Sunday, December 2, 2012

Ad Hominem Attacks

Background

Intactivists often get accused of making ad hominem attacks against those who support male circumcision. Outside of attacks on the circumfetishist community, I haven't seen much of this behavior myself, but I think the issue is worth discussing.

In a formal academic fact-based discussion among reasonable people, attacking a person's character, behavior, or actions is quite irrelevant to any argument or discussion. Outside of a purely academic discussion, however, the parameters are different.

Character Counts

Character, trustworthiness, and motives matter. Would you trust an oil company's "study" on damage from an oil spill? Would you trust a psychologist who was also a pedophile to study affects of child abuse? Of course not. Individuals with a vested interest in a certain point of view are not going to uphold the values of a reasoned discussion. These individuals use irrational statements, straw man arguments, or make unfounded claims to divert attention from an issue they can't defend. A purely academic discussion is impossible with these individuals.

To call into question the motives, bias, or vested interest of these individuals is not a "personal attack": it is stating a fact that gives perspective and insight into the discussion. The ideal is not always possible. It is rarely productive to discuss an issue with someone whose vested interest would prevent him from ever approaching an issue with an open mind.

When Ad Hominem is Appropriate

When an individual makes it clear he has no interest in a proper discussion of an issue and his biases are based in unethical, immoral, or evil associations or actions, ad hominem attacks are absolutely appropriate. An individual's character is based not just on his own actions, but his associations. Associating with others who are evil or immoral reflects on an individual's ability to have an open mind. Furthermore, those who lack morals or judgement have very little credibility because they lack the ability to properly analyze and consider all sides of an argument before drawing a conclusion. These individuals have no interest in a proper academic discussion and they serve only to further their cause. There is no shame in revealing the true nature of unethical or immoral individuals.

Thursday, November 29, 2012

Ways to be Right

Being Right

Most people like to be right. It's human nature. Some people tolerate being wrong better than others. I don't tolerate being wrong very well.

Consider that there is more than one way to be "right". Not only do I want to be right in that I can defend a particular viewpoint, but I want that viewpoint that I am holding to be correct based on all facts and evidence available.

Many people hold tightly to a viewpoint—no matter how foolish—to avoid being proven wrong. However, desperately clinging to a viewpoint that isn't supported by facts or evidence is another type of "being wrong".

Isn't it more "right" to change one's viewpoint to match the one with the evidence to back it up? I definitely feel this way. As much as I don't like to be proven wrong, I'd much rather change my mind to the correct point of view and accept the mild ego bruise of having my original viewpoint discredited.

Ignorance

Claiming someone is ignorant is not an insult. I am ignorant of many things and I admit this readily. One example is opera. I don't know very much about it and I don't like to hear it. I can't understand what's being said, I don't like the vocal style, and it really doesn't do much for me. Because I am ignorant of opera, I do not have the right to say "this is a bad type of music". I can, however, continue to hold my opinion that I don't like it.

For the sake of the argument, let's say an opera expert educated me about the genre. Maybe if I learned more about the amount of effort it takes to sing in the operatic style and if I learned more about the performance and the art of it, I would grow to enjoy opera.

When seeing the video to "Gangnam Style" for the first time, a co-worker made a comment to the effect of: "Wow! I always thought of Asians with glasses and being into books." This was an ignorant comment. This comment was not meant to be racist and it was not malicious: the comment was made by a nice, caring, and wonderful person. This individual has had very little experience with Asians in his lifetime and that lack of experience with other races resulted in ignorance. Obviously, education here is key as this individual's comment would likely be interpreted as racist by most.

The cure for ignorance is education. All viewpoints must be considered to be properly educated. All sources are biased in some way and to some extent. Sources may have guidelines that prevent all viewpoints from being considered so it is important to view as many sources as possible. It is only after careful analysis with an open mind when a properly-constructed viewpoint can be formed.

Tuesday, September 11, 2012

My Intactivist Journey

The first time I became aware of circumcision was when I was seven and I saw my Mom changing my newborn cousin's diaper. I asked her why his penis was so red. Although I don't remember her answer, it must not have satisfied my curiosity because I remember asking again. I remember that her second response contained a hint of annoyance. Maybe questioning this societal norm caused the slightest bit of doubt in my Mom's mind.

