." I will restore it, per the discussion here, should you continue to fail to provide a supporting rationale. Blackworm (talk) 19:42, 29 September 2008 (UTC)

Note also WP:CIVIL, which states: Editors are expected to be reasonably cooperative, to refrain from making personal attacks, to work within the scope of policies, and to be responsive to good-faith questions. Why are you making personal attacks, failing to work within the scope of policies, and failing to respond to my questions above, Avi? Your incivility has now reached a high level. Blackworm (talk) 19:54, 29 September 2008 (UTC)

Blackworm is making some valid points here. Avi and Jakew, you've stated that "severed" is non-NPOV and has connotations, but I don't remember seeing any more detail than that. What connotations do you see it as having, and why do you consider it non-NPOV? What arguments do you have to support those points?

The word is not redundant in the sentence. I was going to point out, as Blackworm did, that "the disposition of the foreskin" could be taken to mean the disposition of that part of the foreskin that's still attached to the penis: are stitches used to close the wound? Is anything done to prevent skin bridges? etc. Leaving out the word could mislead the reader, violating the principle of least astonishment, i.e. leading to a jarring sensation when one comes to the next sentence and suddenly realizes that something quite different is meant. To me, the word "severed" seems to have an appropriate level of precision (conveying more information than "removed", for example), and to have a neutral, medical-sounding tone while not excluding non-medical situations.

While I prefer "severed" for the reasons given above, (and besides, I like the sound of the word,) as a compromise, instead of "After circumcision, the disposition of the foreskin varies." I suggest "The disposition of the foreskin after separation from the penis varies." ☺ Coppertwig (talk) 01:36, 30 September 2008 (UTC)

Thank you, Coppertwig, for the much needed new voice. I could abide in this instance by: "The disposition of the foreskin (or part thereof) separated from the penis varies." This, in accordance with our definition, which states that circumcision removes "part or all" of the foreskin. I still protest the consistent enforcement of language potentially implying that the foreskin is not an integral part of the human male body, and the avoidance of all language potentially implying that it is an integral part of the human male body. I believe this enforcement violates WP:NPOV policy, but I suggest this edit in the interest of putting this petty but significant example of ownership of an article by fiat behind us. I reserve the right to describe foreskins severed by male circumcision as "severed foreskins," both here and in the article at any time. Blackworm (talk) 06:49, 30 September 2008 (UTC)

Separation is usually used to describe the gradual, natural separation of the foreskin from the glans. When a boy is born his foreskin is attached to his glans. Sometime between infancy and adulthood the foreskin naturally separates from the glans and becomes retractable. In my opinion using separation to describe a foreskin that has been cut off from a boy's penis is confusing. -- DanBlackham (talk) 08:06, 30 September 2008 (UTC)

Apparently we're not allowed to say "cut off." It's always "removed." Like a tumor, cyst, mole, or parasite. That is the policy according to Avi and Jakew. Blackworm (talk) 20:43, 30 September 2008 (UTC)

(<-)I'll try saying this again, Coppertwig. Being that there is consternation about the connotation of both terms "severed" and "removed", as I was able to re-write the sentence without the need for either, yet maintaining perfect clarity, why are we still discussing this? Isn't finding a neutral, non-partisan way to word things the essence of WP:NPOV? -- Avi (talk) 00:55, 2 October 2008 (UTC)

We're discussing it because your edit is disputed, and apparently lacks WP:CONSENSUS. Blackworm (talk) 06:31, 2 October 2008 (UTC)

Also, if you won't respond to my questions, could you please respond to Coppertwig's questions, since apparently you "greatly respect [his] ability and judgment" ? Or are you going to be incivil to him, as well? Blackworm (talk) 07:05, 2 October 2008 (UTC)

Avi, you are claiming "severed" is non-neutral when it isn't. It is the most accurate word to describe what happens. This isn't a place for euphemisms. I think if this was a one-off people wouldn't be that bothered, but it isn't. There has been a concerted effort from certain editors to tone down the unpleasant aspects of circumcision which isn't right because it is not reflecting the true reality, and Wikipedia isn't a place for censorship. Tremello22 (talk) 12:01, 2 October 2008 (UTC)

The main problem with "severed" is that the word carries connotations of gore and violence, Tremello. From an anti-circumcision perspective, perhaps those connotations are justified or even intended, but of course Wikipedia is not a soapbox. The proper way to "reflect the true reality" of the procedure is through neutral, appropriately-sourced description of the procedure, not by attempting to drive the point home by using certain language throughout the article. As a general rule, if a point is so weak that can only be made through use of loaded words (as opposed to neutral description), it probably isn't worth making. Jakew (talk) 13:47, 2 October 2008 (UTC)

Jake severed only carries those connotations because of your perception. Wiktionary define's[severed] as separated, cut off or broken apart. Doesn't sound too dramatic or violent to me. In the end it would depend on the context. Garycompugeek (talk) 14:57, 2 October 2008 (UTC)

Jakew, welcome back to this discussion. If you haven't noticed, I asked a question of you above, days ago. Please respond to questions addressed to you. Thank you. Blackworm (talk) 21:20, 2 October 2008 (UTC)

(<-)And also unnecessary, Gary, the way the paragraph is written. -- Avi (talk) 15:01, 2 October 2008 (UTC)

How can you say this again, without further expansion, in the face of two editors (myself and Coppertwig) asserting the contrary and giving a rationale? Also, what gives you and Jakew the right both to ban language you feel has "anti-circumcision" POV connotations ("severed," with more than two editors opposing you), and insist on the use of language others feel has "pro-circumcision" POV connotations ("removed," with more than two editors feeling that way)? Note, again, that both terms you non-neutrally label "problematic"[18] are already in the article, as they are used in many reliable sources. (I see no objection to the lead sentence from you, and assume you would revert attempts to remove the "problematic" word "removal" there. Am I wrong?) You have no case. Please resume having some civility at some point, and allow other editors to use terms used in reliable sources (including very pro-circumcision sources[19]). At the very least, acknowledge the parallel of your "argument" without sources to arguments to remove the word "uncircumcised" due to explicit, sourced high-quality references[20] showing the word has extremely negative connotations -- arguments you have also shrugged off without rationale. If you want to have this issue moderated or arbitrated, I am prepared to go that route. Are you? Blackworm (talk) 21:20, 2 October 2008 (UTC)

Jakew, the definition of gore is "Blood, especially coagulated blood from a wound." Now that seems pretty accurate to me. My point still stands. It is nothing to do with me getting on a soap box and trying to use loaded words. Like I said it is a medical term and is the most accurate word to use to describe what happens. Tremello22 (talk) 15:20, 2 October 2008 (UTC)

(<-)C-Twig, since circumcision is defined above as removal of some or all of the foreskin, I think it self-evident that we are discussing the removed foreskin, but I personally can accept the compromise of "separated foreskin" as you suggest. -- Avi (talk) 23:40, 2 October 2008 (UTC)

"Separation" is the term used to describe the natural separation of the foreskin from the glans some time between infancy and adolescence. The 1999 AAP Circumcision Policy Statement says, "Separation of epithelial layers that may be only partially complete at birth progress with the development of desquamated tissue in pockets until the complete separation of tissue layers forms the preputial space. As a result of this incomplete separation, the prepuce or foreskin may not be fully retractable until several years after birth." -- DanBlackham (talk) 05:33, 3 October 2008 (UTC)

And "removed" is used in the literature to describe the foreskin separated due to circumcision, but there are those here who do not like that term either, Dan. We are trying to come to some acceptable form of compromise; there are issues with every term. Which is why, I still maintain that the optimal construction has no term, and I am much less concerned that readers will have cognitive issues thinking that pharmaceutical companies are making skin cream out of foreskins still attached to infants; but others here seem to be worried about that image, so we are working on finding a solution acceptable to all. -- Avi (talk) 10:19, 3 October 2008 (UTC)

Why should we? "Removed" isn't banned from the article despite concerns nor will it be. Same for "uncircumcised" (i.e. "heathen"). "Severed" shouldn't be either, as that would be enforcing a POV-based double-standard. Why should anyone "compromise" when that compromise can only apparently mean "we exclude all terms Avi/Jakew want excluded, and exclude no terms Avi/Jakew don't want excluded." Also please respond to my suggestion that we enter formal mediation regarding this issue. Blackworm (talk) 15:31, 3 October 2008 (UTC)

As the lengthy discussion above makes quite clear, this emotive pleonasm is both unnecessary and unhelpful. Please avoid WP:POINT, thanks. Jayjg ^(talk) 22:47, 5 October 2008 (UTC)

It's not clear to me, Jayjg. Would you please explain, including an explanation as to what part of my argument of 01:36, 30 September 2008 you disagree with? That's where I explain why, in my opinion, the word "severed" (or equivalent) is not redundant, by which I mean that it's not unnecessary. Avi, you say it's self-evident that we're discussing the removed foreskin. It doesn't seem self-evident to me. Since it might be only part of the foreskin being removed, the reader might reasonably think it's the part still attached to the body being talked about. After all, the part still attached to the body is somewhat important: it may affect that person for the rest of their life, for example whether they have a skin bridge. The part being removed one might think is simply discarded and unimportant, and the reader might not give it a second thought, might not even be consciously aware of rejecting the possibility that that's what's being talked about, because it doesn't seem important. ☺ Coppertwig (talk) 01:04, 7 October 2008 (UTC)

Circumcision is the removal of the foreskin from the penis. Once it is removed, it is, well, removed. That means no longer part of the penis. They don't bury it or eat it or make it into medical products while it's still attached to the infant. Jayjg ^(talk) 01:11, 7 October 2008 (UTC)

C-twig, the paragraph discusses burial, skin grafts, cosmetics, candying, etc. I find it very hard to believe that someone is going to think that IN a paragraph discussing the PROCESS of circumcision (not foreskins in general) that a pharmaceutical company is turning infant foreskins into cream while the foreskin is attached to the baby's penis. C-Twig, if I said the following: “Human skin has been used for cosmetic implantation in Lip enhancement” (see Lip enhancement#Materials and techniques would you seriously believe that that on the surgeon's table there is a person having their skin partially flayed off, with one end attached to the donor and the other being stuffed into the lips of the recipient? I hope not. Same here. I note in the Autologen section of Lip enhancement) it says "an injectable dermal material made from the patient’s own skin," not removed skin, severed skin, flayed skin. I believe that is selbsverstandlich as is the case here, and I would request of you, C-Twig, to explain why there is the possibility of imagining infants having their foreskins buried or whatever while still attached to their penis? -- Avi (talk) 01:22, 7 October 2008 (UTC)

Jayjg and Avi, I meant no disrespect in my last edit to the article. In the absence of comments on the alternatives I'd suggested in the following section, it seemed a good idea to me to try the one of them that I preferred most, until getting a clear indication that there was opposition to it. I didn't see your comments until after I'd edited the article, and then didn't have time to reply immediately.

Jayjg, I agree with each of the statements in your last comment but don't see how they contradict what I said: could you explain further? Avi, LOL, that's not what I mean at all! That would be ridiculous. Certainly, when the reader gets to the part about cosmetics, burial etc. they know that it's a detached foreskin. My point is this. Let's assume a reader who has not previously read the article starts at the beginning of the paragraph, reads along until he or she comes to the end, and then stops. (Allusion to Alice in Wonderland.) In that case, when reading the sentence about the disposition of the foreskin, the reader will not yet have read about cosmetics, skin grafts etc. Therefore, when reading that sentence, the reader may well misunderstand it as I said. That's what I meant. When reading the following sentence, any such reader who had misunderstood will then do a double-take and get straightened out. I don't think in any case, even if the reader stops reading mid-paragraph, that there is any danger here of the reader leaving the article with some misconceptions. The only problem, in my opinion – and it is a relatively minor one, concerned only with style and flow, not with NPOV – is that the reader is subjected to that brief misunderstanding and double-take.

I've added some more alternatives in the section below. ☺ Coppertwig (talk) 12:28, 8 October 2008 (UTC)

You are correct about the need for a disambiguating adjective, but you are missing the broader point that we do not generally allow editors to mandate the exclusion from the article of terms used in reliable sources, based on the expressed views of the editor concerned about the term, in absence of support from reliable sources. Arguments based on the idea that "we can rewrite it using terms [certain editors] don't object to" have been rejected by Jakew and Avi in the past, with the sole rationale being an assertion by these editors that the terms are neutral, but it seems that that exact argument is embraced by the same editors when the terms are opposed by them, despite the presence of even more editors who claim the terms are neutral and appropriate. Instead of narrowing the discussion to each specific instance and seemingly changing our approach based on whether the terms are perceived to be supportive or critical of circumcision (a violation of WP:NPOV), we should be attempting to find a consensus on a method of handling these types of disputes -- obviously the current approach is inconsistent.

The only viable solution I can see is that the choice and frequency of use of terms should more or less reflect that of the terms used in reliable sources. As it happens, policy seems to mandate this approach: "Neutral articles are written with a tone that provides an unbiased, accurate, and proportionate representation of all positions included in the article."(WP:NPOV) Also, WP:TONE (guideline) states, "Standards for formal tone vary depending upon the subject matter, but should follow the style used by reliable sources, while remaining understandable to the educated layman." If the position of a large fraction of sources seems to be that "severed" or "uncircumcised" are neutral and impartial, then it seems those terms may be used in this article, does it not? Blackworm (talk) 17:40, 8 October 2008 (UTC)

Disambiguating adjectives are fine, but emotive pleonasms are not. Since we're not "disambiguating" from "unsevered foreskins", which, of course, are not buried, candied, or used to make medical products, the argument is specious. However, since your concern is disambiguation, I've now changed the adjective to something even more neutral and specific, "circumcised", which, actually, is the topic of this article too. Otherwise the reader, who obviously needs disambiguation, might think that the foreskin had become "severed" or "detached" in some other way. Jayjg ^(talk) 21:04, 8 October 2008 (UTC)

No, had you been following this dispute closely, you'd see that "circumcised" has already been opposed on the same grounds (that it fails to disambiguate -- a circumcised foreskin may refer to the section of foreskin remaining on the penis after circumcision). Yes, we are disambiguating from the section of foreskin remaining on the penis, because the fact we are discussing the severed piece does not become clear until the following sentences, as Coppertwig points out. Also, as we have failed to seek, establish or agree upon a process for determining the neutrality of terms, your arguments regarding the neutrality or non-neutrality of various terms seem to be arbitrary and based on assertion. Avi/Jakew/you reject all my assertions in that area, and those of all other editors, even the ones supported by reliable sources,[21] thus I do not see why I should recognize your similar assertions unsupported by any reliable sources. Perhaps you could explain precisely why your assertions are to be taken as fact (and why our editing decisions must be based on them), and why my assertions regarding neutrality are to be dismissed. Regards. Blackworm (talk) 21:26, 8 October 2008 (UTC)

Actually, I have been following, and the term "circumcised foreskin" is used to refer to the, well, circumcised part. If you insist on pleonasm, it will be a neutral one, and "circumcised" is neutral. And yes, Wikipedia editors get to make these decisions. As for why my assertions should be taken as fact? Well, if you insist on discussing individuals, it's because of my greater experience here. You have edited a total of 250 distinct Wikipedia pages, a significant percentage of which are circumcision-related, and all from a decidedly anti-circumcision point of view. By contrast, I have edited almost 12,000 different pages, from all areas of Wikipedia, helped write Wikipedia's policies, and have adjudicated over 100 Arbitration Committee cases. Jayjg ^(talk) 21:33, 8 October 2008 (UTC)

The circumcised part left on the penis? I'm confused, I thought you wanted to refer to the part that was cut off, not the circumcised foreskin remnant. "Severed" is also neutral, and used in reliable sources, including some reliable sources with no apparently pro/anti POV, some apparently anti- sources, and some apparently pro- sources.

