Talk:Circumcision/Archive 51

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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))

'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)

I oppose this edit by Jayjg, which removed two comments of Blackworm's from this talk page, apparently without Blackworm's approval. ☺ Coppertwig (talk) 15:52, 31 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)

No. Perhaps I should have been more clear: Some view "circumcision" as a euphemism for cutting off parts of genitals, or "genital reduction surgery or genital mutilation performed on children who, by definition are not able to give informed consent."([28]) (Note the absence of "male" or "female" qualifiers.) If, as the IP user notes, "removed" is a euphemism, then the topic title, viewed as a euphemism by some (see link), is indeed being defined in terms of another euphemism. I view my role here as helping to define, describe, and present the topic without the need for secrecy and euphemism -- and yes I accept that this is a very difficult role. Blackworm (talk) 20:17, 3 November 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)

Status of dispute according to Blackworm

Jayjg, Avraham, and Jakew support this edit, which is disputed by Blackworm and others. Note that the slightly different current version as of this writing[29] is also disputed on the same grounds by Blackworm. (To editors named below: if you feel any misrepresentation of your support of opposition in the comments that follow the argument points, please strike your name (and only your name) out using <s>your name</s>, or inform me and I will strike your name out or make another mutually agreed upon edit.)

Blackworm's understanding of the supporting rationale:

• The term "severed" in the context of this edit ("...severed foreskin...") is a pleonasm, i.e., a redundant addition. (Argued by Jayjg, Avraham, and Jakew. Disputed by Blackworm and Coppertwig. The latter view that having no adjective does introduce ambiguity, even if the ambiguity is resolved later, and that this is poor editorial style. Blackworm additionally argues that the phrase Blackworm replaced, "circumcised foreskin," also suffers from this ambiguity, which was the reason for Blackworm's changing it to "severed foreskin," and argues that Avraham's edit replacing "severed foreskin" with "removed foreskin" was inappropriate, claiming that the former is at least as neutral as the latter.)
• "Severed" in the context of this edit is needlessly emotive, and therefore not neutral ("If you insist on pleonasm, it will be a neutral one, and "circumcised" is neutral."[30]), violating WP:NPOV. (Argued by Jayjg, Avraham, and Jakew. Disputed by Blackworm, per precedent and consensus established by Jakew and Avraham: The latter two editors successfully argued that an editor's source-supported claim (the claim against "severed" is not supported by sources) that a term is needlessly emotive is not a strong enough justification for restricting the use of the term in the article. Avraham and Jakew (Blackworm claims) brought this argument in opposing Blackworm's suggested restriction against using the term "uncircumcised" to describe men and penises in the article, in favour of "not circumcised," "non-circumcised," or other more appropriate terminology. (Reliable sources indicate "uncircumcised" has the meanings "spiritually impure: heathen"(Merr.-Webst.) and "not Jewish, not Christian"(Amer.Heritage Dict.)) Blackworm yielded in that dispute, and since silence implies consensus, "uncircumcised" continues to be used in this article. Coppertwig also appears to dispute this point that "severed" is not neutral, describing the term "severed" in this context as having a "neutral, medical-sounding tone [...]."[31] Tremello22 appears to dispute this point ("Avi, you are claiming "severed" is non-neutral when it isn't.").[32] Garycompugeek appears to dispute this point ("Wiktionary [defines] 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.").[33] Blackworm (talk) 09:25, 31 October 2008 (UTC)

US Policies

Recent edits to the US policies section are problematic.

The text "The American Medical Association defines “non-therapeutic” circumcision as the non-religious, non-ritualistic, not medically necessary, elective circumcision of male newborns. It states that medical associations in the US, United Kingdom, Australia, and Canada do not recommend the routine non-therapeutic circumcision of newborns." has been removed for no obvious reason.

The text "The American Medical Association does not recommend non-threapeutic circumcision and supports the AAP's 1999 circumcision policy statement." has been added to the article. There are two obvious problems: "therapeutic" is misspelled and the word "routine" has been omitted. Also, the preceding paragraph ends: "The American Medical Association echoes the 1999 Circumcision Policy Statement of the American Academy of Pediatrics", so the addition is largely redundant.

