Talk:Circumcision

Ethics in lead RfC

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Should ethics be mentioned in the lead? Please see previous discussion for background on the dispute. Current wording in question: “There are various cultural, social, and ethical views on circumcision.” Prcc27 (talk) 02:17, 2 June 2024 (UTC)

Include: major medical organizations like the AAP, the CPS, the KNMG, and the RACP address the ethics of the procedure in their policy statements. WP:WEIGHT says “Neutrality requires that mainspace articles and pages fairly represent all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in those sources.” It is clearly not WP:UNDUE to have a brief and concise sentence on ethics in the lead, when the major medical organizations also address ethics. Yes, the wording could be tweaked, but it is worth noting that (if I remember correctly), the wording was actually created by KlayCax, who is against including it in the lead. Seems like the wording could at least be a good compromise. Prcc27 (talk) 02:19, 2 June 2024 (UTC)

Malformed RFC/Exclude: First of all, it's important to note that the "current wording" was only recently edit warred into the article, rather than being a longstanding part of the article's page. The page already includes much of what is being suggested.

For instance, the lead already states: "Major medical organizations hold variant views on the strength of circumcision's prophylactic efficacy in developed countries. Some medical organizations take the position that it carries prophylactic health benefits which outweigh the risks, while other medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk". along with additionally stating that "Beyond use as a prophylactic or treatment option in healthcare, circumcision plays a major role in many of the world's cultures and religions, most prominently Judaism and Islam. Circumcision is among the most important commandments in Judaism." and so on. This is already covered significantly in depth.

Prcc27 cites discussion of ethics in the AAP, RACP, KNMG, and CPS policy papers to argue that the ethics of circumcision have been addressed in the literature. That's quite indisputable. However, the criteria for including controversies surrounding medical procedures is much more stringent, as it is quite normative (from someone who works in the field) to see these questions addressed in almost any procedure that medical professionals provide to their patients. The criteria for these types of pages is not "whether some controversy or questions of ethics have been raised by philosophers". The criteria is whether: 1.) The controversy is longlasting 2.) The controversy is significant, widespread, and prominent. 3.) Whether it is restricted/prohibited/banned.

Circumcision meets none of these. Even in Denmark, Germany, Poland, Hungary, and the Nordics, where opposition to circumcision is likely the strongest, attempts to criminalize the procedure have been consistently voted down by overwhelming margins. It is true that within the past ten years or so there has been online controversy from Men's Rights Activists, right-wing nationalists (like StoneToss), and others in recent years, along with lesser opposition from "crunchy" liberals and anti-theists as well, but I wouldn't say that this is enough to merit the claim that it is a significant and prominent issue in global culture. (Outside of Northern and Eastern Europe.) Similarly, while there have been attempts at criminalization, these have predominantly come from far-right parties, likely in the context of Islamic immigration, and have been voted down by margins that surpass 5-1 in most European parliaments. Most of the controversy hasn't been about circumcision. It's about immigration of Muslims into Europe.

WP:AVERAGE and systematic bias is likely to skew responses. The average Wikipedian is white, male, technically inclined, formally educated, and English speaker, from a Christian or non-religious country, all of which likely to grow up in capitalistic, individualist, and autonomous cultures that are likely to see controversies surrounding circumcision more prominently than they actually are. A somewhat analogous situation has already been addressed on other articles surrounding body/genital modifications, including the pages on transgender health care, gender-affirming healthcare, gender-affirming surgery, and others, for the reason that their inclusion would inherently bias readers against the medical treatment in general. Despite the fact that there's been significantly more legal, political, religious, and cultural opposition to the practice in present day society. I agree that it should be excluded for this reason. Right off the bat, the proposed wording would - whether intended or not - bias readers. The same applies here.

Ethics shouldn't be mentioned in the lead for transgender healthcare pages, circumcision, and the vast majority of other body mods/medical treatments. The two big exceptions to this in my mind are abortion and female genital mutilation. But those are special cases where, as mentioned above: 1.) The controversy is longlasting 2.) The controversy is significant, widespread, and prominent. 3.) Whether it is restricted/prohibited/banned. All are lacking here. KlayCax (talk) 18:38, 2 June 2024 (UTC)

To give a quick overview of how it fails this:

• 1.) Controversies around circumcision are almost always controversies about other subjects. (Religion, individualism, the role of sexuality, immigration, et al.) There's a lack of any significant protests/organizations against the procedure itself. There's definitely controversy surroundings its use in developed nations. However, we already go into detail about this in the lead, so a WP: DUE amount of WP: WEIGHT has already been given in reference to this.
• 2.) According to reliable sources: significant opposition to the procedure itself is not a prominent part of most cultures, with movements against the procedure being "small". It is also very recent. Only developing to any significant extent in the past 10 years. Even in Europe: it appears that conversations and ethical controversies about circumcision are either in relation to #1. That is, it doesn't have to do with circumcision in of itself, but rather deeper questions surrounding the aforementioned.
• 3.) Neonatal circumcision is legal in every polity. It appears that it will remain this way for the foreseeable future. Once again, it fails the criteria.