Your greater experience may indeed mean you have a better sense of the community consensus on this issue, but then again it may not (as evidenced by the opposition to many of your edits to this article, which failed to gain consensus). I am quite prepared to follow dispute resolution to test your theory. Do you prefer mediation, arbitration, or RfC (or do you resist dispute resolution in this instance)? Blackworm (talk) 21:54, 8 October 2008 (UTC)

When you say "severed foreskin", do you mean the severed part left on the penis? I'm confused, I thought you wanted to refer to the part that was cut off, not the severed foreskin remnant. Jayjg ^(talk) 00:51, 12 October 2008 (UTC)

That makes no sense, since it's not what the word "severed" means. Something "severed" cannot be "left on." Here's a dictionary, that might help clear up your confusion: [22] Blackworm (talk) 08:17, 13 October 2008 (UTC)

And your objections to the word "circumcised" make no sense, since that's not what the word "circumcise" means. "Circumcise" means "to cut off the foreskin of (a male)". Here's a dictionary, that might help clear up your confusion: [23] Jayjg ^(talk) 19:34, 13 October 2008 (UTC)

Have you heard of a "circumcised penis," Jayjg? Here's a hint: it's still attached. A "severed penis" wouldn't be. Blackworm (talk) 17:36, 15 October 2008 (UTC)

Ah, but we're not talking about a circumcised penis, we're talking about a circumcised foreskin. Jayjg ^(talk) 01:47, 17 October 2008 (UTC)

Also, you need ellipses ("[...]") in your quote of the dictionary above, as the actual, full meaning of "circumcise" given by that source is "to cut off the foreskin of (a male) or the clitoris of (a female)." (Emphasis mine.) That's a fact we often forget here, in this misnamed article, as the article is organized in conformance to a non-neutral POV and in contradiction to these basic, reliable sources. Blackworm (talk) 22:29, 15 October 2008 (UTC)

...which is completely irrelevant to the topic at hand. (Note the use of ellipses). Jayjg ^(talk) 01:47, 17 October 2008 (UTC)

Also, these tools may assist the reader to determine the relevance, if any, of Jayjg's[24], Jakew's[25], Avraham ("Avi")'s[26] and my [27]respective edits. What percentage of Jakew's top 25 articles are circumcision related? Apparently you don't hold that against him. What percentage of Avi and Jayjg's top 25 articles are related to Judaism? Should I implicitly question whether this affects your neutrality with regard to circumcision, or assert that you make "all" your edits "from a decidedly pro-circumcision POV?" I don't believe those kinds of claims are productive. Blackworm (talk) 22:18, 8 October 2008 (UTC)

It's unclear what that rather distasteful reference to "articles related to Judaism" has to do with anything, but approximately 0.5% of my edits are circumcision related, as opposed to over 50% of yours. Jayjg ^(talk) 00:51, 12 October 2008 (UTC)

(outdent) In reply to part of Jayjg's post of 21:33, 8 October 2008: Jayjg, I accept your assertion that you have a large amount of experience on Wikipedia and have participated in Arbcom decisions, and I congratulate you for your vast contributions to Wikipedia. I do not accept your assertion that we should therefore accept your assertions as fact. Since I do not accept this assertion as fact, I'm not obliged to accept this assertion as fact.

Some decisions about the writing of Wikipedia articles, when not specified in detail by reliable sources or by Wikipeda policies and guidelines, may be partly based on Wikipedians' dialect, taste, guesses as to what a reader would be looking for, etc. Therefore, in my opinion, a Wikipedian's assertion that in their opinion a certain word has certain connotations is an interesting piece of information which can perhaps be used to influence the finer details of article writing, in a gentle and unassuming way, as opposed to the more definitive way in which information from reliable sources is used. However, I think that that intuition about the connotations of a word would in general be based mainly on the person's total life experience, not on their Wikipedian experience in particular; therefore, I would tend to treat such input from a very experienced Wikipedian in the same way I would treat such input from a less experienced Wikipedian, provided that their history of Wikipedian participation was large enough to allay suspicions of sockpuppetry. (I may respond to other things later.) ☺ Coppertwig (talk) 23:48, 12 October 2008 (UTC)

Blackworm explicitly asked why my assertions should be considered more reliable than his (though he stated it in more dramatic way), and I explained why. I think the reasoning is sound. Jayjg ^(talk) 19:34, 13 October 2008 (UTC)

Alternative terms for "severed"

Current text: "After circumcision, the disposition of the foreskin varies."

An earlier version: "The disposition of the severed foreskin varies."

Suggested by Blackworm: "The disposition of the foreskin (or part thereof) separated from the penis varies."

Possible alternatives, with words selected from Roget's Thesaurus:

• The disposition of the foreskin (or part thereof) detached from the penis varies.
• The disposition of the detached foreskin varies.
• The disposition of the detached foreskin (or part thereof) varies.
• The disposition of the foreskin (or part thereof) when no longer connected to the penis varies.
• The disposition of the foreskin (or part thereof) when no longer attached to the penis varies.
• The disposition of the foreskin (or part thereof) parted from the penis varies.
• The disposition of the foreskin (or part thereof) extracted from the penis varies.
• The disposition of the foreskin (or part thereof) sundered from the penis varies.
• The disposition of the foreskin (or part thereof) cleft from the penis varies.
• The disposition of the foreskin (or part thereof) after being disjoined from the penis varies.
• The disposition of the foreskin (or part thereof) after being uncoupled from the penis varies.
• The disposition of the foreskin (or part thereof) after being dissevered from the penis varies.
• After partition of the foreskin (or part thereof) from the penis, its disposition varies.
• After scission of the foreskin (or part thereof) from the penis, its disposition varies.
• After abscission of the foreskin (or part thereof) from the penis, its disposition varies.

Some more words selected from Roget's Thesaurus:

• disconnected, dissociated, disengaged, reliinquished
• unattached, hived off
• split, unhitch, set apart
• divided, riven, cleft, cloven
• isolated, freed, apart, asunder, sequestered
• divorced, estranged, alienated
• divergence, dichotomy, cleavage, section
• laceration
• incise, trim, clip, snip, snick, prune, dock, pluck
• no longer at one
• no connection
• expropriated, withdrawn
• severally, unconnectedly

I still prefer "severed" but I recognize that some editors see it as having connotations of violence, so perhaps one of the above terms can be used instead. Avi, perhaps you didn't see this comment of mine above or didn't follow my argument as to why in my opinion the word "severed" (or equivalent) is not redundant (nor unnecessary) in this sentence: perhaps you could explain what part of my argument you disagree with. Blackworm, you've asked Jakew to answer a question, but I don't think you've specified a particular question: this previous post of yours contains approximately five questions. All editors should strive to establish good communication, but I don't see Jakew's answering those particular questions as being particularly useful or necessary to this discussion: they look more like rhetorical questions to me, or else like questions to be answered by a consensus process among all editors, not by just one editor. ☺ Coppertwig (talk) 15:39, 4 October 2008 (UTC)

Here are some more alternatives. I know we don't normally use questions in encyclopedic writing, but possibly it's time for an exception.

• (Minimize neoplasm with a zero-length sentence, i.e. just delete that sentence: it adds no information. It does, if understood properly by the reader, help the reader navigate the paragraph, though.)
• The fate of the foreskin after circumcision varies.
• The disposition of foreskins from circumcision varies.
• Where do foreskins end up after circumcision?
• What is the fate of the foreskin?
• Foreskins from circumcision are used for skin grafts. Other...

☺ Coppertwig (talk) 12:25, 8 October 2008 (UTC)

I object to this entire subsection, as it is far from established that we must seek alternatives to "severed." The question I most want answered from Avi/Jakew/Jayjg is: Do you allow other editors with apparently opposite points of view to veto terms used in reliable sources because of a perceived potential emotional response provoked by the words, unsupported by any reliable sources, or is that a privilege reserved to you, and those who agree with your point of view? Blackworm (talk) 17:54, 8 October 2008 (UTC)

Being that "removed" is used in the literature as well, your own arguments and objections apply to you as well, Blackworm. -- Avi (talk) 18:47, 8 October 2008 (UTC)

Except that unlike you, I do not insist on the non-use of the term I dislike (e.g. in my case, "removed"). I do not object to the use of "removed," as it is used in sources; I object to the requirement that we must only use the term "removed" and not other neutral terms such as "cut off" and "severed." I recognize that we must reflect the terms used in sources. In light of this clarification, please respond to the question above. Thank you. Blackworm (talk) 19:24, 8 October 2008 (UTC)

I find this whole exercise ridicules. Why are we trying cage circumcision in soft pillow terms? I suggest someone who isn't circumcised to cut their foreskin off (not me, sorry) and then write some adjectives about the whole episode.(do it without anesthesia for complete effect). Lets face it. We are cutting the skin off our most sensitive organ. (Clamps are even more painfull). It's going to hurt. There is going to be pain and blood. Cutting, severed, whatever... these are terms used to describe circumcisions. Garycompugeek (talk) 22:45, 8 October 2008 (UTC)

Your emotional description of male circumcision doesn't seem necessary, and in fact seems to cast "cut off" and "severed" as being aligned with your views. I don't believe that's the case at all. The terms "severed" and "cut off" are about as hard and disapproving as the word "removed" is soft and approving; i.e., maybe a bit, but not very much. The main difference is that the former two terms could be seen as suggesting that the foreskin is a part of the human body, and the other could be seen as suggesting that the foreskin is more akin to a foreign object or unhealthy growth. The opposition to "severed" and "cut off" here (and incidentally, embracing "removed"), with no reliable sources suggesting they are "shocking" or "emotive" language, seems born of strong emotive reactions to this subtext.

Lots of people say "the foreskin was cut off" or "the foreskin was severed," and many without even being opposed to circumcision. It's matter of fact, or in the language of WP:NPOV, a "businesslike" tone. The people who are actually in the business of circumcising males use the terms. Look at medical sources; a large number say "cut off" and "severed" when discussing male circumcision. WebMD actually says "removal," but then says the "excess foreskin" is "clipped off." I doubt "clipped off" would be seen in a better light than "cut off" or "severed." Blackworm (talk) 07:13, 10 October 2008 (UTC)

What you term emotive Blackworm, I see as simple, soup to nuts, reality. Words themselves do not take sides. It's the context that they are used in that flavor POV. Garycompugeek (talk) 13:00, 10 October 2008 (UTC)

You know what term best describes circumcising? Circumcised. Jayjg ^(talk) 00:52, 12 October 2008 (UTC)

Severed is inappropriate. Removed is a euphemism for cut, but since the foreskin is easily removed by just pushing on it, it is necessary to qualify the type of removal involved, surgical removal. 199.125.109.58 (talk) 16:22, 12 October 2008 (UTC)

You prove that we enforce the use of soft euphemisms ("removed," "circumcised"), rather than use the neutral, businesslike terms provided by many, many reliable sources ("cut off," "severed"). That is a violation of WP:NPOV. It does not have consensus, and thus cannot stand. Blackworm (talk) 06:54, 13 October 2008 (UTC)

"Circumcised" is a "soft euphemism" for "circumcised"? Now I've seen everything. Please review the topic of this article. Jayjg ^(talk) 01:06, 19 October 2008 (UTC)

Clearly, no one here has medical training, which is sad considering the subject. I don't either, but I am well read on the subject. I think the term you are looking for, which is the proper medical term, is "excised." It means to surgically remove. "Cut off" is probably the best lay phrase to translate this into, imo. (Dan Bollinger (talk) 03:21, 28 October 2008 (UTC))

That's not clear and irrelevant Dan. Please comment on content and not editors. Garycompugeek (talk) 16:04, 29 October 2008 (UTC)

The term "excision" had already been suggested here, where it was opposed for the very reason that it sounds like a medical term. Circumcision is not always medical; it can alternatively be ritual, low-tech or even violent (forced circumcisions of adults). ☺ Coppertwig (talk) 15:10, 29 October 2008 (UTC)

I understand that circumcision is not always medical. And, I think this underscores the point I make at the end of this discussion that perhaps this should be divided into two articles in order to deal with this article's length as well as finding suitable language for what is, to me, two topics. (Garycompugeek--point taken.) (Dan Bollinger (talk) 13:25, 30 October 2008 (UTC))

Removal of "disposition" sentence in toto

I find Coppertwig's edit eminently acceptable; even better than my own attempt above, as the article disseminates the same information without any problematic terms. Well done, C-Twig. -- Avi (talk) 19:51, 12 October 2008 (UTC)

Yes, good job. Jayjg ^(talk) 03:26, 13 October 2008 (UTC)

Again, no rationale for Coppertwig/Avraham/Jayjg/Jakew's removing all terms used in reliable sources that may imply that the foreskin is an integral part of the human body, and enforcing the continued use of all terms that may imply that the foreskin is an unwanted growth or foreign body. This is an egregious violation of WP:NPOV, against multiple editors in opposition, perpetrated by these editors mentioned.[-BW] Blackworm (talk) 06:49, 13 October 2008 (UTC)

Interesting, C-Twig is reasonable in your eyes until disagreeing with you, and then gets lumped into your "cabal"? -- Avi (talk) 07:00, 13 October 2008 (UTC)

Please strike out your misquote and personal attack above. Also, you may notice that Coppertwig at first agreed with me on the edit in this instance, stating essentially the same position regarding the word "severed," and asking virtually the same questions to opposing editors lacking a rationale (to which you and Jayjg have still given no response, again displaying grave incivilty and disregard for any editors opposing your edits). Blackworm (talk) 07:45, 13 October 2008 (UTC)

If the struck out phrase is what got distasteful images into your head, I apologize. "Perpetrated" is definitely not appropriate there, and I understand your indignant reaction. That said, however, naming the editors editing in favour of one side of a dispute on which one disagrees intensely is *not* to be spun into something it isn't. Actually, I think it's a nice way of keeping track of editors' views on the best edit.

I'm adding a {{fact}} tag to the part of your message which can easily be read as a quote of me. I ask that you please redact that part, either by providing a diff link to an edit by me where I use that word in the context you describe, removing the quotes, striking the quoted word, or another mutually acceptable change. Otherwise, I may consider removing your entire comment from my talk page and replacing it with a diff link. I'd prefer to avoid that. Thank you. Blackworm (talk) 06:43, 15 October 2008 (UTC)

Just to address the question about the quotation marks and not wanting to extend the discussion or imply anything else, I'd like to mention that Avi could possibly have been quoting from this diff. ☺ 14:18, 15 October 2008 (UTC)

In that case, the quote would be out of context. Unless the editors I mention by name are in fact behaving in the manner I describe in that comment, how could that comment be relevant to this discussion? I have no way of knowing and therefore would not assert that that is the case. And again, rather that take Avi to task for the personal attack, you stand by him and attack me. I'm not impressed. Blackworm (talk) 16:45, 15 October 2008 (UTC)

"Hygiene, and infectious and chronic conditions" section

I have reverted a number of additions to this section, as the material was problematic for a number of reasons. Here are a few of these:

• "Kabya says that before considering circumcision physicians and parents should encourage boys to wash their hands frequently and to learn basic hygiene" - as written, this is completely incomprehensible.
• Lengthy expansion of Fergusson to include detailed discussion of "problems". First. this adds a lot of bulk but relatively little information, and secondly, unless "problems" are defined, this is again incomprehensible.
• Similar situation with Herzog and Alvarez - "complications" and "problems" are discussed without definition.
• Fakjian, strangely, was removed from discussion.
• "Like Fergusson, Van Howe found that circumcised penis's required more care in the first 3 months of life." Would need to be rephrased.
• "To prevent adhesions forming after circumcision, parents should be instructed to retract and clean any skin covering the glans." First, this is the wrong section. Skin bridges are discussed in 'complications'. Second, it is prescriptive.
• "The American Medical Association cite prevention of phimosis as a reason to circumcise." Do they?
• "It is thought that only 1% of males aged 17 still have an unretractable foreskin." What does this have to do with circumcision?
• "Some parents and physicians are not aware of the normal development of the foreskin." Unsourced, and difficult to see how it could be sourced. Also, it is difficult to see how this is related to circumcision.
• "The foreskin is attached to the glans at birth and separates naturally over time and should never be forced." First, this isn't about circumcision. Second, it is prescriptive, and doesn't conform to WP:NPOV.
• "However there still remains misconception that it requires action, be it ‘preputial stretching’, ‘freeing of adhesions’ or even circumcision." First, this is only tangentially related to circumcision. Second, it is hopelessly POV. If the viewpoint exists that action is required and another viewpoint exists that no action is required then one point of view cannot be stated as factual.
• "Oster says that "phimosis is uncommon in schoolboys, and even rarer if the normal development of the prepuce is patiently awaited" - no direct relationship to circumcision.

Jakew (talk) 11:51, 13 October 2008 (UTC)

Thanks for keeping an eye on the article with attention to detail, Jakew. Based on what you say above, your reverts sound reasonable to me. ☺ Coppertwig (talk) 15:15, 13 October 2008 (UTC)

Yes the AMA do use phimosis as a reason to circumcise. I fail to see how the counter-argument to that is non-neutral. I'll add the reference if you want. What does it have to with circumcision? If you are going to prescribe circumcision for preventing the condition then the counter-argument(s) need to be listed. Also knowing how common the condition is, informs one as to whether the operation is worth it. The bit about "not being aware" is sourced, if you checked. The majority agree with Gairdner, oster , rickwood that circumcisions are performed needlessly due to pathologising what is the natural development of the foreskin.

Fakjian was put in the appropriate paragraph further down. Strange you used the word "discussion". As for as I could tell there is no discussion in this section.

"Some studies found that boys with foreskins had higher rates of various infections and inflammations of the penis than those who were circumcised." This is how the Ferguson and Herzog paragraph is currently phrased. There was no mention of meatal stenosis, which was a complication that occurred in more circumcised than uncircumcised boys- so deliberately misleading, if you ask me. Nor was it mentioned the fact that circumcised boys were more at risk in early infancy , but it was the reverse after infancy.

How would you amend the van howe paragraph? It seems perfectly fine to me.

