The Science of Circumcision

In this video Myles discusses the history and science behind circumcision.

Video based on ‘The Science of Circumcision’

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About Myles Power (553 Articles)
My name is Myles Power, and I run the educational YouTube channel, powerm1985. I spend what little free time I have sharing my love of SCIENCE! through home experiments, visiting sites of scientific interest, and angrily ranting at pseudoscience proponents. I am also one of the founding members of the podcast 'The League of Nerds' - which I co-host with James from 'The History of Infection'.

8 Comments on The Science of Circumcision

  1. Refreshing truths!

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  2. Love it, thanks for that video. Hopefully a mom or dad will watch this before they have their sweet bab boy subjected to this procedure

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  3. Wonderful information! I would like to see proper intact infant through adolescent care. Most parents think retraction is necessary, instead it is extremely harmful.

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  4. Foreskin feels REALLY good. Forced genital cutting on healthy patients is unethical.

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  5. I cannot believe you actually spoke out regarding risk factors and choice. What about vaccines?

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  6. p.s. I can’t be bothered creating an account at the mo. If you can be bothered to reply I’ll make the effort to sign up :-)

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  7. Attention Nega Myles. You have work to do. I note that you have already indicated that your altar ego Myles had got some of his circumcision video wrong, but I don’t think you realise just how spectacularly, wildly wrong much of it is, and how damaging it is as he sets out to make circumcised males needlessly miserable. So I look forward to you taking him to task in your next Nega Myles presentation. Thus, in order:

    Kellogg and the Victorians. Aside from how seriously Kellogg’s views were actually taken (probably not as seriously as Myles thinks) it is irrelevant. Look up “genetic fallacy”.

    African HIV. Myles talks about “the study” when actually there were three independent Randomised Controlled Trials (RCTs – the “gold standard” of epidemiology). What he is citing is a Cochrane review – a review of the literature including these RCTs. The S. African one (pubmed/16231970) had n = 3274 of whom 3128 were HIV –ve, and of those 1546 were circumcised. The Kenyan trial (pubmed/17321310) had n = 2784, of whom 1391 were circumcised. The Ugandan trial (pubmed/17321311) had n = 4996, of whom 2474 were circumcised. This leaves me wondering where he got his 2328 figure from. That aside, he shows his ignorance when he states: “It doesn’t take a rocket scientist to know that if you have part of your penis cut off you are probably not going to have sex in the near future, thereby reducing the probability of catching the virus over a set time; the study never addresses this issue.” This is the tired old “lead time bias” argument that intactivists keep using despite it being refuted (pubmed/23156651). HIV tests were conducted at 0, 6, 12 and 24 months. If the benefit was due to men abstaining during recovery then it should show in the first 6 months. In fact the benefit got greater with time, so it cannot have been due to abstinence during recovery. And if Myles had tried reading the primary source documents (it helps, you know) he would have found that the S. African trial did allow for a 6 week healing time in its calculations, and found it made little difference. They wrote, “To analyze the impact of the 6-wk period of abstinence, the analysis was repeated with the duration of the period M1–M3 reduced by 42 d in the intervention group.” They found it only “plays a minor role in explaining the effect of the intervention”. So it WAS addressed.

    Before Myles embarrasses himself further with any more mistakes in this area he should read the debunkings of other criticisms of the African trials here (pubmed/22452415) and here (futuremedicine.com/doi/pdf/10.2217/17469600.2.5.399).

    What Myles calls an “interesting tidbit” is set to avert 3.4 million new infections, and save $16.5 billion in health care costs by 2025 (pubmed/22140367) which makes Myles’ error all the more inexcusable, and irresponsible. He, of all people, should know better, being so knowledgeable about HIV/AIDS denialism he should know about the delays in implementation of anti-retroviral therapy in S. Africa after Thabo Mbeki fell for denialist pseudoscience on the internet. Circumcision is no different. Delays in its implementation have cost millions of lives (theguardian.com/lifeandstyle/2009/jul/05/circumcicision-health-children) according to epidemiologist Elizabeth Pisani. Please Nega, tell Myles, this is a major life or death matter. Literally, MILLIONS of African lives are at stake (and likely elsewhere too as circumcision is now being considered outside of Africa). He MUST do his homework, and get his facts right or else he is no better than the deniers he debunks.