Maybe this will change in 10 or 20 years. But the idea that we should imply a significant controversy that - at least for now - doesn't exist goes against normative Wikipedia guidelines. KlayCax (talk) 18:53, 2 June 2024 (UTC)

”First of all, it's important to note that the ‘current wording’ was only recently edit warred into the article.”

No, I’m pretty sure it was added to the lead by you or another user a long time ago..? And it was recently reintroduced as a compromise.

”According to reliable sources: significant opposition to the procedure itself is not a prominent part of most cultures” is a strawman argument. The lead does not say anything about opposition to circumcision, but rather ethics in general. The literature may not give enough weight to the opposition, but they definitely do give weight to the ethical consideration of the procedure. Prcc27 (talk) 20:50, 2 June 2024 (UTC)

Medical organizations usually give an ethical perspective in policy statements to an extensive amount of body modifications, @Prcc27:. The criteria for including it in the lead of pages is much more stringent. Stuff like abortion, female genital mutilation, and a few other things clearly meet it, but we exclude discussion of the topic on other articles such as gender-affirming surgery. It's oftenseen as introducing bias against whatever's being mentioned. (Which I generally agree with.)

We already include cultural/other views in the lead. So this RFC is basically asking: "Is there substantial legal or ethical controversy over circumcision now?" And I would say in the vast majority of nations, no. KlayCax (talk) 18:22, 5 June 2024 (UTC)

Include When discussing circumcision, there is no doubt that culture and societal norms are very significant, as they are the number one factor that determines its prevalence in a certain place. The lead is also meant to summarize the contents of the article. There is evidenttly substantial content within the article that would warrant the inclusion of such statement in the lead; in particular there is a section for Society and culture. Also, as already stated above, all of the major medical organizations will always include a section regarding ethical considerations in their policies. The proposed concise statement is meant to represent this whole section. The lead doesn't say what these views are (for example, in some cultures it plays a religious role, for others it's a cultural norm, in others it is uncommon etc.) the statement itself is neutral, simply stating the very fact that there are various views throughout the world, which is undeniable.

Regarding the above disagreement, I will not digress; 1) the sentence was not recently edit-warred into the article; this or a very similar brief sentence was always included somewhere in the lead as far back as I remember, and it was never edit-warred out of the article for the longest time. 2) Strawman; nowhere was the word "controversy-ies" added in the lead. This is not about controversies. Also, the various cultural/societal/ethical views are not equal to the various views on prophylactic efficiency of the medical organizations. Piccco (talk) 22:38, 3 June 2024 (UTC)

The problem is that we already include differing cultural views into the article. The very next sentence states:

Major medical organizations hold variant views on the strength of circumcision's prophylactic efficacy in developed countries. Some medical organizations take the position that it carries prophylactic health benefits which outweigh the risks, while other medical organizations generally hold the belief that in these situations its medical benefits are not counterbalanced by risk

and then goes on to state:

Beyond use as a prophylactic or treatment option in healthcare, circumcision plays a major role in many of the world's cultures and religions, most prominently Judaism and Islam. Circumcision is among the most important commandments in Judaism.

The only dispute is whether the lead should state that there is a substantial legal/ethical controversy. Judging by the landscape of 2024, I wouldn't say so, but if that changes then it could be added. Gender-affirming surgery is far more controversial in mainstream society. However, we wisely don't include controversies in the lead because it would bias readers' against it, and significant societal controversy surrounding it is relatively recent. I don't think many people here realize that in Europe "circumcision controversies" are generally about Islamic immigration (and on the fringe: Jews) into Europe. I don't see why we should blowhorn Men's Rights Activist and right-wing populist rhetoric into the article.

The consensus is clear: 1.) Circumcision works in areas of high HIV 2.) Circumcision is debatable/questionable in developed nations 3.) Circumcision is inconsequential in terms of sexual function.

