This was an interesting episode, especially for me as I'm expecting my first child. I was circumcised, but I had been planning to leave my son uncircumcised. This episode actually made me reconsider that a bit. My assumption was that there were no non-religious reasons for circumcising a child, but that's apparently not true.
I didn't find Georganne very convincing - she seemed too didactic to be objective about this issue, and I didn't think she really addressed the points of the other experts very well. I didn't like how she hand-waved the use of antibiotics - antibiotics are a great and powerful tool, but they wreak havoc on our gut biomes and should be used thoughtfully. I would imagine that's especially true for babies.
I would have appreciated some fact checking on one fact in particular: one expert claimed that the foreskin is the most erogenous part of the penis, while another claimed that the foreskin does not contribute to sexual function, and that the glans is where sexual pleasure takes place. It also feels a little weird that all the expert voices in this piece were female. Anyway, I'm not sure I've changed my mind per se, but it got me thinking about it again, which I appreciate.
Thanks for listening, Michael, and congrats! For what it's worth, a few men I reached out to declined to partake in the episode. And I hope Georganne was able to provide some context as to why there are many women's voices prominent in the discussion. Regarding the foreskin vs. glans as the most erogenous zone. Here are a few studies I've looked at: https://www.auajournals.org/doi/abs/10.1097/JU.0000000000002031.12?id=F1 and https://pubmed.ncbi.nlm.nih.gov/26724395/ Although, as you heard, there's much to debate as far as how to definitively answer these questions, and comes down to what you consider as valid evidence.
If the HIV/AIDS studies are influencing you, please know that they were done very poorly. The circumcised men were given condoms and education on safe sex practices while the intact men were not. The US has a high circumcision rate among adult men and has higher std rates than their European counterparts that are not cut.
The foreskin is indeed a very erogenous part of the body. It also protects the glans, keeping it from becoming callused and less sensitive.
If you'd like an academic, male perspective watch this:
" why does this issue in particular seem to get people so intensely fired up?" Um, when you are talking about cutting off a body part, especially in that part of the body, an intense reaction seems reasonable
Wow, I was so disappointed in Noah, Manny and Devan's final sum-up on this episode, which I liked overall. Education is important, but you guys decided to gloss over the fact that Georganne's (and by extension, the Intactivists') version of 'education' is actually misinformation. It's a pretty important problem on that side of the argument.
I think the anti-circumcision movement has some very valid moral and ethical arguments that deserve to be considered on moral and ethical grounds. But Georganne has decided that's not enough. She wants to win the scientific argument as well. And yet she doesn't respect the ethics of scientific discussion.
The epidemiologist and sociologist brought studies with documented methods, data, and results. Georganne dismissed their results and discredited their methods without evidence. She mischaracterized - or lied - about the studies in ways that are clearly intended to make people who haven't read them skeptical. For example, when she suggested researchers paid participants to get circumcised in the African study, when in fact they gave all study participants travel reimbursements, including the half that did not get circumcised. At the end of the episode she says flat out that there is "No evidence that circumcising a baby is a beneficial health procedure. None. None anywhere." That is flat-out false, and she knows it's false. She just doesn't like the evidence that exists.
Georganne is allowed to be skeptical, but she fails to support her skepticism with evidence that's anywhere near as solid as the evidence on the other side. And then she states unequivocally that all the "real" evidence favors her argument. That's RFK anti-vaxx propaganda 101. And these are tactics that activitists use to discredit science in all sorts of debates - on climate, on vaccines, on police violence. Not "education" but misinformation, used as propaganda.
I didn't need the hosts to debate Georganne on facts - the episode gave us the evidence via Dr. Grabowski and Laura Carpenter. But it's bizarre to me that, in their concluding remarks, the guys all seemed to agree that Georganne and her allies are just about "we need to do more education."
The premise of NST is that Manny Noah and Devan are just regular guys, a little under-informed like the rest of us, trying to find out what's really going on. I'm cool with the format that we're all learning together. But part of my buy-in as a listener is knowing that all three of you have backgrounds in journalism and know how to weigh evidence and tease apart facts and opinions.
You/they really shit the bed (to use a scientific term) on that part of this episode. I'm glad you brought new information and new ideas (on both sides of the issue) to my attention. But I'm disappointed and a little embarrassed for you, as far as your analytical skills, with the way you summed up what we all learned.
