Zionazi
2024-12-20 06:36:06 UTC
Reply
PermalinkBecause:
Disclaimer: I'm a 4th year (senior) medical student, graduating with my
MD in May - that's the perspective I'm writing this from. I am not (yet)
a doctor, nothing here is medical advice, ect. ect.
——
The benefits angle.
There are no hygiene benefits - and even if they were that's not a valid
argument. We don't cut off ears to make it easier for kids to wash
behind them.
——
Now this is not justifying the practice, but pointing out that its
benefits seperate it from female genital mutilation which does not serve
any such benefits, especially when done to the clit.
Not quite true - there are some minimal benefits to hygiene, infection
risk, ect. These don't remotely justify the procedure, but they do
exist.
The medical benefits of MGC on the other hand are severely overhyped,
and also in no way justify permanent surgical removal of healthy tissue.
But for the sake of completeness we'll go through them - the three most
common are UTIs, HIV, & cancer.
Briefly lets discuss a number you'll see a lot in this discussion - NNT
or number needed to treat. This is how many times we have to do a
particular intervention to stop 1 instance of the thing we want to
prevent. For example if the NNT for a blood thinner was 500, we'd have
to put 500 people on a blood thinner for some amount of time before we
prevented a single clot. (made up numbers for illustration).
- UTIs, is has been shown that MGM can lower the risk of UTIs in boys.
However, UTIs is boys cut or no are already very rare, and can be simply
treated with a course of antibiotics. The NNT here is in the low
hundreds, so we're permanently maiming hundreds of boys to stop a single
infection that would be cleared in a few days of antibiotics. UTI
prevention is not a valid medical reason for prophylactic MGC
- HIV/STDs. The HIV risk studies are almost all garbage - at this point
it's a mark that someone doesn't know what they're talking about.
Firstly, they were conducted in subsaharan africa, where HIV is endemic.
The risk:benefit analysis has extremely limited applicability to first
world nations where that isn't the case (If you want to talk about
African MGM, that's a whole other can of worms). The methodology of the
study was so poor that they (IMO) produced no valid data - they cut the
men and gave them sex education/condoms/other interventions all at once
while the control group got no intervention. Then, they stopped their
follow-up for "ethical" reasons soon after, and included the time frame
the cut men were still recovering from surgery. Interestingly, if you
don't have sex because your penis is healing, its much harder to get HIV
during that window. Also of note are sex practices in regions of Africa
that make HIV transmission higher in cut men. Finally, even in the most
favorable light possible their results are something like 60% reduction
in transmission. Condoms are at 90%, MGC is very clearly inferior
especially considering it's a permanent surgical intervention. HIV
prevention is not a valid medical reason for prophylactic MGC
- Penile cancer. Already an *incredibly rare disease, the NNT ranges
from 900 to >300,000 to prevent a single case. Given that, like
anal/cervical cancers it is strongly linked to HPV, a more appropriate
intervention would be vaccinating boys for HPV in middle school like we
do girls. Having to cut so many boys to stop a single case doesn't
justify MGC anymore than breast cancer justifies bilateral mastectomies
for infant girls. penile cancer is not a valid medical reason for MGC.
- Finally - the other side of the equation: complications. Even if we
accept a 1-2% serious complication rate (fairly good for routine
surgical procedures on healthy subjects) that doesn't balance things
out. Complications such as severe bleeding, sugical site infection,
sepsis, need for revision, accidental amputation/destruction. Even just
looking at infections & UTIs, if you have to cut >100 boys to prevent
one, you'll have 1-2 complications - like a surgical site infection,
which is much more serious. The risks do not justify the benefits, and
medically speaking there's no tenable argument for routine infant MGC.
In fact, the AAP (American Academy of Pediatrics) has reversed their
policy position and no longer recommends it. Numerous other medical
organizations in other nations don't recommend it.
——
The insensitivity angle.
——
A medically necessary circumcision is pretty rare, given that only 1-3%
of boys will get pathological phimosis (compared to physiological, which
is sometimes mistaken for the other), which is by far the most common
indication for circumcision. Even then - 80% of cases resolve with
medical therapy. Of the remaining 20%, there are less damaging surgical
interventions that are equivalent in outcome like dorsal
slitting/z-plasty, ect. As far as the insensitivity option, i apologize
if this comes of as harsh, but that doesn't matter at all. Mutilate - to
cut off or permanently destroy a limb or essential part of. That's
what's done in MGC, by the most conservative interpretation of the fact.
You are removing the most sensitive tissue of the penis, removing
secretory mucosa/epithelia, making the glans penis an external organ
instead of internal, removing the functional equivalent to the glans
clitoris in the female (frenulum & ridged band), permanently changing
the way the organ functions sexually, introducing scar tissue, and a lot
of stress that will stay with that child for the rest of their life. I
understand that you feel it's insensitive, and you may be right - but
it's also completely accurate.
——
3) In summary im just saying the practice is not so bad that it deserves
such a brutal and horrendous term. It is an insensitive exaggeration
used to push an agenda.
——
But it is - the summary here being that mutilation is an accurate term
to describe whats done, there is in 99.999% of cases no medical
justification to do it, hygiene is not an acceptable reason, and
honestly while I agree with you that MGM was coined in response to FGM
to push an anti-circumcision agenda, there should be an agenda to ban
the practice based on the above facts.
https://www.reddit.com/r/changemyview/wiki/user/POSVT