Can You Imagine You Go To A Fancy Italian Restaurant And Before You Go Through The Doors The Doorman

is there anything so undoing as a daughter?

Is male circumcision as harmful as female circumcision? I have had multiple discussions about this, but someone said that certain types of FGM are equally or less invasive than MGM

Hi! No, no it is not.

Male circumcision

So, the big question about male circumcisions is if it's ethical or not. A while ago, I would have said, no definitely not, since it's a violation of bodily autonomy. However, someone has since pointed out to me that we do a lot of things to infants (and children) that are technically violations of bodily autonomy.

We consider this morally acceptable because we are providing some intervention that they (the children) are not capable of either requesting or refusing on the basis of it's benefits outweighing the harms. The best example of this, in my opinion, is vaccines. We give children a lot of vaccines because we know that they have (and do) substantially lower the chance of the child getting sick and/or dying from a preventable disease. In this case, the minor violation of bodily autonomy (vaccination of a child) is permitted because waiting until they are able to give their consent would introduce a substantially larger risk of harm.

How does this relate to male circumcision? Given this framework, we could accept male circumcision if (1) there are benefits to the procedure, (2) the benefits outweigh any risk of harm, (3) waiting until the child is able to consent to the procedure is not feasible (i.e., some significant portion of the benefits would be lost).

There is some mixed evidence for these three claims. Evidence in favor includes:

There are a number of reviews [1-3] by the same team that provide support for all three points. In particular this review [3] directly reviews the evidence of "arguments opposing male circumcision", debunking each one in detail. However, the fact that they are all by the same team is less encouraging. The evidence here is substantial, but there's a potential for bias.

That being said, the American Academy of Pediatric [4] also concludes that the "health benefits of newborn male circumcision outweigh the risks".

This Cochrane Review (essentially the highest quality evidence) [5] found male circumcision substantially reduces acquisition risk of HIV by heterosexual men and that incidence of adverse events is very low.

And this review and meta-analysis [6] found the same reduction for HPV.

Evidence against:

This review [7] suggests the benefits of male circumcision may not apply in North American countries

This article [8] claims the same for developed countries in general

This commentary [9] claims the same, suggesting that "from the perspective of the individual boy, there is no medical justification for performing a circumcision prior to an age that he can ... choose to give or withhold informed consent himself"

That being said these papers have also been challenged by advocates for male circumcision [10] and even opponents [9, 11] recognize that the rates of complications are very low, and the rates of serious complications even lower. In addition to that, complication rate was greater for older children [11], which provides support for the third point I highlighted above (i.e., waiting until they are older may introduce more harms than benefits).

And all of that being said, if the procedure is done, it should absolutely be done with some form of pain relief. Thankfully, it appears that the vast majority are performed in this fashion [11].

In the end, there is strong evidence supporting male circumcision for infants in developing countries. There are research gaps concerning if these benefits apply to developed countries (i.e., little work has examined this population specifically), which indicates a need for such research. That being said, with the extremely low complication rate and moderate evidence of benefits, there also isn't a strong argument against the procedure.

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Female Genital Mutilation

Comparing this to female genital mutilation (FGM) will highlight just how egregious such equivalencies are.

First, a brief detour into biology. Men and women have various embryological precursors that develop into either male or female sex organs. These are called biological homologues, and they are roughly (although not perfectly) comparable. For example, an embryo has the gonad which, during sex differentiation, develops into the ovary in women and the testicle in men [12].

This framework allows us to make some rough comparisons between male circumcision and FGM. For example, it's likely that the "less invasive" form of FGM you were referred to is type 1A [13]. In this type, only the clitoral hood is removed. Both the clitoral hood and the foreskin develop from the prepuce, as they are homologous structures. Notably, even here, male circumcision and FGM type 1A would still only be homologous if (1) FGM type 1A has a similarly low risk profile as male circumcision and (2) male circumcision actually provides no benefits to the infant.

For the first point, we have little to no data on the complication rate of type 1A FGM, specifically because it is essentially never performed in isolation [14]. This is – almost entirely – a theoretical form of FGM. Despite this, even if it were more common it doesn't necessarily follow that the procedures would have a similar adverse effect profile. In fact, one of the most common arguments against male circumcision involves the numerous nerve endings in the glans (head of the) penis, generally in reference to how the foreskin "protects" the penis head or "preserves sensitization" (neither of which are proven assertions). But while the glans penis and glans clitoris have a similar number of nerve endings in absolute terms, the clitoral head is much smaller and therefore much more densely innervated [15]. As a result, it would be much more likely for the removal of the clitoral hood to result in irritation than the removal of the foreskin.

