From: ((Steven B. Harris))
Subject: Re: FEMALE CIRCUMCISION
Date: 15 May 1995
Newsgroups: sci.med

In <199505132026.NAA11374@infinity.c2.org> qcompson@alpha.c2.org (Q.
Compson) writes:


>Hmmm.  As I said, I understand quite well why one would say this about
>the severe varieties, but what about the moderate ones?  I really
>can't see the difference between routine male circumcision and the
>Eritrean practice of removing the inner labia and clitoral hood.  I
>consider both to be stupid, cruel cultural traditions.

    Comment: On the basis of homologous structures, I certainly see a
difference.  The inner labia are the homologs of the skin of the shaft
of the penis, and have plenty of nerve endings.  The clitoral hood is
basically homologous to what gets removed as the male foreskin, and
though it has nerve endings, what's underneath has more, and (at least
in males) the general consensus is that sexual feeling isn't affected at
ALL over the long run (a few months).  I have this on authority of
several men who were circumsized as adults, who should know.  I'd find
it hard to imagine a woman losing her inner labia as an adult and not
missing them quite a bit.  But perhaps some women on the forum could
comment?

> On the other hand, I have to concede that neither does much long term
harm.<

   Labial excission?  I wouldn't be so quick to decide that.

> Both of these customs would be horrifying to the average European, for
whom neither carries any cultural weight.  Is there any reason, other
than our cultural inculcation and bias, why we routinely offer the
former in our hospitals, yet see fit to punish the latter with five
years of prison? <

    See the above.  If you were just arguing between male circumcision
and clitoral hood removal, I probably couldn't argue with you.


                                             Steve Harris, M.D.

From: sbharris@ix.netcom.com (Steven B. Harris )
Subject: Re: Genital Mutilation, etc.
Date: 20 Sep 1995
Newsgroups: misc.kids,talk.politics.medicine,sci.med,alt.activism,
	alt.activism.children,soc.couples,alt.feminism,rec.org.mensa

>In <43p1s1$8h5@concorde.ctp.com> pdrap@ctp.com (Patrick Draper) writes:
>
>>sbharris@ix.netcom.com (Steven B. Harris ) wrote:
>>
>>>I say that I'm having a lot of trouble imagining a problem so serious
>>>that no artificial lubricant can make up for it. Perhaps some "wise"
>>>person needs so be introduced to a better class of artifical
>>>lubricants? Try your nearest sex shop-- I guarantee you'll find
>>
>>hmmmmmm, we have two choices.
>>Foreskin -- or lubricants, foreskin, lubricants.
>>
>>>potions effective enough for sex with an Egyptian mummy. Yup, that's my
>>>medical advice. No charge this time.
>>
>>And you recommend lubricants?

Comment:

   Only for those who need them, as I thought I made clear.  The
argument for foreskin restoration (as I recall) was that somehow it
made possible sex for people who even lubricants didn't help.  I am
merely challenging the idea that there exist such people.  As for the
ease of buying lubricants vs having your foreskin stretched like
painter's canvas at considerable cost and pain, I think many people
would chose the lubricants.  Even assuming it as an either/or thing,
which I'm also quite skeptical of.

                                             Lubriciously,
                                             Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: alt.support.menopause,sci.med,talk.politics.medicine
Subject: Re: Post-hysterectomy Sex Abstracts (Re: Doctor-bashing)
Date: 16 Mar 1999 11:20:45 GMT

In <7ckvja$1ef@bgtnsc02.worldnet.att.net> "Eva D. Struction"
<EvaDStruc@aol.com> writes:

>Steven B. Harris wrote in message <7cknfq$l2k@dfw-ixnews4.ix.netcom.com>...
>
>>  As I said: money.  They don't do that many bypasses on male bodies in
>>Africa, either. And genetics.  And culture.  Circumcision is more
>>common in America because there are fewer Jews, and Jewish doctors, in
>>Africa.
>
>-----------------------------
>Not true.  All descendants of Abraham/Ibrahim practice circumcision, Muslims
>as well as Jews.  And there are *lots* of Muslims in Africa.
>
>You don't get to blame this one on the Jews.
>
>"Eva"


