Circ'ing reduces HPV by 28% - Mothering Forums

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#1 of 42 Old 01-11-2011, 11:30 AM - Thread Starter
 
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Could everyone give me input on this article. I am due soon (possibly with a boy) and we have decided definitely either way.....

 

http://www.torontosun.com/life/healthandfitness/2011/01/07/16808171.html

 

 

"Male circumcision has now been shown to decrease HIV, herpes simplex virus-2, and HPV infections and genital ulcer disease in men, and also HPV infection, trichomoniasis, and bacterial vaginosis and genital ulcer disease in their female partners," Wawer's team wrote.

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#2 of 42 Old 01-11-2011, 11:50 AM
 
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It is my opinion that the amount and type of "benefit" from circ related to these STDs varies widely across studies, and that often, researchers pick and choose the examples they want to use to show the benefit they prefer. So I tend to view these claims as suspect, and potentially erroneous.

 

In order to know about these particular claims, you would need to see the actual, scientific article and its references. I would be interested in doing this, but I don't have time right now :)

 

However, the bigger question is this: does male circumcision ERADICATE the risk of these/any STDs? Absolutely NOT. It might lessen the risk of some sorts of transmissions, but it might also increase the risk of others (thinking male to male, male to female, and female to male; then considering each individual virus or disease ... you can see it's a complicated matrix). In truth, even if the "best" risk reductions are accurate (which I doubt they are), transmission occurs to and from circ'd partners too. Your son having been circ'd will NOT eliminate his risk of acquiring or transmitting ANY sexually transmitted disease, period. This is unlike the case in favor of some vaccines, which DO effectively eliminate your child's risk of acquiring a particular disease (but vaccines are a totally different issue, and I'll not sidetrack this thread onto that topic).

 

Circumcision is not preventative for STDs. Abstinence, being faithful, and using condoms -- those are the only ways to truly decrease your son's risk of acquiring or transmitting any STD. Period.

 

In some cases, I believe that those who promote circ for STD prevention do a big disservice -- some circ'd men (and their partners) believe that their risk is less than it truly is. In other words, they feel that the circ was analagous to, say, a polio vaccine. Unfortunately, this is totally, completely wrong, and when they then fail to use condoms consistently/effectively, they transmit STDs.

 

Anecdotally, in the US, ask any woman you know who has HPV about the status of her infecting partner -- I'm betting 80% or more were circ'd. So much for "eliminating" risk. Also anecdotally ... look at STD rates in the US in the 1980s and 1990s, when our circ rates were the highest on the planet other than, maybe, Israel ... and guess what, our STD rates were also sky-high. STDs are an issue of behavior and education, not amputation.

 

Regarding HPV specifically, I believe that all children 9-12 years old will eventually be offered Guardisil (or its equivalent) as a two-stage vaccine. Probably by the time my eldest is 10, which isn't that long. I know that parents feel differently about vaccines, and I"m not here to promote them per se, but if HPV is a significant concern for you, you may have your child (boy OR girl) vaccinated at the appropriate time. Again, amputation of foreskin is not the least-invasive, most-appropriate option -- prevention is.

 

Finally, no matter what we may or may not learn about STD transmission in the next 20 years, your INFANT SON receives no benefit from being circ'd. Even if he is sexually precocious, I figure you have at least 10-12 years before this is in any way even a topic of discussion.

 

Someone else here will be better able to address your individual STD questions, I'm sure. HTH!

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#3 of 42 Old 01-11-2011, 11:53 AM
 
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OK the majority of older men here in the USA are circed and the rate of HIV and HPV here are still high so if circ where are helpful as they are saying wouldnt the rates in the USA be super low? Even if it where to be as they claimed that still dosnt give me the right to alter forever how my ds's body was made to work.
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#4 of 42 Old 01-11-2011, 12:03 PM
 
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I promise I am going away (ha ha), but I'm very curious as to where this particular "study" was carried out -- it doesn't specify in the link. US, Africa, Canada ... where? It sort of implies the US, until the part about "developing countries" and access to HPV vaccines. Hmmm, so is it cheaper to circ than to vaccinate? Sheesh.

