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