Hi Andrew, I really appreciate the feedback and understand your disappointment.
As you can tell, debunking every claim made would be frankly an impossible (and unlistenable) task. We wanted to include Grabowski’s defense of the research and our own critique (albeit perhaps not enough) of the unspecific and unscientific arguments made without getting too lost in rattling off statistics and the many back-and-forths you can find even within the medical publication commentary.
Ultimately we landed here, hoping to provide an avenue for conversation at a modest runtime, but I definitely hear your frustration.
i hear that, Noah, and I trust you guys are making a good-faith effort. i'd just say I think you could've noted the fundamental difference between the way the two sides approached facts without adding any runtime. "We're just asking questions," "We just want an open conversation," "We just want people to be able to make up their own minds," are all ways that partisans have introduced some intensely biased anti-science arguments into the mainstream in the last 20 years. And journalists in general have dropped the ball by abdicating any responsibility to point out when one side of a debate is countering evidence with opinion and distortion.
Like I said, I left the episode thinking that the anti-circumcision folks have some really good points on moral, ethical and cultural grounds. But when you guys credited them with just wanting to educate people, I honestly wasn't sure whether you were doing both-sidesism, or you actually couldn't tell that their _scientific_ argument swung between weak and misleading. You could've swapped out comments where you credited them with wanting to inform people for comments noting that flaw in their approach, and still ended up with the same runtime.
"The epidemiologist and sociologist brought studies with documented methods, data, and results." Which means promoting studies with statistically irrelevant results and deeply methodologically flawed. They promote the same health benefits for mutilating girls - which carries stiff legal penalties. At the end of the day, these people would be demanding we mutilate girls too if they thought they could get away with it.
Never forgive the mutilators. They are no different than pedophiles.
I appreciate you guys trying to tackle this topic. It’s a challenging one, but to Laura’s point, it’s very interesting because it crosses many different topics and acting as a proxy argument in some ways.
I would have liked to see a less bias perspective from Kate. She completely missed articulating limitations of the research she referenced. The African RTC circumcision trials actually drew a lot of criticism in the scientific community, many of which were published in scientific journals. Main concerns were:
*Statistical bias from the trials ending early—any scientific researcher should understand this.
*Lead time bias appeared to be partially controlled for but not completely.
*Expectation & Observer bias in self reporting.
*Behavioral counseling bias—in some cases the intervention group received more intense safe sex counseling.
*Selection bias from men dropping out or getting circumcised mid-trial.
*Sexual activity bias—sexual risk was controlled by questionnaires which are notoriously flawed.
Quoting 60% relative rate protection in the context of America, is quite disingenuous. Better studies are needed to understand cause and effect since we don’t observe that benefit anywhere else. For example one study covered nearly 570,000 men in Ontario Canada, for 21 years and it showed no statistical difference in infection rates.
Kate also aligns with the 2012 AAP statement which two of the original authors now criticize for accuracy on medical grounds. Kate appeared unaware of statements. The AAP themselves advise against referencing expired policies and this one has been expired for 10 years beyond the 5-year shelf life of the policy.
Kate’s reasons for the drop in circumcision is also quite limited. Medicaid defunding was only correlated with drops in circumcision rates. Rates didn’t increase in areas where insurers started covering the procedure again. The John Hopkins paper on this, which Kate was a co-author on, really shows how bias some of these researchers are. Their conclusions were not supported by their data and were mostly speculative.
Finally, Kate’s understanding about sexual impact is exceptionally limited. She didn’t even quantify the percent of people who reported negative sexual impacts, nor did she explain the limitations. Why didn’t you guys interview a sexologist on that topic? This was a big gap in this reporting.
The comparison to FGM was also ridiculous. People who can’t identify the bioethical similarities, shows the limited perspectives they have.
At the end of the day, people are turning away from the procedure because conflicting evidence of benefits, easy access to alternatives, concerns of risks, more respect for bodily autonomy—especially with sexual rights, and cultural familiarity.
