Religious Rights on Trial?

Just a quick post, there's a recent news story here about a case moving up the Oregon court system where a custodial father wants to circumcise his 12 year old because he (the father) has converted to Judaism. The ex-wife/mother is suing to stop it.

What I find stupefying is the title of the news "Religious Rights on Trial as Circumcision Case Reaches Oregon’s High Court"

You couldn't find a better spin doctor. Let's step back out of the box and put it in plain terms: the dad is whining his religious rights are impeded by people wanting to stop him from getting his son's penis cut. People like the boy's mother.

I just hope the case either drags on till the boy is 18, or the judge finds, like a similar recent case in Chicago, that the boy will choose for himself at 18.

Male Circumcision Overstated as Prevention Tool Against AIDS

People have noticed that some circumcising countries have lower AIDS rates than non circumcising countries in Africa. However comparing USA (a circumcising country) to Europe, Japan, Australia (non circumcising regions) you get an opposite result.

Finally someone has made some sense of all this here.

It's a classic causation vs correlation confusion. Circumcision advocates were touting it as a great way to prevent the spread of HIV, seeing the correlation. However, in this study, they find that the biggest driver of HIV spread is really the infection rates of prostitutes, and the percentage of the population prostituting and patronizing prostitutes. The causation of the circumcision correlation is revealed to be that circumcising countries are generally more religious, so less women prostitute and less men patronize them, per capita.

So treating, educating, protecting prostitutes will net a far greater gain in HIV control than mass circumcision.

Lesson on Confounds: When comparing circumcised to intact, don't forget the foreskin

Confound (freedictionary.com):

1. To cause to become confused or perplexed.
2. To fail to distinguish; mix up: confound fiction and fact.
3. To make (something bad) worse: Do not confound the problem by losing your temper.
4. To cause to be ashamed; abash: an invention that confounded the skeptics.

The first time I heard the word "confound" was in a graduate class where the professor was teaching us to be critical of published papers. She was talking about how to look for "confounds" which would render the results of the studies or experiments in the papers to be caused by something other than what the authors listed in their conclusions.

What makes me think of confounds today is the sudden appearance of news articles saying "Scientists Disagree about Circumcision Sensation" quoting two recent studies that contradict each other on whether or not a circumcised penis has less sensation than an uncircumcised one. Since I have a healthy distrust of the news media (they are trained and paid to find sensational stories, not be critical thinkers), I decided to go straight to the sources.

First, the news clip:

Kimberley Payne of the Riverside Professional Centre in Ottawa, Canada, and her colleagues tested the sensitivity of 20 intact
and 20 circumcised men's penises as they watched erotic movie
clips, by touching the penises with filaments that press down
with predetermined amounts of pressure.... They found no
difference in penile sensation between circumcised and
uncircumcised men.
However, when Robert Van Howe of Michigan State University used a similar method to measure sensitivity at 19 points along the penises of 163 men, he found that the five most sensitive points were all in portions of the penis removed by circumcision,
especially those in folds exposed as the penis becomes erect....

Something should already be fishy: Howe used more subjects, and we know how many points along the penises he measured. The reporter tells us how Payne measured sensitivity, but was that 1 point? 3? 10?

Now for the first study:

Sensation and Sexual Arousal in Circumcised and
Uncircumcised Men.
Kimberley Payne , Lea Thaler , Tuuli Kukkonen , Serge Carrier
, Yitzchak Binik
Introduction. Research, theory, and popular belief all suggest
that penile sensation is greater in the uncircumcised as
compared with the circumcised man. However, research involving
direct measurement of penile sensation has been undertaken only
in sexually functional and dysfunctional groups, and as a
correlate of sexual behavior. There are no reports of penile
sensation in sexually aroused subjects, and it is not known
how arousal affects sensation. In principle, this should be
more closely related to actual sexual function. Aim. This
study therefore compared genital and nongenital sensation as a
function of sexual arousal in circumcised and uncircumcised
men. Methods. Twenty uncircumcised men and an equal number of
age-matched circumcised participants underwent genital and
nongenital sensory testing at baseline and in response to
erotic and control stimulus films. Touch and pain thresholds
were assessed on the penile shaft, the glans penis, and the
volar surface of the forearm. Sexual arousal was assessed
via thermal imaging of the penis.
Results. In response to the erotic stimulus, both groups
evidenced a significant increase in penile temperature, which
correlated highly with subjective reports of sexual arousal.
Uncircumcised men had significantly lower penile temperature
than circumcised men, and evidenced a larger increase in
penile temperature with sexual arousal. No differences in
genital sensitivity were found between the uncircumcised and
circumcised groups. Uncircumcised men were less sensitive to
touch on the forearm than circumcised men. A decrease in
overall touch sensitivity was observed in both groups with
exposure to the erotic film as compared with either baseline
or control stimulus film conditions. No significant effect
was found for pain sensitivity. Conclusion. These results
do not support the hypothesized penile sensory differences
associated with circumcision. However, group differences in
penile temperature and sexual response were found.