Anyway, what is the purpose of having the medical analysis section if not to debate whether to circumcise? You mention "relevance for circumcision", the question could also be asked then what do all these conditions have to do with circumcision? Nothing, unless it is to debate whether one should circumcise to prevent the conditions. I have taken on some of your points and amended the section. Tremello22 (talk) 15:16, 13 October 2008 (UTC)

Tremello, please could you quote the passage from the AMA's statement in which they cite prevention of phimosis as a reason to circumcise? They do discuss prevention of phimosis, but I can't find anything about this being a reason to circumcise. If they do make such a statement, then we cannot use primary sources to make a counterargument; please see WP:MEDRS#Respect secondary sources.

The question "what does it have to do with circumcision" is of vital importance because, per WP:NOR, we must discuss what reliable sources say about the subject of the article.

As for "not being aware", it is difficult to see how it could be sourced as a statement of fact. Furthermore, you offer no source in support of your claim that the "majority" agree with Rickwood, etc. All we know is that, according to Rickwood and a few other authors, other physicians make diagnoses that are, in the opinion of Rickwood etc., inappropriate. It seems unlikely that the physicians making these diagnoses believe that they are incorrect. Presumably this happens often enough that Rickwood etc., consider the issue worth writing about, so either one physician is making an awful lot of diagnoses or there are lots of these physicians. Therefore, it seems that we have a situation in which there are two or more significant viewpoints.

Why was Fakjian moved? There's no logical basis for this. Fergusson et al., Herzog and Alvarez, and Fakjian are all epidemiological studies comparing the frequency of balanitis (etc) in circumcised and uncircumcised males (others include, as I recall, O'Farrell, Wilson, Taylor, Davidson, Richters, Parker, and Van Howe). They belong together.

"Some studies..." is a concise way of summarising these studies. This article is written in summary style. There is space in medical analysis of circumcision for in-depth discussion, but here we need to be brief. Of course there's no mention of meatal stenosis, since that is already discussed in the "complications" section.

Some comments on your latest changes:

• "An inflammation of the penis and foreskin is called balanoposthitis, just the glans is called balanitis." No, just the glans is called the glans. :-)
• "Both conditions are usually treated with topical antibiotics (metronidazole cream) and antifungals (clotrimazole cream) or low-potency steroid creams." - or circumcision, as the source clearly states, and as this paragraph originally stated. Why delete the one thing most relevant to the article?
• "They are also relatively rare despite cirumcision status: Kabya found that in uncicumcised boys, 9 out of 603 had balanoposthitis." Other studies, of course, found other rates. We could list them all, but since this article is about circumcision and not the incidence of balanoposthitis, what's the point?
• "Consequently, there is debate as to whether neonatal cirumcision should be used to lower the the risk of getting the conditions.[ref:fakjian]" I don't see how the source supports the claim. Can you quote the relevant passage?
• "Fergusson studied 500 boys and found that by 8 years, circumcised children had a rate of 11.1 problems..." same problem as before: too much detail, ill-defined 'problems', etc.
• "Herzog and Alverez found the overall frequency of complications..." same problem as before
• "Like Fergusson, Van Howe found that circumcised penis's required more care in the first 3 months of life. Unlike Fergusson and Alvarez, he found that circumcised boys are more likely to develop balanitis." - delete "like fergusson", change "penis's" (possessive) to "penes" (plural), delete "unlike fergusson and alvarez".
• "The American Medical Association cite prevention of phimosis as a reason to circumcise." - see above
• "The foreskin is attached to the glans at birth and separates naturally over time and should never be forced." - same issue as before.
• "It is thought that only 1% of males aged 17 still have an unretractable foreskin." - same issue as before.
• "However there still remains misconception that the unretractable foreskin in infancy is pathological and requires action, be it ‘preputial stretching’, ‘freeing of adhesions’ or even circumcision..." - and again. If relevant, it's fine to say that Rickwood has expressed this opinion. It cannot be endorsed without violating NPOV.
• "Oster says that "phimosis is uncommon in schoolboys, and even rarer if the normal development of the prepuce is patiently awaited"" No doubt he does, but relevance to circumcision is not obvious.
• "Metcalfe recommended that, "if physicians dissuade parents from having their infants circumcised, they must give those parents the information concerning hygiene and the slow natural separation of the foreskin from the glans."" Better.
• "O' Farrel claims that circumcised men are more likely to wash." First, the authors (there were several) were O'Farrell et al.. Second, "states" or "reported" is more neutral than "claims", which implies doubt. (Discussion of O'Farrell needs reworking anyway.)

Jakew (talk) 17:10, 13 October 2008 (UTC)

AMA statement: "Properly performed circumcision protects against the development of phimosis" It seems the ref (5) links to the AAP statement where they list phimosis under penile problems. The implication is that phimosis is obviously a condition of the uncircumcised penis and it is a problem. How serious is the problem, is the question. And is it worth performing neonatal circumcision to prevent it? The most important question is: what is phimosis? There appears to be a disagreement (according to you) about whether it is phimosis or just a normal stage of prepuce development. Incidently they quote Oster as their reference.

I realise we need to be brief. This was just a start because I just recognised that it seemed a little one-sided. I don't expect this to be the final edit.

"The question "what does it have to do with circumcision" is of vital importance because, per WP:NOR, we must discuss what reliable sources say about the subject of the article." Well phimosis was already mentioned in the previous version, which was "Forcible retraction of the foreskin in boys can lead to infection[107] and acquired phimosis. Furthermore, developmentally non-retractile foreskin may be misdiagnosed as phimosis and lead to unnecessary circumcision.[160]" So what do you suggest then? That is not really treating the subject of phimosis in a balanced way is it? To the average reader it looks like "arguments FOR cirucmision". The title of the section is "medical analysis of circumcision" Not "arguments FOR circumcision"

We could list them all, but since this article is about circumcision and not the incidence of balanoposthitis, what's the point? You have lost me there. The subject of this section of the article is what? It is "Medical analysis of circumcision", is it not? So according to your way of thinking, if you tell someone that circumcision will prevent a disease then: a)it isn't important how serious that disease is, b)how common it is or c)how much circumcision protects you from that disease, if at all? I would propose we use a range to find the incidence. You could have added that, could you not?

Why was fakjian removed , a better question is why those studies? It wasn't really removed anyway i just used it to suggest there is debate over whether circumcision should be used to prevent circumcision. The title of the fakjian study is "An argument for circumcision. Prevention of balanitis in the adult". "Argument" implies that there is debate. Also, What criteria should be used for picking which studies go into the main article? Van Howe found different conclusions, but was not included. It is called balance and reflecting the true picture instead of trying to push your point of view.

Also instead of writing out minor mistakes such as not putting et al or not phrasing something well, wouldn't it be easier if you just amended it yourself? It doesn't really add to your list of other arguments does it? So unless it is important then I wouldn't bother bringing it up. Tremello22 (talk) 21:25, 13 October 2008 (UTC)

Ok, Tremello, we're obviously reading the same part of the AMA's statement. However, for some reason, you're reading the statement you quote as a reason to circumcise. That doesn't make a lot of sense to me. There's a difference between saying that something has an effect (even a desirable effect) and saying that it should therefore be done. To illustrate using an extreme example, a statement that a "properly performed leg amputation protects against the development of athlete's foot", while true, doesn't seem to be "citing athlete's foot as a reason to perform leg amputation".

You ask a number of questions ("How serious is the problem", etc) that may be important, and if so, they will have been discussed in reliable sources in the context of the subject of this article. So instead of performing original research by citing sources that don't even discuss circumcision, the obvious thing to do is to cite secondary sources that discuss these issues in the context of circumcision.

I'm afraid I don't quite understand what you perceive as the problem with the previous version. The two sentences which you quote are not perfect, I agree, but I would note that a) the sentences are short, and b) both sources cited make these remarks in the context of circumcision.

Regarding the incidence of balanoposthitis, I'm not suggesting that these issues are unimportant, but — again — if it's important, then sources can be found that discuss this information in the context of circumcision. It's questionable whether such information should be added to the article even then, though, because a large number of statements have been made about circumcision and we have limited space available, and must remain focused. I don't think that adding a range would be productive because, as I said, the subject of the article is circumcision, not the incidence of balanoposthitis. (I would encourage adding this information to the appropriate article, however.)

Re the title of Fakjian's study, "argument" may imply that there is debate over circumcision itself, but it doesn't imply that there is debate over a specific condition. The fact that this source is used to support a point that it doesn't make is disturbing, especially so given that the point it did make has been deleted.

You ask what criteria should be used to include sources in this article. That's a very valid point. Failing to include Van Howe might suggest that every study found reduced rates of penile inflammation in circumcised males. On the other hand, including Van Howe's study as well alongside too few of the other studies might suggest that results have been more mixed than they have been. If lots of space were available, the solution would be obvious: include all of the studies. In the absence of that, we can either cite a representative selection or, ideally, find and use reliable secondary sources instead. I would be grateful, incidentally, if you would adhere to WP:CIVIL and avoid accusations of POV pushing. Jakew (talk) 22:25, 13 October 2008 (UTC)

Reply to Tremello: If an editor chooses to mention a mistake on the talk page rather than editing the article, I think that's fine: I can think of a number of reasons why one might consider that preferable under some circumstances. For substantial changes, I would prefer that editors follow the request in the template at the top of this talk page, which says "Please ... discuss substantial changes here before making them." ☺ Coppertwig (talk) 00:08, 14 October 2008 (UTC)

The point is coppertwig, I obviously knew that it was fergusson et al. And if something is phrased badly then I am not going to object to it being improved, am I? So there was no point in bringing another argument up when it is irrelevant and there are other more important things to discuss. We might as well concentrate on the things we are disagreeing with. Tremello22 (talk) 11:04, 14 October 2008 (UTC)

Arbitrary section break

Yet more edits to this section have brought more problems:

1. The section is now far too long, containing (as I judge by eye) more text than any other section about medical aspects of circumcision.
2. A huge amount of text has been added: "Escala and Rickwood recommend against a policy of routine infant circumcision to avoid these complaints, saying that "the condition affects no more than 4% of boys, is commonest during pre-school years (but rare prior to toilent training) and is usually associated with a prepuce which is partly or completely non-retractable. It does not cause phimosis and no single pathogen is involved. Most boys suffer a single episode and circumcision is indicated only for those with recurrent, troublesome attacks." Surely one sentence would be enough?
3. The text discussing O'Farrell has been expanded from "In a study of 225 men, O'Farrell et al. found that circumcised men were less likely to be diagnosed with balanitis than uncircumcised men." to "In a study of 225 men attending a sexually transmitted infections (STI) clinic, O'Farrell et al. found that less circumcised men were diagnosed with balanitis than uncircumcised men (5% and 42%, P=0.036)." Unfortunately, this not only increases the word count, but is wrong. The correct figures are provided in the full text of the study, and are given in the quote in the ref tag. These figures (5 and 42%) are associations with washing, not circumcision.
4. In addition to Van Howe's 1997 study, we also quote his 2007 study, which was a follow-up including the earlier observations. It would be more logical to cite just the follow-up, and in a single sentence, rather than dedicating four sentences to Van Howe and one sentence each to the other studies.
5. The AMA's statement ("The American Medical Association state that circumcision, properly performed, protects against the development of phimosis.") has been removed, and has been replaced by Van Howe. Why replace a secondary source with a primary? This makes no sense whatsoever.
6. After Rickwood, the text "A later study by Rickwood and Shankhar echoed these findings saying that "The incidence of pathological phimosis in boys was 0.4 cases/1000 boys per year, or 0.6% of boys affected by their 15th birthday, a value lower than previous estimates and exceeded more than eight-fold by the proportion of English boys currently circumcised for 'phimosis'." has been added. Why? This point has been made already.
7. Metcalfe has been expanded at length, with unnecessary citations to Metcalfe's sources. We don't need to cite the sources cited by our sources. Additionally, the point of the expansion is unclear. The first two sentences say almost the same thing as the last.
8. More lengthy additions: "In a study to determine the most cost-effective treatment for phimosis, Van Howe concluded that using cream was 75% more cost effective than circumcision at treating pathological phimosis. Also adding that "The argument that circumcision is a minor surgical procedure without complications is not only erroneous, but also irrelevant. It is ethically as well as economically questionable to operate on a child to treat a physiological process."" This argument isn't about cost-effective treatment of phimosis. It's about circumcision. At most, cut back to a single sentence: "Van Howe stated that using cream was 75% more cost effective than circumcision at treating pathological phimosis."

Jakew (talk) 14:28, 14 October 2008 (UTC)

I think you are over-reacting to this edit. If there are any problems, they are minor. And can be solved with a bit of tweaking.

You mention the citation of later studies as if that makes a difference - it doesn't, I could say the same about citing all the studies showing that uncircumcised were more likely to get balanitis.

I feel that the previous metcalfe quote didn't properly represent his opinion.

You are right about O farell , that was a mistake. That can be changed back.

re. van howe - it doesn't say that the final 2 sentences are about cost-effective treatment. It is about whether circumcision should be used to cure phimosis. If you feel that bit should go elsewhere in the section, then move it, simple. Why at most? You would prefer it got cut out all together? May I ask why?

The AMA statement references the AAP and so it is a secondary source citing a secondary source. It is also nearly 10 years old. It doesn't give any information to the reader about why it prevents phimosis, nor does define what it means by phimosis, or say what primary sources it uses to come to that conclusion. Therefore it seeemed a bit arbitrary to me.

I will do my best to cut it down a bit anyway, but not so much that it leaves out important inforamtion. Tremello22 (talk) 15:29, 14 October 2008 (UTC)

I oppose lengthening the article. As I said above, I request that editors follow the request at the top of this talk page, and discuss substantial changes here on the talk page before editing them in. For example, grammatical errors should be fixed by discussion here on the talk page before adding the material. For some Wikipedia articles, adding material with grammatical errors may be OK and preferable to not adding the material at all; but this is (was?) a heavily-edited, polished article, so substantial changes should not be made before ironing out problems on the talk page and getting rough consensus. ☺ Coppertwig (talk) 15:33, 14 October 2008 (UTC)

I support lengthening the article to clarify misleading points. The alternative is to remove the information completely. Let's not also forget the wiki crede Be Bold. Garycompugeek (talk) 20:16, 14 October 2008 (UTC)

Tremello, regarding citation of later studies, data presented in Van Howe's 2007 paper is a superset of that presented in his 1997 paper, as he states at least twice in the text of his (later) paper. The difference is that the first paper included observations by Van Howe made between 1 June 1995 and 30 April 1997, whereas the later paper included his observations upto 31 May 2001. There is no logical reason to report on the 1995-1997 period twice, which is in effect the result of reporting on both papers; it makes far more sense to include the latter paper — the observations from 1995-2001.

Re Metcalfe, I would suggest deleting the last sentence, then. The important thing is to be concise.

Re treatment of phimosis, that isn't what this article is about, and we need to avoid giving too much weight to one particular viewpoint. In an in-depth article such as medical analysis of circumcision or phimosis, detailed discussion is appropriate. In this article, all that really needs to be said (with appropriate sourcing, of course) is that "circumcision is sometimes used to treat phimosis, but that this is controversial". That's 12 words, which is a lot more concise than 68.

Re the AMA statement, it is thus in effect a tertiary source, which is appropriate for inclusion, but if you prefer we can cite the AAP directly. Deleting the AMA statement and replacing it with a single primary source asserting the opposite seems rather questionable in terms of WP:NPOV. Jakew (talk) 16:50, 14 October 2008 (UTC)

Gary, I have already shortened the section. I don't know if jakew is satisfied with that, or not. Tremello22 (talk) 20:26, 16 October 2008 (UTC)

I appreciate your efforts, Tremello. I've made a number of tweaks to address the remaining issues.

Please note that I've replaced Van Howe's phimosis statement with the AMA's statement, since it's preferable to cite a secondary source. If we cited one primary source we'd need to cite others as well, and that would add a lot of material. Jakew (talk) 23:44, 16 October 2008 (UTC)

Medical analysis section

I'm starting to think though that the whole medical analysis section of the circumcision article should be left at a few lines. Something like "There exists a debate over the medical advantages and disadvantages of circumcision..." ,and then just have a link to the main Medical analysis of circumcision article. This means the topics can be dealt with in the fairest manner possible, without the restriction of space. Therefore, there would be no fear of violating NPOV. I appreciate we all have different views on this matter so I would like to see all opinions expressed. It is getting quite tiresome editing back and forth over which bits to include - which sources are relevant, etc. As it stands, it seems like there is no real method or criteria as to what studies to include. For instance, look at the UTI section. This wouldn't be a problem on the medical analysis of circumcision page. Also, most of the stuff in the medical analysis section of the circumcision page is repeated on the Medical analysis of circumcision page. Some sections of the circumcision page go into greater detail than on the medical analysis of circumcision page. Transferring would also have the advantage of cutting down the size of the circumcision page to the recommended size. It already warns you when making an edit that this article is too long. So, would anyone disagree with this? Tremello22 (talk) 21:03, 14 October 2008 (UTC)

Please don't shorten the medical section down to just a few lines without first getting agreement on this talk page about what exactly it will say. "A few lines" sounds probably too short, to me. I have another idea:

Consider this version, which was just after I finished shortening the article in September 2007. If there is any section such that you can't find an acceptable version either there or in a more recent version, then I suggest that you explain on this talk page what things you feel are not explained adequately and why, and then we can consider how to handle each thing.