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#5 of 42 Old 01-11-2011, 12:27 PM
 
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I will second what was said previously. There is a vaccine available that is more than 90% effective against HPV both boys and girls can get it. Claiming circumcision has any utility against HPV at this point shows intellectual dishonesty. Funny when gardasil was first announced i remember a rash of article asking the ethical question, should girls get a vaccine for the benefit of boys. Remember if girls couldn't get HPV neither could boys.

 

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#6 of 42 Old 01-11-2011, 01:22 PM
 
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Just from a logical standpoint, wouldn't damaged tissue be more likely to increase risk of spreading disease than decreasing it?  My DH is circumcised and has a ring of scar tissue around his penis that will sometimes get chafed and raw. Open wounds increase the rate of transmission of STDs. Of course, not everyone who gets circumcised is going to have those problems, but it's a risk.

 

As for the vaccine Gardasil, it only protects against 4 of the strains of HPV.  There are over 100.

Safe sex is a better option for reducing STDs.

 

DH and I are expecting a boy in April and we plan on leaving him intact. If he wants to be circumcised when he is older and knows about it, we're fine with that.

 


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#7 of 42 Old 01-11-2011, 01:45 PM
 
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These studies were done in Africa on men who were circumcised as adults.  You just can't use those studies to make this kind of broad speculation to circumcising newborn boys in the US (who won't be sexually active for years). 

 

But regardless, it's a very lousy reason to cut off part of a newborn's penis anyway don't you think?  There are all kinds of things you can cut off of the body that would lower the risk of various infections and diseases but of course we don't do that. 

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#8 of 42 Old 01-11-2011, 02:06 PM
 
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#9 of 42 Old 01-11-2011, 03:18 PM
 
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He is still going to have to practice safe sex (abstinence,monogamy or condoms.)  Removing the best part of his penis based on one study today is completely unfair to the man he is going to be 20 years from now.  He may not make the same decision as you may now.

 

When I was pg with my first and still thought of circumcision as normal, I went round and round in my head about all the diseases it was supposed to reduce or prevent.  Then one day it occurred to me that he was going to be born with his foreskin.  There must be a reason for it.  I would be horrified to find out that part of my genitals had been amputated b/c of what doctors thought in 1978.

 


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#10 of 42 Old 01-11-2011, 03:40 PM
 
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He's not going to have sex for at least, oh, 13-18 or so years after he's born, so even if circumcising does help fight off STDs, there's no point in getting it done now. He can wait until he's old enough to weigh which pros and cons matter to him. There are advantages to circumcision being done as an adult (relative to it being done as a baby, I mean), including (a) he is already fully retracted and does not require premature retraction (which is horribly painful by itself) in order to be circ'd (b) his penis is fully grown, so the doctor knows how much skin can be removed without causing him erection problems (c) he won't be wearing diapers and constantly exposing an open wound to urine and feces (d) he will have better access to pain relief (e) he will be old enough to give informed consent, whereas performing cosmetic surgery on the genitals of an infant is a human rights violation. Those should apply to getting it done as a teenager too, if he wants it then.

 

For all you know, he and his future wife will both save themselves for marriage and the risk of STDs will be a moot point all together, while his lack of foreskin causes her sexual pain.

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#11 of 42 Old 01-11-2011, 04:06 PM
 
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Here's a link to the article's summary: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61967-8/fulltext#   I don't think the full text is free.

