The AAP has reversed its stance on routine infant circumcision, a topic on which they’ve been silent since 1999 when they stated that the risks of circumcision were greater than the benefits to the degree that they did not recommend for or against the surgery.
And while pro-circumcision advocates will see this as an endorsement of the routine circumcision, Dr Douglas S Diekema of the AAP says it is not actually that. He told The New York times:
“We’re not pushing everybody to circumcise their babies,” Dr. Douglas S. Diekema, a member of the academy’s task force on circumcision and an author of the new policy, said in an interview. “This is not really pro-circumcision. It falls in the middle. It’s pro-choice, for lack of a better word. Really, what we’re saying is, ‘This ought to be a choice that’s available to parents.’ ”
Anti-circumcision activists believe, however, that the decision of whether a child should retain his foreskin should belong to the child, when he becomes of legal age to make the decision, and if it is not a medically necessary surgery, the parents should not have the right to make the irreversible decision for their child.
NYT quotes one anti-circumcision activist:
“The bottom line is it’s unethical,” said Georganne Chapin, founding director of Intact America, a national group that advocates against circumcision. “A normal foreskin on a normal baby boy is no more threatening than the hymen or labia on your daughter.”
The AAP based its decision upon a series of groundbreaking studies in Africa where heterosexual men who had been circumcised showed a 40-60% reduction in HIV transmission rates. The academy then considered more than 1000 other studies when making their decision. Dr. Diekema agrees that the effects in preventing HIV transmission will most likely be less marked than the benefits seen in African populations studied.
The NYT explains the risk of complications from the procedure:
Although newborn male circumcision is generally believed to be relatively safe, deaths are not unheard of, and the review noted that “the true incidence of complications after newborn circumcision is unknown.”
Significant complications are believed to occur in approximately one in 500 procedures. Botched operations can result in damage or even amputation of parts of the penis, and by one estimate about 117 boys die each year.
The biggest note to those who regularly follow the issue of routine infant circumcision is that the AAP is now recommending anesthesia to babies who are having the surgery performed, as it is usually performed without any at all.
However, the NYT notes that with anesthesia will come greater risk of complications.
On a personal note, I feel it crucial to betray that I, as the author, have a very strong bias on this issue. I feel it would be disingenuous of me to write this article without stating that I am a strong “intactivist” (though legally I believe parents should still have a choice) as we like to call ourselves, and did enormous amounts of research into whether or not circumcision was right for my sons when they were born. They are not circumcised, a decision I feel very strongly about and will stand by.
I am keeping abreast of all further studies and rulings by the AAP, which is an organization I believe in and most often agree with, but will admit personal disappointment with the way in which the AAP’s ruling, which seems to be intended to come out as “not against” is being sold as “for circumcision”.
What do you think about the AAP’s statement?
Image of scalpel courtesy of Shutterstock
“though legally I believe parents should still have a choice” This bothers me on a deep level. I understand not being an activist either way, because I am also in many cases. The point of this debate is whether or not the choice should be available for parents. Which i believe it shouldn’t, unless there is a solid medical reason later in life. (perpetual infection, too tight, ect…) Circumcision is based in sexual repression. It makes it harder to masturbate and removes sensation. While i know the article was meant to be an unbiased debate starter, but you did mention… Read more »
How about cutting part of an infant’s ear? Does that also ought to be a the choice of that parent?
What if I say it’s for religious reasons? And what a couple million religious fundamentalists are backing me and might get upset if this is refused? Will the “Academy of Pediatrics” issue a similar statement for cutting part of one’s ear?
You bet!
Depending on the gender of the baby I advocate removal of either one testicle OR one ovary and one breast at birth. The resultant reduction in cancer rates would approach 50%.
Haha. A+.
If it’s all about supposed health benefits, it seems to me that removing the appendix immediately after birth would provide great benefits to many individuals down the road, so why isn’t an appendectomy routinely performed on each newborn?
I don’t understand how one can argue for circumcision of infants as a mean to lower HIV infections for three reasons. 1.Small Kids don’t have sex, so the circumcision can wait. 2.The danger of an infection with HIV depends on the behaviour of the particular person. 3.It is the boys body and he should be in charge of what risks he is willing to take, when he is old enough to have sex. Joanna: ” I feel it would be disingenuous of me to write this article without stating that I am a strong “intactivist” (though legally I believe parents… Read more »
You don’t understand for those three reasons because those that argue for it will ignore those three reasons and instead use these three. 1. As a baby he won’t remember at such a young age and will save him a more painful surgery later. 2. But it reduces STDs!!! 3. He will “look like his father” and “it won’t gross out his future partners (presumably women)” So in the face of what other people think and going on contested data it is just fine to shape boys to the culture rather than shaping culture to boys (because good luck on… Read more »
Yeah, I’ve really never understood the idea that it might gross out future partners – but I do live in England, where it is only really done for religious or medical reasons. Honestly it really doesn’t come up in my sex life at all. It’s not like it’s difficult to move out of the way, and frankly if having a foreskin means boys and men have to wash a bit more thoroughly, that’s probably a good thing! My brother is also uncircumcised, while my dad is circumcised – my brother is more grateful than not for that! On the 1… Read more »
It’s not like it’s difficult to move out of the way, and frankly if having a foreskin means boys and men have to wash a bit more thoroughly, that’s probably a good thing!