In fifth grade after "family life" (a fancy name for sex ed), on the bus ride home, I asked my best friend a question out of curiosity (although I could only get up enough nerve to spell the word): "Are you C-I-R-C..." Before I finished what was a painfully awkward question, he answered "no." I sat in stunned silence. I didn't know what to make of it. I thought to myself, "well, why not?" Like many kids this age, I wanted my best friend to be just like me. I couldn't help but think that there was more to it than the "hygenic reasons" rhetoric used to justify circumcision back then.

In high school, one of the things I feared was being made fun of in the showers for having only one testicle. The doctors went in to bring down an apparent undescended testicle only to find it dead and undeveloped (possible in-utero torsion or other birth defect) necessitating its removal. I was never made fun of for this and no-one ever mentioned it to me.

For as fervent an effort as boys make not to look at each other in the shower, I couldn't help but notice that one boy in my high school PE class was intact. I felt envious even though I didn't know at that time that the foreskin had any significant function. Even though I didn't have any real reason to doubt the pro-circumcision rhetoric, I was not entirely comfortable with it.

As I got older, I began listening to talk radio. In college, I started listening to Dr. Dean Edell's radio show. He talked about circumcision on a regular basis. This is when I started thinking seriously about it. Although I had never been comfortable with circumcision, it wasn't until Dr. Dean Edell's rants that I had evidence and support to justify my discomfort. Dr. Edell mentioned two websites: National Organization of Circumcision Information Resource Centers and Foreskin.

At the childbirth education class preparing for our first son's birth, the instructor mentioned that the circumcision segment of the class would be next. I was anxious about this whole segment and my emotions were running high. The instructor started the circumcision segment of the class by asking if there were any reasons not to circumcise. I spoke up physically shaking with nervousness, and through quavering voice, entered into rant against circumcision covering the issues from ethical to harm to sexual function to the fact that I hate what was taken from me. I was completely surprised, thankful, and comforted by the instructor's complete agreement with what I had said. When she passed around the various mutilation devices used for the procedure, I passed them by without even looking at them. The instructor argued against it circumcision and backed up the statements I made as well as providing additional information. She recited a story about how she went along with circumcision for her first son when the nurses asked her while she was still delirious from pain medicine. Later, she thought about the issue and left her other sons intact. She now speaks out against circumcision at all the childbirth education classes she teaches. Although she is a nurse, she refuses to participate in the procedure at the hospital. After that class, a woman sitting next to my wife and I thanked me for my bravery at speaking out and indicated that if she and her husband were having a boy instead of a girl that they would leave him intact.

Earlier this year, I started taking an active role in the community on Twitter which has proven to be a tremendous opportunity and a source of frustration. The Twitter community serves as both a support group and a means to get the message out; I suspect it's more successful in the former capacity. It is extremely difficult to change an entire society's view on an issue that has been part of culture for many years: culture is one of the hardest things to change.

Although I believe I may have influenced relatives to keep their boy intact, it is an uneasy outcome as their boy recently had a UTI and the husband is urging to have him cut. My influence is limited.

I have a great number of regrets due to my failure to properly influence friends, family members, and co-workers to follow the right side of this issue. In some cases, my emotions got in the way and my message was not delivered effectively. In other cases, the audience was just plain not receptive and no amount of convincing would have worked. Still other cases are the result of me not speaking up when I should have. I know the outcomes of some cases and not others. Unless the outcome is to leave the child intact, I'd rather not know.

I strive to find my place both in the I2 community and to find the most effective ways to influence friends, family, and co-workers.

Monday, September 10, 2012

The AAP-Circumfetishist Connection

There is at least one connection between circumfetishist groups and the American Academy of Pediatrics. One connection is Edgar Schoen, who was once head of the AAP's "Task Force on Circumcision". Another connection is more recent: there is some evidence that AAP's recently-updated policy statement on circumcision was sent to Brian Morris, in advance of its release to the public, for review and comment.

My view of this connection seems to differ from others in the I2 community. Many view this connection as further evidence of a virtually impregnable coalition of pro-circumcision advocates. It is true that an alliance of pro-circumcision groups, each with their own motives, makes the struggle for I2 more difficult. The alliance is also a weakness.

Associating with depraved and downright evil individuals is a liability for the AAP. The connection between the AAP and circumfetishists—especially Vernon Quaintance—may cause people to rethink what the true motives behind circumcision advocates might be. If circumcision is really about "medical benefits" as the AAP claims, why is it interested in feedback from Brian Morris, a biologist, who is not a medical doctor?