OK, so Payne measured two points on the penis and one on the forearm (?) at different stages of arousal, also measuring temperature on the penis. They measured sensitivity on the shaft and head, but hmmmm, isn't there another part of the penis? the foreskin? isn't that cut off with circumcision? why not measure that, Ms. Payne?

Now for the other study:

Fine-touch pressure thresholds in the adult penis.

Morris L Sorrells , James L Snyder , Mark D Reiss ,Christopher Eden , Marilyn F Milos , Norma Wilcox , Robert S Van Howe

OBJECTIVE To map the fine-touch pressure thresholds of the adult
penis in circumcised and uncircumcised men, and to compare the
two populations.
SUBJECTS AND METHODS Adult male volunteers with no history
of penile pathology or diabetes were evaluated with a
Semmes-Weinstein monofilament touch-test to map the
fine-touch pressure thresholds of the penis. circumcised
and uncircumcised men were compared using mixed models for
repeated data, controlling for age, type of underwear worn,
time since last ejaculation, ethnicity, country of birth,
and level of education.
RESULTS The glans of the uncircumcised men had significantly
lower mean (sem) pressure thresholds than that of the
circumcised men, at 0.161 (0.078) g (P = 0.040) when
controlled for age, location of measurement, type of underwear
worn, and ethnicity. There were significant differences in
pressure thresholds by location on the penis (P < 0.001).
The most sensitive location on the circumcised penis was the
circumcision scar on the ventral surface. Five locations on
the uncircumcised penis that are routinely removed at
circumcision had lower pressure thresholds than the ventral
scar of the circumcised penis. CONCLUSIONS The glans of the
circumcised penis is less sensitive to fine touch than the
glans of the uncircumcised penis. The transitional region
from the external to the internal prepuce is the most
sensitive region of the uncircumcised penis and more
sensitive than the most sensitive region of the circumcised
penis. Circumcision ablates the most sensitive parts of the
penis.

Ouch, the most sensitive parts are cut off in circumcision and the circumcision scar is the most sensitive part left over? That's not very nice. They measured many locations on the penis, seeming to use the same method as Ms. Payne. But first, they eliminated all volunteers with penis problems. And then they ask how old they are, when they last ejaculated, what kind of underwear they had, their country of birth, education level, ethinicity.. dang they really want to make sure that nothing can confound their results. And by the way, those P values are results of statistical tests to prove the data is statistically significant, i.e. it's not a result of random chance.

Although, I do see one confound - Howe doesn't tell us what state the penis is in. Was it soft, hard, both? Looks like both parties may need further research.

And that, folks, is the lesson in confounds. If you don't control for everything that might change your results, critical thinkers won't believe your assertions. Since Ms Payne's group didn't measure sensitivity on the portions of the penis that are removed in circumcision, can she really say that circumcised penises have the same sensitivity? The only thing I get from her study is that the shaft and head of the penis feel the same, but I'm still curious about the foreskin. Hell, she didn't even say whether she turned away volunteers that had penis problems, but she did have age matched volunteers.

When using research to guide serious decisions, like whether or not to cut off the end of your newborn son's penis, you might want to look for confounds before you form your final opinion.

"I'm too tired for sex" - What your husband really hears.

This post is for all you ladies out there that say you're too tired for sex with your man. You might want to rethink if you knew what he was really hearing you say.

I'm a man, obviously, but I'm also pretty sure that I'm a normal man when I say I've wanted sex every day of my life since I was about 13. The only time in my life I got nearly that much was when we were newlyweds, but now with one kid here and another one coming, I have to constantly tell my wife what I really hear when she says "I'm too tired for sex today."