An additional problem, which existed before the edits were made, can also be found here. It involves the text "The medical harms or benefits of non-threapeutic have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly." The source cited is this, which a) fails to support the statement, b) isn't a US policy statement, and c) doesn't even mention a US policy statement. Its presence is thus somewhat perplexing. Jakew (talk) 21:31, 1 November 2008 (UTC)

I agree that sentence serves no relevance and may be removed Jake. As for the edits in gerneral I feel they reflect the source clearer and more accurately, spelling aside of course :P Garycompugeek (talk) 21:40, 1 November 2008 (UTC)

Replaced first sentence inadvertantly removed, removed redundancy plus removed last sentence. Garycompugeek (talk) 14:59, 2 November 2008 (UTC)

Keratin and Langerhans cells

Relevant discussion at

→ Paring back the WHO info, ROUND II (near end of thread)

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)

PLEASE PLEASE PLEASE LOOK AT NON-ANGLOPHONE SOURCES THAT IDENTIFY THE NECESSARY IMMUNE FUNCTION OF LANGERHANS CELLS THAT ABSORB AND KILL HIV. CIRCUMRAPE REMOVES A VITAL PART OF THE IMMUNE SYSTEM.Brit Pariah (talk) 06:19, 13 November 2008 (UTC)

It would be helpful if you would give us references to particular sources. If you can read them, maybe you could give us quotes and translate the quotes into English for us. I can only read a few languages.

Maybe Langerhans cells kill some HIV; but I think Langerhans cells are also invaded by HIV, and the HIV live and grow in those cells. So the situation is complex. ☺Coppertwig(talk) 03:10, 15 November 2008 (UTC)

Pornographic photos of penises

Understanding that Wikipedia is not censored, I see no reason why we have to include real photos of a man's penis when we could just as easily show what the picture shows through sketches. Wikipedia, because of the vast amount of people who refer to it, should not cater to everyone's coarse desires. I would not want my wife or girlfriend looking at those pictures. We need to improve and be more respectful. —Preceding unsigned comment added by 140.180.51.212 (talk • contribs) 22:50, 16 November 2008

Maybe sketches would be OK, or maybe photographs are better; but at least we have to have either sketches or photographs, or else the information isn't being presented. So please don't remove the photographs without at least putting sketches in their place. ☺Coppertwig(talk) 23:18, 16 November 2008 (UTC)

Wikipedia is not censored. The photos are appropriate. Blackworm (talk) 22:22, 26 November 2008 (UTC)

Miscellaneous comments

I've made a number of small edits to the article. Here are some other possible changes for discussion:

Arbitrary subsection 1

• Article size: When editing the page, a note at the top says, "This page is 140 kilobytes long. It may be appropriate to split this article into smaller, more specific articles. See Wikipedia:Article size."
• In the procedures section it says "The device is then placed (this sometimes requires a dorsal slit) and remains there until bleeding has stopped." I think "bleeding has stopped" is the wrong phrase. In the source it says "hemostasis". I think in this context it means that blood flow to the tissue has stopped. I suggest changing it to "until blood flow has stopped"; or if we're not sure what it means, then changing it to "hemostasis" as in the source.
• I suggest deleting this part from the "cultures and religion" section, since it's material more relevant in the "prevalence" section: "Circumcision is most prevalent in the Muslim world, parts of South East Asia, Africa, the United States, The Philippines, Israel, and South Korea. It is relatively rare in Europe, Latin America, parts of Southern Africa, and most of Asia and Oceania."
• This doesn't sound NPOV to me: "While endorsing circumcision for males, scholars note that it is not a requirement for converting to Islam": all scholars endorse circumcision? Should it say "Islamic scholars" or something? ☺Coppertwig(talk) 00:32, 2 November 2008 (UTC)

  I'm changing it to "blood flow has stopped", and I'm also removing the link to hemostasis. I think hemostasis here means "the stoppage of the circulation of blood in a part of the body", definition 2 here, whereas the hemostasis page deals only with definition 1.

  Prevalence: I'm moving this to the prevalence section (after the 2nd sentence); but it seems unsourced, may be redundant with information already in the prevalence section and should perhaps be deleted.

