Diskussion:Zirkumzision

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Neue Cohortstudie: Genitalverstümmelung schützt nicht vor HIV

Genau wie jede andere seriöse Studie bisher zeigt auch diese: wenn man die Vorhaut abschnippelt ist man nicht mehr vor HIV geschützt. Hier wurden 800.000 Patienten getestet.--Albin Schmitt (Diskussion) 18:27, 19. Okt. 2021 (CEST)

Oh, übrigens kam auch zur selben Zeit eine kanadische Studie heraus, mit 500.000 Untersuchten, die zu demselben Ergebnis kamen. Aber ich weiß ja, dass hier ein einziger sehr aktiver Nutzer jegliche Wissenschaft aus dem Artikel heraushält, also gehe ich mal davon aus, dass seriöse Forschung nicht angesehen ist. Tja, ist dann halt so, wollte hier nur die Diskussion anregen, damit Leute sich auch informieren können.--Albin Schmitt (Diskussion) 18:31, 19. Okt. 2021 (CEST)

Sonderbehandlung

Bezüglich dieser und dieser Änderungen: Einen Zusammenhang zu der NS-Verwendung des Wortes Sonderbehandlung kann ich hier beim besten Willen nicht erkennen. Ich finde auch nicht, dass herausgehobene Stellung besser klingt. Jedenfalls ist es aber inhaltlich nicht das gleiche; Shaw kritisiert ja wohl gerade nicht eine besondere Bedeutung der Zirkumzision, sondern die gleichwohl erfolgende Sonderbehandlung. Insofern müsste die inhaltliche Änderung quellenmäßig belegt werden. Ansonsten möchte ich noch ganz freundlich auf WP:Edit-War hinweisen: Wer eine so mit Begründung revertierte Bearbeitung erneut durchführen will, sollte zuvor die Diskussion mit dem Revertierenden suchen (vorzugsweise auf der zum Artikel gehörenden Diskussionsseite) und erst nach Vorliegen eines entsprechenden Diskussionsergebnisses bzw. bei Ausbleiben von Reaktionen nach einer angemessenen Wartefrist seine Bearbeitung wiederholen. Dies gilt nicht nur beim Wiederholen einer eigenen Bearbeitung, sondern auch von Bearbeitungen anderer. MfG --Yhdwww (Diskussion) 17:46, 26. Okt. 2021 (CEST)

„herausgehobene Stellung“ ist ziemlich unpassend und unverständlich. Mein Vorschlag: Eine abweichende Behandlung/Privilegierung der Zirkumzision aus religiösen Gründen sei nicht zu rechtfertigen. Von Rechtsphilosophie ist bei David Shaw keine Rede.

Allerdings heißt es dort tatsächlich „special treatment [...] given to the family’s interest in having the operation done“ und „why should this procedure be treated differently simply because of the weight of religious tradition?“

David Shaw 2009 pdf

p. 183 The implication is that, in the case of NTC [non-therapeutic circumcision], special treatment should be given to the family’s interest in having the operation done. This is quite wrong: what is in a child’s best interests does not change according to the

p. 184 implications for his parents of not having a non-therapeutic operation. Another addition is ‘and family’; on the standard checklist only the parents’ views are mentioned. Again, this seems to be slanting the supposedly objective best interests test in favour of NTC, as other family members are very likely to also be in favour of the operation. We accord great importance to religious beliefs in our society and allow parents great latitude in raising their children, but tend not to allow parents to harm their children in pursuit of non-medical ‘best interests’. Jehovah’s Witnesses are not allowed to refuse blood transfusions on their children’s behalf, despite the fact that from their point of view it is in the child’s best interests to die rather than receive blood. NTC is unlikely to result in death, but it is a clinically unnecessary irreversible operation, so the argument that it is in a child’s best interests is weak at best.