If I were a member doctor of the AAP, I would be appalled to learn that the AAP fraternized with circumfetishists. Publicly revealing the AAP's associations could cause an outcry resulting in embarrassment; a strong enough public outcry might even pressure them into changing their view on circumcision.

Saturday, September 1, 2012

A Look at Circumcision Death Rates

It is quite frustrating for me that finding indisputable, universally accepted circumcision death rate statistics seems to be impossible. Older sources put the number at 1:500,000 (Circumcision: Position Paper on Neonatal Circumcision). A newer study places the number at 9.01 in 100,000 or approximately 117 per year in the United States (Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths).

The study, authored by Dan Bollinger has received both criticism and support in least one forum. Still more criticism can be largely discredited due to straw man analysis and authorship by a circumfetishist. Bollinger's analysis provides the most accurate and up-to-date numbers regarding circumcision death rates the medical community has seen so far.

A number of articles cover this research comparing the death rate from circumcision to that from SIDS. The death rate is greater than that from suffocation and automobile accidents.

Drop-side cribs were banned after more than 30 reported deaths (After dozens of deaths, drop-side cribs outlawed). An entire class of products was banned due to approximately 30 deaths. But we don't ban cosmetic surgery that kills more than one hundred babies a year?

Unfortunately, neither the Bollinger research nor the associated news stories is good enough for Wikipedia:

Neither new source meet WP:MEDRS; Thymos does not appear to be MEDLINE indexed, or even have any information which would help establish its reliability such as discussing its editorial board or policies. There is no indication this meets WP:RS, much less WP:MEDRS. In any event, this would be a primary study anyways, and would not qualify for MEDRS.

Recent deaths due to metzitzah b’peh in New York (Baby’s Death Renews Debate Over a Circumcision Ritual, How 11 New York City Babies Contracted Herpes Through Circumcision) are often dismissed by pro-circumcision advocates as isolated cases not relevant to the discussion. It is disturbing that genital mutilation followed by felatio is legal. It is indisputable that these deaths are associated with and caused by a circumcision ritual and are quite valid as part of the larger discussion.

The corruption and malaise within the medical community is a frustrating reality for intactivists. Whereas science as a whole advances consensus through properly-vetted research, "medical science" is fractured and moves to serve medical device manufacturers, health care providers, and pharmaceutical companies. Good research, such as Bollinger's, is marginalized due to arbitrary constraints (e.g. Wikipedia:MEDRS). Meanwhile, improperly-conducted, unethical research (such as the Africa HIV circumcision studies) published in journals such as Cochrane "pass the test" and are touted as indisputable fact. Cochrane is seen as a reliable source by many despite its tremendous incompetence at properly vetting articles.

Regardless of number, are any deaths from circumcision acceptable? How many children die from being intact?

Saturday, August 11, 2012

Genital integrity advocates: Can't we all just get along?

There have been a couple of recent blog entries that have brought increased awareness to a reality I've suspected for some time but have ignored. Many anti-FGM advocates are neutral to—or even openly hostile to—the campaign against male routine infant circumcision (RIC) and non-consensual male circumcision. Common sense would indicate that an individual against genital mutilation of one gender would be against genital mutilation of the other gender.

This topic has fostered the ire of others in the I2 community resulting in a number of discussions on Twitter. Maria of Barrel of Oranges upstages my blog post here with a compelling and comprehensive post in her blog Circumcision: Human Rights Make no Anatomical Distinctions and the guest post in Martin S. Pribble's blog Circumcision: Human Rights Make No Anatomical Distinctions – By Maria Bangs.

The subject of people who are anti-FGM but who are indifferent to or support MGM has been a source of frustration to me for some time. Recently, the blog entry Male Circumcission [sic] and HIV/AIDS by ExquisiteLady opened the door for me to discuss this issue. I learned of ExquisiteLady through retweets of @NoFGM1 on Twitter. I have her blog in my RSS reader. She highlights many of the struggles that African women face as well as important issues relevant to women in general including child abuse, rape, depression, HIV, and FGM. Another blog post, Male circumcision and FGM are not equivalent from Margaret Nelson covers similar territory.