 

It does not reduce HPV infection by 28%; it appears to reduce HPV infection from 38.7% to 27.8% in this study.  Keep in mind they're dealing with correlations, not causation.  Over a quarter of the women in the experimental group (partner was circ'd) still got HPV--what good did that do them?  I can't comment further on the study's methods without reading the full article, but here's a rough breakdown for you.  If we make the giant assumption that this study is an accurate representation of reality, as a female sexual partner in Uganda your risk of getting HPV is:

 

• 38.7% if your partner is intact

• 27.8% if your partner is circ'd as an adult

[the following are my own approximations]

• low with typical condom use

• close to 0% with perfect condom use

• close to 0% if your partner has his entire penis lopped off

• 0% if you completely abstain from all sexual activity

 

But you're not in Africa, so those first two numbers won't apply to your son's situation anyway.

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#12 of 42 Old 01-11-2011, 04:19 PM
 
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We are leaving sexual health matters up to our children. By the time they are ready to be sexually active, they will know that they can come to us for help staying safe. We will not permanently alter their bodies in any way without their permission for decisions they can make on their own. I have one girl and one boy. Both will be in charge of their sexual health and have parental support and guidance to reduce their chances of getting STDs. Amputating healthy body parts from a newborn is not a part of the plan.

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#13 of 42 Old 01-11-2011, 04:34 PM
 
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The US has the highest rate of STDs of any developed country.  Most men of sexually active age in the US are circumcised (circ rates have been dropping dramatically, but those baby boys have not reached puberty yet.)  Few men in many of the developed countries with much lower rates of STDs are circ'd.

 

In the real world, circ does not protect against STDs.  Condoms (latex not not lambskin,) abstinence and testing protect against STDs.


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#14 of 42 Old 01-11-2011, 06:14 PM
 
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Congrats to you! My little guy is my side kick (the robin to my batman... or something like that, lol) and totally in love with his mommy. I just adore him joy.gif... not to gush or anything...

 

Our much-trusted family doctor, who is from a non-circing culture, not circ'd himself and didn't circ his own son gave me this advice "don't listen to anyone who is trying to give you some medical benefits speech. The numbers just aren't there. All of my friends (from the same culture) are doctors and intact, and none of them has had a problem.  Circumcision doesn't protect from STDS, safe sex and condoms are the only things that do that." My (American) pediatrician tried the HPV statistics on me, and as soon as I mentioned condoms, he got an "I'm stumped" look and tried the locker room argument (which is easily refuted too, but I won't waste time on that here). The argument isn't nearly as strong as you might imagine from the way it is used in American culture. I felt so much turmoil until ds was born, and then I was more like "seriously? this is it?" Dh wanted to circ so badly and was so torn up... again, until after ds was born. He feels the same way I do. What's the fuss? It's like being in a fearful panic over his earlobe, and how ears can get dirty and whatnot so gosh, we should just get rid of them... lol. It's just another body part, and all body parts are important. (I'm pretty sure penises are especially important... though I can't quite be certain... hint of jovial sarcasm there...)

 

My son is 9 months now, and I love every part of him... couldn't imagine having any parts cut off. You can always give it some time.... any boy who wants to get circ'd later in life can easily have it done. From what I understand, it's an outpatient thing and they are back at work, etc within a day or so. In any case, good luck to you and good for you for taking the time to really examine the evidence.


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#15 of 42 Old 01-11-2011, 07:04 PM
 
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Vachi73,
Quote:
STDs are an issue of behavior and education, not amputation.
I think this iis one of the best single line reasons I've heard in regards to STDs and Circ. I hope you don't mind if I use this line!

 
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Quote:
Originally Posted by tammylsmith View Post

Congrats to you! My little guy is my side kick (the robin to my batman... or something like that, lol) and totally in love with his mommy. I just adore him joy.gif... not to gush or anything...