Funny but true.
It’s no secret that sex education is not exactly up to par here in the States but instead of teaching things like that (because I’m thinking genital hygiene would be included in sex ed, as well as basic hygiene of course) it’s apparently easier to just chop it off.
Circumcision solely for cosmetic reasons seems TOTALLY unjustifiable. and I say that admitting that I’ve never been with an uncircumcised man and I assume it would take some getting used to the first time. It would “look different” and I wouldn’t know what to do with it But I assume I’d deal with it.
Even if circumcision lowers the risk of penile cancer or HIV, that doesn’t seem like a sufficient justification for removing a body part that has other important functions. The risk of penile cancer and HIV (at least in the U.S.) are still very low. Circumcision seems like a relic of an earlier time when there was a belief that modern science and medicine could always “improve” on nature.
That 40-60% study, isn’t that the one with a mountain of methodological errors?
I am not surprised, but I must say I am disappointed. If circumcision really is so effective against HIV, STD/STIs and penile cancer as is claimed one have to wonder why Europe with only a 1/8 to 1/5 of USAs circumcision rate see lower incidence levels of all these? Perhaps one should look into other more significant factors for the US population before being so gung-ho about circumcision. But then again, Oprah needs her anti-wrinkle cream. Or you could by some from here: http://ccr.coriell.org/Sections/Search/Search.aspx?PgId=165&q=foreskin Just USD 85.00 for a cell culture harvested from a newborn or a 1 day old… Read more »
Jesus… that’s pretty vile! 🙁
I think too many people spend too much time judging the way other people choose to parent. While I DO believe in circumcision, I don’t frown upon those who don’t. I am comfortable with my decision and think that with all of the real injustices being carried on the world, this is a silly thing to waste time and energy on. I think we need to do what WE think is best for OUR children and let others do the same.
Does that include what some parents “think is best” for their daughters?
Where does that end, though Marci? What if what I thought was best for my children constituted physical abuse? Would you say, “Well, that’s the way she chooses to parent her sons”?
I would hope not.
Also, the argument of “there are other injustices in the world, this one is silly” is dismissive. Everyone thinks that the issues that aren’t that important to THEM are unimportant, but the fact is that even though there are wars and rapes and murders, this is still a very important topic.
I am comfortable with my decision and think that with all of the real injustices being carried on the world, this is a silly thing to waste time and energy on.
So for the about the ten thousandth time here comes the, “Something that’s happening is not as important as something else that’s happening.”
I’d really like to see some actual hierarchy on this. How exactly do drugs, sexual slavery, labor slavery, DV, theft, and other things rank in relation to each other so everyone can get a nice neat list of what the “most important” topic is?
Peace of my body that got cut off is a silly thing to waste time on? I can’t claim it back from my parents – or the doctor who did it, so I try to avoid a similar fate for other people.
What a silly thing to do.
But circumcising your baby is NOT a silly thing to do?
I propose a new religious ritual where little girls’ vocal cords are severed soon after birth, to ensure that they ‘remain silent in church’ as God intended. There could possibly be medical benefits to this, like immunity to laryngitis.
And it’s a Sacred Religious Tradition, so that means informed consent is unnecessary. Who’s on board?
Off with children’s feet. They fit better in the cribs. And those blade thingy’s will look cool later in life.
/sarcasm
What does “believe in circumcision” mean? Seriously. Where did you obtain this “belief”? Really; seriously.
Next time you have a bible handy, check a couple of verses: Galatians 5:2, Acts 15:28, 1 Corinthians 12:18.
Honestly this bothers me. It seems that people have no problem violating a boys bodily autonomy if they can find the slightest excuse for it. To men unless there is an actual medical necessity the foreskin should be left alone until the boy in question is of age to decide what he wants to do with it. And no, I’m even against religious exceptions to this. One thing that sits in the back of my mind is that a lot of the evidence to support circumcision of American boys is coming from studies in Africa. Are there no studies of… Read more »