Misperceptions and Myths

It cannot be taken for granted that just because someone is knowledgeable regarding a human rights issue affecting one gender that he is knowledgeable about the human rights issues facing the other gender. Many anti-FGM folks seems to suffer from the same misperceptions and myths that those in favor of male circumcision suffer from. These myths and misperceptions include:

  • The foreskin is merely a flap of skin
  • The foreskin is merely a "foreskin" and nothing more
  • The foreskin has no function
  • The foreskin does not affect sexual pleasure for men (or women)
  • Those who have been circumcised suffer no negative physiological or emotional effects
  • Circumcision has health benefits
  • Circumcised men are able to fully enjoy sex and masturbation

All of the above statements are false.

It is quite shocking to me that many anti-FGM advocates claim health benefits for male circumcision while, in the same breath, reiterating that FGM has no health benefits! There is medical "evidence" for health benefits for FGM that revolves mainly around claims of hygiene and bacteria (e.g. UTIs, STDs, etc.) reduction. These claims are similar to the "evidence" used to defend male circumcision on medical grounds. Medical benefits to genital cutting are irrelevant: these are human rights issues.

FGM and MGM are the Same Issue

Statements have been made that FGM and MGM are fundamentally different issues. For someone without adequate information or perspective, I suppose this is an understandable viewpoint. This viewpoint is incorrect, however.

Men are circumcised for reasons of culture, hygiene, health, religion, ego (father won't admit he was wronged so commit wrong on son), and to control sexuality. These are exactly the same reasons why FGM is performed. This point is made crystal clear by the web page Similarities in Attitudes and Misconceptions toward Infant Male Circumcision in North America and Ritual Female Genital Mutilation in Africa. Kudos to the FGM Network for not trivializing MGM.

Men are victims of forced circumcision both as infants (in countries like the USA) and as adults (in Africa). This is similar to non-consensual FGM. Eighty-five percent of FGM victims suffer from Type I/II types (see Female genital mutilation on Wikipedia). In countries such as Egypt, the FGM is often performed in a hospital setting such as is done with MGM in the US. I have no interest in trivializing FGM: my statements are to illustrate the similarities between these two evils.

Anti-FGM advocates have claimed that men can have normal, healthy sex lives even after circumcision while FGM robs women of all sexual pleasure. Many FGM victims can still experience sexual pleasure—including orgasm—just as MGM victims do.

Many women defend FGM just as many men defend MGM. This isn't a simple issue of men oppressing women or women oppressing men. Religion, culture, shame, and tradition all have influence on the desire to cut the genitals of one's children.

The following list enumerates a number of blog entries and news articles that back up my claims made here and provide additional information:

Cultural Oppression and Severity

There is no doubt that there are many forms of FGM (e.g. infibulation) that, along with surrounding cultural practices, are worse than male circumcision. Cultural practices that control women's sexuality, cause permanent harm and disfiguration of genitals, and result in disease have no place in a modern society. This vile treatment of women needs to stop.

A difference of severity in some forms of FGM is not a reason to trivialize MGM. If one is consistent and logical, being neutral to MGM requires accepting that some forms of FGM are OK as well. Anti-FGM and anti-MGM advocates are both campaigning for dignity of the innocent and for human rights. Renewed interest in the bogus and discredited health benefits of male circumcision (particularly with regards to its use as a "surgical vaccine" in the fight against HIV) has re-invigorated an interest in FGM for the same purpose. The male circumcision campaign in Africa has backfired and has resulted in the increased rate of infection among women and men in areas with high rates of HIV.

Conclusion

As long as male circumcision is considered a "valid" medical procedure, FGM will continue. Anti-MGM advocates or "I2 Advocates" are universally against FGM. It is time for anti-FGM advocates to stand in solidarity with us to fight this scourge on human civilization together.

Tuesday, July 31, 2012

Finding Balance

I recently took a break from intactivism due to a family vacation, work deadlines, and home improvement projects. My intactivism efforts included a few blog entries, participation in Twitter discussions, and efforts to improve the Wikipedia circumcision article. I'm not the most prolific or effective #i2 contributor, but I do try to make a difference.

The few months I spent closely following my Twitter feed, making efforts to improve Wikipedia and research have induced tremendous stress, anxiety, and anger. At various times, I found myself compulsively checking my phone to make sure I didn't miss any updates. I felt obligated to respond to mentions as quickly as possible. I felt compelled to respond to every argument used to justify the state of the Circumcision article on Wikipedia. It became difficult to relax and enjoy life "in the moment" due to anxiety caused by this self-induced need to be involved.