And for the second point, I've discussed the mixed literature on the topic in developed countries. However, most FGM is performed in developing countries (although certainly not exclusively so) [14], and in this context there is strong evidence of a health benefit to male circumcision and absolutely no health benefit to FGM.

To complete the comparisons between FGM and male circumcision in terms of homologous structures [12, 13]:

Type 1B involves the removal of the clitoris with the prepuce (clitoridectomy). This, anatomically speaking, would be similar to removal of (minimally) the penis head.*

Type 2 involves partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. This would be roughly comparable to the removal of the penis head, mutilation/cutting/removal of penile raphe (underside of the penis) with or without mutilation/cutting/removal of the scrotum.*

Type 3 is infibulation, or the narrowing of the vaginal orifice with creation of a covering seal by cutting and apposition the labia minora and/or the labia majora, with or without excision of the clitoris. There is no direct comparison for men, as they do not have a vaginal orifice or any similar structure.

Type 4 is all other mutilation/anything that cannot be categorized as above.

*Note: these comparisons aren't perfect due to differences in how the homologous structures are arranged. For example, removal of the penis head would also impact the urethra, whereas removal of the clitoris would not. That being said, these comparisons are far more accurate than between FGM types 1B - 4 and male circumcision.

To further drive home the differences, FGM results in substantial, severe health complications (unlike male circumcision) and has absolutely no known health benefits (possibly unlike male circumcision). These articles [16-21] go into great detail on this; the complications range from: infection, incontinence, infertility, severe and sometimes chronic pain, pregnancy complications, PTSD and post-traumatic symptoms, other psychiatric disorders, greater risk of STDs, and death.

There is no evidence of any benefits.

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Conclusion

Hopefully, it's clear that male circumcision and female genital mutilation are in no way comparable.

The opponents of male circumcision often suggest that any violation of the bodily autonomy of infants is morally wrong, but this fails to consider the nuanced situation inherent to infant-hood and early childhood. They are physically and mentally unable of consenting to or refusing any medical procedure, which is why we have a – generally recognized – moral caveat to this principle that allows caregivers to act in the best interests of the child, particularly when waiting for the child to grow older before allowing any intervention would increase the risk of harm. (Childhood vaccinations and, really, any other medical procedure done on children, are other examples of this.)

It's possible that future research may indicate that male circumcision is not associated with benefits in developed countries. (This would remove male circumcision from the category of procedures described above.) Even then, however, it would not be comparable to FGM due to the vastly different complication rates.

I hope this helps you!

References under the cut:

Morris, B. J., & Krieger, J. N. (2013). Does male circumcision affect sexual function, sensitivity, or satisfaction?—a systematic review. The journal of sexual medicine, 10(11), 2644-2657.

Morris, B. J., Kennedy, S. E., Wodak, A. D., Mindel, A., Golovsky, D., Schrieber, L., ... & Ziegler, J. B. (2017). Early infant male circumcision: systematic review, risk-benefit analysis, and progress in policy. World journal of clinical pediatrics, 6(1), 89.

Morris, B. J., Moreton, S., & Krieger, J. N. (2019). Critical evaluation of arguments opposing male circumcision: A systematic review. Journal of Evidence‐based Medicine, 12(4), 263-290.

Task Force on Circumcision, Blank, S., Brady, M., Buerk, E., Carlo, W., Diekema, D., ... & Wegner, S. (2012). Male circumcision. Pediatrics, 130(3), e756-e785.

Siegfried, N., Muller, M., Deeks, J. J., & Volmink, J. (2009). Male circumcision for prevention of heterosexual acquisition of HIV in men. Cochrane database of systematic reviews, (2).

Shapiro, S. B., Laurie, C., El-Zein, M., & Franco, E. L. (2023). Association between male circumcision and human papillomavirus infection in males and females: a systematic review, meta-analysis, and meta-regression. Clinical Microbiology and Infection, 29(8), 968-978.

Bossio, J. A., Pukall, C. F., & Steele, S. (2014). A review of the current state of the male circumcision literature. The Journal of Sexual Medicine, 11(12), 2847-2864.

Frisch, M., & Earp, B. D. (2018). Circumcision of male infants and children as a public health measure in developed countries: a critical assessment of recent evidence. Global public health, 13(5), 626-641.