  I'm inserting "Islamic". ☺Coppertwig(talk) 15:33, 6 December 2008 (UTC)

Arbitrary subsection 2

• Re "Obstetricians used anaesthesia significantly less often (25%)": I skimmed the study and found the 25% figure mentioned twice, but I didn't find it saying anywhere that this result was statistically significant. Is anyone else more familiar with this study able to pinpoint where it says that? Otherwise perhaps we need to change the wording. I suspect it may be wrong, because it's wrong in another way: it was 25% of obstetricians who responded to the survey, not 25% of obstetricians (in the whole world) as the article seemed to say (I'm just changing it).
• Re "A 2006 follow-up study revealed that the percentage of programs that taught circumcision and also taught administration of topical or local anesthetic had increased to 97%." Is this really what the source says, or does it say that of those that taught circumcision, 97% also taught anesthetic?
• Pain section: Isn't there a source somewhere stating that in addition to pain relief during the operation, pain relief during healing over the following few days should also be used? If so, that should be added; if the opinions that it's relatively painless are included then the opinions of pain-relief advocates should also be included. The section heading might need to be changed to just "Pain and pain relief" rather than "Pain and pain relief during circumcision". If changing a section heading, it's a good idea to insert <span id="Pain and pain relief during circumcision" />
• "a causal relationship between lack of circumcision and HIV," I suggest changing to "a causal relationship between circumcision and reduced rate of HIV acquisition"; it sounds more logical and NPOV to me It's harder to visualize how a non-act can cause something, and "lack of circumcision" makes it sound as if circumcision is the norm.☺Coppertwig(talk) 00:32, 2 November 2008 (UTC)

  Re Obstetricians: I'm deleting "significantly."

  Pain relief and 2006 followup study still need to be addressed.☺Coppertwig(talk) 15:33, 6 December 2008 (UTC)

Arbitrary subsection 3

• Millet et al study says among other things: " Male circumcision had a protective association with HIV in studies of MSM conducted before the introduction of highly active antiretroviral therapy (odds ratio, 0.47; 95% confidence interval, 0.32-0.69; k = 3)." Our article citing it: "A meta-analysis of data from fifteen observational studies of men who have sex with men found insufficient evidence of a protective effect of circumcision; the authors recommended further investigation." doesn't seem an accurate summary to me. How about "A meta-analysis of data from fifteen observational studies of men who have sex with men found insufficient evidence of a protective effect of circumcision in the pooled data, but indications of a protective effect from data before the introduction of highly active anti-retroviral therapy; the authors recommended further investigation."
• I suggest shortening the HPV section. I'm not aware of any reason to give it that much weight in comparison to HIV and other infections.
• "In a cross-sectional study of 398 patients, Fakjian et al. reported that balanitis was diagnosed in 12.5% of uncircumcised men and 2.3% of circumcised men." I'm not sure if I have easy access to this study. Is the study claiming that 12.5% of the men who were not circumcised among the 398 patients they studied had a diagnosis of balanitis, or are they claiming that 12.5% of the general population of men who are not circumcised have diagnoses of balanitis? (worldwide?) The way it's stated in the article sounds like the latter to me, but the number of significant digits is unbelievable in that case, so I suspect the study means the former, in which case we need to reword it, perhaps by inserting "the" before "uncircumcised" and again before "circumcised".
• The first mention of urinary tract infections is in the Complications from circumcision section, and seems to imply that circumcision may lead to a higher rate of UTIs. Several sections later is the Urinary tract infections section, which seems to imply strongly that circumcision lowers the rate of UTIs. Perhaps these two sections could be moved closer together, or the sections could each mention the other ("see also"), or something else done to help resolve this apparent discrepancy. ☺Coppertwig(talk) 00:32, 2 November 2008 (UTC)

Good points, Coppertwig. I agree with your proposals regarding Millett and Fakjian.

Regarding HPV, I would certainly agree with shortening the material. I don't think it's necessary to directly discuss the HPV primary sources in this article, given that we already discuss two meta-analyses (Van Howe & Castellsague). We could probably just include these. As you mention in another subsection, the size of the article is becoming slightly problematic, and trimming the material would help in this respect. It might be a good idea to examine what other parts of the article can be simplified, too.

I think that the UTI material is potentially confusing, but the underlying problem is that the entire paragraph beginning "Meatal stenosis (a narrowing of the urethral opening)..." is too long and detailed. The final sentence (which mentions UTIs) is about conditions potentially caused by meatal stenosis, which seems an absurd amount of detail since that isn't the subject of this article. I don't think we go into this much detail about any other proposed risk or benefit. It would make sense to remove this paragraph and instead add the words "meatal stenosis" to the paragraph beginning, "Other complications include..." Jakew (talk) 16:10, 2 November 2008 (UTC)