I found myself occasionally losing patience, having difficulty concentrating at work, and becoming less happy. One of my character weaknesses is a susceptibility to a greater emotional investment than should be warranted. I allowed my emotions—anger, frustration, helplessness—to affect my quality of life. Although it is my responsibility to overcome my emotions and this problem is mine to solve, it is also noteworthy that there is an emotional harm done to victims of non-consensual genital cutting.

After a break, my wellness returned. My laid-back nature returned. My patience returned. The anxiety and stress melted away.

I am in a better, more mature place now. I need to find a way to be involved without being consumed. I need to find a way to participate without such emotional attachment. I need to find balance. I want to continue to be involved because this issue is extremely important to me. I want to see routine infant circumcision end, but I cannot let the negativity of this evil consume me and damage my quality of life and my relationships.


Friday, June 15, 2012

Motivations of Circumcision Advocates

Most Americans don't think about circumcision much. It is just another standard medical procedure done in the hospital (e.g. like cutting the umbilical cord) that is done to newborn boys and it is not a big deal. There is nebulous and vague talk of "benefits" and hygiene. Most Americans are ignorant on this subject.

Rational open-minded people are nearly always convinced by talk of ethics and accurate information that cutting their children's genitals is wrong.

Some honestly and truly believe that the "medical benefits" outway ethical concerns. Men do not want to admit that something is wrong with their penis. Men want their penis to be better ("male enhancement products" are commonplace in American culture)! It is easier for a man to believe that the foreskin is a useless flap of skin than to believe his penis isn't perfect. These men tend to have their children cut so their sons' penises aren't better than theirs and/or so they don't have to admit something was taken from them.

The most voracious and dangerous circumcision advocates are the circumfetishists. When I first heard this term, I honestly thought it was just a derogatory term that I² advocates used to describe those who support circumcision. Later, when I stumbled across circleaks.org, I began to realize that circumfetishism is real and it is actually is a "fetish" or, more accurately, a form of pedophilia. I read some of the circleaks.org content with my mouth literally hanging open, aghast. I had to stop: the content made me sick to my stomach.

Sex and sexual arousal are powerful human motivators. The sexual motivations of circumfetishists and the thrills that they obtain from thinking about, writing about, watching, or participating in circumcisions results in immutable beliefs.

In looking through the types of disturbing content posted to circlist, it became clear that the circumfetishists enjoy the fact that they are circumcised and some even want to get circumcised again! Now this is looking more like self-harm. The following statement from the Wikipedia article clarifies my point:

The sexual organs may be deliberately hurt as a way to deal with unwanted feelings of sexuality, or as a means of punishing sexual organs that may be perceived as having responded in contravention to the person's wellbeing (e.g., responses to childhood sexual abuse).

It is my belief that the majority, if not all, circumfetishists are victims of sexual abuse. Some of the posts from circlist captured on circleaks.org imply or explicitly state this fact. In order to realize circumfetishism, that abuse, combined with a sociopathic personality, sadism, and masochism results in an individual who enjoys and obtains sexual pleasure from both his own circumcision and that of others.

As abuse victims, I would otherwise pity the circumfetishist—but their vile behavior and actions qualify them as evil. These individuals must be stopped.

P.S. If you do desire to have your son circumcised, you will want to look at the doctor's groin during the circumcision. It is not unheard of for him to get aroused during the procedure. Let's hope this disturbing thought results in reconsideration!

Wednesday, June 13, 2012

Africa HIV Claims

The American medical community and media has bought into the idea that circumcision is a valid tool for HIV prevention. The African studies showing a benefit are dubious; see "Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns".

The WHO, the American NIH, the American CDC, the Bill and Melinda Gates Foundation, and the governments of a few African countries (largely corrupt governments likely receiving kickbacks from American charities and medical device manufacturers) recognize the African HIV studies as valid. Additionally, virtually all of the meta-studies in the medical journals and publications accept the RCTs and they confirm that circumcision has an HIV-reduction benefit. To a casual onlooker, this appears to be a "medical consensus". But is it?

According to "How Well Do Meta-Analyses Disclose Conflicts of Interests in Underlying Research Studies", many meta-studies are not properly vetting the original study.