Note in the talk page archive link I give above (labelled "shortening the article"), there's a table with a target number of words for each section to provide a reasonable balance. I don't think shortening the medical part down to just a few lines would leave a balanced article: the religious and cultural parts would be too big in comparison, in my opinion. ☺ Coppertwig (talk) 21:26, 14 October 2008 (UTC)

Making the material more concise would certainly be a good idea, but I think your proposal is too extreme.

This article is written in summary style. and there are several sections, each of which summarises a more in-depth article. These in-depth articles include: Circumcision in cultures and religions, Bioethics of neonatal circumcision, Circumcision and law, Medical analysis of circumcision, Sexual effects of circumcision, History of male circumcision, and Prevalence of circumcision.

As I say, I'd agree with making the medical aspects section more concise, because it would reduce the overall article length, and it would keep the length of this section in proportion. But similarly, reducing medical aspects to a "few lines" as you suggest would be disproportionate: it would give too much coverage to other aspects at the expense of medical aspects. What we need to do is to summarise the important information without going into too much detail. It's not easy, unfortunately, but while just giving up may be tempting, I don't think it would serve the reader well. Jakew (talk) 21:33, 14 October 2008 (UTC)

I agree the sections should be proportional however sections with stubs may be summarized to condense space and prevent redundancy. Garycompugeek (talk) 22:08, 14 October 2008 (UTC)

They are summarized; all the sections of this article are summarized. I still prefer a balance; I believe this is consistent with WP:SUMMARY, which says, in part, "The summary in a section at the parent article will often be at least twice as long as the lead section in the daughter article." ☺ Coppertwig (talk) 00:06, 15 October 2008 (UTC)

Simple solution, just leave the "Policies of various national medical associations". It is more than a few lines and would leave the medical considerations in proportion with the rest of the article. Surely that is the easiest and most sensible option? Divide the medical associations policies into "policies on therapeutic circumcision" and "policies on non-therapeutic circumcision"; at the moment it is unclear which the medical analysis section is dealing with. It is also unclear what the section is trying to accomplish? Most of it can be found on the medical analysis of circumcision page.

It is easy to say just leave it as a summary for each medical condition,not so easy in practice. As often, to put across both points of view, often takes up space. I am sure if people are concerned with specifics it wouldn't be too hard for them to click a link. But most people just want to know a risk - benefit analysis - i.e would it be worth it, all things considered; and that is already provided by solid reliable secondary sources - i.e the medical associations. Again, it is unclear how going into specific conditions relates to anything? It is just beyond the basic reader if you ask me - mentioning authors names and individual studies and whatnot. For those that are interested in how the medical associations made their decisions or if they want a more in-depth analysis - they can go to the "medical analysis of circumcision" page. Tremello22 (talk) 19:21, 15 October 2008 (UTC)

The effect of that would be much the same as reducing the section to a few lines: we would fail to summarise the medical aspects themselves.

In principle, policy statements are excellent secondary sources about specific aspects of circumcision, and could be used as such for a brief summary of the individual medical aspects. However, the content of the current policies section is such that we only discuss their recommendations, for which they are primary sources. They are, of course, highly notable primary sources, and should not be excluded. But by themselves, the recommendations are not an adequate summary of the literature about the medical aspects of circumcision. Jakew (talk) 19:58, 15 October 2008 (UTC)

(unindent) The point I was trying to make Jakew is that discussing specific medical conditions in detail can get out of context and we lose sight of the bigger picture of circumcision. Hence my question what is the purpose of this section? The views of secondary sources such as medical associations or the WHO or whatever, see the bigger picture - if people want to know the nitty-gritty (the general reader does not want read a compilation of studies) then they can go to medical analysis of circumcision. You now say they are primary sources yet above you say they are secondary sources; make up your mind. They are clearly the most reliable sources on the subject of circumcision - be it therapeutic or non-therapeutic. I'll ask again, what is the purpose of the medical analysis section? If the purpose of the medical analysis section is to debate whether to circumcise or not, then there is always going to be conflict over what gets put into the section - easiest solution is to take it our of our hands and veer ourselves away from promoting our own points of view and just leave the views of respected secondary sources. Then, how they came to their decisions could be left to the page where there is enough space to give both sides of the debate. At the moment the medical analysis of circumcision page is quite poor, there is no reason why we couldn't merge the medical analysis section from here into that page and make a very good article. Any future debates over what to put in the section and any ambiguity over what the medical analysis section is for would be put to rest. Tremello22 (talk) 20:24, 15 October 2008 (UTC)

Since the literature about circumcision includes a lot of information about medical aspects, then reducing the medical aspects in this article down to only a few lines would be undue weight; as would making it much longer in proportion to the history, religious etc. sections than it was when shortened according to consensus in July-Sept 2007.

No specific problems about the section have been raised in this discussion. While it may be difficult to arrive at a consensus version of intermediate length, I'm not convinced it's impossible.

Garycompugeek, you reminded us of "be bold" I would like to point out that that guideline also says "...but be careful." That guideline is very useful for people who are in situations for which they can't find instructions or for which there are no instructions, especially for new users or for users in situations that are new to them. However, in my opinion, it is not intended to encourage people to do things which they know, or can be reasonably expected to predict, are likely to be opposed by other editors. ☺ Coppertwig (talk) 21:10, 15 October 2008 (UTC)

The views of medical associations in regards to circumcision would still be left, and they are more than a few lines. It could also be divided to views on therapeutic and non-therapeutic(routine infant circumcision). At the moment the medical analysis section does not make this distinction. I'm still not sure what purpose the section serves given that the general reader would just like to know about the overall consensus on circumcision whereas the person that is interested in the medical studies of circumcision's effect on certain conditions would be going to the medical analysis section anyway. Tremello22 (talk) 20:32, 16 October 2008 (UTC)

The "medical analysis" section is intended to give an overview of the medical aspects of circumcision, including the (proposed) medical risks and benefits (in a nutshell - what are the medical consequences of circumcision or non-circumcision?). The "policies" section is an overview of the recommendations of medical organisations (in a nutshell - in the view of these prominent organisations, is there enough evidence of benefit to recommend circumcision as a routine procedure?). If you consider the two "nutshells", you'll see that although they're related, the questions are actually quite different, and answering one does not answer the other.

I'm afraid that I don't share your viewpoint that the "general reader" is only interested in recommendations, and is uninterested in other medical aspects. I'm not even sure that it's possible to define what a "general reader" is interested in. Some readers will be interested in medical aspects, some recommendations, some history, some religious aspects, and so on. The parts of the article that I find most interesting are probably not the same parts of the article that you find most interesting. All we can do is to present a well-rounded general overview of the subject, summarising each more detailed article, and leave it to the reader to decide which of these (s)he is interested in.

If you read my previous comment carefully, you'll see that I describe these statements as both primary and secondary. As with many sources, it depends upon what part of them is used: they're secondary sources for some summarised conclusions from scientific studies, and primary sources for statements of what their own recommendations are. Regarding policy statements being highly reliable sources, I certainly agree with you.

I agree that discussing specific conditions in too much detail is undesirable, but I think that not discussing them at all is too extreme. Jakew (talk) 21:29, 16 October 2008 (UTC)

Jakew, I still don't agree with going into this much detail in the medical analysis section as we are always going to disagree - so it seems pointless (especially when there is an article dedicated to the subject). It's always going to be your interpretation over mine. There is only so many wikipedia rules you can use as a get-around before it gets obvious that the medical benefits of circumcision are presented way out of context. I think secretly , you know this. If we wanted a fair article then we would just cite the medical associations views on circumcision as a whole. The problem being that if we don't cite the medical associations views, it is up to us or you to use our/your own judgment to determine what medical conditions to discuss in the medical analysis section and what to put in there. This is part one of the problem. Part 2 is that, say if you are read one section , there is no context in terms of circumcision as a whole. No thought is given to the relative weight(measured in terms of words written and number of subheadings) of the supposed benefits in relation to to the downsides. In other words it reverses the views of the medical associations - that find not enough evidence to recommend circumcision. Tremello22 (talk) 23:24, 17 October 2008 (UTC)

Or that the benefits outweigh the risks. Garycompugeek (talk) 23:40, 17 October 2008 (UTC)

Downsides/risks, same difference only risks makes it seem like we are just referring to the immediate physical complications post-circumcision -or maybe that is just me. Tremello22 (talk) 23:49, 17 October 2008 (UTC)

Actually, if you examine the amount of coverage in the policy statements themselves, you'll find that the degree of coverage is similar. At a rough count, for example, the 1999 AAP statement dedicates a total of 24 paragraphs to discussion of proposed benefits and 1 to complications. The situation is similar with many other statements. So unless you wish to assert that the medical associations reverse their own views, this line of reasoning appears to be dubious at best.

Nobody has suggested that we remove the medical associations' views, so I don't quite understand why you raise concern about that. Jakew (talk) 12:17, 18 October 2008 (UTC)

Jakew I meant that leaving the medical associations statements on their own without the analysis means that there is less of a problem over what to put in the medical analysis section.

So what if the AAP dedicates a total of 24 paragraphs to discussion of proposed benefits and 1 to complications in their statement? At the end of it they didn't recommend it and people only read that they didn't recommend it. In a wikipedia article people read everything - so it would be easy for an uninformed person to look at the contents of this page and get the impression that the risk of getting all those conditions listed in the medical analysis section is lowered by circumcision. Tremello22 (talk) 19:54, 18 October 2008 (UTC)

I'm sorry, I don't understand. You seem to be saying that when people read the AAP statement they only read the conclusion, but when they read a Wikipedia article they read the whole thing. I disagree: I think people do a variety of things. Some will read the whole Wikipedia article; many will read only part of it. Some will read the whole AAP statement; others will read part of it. Regardless, the policy WP:UNDUE says we must base the amount of weight we give things on the amount of weight in the sources. If the AAP spend a lot more space on benefits than complications, then this is a reason for the Wikipedia article to also give more weight to benefits than to complications (though we also need to balance this with what other sources do). ☺ Coppertwig (talk) 20:07, 18 October 2008 (UTC)

People don't generally read the full statement Coppertwig, for one, they ususally don't have access to it. It would be too much specialised information and they probably wouldn't understand it all. They usually rely on the opinions of doctors and then they put it in layman's terms for them. They will usually summarise by saying if it is worth it or not , or if the risks outweigh the benefits. Tremello22 (talk) 20:50, 19 October 2008 (UTC)

Defining the controversy

Two concerns about the advocates versus opponents paragraph in the lead:

1. The "introductory" sentence (There is scientific evidence supporting both sides of the circumcision controversy.) was removed on August 10, 2008 (based on wp:weasel).

The sentence was re-added on September 26, 2008 for reasons that, based on the discussion that prompted its re-addition, aren't entirely apparent.

After two editors (one being me) voiced concern that the sentence did/does a poor job of introducing the paragraph, no counterpoint was made, so I removed it again on October 9, 2008.

It has since been deleted and re-added a couple of times. The last time it was re-added, the edit summary stated that: this illustrates important controversy - gain consensus for lead changes. However, the sentence does not illustrate or define the controversy (at all). Moreover, it was re-added without consensus 1.5 months after the initial removal.

Multiple editors have claimed that the sentence is misplaced, includes weasel terms, and does not introduce or illustrate the controversy, or the paragraph. Therefore, I propose that it either be removed (not preferred), or re-written so it actually introduces the material in the paragraph and defines/illustrates the debate.

Which leads me to my second, more pressing, concern...

2. As written, it is unclear whether the paragraph refers specifically to neonatal circumcison, or circumcision in general. The idea that someone would claim elective, adult circumcision is a bodily rights violation is somewhat absurd. While some people may hold this opinion, I don't think it is common, and I don't believe it is the point we are trying to illustrate. However, because the paragraph has been "worked over" so many times, we've lost this distinction. Thoughts on these concerns? AlphaEta 23:35, 14 October 2008 (UTC)

There is nothing weasely about stating the controversy of circumcision. You seem to be the only editor taking issue with it. Don't be obtuse Alpha, of course it illustrates controversy. It illustrates it by stating it. Then is followed by examples from both sides of the controversy. Just because you keep removing it doesn't mean it did not have consensus. I welcome other editors thoughts on the matter. Garycompugeek (talk) 01:45, 15 October 2008 (UTC)

I never said the sentence was weasely. Nor am I the only one who has removed it or questioned its purpose (see the links I provided above). AlphaEta 18:42, 15 October 2008 (UTC)

My apologies Alpha. Let me redirect the weasel comment towards Tremello and strike out the only editor part. Garycompugeek (talk) 22:51, 15 October 2008 (UTC)

Re point 1, I agree that the sentence should be removed, at least until it can be rewritten so that it's more meaningful. The sentence has been discussed previously, of course, and I don't want to repeat the arguments made at the time. However, I'm just wondering how it might be rewritten. "Proponents on both sides of the circumcision controversy cite scientific evidence in support of their position" is slightly better, though it still presumes that the existence of a controversy is already established. Additionally, it's still somewhat empty - after all, what else are they going to cite? Secret messages from the planet Zarq? Moreover, what does it have to do with claims that it "is best performed during the neonatal period" or that it "violates the individual's bodily rights"? Neither of these are scientific statements, and they cannot directly be supported with scientific evidence. They're value judgements.

Re point 2, it is indeed unclear what the paragraph is about. Looking at the arguments, it is probably about neonatal circumcision, which seems quite reasonable, as I think it is safe to say that controversy tends to focus on circumcisions performed in infancy. However, this needs to be made clear. As an alternative, I suppose we could modify the paragraph to have a broader scope, but I think that it would be (even) more difficult to do. Jakew (talk) 11:13, 15 October 2008 (UTC)

Suggested new versions of sentence; I prefer the first one:

• Routine neonatal circumcision is controversial, with both scientific evidence and value judgements coming into play on both sides.
• There are reasons both for and against routine neonatal circumcision.
• There are reasons, with some support from scientific evidence, both for and against routine neonatal circumcision.
• There are reasons, some supported by scientific evidence, both for and against routine neonatal circumcision.
• Routine neonatal circumcision may be associated with both risks and benefits.

I agree with AlphaEta's statement "the sentence does not illustrate or define the controversy"; merely asserting something does not necessarily illustrate it. ☺ Coppertwig (talk) 13:55, 15 October 2008 (UTC)

I think any of those would be reasonable. However, I think use of the term "routine" should be avoided. It implies that controversy is about the idea that all newborn boys should be circumcised, but in practice controversy tends to focus on whether parents should be permitted to choose circumcision for their son(s). A couple of relevant quotes from the literature: "I believe that the term "routine infant circumcision" is a misnomer. It denotes a position that nobody really holds, namely that as a matter of routine, all healthy boys should be circumcised. Opposition to a policy of "routine infant circumcision" does not have to indicate opposition to a parent’s right to choose for their son to undergo the procedure, nor the provision of the procedure in general." (Footnote 2 in: Viens AM. Value judgment, harm, and religious liberty. J Med Ethics. 2004 Jun;30(3):241-7) "Burger and Guthrie"4 made the valid point that the term "routine circumcision", which appears so frequently in the literature, should never be used for a procedure with so many contraindications." (Warner E, Strashin E. Benefits and risks of circumcision. Can Med Assoc J. 1981 Nov 1;125(9):967-76, 992) Jakew (talk) 15:02, 15 October 2008 (UTC)

As you say yourself, the term is frequently used in sources. Advocates such as Edgar Schoen, cited in this article as an impartial expert, do in fact take the position that all healthy boys should be circumcised. "Routine" also may simply mean "common" or "expected," which definitely describes circumcision in medical milieu of the last century in the United States and elsewhere. Blackworm (talk) 16:28, 15 October 2008 (UTC)

I added [[28]] back on July 2nd. Avi said this was OR and as a compromise we added [[29]]. It was subsequently modified by Avi again to [[30]] and I later changed discussion to controversy. Alpha has tried to move sentence to end of para and/or delete it. I have no qualms about modifying sentence as long as we illustrate controversy neutrally. Garycompugeek (talk) 16:20, 15 October 2008 (UTC)

Can I request that we stop for a moment and discuss the purpose of this sentence? I don't fully understand what it's intended to do. What piece of information do we want the reader to have? Why is this sentence (in whatever form it may take) needed? That is, if the purpose is to say that there is a controversy, don't the other two sentences make that obvious enough?? Gary, can you clarify these questions please? It's difficult for me to propose or think constructively about proposed sentences when I don't understand the purpose. Jakew (talk) 16:28, 15 October 2008 (UTC)

By "routine", I didn't mean circumcision of all infants. I meant circumcision in cases where there was no specific medical indication for that particular infant, but only general purposes such as preventing possible future disease. Would "elective" be a better term, or is there another term that can be used? How about "neonatal circumcision of healthy infants" or "neonatal circumcision of normal infants" or "neonatal circumcision in the absence of [specific] medical indication"?