Deacon, M., & Muir, G. (2023). What is the medical evidence on non-therapeutic child circumcision?. International journal of impotence research, 35(3), 256-263.

Moreton, S., Cox, G., Sheldon, M., Bailis, S. A., Klausner, J. D., & Morris, B. J. (2023). Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health. World Journal of Clinical Pediatrics, 12(5), 244.

Shabanzadeh, D. M., Clausen, S., Maigaard, K., & Fode, M. (2021). Male circumcision complications–a systematic review, meta-analysis and meta-regression. Urology, 152, 25-34.

26: The Reproductive System . (n.d.). In Anatomy and Physiology (Boundless) . LibreTexts. https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Anatomy_and_Physiology_(Boundless)/26%3A_The_Reproductive_System

Abdulcadir, J., Catania, L., Hindin, M. J., Say, L., Petignat, P., & Abdulcadir, O. (2016). Female genital mutilation: a visual reference and learning tool for health care professionals. Obstetrics & Gynecology, 128(5), 958-963.

WHO, U. O. (2008). Eliminating female genital mutilation: An interagency statement. World Health Organization.

Shih, C., Cold, C. J., & Yang, C. C. (2013). Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. The Journal of Sexual Medicine, 10(7), 1783-1789.

Utz-Billing, I., & Kentenich, H. (2008). Female genital mutilation: an injury, physical and mental harm. Journal of Psychosomatic Obstetrics & Gynecology, 29(4), 225-229.

Klein, E., Helzner, E., Shayowitz, M., Kohlhoff, S., & Smith-Norowitz, T. A. (2018). Female genital mutilation: health consequences and complications—a short literature review. Obstetrics and gynecology international, 2018(1), 7365715.

Iavazzo, C., Sardi, T. A., & Gkegkes, I. D. (2013). Female genital mutilation and infections: a systematic review of the clinical evidence. Archives of gynecology and obstetrics, 287, 1137-1149.

Berg, R. C., & Underland, V. (2018). Immediate Health Consequences of Female Genital Mutilation/Cutting (FGM/C).

Sarayloo, K., Roudsari, R. L., & Elhadi, A. (2019). Health consequences of the female genital mutilation: a systematic review. Galen medical journal, 8, e1336.

Reisel, D., & Creighton, S. M. (2015). Long term health consequences of Female Genital Mutilation (FGM). Maturitas, 80(1), 48-51.

a manifestation routine.

! long post ahead !

in this post, i want to give you an idea of how a manifestation "routine" could look like. i'm aware that this is one of my longer posts but i wanted to give as many insights and as much reassurance as possible. it’s a guide especially for those, who need a bit guidance, who may have come off track a little and who want to discipline themselves a bit more.

morning and evening.

right before you wake up or fall asleep, lay down on your bed and close your eyes. try to calm your mind, loose any tension built up in your body and take deep breaths in and out. with your eyes closed, pay attention to the darkness you're seeing. everything around you doesn’t exist for now. the outer world is none of your concern. your responsibilities fade away and in this given moment, there is nothing that needs to be worked on, nothing that needs to be fixed, nothing that needs to be dealt with. right now, it’s only you in this darkness. you are safe. you are protected.

now, think about it: what is it that you want? what is it that you wish to experience? this isn’t about what you feel like you should want or what you need to experience but rather what YOU deeply want. what would having / being it feel like? what would it look like? what if you had / were exactly what you wanted?

as you become more and more decisive and definitive about who you want to be and what you want to have, you begin to enter the state of the wish fulfilled. you take a step towards the end. you start to bask yourself in the feeling of being the version of yourself who has or is what you desire to have or be. for this, you can visualise yourself or use affirmations that go hand in hand with your desired outcome.

at the same time, let go of your old conception of self. leave your old mindset. right now, you aren’t who you were before you entered this state of calmness. shift your states. go from your former one to your desired one. give life to your new state and death to your old state. abandon the old story. you don’t need it now. you no longer need to retell it. you don’t need to carry it with you anymore.

don’t focus on details. don’t worry about your scenes of visualisation or wording of affirmations. don’t try to make it perfect. don’t question it. and don’t reason your way into it. try to make it natural. try to make it enjoyable. in imagination, you cannot do anything wrong. feel free to imagine any way you would like to. doing any technique without feeling it to be true and without accepting it won’t do anything. it cannot change you. not the technique itself but the feeling will alter self. your visualisations and affirmations shall only support you by guiding you to your desired state. don’t perform anything in vain. do it with purpose. do it with conviction. do it with acceptance. mere repetitions lead to mere results. if you repeat, then do it with feeling. for feeling is the secret.