The penultimate criterion asks doctors to consider the patient’s religious or cultural background, which once more differs from the standard checklist. The standard criterion is ‘any knowledge of the patient’s religious, cultural and other non-medical views that might have an impact on the patient’s wishes’. A young child will not have any such views, and the focus on the NTC best interests checklist has shifted to ‘religious or cultural background’. This might seem innocuous, but it is not. The sincerely held religious beliefs of an adult patient carry much more weight than the sincerely held religious beliefs of a patient’s parents; this is actually a radical shift in the best interests test, and one that introduces an undeniable bias in favour of the parents’ preferences.

p. 185 In the case of NTC, the foreskin will not grow back; why should this procedure be treated differently

p. 186 simply because of the weight of religious tradition? The very fact that NTC is also sometimes referred to as ‘ritual’ circumcision implies that it is something that is done out of unreflective habit. If you ask the father who is requesting NTC for his child why he wants it, the most likely response apart from ‘it’s my religion’ would be ‘my father had it done to me’. But this is not a good reason for exposing a child to risk.

--Vsop (Diskussion) 19:48, 26. Okt. 2021 (CEST)

Yhdwww, ich denke auch nicht, dass es hier das Potenzial eines Missverständnisses gibt – also dass jemand beim Lesen denken könnte, hier wäre das gemeint, was die Nazi-Behörden als Sonderbehandlung bezeichneten. Mein Punkt ist eher, dass das Wort seit dieser Zeit nicht als ein normales Wort gelten kann. Es bedeutet nicht einfach „besondere Behandlung“, sondern in exakt dieser Form hat der Begriff eine entsetzliche Geschichte. Der Begriff gehört nicht in einen Satz mit irgendetwas auf das Judentum Bezogenem. Eigentlich gehört er nirgendwo mehr hin, aber in einen solchen Kontext auf keinen Fall.

An „herausgehobene Stellung“ hänge ich nicht. War eher eine Verlegenheitslösung. Bessere Vorschläge sind willkommen – Vsop hat schon welche gemacht, die von mir aus gut sind. --Mushushu (Diskussion) 23:02, 26. Okt. 2021 (CEST)

Also mit Privilegierung könnte ich gut leben. MfG --Yhdwww (Diskussion) 15:29, 27. Okt. 2021 (CEST)

Japan, USA, Grossbritannien und Israel - Was hat Statistik und wissenschaftliche Meinungen mit der "Regelung ... in einzelnen Staaten" zu tun?

Was hat Statistik und die Meinung von Wissenschaftlern im einem Abschnitt der mit "Regelung der Beschneidung Minderjähriger in einzelnen Staaten" zu suchen? Kann gerne wo anders einfügt werden. Aber dort wo es jetzt steht ist es total am falschen Ort. --81.6.59.149 09:19, 18. Mai 2022 (CEST)

PS: Auch im Unter-Abschnitt zu den USA, Grossbritannien und Israel sind Statistiken enthalten, die nicht zur Überschrift übergeordneten Abschnitts passen. Die statistischen Daten gehören in den Abschnitt "Anteil Beschnittener in der Gegenwart" und die Meinungen der Wissenschaftler in in dem Abschnitt "Indikationen" oder so. --81.6.59.149 09:19, 18. Mai 2022 (CEST)

Empfehlungen der Leitlinie fehlen

Die Empfehlungen der [https://www.awmf.org/leitlinien/detail/ll/006-052.html aktuellen S2k-LL für Kinder] fehlen noch, ev. komme ich "demnächst" dazu, die einzupflegen.--Julius Senegal (Diskussion) 15:53, 21. Aug. 2022 (CEST)

Bildzeile

Die Bildbeschreibung ist ziemliches Holperdeutsch.

"Zirkumzision an einem Jungen in Zentralasien, vermutlich Turkmenistan (um 1870)"

Sollte man umformulieren, etwa:

Zirkumzision eines Jungen in Zentralasien, vermutlich Turkmenistan (um 1870) --178.2.8.223 11:21, 24. Nov. 2022 (CET)

Sexual function claims

Apologies for any previous miscommunication. I'm not a native speaker of German. (I'm fluent in English and Spanish; I'm chosing to write this in English because I'm guessing it's the better lingua franca on here.) The original edit I made on sexual function was based on the 2021 English circumcision page.