 

Our much-trusted family doctor, who is from a non-circing culture, not circ'd himself and didn't circ his own son gave me this advice "don't listen to anyone who is trying to give you some medical benefits speech. The numbers just aren't there. All of my friends (from the same culture) are doctors and intact, and none of them has had a problem.  Circumcision doesn't protect from STDS, safe sex and condoms are the only things that do that." My (American) pediatrician tried the HPV statistics on me, and as soon as I mentioned condoms, he got an "I'm stumped" look and tried the locker room argument (which is easily refuted too, but I won't waste time on that here). The argument isn't nearly as strong as you might imagine from the way it is used in American culture. I felt so much turmoil until ds was born, and then I was more like "seriously? this is it?" Dh wanted to circ so badly and was so torn up... again, until after ds was born. He feels the same way I do. What's the fuss? It's like being in a fearful panic over his earlobe, and how ears can get dirty and whatnot so gosh, we should just get rid of them... lol. It's just another body part, and all body parts are important. (I'm pretty sure penises are especially important... though I can't quite be certain... hint of jovial sarcasm there...)

 

My son is 9 months now, and I love every part of him... couldn't imagine having any parts cut off (and his penis is so darn cute... Just love all those sweet little baby bits love.gif) You can always give it some time.... any boy who wants to get circ'd later in life can easily have it done. From what I understand, it's an outpatient thing and they are back at work, etc within a day or so. In any case, good luck to you and good for you for taking the time to really examine the evidence.

 

Just don't EVER let him read that when he's older, or he'll really get a complex!  LOL!  (I have to agree, my ds's little baby bits are all pretty adorable too!  although he's looking more grown up every single day and its so bittersweet - he just turned TWO yesterday!!!!)
 

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You betcha, Queen!! thumb.gif
 

Quote:
Originally Posted by QueenOfTheMeadow View Post

Vachi73,

Quote:
STDs are an issue of behavior and education, not amputation.


I think this iis one of the best single line reasons I've heard in regards to STDs and Circ. I hope you don't mind if I use this line!


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Just don't EVER let him read that when he's older, or he'll really get a complex!  LOL!  (I have to agree, my ds's little baby bits are all pretty adorable too!  although he's looking more grown up every single day and its so bittersweet - he just turned TWO yesterday!!!!)
 


Aw... two already! (my dd is 3 1/2 so I know what you mean!)

 

I do joke, but this makes me think of an interesting point, that I am the keeper and protector of his body for just a tiny, short portion of his life. He is adorable, he is my beautiful baby now (and forever!) but I am not raising a baby. I am raising a man. I will gradually pass off the keys, so to speak, and I don't want to make a decision for a baby boy that actually affects the grown man more. The grown man should have a say! Hope I'm not being to corny. I'm still all mushy over my babies, I guess shy.gif


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Quote:
Originally Posted by tammylsmith View Post

Congrats to you! My little guy is my side kick (the robin to my batman... or something like that, lol) and totally in love with his mommy. I just adore him joy.gif... not to gush or anything...

 

Our much-trusted family doctor, who is from a non-circing culture, not circ'd himself and didn't circ his own son gave me this advice "don't listen to anyone who is trying to give you some medical benefits speech. The numbers just aren't there. All of my friends (from the same culture) are doctors and intact, and none of them has had a problem.  Circumcision doesn't protect from STDS, safe sex and condoms are the only things that do that." My (American) pediatrician tried the HPV statistics on me, and as soon as I mentioned condoms, he got an "I'm stumped" look and tried the locker room argument (which is easily refuted too, but I won't waste time on that here). The argument isn't nearly as strong as you might imagine from the way it is used in American culture. I felt so much turmoil until ds was born, and then I was more like "seriously? this is it?" Dh wanted to circ so badly and was so torn up... again, until after ds was born. He feels the same way I do. What's the fuss? It's like being in a fearful panic over his earlobe, and how ears can get dirty and whatnot so gosh, we should just get rid of them... lol. It's just another body part, and all body parts are important. (I'm pretty sure penises are especially important... though I can't quite be certain... hint of jovial sarcasm there...)

 

My son is 9 months now, and I love every part of him... couldn't imagine having any parts cut off (and his penis is so darn cute... Just love all those sweet little baby bits love.gif) You can always give it some time.... any boy who wants to get circ'd later in life can easily have it done. From what I understand, it's an outpatient thing and they are back at work, etc within a day or so. In any case, good luck to you and good for you for taking the time to really examine the evidence.