"I'm too tired for sex today." from the wife = to the husband "Everything I've done today, no, everything I've done since the last time we had sex that could have contributed to making me tired right now is more important to me than having sex with you."

Let me give you some examples:

1. I'm too tired for sex = making sure all the dishes are clean is more important to me than having sex with my husband.

2. I'm too tired for sex = vacuuming the hallway is more important to me than my husband's spermcount getting so high that he starts drooling when he sees anything with boobs and a vagina.

3. Taking care of the baby makes me too tired for sex = To me, sex is nothing more than a tool to get your sperm into my eggs, so no sex from now until it's time to have another baby.

4. We're too stressed out to have sex = I didn't hear you or any of those scientific studies that tell me that sex is a great stress reliever.

5. We just did it yesterday = We'll never do it daily ever again like our newlywed period, that's ancient history.

6. I love you honey, so I made your favorite meal = I'm going to make it up to you for not having sex with you for 2 months because I was too tired every day by..... working so hard in the kitchen for an hour and a half that I'll be too tired for sex tonight.

7. You used to give me so much more foreplay = I don't realize that this toddler that makes me too tired for daily sex makes you too tired to give me 2 hours of foreplay and makes it so we can't start foreplay till later than we used to and makes it so we can't sleep till noon after having sex till 3AM, and I forgot that yesterday I fell asleep telling how good you made me felt when you tried to give me more than 20 minutes of foreplay.

8. When I woke up to go to the bathroom at 2AM you weren't holding me anymore = I forgot that you can only sleep while touching my body if your balls are absolutely empty.

9. You used to take showers with me = why did you expect a shower together could lead into sex? and why are you spanking your monkey every time you shower like a teenager?

10. My body isn't what it used to be = I know we used to fuck like bunnies, but I'm gonna let this feeling that I'm 1% less sexy than before cause us to have 99% less sex.

Yeah, I've read the Mars and Venus books. It's too scary how true they are - Women need to feel love and romance to want sex, but men need sex to feel loving and romantic. Ladies, it can't be all about you all the time, once in awhile take one for the team. It's all too simple: If you're too tired for sex everyday, show your man you love him by taking steps to get rid of what's making you tired. Every day you go without sex, move sex up a little higher on your to-do list. I can guarantee you just a few days without it and sex is already #1 on your man's to-do list. Yes, it's a tiny part of a relationship, but sex is the keystone that makes the whole thing possible. Without it, you're just roommates of the opposite sex.

And finally, I don't hate my wife. I love her. That's why I'm spanking my monkey instead of cheating. I have told her all of these translations to help her modify her behavior with stuff like telling me whenever she's not too tired for sex such as 10am Saturday, giving me quickies from time to time, napping while our son naps instead of doing chores, I'll take a dirty house and sex over a clean one and no sex any day. 자기야 사랑해! 이번에는 임심했어도 나랑 섹스 해줘서 고마워.

Circumcision HIV news frenzy

There's been alot of press lately covering two studies in Africa that show circumcised men contracting HIV at a slower rate than uncircumcised men. Pushing aside all the debate over what this does or doesn't mean, I want to know why there's so little press attention given to contradicting studies. For example an even newer study has shown that African adolescents who are still virgins, but have been circumcised are much more likely to have HIV than uncircumcised ones because they were circumcised in unsanitary conditions with shared knives.

My only guess is that the typical American man who was circumcised at birth doesn't want to admit his circumcision is useless. He doesn't want to admit his parents made a mistake. He doesn't want to admit that an ancient ritual body mod from the Bible is nothing more than an ancient ritual leftover in modern society. He doesn't want to admit he's missing out on something special. A recent South Korean study surveyed a large number of men who were circumcised after sexual maturity, and the majority reported worse sex, but that news story was drowned out by all the "Circumcision = HIV Vaccine!" headlines.

Judging by my previous posts, I have no readers, but if you read this, please comment on why you think there's no balance in the press coverage, or whether you had even heard of the contradicting studies.

My Love-Hate Relationship

I have a love-hate relationship.... with my car. I love the car, hate the price.

The pros:
FUN FUN FUN.
All Wheel Drive all weather traction.
Turbo power.
A real back seat.
Awesome reliability.