With any scientific or medical topic, the majority of new research will be funded by those trying to prove or disprove a theory. This is the scientific method. And that's how it should be. In this case, there are endless studies by organizations promoting a pro-circumcision point-of-view. The large volume of studies gives the impression that there is a "consensus" where all studies show the same result. In reality, it's a large number of studies by those trying to prove a point-of-view. This is not the same as consensus.

The question here is: what is the general consensus in the medical community on this issue? I would like to gain clarity. I am aware that numerous national medical organizations outside the US (e.g. Brazil, Australia) have rejected the notion that circumcision is a valid HIV-reduction tool.

So now here's the heart of the issue: I want to remove the Africa HIV claims from the lead of the Wikipedia circumcision article. Ultimately, I'd like to remove those claims entirely, but the lead is a good start. In the lead, these Africa HIV claims are front-and-center: someone skimming the article may see these claims and decide circumcision is good without reading rest of the article. That's why the pro-circumcision advocates want these claims in the lead! I can remove these claims if I can show that these claims don't represent consensus in the medical community.

What I am asking for is feedback either here or on Twitter for any references, sources, or ideas regarding whether or not there is medical consensus on this issue—and what it is.

Friday, June 1, 2012

Wikipedia and I2

1.0 Current State


It is worthwhile to take a look at the Wikipedia article on Circumcision as well as the Female Genital Mutilation article. The article on circumcision describes the medical benefits of the procedure. The FGM article, on the other hand, approaches the topic from a human rights point-of-view and connotes a negative view of FGM.

The differences between these two articles reflects commonly-held American/Western viewpoint that circumcision is not harmful and may have significant benefits while FGM is a violation of human rights and must be stopped. The circumcision article at Wikipedia and all articles relating to this topic are watched over by a single editor whose seniority grants him virtually complete control over the article: he acts as a gatekeeper. This editor is supported by a few administrators who tend to back up his decisions.

There are many incorrect claims, inaccuracies, and biases in the Wikipedia Circumcision article. The following sections highlight two issues.

1.1 Africa HIV-Circumcision Claims


One of the most disturbing claims of the Wikipedia Circumcision article is the following claim in the article lead:

One analysis of studies done in Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%,[15][16] and studies have concluded it is cost effective in sub-Saharan Africa.[17] The WHO currently recommends circumcision be part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV.[18] Some organizations have discussed under what circumstances circumcision is ethical.[19][20]

Wikipedia editors are insistent that this claim is consistent with medical consensus.

At the time of this writing, the Wikipedia circumcision article is protected from editing due to disputes. One of the current disputes is over the inclusion of the Boyle-Hill study finding serious flaws in the African HIV-Circumcision research. The current discussion of the circumcision article can be found on the Circumcision Talk page.

1.2 Sexual Function


The Wikipedia Circumcision article makes dubious claims about the loss of sexual function in circumcised individuals:

A 2010 review reported that "...despite conflicting results in some of the historical observational studies, most recent articles do not show evidence of adverse effects on sexual function."[59] A review which analysed the data from eight clinical trials concluded that the "evidence suggests that adult circumcision does not affect sexual satisfaction and function."[12]

2.0 Challenges


2.1 Research Reliability


Wikipedia prefers reliable secondary sources to back up claims made in articles. Although the definition of a reliable secondary source is well defined, editors have been known to reject certain sources as fringe if the editor doesn't agree with the study's conclusions.

2.2 Quantity of Research and Medical Consensus


As with many controversial issues, it can be difficult to determine medical or scientific consensus. Although Wikipedia gives some guidance as to what defines medical consensus, editors tend to "count up articles supporting a point of view" in medical journals to determine consensus. This is clearly an inaccurate approach since the advocates of a point-of-view—especially when well-funded—tend to conduct more research while the status quo point-of-view tends to have fewer research papers supporting it.

2.3 Conflict of Interest


The type of conflict-of-interest that Wikipedia is primarily concerned with is when an organization directly edits a page making the content biased. For example, it would not be allowed for the Romney or Obama campaigns had editors change the "Barack Obama" or "Mitt Romney" articles to introduce negative, un-sourced, and/or inaccurate information about their opponents.

The African HIV-Circumcision studies have issues cannot be rejected from the Circumcision article without Boyle-Hill due to the following statement regarding assessment of evidence quality:

Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.