The question shouldn’t be “should you or shouldn’t you circumcise your son”, it should be, “What makes the standard highly effective, affordable, first-line treatments not sufficient considerations, that would justify a higher a risk intervention such as circumcision? And when considering the higher risk intervention, what are the mitigation steps to reduce negative outcomes?” These are the questions that experts on this topic should easily be able to articulate.
Georganne provided a nice history and context to why the procedure is popular here and I think her comments added context to the discussing, but the lack of imperial support was an issue and it would have been worth fact checking to support the overall conversation.
Laura Carpenter has the most sensible assessment in this discussion. Though she missed that the majority of new parents are attempting to asses the medical evidence which continues to get weaker in support of circumcision and the bioethical justification which continues to get stronger in support of not-circumcising.
Overall, pretty good discussion and it’s exactly the type of balanced discourse that we should be having in America, especially considering that all other western countries pretty much abandoned the practice over 30 years.
Concerning Dr. Grabowski's statement on comparing male circumcision and FGM, they compare male circumcision to only one form of FGM in order to highlight the differences. The truth is, FGM type 1a is removal of the clitoral hood, which is the female foreskin. FGM type IV is any other form of damage to healthy female genital tissue including a prick. All forms of FGM are considered human rights violation regardless of tissue damage, motives, health claims, or if it's performed in a medical setting. In fact, the medicalization of FGM has been discouraged because damaging healthy genital tissue in minors without an active medical indication is always wrong and harmful even if it's done as a medical procedure. We don't apply the same protection to boys because the practice is culturally sanctioned. They are the same.
With the decrease in circumscion in the US, I wonder if there is a correlation with the decrease in religiosity? As more people "lose their faith", will the numbers keep going down, and for those that keep up the tradition, is it purely due to their faith?
Physicians who mutilate boys should get the same penalty as those who mutilate girls - 20 years to life in prison. It is common law battery. It is a violation of the 14th ammendment right to bodily integrity - parents have no right to proxy consent for something that is not medical, but merely cosmetic.
Physicians who mutilate children must be sexually motivated. They are no better than Jeffrey Epstein and are probably pedophiles. Investigate them all.
This was an interesting episode, especially for me as I'm expecting my first child. I was circumcised, but I had been planning to leave my son uncircumcised. This episode actually made me reconsider that a bit. My assumption was that there were no non-religious reasons for circumcising a child, but that's apparently not true.
I didn't find Georganne very convincing - she seemed too didactic to be objective about this issue, and I didn't think she really addressed the points of the other experts very well. I didn't like how she hand-waved the use of antibiotics - antibiotics are a great and powerful tool, but they wreak havoc on our gut biomes and should be used thoughtfully. I would imagine that's especially true for babies.
I would have appreciated some fact checking on one fact in particular: one expert claimed that the foreskin is the most erogenous part of the penis, while another claimed that the foreskin does not contribute to sexual function, and that the glans is where sexual pleasure takes place. It also feels a little weird that all the expert voices in this piece were female. Anyway, I'm not sure I've changed my mind per se, but it got me thinking about it again, which I appreciate.
Thanks for listening, Michael, and congrats! For what it's worth, a few men I reached out to declined to partake in the episode. And I hope Georganne was able to provide some context as to why there are many women's voices prominent in the discussion. Regarding the foreskin vs. glans as the most erogenous zone. Here are a few studies I've looked at: https://www.auajournals.org/doi/abs/10.1097/JU.0000000000002031.12?id=F1 and https://pubmed.ncbi.nlm.nih.gov/26724395/ Although, as you heard, there's much to debate as far as how to definitively answer these questions, and comes down to what you consider as valid evidence.
If the HIV/AIDS studies are influencing you, please know that they were done very poorly. The circumcised men were given condoms and education on safe sex practices while the intact men were not. The US has a high circumcision rate among adult men and has higher std rates than their European counterparts that are not cut.
The foreskin is indeed a very erogenous part of the body. It also protects the glans, keeping it from becoming callused and less sensitive.
If you'd like an academic, male perspective watch this:
https://www.youtube.com/watch?v=Ceht-3xu84I
or the Adam Ruins Everything episode on the topic
Physicians always come up with a new excuse to continue their pedophilic mutilations.
It's always been a "cure" searching for disease. From sexual "purity" to paralysis to std's.