I work in the urology field and noticed that this page currently makes broad, sweeping, and definite claims surrounding the procedure's impact on sexual function. These claims are completely absent from other Wikipedia articles surrounding this topic — compare the English, Spanish, Italian, and French versions of the article to the current wording in German — and heavily controversial. (The World Health Organization, Canadian Urological Association, and American Academy of Pediatrics all state that the highest quality evidence shows it doesn't make a substantial difference.)

Something like the 2021 English version or present Spanish/Italian/French versions are a much better reflection of the present scientific literature on the matter.

• Those versions state that the impact of circumcision on sexual function is controversial (True)
• They also state that studies have shown positive, neutral, and negative effects on sexual function (True)
• A majority state that high-quality studies of consensual, adult circumcision have predominately not shown a substantive benefit or decrease in sexual function. (There is a general consensus on this part, although not universal. Most also preface this statement with the fact that these claims are based off of studies of consenting adults and can't be extrapolated to routine circumcision on minors.)

I'm uncertain why the present German-language page on this topic differs so radically.

I recommend that editors use something like Google translate and compare each version. The English/Spanish/French/et al. are all way closer to each other.

Thoughts? I'm in the process of learning German. But I wanted to speak in English - for the moment - to avoid any possible confusion.

Note: I'm using a translator so I can (predominately) understand what you're saying. --KlayCax (Diskussion) 08:20, 5. Feb. 2023 (CET)

From my own experience, I can report most of my sexual partners who were circumcised had quite some problems getting to orgasm and some of them always needed lube. I can also see that the German article contains many high quality references that convincingly show that circumcision can have a negative impact on sexual function. Why should this NOT be mentioned in the article? I would suggest that you translate the German article and include these missing references in the English and French articles you mention. 80.71.142.166 18:01, 21. Feb. 2023 (CET)

Because (as listed below) the overwhelming majority of medical organizations have policy positions that contradict this. Of course that doesn't mean that routine circumcision of neonates isn't ethically problematic — I completely agree — but claims that it always or usually damages sexual function are predominately rejected — and at best — are controversial. The Canadian Urological Association, World Health Organization, AAP, AMA, and multiple other major medical organizations explicitly state it doesn't.

A majority of the sources in the article suffer from significant methodological problems and have been directly criticized in multiple current policy statements of major medical organizations. For example, O'Hara (1999)'s results are taken from a sample of from an anti-circumcision newsletters' members and their close friends. This is a classic example of self-selection bias. Of course individuals recruited through an anti-circumcision newsletter are going to report a greater desire for penises that have not been circumcised. Similarly, the response to Masters and Johnson (1966) is taken from NoHarmm, an anti-circumcision activist website that appears to be from an anonymous author. To call this widely problematic is an understatement. Other sources are similarly cherrypicked and/or misrepresented

As someone who works in the urology field, it's shocking to me that this version of the page claims this as if it's an undisputed fact, as it's a position that's been rejected by a multitude of major medical organizations, including in non-circumcising countries. KlayCax (Diskussion) 07:39, 23. Feb. 2023 (CET)

Private Erfahrungen und Wiedergegebenes von andren Personen sind in keiner Weise überprüfbar und von daher für WP nicht relevant. Nur Aussagen, die valide belegt sind, können im Artikel wiedergegeben werden. Wie das in Artikeln anderer Sprachräume gehandhabt wird, das ist nicht unsere Aufgabe. -- Muck (Diskussion) 15:39, 22. Feb. 2023 (CET)

Every major medical organization that has weighted on the issue as stated the opposite of the present wording within the article.

The World Health Organization: states that there is "no good evidence" that circumcision increases or decreases sexual pleasure.

The Canadian Urological Association: — which opposes routine circumcision — states that There is lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood.

Mayo Clinic: Circumcision doesn't affect fertility, nor is circumcision generally thought [in the scientific community] to enhance or detract from sexual pleasure for men or their partners.

Cleveland Clinic: Circumcision doesn’t affect fertility (ability to produce a biological child). And researchers believe it doesn’t hurt or enhance sexual pleasure.