As for the purpose of the sentence: I think that, like the "disposition" sentence which has been disposed of, it isn't there for the purpose of providing any information except that information, useful in the extremely short term, about what the paragraph is about. In other words, it makes the paragraph easier to read by letting the reader know what is coming, so that the following sentences are not surprising and can be easily understood on first reading. I think the sentence does this job well and mildly prefer having such a sentence, but deleting it is OK with me too. ☺ Coppertwig (talk) 16:47, 15 October 2008 (UTC)

Thank you Coppertwig. That was very concise and to the point. Garycompugeek (talk) 17:20, 15 October 2008 (UTC)

"Routine neonatal circumcision has created much controversy."? —Preceding unsigned comment added by Garycompugeek (talk • contribs)

I suggest: "Circumcision of male newborns, children, and adolescents is controversial when there is no immediate medical need." We shouldn't assert that there are "reasons" for and agaisnt circumcision (though we may assert that reasons for and against have been put forth by others). Blackworm (talk) 18:12, 15 October 2008 (UTC)

I agree with the content of Blackworm's suggestion. If the sentence is re-worded so that it briefly defines the nature of the controversy (i.e. circumcision of healthy people who are incapable of consenting is controversial), it would fulfill a useful function. AlphaEta 18:42, 15 October 2008 (UTC)

I can see what you're saying, AlphaEta, but I'm concerned that "when there is no immediate medical need" is very similar in meaning to one of the arguments attributed to opponents of circumcision ("is medically unnecessary"). In effect, it would frame the paragraph and the controversy in terms of one of the arguments used by opponents. "...Is controversial when performed for prophylactic purposes" would have exactly the same problem, but framed in terms of one of the arguments attributed to advocates. If we need a sentence to introduce the paragraph, we should do so in such a way that is neutral with respect to the controversy itself. Jakew (talk) 19:05, 15 October 2008 (UTC)

Huh? Does anyone actually argue that male circumcision is medically necessary? The medical sources all seem to agree that unless there is medical indication in each specific case, the procedure is elective. That male circumcision is not generally medically necessary is accepted by everyone involved in the controversy, except perhaps the most extreme, fringe advocates (I say "perhaps" because I have seen no source, even a fringe pro-circ website, make the claim that it is generally medically necessary). The differences in opinion begin where one side perceives medically unnecessary procedures on minors to be wrong, and the other perceives the harms of the medically unnecessary procedure to be outweighed by the benefits. In any case, it is the opponents who "create" the controversy, not the proponents, and thus it seems appropriate for us to specify precisely what forms of male circumcision are opposed -- i.e., non-therapeutic, elective (i.e., "no immediate medical need") male circumcision of minors. Blackworm (talk) 21:19, 15 October 2008 (UTC)

You do however shed light on the fact that the article implies only those opposed state that it is medically unnecessary -- very problematic given that all or virtually all sources agree that it is. Opponents do not argue or "claim" that it is medically unnecessary, because no one argues against that -- they do argue that as it is medically unnecessary, and carries other harms, it should not be performed on minors. Blackworm (talk) 21:43, 15 October 2008 (UTC)

I think "elective" is a suitable word. "Non-therapeutic" is an alternative option, but I think in this context it might introduce bias since it is not immediately obvious, if one is unfamiliar with the usage of the term, whether circumcisions performed to protect against disease are therapeutic or not. (An additional problem is that it implies that therapeutic neonatal circumcisions are non-controversial, though often there seems to be controversy over whether they're therapeutic or not.) I'd prefer to use something shorter than "circumcision of healthy infants", but otherwise it seems fine. Jakew (talk) 18:24, 15 October 2008 (UTC)

If you take religious circumcision out of the equation (30% circumcise, two-thirds of which are Muslim, Jews would take up a percentage of that 30% too)- that would leave about 5-10% who circumcise in infancy for medical reasons vs. 90-95% who do it for other reasons, or don't do it at all. So advocacy of infant circumcision for medical reasons is surely a minority view-there is no debate in the majority of countries - they are against it. So, we shouldn't give WP:Undue weight to a minority viewpoint. Also the last 2 paragraphs giving the opinions of the WHO and other medical associations should probably be merged into the same paragraph. Tremello22 (talk) 20:02, 15 October 2008 (UTC)

Faulty argument. You can't conclude that someone is opposed to something just because they haven't done it. (By the same line of reasoning, you'd have to conclude that approximately half the world's population are against access to clean water.) Consequently we can't conclude that advocacy or opposition is a minority view based solely on the prevalence of circumcision. Jakew (talk) 20:13, 15 October 2008 (UTC)

Faulty analogy. People don't have access to clean water because they do not have a choice. In most countries that do not circumcise, they do have a choice and they choose not to do it. —Preceding unsigned comment added by Tremello22 (talk • contribs)

Your argument seems to rest on the assumption that the outcome represents a conscious decision. How can you be sure that people have actually considered the issue and have made a deliberate decision not to circumcise? What if it didn't occur to them? What if there is demand that cannot be met? Regardless, the essential point remains: in the absence of large-scale surveys, there is no way to know whether people who do not circumcise are neutral or opposed to circumcision (or even in favour of it). Consequently, one cannot use prevalence data to judge the issue. Jakew (talk) 20:50, 15 October 2008 (UTC)

Jakew writes: I think in this context ["non-therapeutic"] might introduce bias since it is not immediately obvious, if one is unfamiliar with the usage of the term, whether circumcisions performed to protect against disease are therapeutic or not. The reader's ignorance about terms isn't really our problem, Jake. They can look up the word[31] to confirm that therapeutic basically means "for immediate medical need." Or, we can say, "for immediate medical need," as I suggest above, which eliminates any problem. Blackworm (talk) 21:25, 15 October 2008 (UTC)

AlphaEta, I think there's more controversy than solely about circumcising those who are too young to consent. If an adult approaches a doctor and asks whether it's a good idea to get circumcised in order to prevent disease, isn't there also controversy as to what the answer to that question is? ☺ Coppertwig (talk) 22:12, 15 October 2008 (UTC)

That's a good point. The current advocates and opponents sentences encompass both the medical and consent aspects of circumcision, which, as your example illustrates, may exist as separate debates. AlphaEta 22:36, 15 October 2008 (UTC)

How about "Scientific evidence and value judgements have come into play on both sides of the question of circumcision in the absence of immediate medical need." Medical associations have mentioned both benefits and risks of circumcision, and generally don't take a strong position either way, so I think this sentence is reasonable as far as due weight is concerned. ☺ Coppertwig (talk) 23:11, 15 October 2008 (UTC)

What is "the question of circumcision [...]"? Is it the same as the circumcision-related question parents currently often ask themselves, or their doctors, when a baby boy is born? Let's use the word "controversy," as in "the controversy surrounding the practice, common in some areas, of circumcising male minors for non-therapeutic reasons," as the word "controversy" is used in sources,[32][33][34] and in other articles on topics with controversial elements. Blackworm (talk) 02:32, 16 October 2008 (UTC)

I think we've talked this through. I agree with Blackworm that the word "controversy" should be used as the most descriptive adjective and typical word used by sources. I will support this change if you would like to modify the sentence Coppertwig. Garycompugeek (talk) 11:53, 16 October 2008 (UTC)

"Controversy" should include a discussion on the fact that there is no controversy in most of the world. If one looks in the index of baby care books not printed in English, one cannot even find the cognate for the word "circumcision."

Please make this article less provincial. Brit Pariah (talk) 05:32, 16 October 2008 (UTC)

Welcome to Wikipedia! Just go ahead and edit the article, bringing reliable sources supporting your claims and referencing them in the article. Blackworm (talk) 07:10, 16 October 2008 (UTC)

If we're careful with words, we can say that a controversy exists without implying that there is universal controversy. Still, it might well involve adding yet more words to an already complex sentence. Moreover, the sentence is that is at present unsourced (and becomes increasingly difficult to source as we add to it), and slightly tilts the paragraph away from NPOV by framing the controversy in terms of one of the opponents' arguments.

There is an obvious alternative: "" (that is, no sentence). The advantages include: no sourcing issues, no NPOV issues, and no problems with defining the controversy in a way that is too broad or too narrow. Per Coppertwig's explanation, the sentence is not essential anyway, so this seems a fairly obvious solution. Any comments? Jakew (talk) 13:01, 16 October 2008 (UTC)

This is a controversial topic. We should say that a controversy exists, and fully explain the controversy, which naturally will begin in terms those with opposing views use. Why wouldn't those opposing something be allowed to frame the controversy? If supporters want to frame it differently we can reflect that, and let the reader decide which framing is appropriate. But your argument just sounds like a call to (again) silence any mention of controversy. There is also no implication of "universal controversy," whatever that means, that isn't already present in the sources. By the way "controversy" means, 1. a discussion marked especially by the expression of opposing views : dispute 2. quarrel, strife.[35] Naturally, strong supporters would wish to deny a controversy exists, or minimize the controversy, and we must be aware of that when considering the NPOV aspects of this controversial topic. This must be the only controversial topic in Wikipedia where resistance to actually calling the topic controversial in the article is taken anywhere seriously. Blackworm (talk) 13:39, 16 October 2008 (UTC)

I have no objection to stating that it is controversial, provided that we do so in a way that is neutral and appropriately sourced. For example, a simple statement of the form "neonatal circumcision is controversial" (citing "Considerable controversy surrounds neonatal circumcision" in the AAFP statement) would be fine, since it would avoid framing the argument in terms of arguments used by one side or another, and would, of course, be appropriately sourced. Jakew (talk) 13:52, 16 October 2008 (UTC)

It sounds like your agreeing to my previous suggestion - "Routine neonatal circumcision has created much controversy.", however doubts have been cast that this is not accurate enough because controversy exist outside of neonatal circumcision as Coppertwig points out. This topic is steeped in controversy. It should be illustrated not brushed under the rug. That would be a violation of WP:NPOV. Garycompugeek (talk) 14:47, 16 October 2008 (UTC)

I'd agree that there are some similarities between the two sentences, Gary, though obviously there are some differences as well. I think that the example sentence I gave is closer to that particular source.

Strictly speaking, the problem you mention is that the scope is too narrow: in addition to controversy about neonatal circumcision, there is also controversy about non-neonatal circumcision. And in addition to controversy involving those who cannot consent, there is also controversy involving those who can consent. However, I'd like to make two observations about that.

First, in an ideal world, we would be able to describe all controversies in a brief, neutral, well-sourced sentence. However, in practice, we may find that we cannot construct such a sentence, or that even if we could construct such a sentence we cannot find a source to support it. Consequently, we may find that we have a choice between a sourced statement describing some of the controversy or nothing. Which is better? I don't know. Personally, I favour illustrating controversy using opposing arguments, but avoiding asserting that there is a controversy, which seems unnecessary given the illustrative examples anyway. An alternative view is that it is important to state that there is a controversy, and from that point of view I suppose it would seem better to use a sourced statement describing a subset of the total controversies.

Second, we need to think about the relationship between the first sentence (if any) and what follows. If we assert the existence of a controversy about neonatal circumcision, then the arguments that follow make sense (to clarify, I'm not saying that they're right or wrong, just that they are consistent with this context). However, if we try to include all controversies, which would include (as Coppertwig points out) those over whether it's a good idea for an adult to get circumcised in order to prevent disease, then some of the arguments listed are nonsensical in this context. Jakew (talk) 15:55, 16 October 2008 (UTC)

If we can source it, we can use a very short sentence or a sentence fragment joined to the following sentence with a colon:

• There is controversy.
• There is controversy connected with the topic of circumcision.
• There is controversy:
• Controversy:
• Controversy about circumcision:

If it can be justified in terms of sources (i.e. if we can justify based on sources that there is controversy about (male) circumcision in general, not only about neonatal circumcision), then I would prefer to reorganize the third sentence of the paragraph to allow it to refer to both circumcision in general and neonatal circumcision. I think the second sentence is already OK in this regard. The 3rd sentence can become, "Opponents of circumcision claim that it is medically unnecessary, adversely affects sexual pleasure and performance, is a practice defended by myths, and when performed neonatally violates the individual's bodily rights." This has the advantage, I think, of making the two sentences more parallel: for example, mentioning sexual function as the second item in both. ☺ Coppertwig (talk) 16:54, 16 October 2008 (UTC)

This brings me back to my first edit (I think) of this article. "There is great controversy surrounding circumcision." That controversy exist seems defacto. Its not necessary to source every sentence in an article however if we wish to list a source that states there is controversy we have plenty to choose from. Garycompugeek (talk) 17:28, 16 October 2008 (UTC)

Jakew, There is a subtle difference in my opinion between stating that something is controversial, and mentioning opposition to it. The mentioned opposition could be a tiny fringe minority, or insignificant, but if sources generally agree that controversy surrounds a topic (especially "considerable" controversy), it shows that there is more than fringe opposition. As for any weight given various controversies, I'd be interested in seeing sources mentioning controversy in circumcision of consenting male adults. It is certainly not nearly as controversial as circumcision of minors, and I would assume that any such controversy is probably restricted to a small, dispassionate debate among a very small group of people in the medical field -- therefore its mention is secondary (and seemingly not good for the lead). I like your edit suggestion, but would prefer "circumcision of children is controversial," (instead of "neonatal circumcision...") as "neonatal" excludes circumcision of older children and adolescents (which is apparently more common than neonatal circumcision, as it is common among Muslims). Blackworm (talk) 17:09, 16 October 2008 (UTC)

Coppertwig (and others), what do you think of "medical associations admit that it is medically unnecessary" instead of "it is medically unnecessary"? Again, the way the paragraph is written ("claim") makes it seem as if there is significant dispute over whether circumcision is medically necessary, which I do not believe is reflected by the sources (i.e., it seems virtually everyone agrees that it isn't). Blackworm (talk) 17:09, 16 October 2008 (UTC)

Btw here are some sources for "children" (or alternately "minors", or "infants and children" in case "children" alone might be taken to exclude infants) rather than "neonatal:"

• The removal of the foreskin of male babies and young boys, whether for religious or medical reasons, is a controversial issue.[36]
• Circumcision of male babies and children at the request of their parents is an increasingly controversial area and strongly opposing views about circumcision are found within society and within the BMA’s membership.[37]

Also the Milos source quoted as opposition in that paragraph mostly discusses circumcision of neonates, but also mentions children several times, and this: It is imperative that mutual respect for these inalienable human rights be extended, not only to the women in Africa with whom we can identify, but also to men, male children, and male newborns. Blackworm (talk) 17:39, 16 October 2008 (UTC)

Blackworm, do you think we should make the paragraph pertain to circumcision of male babies and children (i.e. not include adults)? Based on your sources above, I think we can say something like "Circumcision of babies and children is controversial." I would still prefer to rewrite the 3rd sentence as I suggested above anyway: it makes the sentences more parallel, and the fact that the first 3 parts of each sentence could apply to either children or adults doesn't detract, in my opinion, from having the main focus of the paragraph be children. Garycompugeek, as I read the policy WP:V, it is necessary for every sentence in an article to contain only assertions attributable to a reliable source. ☺ Coppertwig (talk) 19:08, 16 October 2008 (UTC)

"Views differ on whether limits should be placed on caregivers having a child circumcised." Coppertwig I took this sentence from the beginning of the consent section. Notice it is not sourced. I think your taking my meaning a bit to literally but I may be mistaken. Garycompugeek (talk) 19:21, 16 October 2008 (UTC)

Maybe "not sourced" has more than one interpretation. Not every sentence needs a footnote attached, but every sentence must contain information which is attributable to reliable sources. I oppose using that sentence in the lead, as it narrows the controversy specifically to whether limits should be placed, rather than the broader question of whether to circumcise or not, a decision which is often made by parents; therefore I see it as being too specific for the lead, which is a more general summary. ☺ Coppertwig (talk) 19:43, 16 October 2008 (UTC)

I oppose using the consent sentence for the lead also Coppertwig. It was merely an example to my statement. I also understand every sentences need to be attributed to reliable sources. My point was every sentence does not need a footnote. I guess this means we are on the same page. Garycompugeek (talk) 20:51, 16 October 2008 (UTC)

Great! Apparently we agree. High five! ☺ Coppertwig (talk) 21:26, 16 October 2008 (UTC)

Blackworm, re "medical associations admit that it is medically unnecessary": That's an interesting suggestion. We would need a source which is a circumcision opponent stating that medical associations admit that in the context of giving a reason not to circumcise. I'm not sure that the word "admit" is NPOV here; would it count as a quote from such an organization? This might misrepresent the actual positions of medical associations, which are more complex than that; I think it may be better to leave the shorter wording and let the reader see the positions of the medical associations in the section for that purpose. How about "Opponents of circumcision claim that it is medically unnecessary, citing position statements of medical associations, ..." (if verifiable). This assumes re-arranging the sentence, e.g. as I had suggested. ☺ Coppertwig (talk) 19:52, 16 October 2008 (UTC)

Rearranging the sentence seems a good idea to me. I would suggest using the word "argue" in both cases, rather than "claim". I think the word "argue" is more neutral in general, as "claim" can sometimes suggest that an argument is dubious. I believe that this would address the concern raised by Blackworm.