The cons:
$520/month car note.
premium fuel bill.
Got raped on trade-in.
Trunk too small for baby stuff.

It's a 2002 Subaru Impreza WRX sedan that I bought new in early 2003. Now with the baby, I keep kicking myself saying "shoulda got the wagon" which would tip the scales to the pros side. However, as it stands, I'm constantly stuck on the fence between keeping and selling it. Since I never advertise it for sale, though, inertia keeps it in my hands.

That $520 per month has a high opportunity cost for us. It's a playstation 3 every 5 weeks. That's 2 Nintendo Wiis a month. It's a trip to see any of our friends living in the Northeast every month. It's paying off my school loans 10 years earlier. It's a new car for my wife every month.

Yes, you read that right, a new car for my wife every month. She was so scared of a car loan, seeing me in agony over mine every month, that she wanted to buy a car with cash. Some older friends of ours sold us their Volvo 240 Wagon that they had bought new when their daughter was born in 1988. It's been very useful and reliable, and is surprisingly fun to drive. The Volvo was cheap, but can never be as cheap as my wife's first car. She wanted training wheels that wouldn't make her cry if she wrecked it, so we bought an old Mitsubishi Galant from a friend of mine as a favor to him, to get it out of his driveway and out of his wife's hair. We paid him $150 for it, then sold it on ebay 6 months later for over $700. That car paid for all its own gas, insurance, maintenance, and ebay fees.

Meanwhile, I've gotten into SCCA solo autocrossing - driving around cones in a parking lot as fast as you can. I've been surprised at how many people show up in old and non-sport cars. Also, I'm finding that I have a long way to go before my abilities reach the limits of my car.

Where am I going with all this rambling? My plan to end my love-hate relationship with the WRX. Sometime in the near future, I'm going to sell the WRX, buy a newer wagon for my wife, take the Volvo as my own, and autocross it! Tuning parts for it are inexpensive new, and dirt cheap used. The AC never worked for us, so I can strip it for weight savings. There's a wealth of information online for people racing it. And finally, we have the title for it in hand, if I break it, no big deal.

Call me crazy, call me stupid, but I'm going to drive an 80's grocery getter like a sports car in the pursuit of being both happy with my car and my money.

Circumcision craziness

Anyone who knows me well knows that I'm strongly opposed to circumcision, but I've found it difficult to change the opinions of proponents and convince relatives I was doing the right thing by leaving my son intact.

The reason I'm opposed is becaused although the risks are low, I suffered from a side effect until I was about 20 and could find the cause and remedy. So it's very emotional to me, but one of my good friends has told me that my old way of arguing about it was just wrong, even though people who think circumcision is good just look stupid to me, nobody likes being told they are stupid, so I was just making them angry and closing them off, rather than drawing them over to my point of view.

I only started convincing my mom after reading up on all the statistics and numbers and studies, so I could show her counterpoints and examples of why common reasons to circumcise aren't that good. Lately I've been getting into economics, reading up stuff on finance and mostly microeconomics just so I can understand the ebb and flow of money to and from me, trying to control it more. So let's put my new economic knowledge to use on the circumcision debate. I could do a raw statistical argument, but there are a million websites out there already that try to do that from both points of view.

I'm going to do a quick rough cost-benefit analysis of neonatal circumcision with the common reasons why people advocate it, and hopefully try to explain why the American Academy of Pediatrics' official stance on circumcision is: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."


1. UTI's in the first year of life - a neighbor that had a son after us was frustrated that he got sent home without circumcision due to being too jaundiced to have it done yet. She was afraid that he would get a Urinary Tract Infection, no doubt referring to a study that said uncut baby boys are a whopping 10 times more likely to get one in the 1st year of life than cut boys. If you look at the numbers from that study, it was something on the order of 1 in 100 uncut boys versus 1 in 1000 cut boys. In other words, that giant 10 times more likely was 1% instead of 0.1%. The cure for a UTI is a round of antibiotics. If you don't have insurance, the circumcision would cost about $150 and the antibiotics about $40..... so getting your baby boy circumcised to avoid a UTI in the first year of life is the same as paying $150 now to reduce your chance of possibily paying $40 in the next year from 1 in 100 to 1 in 1000. Granted most people have insurance that would distort the money they see out of pocket, but some insurance plans, most notably Medicaid in 16 states have dropped coverage of neonatal circumcision, like the UK national health service did in the 1940's.