It's also important that on questions of gender-affirming surgery, circumcision, and other issues, that Wikipedia understands WP:AVERAGE, and to not stigmatize bodily diversity of peoples. KlayCax (talk) 18:18, 5 June 2024 (UTC)

I feel as though you are just repeating what you already said and are being verbose, which may inadvertently discourage other users from participating in this RfC. The lead neither says nor insinuates that there is an ethical controversy. We already explained that those other sentences do not address the ethics of circumcision. And since we have a section on ethics in the body, it should be addressed in the lead. I already explained why gender affirming surgery should not mention ethics in that article’s lead if medical organizations do not go out of their way to address it in their policy statements. Prcc27 (talk) 21:02, 5 June 2024 (UTC)

I feel like the points in the latest response have already been addressed and, as Prcc27 noted, are repeated. The views of medical organizations on prophylactic efficiency, as I said, are a different thing. The role of circumcision in Judaism is, of course, important, but that sentense alone does not cover the diversity of views from all over the world. See, for example, the lead of the article that you created in 2022, which concludes with "This has subsequently led to widely varying views related to the practice". Lastly, ethics is not a fringe discussion in medicine and is independent from the rhetorics mentioned above. It is true that all circumcision policies of major medical organizations dedicate a separate section to this subject. Please, do not equate the various cultural/societal/ethical views with "controversy" and keep in mind that the word itself is never used. Piccco (talk) 22:44, 5 June 2024 (UTC)

I'm perfectly alright with This has subsequently led to widely varying views related to the practice in the lead. @Piccco:, @Prcc27:. But, yes. Discussions of ethics concern most issues in medicine and healthcare. The criteria for lead inclusion has traditionally been what I stated above. 1.) The controversy is longlasting 2.) The controversy is significant, widespread, and prominent. 3.) Whether it is restricted/prohibited/banned. All are lacking here. I don't think, like gender-affirming care, we can simply isolate it to that. I'm bringing up WP: AVERAGE because this is another example of editors attempting to push views into the article that are fringe globally. (But have significant currency among white individuals of European descendent.)

The ethics of circumcision article is problematic in of itself. Not the least, among other reasons, it was written by a "long-term sockpuppet" who was known for "inserting long anti-circumcision rants into articles".

To say that gender-affirming care hasn't been controversial ethically among the vast majority of the non-Western world or among conservatives in the West is a bit disingenuous.

(i.e. I'm non-religious/culturally liberal. But I realize that this isn't the predominant view globally. Should we include the ethical perspectives of the Catholic Church, Sunni Islam, Hinduism, Buddhism, and everything else?)

I think for topics such as this - body modifications are outright forbidden in certain major religions - it's best to only include it based on the three criteria listed above. No one's saying that differing viewpoints of circumcision shouldn't be added in this lead. (Indeed, a RFC on this will find that an overwhelming amount of editors agree.) It's how much it is WP: DUE in light of WP: AVERAGE and WP: WEIGHT.

Does This has subsequently led to widely varying views related to the practice work for you + self close? I'll support that. KlayCax (talk) 17:46, 7 June 2024 (UTC)

I think part of the confusion here is the fact that ethics was previously seen as a “controversy” on this talk page. That was indeed a reason given by 1 user in the past to include ethics in the lead, which I echoed. But the current wording does not actually mention that circumcision is controversial or imply that. And that is not the main argument for inclusion anymore. Your arbitrary proposed criteria of a “controversy” being long-lasting, significant, widespread, and prominent, and for circumcision to be banned is not compatible with WP:DUE. The main reason for inclusion is simply because it is an important consideration made by parents and medical organizations, so WP:DUE is met. Circumcision does not have to be “controversial” for the ethics to be significant enough. The current wording is vague enough as it is (I believe BonCourage even said it was “nothing-y”). If anything, we should be expanding on the wording, not condensing it. Cultural views and ethical views are two different things, which is why we have separate articles for them. We should not conflate the two, so I oppose your proposed compromise. As for WP:AVERAGE.. that is not a Wikipedia policy, and as experienced Wikipedia users, we should be able to put our own bias aside and edit neutrally. Prcc27 (talk) 20:28, 7 June 2024 (UTC)

Your arbitrary proposed criteria of a “controversy” being long-lasting, significant, widespread, and prominent, and for circumcision to be banned is not compatible with WP:DUE. It's not arbitrary. It's been the working guideline on other pages surrounding body modifications. Tattoos, hair dying, circumcision, gender-affirming/transgender healthcare & body mods, breast argumentation and reduction, and other things all have had various forms of controversies surrounding them. We generally do not include any of these things in the leads of their pages. (A notable exception to this is body piercing.) As for length: it's already 1/4th of the introduction, @Prcc27:.