Comment:

     Nothing you've said contradicts what I said.  Something like 40%
of the 600 million people in Africa are Muslim, and the rest are from
religions that quite often do not particularly emphasize circumcision,
though it is being seen more often among the upper class non-Muslims
in some sub-Saharan cities.  Some non-Muslim males are circumsized in
Africa, therefore, but enough men are not, that non-circumcision is one
the factors being seriously considered in the spread of HIV in Africa.
I can find no good statistics, but I would guess from what I see in the
AIDS literature that the male circumcision rate in Africa does not
exceed 50%.

    In North America the male circumcision rate is about 85%, and it is
higher still in the U.S.  Higher, in fact, than any place on Earth
other than Israel.  Drastically higher than in Africa.

   Now, I gave my best explanation and guess for why this is.  "Blame"
is your word, not mine, since I regard this as not a really big deal
(though in civil rights terms I'm rather surprised that we let it
happen).  Nor did I intend it as some kind of anti-Jewish sentiment.
I'm not anti-Jewish and only mildly against male circumcision.  I
regard it as a silly religious fad, and a dumb thing to do to your kid
unless he's Jewish and will suffer greatly socially if left intact.
Medically I cannot recommend it, but I can't medically recommend nose
jobs for people don't like the length of their schnozes, either.  It's
a personal choice, though I probably would not oppose a law which
required Jewish males to wait to do it until they were of an age to
legally marry, vote, buy a pistol, or whatever.  Let's be consistant,
now.  If your kid's not responsible enough to decide to have an
abortion or get married without your parental say-so, he's hardly
mentally mature enough to chose to join in your religious community,
especially when this means cutting off a piece of himself.  We know
from the experience of Russian Jews that circumcision in adulthood,
using modern medical techniqes, is neither very dangerous, nor horrible
in terms of outcome, from the view of the patient.   Cosmetic
rhinoplasty is roughly comparable in terms of damage and social value
for the patient, and I see no reason why we as society should not treat
them both the same.

    However, all that being said (and perhaps it needed to be) I do not
believe that the fact of nearly universal male circumcision in the
United States did not come about in this century, and nowhere else on
Earth but Israel, as a matter of chance.  Or because some strange
glowing meteorite fell in this country and caused people to get out the
scalpels and turn on their children.  I've given you my best
explanation for the reason why it did happen: a strong Jewish influence
on prevailing American medical attitudes about proper pediatric care,
from Benjamin Spock on down, which in turn basically influenced the
entire society.  If you have a better explanation for the oddly
American universality of male circumcision, unique in the world save
for the one place I mentioned, I'm listening.  Spin me a better story,
and I'll buy it.  We have more hip and knee replacement here because
they cure pain in adults, restore function, and adults want them, and
can afford them.  Ditto for hysterectomies, like it or not.  But this
doesn't wash for circumcision of babies.

                                     Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,talk.politics.medicine
Subject: Re: Post-hysterectomy Sex Abstracts (Re: Doctor-bashing)
Date: 17 Mar 1999 07:29:28 GMT

In <7cncqb$a6h@bgtnsc02.worldnet.att.net> "Eva D. Struction"
<EvaDStruc@aol.com> writes:

>Eva D. Struction wrote in message <7cllct$q95@bgtnsc02.worldnet.att.net>...
>>
>>Steven B. Harris wrote in message <7cleqd$9g7@sjx-ixn5.ix.netcom.com>...
>
>>>I've given you my best explanation for the reason why it did happen: a
>>>strong Jewish influence on prevailing American medical attitudes about
>>>proper pediatric care, from Benjamin Spock on down, which in turn
>>>basically influenced the entire society.
>>
>>I knew that Leonard "Spock" Nimoy was Jewish, but I didn't think Dr.
>>Benjamin was.  I'll have to check.
>--------------------------
>I have checked.  I was correct.  Dr. Benjamin McLane Spock was "a
>Connecticut Yankee," not a Jew.  So then, who else consituted your "strong
>Jewish influence
>on prevailing American medical attitudes about proper pediatric care,"
>please?
>
>(I will read sci.med for a few days as I am interested in your answer.)
>"Eva"



   Wups, you're right, of course, about the baby Spock (yeah, it's got
to be Nimoy on the brain).  And I should know better, because he (Ben
Spock) just died and they gave his bio.

    Still think my thesis is correct.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: talk.politics.medicine,sci.med
Subject: Re: Is circumcision medically justified?
Date: 17 Mar 1999 08:16:43 GMT

>> Finally, On a more serious note .....
>>
>> Female cicumcision is now outlawed by the WHO and is generally seen as
>> child abuse if practiced - outcry a plenty there - and rightly so.
>> 
>> I wonder if a male infant circumcision is essentially the same thing?
>>
>> Lazarus



     That depends a lot on what kind of "female circumcision" it is.
There are Muslim groups which claim the whole idea is just to remove a
bit of the hood of the clitoris, and none of the clitoris itself, and
that this is what the true scholars always recommended (and, while
we're at it, that it's more of a recommendation for women, whilst being
a very strong near-necessity of faith proving for Muslim men, at least
before marriage; Islam doesn't have the same age recommendations and
ritualizations for the procedure as Judaism).  Anyway, these groups
claim that clitoral hood removal actually improves sensation for women.
I take no stand on the issue, except to note that this sort of thing
would be much closer to what is done to Jewish and Muslim boys.  And
also, we should note that Islam is not monolithic.  Circumcision is not
one of the five pillars of the faith, so there's room for argument and
plenty of it.  Sunis vs Shiites, and so on.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med,talk.politics.medicine
Subject: Re: Post-hysterectomy Sex Abstracts (Re: Doctor-bashing)
Date: 17 Mar 1999 14:38:41 GMT

In <7co2ub$cr3@bgtnsc02.worldnet.att.net> "Eva D. Struction"
<EvaDStruc@aol.com> writes:


>Steven B. Harris wrote in message <7cnlko$onh@dfw-ixnews5.ix.netcom.com>...
>>In <7cncqb$a6h@bgtnsc02.worldnet.att.net> "Eva D. Struction"
>><EvaDStruc@aol.com> writes:
>
>[talking about the high rate of male circumcision in the U.S.]
>>>>>[Steve] I've given you my best explanation for the reason why it did
>>>>>happen: a strong Jewish influence on prevailing American medical
>>>>>attitudes about proper pediatric care, from Benjamin Spock on down,
>>>>>which in turn basically influenced the entire society.
>>>>
>>>>[Eva] I knew that Leonard "Spock" Nimoy was Jewish, but I didn't think
>>>>Dr. Benjamin was. I'll have to check.
>>>--------------------------
>>>[Eva] I have checked. I was correct. Dr. Benjamin McLane Spock was "a
>>>Connecticut Yankee," not a Jew. So then, who else consituted your
>>>"strong Jewish influence on prevailing American medical attitudes about
>>>proper pediatric care," please?
>>
>>[Steve] Wups, you're right, of course, about the baby Spock (yeah, it's
>>got to be Nimoy on the brain). And I should know better, because he (Ben
>>Spock) just died and they gave his bio.
>>
>>    Still think my thesis is correct.
>--------------
>He died almost a year ago, I think.  As the frog said, time's fun when
>you're having flies.
>
>But if you still think your thesis is correct, and that there was a "strong
>Jewish influence on prevailing American medical attitudes about proper
>pediatric care"......well, I ask you again:  WHO exerted it?
>
>"Eva"


Comment:

Okay, if you want names, you would probably start with Abraham
Wolbarst, a prominent urologist of the 1930's who decidedly
confirmed in the pages of JAMA that not only did circumcision
cure masturbation but also many other childhood illness.  And
prevented cancer, too.  And there were other guys like Ravich and
Wynder doing much the same.  There's a review of Jewish medical
doctors' role in the acceptance of routine circumcision in the US
on the web at:

 http://www.fathermag.com/health/circ/jews-circ

It's not scientifically up to par, but it has the names and the
cites.  Nor is it particularly an antisemitic article, and points out
quite rightly that the circumcision hysteria in the US was a rather
Victorian thing launched circa 1870 mostly by hung-up Christians as a
way to cure masturbation, to which Jews were said to be immune, and
therefore morally superior.  Jews naturally got caught up in this
argument.  The role of Jewish physicians in defending routine
circumcision has not been sole, or even (in the beginning) important.
It has been mainly in the last 70 years, corresponding with Jewish
influence on American Medical politics. However, the opinion has become
professionally untenable at least since the American Academy of
Pediatrics came out against routine circumcision in the 1971
(following which Benjamin Spock changed his mind and his book,
regarding the subject). A view reaffirmed by the American Academy just
as strongly in their house mag _Pediatrics_, as late as last month.

    But don't take my word for it.  Go to medline and see who's
still arguing what among the professionals who lead the opinions
to which doctors adhere, and recommend to their patients.  You'll
find stuff like Aaron J. Fink's "In defense of circumcision"
(Pediatrics 1986 Feb;77(2):265-7) and little editorials like E.J.
Schoen's 'Ode to the circumcised male' (Am J Dis Child 1987
Feb;141(2): 128).  Indeed, my own initial search on the history
of circumcision in the US turned up just four reviews-- I didn't
weed them out of other stuff, but reproduce all four of them in
full below.  Note the opinions expressed: "The medical benefits
of circumcision appear to exceed the risks of the procedure," and
in another: "It is our conclusion that, as the safest and most
commonly performed surgical procedure in this country, the
benefits of posthetomy, which include a reduction in some kinds
of cancer and sexually transmitted diseases, well outweigh the
risks cited by those who oppose it." And: "The authors of this
article wrote a review article on circumcision in 1981 and Dr.
Grossman has recently published a book designed to teach proper
circumcision technique, and to familiarize the operator with the
common congenital anomalies as well as the prevention and
treatment of the complications of circumcision."

   These are articles written for scientific publications by
doctors who supposedly are scientists.  Alas, if you look at the
names, one can guess that they aren't exactly Japanese or Eskimo
or native American scientists.  But these ARE the physicians now
leading the minority argument.  If you want the other side-- the
view now accepted by most of the world's medical profession, you
can see articles by guys whose names are Gordon A (Br J Obstet
Gynaecol 1995 Dec;102(12):939-40) "Why do we still circumcise
male babies?" or McHugh M (Ir Med J 1981 Feb;74(2):
55-6) "Circumcision -- is it ever necessary?" or even Fitzgerald
WD (Northwest Med 1971 Oct;70(10):681-2) "Circumcision is
barbarous."  There's a difference between doctors arguing a point
that their religion teaches, and those arguing against a
procedure on which their religion is at least neutral or even
favorable.

   Anyway, you're welcome to read this stuff.  Study it and then
tell me I'm out to lunch.

                                  Steve Harris, M.D.


[Present Consensus by the American Academy of Pediatrics]

Pediatrics 1999 Mar;103(3):686-93
Circumcision policy statement.
[Medline record in process]

Existing scientific evidence demonstrates potential medical
benefits of newborn male circumcision; however, these data are
not sufficient to recommend routine neonatal circumcision. In
circumstances in which there are potential benefits and risks,
yet the procedure is not essential to the child's current
well-being, parents should determine what is in the best interest
of the child. To make an informed choice, parents of all male
infants should be given accurate and unbiased information and be
provided the opportunity to discuss this decision. If a decision
for circumcision is made, procedural analgesia should be
provided.

