CDC stats....Does anyone wonder?

[Anastasiya]

I have this sneaking suspicion that the reason the CDC stats on circumcised boys is so low is so that, once the AAP and CDC and whoever else come out with the new data supporting it, it will look like the rates will skyrocket and therefore convince the multitudes that circumcision is, in fact, good.

How will they do this? By keeping it to themselves that the low data was, in fact, an error, and then publishing the "new" data which may very well be the true numbers, but to everyone else will look like the percentages just increased.

Does this make any sense?

I'm hoping this is not the case, and that the stats are correct.

I'm also hoping that IF they do come out with new recommendations, the majority will realize that it's a load of crap and the organizations will look ridiculous.

[Anastasiya]

Guess I'm the only skeptic, huh?

[dmpmercury]

At first I was happy to hear the stats but as you look closer into it it looks like they could be making them look really low to sound alarm bells and to use their bogus HIV and no complication studies to try to get the AAP stance to change and to get insurance to cover it again. I believe rates are going down but I think it is overstated.

[PlainandTall]

I would not assign any motive to those numbers as they were never released in any sort of official fanfare to the masses by the CDC- in fact- the release of those numbers was the result of some determined pushiness from a grassroots place. The number was presented in a powerpoint. In a stroke of brilliance- perhaps their own disbelief because these numbers had never been announced anywhere and any intactivist would be well aware of that- this person caught a photo of the powerpoint screen before it vanished. That photo- as far as I know- is the only evidence, that this number (regardless of its veracity) was ever disclosed even to a very tiny specific and elite audience. This photo, not the statistics, but the photograph of the statistic being used in a powerpoint, became the news story. This news story was then carried by the New York Times and grew a life of its own... at that point the photograph as headline faded and was replaced by the statistic. Other news sources now neglect the original source (the photo) and now cite the New York Times as the source of the statistical release. The CDC remains oddly silent.

[Anastasiya]

Originally Posted by PlainandTall

I would not assign any motive to those numbers as they were never released in any sort of official fanfare to the masses by the CDC- in fact- the release of those numbers was the result of some determined pushiness from a grassroots place. The number was presented in a powerpoint. In a stroke of brilliance- perhaps their own disbelief because these numbers had never been announced anywhere and any intactivist would be well aware of that- this person caught a photo of the powerpoint screen before it vanished. That photo- as far as I know- is the only evidence, that this number (regardless of its veracity) was ever disclosed even to a very tiny specific and elite audience. This photo, not the statistics, but the photograph of the statistic being used in a powerpoint, became the news story. This news story was then carried by the New York Times and grew a life of its own... at that point the photograph as headline faded and was replaced by the statistic. Other news sources now neglect the original source (the photo) and now cite the New York Times as the source of the statistical release. The CDC remains oddly silent.

Interesting. Thanks for the info!

[Pirogi]

I dunno. Maybe it's my tinfoil hat tendencies, but that seems a little too convenient. Does anyone actually know the person who captured the ppt in the photo? Is that person actually an intactivist? Seems like a convenient way for the CDC to release the info without actually having to release it officially. That way, the right group of people can use it to sway public opinion. The CDC doesn't have to be responsible for the number, in case it was an "error," but the powers that be can use it to further an agenda. Since when has the NYT been anti-circ? Why would they even care if some random person took a picture of the CDC ppt slide? How did that make it into the newspaper? It all seems fishy to me.

[brant31]

The only photos of the CDC Powerpoint presentation that I have seen came from my friend "B". We split up tasks in Vienna; he went to the CDC presentation and I went to the WHO presentation. We each took photos of just about all the slides they put up.

There were no handouts in either presentation.

It was IntactAmerica that actually alerted the NYT about the CDC's figures.

I have no inside information about what the CDC intends to do with the figures, though the briefing I got immediately afterward suggested the data were presented with an air of "The US is moving rapidly into undesirable territory here; some factors are leading too many parents to make an irresponsible choice. Maybe they need more education from their doctors or greater financial access to circumcision. We're going to look into it."

As has been noted, the circumcision figures were presented not as absolutes but to show trending. The presentation was ostensibly about AEs (adverse outcomes of circumcision).

[Pumpkinheadmommy]

My sneaking suspicion is that the CDC is remaining 'oddly silent' on this is because if they speak out they would have to admit they were trying to mislead people in their presentation.

[eepster]

I would say, that basically the stat is what it is. It's accuracy is undoubtedly a bit off do to collection method (it misses out of hospital circs, it may count automatically billed circs that weren't actually preformed, it says nothing about babies born out side hospitals, etc) but everyone knows and accepts that.

The stat is the stat. This particular stat isn't even all that cookable (if you are interested in how to cook stats, read this book How to Lie With Statistics.)