It's definitely not a silly question. Roman Catholics and Sunni Muslims have far more followers than there are individuals born in the Western World. KlayCax (talk) 01:32, 9 June 2024 (UTC)

And I already explained to you why we do not include ethics in those articles, and I’m not going to explain it again. Prcc27 (talk) 03:41, 9 June 2024 (UTC)

Except major medical organizations do discuss it in the context of ethics. (I know this: as I'm a member of the American Academy of Pediatrics.) The same applies to the other medical treatments listed.

Even if this was the case — and it's not — one could also state that your suggested principles are also arbitrary. Why should that be the criteria chosen? KlayCax (talk) 00:32, 10 June 2024 (UTC)

There is nothing stopping you from expanding and improving those other articles.. Arguably, there should at the very least be a sentence or two in the body of the gender affirming surgery article about ethics. But I am still not sure if ethical consideration of affirming surgery is something most/all major medical organizations give consideration to for affirming surgery, unlike with circumcision where many (most?) do. If not, it could be WP:UNDUE for that article’s lead. We are only able to figure out what is WP:DUE based on its prominence in the sources; one source does not really tell us much with regards to this. In any case, we should be focusing on this article, not other articles. Echoing what the reliable sources say is not arbitrary whatsoever. As long as WP:ONUS is met, we let the sources speak for themselves. Prcc27 (talk) 15:19, 10 June 2024 (UTC)

Ethical consideration of affirming surgery is something most/all major medical organizations give consideration to for affirming surgery. They do. Most medical organizations have ethical statements — if at not least ethical analysis — on almost every medical intervention/procedure. (Including, say, the prophylactic benefits of vaccines against X disease.) Therefore, that's a bad criteria to weight it by, and subjective in of itself.

Therefore, 1.) Significant, widespread, long-lasting societal and political controversy 2.) Current legality are the best measures to look at. Both criteria fail here. KlayCax (talk) 17:16, 12 June 2024 (UTC)

Gender-affirming surgery and circumcision do not really have much in common, besides both being surgical procedures. Compared to circumcision, gender-affirming is, in fact, a very rare procedure. It is also elected by the person themselves, it has no religious significance, nor is it a cultural norm in any society, it has not been widely practiced for millennia, it is not routinely performed on millions of children annually etc. This comparison is a bit arbitrary and continues to be wrongly based on the amount of controversy these procedures generate, even though we have long clarified that controversies are not the subject of this discussion. Piccco (talk) 22:25, 12 June 2024 (UTC)

You're misunderstanding what I'm saying, @Piccco:. I don't think disputes/controversies belong in the lead of either article. (Or the majority of other pages for body modifications/medical procedures). The rare exceptions being the foreamentioned criteria. This would be abortion, female genital mutilation, conversion therapy, lobotomy, water fluoridation, embryonic stem cells, and a few other things with substantial public controversy.

Elected by the person themselves That's how someone who has a liberal, individualist viewpoint would see it. It's a view I hold too as well. However, this is exactly what I mean by WP: AVERAGE. Globally, the majority of people do not hold to individualist, autonomy-driven ethics. They hold a viewpoint much closer to virtue ethics/communitarianism. There's no WP: NPOV way for Wikipedia to side with one ethical viewpoint over the other. Why should we privilege the viewpoint of an individualist Westerner over that of a Roman Catholic, Sunni Muslim, or devout Jew? Is there a way to do this while maintaining neutrality? I doubt it.

We have long clarified that controversies are not the subject of this discussion Why should the lead not be WP: WEIGHT'ed by public controversy and legality? We're both arguably using a subjective sense of criteria to determine what belongs in it or not. I however believe that the criteria I'm suggesting is in line with WP: COMMONSENSE and WP: PRECEDENT on other articles. KlayCax (talk) 01:39, 13 June 2024 (UTC)

• Include per WP:DUE and MOS:LEAD - emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources ... including any prominent controversies. A search for ethical views on circumcision in scholarly/academic literature shows it is well-sourced, a prominent viewpoint, notable and controversial, so it is undoubtedly DUE for the lead. Isaidnoway (talk) 20:48, 13 June 2024 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Misinformed page.