I think that we should avoid an addition of the form "citing position statements of medical associations", since if we did so for the opponent we'd have to do something similar with the proponent (Schoen, for example, cites the WHO in support of one of his arguments). To my mind, the evidence cited by opponents and proponents in support of their arguments is far too much detail for the lead. Jakew (talk) 23:16, 16 October 2008 (UTC)

Verbatim repeat of my comment above: Opponents do not argue or "claim" that it is medically unnecessary, because no one argues against that -- they do argue that as it is medically unnecessary, and carries other harms, it should not be performed on minors. Also if your last sentence is true, then let's remove the part about "0.5%" of circumcisions having complications, as that is cited by Schoen. Blackworm (talk) 21:02, 17 October 2008 (UTC)

Good point Blackworm - I think the same. Yes there is no medical claim it is unnecessary, we know it is unnecessary - all medical associations say so. If people choose to do it later when they are an adult then there is no controversy over that. There are 2 aspects to the controversy as far as I can see. One is that this is being done to the child without his personal consent. Secondly there is controversy over why it still goes on even though the medical associations agree that there is no net benefit - this bit is particularly relevant to the USA. I definitely think the Schoen 0.5% claim should be taken out. Do we even know what he is basing that on? I guess he disagrees with the most reliable estimate by williams and kappilla of 2-10%. And what is a complication - how many undesirable cosmetic results go under-reported as the people just live with it? Is that even considered by Schoen a complication ? And why should we be specific to one circ advocate when the sentence implies otherwise? (i think I have mentioned this point before).Tremello22 (talk) 00:11, 18 October 2008 (UTC)

Blackworm, I think Schoen's argument could be simplified to something like "that it has a low complication rate". Tremello, his source in this particular article is unclear, but elsewhere he has cited the AAP's estimate of 0.2% to 0.6% (see, eg., Schoen EJ. Circumcision for preventing urinary tract infections in boys: North American view. Arch Dis Child. 2005 Aug;90(8):772-3.) Jakew (talk) 12:26, 18 October 2008 (UTC)

Blackworm, you have a good point. Now, since we're trying to express things in just a few words, I think we need to avoid trying to express the precise degree to which there's consensus as to whether it's medically necessary; that can be done later where there's more room. I think the following wording avoids implying that they're the only ones who argue that, while also avoiding implying anything else that might require additional detail to explain properly: "Among their arguments, opponents of circumcision state that it's medically unnecessary, ...". (Other alternatives: "Among other arguments, ..."; and "Arguments of opponents of circumcision include that it's medically unnecessary...") I suggest modifying both the opponents and proponents sentences in this way. I suggest simply deleting the first sentence. Rearranging wording a bit for flow and replacing the 0.5% according to Jakew's suggestion, this gives us (I have not included the full footnote info though):

Among their arguments, Advocates for circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision, on the other hand, state among their arguments that it is medically unnecessary, adversely affects sexual pleasure and performance, is a practice defended by myths, and when performed neonatally violates the individual's bodily rights.

Here, the phrase "on the other hand" helps the reader orient themself in the paragraph, serving a similar purpose to the earlier first sentence, which I suggest leaving out; it alerts the reader that the entire paragraph is not about advocates, making it easier to assimilate the information. ☺ Coppertwig (talk) 16:05, 18 October 2008 (UTC)

New suggestion, based on recent edits:

Among their arguments, Advocates for circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision, on the other hand, state among their arguments that it is excessivelytraumatically painful, adversely affects sexual pleasure and performance, may increase the risk of certain infections, and when performed on babies and children violates the individual's bodily rights.

AlphaEta deleted the word "excruciatingly" on the grounds that "descriptions of pain in the source are seldom accompanied by the adverb "excruciatingly"". Words appearing only once in a source often end up in the article. In this case, the source uses, besides the word "pain" by itself a number of times, the phrases "excruciating pain", "painful and traumatic", "overwhelming pain" and "excruciatingly painful". Just saying that it's painful doesn't seem to me to convey adequately the message of this source. On the other hand, "excruciatingly" could be considered to not be in an "impartial tone" as required by NPOV. I suggest "excessively painful". ☺ Coppertwig (talk) 01:48, 19 October 2008 (UTC)

Request for discussion: I would like to see whether there's consensus for replacing the controversy paragraph with the above suggested paragraph; note that this suggestion involves deleting the current first sentence of that paragraph, which is "There is scientific evidence supporting both sides of the circumcision controversy.". I've just replaced "excessively" with "traumatically" in that paragraph. If we can establish consensus, I'll recopy the paragraph to remove the struck-out word, insert the full footnote info and ask an admin to put it in via an "editprotected" request. (Note: if anyone wishes to argue for lifting the page-protection early I would go along with that; I had made a mistake when filing the 3RR report, as noted at WP:3RRN.) ☺ Coppertwig (talk) 16:51, 19 October 2008 (UTC)

I think this is simpler:

Advocates for circumcision state that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period. Opponents of circumcision state that it causes significant pain, adversely affects sexual pleasure and performance, may increase the risk of certain infections, and when performed on babies and children violates the individual's bodily rights.

The "among their arguments" wording is over-wordy, and it is understood that not every single detail of the pro or con view needs to be in the lede. Jayjg ^(talk) 16:59, 19 October 2008 (UTC)

You're right. That's less wordy. I think it's an improvement. "significant pain" sounds OK to me: I think it gets the point across. ☺ Coppertwig (talk) 17:06, 19 October 2008 (UTC)

Clarification: I assume your suggestion, Jayjg, also includes deleting the current first sentence of the paragraph.☺ Coppertwig (talk) 20:42, 19 October 2008 (UTC)

Blackworm, would you please clarify your position? I see you've edited the first sentence of the 3rd paragraph, and I think your edit is probably an improvement. However, I've proposed deleting that sentence (stating that there is a controversy) entirely. Do you oppose deleting that sentence? ☺ Coppertwig (talk) 18:04, 23 October 2008 (UTC)

I oppose removing the sentence stating there is a controversy for the reasons I've listed above. Initially you supported stating there is a controversy. What has made you change your mind? Garycompugeek (talk) 19:05, 23 October 2008 (UTC)

Blackworm's recent edit to the opening sentence of the advocates/opponents paragraph is a perfect compromise! AlphaEta 18:28, 23 October 2008 (UTC)

Hmm, thank you although perhaps it was a bit too bold given all the discussion here. Maybe some more feedback from others? I appreciate the desire to keep the paragraph short (this is the lead after all) but I think we now succeed in three points where we didn't: One, we mention a controversy before discussing it (the previous sentence talked about the controversy as if we've already mentioned it), two, we make clear that the controversy we are focussing on here is the major one, i.e. the one concerning infants and children, and three, we refrain from asserting a non-neutral view that both sides are correct to some degree. Blackworm (talk) 19:42, 23 October 2008 (UTC)

Garycompugeek, I don't remember supporting stating that there is a controversy. I very weakly supported having a first sentence in the paragraph that tells the reader what the paragraph is about; most or all suggested versions of such a sentence happened to mention controversy. Later, since it seemed difficult to reach consensus on the wording of such a sentence, it seemed to me to be a good idea to delete it; the advantages of shortening the lead also appealed to me. However, Blackworm has come up with a version of the sentence which seems promising in terms of achieving consensus, so perhaps everything is working out. ☺ Coppertwig (talk) 15:23, 24 October 2008 (UTC)

I think that the current statement of the controversy ("Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions") is problematic.

The first problem is that the scope is arbitrarily narrow. As noted above, controversy also exists (albeit perhaps to a lesser extent) about the circumcision of adults. Without this sentence, the paragraph can be interpreted in a broader sense. Why, then, are we imposing this unnecessary reduction in scope?

The second problem is that the final sentence already includes the words, "...and when performed on babies and children violates...". The purpose of these words is unclear if the first sentence is present. However, if the first sentence is deleted, it helps to distinguish between sub-controversies.

As I stated in my post of 13:01, 16 October 2008 (UTC), I think that the best approach is to include no initial sentence. Jakew (talk) 15:40, 24 October 2008 (UTC)

I find your argument convincing, Jakew, and now prefer to delete the sentence than to have the current sentence, though some other versions of the sentence may be OK. Although we didn't find a source that states that there is any controversy about circumcision of adults, it would be OR to imply that there is none. Blackworm, surely you wouldn't be prepared to state that the WHO's advocacy of circumcision to reduce HIV transmission (or whatever it is they're recommending) is uncontroversial? I don't get the impression that they're just talking about babies and children. ☺ Coppertwig (talk) 16:03, 24 October 2008 (UTC)

The only reason the WHO's position is controversial is because adult men are being circumcised on a "nominally voluntary" basis, and perhaps also do not have the resources to make an informed decision; and also because the programs encourage circumcision of infants and children. The "circumcision controversy" as described by reliable sources concerns infants and children. Let's actually present this controversy. Blackworm (talk) 18:25, 24 October 2008 (UTC)

I do not find your argument convincing. Jakew, please bring sources stating a controversy in the circumcision of adults. This is ridiculous -- the male circumcision controversy is the controversy of cutting parts off the penises of infants and children, not the obscure, scholarly and friendly debate among three or four researchers as to whether adult circumcision is beneficial. Stop obscuring this controversy. Blackworm (talk) 18:14, 24 October 2008 (UTC)

Note also that the Schoen source used to present the propronents' position entirely describes circumcision of infants (note the title of the article). Thus statements like "low complication rate" are misleading unless one already reduces the context to infants. Blackworm (talk) 18:37, 24 October 2008 (UTC)

As requested, Blackworm: "Should men be circumcised to help slow the spread of HIV infection? The controversial idea is on the agenda..."[38] Jakew (talk) 21:02, 24 October 2008 (UTC)

Well done, Jakew! Thanks! I thought infants weren't the only controversy. ☺ Coppertwig (talk) 22:13, 24 October 2008 (UTC)

Well, okay, that this is controversial also would be a welcome addition to the article, which as it stands presents the WHO's position on HIV and male circumcision as if it is not controversial at all. Thus, based on the source Jakew brings, we could add this sentence: The idea of circumcising men in an attempt to slow HIV infections is controversial. It could be added immediately after the WHO's 2007 recommendation in the lead. This of course does not involve nor affect the paragraph of the much more explored controversy of routinely circumcising male infants and children. Blackworm (talk) 18:09, 27 October 2008 (UTC)

That suggestion is problematic for several reasons, Blackworm. First, it would imply through juxtaposition that the WHO's 2007 recommendations were controversial, for which we'd need a source stating that they are (a source published 18 months before the recommendations were issued cannot do so for obvious reasons). Second, as previously noted, the recently-added sentence "Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions" is problematic, partly because it describes the controversy in a way that is too narrow, and partly because it renders part of the same paragraph ("...and when performed on babies and children violates...") nonsensical. The correct solution is either to remove the problematic sentence, or to amend it so that it is no longer problematic. Simply adding material may be tempting, but it is difficult to justify when it a) fails to address the underlying problem, b) introduces new problems, and c) adds bulk to the lead without justification. Jakew (talk) 19:06, 27 October 2008 (UTC)

My thoughts

There is scientific evidence supporting both sides of the circumcision controversy. Advocates for circumcision claim that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a complication rate of less than 0.5% when carried out by an experienced physician, and is best performed during the neonatal period.[19] Opponents of circumcision claim that it violates the individual's human rights, is painful, may increase the risk of certain infections, and adversely affects sexual pleasure and performance.[20]

My criticisms for what they are worth. O.K, i think that a complication rate of less than 0.5% should be replaced with has a low rate of complications. Also, the controversy is related to infant circumcision not circumcision in general. Nobody cares if an adult circumcises himself. So the opening sentence should reflect that. Also, given that the opponents are the ones who are creating the controversy, their opinion should come first. Also explain why their is a controversy - this: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice." should be incorporated. Here is my suggestion (rough):

There is a controversy, particularly in the USA (where the neonatal circumcision rate is high), over whether boys should be circumcised. Opponents state that it is not medically necessary, reduces sexual pleasure, violates the child's right to genital integrity and carries serious risks.^ref^ Virtually all national medical associations do not recommend routine infant circumcision, however they do support the parents right to choose.^ref^ Advocates of circumcision state that it provides important health advantages which outweigh the risks, that it has no substantial effects on sexual function, has a low complication rate, and is best performed during the neonatal period. The WHO have recently stated that circumcision could be used to lower the rate of HIV contraction in Africa.^ref^ Tremello22 (talk) 21:52, 19 October 2008 (UTC)

Tremello22, It's not clear to me whether your comments are about the current lead, or about Jayjg's suggestion above. Do you have any strong objections to replacing the current 3rd paragraph of the lead with Jayjg's suggestion of 16:59, 19 October 2008?

Before I comment on your suggestion, would you please clarify what text in the current lead it's intended to replace? Note that the lead already provides information about the WHO's position with respect to HIV and about the positions of medical associations. Thanks. ☺ Coppertwig (talk) 17:18, 23 October 2008 (UTC)

Yes I do have a problem with Jayjg's suggestion. I was just throwing out the idea of merging the last 2 paragraphs of the current lead together to make the lead flow a bit more. The current lead as it stands now, after Blackworm's modification, is a bit better though because it makes clear we are talking about circumcision in children. Tremello22 (talk) 18:15, 23 October 2008 (UTC)

Thank you, Tremello22. I re-read your comments above, and I could be wrong but it seems to me that the problems you have with Jayjg's suggestion also mostly apply to what was in the lead, so I took the liberty of putting in Jayjg's wording, except that I kept the first sentence of the paragraph in place and also kept the phrase "extremely painful". I hope you don't mind. This edit removed the "0.5%" as you suggested, so perhaps it's closer to your suggestion than the lead was.

In reply to your comments: I've left the opening sentence in place, and Blackworm has edited it to reflect that it's about children. Re the opponents coming first: I guess that's probably OK with me; I don't see much reason for having one or the other first, but I think you're right that it sounds more logical with the opponents coming first: the advocates' views seem unimportant until one has been exposed to opponents' views to be refuted by them, especially since most of the advocates' views stated in that sentence are arguing that it does no harm, rather than giving positive reasons for doing it. I have not changed the order of the sentences, in order to give others time to comment.

I think your suggestion is interesting; however, it implies that the AMA is an opponent of circumcision and that the WHO is an advocate of circumcision, and I think that's OR. I think the AMA and WHO might be offended at being cast in that light. They have made measured statements; they have not stated, as far as I know, that they recommend that people be circumcised or that they recommend that people not be circumcised.(Not sure exactly what they said.)^{(15:07, 24 October 2008 (UTC))} Therefore I think the current format is better; although the last two paragraphs, with the AMA and WHO positions, could be combined into one to reduce the number of paragraphs. I wouldn't shorten the sentences. In any case, having the paragraphs immediately follow the controversy paragraph joins the ideas together reasonably well. Another option might be to join the 3 last paragraphs while keeping the sentences of the last 2 paragraphs in the current order and not mixing them in with the 3rd paragraph; but I think that would make too long a paragraph.

I don't think the AMA and WHO statements "explain why there is a controversy"; I think the last two sentences in the 3rd paragraph explain that, and that the organizations are responding to the controversial situation by taking positions.

