Circumcision debate: What would you do?
If you're the expectant parent of a baby boy, you face an age-old question that's now a roiling, 21st-century controversy: Will your son be circumcised?
Circumcision debate: What would you do?
Sari Harrar
If you’re the expectant parent of a baby boy, you face an age-old question that’s now a roiling, 21st-century controversy: Will your son be circumcised? Or, as the Journal of Men’s Health put it, bluntly, in a 2010 survey of Canadian doctors on the subject: “To cut or not to cut?.”
A brand-new position statement from the American Academy of Pediatrics lines up the health benefits -- lower risk for urinary-tract infections and HIV, less chance he’ll pass on other sexually-transmitted diseases like HPV (responsible for cervical cancer).
But the AAP stopped short of endorsing circumcision. And the procedure’s less popular than ever.
This procedure, which removes the foreskin of the penis, was performed in hospitals on 61 percent of boys in 2000. The rate dropped to between 54 and 57 percent by 2008, according to the Centers for Disease Control and Prevention. One big reason: Money. Eighteen states no longer provide Medicaid coverage -- and rates there are 24 percent lower than elsewhere, UCLA researchers say. Colorado was the latest, dropped Medicaid coverage in 2011; attempts to get the funding back were defeated this year by budget-conscious legislators and anti-circumcision advocates. (The numbers don’t include out-of-hospital circumcisions; Jewish families, for example, often have a mohel perform the circumcision, a bris, at home.)
But there’s another reason for the decline. “Intactivists” -- circumcision opponents who say boys have the right to an intact foreskin -- say the procedure’s as barbaric as female genital mutilation. That it’s painful despite advances in pain relief for babies. And that the health benefits have been over-stated. Some experts say boys should decide for themselves after age 16.
Last fall, a ban on male circumcision ban nearly made it onto the November ballot in San Francisco -- until a judge ruled that the issue should be decided by the state rather than by one city’s voters. And this summer, a German court ruled that circumcision violated the “fundamental right of the child to bodily integrity,” and should be decided by the child himself once he gets older. Germany's Medical Association had told doctors not to perform circumcisions following the court ruling. But this week, German chancellor Angela Merkel weighed in, pledging to protect circumcisions performed for religious reasons.
Twelve years ago, anti-circumcision groups attempted to stop Medicaid funding for circumcisions in Pennsylvania, but failed.
Does circumcision matter for health? One new study says yes. Disease experts and health economists from Johns Hopkins say if rates fell to 10 percent -- the level in European countries that don’t cover it -- the result could be:
- 211 percent more urinary tract infections in baby boys.
- 12 percent more HIV cases in men.
- 29 percent more human papillomavirus (HPV) cases in men.
- 18 percent more high-risk HPV infections in women.
There could also be more cases of cervical and penile cancer linked to HPV and more cases of HIV. The decline in American circumcisions over the past 20 years has already cost the nation upwards of $2 billion in health care costs, the researchers say. The future tab could top $4.4 billion.
What do you think? What would you do?
"Disease experts and health economists from Johns Hopkins say if rates fell to 10 percent -- the level in European countries that don’t cover it -- the result could be..."
The rather glaring defect with that logic, not addressed in the AAP report, is that HIV rates in virtually all European countries are way LOWER than in the United States. And other STD occur at either lower or similar rates as well. Ditto for China, Japan, Australia, and other non-circumcising countries throughout the world.
The AAP task force report is based on studies in sub-Saharan Africa, and contains the following gem:
"Specifically, the Task Force recommends additional studies to better understand the impact of male circumcision on transmission of HIV and other STIs in the United States because key studies to date have been performed in African populations with HIV burdens that are epidemiologically different from HIV in the United States."
That is, the AAP is throwing it's weight behind slicing the genitals of male infants in the United States based on studies which it admits may not even be applicable! Not really great for their credibility.