Because the African HIV-Circumcision studies are of a high-quality type (RCT), they meet Wikipedia's guidelines for supporting article content. The Boyle-Hill study shows that these studies are not true RCTs. The Boyle-Hill study (and any other studies drawing similar conclusions) is critical to support the removal of the African HIV-Circumcision claims from the article.

3.0 Plan of Action


3.1 Make Efforts to Change Policy


3.1.1 Scientific and Medical Organizations


Wikipedia medical policy states the following regarding medical and scientific organizations:

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include the U.S. National Academies (including the Institute of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health and Centers for Disease Control and Prevention, and the World Health Organization. The reliability of these sources range from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature.

David R. Tomlinson, founder of the circumcision device maker AccuCirc is a medical adviser to the WHO. Thomlinson, who admits he is the mad scientist type, represents a conflict of interest in his association with the WHO and the WHO's conclusions regarding circumcision and HIV. Removing the WHO as a "reliable source" would help to improve the quality of the circumcision article.

3.1.2 Reliability of "Reliable Sources"


Many pro-circumcision studies are published by the Cochrane Collaboration. The Cochrane Collaboration receives funding from the WHO. The WHO receives funding from the Bill and Melinda Gates Foundation.

It is doubtful that the Cochrane Collaboration is conducting itself properly. Based on a study published in JAMA, the Cochrane Collaboration does not properly conduct peer review of the articles it publishes failing to disclose conflict of interest the majority of the time:

However, very rarely was this information reflected in the meta-analyses. Only two (7%) reported RCT funding sources and none reported RCT author-industry ties. The authors conclude "without acknowledgment of COI due to industry funding or author industry financial ties from RCTs included in meta-analyses, readers’ understanding and appraisal of the evidence from the meta-analysis may be compromised."

If conflict of interest were properly disclosed, many pro-circumcision research studies could be eliminated from the article due to compromised reliability.

3.2 Editor Conflict of Interest


Although Wikipedia doesn't ban editors with a conflict of interest from editing articles, it does present specific criteria for these edits. At least one editor's conflict of interest is front-and-center. The following is an excerpt from the circumcision article:

Promotion
.
Circs.org maintained by <editor name removed>.

Due to the editor's seniority, he is believed to edit from a neutral point-of-view. His point-of-view and his edits to the circumcision article over the past eight years have been not been neutral overall. Change to Wikipedia policy to further highlight and address conflict of interest would be beneficial both to Wikipedia as a whole and the circumcision article.

3.3 Discussion on the FGM Page


There have been battles on the FGM Talk page similar to (though to a lesser extent) those on the circumcision page. At least one editor is trolling from a pro-FGM point-of-view to highlight the gross disparity between FGM and circumcision articles. These are generally analogous procedures of male and female genital mutilation but with completely different treatment in Wikipedia. It is noteworthy that an editor of the circumcision article has made some pro-FGM statements on the FGM talk page.

3.4 Collect & Analyze Research


I am in the process of collecting research and links from I2 advocates on Twitter, pro-I2 websites, news stories, and research papers. It will take me some time to sort through this information. Please contact me via Twitter (using the same username as this blog) if you are willing or able to help out with sources.

3.5 Edit the Circumcision Article


Editing the Wikipedia circumcision article is easy. Getting those changes to stick is the hard part. Addressing Wikipedia policy, challenging invalid research, and using reliable secondary sources can work towards making a positive change in the circumcision article. Tangentially, it may also be useful to approach editor conflict of interest issues. An effort to use a similar approach for both FGM and circumcision articles to eliminate cultural bias (e.g. circumcision is accepted in American culture while FGM isn't) might be a useful tactic as well.

4.0 Next Step


My next step is to write another blog entry summarizing a possible edit to the Wikipedia circumcision article. Once arguments for the change seem airtight, I'll make the edit. I have no doubt that it will be a significant battle—even with airtight arguments for the change.

I welcome any thoughts, ideas, or other feedback regarding this blog entry.

Wednesday, May 23, 2012

Introduction

I created this blog to be able to explore I2 subject matter in a more in-depth capacity than is practical with social networking, though blogs and social networking can definitely complement each other. I will use this blog to capture my thoughts on the issue of genital integrity and intactivism.

Another goal that I have for this blog is to help me formalize strong, arguments for I2. Feedback from other bloggers or those on social networking that read my posts here can help me make those arguments airtight. Hopefully, these arguments can try to change the biased viewpoints of sources such as Wikipedia that present an anti-I2 point-of-view.