----------------------------------------------------------

The opposition:


Urol Clin North Am 1995 Feb;22(1):57-65
Neonatal circumcision.
Niku SD, Stock JA, Kaplan GW

Division of Urology, University of California, San Diego Medical
Center.

Circumcision remains the most common operation performed in males
in the United States. When performed by an experienced operator,
circumcision is usually a safe and simple operation. The medical
benefits of circumcision appear toexceed the risks of the
procedure. The history, embryology, indications, techniques, and
complications of neonatal circumcision are discussed.

Publication Types:
  Review, tutorial

----------

Clin Pediatr (Phila) 1994 Dec;33(12):726-30
A perspective on controversies over neonatal circumcision.
Weiss GN, Weiss EB

North Little Rock Veterans Administration Medical Center,
Arkansas.

Controversy continues to surround the issue of male circumcision,
especially in the United States. The following report reviews the
history of this practice, along with the medical and sociopoliti-
cal positions currently espoused.  It is our conclusion that, as
the safest and most commonly performed surgical procedure in this
country, the benefits of posthetomy, which include a reduction in
some kinds of cancer and sexually transmitted diseases, well
outweigh the risks cited by those who oppose it.

Publication Types:
  Historical article


Comments:
Comment in: Clin Pediatr (Phila) 1995 Jul;34(7):395-6; discussion
398-9
Comment in: Clin Pediatr (Phila) 1995 Jul;34(7):396-7; discussion
398-9


----------

J Natl Cancer Inst 1993 Jan 6;85(1):19-24
History of circumcision, medical conditions, and sexual activity
and risk of penile cancer.

Maden C, Sherman KJ, Beckmann AM, Hislop TG, Teh CZ, Ashley RL,
Daling JR

Division of Public Health Sciences, Fred Hutchinson Cancer
Research Center, Seattle, Wash.

BACKGROUND: Epidemiological evidence suggests lack of neonatal
circumcision as the strongest risk factor for penile cancer, but
the role of sexually transmitted diseases in the etiology of
penile cancer has remained unclear. PURPOSE: To further clarify
risk factors for penile cancer, we examined the role of circum-
cision, personal characteristics and habits (such as smoking),
sexually transmitted diseases, past sexual activity, and medical
conditions of the penis. METHODS: A population-based, case-contr-
ol study was conducted in western Washington state and in the
province of British Columbia. We interviewed 110 men with penile
cancer diagnosed from January 1979 to July 1990 and 355 control
subjects from the general population, frequency matched to case
subjects on age and date of diagnosis. Tumor tissue from 67 case
subjects was tested for human papillomavirus (HPV) DNA by
polymerase chain reaction. Results of blood tests from 69 case
subjects and 208 control subjects were available for study.
STATISTICALLY SIGNIFICANT RESULTS: Relative to men circumcised at
birth, the risk for penile cancer was 3.2 times greater among men
who were never circumcised and 3.0 times greater among men who
were circumcised after the neonatal period. For current smokers,
the risk was 2.8 times that of men who never smoked. The risk
among men reporting a history of genital warts was 5.9 times that
of men reporting no such history. Of 67 tumors tested for HPV
DNA, 49% were positive; the majority of these positive tumors
(70%) were type 16, which has been associated with anogenital
carcinoma. Relative risks (RRs) associated with a reported
history of penile rash or penile tear were 9.4 and 3.9, respec-
tively. Among men not circumcised at birth, RRs associated with
presence of smegma and difficulty in retracting the foreskin were
2.1 and 3.5, respectively. Twenty-eight percent of case subjects,
compared with only 10% of control subjects, reported 30 or more
sexual partners, and men with HPV-positive tumors were more
likely to report a greater number of sexual partners. CONCLUSIO-
NS: These results suggest that the absence of neonatal circumcis-
ion and potential resulting complications are associated with
penile cancer. Additionally, medical conditions of the penis,
sexual activity, infection with HPV, and smoking may increase the
risk for penile cancer. IMPLICATIONS: A larger study would allow
examination of interrelationships of circumcision, infection with
HPV, and smoking as risk factors.