 

Doing a flyby through here looking for info on circ for a friend.   

 

However, the bolded in the above quote?  Totally squicked me out.  If a father posted on the internet about finding his daughter's vulva cute, I think many poster's here would be singing a different tune.  Our children's genitals are not eye candy.  Circ'd, un-circ'd, female, male.  Speaking of children's genitals this way just really makes me feel ill.

 

 Sadly, this isn't the only time I have seen this kind of thing brought up in this forum.  Being an advocate for keeping boys intact is a worthy cause.  But when advocates use this kind of language, the worth gets lost in the squick factor.  

 

 

 

 

 

 




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#20 of 42 Old 01-12-2011, 02:30 PM
 
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This study is by Maria Wawer, wife of Ronald Gray, who did the Uganda RCT on circ and HIV.  Gray is also listed as a contributor to the piece.  Wawer, you will recall, authored the "study" (also published by The Lancet) where 922 intact HIV+ males were enrolled, one-half were then circumcised, and all were let loose on their HIV- partners.  The purpose was to see if circumcision protected women from HIV transmission.  Funny enough the reverse was found to be true, the circumcised men transmitted HIV more effectively than the intact men. [But the press just said, "
Circumcision does not protect women from HIV"; no article pointed out the truth, "Circumcision increases HIV among women."  But what about the ethics of the study?  Clearly, as someone else has said, this study was "worse than Tuskegee."  It treated black African men and women as lab rats.  Would such a study ever have been conducted on white Americans or Europeans?  Why did The Lancet publish that study?  Why did it publish this one on HPV?  Good questions that need to be answered.

 

And this HPV study is hardly definitive.  An article by Vardas, et al. entitled "External Genital Human Papillomavirus Prevalence and Associated Factors Among Heterosexual Men on 5 Continents" published this month in the Journal of Infectious Diseases [JID 2011:203 (1 January)] found:  "Neither condom usage nor circumcision was associated with HPV DNA prevalence."  But, of course, the circumcised American press failed entirely to pick up on this one, probably because it fails to confirm the pro-circumcision paradigm so important to the circumcised male. 

 

The Vardas study, of course, is confirmed by our experience in the real world here in the U.S.  We have the highest rate of circumcision in the industrialized world outside of Israel; and our STD rates, including HPV, are equal to or greater than those found in European countries where very few to virtually none are circumcised

 

In short, HPV prevention is no reason to circumcise. Nor is the "prevention" of any other STD.

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#21 of 42 Old 01-12-2011, 03:37 PM
 
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The following study states that langerhans cells which are produced by the mucosa of the genitalia (inner foreskin) actually kill invading HIV. So by removing the foreskin you are removing the bodies natural defense against HIV infection. 

 

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/05/AR2007030500357.html

 

I love scientific articles like these. 

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#22 of 42 Old 01-12-2011, 06:35 PM
 
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I'm not sorry, and there was nothing remotely offensive said. I was being light-hearted. I only meant that all parts of a baby are beautiful... boy or girl, but we need to remember that they are not our parts to make decisions about. Nothing needs to be altered in any way because nature made them perfect.  In any case, I went back and edited so as not to derail the discussion.


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Quote:
Originally Posted by tammylsmith View Post


Aw... two already! (my dd is 3 1/2 so I know what you mean!)

 

I do joke, but this makes me think of an interesting point, that I am the keeper and protector of his body for just a tiny, short portion of his life. He is adorable, he is my beautiful baby now (and forever!) but I am not raising a baby. I am raising a man. I will gradually pass off the keys, so to speak, and I don't want to make a decision for a baby boy that actually affects the grown man more. The grown man should have a say! Hope I'm not being to corny. I'm still all mushy over my babies, I guess shy.gif


There is nothing corny about this.  It is such an important fact.  We are not raising children.  We are raising adults.  We are raising an individual, a person who will grow up to be a partner, an employee, an employer, a neighbor, and a community member and so many more things.  I am acutely aware that I am raising someone's future husband or wife and parent.  This fact shapes my parenting greatly.