The creativity here is in what you do with that stat. This is called spin. The CDC had this stat. Some how or another is got out (I'm inclined to go with brant31's version since he seems to have some first person knowledge of how it got out.) Once it was out, there was no putting it away again. At this point the only thing to do is to try to use it. This is why the CDC is now using it to be alarmist and try to get more insurance coverage.

[vachi73]

Believe me, I am as much a conspiracy theorist as the next person, but in this case, I don't think there was any direct intent to (a) release the numbers to the greater public, nor (b) skew them in a specific direction for a specific purpose.

Would someone clarify for me the difference between the 32-ish% circ rate reported for a single year and the 43% circ rate reported elsewhere? I know there are two sources, but I can't recall which is which.

FWIW, I think the "true" rate is somewhere between 45-50% by 6 months of age. I wish the 32% were right, and that the downward trend were accurate, but I think what we might be seeing is actually a change in venue for circ (e.g., pediatrician's office, ped urologist, mohel) not so much not doing circ at all.

For goodness sake, we live in Colorado, and I know literally three other boys under 6 who weren't cut. Almost every kid my boys play with was circ'd, even one of them as an 11-month-old adopted from abroad (that one is a whole different, sad, sickening story that I'll skip for now). I would say that, in my experience, the circ rate here is more like 90%+.

[eepster]

Originally Posted by vachi73

For goodness sake, we live in Colorado, and I know literally three other boys under 6 who weren't cut. Almost every kid my boys play with was circ'd, even one of them as an 11-month-old adopted from abroad (that one is a whole different, sad, sickening story that I'll skip for now). I would say that, in my experience, the circ rate here is more like 90%+.

Even if the rate in Colorado is 90%+ (I think that is probably not accurate) it only has a population of about 5 million people (1.59% of the total us population.) In comparison, California, with it's very low circ rate, has almost 37 million people (7 times the population of Colorado.)

When you average them together, CO's high rate doesn't do much to off set CA's low rate.

[tennisdude23]

Originally Posted by vachi73

Believe me, I am as much a conspiracy theorist as the next person, but in this case, I don't think there was any direct intent to (a) release the numbers to the greater public, nor (b) skew them in a specific direction for a specific purpose.

Would someone clarify for me the difference between the 32-ish% circ rate reported for a single year and the 43% circ rate reported elsewhere? I know there are two sources, but I can't recall which is which.

FWIW, I think the "true" rate is somewhere between 45-50% by 6 months of age. I wish the 32% were right, and that the downward trend were accurate, but I think what we might be seeing is actually a change in venue for circ (e.g., pediatrician's office, ped urologist, mohel) not so much not doing circ at all.

For goodness sake, we live in Colorado, and I know literally three other boys under 6 who weren't cut. Almost every kid my boys play with was circ'd, even one of them as an 11-month-old adopted from abroad (that one is a whole different, sad, sickening story that I'll skip for now). I would say that, in my experience, the circ rate here is more like 90%+.

I always find it interesting when people say things like this. Although you may feel that the rate is 90% + based on the people you are in contact with, statistically this is not an accurate sample whatsoever and don't think of it as reflective of the actual rates, which in fact are much lower. Circumcision rates really vary from hospital to hospital, community to community, etc. The fact that you know three intact kids is a sign that the times are changing.

[brant31]

It's also my experience that a lot of parents who choose not to circumcise are quieter about the subject than many who have circumcised. This may be for several reasons; first, rightly or wrongly circumcision is still perceived as the norm and many parents don't want to draw attention to their different choices. Second, keeping your child intact is inherently respectful of his body and his privacy, implying there is literally nothing to talk about. Related to that is the fact that the "locker room" argument is alive and well, so some parents are choosing circumcision for some arguably very public reasons ("his penis will be seen by others and we want his to conform") and therefore they may be less inhibited about talking about it publicly. And my own weird idea is that many parents who choose circumcision feel a need to bring it up in search of positive reinforcement or normalizing something that on some level they're still not 100% with. I can't count the number of times friends of mine have randomly inserted a comment about their son's circumcision into an unrelated conversation, usually soon after it's taken place. (Well guess what, they're neither shocking me nor getting any reinforcement, positive or negative. I act like they said they just fed their cat to their dog and it's none of my business.)

Just like some intact guys prefer to use a stall rather than a urinal (for reasons you can imagine, and some you might not), I'm sure some parents of intact boys prefer not to change them in public or leave older ones in situations where they have to be undressed with others. So convos and visual experiences have always proved to be notoriously unreliable indicators of true MGC patterns.

[Ron_Low]

Originally Posted by vachi73

Would someone clarify for me the difference between the 32-ish% circ rate reported for a single year and the 43% circ rate reported elsewhere?

Nothing sinister. Both numbers could be derived from the one slide. 43% was the average circumcision rate over the three-year period and 32.5% was the rate for just the most recent year. 32.5% would be the "present" rate. If for some reason the most recent data is lopsided in that the total number of births is a robust number but the circs are undercounted due to billing delays or some similar craziness, then I guess the 43% is the best "present" rate.