" why does this issue in particular seem to get people so intensely fired up?" Um, when you are talking about cutting off a body part, especially in that part of the body, an intense reaction seems reasonable
Wow, I was so disappointed in Noah, Manny and Devan's final sum-up on this episode, which I liked overall. Education is important, but you guys decided to gloss over the fact that Georganne's (and by extension, the Intactivists') version of 'education' is actually misinformation. It's a pretty important problem on that side of the argument.
I think the anti-circumcision movement has some very valid moral and ethical arguments that deserve to be considered on moral and ethical grounds. But Georganne has decided that's not enough. She wants to win the scientific argument as well. And yet she doesn't respect the ethics of scientific discussion.
The epidemiologist and sociologist brought studies with documented methods, data, and results. Georganne dismissed their results and discredited their methods without evidence. She mischaracterized - or lied - about the studies in ways that are clearly intended to make people who haven't read them skeptical. For example, when she suggested researchers paid participants to get circumcised in the African study, when in fact they gave all study participants travel reimbursements, including the half that did not get circumcised. At the end of the episode she says flat out that there is "No evidence that circumcising a baby is a beneficial health procedure. None. None anywhere." That is flat-out false, and she knows it's false. She just doesn't like the evidence that exists.
Georganne is allowed to be skeptical, but she fails to support her skepticism with evidence that's anywhere near as solid as the evidence on the other side. And then she states unequivocally that all the "real" evidence favors her argument. That's RFK anti-vaxx propaganda 101. And these are tactics that activitists use to discredit science in all sorts of debates - on climate, on vaccines, on police violence. Not "education" but misinformation, used as propaganda.
I didn't need the hosts to debate Georganne on facts - the episode gave us the evidence via Dr. Grabowski and Laura Carpenter. But it's bizarre to me that, in their concluding remarks, the guys all seemed to agree that Georganne and her allies are just about "we need to do more education."
The premise of NST is that Manny Noah and Devan are just regular guys, a little under-informed like the rest of us, trying to find out what's really going on. I'm cool with the format that we're all learning together. But part of my buy-in as a listener is knowing that all three of you have backgrounds in journalism and know how to weigh evidence and tease apart facts and opinions.
You/they really shit the bed (to use a scientific term) on that part of this episode. I'm glad you brought new information and new ideas (on both sides of the issue) to my attention. But I'm disappointed and a little embarrassed for you, as far as your analytical skills, with the way you summed up what we all learned.
Hi Andrew, I really appreciate the feedback and understand your disappointment.
As you can tell, debunking every claim made would be frankly an impossible (and unlistenable) task. We wanted to include Grabowski’s defense of the research and our own critique (albeit perhaps not enough) of the unspecific and unscientific arguments made without getting too lost in rattling off statistics and the many back-and-forths you can find even within the medical publication commentary.
Ultimately we landed here, hoping to provide an avenue for conversation at a modest runtime, but I definitely hear your frustration.
i hear that, Noah, and I trust you guys are making a good-faith effort. i'd just say I think you could've noted the fundamental difference between the way the two sides approached facts without adding any runtime. "We're just asking questions," "We just want an open conversation," "We just want people to be able to make up their own minds," are all ways that partisans have introduced some intensely biased anti-science arguments into the mainstream in the last 20 years. And journalists in general have dropped the ball by abdicating any responsibility to point out when one side of a debate is countering evidence with opinion and distortion.
Like I said, I left the episode thinking that the anti-circumcision folks have some really good points on moral, ethical and cultural grounds. But when you guys credited them with just wanting to educate people, I honestly wasn't sure whether you were doing both-sidesism, or you actually couldn't tell that their _scientific_ argument swung between weak and misleading. You could've swapped out comments where you credited them with wanting to inform people for comments noting that flaw in their approach, and still ended up with the same runtime.
"The epidemiologist and sociologist brought studies with documented methods, data, and results." Which means promoting studies with statistically irrelevant results and deeply methodologically flawed. They promote the same health benefits for mutilating girls - which carries stiff legal penalties. At the end of the day, these people would be demanding we mutilate girls too if they thought they could get away with it.
Never forgive the mutilators. They are no different than pedophiles.
I appreciate you guys trying to tackle this topic. It’s a challenging one, but to Laura’s point, it’s very interesting because it crosses many different topics and acting as a proxy argument in some ways.