The circumcision page on Wikipedia is grossly incorrect and biased. It states that there are basically no downsides, and no changes in pleasure. This is incorrect.

source:

https://www.cirp.org/news/1997/1997-12-01_Mothering.php 104.194.36.23 (talk) 11:23, 5 July 2024 (UTC)

This precise topic over whether circumcision decreased pleasure during sex was debated last year (see Talk:Circumcision/Archive 85#"Circumcision does not affect sexual function, sensation, desire, or pleasure."). After a prolonged and, at times, heated debate, it was decided to retain the statement involving pleasure.

To the topic of the specific reference you provided, the article was published in 1997 (so approaching 26 years old) and was authored by Paul M. Fleiss, an anti-circumcision activist and a person who is "known for his unconventional medical view(s)". Additionally, there has been a great deal of research on the topic of circumcision and pleasure since that article was published. Wikipedialuva (talk) 08:26, 11 July 2024 (UTC)

Yes, it is grossly misinformed and obviously written in support of the US medical industry who support circumcision strongly for financial reasons. They write as if for example HIV prevention is functioning at a relevant level, and then only have a small added sentence at the end which mentions that it is not agreed upon. Wikipedia has an article which includes HIV prevalence, and in many western European countries the HIV prevalence is far lower than in the US where people are circumcised. This is FACTUAL EVIDENCE against the effectiveness of circumcision in preventing HIV.

212.97.248.58 (talk) 11:22, 24 August 2024 (UTC)

Discussions challenging the protective effects of male circumcision against HIV seem to come up every few months. The last one was in April to June of this year (see: Talk:Circumcision/Archive_85#Lack_of_Consensus_on_HIV_prevention).

Yes, it is grossly misinformed and obviously written in support of the US medical industry who support circumcision strongly for financial reasons.

Both US-based medical organizations (including the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Centers for Disease Control and Prevention (CDC)), and international based medical organizations (including the World Health Organization (WHO), and UNAIDS) have all acknowledged that male circumcision offers a level of protection against acquiring HIV. The argument that circumcision is primarily supported by the U.S. medical industry for financial gain overlooks the substantial body of evidence that supports the claims of reducing the acquisition of HIV. The claims that "the US medical industry" strongly supports circumcision for financial reasons appear to be WP:FRINGE.

They write as if for example HIV prevention is functioning at a relevant level, and then only have a small added sentence at the end which mentions that it is not agreed upon.

As per policy. The Wikipedia policies WP:DUE and WP:BALANCE require that due weight and proper balance be considered when editing articles. Wikipedia does not give equal weight to all points of view; it gives weight "in proportion to the prominence of each viewpoint in those sources."

Wikipedia has an article which includes HIV prevalence, and in many western European countries the HIV prevalence is far lower than in the US where people are circumcised. This is FACTUAL EVIDENCE against the effectiveness of circumcision in preventing HIV.

The comparison of HIV prevalence rates between countries must consider a multitude of factors, including but not limited to sexual behavior, access to healthcare, education, and public health initiatives. The casual claim that Western European countries exhibit lower HIV prevalence than the U.S. does not account for these variables. For instance, South Korea presents a counterexample to these claims: it has an HIV prevalence rate that is significantly lower than that of many European countries, despite having a higher circumcision rate than the United States. Regardless, without WP:reliable sources, your claims appear to be original research and not eligible for inclusion under the policy of Wikipedia:No original research. Even assuming you are able to locate sources to support this view, they would still need to be evaluated in conjunction with WP:DUE and WP:BALANCE policies discussed above. Wikipedialuva (talk) 22:12, 25 August 2024 (UTC)

Insurance

"The American Academy of Pediatrics (2012) recommends that neonatal circumcision in the United States be covered by third-party payers such as Medicaid and insurance." But is it indeed covered? Benjamin (talk) 19:11, 19 August 2024 (UTC)

@Benjaminikuta: The coverage of neonatal circumcision depends on each insurer. In general, the procedure is covered by most commercial insurance; however, each state can set their own policies over whether that state's Medicaid program covers neonatal circumcision. This has resulted in a patchwork of coverage for the procedure. Some state Medicaid programs will stop covering it, only to reinstate coverage for it a few years later (such as Colorado). (source:[1]) Wikipedialuva (talk) 22:33, 25 August 2024 (UTC)

Interesting, thanks! Can we include this information? Benjamin (talk) 08:55, 26 August 2024 (UTC)