But it all just makes no sense. It's not like Oprah went on TV to talk people out of circ. The rate should have continued a gradual decline reflecting our continued painstaking efforts to educate decision makers in all the same ways that had been available in prior years.

[eepster]

Originally Posted by Ron_Low

But it all just makes no sense. It's not like Oprah went on TV to talk people out of circ. The rate should have continued a gradual decline reflecting our continued painstaking efforts to educate decision makers in all the same ways that had been available in prior years.

Things like this often pick up speed as they go and snowball.

I was going to use the 100 monkey story as an explanation, but upon googling for it discovered that a new supernatural version of the story has inexplicably taken over the nice simple explanation of the way social change happens version I've known since highschool (possibly by the 100th monkey effect .)

Anyway... There was always a small % who refused circ, even at the hight of the phenomenon. Once the internet came along, and things like rooming in and staying basically aware of what was happening in the hospital became the norm, sensible parents started to notice what was actually being done to baby boys. More people started to say "no." It was still a pretty small minority, but people would see those baby boys and ask the parents about it. So, some of those who asked that small %, who figured it out themselves, didn't circ either. So in this manner, the small % of nay-sayers grew. It grew gradually and steadily. As the number steadily grew it continued to be that only the people who were willing to go against what was still the norm, were going to actually start doing this weird thing they saw happening and say "no."

Then a funny thing happened, the steady growth had gotten the number up to a certain point, where it suddenly wasn't really about going against the norm anymore. Suddenly, the rate was pretty darn close to 50%, around 45% had become nay-sayers. No it wasn't a majority yet, but it wasn't a very clear minority either anymore. It was very suddenly just enough that it was just a normal possibility. Once 45% of people are doing something, it isn't really weird, is it?

Once some thing becomes normal, that it what it is. You can suddenly talk about it without being embaressed, and you ask yourself questions about it. As we know, there are clear reasons why not circ'ing is better, so as soon as the possibility became open, the vast majority will said no. For many, while not circ'ing was an obvious minority, it was too weird and therefore was just not going to be open to questioning, but as soon as it fell into the realm of normal, and therefore open to questioning, saying "no" suddenly became a no brainer.

So, the sudden switch from slow steady growth over the last couple of decades, to a booming surge of growth over the last 3 years doesn't surprise me at all.

[PlainandTall]

eepster- I think you are right on with that. The mindest of the first 30% of parents who protected their son's genital integrity- will be vastly different from the last 30%. I've long felt that the majority of parents who circumcise are just going with the flow-they are people who don't want to make waves ask difficult questions or stand out. They won't take convincing, they won't have to read about the history of circumcision or consider medical ethics ... they won't have to look into it at all... they can just be told, "Most people don't do that anymore." and they will say, "Oh... OK"

[Arduinna]

People actually choose to circ or not based on rates? That makes no sense to me.

[vachi73]

Thanks for clarifying, Ron. Is that solely hospital discharges or does that include everything in first 28 days of life (and, thereefore, presumably those who are circ at 8 days and those done by pediatricians in the first month)?

I do not think that MOST parents decide on circ based on prevailing stats. That may be a factor, usually the "locker room" argument, but I think that the vast majority of parents who circ never do much research, they just assume it should be done or that baby should "match" dad.

Actually, this would be an interesting question research: which factor was most important in your decision to circ/ not circ your son? I'm sure it has been asked before, but it might help inform the intactivist agenda.

I am a little research-nerdy, though!

[brant31]

Originally Posted by vachi73

Is that solely hospital discharges or does that include everything in first 28 days of life (and, thereefore, presumably those who are circ at 8 days and those done by pediatricians in the first month)?

I think this was covered in another thread... the company the CDC contracted with to get the numbers looked at hospital discharge sheets (notoriously unreliable) and hospital coding of procedures for insurance, up to 28 days from birth. So, no ritual circumcisions and probably few Ped/PedUrol/FP/midwife circumcisions. Also missed all the circumcisions coded under "general maternity procedures" or any other package of services.

[PlainandTall]

I disagree that you can trust what people say to be their true motivation

- I think the fundamental attitude is a herd mentality of a sheep... but not even a sheeple one WANTS to be a sheep... you can't feel PROUD to be a sheep... or be an empowered and enlightened sheep... so while their core guiding morality is to submit to the pressure of the herd- their intellect will NEVER admit that... so we have culturally developed pre-made "cue cards" for the herd to snap up as they stampede through the gate... these are ANY AND ALL excuses to circumcise a baby boy that are NOT EVER applied to baby girls... for example- to reduce STDs, UTI's, risk of infection, avoid the possibility of needing it later when he will remember etc etc.... if these "reasons" were true concerns they would demand that girls also be protected from these issues- or at least that we look into the possibility that female genital reduction surgery could help these "terrible" problems.