    Sadly Myles’ knowledge of the effect of circumcision on sexual function and pleasure is no better. “There are between 10,000 and 20,000 nerve endings compacted onto the human foreskin” says Myles, parroting urban myths that are all over the internet. Did it not occur to him to fact check these numbers first? The 10000 one came from New Zealand intactivist Ken McGrath who has since retracted (McGrath, personal communication) but this seems not to have got out. The 20000 one can be traced back to the magazine “Mothering” in 1997. This same magazine, it may be noted, has a history of publishing HIV/AIDS denialism. How do I know this? Because Myles said so at a “Skeptics in the pub talk” I attended in Liverpool on 15th January 2015. Oh, the irony! In fact “Mothering” has quite a history of peddling quackery (sciencebasedmedicine.org/mothering-peddling-health-misinformation-and-misinformed-consent/). Oh Nega, you could have a field day here! For detail on exactly how the 20000 urban myth originated Google my article “Sloppy scholarship and the anti-circumcision crusade” and tell Myles to scrape the egg off his face.

    “which are used in the ejaculation reflex” Oh give it a rest Myles. This is male bovine excrement. There is not a jot of evidence to support this, it is pure speculation, and refuted by multiple studies showing that circ make no difference to sexual function and satisfaction. These include RCTs (pubmed/18086100 & pubmed/18761593) meta-analysis (pubmed/23749001) and an extensive review (pubmed/23937309). Myles doesn’t give his source, but I suspect it may be the extensively cited work by intactivists Cold &Taylor (pubmed/10349413). This is rich in descriptive detail, but fails to demonstrate that the foreskin is erogenous, fails to distinguish genital corpuscles (which are thought to be the source of erogenous sensation), downplays the importance of the glans, ignoring work showing it to be a densely innervated sexual sensory structure (pubmed/9598486, pubmed/10037378, pubmed/3697758) and its claim about the foreskin being erogenous tissue necessary for sexual function has been rightly dismissed as unproven speculation (pubmed/15097799). For the most up to date review of the histology Myles should read pubmed/26185672.

    Having parroted the 20000 nerves myth Myles goes on to parrot the keratinisation myth. Nega, now is your chance to be cruel to Myles. Challenge him to produce some evidence for this! He could spend hours trying to find a scientific study that actually measures glans keratinisation of circumcised vs uncircumcised, and which finds a difference. He will fail. It is just another of those evidence-free claims endlessly parroted all over the internet (in fact it predates the internet), the parrots never bothering to fact check it first. In fact the ONLY study to look for it (by actually taking tissue samples, sectioning them, staining for keratin and looking at them down a microscope) found no difference (pubmed/10845974). Even the late John Taylor, on his website, said that keratinisation is “Probably not to any significant extent” (research.cirp.org/faq1.html). Now if it does not happen, why should the glans be desensitised? And indeed it is not desensitised (pubmed/15833526).

    Circ opponents greatly hype up the supposed merits of foreskins, and harm of circumcision, cherry-picking and misinterpreting their way through the literature as they go, and ignoring the critiques of the few studies that superficially support their cause (Nega, you must advise Myles to beware works by Bollinger, Van Howe, Sorrells, Bronselaer & Frisch, he must read the rebuttals before using them). But it is all hype and speculation aimed at scaring parents into not circumcising their sons, and making circumcised males miserable, thereby drawing angry, motivated new recruits into the movement. So again Myles is doing real harm here by damaging the self-esteem of circumcised males. Please Nega, ask Myles to retract his false claims about circumcision harming sexual pleasure. It does not. Myles is only going to cause unnecessary anxiety and distress to circumcised males. Is that what he wants? Is he really such a cruel ba$tard, or is he just ignorant of the facts?

    He is certainly ignorant of the complication rate for medical infant circumcision. It is not 1 in 100. It is <0.5 %, and is mostly trivial things easily remedied (pubmed/24820907). I’ll be generous because that one may not have been available at the time Myles put together his first effort at producing his own pseudoscience (sorry, his video is just so bad I can’t think of a more polite way of describing it). The link he provides to the supposed fatality rate of 1 in 500,000 does not say this, but does state: “The potential health benefits from circumcision justify it being a covered medical service by third-party payers, and it should be an available service for those who desire it.” This being the most recent AAP and CDC position, and which contradicts his claim that, “Even the most optimistic of benefits do not outweigh the negative side effects”. Now, he can fairly point out that other professional bodies disagree (but only outside of high HIV countries) so the honest approach is to acknowledge that a case can be made, but that the jury is still out on this one (for low HIV countries). This is the appropriate position to take at present, and is mine.

    So Nega, you have a big job to do. Re-emphasise the importance of circumcision against HIV in Africa, and acknowledge that in low HIV countries the debate is still on-going. And please reassure circumcised men that they are not missing much. I look forward to you giving Myles a good debunking. Oh, and please tell him to avoid anti-circumcision websites for his information. That is like trying to learn about evolution by going to answersingenesis.org. I recommend pubmed.

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