No major medical organization states that it does. While 7+ — including harsh critics of the practice on ethical grounds — states that it doesn't. The article presently gives the misleading impression that the dominant viewpoint or overwhelming consensus of the scientific community that it does. (And always decreases pleasure on top of that.)

The claim itself is completely unsourced. It's just given and assumed. (Despite the above policy positions from official major medical organizations.)

Compare the Spanish, Italian, or English version to this. This article is radically outside the articles on the subject in other languages. KlayCax (Diskussion) 07:39, 23. Feb. 2023 (CET)

Ich unterstütze deinen Ansatz, das Belegniveau auf Leitlinienaussagen wissenschaftlicher Fachgesellschaften und WHO anzuheben. Weil auch nach den Richt- und Leitlinien der deutschsprachigen Wikipedia bei der Literaturverwertung auf die "Rezeption in der Fachwelt" zu achten ist (WP:RMLL#C). Aber Achtung, es gibt auch die Leitlinie „Phimose und Paraphimose bei Kindern und Jugendlichen“, herausgegeben von der Deutschen Gesellschaft für Kinderchirurgie (DGKCH) unter Federführung des auch politisch aktiven Beschneidungsgegners Maximilian Stehr. Dort lautet das Fazit zum Thema "Mögliche Auswirkungen auf die Sexualität und sexuelles Erleben": „Anhand der aktuell existierenden Literatur ist es nicht möglich allgemeine Aussagen bezüglich Risiken und Komplikationen der Zirkumzision im Kindesalter im Hinblick auf sexuelle Funktionen und sexuelles Erleben zu treffen. Jedoch finden sich Hinweise, dass Beeinträchtigungen sexueller Funktionen und des sexuellen Erlebens mögliche Konsequenzen der Beschneidung sein können.“[1] --TrueBlue (Diskussion) 16:08, 23. Feb. 2023 (CET)

Right. I think that should be mentioned. But this seems to be more in relation to botched circumcisions and those performed incorrectly. (If I'm understanding correctly.)

Is this wording alright? (Removing the low-quality studies that I mentioned above.) It borrows from the current Italian, English, and Spanish wording.

There has been discussion surrounding circumcision's affects on sexual function. When properly performed by a trained medical practitioner in a sterile setting, the general consensus among major medical organizations is that circumcision has a neutral impact on sexual function, sensation, desire, or pleasure. This has been indicated by the highest quality evidence; lower quality evidence has given both increased and decreased results on these metrics. (Canadian Urological Association, 2018; Mayo Clinic, and Cleveland Clinic statements on the matter get cited here.) A 2013 systematic review published in the Asian Journal of Andrology found that circumcision did not appear to adversely affect or prevent pain with intercourse, premature ejaculation, time until ejaculation, erectile dysfunction or difficulties with orgasm. The effect of circumcision on sexual partners' experiences has not been well studied. Existing evidence is insufficient to make conclusive determinations on circumcision's impact on sexual partners. (Tian et al., 2013 goes here; Bossio et al., (2014) goes here as well.) KlayCax (Diskussion) 18:42, 23. Feb. 2023 (CET)

For example, Bronselaer et al., 2013 in the article is cited, yet it has been widely rejected by multiple medical organizations as suffering overwhelming methodological problems, and, has been, to quote: "widely criticized". Similarly, O'Hara (1999) is cited, yet it was drawn from an non-representative sample of an anti-circumcision newsletter.

I suggest the above italicized wording. Similar wording is used in other versions of the article. KlayCax (Diskussion) 18:42, 23. Feb. 2023 (CET)

I think the section is o.k. as it is. Individual studies and their results are presented. (The fact that the participants in the O'hara study were recruited from anti-circumsion groups is mentioned.) Your proposed edits, however, are not. Your extensive claim of a " consenses among major medical organizations is that circumcision has a neutral impact on sexual function" lacks any factual basis.

First of all, the Mayo Clinic and the Cleveland Clinic are not 'medical organizations' but private clinics.