2. Phimosis/Balanitis - Phimosis is a condition where the foreskin cannot be retracted fully. Technically all babies are born with it, since the foreskin starts off fused to the head of the penis, and should fully separate by sexual maturity, but some grown men still can't, and their condition is called Phimosis. Balanitis is inflammation of the head of the penis, and when really bad with the foreskin retracted, the foreskin can't go back to its natural state, covering the head. Both have simple nonsurgical cures, but when a man has these problems repeatedly or severely, he might want to be circumcised. So in America, alot of parents circumcise to avoid these problems. Let's say there are 1 million boys born every year and they all get circumcised. At $150 each, that's $150 million, alot of money. Even if Phimosis/Balanitis affected 6% of them, and all of those affected chose circumcision, that will only be 60000 men times $150, resulting in $9 million. Again, you might say "but insurance paid for the circumcision" and I'll say "but you paid for the insurance". Ignoring the medical costs of the boys who suffered circumcision complications (I'll get to that next) that's $141 million extra the insurance companies would have to pay out, and recover somewhere: higher insurance premiums... and people wonder why our health care costs are going up faster than inflation. Again, this boils down to paying for surgery on an infant because he may need it as an adult... paying $150 now to avoid a 6% chance of paying for it later at a possibly higher price.

3. Penis Cancer - Hopefully, the sheer probability numbers will show how weak the penis cancer argument is, but I'll try to break it down with a cost benefit analysis. A study has shown that penis cancer occurs in about 1 in 100000 uncircumcised men over 80 years old. Is the life expectancy for men even 80 yet in USA? A quick check with google shows it to be 75, meaning most men are expected to die before they are old enough to even get penis cancer. Ignoring the actuaries, my mom wanted us to circumcise our son to avoid penis cancer. Let's say there's 1 million boys born this year and all get circumcised at $150 each to avoid penis cancer. And let's say 10% live to be old enough to get penis cancer, so 100000. With the above probability, only one of them would have gotten penis cancer had he been left uncut. So $150 million worth of circumcisions have to be performed to prevent one case of penis cancer, but I won't stop there, I'm going to add in some of the circumcision complications. The rate varies depending on who you ask, but the complications vary from mild - excess bleeding, infection - to severe - loss of penis, loss of life. Let's take the low end, 0.2%, or 1 in 500, and while the medical costs to fix the complications vary, let's say they average out to $100 per person. Then 2000 boys suffered complications at a cost of $200000 to save this 1 old man from penis cancer, all while when caught early, penis cancer can be cured by freezing the tumor like you would a wart, or just cutting off the penis, probably at most $500. So when someone is asking USA to circumcise all our newborn boys to prevent penis cancer, they're asking society to pay $150 million now, $200 thousand real soon, just to avoid paying $500 on one old man about 85 years from now.

So there you have it: neonatal circumcision is not cost effective. Some people may point out the recent HIV studies. I deliberately left them out, because that issue is much more complicated, since it all boils down to sexual behaviors of a bunch of horny boys. So I won't pretend to know how much money dumped into sex ed it would take to convince teen boys to have safe sex or no sex, which is worlds better at preventing HIV than circumcision.

However, I do want to wrap it up with what convinced my sister we were doing the right thing by not circumcising. She was saying one of her boyfriend's frat brothers was embarassed because he had to miss class to recover from circumcision. She was concerned our son would have to go through the same thing in college. I told her that first of all, a low percent of uncircumcised men actually need it as adults, the ones that weren't circumcised and didn't need it also didn't feel the need to tell her about it. I then asked her if she would cut out the tonsils, appendix, or gallbladder of a newborn because it might cause problems later. She said no. It's the same thing. Doctors used to cut out kids' tonsils at the drop of a hat, but now they wait till they really really need to be taken out. I hope foreskins go the same way, doctors waiting to cut them off till they really need to go, insurance making non medically necessary circumcisions an out of pocket cost. In fact, the first intact boys I saw as a kid were sons of a doctor. The American Academy of Pediatrics knew what they were saying when they didn't recomend routine neonatal circumcision. Another way to phrase their stance is: the benefits do not outweigh the costs.