I would have liked to see a less bias perspective from Kate. She completely missed articulating limitations of the research she referenced. The African RTC circumcision trials actually drew a lot of criticism in the scientific community, many of which were published in scientific journals. Main concerns were:
*Statistical bias from the trials ending early—any scientific researcher should understand this.
*Lead time bias appeared to be partially controlled for but not completely.
*Expectation & Observer bias in self reporting.
*Behavioral counseling bias—in some cases the intervention group received more intense safe sex counseling.
*Selection bias from men dropping out or getting circumcised mid-trial.
*Sexual activity bias—sexual risk was controlled by questionnaires which are notoriously flawed.
Quoting 60% relative rate protection in the context of America, is quite disingenuous. Better studies are needed to understand cause and effect since we don’t observe that benefit anywhere else. For example one study covered nearly 570,000 men in Ontario Canada, for 21 years and it showed no statistical difference in infection rates.
Kate also aligns with the 2012 AAP statement which two of the original authors now criticize for accuracy on medical grounds. Kate appeared unaware of statements. The AAP themselves advise against referencing expired policies and this one has been expired for 10 years beyond the 5-year shelf life of the policy.
Kate’s reasons for the drop in circumcision is also quite limited. Medicaid defunding was only correlated with drops in circumcision rates. Rates didn’t increase in areas where insurers started covering the procedure again. The John Hopkins paper on this, which Kate was a co-author on, really shows how bias some of these researchers are. Their conclusions were not supported by their data and were mostly speculative.
Finally, Kate’s understanding about sexual impact is exceptionally limited. She didn’t even quantify the percent of people who reported negative sexual impacts, nor did she explain the limitations. Why didn’t you guys interview a sexologist on that topic? This was a big gap in this reporting.
The comparison to FGM was also ridiculous. People who can’t identify the bioethical similarities, shows the limited perspectives they have.
At the end of the day, people are turning away from the procedure because conflicting evidence of benefits, easy access to alternatives, concerns of risks, more respect for bodily autonomy—especially with sexual rights, and cultural familiarity.
The question shouldn’t be “should you or shouldn’t you circumcise your son”, it should be, “What makes the standard highly effective, affordable, first-line treatments not sufficient considerations, that would justify a higher a risk intervention such as circumcision? And when considering the higher risk intervention, what are the mitigation steps to reduce negative outcomes?” These are the questions that experts on this topic should easily be able to articulate.
Georganne provided a nice history and context to why the procedure is popular here and I think her comments added context to the discussing, but the lack of imperial support was an issue and it would have been worth fact checking to support the overall conversation.
Laura Carpenter has the most sensible assessment in this discussion. Though she missed that the majority of new parents are attempting to asses the medical evidence which continues to get weaker in support of circumcision and the bioethical justification which continues to get stronger in support of not-circumcising.
Overall, pretty good discussion and it’s exactly the type of balanced discourse that we should be having in America, especially considering that all other western countries pretty much abandoned the practice over 30 years.
Concerning Dr. Grabowski's statement on comparing male circumcision and FGM, they compare male circumcision to only one form of FGM in order to highlight the differences. The truth is, FGM type 1a is removal of the clitoral hood, which is the female foreskin. FGM type IV is any other form of damage to healthy female genital tissue including a prick. All forms of FGM are considered human rights violation regardless of tissue damage, motives, health claims, or if it's performed in a medical setting. In fact, the medicalization of FGM has been discouraged because damaging healthy genital tissue in minors without an active medical indication is always wrong and harmful even if it's done as a medical procedure. We don't apply the same protection to boys because the practice is culturally sanctioned. They are the same.
With the decrease in circumscion in the US, I wonder if there is a correlation with the decrease in religiosity? As more people "lose their faith", will the numbers keep going down, and for those that keep up the tradition, is it purely due to their faith?
Physicians who mutilate boys should get the same penalty as those who mutilate girls - 20 years to life in prison. It is common law battery. It is a violation of the 14th ammendment right to bodily integrity - parents have no right to proxy consent for something that is not medical, but merely cosmetic.
Physicians who mutilate children must be sexually motivated. They are no better than Jeffrey Epstein and are probably pedophiles. Investigate them all.
Never forgive the mutilators.