The American Academy of Pediatrics (AAP) has not renewed its circumcision policy statement since 2017. Thus, the AAP currently has no policy on the issue of circumcision.

Some medical organizations which have taken a clear stance against non-therapeutic circumcision of minors, such as the Swedish Association of Pediatricians or the Danish Medical Association, have not issued a detailed policy statement dealing with any aspects such as the sexual effects of circumcision in detail.

The Canadian Urological Association only speaks of a "lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood". "Lack of Evidence" that negative effects on sexuality exist is not the same as an evidence-based judgment that circumcision has been proven to have a neutral impact on sexuality.

The conclusion that there is "lack of evidence" for negative sexual effects resulting from neonatal circumcision rests primarily on undue reliance placed on flawed and heavily criticized studies on adult males conducted in Africa. These studies were authored by the very same collective around Ronald H. Gray and Robert C. Bailey, who is also responsible for two of the African RCTs reporting a reduced HIV infection risk, which US government organizations (e. g. PEPFAR) and western NGOs used as the basis for a controversial multi-billion-dollar mass circumcision campaign in Africa. A program which has itself come under heavy criticism in recent years and is now being criticized by African doctors as an "unethical human experiment" and a form of "Western neocolonialism". [2]

These authors were clearly biased in favor of circumcision. They pursued the goal of introducing mass circumcision as a public health measure against HIV-transmission. Negative effects on sexual function might have put this goal at risk.

When these questionable studies are excluded from the analysis a fairly consistent picture emerges showing that the majority of the available evidence suggests that circumcision more or less adversely impacts sexuality.--Aeamis (Diskussion) 23:55, 23. Feb. 2023 (CET)

This isn't about the ethics of routinely circumcising neonates. On this issue, I want to make it clear that I completely agree with you that it's wrong. However, whether or not circumcision impacts sexual function is completely inconsequential to whether it is unethical to do so without the person's express consent or an immediate medical need.

If the Canadian Urological Association — among multiple other major medical organizations in non-circumcising societies — states that there is a "lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood" than we definitely shouldn't state in Wikivoice that it does.

As for the subject of the African RCT trials, Ronald H. Gray, and Robert C. Bailey, you're messing up the three African RCTs trials conducted in 2002 related to HIV/AIDS transmission with a multiude of others performed by other medical researchers. Bailey, Gray, et al. never performed a study related to circumcision and sexual function.

I'm okay with revising the proposed wording above (although it's directly copied from a featured article on this very topic) — perhaps we could leave it as "controversial" and then quote the Canadian Urological Association and the others — but it's abundantly clear that the current wording is misleading for the reasons stated above.

Finally, no major medical organization or clinic states that there is a "fairly consistent picture" that circumcision "adversely impacts sexuality". The ones that do make statements on the matter state that most studies have not found a substantive improvement or decrease in function. KlayCax (Diskussion) 05:50, 24. Feb. 2023 (CET)

Studies that find no negative impact on sensation are biased and measure the sensitivity of the skin that remains and by this ignore the loss of the sensitivity of the skin beeing cut away. The canadian urological association states: "It is obvious that the foreskin has sensory nerves, which are lost following a circumcision". Of cause the human brain is capable to compensate physical restrictions of the body and it cannot miss or compare what it never experienced, but the capability to compensate does not eliminate the reduction in sensitivity.

The german guidelines clearly state that a reduction of sensibility and functional impairments are common risks of every circumcision. --Motorpsycho (Diskussion) 12:40, 25. Feb. 2023 (CET)

Studienlage

Ich habe folgenden Artikel entdeckt: https://www.fitbook.de/health/beschneidung-mann-gesund Darin sind gleich mehrere akademische Artikel enthalten, welche sich auf die Studienlage beziehen. Ich kenne mich mit dem Thema nicht aus, aber möglicherweise sind diese Quellen ja auch für den Wikipedia-Artikel interessant. Vielleicht will sie ja jemand einbauen, falls relevant. 80.71.142.166 17:55, 21. Feb. 2023 (CET)