Then there is the troubling comparison to female genital cutting. In the case of baby girls, would the AAP even dare to conduct studies designed to determine "potential health benefits"? Absolutely not, because girls are rightfully protected by law against ANY form of cutting, even a symbolic ritual nick (as previously recommended by the AAP), with no legitimacy given to arguments based on "health benefits", "parental choice", "religious tradition", etc.”
— Hans Castorp- Just as female circumcision (genital mutilation) is a despicable atrocity intended to permanently reduce the sexual sensation of women, so too, male circumcision is nothing but penile-reduction surgery (genital mutilation) intended to permanently reduce the sexual sensation/function of men. Circumcised men suffer from erectile dysfunction 4.5 times more often than do genitally intact men. Circumcision of defenceless minors is a human rights’ abuse.
http://www.cirp.org/library/sex_function/
http://www.cirp.org/library/legal/boyle1/
— Gregory Boyle, PhD, DSc - These are the same people who, probably, advocate women's rights for abortion. If abortion is legal (and I have nothing against it being legal), how come they want to stop people of performing circumcisions? It's been done for centuries with little or no negative effect. What happened to "it's none of your business" crowd? You mean to tell me that it's no one's business if/when a woman gets an abortion, but it is in case of a circumcision? Absurd. Leave it up to families to decide. And spare me the argument of a baby not being able to make a decision for him/herself. The fetus can't make that decision either, his mother does it for it. Tradition of circumcision may seem barbaric to some, but I'm sure we can find faults with any culture/nationality's traditions. I haven't heard anyone crying wolf about Christians baptizing their kids. What is it with dunking a baby in cold water? What if he/she will drown? C'mon people. Are we to allow friggin' government to completely rule every aspect our lives? Or let politically correct morons to dictate to us what to do in a privacy of our homes?— hollandpa
- Baptism doesn't cause any permanent disfiguration to the body. Nor does it alter the function of any part of the body. The child could decide at any time to change their religion without any physical marking being left behind.
— gymdaddy - So if you abuse your children in privacy of you home, it is then okay? — gymdaddy
- Women's right to abortion is allowing a woman the right to make decisions on her own body. The same consideration should be given to a baby boy. — gymdaddy
- Don't most kids have problems with tonsils as they get older? With this logic, we should just cut out every child's tonsil at birth to because he COULD have problems as he grows up.
If all this is true, I still think that the boy should be left intact and when he's 16 make the decision for himself. It's his body. Teach him the proper hygiene and ways of conducting himself and he'll be even less likely than catch disease or a UTI.
It's a cruel procedure.— PotteryPete - And if girls breast buds were cut off at birth, it would eliminate all breast cancer. — gymdaddy
- @hollandpa: Are you seriously comparing altering an infant's body forever to baptism? You need to come up with a better argument than that. That's just wrong. Circumcision is a barbaric procedure leftover from the days when hygienic standards were far, far below what they are today.— PotteryPete
- I travel all over the world to places like India and China where sanitary conditions are very much lacking in many places and nearly all these people are intact with seemingly no problems. — gymdaddy
- I often wonder who the doctor was who did me. I'd like to thank him for doing such a beautiful job!— phljoe1
- And I would like to sue mine. The fact is, neither of us had any say in the matter. If we were left intact at birth, we could both make the decision as adults, you for it and me to choose not to have it done. This would have made us both happy. — gymdaddy
- Except that the procedure is much more complicated in adults and the risks of complications are much greater.. I'm glad my parents had it done when I was a baby.. I am curious why you are unhappy with it? Being circumcised, I feel that it is cleaner and looks better down there. — tom.1027
- I don't think I'd have been too happy with even a temporary "loss of use" if having the procedure as an adult. Plus the discomfort would be top of mind while healing. You have much more free time to recover as a baby. But I do see your point. Just happy mine's already done.— phljoe1
- Obviously this site doesn't like to post my comments. Do they find facts not supportive of the moderator's personal views? You don't think my personal feelings and opinions count?— gymdaddy