One problem with your version is that I don't think we can confidently say that "Virtually all national medical associations do not recommend routine infant circumcision,...": how do we know a new policy wasn't published last week, (or last year, in Chinese or something, and we haven't happened to notice)? And the statement is likely to go out of date. (I think there's something in the Manual of Style about avoiding making statements that will go out of date, but I can't find it at the moment.) The current version, stating that the AMA stated something in 1999, is easily verifiable and will not go out of date. Re "The WHO have recently stated that circumcision could be used to lower the rate of HIV contraction in Africa": see my comment of 23:25, 22 October 2008 on this talk page. ☺ Coppertwig (talk) 14:42, 24 October 2008 (UTC)

It is not feasible to try and make statements that never go out of date. Article's are continually updated to reflect current changes in the present. I can live with Tremello's and/or Blackworms suggestions however as Jake points out circumcision of adults can also be considered controversial to a lesser extent. Maybe we are going about this the wrong way. Perhaps we should state it in a way that frames the benefits vs the risk. IE . There is much controversy regarding the risks of circumcision versus its benefits. Garycompugeek (talk) 17:49, 24 October 2008 (UTC)

Some statements can be expected to go out of date sooner or to be more likely to go out of date; it's certainly feasible to try to avoid those. I suppose some scholar in the distant future might discover that the AMA hadn't actually stated that in 1999, but let's not worry about such remote scenarios. Re this edit which changes "Circumcision of male infants and children is controversial, with both advocates and opponents pointing to scientific evidence to support their positions" to "There is great controversy regarding the risks of circumcision versus its benefits": I agree with Blackworm that we haven't verified that it's the risks and benefits that are controversial; also I don't think we can justify use of the word "great" as NPOV. How about just using the short sentence, "There is controversy."? ☺ Coppertwig (talk) 12:59, 29 October 2008 (UTC)

I think "There is controversy" would be fine, but I'm also quite happy with Blackworm's latest edit, which changes the sentence to read: "There is controversy surrounding circumcision." Jakew (talk) 13:39, 29 October 2008 (UTC)

I was trying to define the controversy but this is acceptable to me. Garycompugeek (talk) 14:22, 29 October 2008 (UTC)

Sorry, I hadn't noticed that; I thought Blackworm had just been reverting to the previous version. Yes, it's fine with just "There is controversy surrounding circumcision". The problem with trying to put more information into the sentence is that it's difficult to word it in a NPOV way. Different sources might express different opinions about how much controversy there is around adult versus baby circumcision; and we don't have many sources stating clearly that there is controversy; for example, I don't think we have anything like that for adult circumcision after the WHO position statement. Looking at stuff that's published that expresses differing opinions and calling it "controversy" could be OR. Also, it's hard to find words to express concisely that there's controversy about infant circumcision and that while there's also controversy about adult circumcision, (or was a couple of years ago anyway), it might be either somewhat less or a lot less controversial although we don't really have a source stating that so it could even be more controversial for all we know. ☺ Coppertwig (talk) 15:02, 29 October 2008 (UTC)

ADHD and RIC in the United States

In the 1990s, worldwide epidemiological data became available on the prevalence of ADHD. Everyone was amazing that ADHD seems to occur rarely outside of North America. And for 15 years, many ideas have been considered. Is ADHD a product of permissive Western culture? (Given the liberal social policies of Western Europe in comparison to North America, this appears to be a non-starter question.) Is ADHD a "social construct" invented by drug companies? (Perhaps the efforts to broaden diagnosis criteria to little girls who do not exhibit hyperactivity is.) And how do American health professionals talk with Europeans who don't believe ADHD exists? (Perhaps ADHD doesn't in Europe.)

ADHD is an American boys' disease. And what do Americans do to boys that Europeans and Asians do not do? One simple answer: They remove healthy tissue routinely for cosmetic reasons or on the off chance the procedure with reduce likelihood - but not prevent - a disease that could be cured with move conservative methods. And the kid will probably never get such a disease or need circumcision at all. Ever.

ADHD is marked by an abnormal cortisol reaction to stresses in everyday life, abnormal dopamine levels and glucose metabolism in the brain. Is it possible the the trauma of strapping down, ripping, crushing, pulling, tearing, crushing and finally cutting to prevent a host of diseases he probably won't get anyway, alters the autonomic and limbic fight-or-flight mechanism and that serious neurological damage is done even in the absence of memory of the event?

Second consideration: If circumcision actually reduces the chances of female-to-male HIV infection, why does the United States have a higher HIV infection rate than the United Kingdom, France, Italy, Germany, Japan and Canada? Could circumcision actually INCREASE the risk of HIV by removing Langerhans cells that provide a barrier to entry into the body? The science suggesting circumcision prevents HIV is extremely flawed. And promoting circumcision as an "arrow in the quiver" of the fight against HIV merely makes circumcised men believe they no longer need to use condoms.

Brit Pariah (talk) 03:39, 16 October 2008 (UTC)

We need stuff that is cited in reliable sources. Not to be curt, but this isn't a forum for discussion of the topic, or your own analysis. Blackworm (talk) 07:40, 16 October 2008 (UTC)

Small

Re this edit which removed a "verify source" tag: I looked at the abstracts of the four sources (I'm not sure if I can access the full text), and except for Ganiats, I'm not sure if we can justify the word "small" as verifiable for either the benefits or costs. Perhaps the "verify source" tag is still needed. ☺ Coppertwig (talk) 14:58, 17 October 2008 (UTC)

More he said, she said.

The source: If insufficient foreskin is removed the cosmetic appearance is such that the penis does not appear to be circumcised; phimosis may still subsequently develop.

Wikipedia's interpretation: If insufficient skin is removed, the child may develop pathological phimosis in later life.

The source: In a series of consecutive circumcisions in Australia, Leitch found that in 9.5 per cent of patients the operation had to be repeated because of inadequate skin excision at the initial procedure. MacCarthy et al.17 reported this figure to be 1 per cent in a study from the UK. In a more recent series from Israel, where religious circumcision is widespread, of 60 children referred following potentially inadequate circumcision 42 required recircumcision; the majority of these children were operated on before 4 years of age.

Wikipedia: Cathcart et al. report that 0.5% of boys required a procedure to revise the circumcision.[118]

Blackworm (talk) 20:54, 17 October 2008 (UTC)

What is your point? The first I think I amended it. The second wasn't me - I don't know who added that - i think Jakew amended that one. I remember adding the Leitch reference but in relation to something else. Jakew took it out saying it had nothing to do with circumcision. I don't think that gives a good representation on the amount of circumcisions that get re-done -surely it is higher. Tremello22 (talk) 22:52, 17 October 2008 (UTC)

Improvments

I have made improvments to the article by listing the benefits of circumcision as demonstrated by empirical evidence. —Preceding unsigned comment added by 70.68.174.22 (talk) 11:52, 18 October 2008 (UTC)

I apologize; somehow I didn't see this section earlier and thought you hadn't posted to this talk page. Thank you for your contributions!

We've had extensive discussion here to determine how much space to devote to each subtopic. This article is a concise summary; more detailed information goes in the subarticles, linked to from the tops of various sections. See for example Talk:Circumcision/Archive 32#Article too long?. Please note the template at the top of this talk page which says "Please read this page and discuss substantial changes here before making them." I generally oppose making this article much longer. The material you added didn't seem neutral to me in terms of a balance between pro-circ and anti-circ viewpoints. ☺ Coppertwig (talk) 23:38, 18 October 2008 (UTC)

Improvements #2

I feel it is important that people understand the benefits of circumcision. There is much empirical scientific evidence showing that it reduces the risk of all kinds of different problems. There is also new evidence showing that male circumcision can reduce the rate of cervical cancer among women by 20%!

I am completely in the dark as to why there are so many people opposed to receiving this information; it is very important and practically useful. Moreover, there are a number of instances in this article where details are either discarded or fudged. For example, somebody has suggested that circumcision affects “sexual performance.” Most research finds that it “IMPROVES” sexual performance by increasing ejaculatory latency time, and it reduces the risk of spreading or acquiring an STD.

I find that the editors of this article would like nothing more than to convince people that circumcision is purely cosmetic, religiously based, or “bad.” That is absolutely absurd and there is a mountain of scientific studies showing this. There are many practical reasons…

In addition, circumcision practically eliminates the risk of men from acquiring penile cancer!! So please, stop challenging my edits, they are valid and should be listed. --70.68.174.22 (talk) 22:00, 18 October 2008 (UTC)

Perhaps you would like to enlighten all the major medical organizations who unilaterally do not recommend circumcision because they feel the risk's outweigh the benefits. Garycompugeek (talk) 23:27, 18 October 2008 (UTC)

Gentlemen (and/or ladies & gentlemen), this isn't the place to argue about the merits of circumcision.

To 70.68.174.22: these changes seemed to add a large amount of material to the lead section of the article, which is already very long. Additionally, they were insufficiently neutral, and contained some personal interpretation or extrapolation beyond sources. This is a somewhat controversial article, and changes — especially drastic ones — are unlikely to succeed unless there is consensus for them. I would suggest trying to gain that consensus, here, on the talk page, instead of repeatedly trying to force through your changes. Jakew (talk) 23:43, 18 October 2008 (UTC)

Agree with Jakew. Gary, while the IP user is clearly not familiar with Wikipedia's policies on original research, I believe you should consider whether because they feel the risks outweigh the benefits is also an interpretation beyond sources. Blackworm (talk) 00:08, 19 October 2008 (UTC)

Your both right of course. Still I thought a response was in order. Education goes a long way in these matters. Garycompugeek (talk) 01:26, 19 October 2008 (UTC)

Non-religious what?

"The American Medical Association defines non-therapeutic circumcision as the non-religious, non-ritualistic, not medically necessary, elective circumcision of male newborns. ... Reasons for non-therapeutic circumcision include religious beliefs as well as cultural and family conformity."

Is this written this way for a reason? —Preceding unsigned comment added by 67.240.138.239 (talk) 14:12, 18 October 2008 (UTC)

LOL! Good point! We'll have to look at that! ☺ Coppertwig (talk) 15:47, 18 October 2008 (UTC)

What exactly is wrong with that wording? Am I missing something? --Pwnage8 (talk) 01:47, 19 October 2008 (UTC)

the second sentence comes from the BMA, I'll remove it, it shouldn't be in the USA section. Tremello22 (talk) 21:27, 19 October 2008 (UTC)

External links

I oppose this edit on the grounds that a link to a discussion forum is not encyclopedic. Please discuss here on the talk page any links or other information you want to add, before editing the article. See WP:EL#Links normally to be avoided, which says, "Links to social networking sites (such as MySpace), chat or discussion forums/groups (such as Yahoo! Groups), USENET newsgroups or e-mail lists." ☺ Coppertwig (talk) 17:47, 18 October 2008 (UTC)

It is a minor revert and the editor is being told what policy pertains to it. If the editor does this again, he/she should be reported to a sysop or administrator's board. forestPIG^(grunt) 17:48, 18 October 2008 (UTC)

Radical suggestion

Hey, I don't know about the rest of you, but I think our extreme focus on two or three paragraphs in the lead has come at the expense of the rest of the article. We've had a few embarrasing errors (including a misspelling of the word circumcision) go unnoticed for months while we squabbled about a few points.

How about this ridiculous set of suggestions to settle things down a bit:

1. Move the current advocates and opponents paragraph down to the "Ethical issues" section (a skeleton version already exists there anyway).

2. Move the AMA and WHO/CDC/HIV paragraphs down to the "Medical analysis" section

3. Summarize all three points in the lead with something like:

The medical and moral aspects of male circumcision make it a controversial issue. Currently, non-therapeutic circumcision is not recommended by any major medical association in the English speaking world. However, the WHO has recently advocated the use of circumcision in Africa to stem the heterosexual spread of HIV/AIDS.

Thoughts? Am I a moron, or what? AlphaEta 01:42, 19 October 2008 (UTC)

Why does the lead still quote a ten-year-old statement from the AMA about what medical organizations "currently" do? Does that not strike you as ridiculous? Jayjg ^(talk) 01:45, 19 October 2008 (UTC)

That would only be ridiculous if someone would provide reliable sources stating that these medical organizations have changed their positions. I'm not aware of any WP:RIDICULOUS policy. Blackworm (talk) 01:54, 19 October 2008 (UTC)

See Wikipedia:RS#Scholarship: "...scholarly material may be outdated, [or] superseded by more recent research...." The AMA's position cannot take into account more recent studies, including the WHO studies. Outdated medical statements fail WP:RS. Jayjg ^(talk) 16:53, 19 October 2008 (UTC)

1. No, the controversy being made less prominent is the crux of the dispute over the lead. Your suggestion to make it less prominent is not acceptable.

2. No, the AMA paragraph is an important summary of medical organizations positions, which we explore is great detail later the article.

3. Your suggested paragraph only mentions the WHO as an authority, lending undue weight to that organization's views, especially on their views as pertaining to the controversy -- since the controversy is what you lead the paragraph with. Blackworm (talk) 01:52, 19 October 2008 (UTC)

Okay, I admit that the suggested text was thrown together in haste and can't really even be considered a proper "paragraph" (on second look, it's quite horrible). It was meant to serve as a rough approximation of a shorter, more-compact synopsis of moral and medical issues surrounding circumcision. The goal was is not to minimize (especially controversial issues), but to summarize. Oh well, figured I give it a try. AlphaEta 02:55, 19 October 2008 (UTC)

"WHO has recently advocated the use of circumcision in Africa" doesn't sound quite right to me. What quote from the WHO is that based on? I suspect that may not be quite a precise reflection of their position.

I think medical association policies from 10 years ago are the current policies if no new policy has been announced. It would be different if it were from 100 years ago. The article clearly states that it's from 1999, so there's nothing misleading there. Medical facts may go out of date, but medical policies are more like laws in my opinion: they tend to remain in force until they're repealed or have been ignored for a long time. ☺ Coppertwig (talk) 17:01, 19 October 2008 (UTC)

They are indeed the current policies, but they are still fatally out of date, and fail Wikipedia:RS#Scholarship. What is the AMA position regarding circumcision in light of the WHO studies? It doesn't have one, of course, because its policy is "outdated, [or] superseded by more recent research". Jayjg ^(talk) 17:04, 19 October 2008 (UTC)

I know, I didn't put enough thought into the proposed "paragraph". I'm striking the text so we don't waste any more time on it. AlphaEta 17:10, 19 October 2008 (UTC)

Jayjg, the WHO studies are about using circumcision to lower the rate of HIV in Africa. The medical association policies are about neonatal circumcision in developed countries. The policies are not out of date; if they found new information then they would re-write the policies. Also please note that those RCT trials in Africa have not studied the long term effects of circumcision in relation to HIV reduction. They have only done it in a controlled setting too - in the real world many other things may come into play - such as increased risky behaviour due to thinking that they are now invincible now that they are circumcised; also less condom use as the penis becomes keratinized and so they don't want to reduce the sensation further. Tremello22 (talk) 21:19, 19 October 2008 (UTC)

Jayjg, if you have reliable sources criticizing the current policies of major medical organizations on that basis, or any basis, please bring them, and we can summarize them. Otherwise, your view is original research. If the year of any medical organization's last published policy review isn't given in the text, I invite you to add it, and let the reader decide whether the policies are out of date.

Coppertwig, here are sources on the WHO "advocating" or "recommending" or "urging" male circumcision with the reason given that it will reduce the spread of HIV: [39] [40] [41]. Blackworm (talk) 07:02, 22 October 2008 (UTC)

Well done Blackworwm! Garycompugeek (talk) 13:09, 26 October 2008 (UTC)

Blackworm, you have failed to address the issue raised by Wikipedia:RS#Scholarship: "...scholarly material may be outdated, [or] superseded by more recent research...." Many of the studies cited in the article post-date that statement. Please justify citing out-of-date medical statements in the lede in terms of policy. Jayjg ^(talk) 02:54, 26 October 2008 (UTC)

Only WHO seems to be recommending circumcision (along with much criticism). The AMA statement is still the best sourced policy summary we have for the the lead. The fact that it is 10 years old means little considering it is still true. If major medical associations did an about face (trend is not going that way) then the AMA statement could be considered out of data and misleading. Garycompugeek (talk) 13:04, 26 October 2008 (UTC)

Gary, to my knowledge two major policy statements have been released in the period since publication of the RCTs. One is WHO. The other is AUA, who added the recommendation "that circumcision should be presented as an option for health benefits" in 2007 (their previous statement, for comparison, can be found here).

Understood, however that certainly is not enough weight to dislodge the AMA summary statement. Garycompugeek (talk) 13:44, 26 October 2008 (UTC)

The WHO document briefly discusses criticism of the US and Australasian statements in s2.3.2 (see p16, 2nd paragraph). Jakew (talk) 13:34, 26 October 2008 (UTC)

I realize that they recommend circumcision. I'm just concerned about the precise wording with respect to "Africa": i.e. are the WHO recommending circumcision specifically in Africa? Or more generally? I think we need to be very careful with the precise wording there; it might be necessary to quote them. ☺ Coppertwig (talk) 23:25, 22 October 2008 (UTC)

Source says "excruciating pain." Why can't we?

The source says "excruciating pain." I don't understand the reason behind this edit, as referring to it as excruciating once would be enough to verify the source's view. The word is used three times in the source, including in the abstract. On what policy grounds was this edit made? Blackworm (talk) 01:49, 19 October 2008 (UTC)

See also the #Defining the controversy section. ☺ Coppertwig (talk) 01:52, 19 October 2008 (UTC)

Yes, that dispute is relevant, since language used in one side's sources is also apparently censored there. Blackworm (talk) 01:57, 19 October 2008 (UTC)

See also Wikipedia:NPOV#Impartial_tone. Jayjg ^(talk) 01:53, 19 October 2008 (UTC)

What isn't impartial about it? We are attributing the view to the proponents of the view. Also, read WP:NPOV, which states that To write from a neutral point of view, one presents controversial views without asserting them; to do that, it generally suffices to present competing views in a way that is more or less acceptable to their adherents, and also to attribute the views to their adherents. Blackworm (talk) 01:57, 19 October 2008 (UTC)

It says "more or less acceptable to their adherents"; it doesn't say "precisely the way the adherents would word it". I think "excessively painful" would be "more or less acceptable". I think the word "excruciatingly" is a colourful word, not what I would consider "impartial tone"; it conveys emotion as well as meaning. Its meaning is not clear. Does it mean "as painful as torture"? What does it mean?