Comments:
  Comment in: J Natl Cancer Inst 1993 Aug 4;85(15):1251

PMID: 8380060, UI: 93095139

----------

Obstet Gynecol Annu 1984;13:181-95
The circumcision controversy: an update.
Grossman EA, Posner NA

One constructive feature has come out of all of the circumcision
controversy. It has made us aware that neonatal circumcision is
not a simple procedure and that it should not be regarded as
"routine." It is a surgical procedure and it should be taught as
one. The authors of this article wrote a review article on
circumcision in 1981 and Dr. Grossman has recently published a
book designed to teach proper circumcision technique, and to
familiarize the operator with the common congenital anomalies as
well as the prevention and treatment of the complications of
circumcision. The advocacy of neonatal circumcision cannot be
considered as a cut and dried issue. For some, it has an absolute
religious indication, which transcends current medical logic. For
others the available facts still allow for a decision based on
one's perception of those facts. If one has the perception that
there is value in improving local hygiene, or that the loss of
the prepuce will allow for an earlier discovery of a penile
lesion, or that circumcision actually does cause a decrease in
the incidence of penile or cervical cancer, or group conformity
is important, then one might well advocate neonatal circumcision.
If, however, one sees the potential values as insignificant in
light of the lack of hard data relating circumcision to penile
or cervical cancer, and that if one is concerned with the "rape
of the phallus," then one is against routine neonatal circumcisi-
on. But, this individual must be aware that a small percentage of
males will need a circumcision at a later time in life, when
technical and psychological problems may lead to an increased
morbidity. The decision of the physician, and the advice given to
the new parents, at present, appears to be more subjective than
the advice concerning RhoGAM, or DPT immunization, although it
occasionally is given with as much certainty. We are dealing with
the art of medicine rather than science. On this basis, rather
than deride each other for positions taken, and religious
considerations aside, we would do much better to develop better
scientific studies to answer the scientific questions. Today's
tendency to make decisions on evaluation of the risk:benefit
ratio is clearly difficult if both are not adequately quantitat-
ed. Until these are available the decision of whether or not to
circumcise must result from an objective discussion between
the doctor and the parents of newborn males.

Publication Types:
  Historical article;  Review

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: alt.atheism,alt.parenting.solutions,misc.kids.pregnancy,sci.med,
	rec.travel.air,alt.circumcision,sci.med.nursing
Subject: Re: Terrified of EPISIOTOMY!
Date: 12 May 1999 08:04:55 GMT

In <7haeb8$d3e$1@plonk.apk.net> kicker@apk.net (Starlight) writes:
>
>Norma Anderson (shmily@msn.com) wrote:
>
>: I feel so sorry for circumcised boys, they will miss out on so much.
>
>I know I'm probably going to regret asking this but, exactly what are they
>going to miss out on?  And how would you, as a female, truly know what
>they are missing out on?  Everything you know about it is strictly
>heresay.
>Becky
>harmony@apk.net



   And there are a huge number of men circumsized in adulthood whose
testimony we have about exactly what it does to sexual performance and
sensation.  In WWII, for example, it was quite common to require
circumcision of all Navy recruits reporting for tropical duty.  Since a
lot of men didn't really want to be infantry taking Iwo Jima, a lot of
them signed up to be swabbies, and got snipped.  Overall, the general
opinion was that after an initial period of hypersensitivity, it didn't
make a nickel's worth of difference.  Had it been otherwise, you can
bet that WWII would have had a lot more infantry.  Word leaks about
that kind of thing, don't you know.   There are limits to what a man is
willing to give up for his country.