Arbitrary subsection 4

• "Two studies have reported that the rate of penile cancer is 3 to 22 times higher in men who were not circumcised." This seems to imply "higher than the rates mentioned in the previous sentence", which is probably not what is meant.
• "Neonatal circumcision is not considered medically necessary and is therefore categorised as non-therapeutic." Really? In all cases? Hard to believe. Citation needed.
• US policy: As I think Jakew may have pointed out, the last sentence of the 1st paragraph and the 1st sentence of the 2nd paragraph are mutually redundant.
• AMA: I suggest replacing "The American Medical Association does not recommend non-therapeutic circumcision and supports the AAP's 1999 circumcision policy statement." with "The American Medical Association supports the AAP's 1999 circumcision policy statement, which states that while there is evidence for potential benefits, "data are not sufficient to recommend routine neonatal circumcision.""☺Coppertwig(talk) 00:32, 2 November 2008 (UTC)

Re the penile cancer statement, it does need rephrasing. Another problem is that, as written, it implies that exactly two studies have investigated the issue (in fact, several have done so; see medical analysis of circumcision for citations). I would suggest something like "Researchers have reported that the risk of penile cancer is greater in uncircumcised men than in circumcised men; estimates of the relative risk include 3[ref] and 22[ref]."

Re the unsourced "Neonatal circumcision..." sentence, the entire paragraph is somewhat problematic. Consider the previous sentence, which is also unsourced: "Most guidelines make a distinction between therapeutic and non-therapeutic circumcision." Do they? I think we should consider deleting this paragraph, replacing it with some kind of sourced overview. One possibility - while not ideal - is to use the AMA's statement: "Recent policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns."

Re the US policies section, specifically that of the AMA, I would note that this material has been changed slightly. However, since we've described the policy of the AAP in the previous paragraph, it seems rather unnecessary to restate it. Wouldn't it make more sense to simply state that the AMA supports the AAP's statement? It seems to me that we could expand discussion of the AAP in the first paragraph, and still use fewer words overall. Jakew (talk) 16:46, 2 November 2008 (UTC)

Yes and no Jake. On one hand we could remove the first part of the sentence "The American Medical Association does not recommend non-therapeutic circumcision and supports the AAP's 1999 circumcision policy statement." and leave the AMA's support of the AAP statement, but in this case redundancy strengthens the statement's position because another major is supporting it. The reader may only be interested in one particular organizations stance and not forced to read others for conclusion. Garycompugeek (talk) 17:20, 2 November 2008 (UTC)

Coppertwig, what is the rationale behind your suggestion? It seems that it needlessly makes the sentence longer, and only by repeating information already presented. It also makes it sound like the AAP only believes there are benefits, just not enough of them to recommend it; when the phrase they use elsewhere in their conclusion is "there are potential benefits and risks," seemingly indicating that a weighing of such benefits and risks had them arrive at their finding that the data on its benefits is insufficient to recommend it. Blackworm (talk) 22:36, 3 December 2008 (UTC)

I'm trying to make it more accurate. "The American Medical Association does not recommend non-therapeutic circumcision" sounds as if it could be interpreted to mean they recommend against it. I don't think they say anything along the lines of "We do not recommend non-therapeutic circumcision". Making a statement about what is missing from a source seems to me to be OR. Can you think of other suggested wordings? ☺Coppertwig(talk) 23:21, 3 December 2008 (UTC)

The source is crystal clear Coppertwig. They do not recommend non-therapeutic circumcision and supports the AAP's 1999 circumcision policy statement which does not recommend circumcision. Garycompugeek (talk) 23:33, 3 December 2008 (UTC)

It seems to me that it follows that if they state (or agree) that the data are insufficient to recommend circumcision, then they do not recommend male circumcision. The problem I think you're talking about is how "not recommending" is often (but not always) used to mean "recommend against" -- however we do not know which meaning the AAP/AMA intend here (hypothetically it's possible that they do in fact recommend against it, but are intentionally or unintentionally unclear on that, for example). Thus, due to this lack of clarity in meaning, it is best to summarize their statement with minimal editorializing. How about: "The American Medical Association agree with the AAP that data are insufficient to recommend non-therapeutic circumcision." That seems to be very close to the source, short, and leaves open whether they are neutral to the procedure or (perhaps secretly or vaguely) recommend against it. Blackworm (talk) 06:30, 4 December 2008 (UTC)