How about saying "traumatically painful" instead? That sounds like a more impartial tone to me than "excruciatingly", although I think it's a stronger claim. I only see the word "excruciating" twice in the source, but I see "traumatic" or "trauma" four times. ☺ Coppertwig (talk) 02:12, 19 October 2008 (UTC)

How about "causes significant pain"? That sets a nice impartial tone. Jayjg ^(talk) 16:48, 19 October 2008 (UTC)

I don't think "causes significant pain" is an appropriate summary of the words "excruciating pain" used in the source, especially considering that we often use "significant" to mean "statistically significant" or "detectable" in the article. I would accept "traumatically painful" or "extremely painful." Blackworm (talk) 20:01, 21 October 2008 (UTC)

The source describes the pain as "excruciating" twice. The source uses "pain" or "painful" without any modifiers five times (not including quotations from other sources), including in the conclusion. In what way does inclusion of "excruciatingly" better reflect the source? AlphaEta 02:16, 19 October 2008 (UTC)

"Excruciatingly" summarizes their message. An article doesn't have to repeat something over and over again to get the point across. Note the other words I also quoted, and their statements that the trauma has long-term effects, etc. Using the word "pain" unqualified several times doesn't erase the earlier adjective; if it did we would have to repeat the phrase "male circumcision" throughout this article to get the point across. They're not saying it's like stubbing your toe. ☺ Coppertwig (talk) 02:25, 19 October 2008 (UTC)

I realize I'm not the sharpest tool in the shed, but I do know that adjectives, adverbs and other modifiers are subsequently implied and that their repetitious use is unnecessary. Look, I'm not trying to be a stick in the mud. I simply disagree that using the word "excruciatingly" "summarizes their message" or better reflects the source. I may be completely wrong, it happens all the time.... AlphaEta 02:43, 19 October 2008 (UTC)

It's perfectly valid to have that opinion. I apologize if my message seemed to imply that you needed obvious things explained, AlphaEta. I have great esteem for your encyclopedic ability and intelligence. Any shortcomings of my message were due solely to my difficulty in figuring out how to formulate and express my argument. ☺ Coppertwig (talk) 02:56, 19 October 2008 (UTC)

Perhaps we could keep "excruciatingly", but put quotation marks around it. I'm not very comfortable having it in a Wikipedian sentence without the quotation marks, because it seems to me to lack encyclopedic precision. It's not clear what it means. I don't think we can confidently assert that the source is claiming that circumcision is literally as painful as torture. ☺ Coppertwig (talk) 13:21, 19 October 2008 (UTC)

Just the threat of cutting the penis is an effective form of torture. Garycompugeek (talk) 14:09, 19 October 2008 (UTC)

Please restrict discussion on this page to article content and reliable sources, rather than discussion of the subject matter itself. See WP:Talk#How to use article talk pages. ☺ Coppertwig (talk) 15:39, 19 October 2008 (UTC)

AlphaEta, if it didn't summarize their message, they wouldn't put it in the abstract. Some of the time they use "painful" elsewhere, they aren't even referring to the immediate pain of having tissue cut off the body, but to later, lingering pain. Again, similar to "medically unnecessary," that it is painful isn't even disputed anymore; it's the extent of the pain that is emphasized by opponents. The word "torture" doesn't appear in the source, so the comparison to torture doesn't apply here -- and it seems odd for Coppertwig to apparently claim that the source's actual words imply a pain equivalent to torture, then want to scare quote the word based on our own rejection of that view. "Excruciating" may seem like a strong word if it conflicts with one's views, but then here we are specifically attributing the view to opponents, using their exact words. Other sources don't avoid the word either:

• "Unanesthetized babies showed excruciating pain during circumcision..."[42]
• "6 Patients [...] experienced excruciating pain when the foreskin was clamped..."[43]
• "Because we now know that the infant experiences excruciating pain at the time of the circumcision..."[44]
• "The excruciating pain which the children are subjected to..."[45]

• "...endure the excruciating pain of circumcision..."[46]

That male circumcision results in excruciating pain is their sourced, cited view. Let's present that view. Blackworm (talk) 21:44, 19 October 2008 (UTC)

Note that I've requested discussion of a suggested version of the paragraph in section #Defining the controversy above. ☺ Coppertwig (talk) 16:53, 19 October 2008 (UTC)

I would put it like this: That male circumcision results in "excruciating" pain is their sourced, cited view. If we use the word ourselves without quotation marks in the article, we should have some idea of what it means. My Collins dictionary doesn't mention torture in the definition of "excruciating", but does mention it in the definition of "excruciate"; the definition of "excruciating" at dictionary.com does mention "torturing". It seems somewhat unclear to me what "excruciatingly" is supposed to mean in this context.

Blackworm, you said "The word "torture" doesn't appear in the source, so the comparison to torture doesn't apply here -- and it seems odd for Coppertwig to apparently claim that the source's actual words imply a pain equivalent to torture, then want to scare quote the word based on our own rejection of that view." I'm not sure what I wrote that caused me to appear to make that claim, but I did not actually make that claim, nor do I want what you state that I want. My actual position is expressed in my own words in my comments above. I'm not suggesting scare quotes; I'm suggesting quotation marks to indicate a quotation; and I don't think I've indicated that I or anyone else accepts or rejects the view expressed in the source. ☺ Coppertwig (talk) 22:07, 19 October 2008 (UTC)

Sorry if I did not understand you properly. As I state above, I can abide by "traumatically painful" or "extremely painful," but I do feel quite strongly about emphasizing the high degree of pain opponents state, rather than have them state merely that pain exists (which I do not see as controversial, nor an accurate reflection of the source). Blackworm (talk) 20:01, 21 October 2008 (UTC)

"Extremely painful" seems to accurately represent the high degree of pain that is noted in the citation while maintaining an encyclopedic tone. AlphaEta 01:14, 22 October 2008 (UTC)

I agree with AlphaEta about "extremely painful". ☺ Coppertwig (talk) 23:30, 22 October 2008 (UTC)

HIV lead tweak

The World Health Organization (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex when not practicing Safe sex.

This is shorter, more to the point, and provides good link. Thoughts? Garycompugeek (talk) 18:51, 23 October 2008 (UTC)

This seems to be an inaccurate representation of what the sources actually state. The World Health Organisation, for example, state "The efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt." They do not state "The efficacy of male circumcision in reducing female to male transmission of HIV when safe sex is not practiced has been proven beyond reasonable doubt." Jakew (talk) 19:11, 23 October 2008 (UTC)

They say "but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV." in other words safe sex. Garycompugeek (talk) 19:23, 23 October 2008 (UTC)

Two problems. First, "should not replace [safe sex]" means something like "should be used as well as [safe sex]", which would seem inconsistent with a belief that circumcision was only effective when practicing unsafe sex. Second, there is a distinction between stating whether something is effective and stating when and if it should be done (I might say that "holding a sheet while jumping off a building may reduce your risk of injury", but I would not say that "you should hold a sheet and jump off a building"). In this case, the WHO are saying that circumcision is effective, but should be used in addition to other interventions. These are two different statements. Jakew (talk) 20:00, 23 October 2008 (UTC)

I understand your points Jake, however, if one is practicing safe sex then one is already protected or it wouldn't be safe sex. Garycompugeek (talk) 20:12, 23 October 2008 (UTC)

That may be so, Gary (assuming that safe sex is indeed 'safe' rather than 'safer'). However, the statement is attributed to the WHO, etc, and needs to represent what they actually say, not what you and I might have said if we were in their place. And the source quoted above discusses "female to male transmission of HIV", not "female to male transmission of HIV when practicing unsafe sex", not "female to male transmission of HIV when there is a full moon", not "female to male transmission of HIV in Africa", and not "female to male transmission of HIV on the third Tuesday of the month". Jakew (talk) 14:34, 24 October 2008 (UTC)

I agree with Jakew that we have to convey the meaning accurately, paying attention to a number of distinctions that are involved. "Safe sex" generally doesn't mean "100.00% safe sex", in my opinion. Methods of birth control generally have nonzero pregnancy rates, generally on the order of something like 1% per year; it seems likely to me that methods of avoiding disease transmission (i.e. "safe sex") also involve significant nonzero disease transmission rates. Even if we believed that the disease transmission rate while practicing "safe sex" was zero, that wouldn't justify making a logical deduction on that basis and attributing the resulting conclusion to the WHO. ☺ Coppertwig (talk) 14:57, 24 October 2008 (UTC)

"Surgical" in first sentence

Re "surgical removal" versus "removal" in the first sentence: how about "excision" instead? ☺ Coppertwig (talk) 15:15, 24 October 2008 (UTC)

How about "amputation?" How about "cutting off?" How about "severing?" Why must we couch circumcision in medical jargon and immediately act as if it only exists in a medical context? Blackworm (talk) 18:08, 24 October 2008 (UTC)

I'm sorry; I'm not sure if I understand your position. Do you oppose using the word "excision" here? If so, on what grounds? "Cutting off" or "severing" are OK with me but have been opposed by some other editors, I believe. "Amputation" is most often used for limbs, so it makes it sound to me as if the whole penis is being cut off by mistake. ☺ Coppertwig (talk) 20:42, 24 October 2008 (UTC)

I oppose using "excision" to define circumcision, to the exclusion of other terms, as it is a needlessly technical term for "cutting out." (See Wikipedia:Technical_terms_and_definitions, which has guidelines for technical articles -- I don't believe this to be a generally technical article, but even if it was, we'd still have to explain that "excision" means "cutting out.") Besides being needlessly technical, "excision" conveys a medical context that is both unjustified, and non-neutral. It arguably conveys medical precision, medical care, medical cleanliness, medical ethics, and medical benefits. "Cutting (out/off)" is neutral, tells us in plain English what circumcision is, and to my knowledge is only opposed by User:Jakew on invalid grounds, and using non-reliable sources to present his objection.[[47]] Blackworm (talk) 21:10, 24 October 2008 (UTC)

bodily rights

I prefer the term "bodily rights" to "human rights" in this context, and disagree with the statement in Blackworm's edit summary where he made this edit. I don't think the term "bodily rights" was invented by Wikipedians. Google hits: '"bodily rights"': 4,820; '"bodily rights" Wikipedia': 517. "Bodily rights" is a more specific term than "human rights". "Human rights" is a broad term encompassing (arguably) such things as bodily rights, reproductive rights, freedom of association, intellectual rights, possibly even property rights. Here, we're talking about bodily rights, so we should avoid the unnecessarily vague (in this context) "human rights". ☺ Coppertwig (talk) 18:43, 24 October 2008 (UTC)

The cited source says "human rights." Let's say "human rights," which incidentally has 72 MILLION hits on Google. Also, if over 10% of pages on the Internet containing the phrase "bodily rights" also contain the word "Wikipedia," I'd say that's a startling correlation; wouldn't you? Furthermore, "bodily rights" (which is ill-defined, obscure, and doesn't even have an article in Wikipedia) aren't the only human rights opponents state are violated; there is the right to be free from pain and suffering, the right to proper care as an infant, and the right to be free of sex discrimination (gender equality). Proponents of male circumcision hate when opponents talk about "human rights," but that is no reason to to change the sourced, cited claim of opposition on human rights (~72,000,000 hits) grounds, to some obscure, vague, incomplete, and ill-defined term bodily rights (~5,000 hits, or 0.007% of human rights). Blackworm (talk) 18:57, 24 October 2008 (UTC)

Here -- a little wikifying of your words so that you may see for yourself which one is "different", and thus seems not to be a notable concept: "bodily rights, reproductive rights, freedom of association, intellectual rights, possibly even property rights." Blackworm (talk) 19:04, 24 October 2008 (UTC)

OK, I'm convinced: "human rights" is OK. I see the term actually appears in the title of the cited source. Although, for a term allegedly invented by Wikipedians, it's odd that "bodily rights" is the only one with a redlink. ☺ Coppertwig (talk) 20:42, 24 October 2008 (UTC)

"Invented by Wikipedians" doesn't mean "approved by the Wikipedia community."  ;) But seriously, I only meant that the term as used here was original research. Thanks, Coppertwig. Blackworm (talk) 20:57, 24 October 2008 (UTC)

I was only kidding about the redlink. Should've put an extra-big smiley. ☺ Coppertwig (talk) 21:47, 24 October 2008 (UTC)

Notice of RfC

A request for comments has been filed that may involve some or all editors of this article. See discussion here. ☺ Coppertwig (talk) 00:54, 25 October 2008 (UTC)

Should you do the work of identifying all editors active on this article since I've arrived, and notifying them, Coppertwig, or should I? Also, please include my block log on the RfC you've filed, as is customary in these situations. Thank you. Blackworm (talk) 08:15, 25 October 2008 (UTC)

Keratin and Langerhans cells

The material on keratin and Langerhans cells got deleted somehow. I'd like to put it back in. I think it's important because it explains a possible reason why circumcision might help protect against a number of diseases (in the case of keratin) and HIV in particular (in the case of Langerhans cells). Otherwise we're only presenting dry statistics. We can now cite a secondary source for this theory: the WHO document. I suggest the following: "According to the WHO, the layer of keratin on the inner surface of the foreskin is thinner than on the shaft of the penis, which may make it easier for pathogens to enter, and cells targetted by HIV are also closer to the surface on the inner foreskin." (p. 13.) Coppertwig (talk) 01:48, 26 October 2008 (UTC)

Should this be in Medical analysis of circumcision instead, Coppertwig? Perhaps Jakew could also weigh in. Blackworm (talk) 06:50, 27 October 2008 (UTC)

Too much in lead

This is way too much for the lead

Early depictions of circumcision are found in cave drawings and Ancient Egyptian tombs, though some pictures may be open to interpretation.[2][3][4] Male circumcision is a commandment from God in Judaism.[5] In Islam, though not discussed in the Qur'an, circumcision is widely practiced and most often considered to be a sunnah.[6] It is also customary in some Christian churches in Africa, including some Oriental Orthodox Churches.[7] According to the World Health Organization (WHO), global estimates suggest that 30% of males are circumcised, of whom 68% are Muslim.[8] The prevalence of circumcision varies widely between cultures. For example, estimates of the rate of circumcision among boys include nearly all in the Middle East[9], 2% in Scandinavia and less than 5% in Britain.[10] Recent estimates of the infant circumcision rate include 56% in the United States,[11] less than 14% in Canada,[12] and less than 15% in Australia.[13] Neonatal circumcision is thought to have become common in English-speaking countries in the mid-nineteenth century;[14] more recently, the rate is reported to have declined in Australia and Canada.[15] In the United States, reports variously state that it is falling,[16] stable,[17] or increasing.[18]

I suggest shortening to this-

Early depictions of circumcision are found in cave drawings and Ancient Egyptian tombs, though some pictures may be open to interpretation.[2][3][4] Male circumcision is a commandment from God in Judaism.[5] In Islam, though not discussed in the Qur'an, circumcision is widely practiced and most often considered to be a sunnah.[6] It is also customary in some Christian churches in Africa, including some Oriental Orthodox Churches.[7] According to the World Health Organization (WHO), global estimates suggest that 30% of males are circumcised, of whom 68% are Muslim.[8] The prevalence of circumcision varies widely between cultures.

No need to go into detail and/or duplicate data from prevalence section. Garycompugeek (talk) 19:23, 27 October 2008 (UTC)

I agree with Gary and support his proposal. AlphaEta 00:50, 28 October 2008 (UTC)

I also agree, though I should note the end of this discussion, which explains why the material was added. Jakew (talk) 11:35, 28 October 2008 (UTC)

Shortening the paragraph sounds like a good idea to me. Garycompugeek's shortened version is OK with me, and I don't immediately see a better way to do it. Given Tremello22's comments in the discussion Jakew linked to, we should consider including the sentence about when it became popular; although I don't think we need to give extra weight to information about English-speaking countries just because this is the English Wikipedia, and I'm not sure whether Tremello22 explained why it was important to include that information. By the way, Tremello22's idea of joining the last two paragraphs into one sounds like a good idea to me, except that I can't see how to do it without unduly changing the weight of the various statements. ☺ Coppertwig (talk) 12:06, 28 October 2008 (UTC)

I think I understand what Tremollo22 was getting at as well as people's objection to it. One of the aspects about the historical adoption of circumcision by doctors in the mid 1800s is that it medicalized it, predominantly in English-speaking countries. This secular version of circumcision is in sharp contrast to the cultural/religio version that existed prior, and continues to this day elsewhere. Considering these two types as two topics is warranted. I respectfully suggest splitting this article into two portions along those same lines. I think you will find that much of the difficulties you are having will fade if you do. (Dan Bollinger (talk) 02:30, 29 October 2008 (UTC))