Infant circumcision: Evidence, policy, and practice

Wodak, Alex; Ziegler, John B.; Morris, Brian J.

doi:10.1111/jpc.13420

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…A defence by the chair of RACP committee was repudiated . Arguments by another commentator were also criticized . Guidance by the British Medical Association failed to involve a review of the medical literature and thus cannot be relied on .…”

Section: Physical Harmmentioning

confidence: 99%

Critical evaluation of arguments opposing male circumcision: A systematic review

Morris

Moreton²,

Krieger

2019

J Evidence Based Medicine

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Objective To systematically evaluate evidence against male circumcision (MC). Methods We searched PubMed, Google Scholar, EMBASE and Cochrane databases. Results Database searches retrieved 297 publications for inclusion. Bibliographies of these yielded 101 more. After evaluation we found: Claims that MC carries high risk were contradicted by low frequency of adverse events that were virtually all minor and easily treated with complete resolution. Claims that MC causes psychological harm were contradicted by studies finding no such harm. Claims that MC impairs sexual function and pleasure were contradicted by high‐quality studies finding no adverse effect. Claims disputing the medical benefits of MC were contradicted by a large body of high‐quality evidence indicating protection against a wide range of infections, dermatological conditions, and genital cancers in males and the female sexual partners of men. Risk‐benefit analyses reported that benefits exceed risks by 100‐200 to 1. To maximize benefits and minimize risks, the evidence supported early infant MC rather than arguments that the procedure should be delayed until males are old enough to decide for themselves. Claims that MC of minors is unethical were contradicted by balanced evaluations of ethical issues supporting the rights of children to be provided with low‐risk, high‐benefit interventions such as MC for better health. Expert evaluations of case‐law supported the legality of MC of minors. Other data demonstrated that early infant MC is cost‐saving to health systems. Conclusions Arguments opposing MC are supported mostly by low‐quality evidence and opinion, and are contradicted by strong scientific evidence.

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Section: Physical Harmmentioning

confidence: 99%

Critical evaluation of arguments opposing male circumcision: A systematic review

Morris

Moreton²,

Krieger

2019

J Evidence Based Medicine

Self Cite

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show abstract

“…Van Howe takes umbrage at published critiques by numerous researchers concerning his articles and analyses [2] [4]- [15], as well as the published critiques of articles by other MC opponents [16]- [59] misrepresenting and distorting the strong scientific evidence documenting various benefits of MC for prevention of infections and other adverse medical conditions in males. This regrettable approach by MC opponents jeopardizes public health efforts and puts global health and lives at risk.…”

Section: Denialismmentioning

confidence: 99%

Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection

Morris¹,

Barboza²,

Wamai³

et al. 2017

WJA

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Aim: To critically evaluate data and arguments by Van Howe defending his stance opposing male circumcision (MC), in particular his meta-regression analyses evaluating the ability of MC to reduce HIV infection risk in heterosexual populations within and outside Africa. Methods: We performed metaregression analysis of log odds of HIV infection between uncircumcised and circumcised men using a single covariate (MC prevalence) in the meta-regression model involving the metareg package in STATA 13 for 103 populations worldwide and for populations within Africa. The meta-regression of log odds and MC prevalence was fitted to a line, as were empirical Bayes estimates resulting from post-estimation. Results: Our critical evaluation of Van Howe's arguments attempting to undermine the scientific evidence in support of the benefits of MC in protection of men against HIV during heterosexual intercourse, as well as other infections and conditions, together with his use of statistics to support his beliefs, revealed serious flaws, obfuscation and missing data. We therefore performed our own meta-regression analysis using a trivariate model. Doing so revealed that for MC prevalences of 50%, 75% and 100% for general populations within Africa, odds ratios for HIV risk in uncircumcised vs. circumcised men were 1.35, 1.58 and 1.85, respectively. Our meta-regression analysis of data for all countries yielded similar findings. For a general population outside Africa with 100% MC prevalence, OR was 1.5. Van Howe failed to acknowledge that since MC prevalence in US whites (91%) and blacks (76%) exceeds 75% his results support MC having a protective effect in those population groups. Conclusions: The protective effect of MC against How to cite this paper: Morris, B

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Tye & Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*

Bailis¹,

Moreton²,

Krieger³

et al. 2022

ASM

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Tye and Sardi recently reviewed the evidence purporting to implicate male circumcision, especially when performed early in infancy, in psychological problems in men. Here we provide a critical evaluation to determine the veracity of their evidence and claims. Missing from their review were critiques pointing out fundamental flaws in key studies. We argue that psychological stress in some men may be caused by anti-circumcision propaganda telling them that they are victims of "genital mutilation", a term adopted from dissimilar female practices in particular ethnic groups. Sexual dissatisfaction results. We critically discuss claims about foreskin "gliding", the eccentric foreskin-related sexual practice of "docking", and the use of lubricant in masturbation. We further find that a study claiming to show numerous differences in socio-affective processing in men circumcised as neonates stem from statistically flawed and one-sided data that has been misinterpreted, and in fact shows the opposite of the hypothesis that psychological problems in some men can be attributed to the pain of their circumcision as newborns. Importantly, since the brain regions responsible for empathy, namely subcortical gray matter and white matter in frontal and parietal regions, were similar in neonatally circumcised and uncircumcised men, the null hypothesis remains null. In conclusion, we find no compelling evidence to support newborn circumcision pain being responsible for psychological problems in neonatally circumcised men. Men who come to believe that they are victims of their infant circumcision are in actual fact likely victims of false claims perpetrated by activist community groups with trenchant opposition to circumcision.

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Infant circumcision: Evidence, policy, and practice

Cited by 4 publications

References 5 publications

Critical evaluation of arguments opposing male circumcision: A systematic review

Critical evaluation of arguments opposing male circumcision: A systematic review

Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection

Tye & Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*

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Infant circumcision: Evidence, policy, and practice

Cited by 4 publications

References 5 publications

Critical evaluation of arguments opposing male circumcision: A systematic review

Critical evaluation of arguments opposing male circumcision: A systematic review

Expertise and Ideology in Statistical Evaluation of Circumcision for Protection against HIV Infection

Tye &amp; Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*

Contact Info

Product

Resources

About

Tye & Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*