this way, you become conscious of your new self. and since consciousness is the one and only reality, things can only appear through consciousness. becoming conscious of having your desire means to feel your desire to be yours. by making consciousness your aim, you are aiming to become conscious of BEING and HAVING your desire.

rest of the day.

after you took time to meditate in the morning, you continue to live with your wish fulfilled during the day. whenever you think of your desire, whenever you start to desire something, you claim it to be yours. you declare that it’s part of your reality now. you simply accept it to be true instead of letting your mind wander, overthink or worry. you don’t leave any space for feelings of desire and refrain from living in desire as well. you don’t have to go into a deep meditative state either. you think of it, recognise your desire, imagine it to be yours, feel it to be yours and then go on with your day. this way, you only aim for your inner fulfillment and get rid of any desire that comes up.

you don’t need to force yourself to think of your desire for a very long time, nor do you need to immediately start affirming or visualising a scene that implies you having your desire. what you do is that you take some time, not a lot, to acknowledge your desire and to shift your state from desiring to owning. you do this for as long as you like, until you have accepted your desire to be yours. you will know when you have shifted your state as you won’t feel feelings of desire anymore. you won’t want it anymore because you know there is nothing left to desire that isn’t already yours.

there's no need to constantly bring you back and to remind yourself of your manifestation. the moment you accept it, you can let it go. it’s done now. it belongs to you. assuming your desire to be yours once you think of it is totally enough. you don’t need to obsess over it either.

the more you do this, the easier it will be for you to remain in your desired state. you will get used to the state because you get used to the feeling. it will start to feel familiar to you. it won’t be as difficult as before. it won’t scare you as it did in the beginning.

once in the state, it will become easier to handle the outer world. your thoughts come from your state aka your feeling and if you happen to be in the state you wanted to occupy, you will respond better to 3D circumstances (if there are any). you'll stop viewing your physical world the way you used to and you'll also stop feeling like it’s a lot of work to be in the state of the wish fulfilled. you'll stop viewing the act of shifting your state as effortless. as normal. as natural. you can happily live in the 3D while still experiencing your manifestation from within, giving your inner self what you want. from now on, you will want to identify with your real self more frequently and anything outside of you will lose importance. you won’t care about how the world may look like, you won’t stress about your physical existence. anything that does not serve you will be of little account.

everyday.

the purpose of this guide is to motivate you to make fulfillment your one and only goal. make it a lovely habit to daily manifest your desires. do it each day.

do not waste time contemplating whether your desires are easy to manifest, quick to manifest, possible to manifest or logical to manifest. stop categorising your manifestations into "big" and "small". do not concern yourself with these matters.

the moment you accept your assumption to be true, it has no option but to materialise. your 3D can never stop reflecting your 4D. you can never run away from your feelings, so why not change them? why not choose lovely feelings for yourself? why not claim great things about yourself? why not immediately grant yourself every wish you have? stop wasting time, conditioning your desires and doubting your abilities as creator of your reality.

within imagination, all things exist and all things are possible. you can be or have anything you'd like in your imagination. it doesn’t have to be hard to get. you don’t need to earn your way to happiness. and you don’t need to work hard for it either. so why would you deny yourself that experience? why would you actively choose not to fulfill yourself? why would you not manifest your desires?

make your imagination a place you love spending time in. make yourself feel feelings of wealth, love, success, health and more. make it so amazing, so addicting that you cannot be bothered or moved by the limitations of the outside world. quoting aphrodite apprentice: "see your desires as invitations to experience something new within yourself and fulfill yourself. and then walk in that fulfillment. just live your entire life in fulfillment."

with love, ella.

Anyone who reblogs this post will have their user written on a poster saying "We Stand With Palestine" that I hope to put up somewhere in the village I live in, or the town that the village is next to.

Monday’s Watch.

not all angels are in heaven. for example i’m mostly at home

seeking, yearning, reaching hands

i've been craving matcha milk so much mmm it's so good when its cold and sweetened but the weather is slightly warm outside so you take a sip it feels like you can taste the mellow notes of summer in your mouth, doesn't really hit the same in winter though :/

ask polly