 

Education and safe behavior are the keys to good sexual health.  It is not my place to alter another's body.

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#24 of 42 Old 01-12-2011, 07:11 PM
 
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It's his penis, so let him read the article and decide on his own if he feels it's "worth it". Then he can at least be knocked out and have pain meds if he chose to cut off a part of his genitals!

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#25 of 42 Old 01-14-2011, 09:28 AM
 
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Actually, it is a reduction of 28%. (38.7-27.8)/38.7 = 28%

 

Not that I am endorsing it!! I am still vehemently against circ'ing for something that is a matter of edication and prevention.
 

Quote:
Originally Posted by outlier View Post

Here's a link to the article's summary: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61967-8/fulltext#   I don't think the full text is free.

 

It does not reduce HPV infection by 28%; it appears to reduce HPV infection from 38.7% to 27.8% in this study.  Keep in mind they're dealing with correlations, not causation.  Over a quarter of the women in the experimental group (partner was circ'd) still got HPV--what good did that do them?  I can't comment further on the study's methods without reading the full article, but here's a rough breakdown for you.  If we make the giant assumption that this study is an accurate representation of reality, as a female sexual partner in Uganda your risk of getting HPV is:

 

• 38.7% if your partner is intact

• 27.8% if your partner is circ'd as an adult

[the following are my own approximations]

• low with typical condom use

• close to 0% with perfect condom use

• close to 0% if your partner has his entire penis lopped off

• 0% if you completely abstain from all sexual activity

 

But you're not in Africa, so those first two numbers won't apply to your son's situation anyway.



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#26 of 42 Old 01-14-2011, 10:07 AM
 
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I think this directly addresses the OP's issue.

 

http://www.youtube.com/watch?v=xKnSWo3hkf4 

 

"So we're talking ... you could have this chopped off or you could wash it.  Your call."

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#27 of 42 Old 01-14-2011, 10:39 AM
 
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I agree with everything else that has been said here. It's your responsibility to teach your child about safe sex, not to alter his body forever before he is old enough to make any decisions for himself.


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#28 of 42 Old 01-14-2011, 12:10 PM
 
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Would you ever tell your son, "Don't use condoms, kid, you don't have a foreskin!"  I doubt it.  But that's what this study suggests.

 

Condoms and safe sex prevent STDs.  Circumcision does not.

 

Why would you assume your baby boy's going to be a, ahem, "social butterfly" anyway?

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#29 of 42 Old 01-14-2011, 01:00 PM
 
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Yes, it only protects against 4 strains, but 2 of those strains are responsible for 75% of all cervical cancer cases, and 2 more are responsibile for 90% of genital warts cases. 

Regardless, circumcising to prevent HPV makes no sense at all.

Quote:
Originally Posted by mamapigeon View Post

Just from a logical standpoint, wouldn't damaged tissue be more likely to increase risk of spreading disease than decreasing it?  My DH is circumcised and has a ring of scar tissue around his penis that will sometimes get chafed and raw. Open wounds increase the rate of transmission of STDs. Of course, not everyone who gets circumcised is going to have those problems, but it's a risk.

 

As for the vaccine Gardasil, it only protects against 4 of the strains of HPV.  There are over 100.

Safe sex is a better option for reducing STDs.

 

DH and I are expecting a boy in April and we plan on leaving him intact. If he wants to be circumcised when he is older and knows about it, we're fine with that.

 



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#30 of 42 Old 01-15-2011, 11:12 AM
 
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Another way to look at the STD "reduction" argument is to consider that nearly 100% of women who pass on STD's to their partners in the US are uncircumcised.  Yet, no one finds it necessary to talk about routinely slicing off bits of baby girls' vulvas at birth.  Why is it any less ludicrous to argue for RIC of boys in the name of STD reduction?   


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