I agree with Coppertwig. Saying "does not recommend non-therapeutic circumcision" is apparently OR, and without the context provided in the original document it may potentially mislead. Their actual policy statement is somewhat more complex and subtle than that. The AMA themselves express it by reference to the AAP's policy ("The AMA supports the general principles of the 1999 Circumcision Policy Statement of the American Academy of Pediatrics..."). Once again, it seems that the sensible approach is to simply state that the AMA supports the AAP's policy statement, which is after all discussed in the preceding paragraph. Certainly the current explanation of the AAP's policy is inadequate, and suffers from the same problems that Coppertwig highlighted, but to my mind it seems that the solution is to solve this problem once, in the appropriate place, not to try to express what is largely the same information twice, in two consecutive paragraphs. Jakew (talk) 10:36, 4 December 2008 (UTC)

Let's quote their actual policy statement then, as I suggest. How about replacing the AAP and AMA paragraphs with:

The American Academy of Pediatrics (1999) stated: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, 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." The AAP recommends that if parents choose to circumcise, analgesia should be used to reduce pain associated with circumcision. It states that circumcision should only be performed on newborns who are stable and healthy.

The American Medical Association supports the AAP's 1999 circumcision policy statement with regard to non-therapeutic circumcision, which they define as the non-religious, non-ritualistic, not medically necessary, elective circumcision of male newborns. They state that "policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns."

Blackworm (talk) 18:44, 4 December 2008 (UTC)

Sure that is accurate (can't get more accurate than quoting the source) Blackworm, but for simplification, I think people typically only want to know if X medical association recommends circumcision or not. Garycompugeek (talk) 20:53, 4 December 2008 (UTC)

It may be too long and put undue weight on U.S. organizations. Other than that, at the moment I don't see any problem with it. No strong objection. ☺Coppertwig(talk) 02:05, 5 December 2008 (UTC)

Likewise, I think it's ok, and I've implemented the change. Jakew (talk) 12:08, 5 December 2008 (UTC)

(sigh) I'm still not convinced it was necessary (considering article size and above arguments) but I have no strong objection to quoting the source directly. Garycompugeek (talk) 14:12, 5 December 2008 (UTC)

Re penile cancer: I used Jakew's wording, adjusted slightly to reflect the categories of circumcision status described in the sources.☺Coppertwig(talk) 15:33, 6 December 2008 (UTC)

Arbitrary subsection 5

• "The medical harms or benefits of non-therapeutic circumcision have not been unequivocally proven": this statement seems non-NPOV to me, as well as not being supported by the given source, and, as Jakew pointed out, is not about U.S. policy. In addition, it's a news source; these tend not to be very reliable for medical information.
• I'm just noting this here for future reference: "The 1989 statement by the Academy reversed a long-standing opinion that medical indications for routine circumcision were lacking." from the AMA "Report 10 of the Council on Scientific Affairs (I-99):Neonatal Circumcision".
• The link to the American Urological Association website for document "Circumcision" doesn't work; I looked at their site map and got the impression they no longer have such a page.
• "Circumcision in the English-speaking world": why do we have such a section? Is this undue weight? Within the section, is too much weight given to U.S. information? I suggest shortening this section; the detailed information can be provided in a subpage (presumably History of male circumcision). Some of the material in this section might be more appropriate in the Prevalence of circumcision section.
• "Map published by the United Nations": Is this the same map as the one published by the United Nations, or has it been redrawn by Emilfaro? Who owns the copyright?

☺Coppertwig(talk) 00:32, 2 November 2008 (UTC)

I've fixed the link for the AUA's policy. It seems that they've reorganised their site recently: previously there was a page containing a number of policies (possibly all of their policies), whereas now they seem to have a page per policy.

Re the English-speaking world, the coverage certainly seems rather Anglo-centric. I'm not sure whether this is undue weight; it may simply reflect the coverage in available sources. I think there's a certain amount of overlap between the 'prevalence' and 'history' sections, especially with older prevalence data. It does seem as though too much weight is given to US info, and I would be in favour of shortening the material.

Re the map, the description is inaccurate. This isn't the same map, and describing it as such is misleading. It's also unnecessary to cite the sources used by the source we cite (and doing so misses the point of secondary sources, I think). I would suggest rephrasing to something like: "Map showing percentage of males who have been circumcised at country level. Based upon United Nations (WHO/UNAIDS) publication." Jakew (talk) 17:20, 2 November 2008 (UTC)

Thanks for all your comments, and for fixing that link, Jake.

Re "The medical harms and benefits": this sentence is no longer there, so that's fine.☺Coppertwig(talk) 15:33, 6 December 2008 (UTC)