Saturday, April 25, 2009

American Academy of Pediatrics Statement on Circumcision We Hope to See

Somewhere circulating within the emails of the American Academy of Pediatrics' Task Force on Circumcision, there is a draft proposal updating the AAP's 1999 "neutral" stance on circumcision in light of the growing medical evidence in favor of male circumcision. You can call this a fictional wish-list, but we hope the AAP has the guts to issue a report something like this:


"DRAFT DRAFT DRAFT"
Task Force on Circumcision
American Academy of Pediatrics
Benefits of Male Circumcision Outweigh Risks
A Call to Universal Circumcision
Executive Summary


After a comprehensive review of the latest medical and scientific evidence, the American Academy of Pediatrics concludes that all males should be circumcised, preferably at birth, as a matter of both personal medical well-being and general public health to protect themselves, their future sexual partners, and society as a whole from a number of debilitating, life-threatening, and costly diseases.

In 1999, the AAP declared that “scientific evidence demonstrates potential medical benefits of newborn male circumcision,” but we cautioned that “these data are not sufficient to recommend routine neonatal circumcision.” This position, reaffirmed in 2005, understandably left parents of newborn males in a quandary. While the medical benefits of circumcision were established, such as a substantial reduction in urinary tract infection, the evidence was not then compelling to recommend that every male be circumcised. Parents were left to draw their own conclusions, which meant that social, familial, and other non-medical concerns often took priority over health care in the decision-making process.

With substantial new scientific evidence over the last four years, the AAP now recommends that all newborn males be circumcised, and we encourage all public and private health insurers and medical providers to cover, promote, and establish efficacious ways to achieve universal male circumcision. We endorse routine neonatal circumcision, with all the appropriate analgesics to alleviate pain, and we recommend that all males, regardless of age, be circumcised. Circumcision not only confers life-long benefits on the male, but it also protects his female partners and society as a whole.

Among its other benefits, circumcision reduces a male’s chance of acquiring HIV by at least 50 percent, reduces his risk of acquiring HPV by 35 percent and spreading HPV to his female partners, reduces his chances of contracting Herpes Simplex Virus Type II by 28 percent, and reduces the likelihood of causing cervical cancer in his female partners. The AAP does not assert that circumcision eliminates these painful and costly medical scourges, but it will significantly reduce them. These health benefits to males and females far outweigh any risks posed by circumcision, and to suggest otherwise is to engage in a head-in-the-sand approach to science for political and non-medical reasons.

We recognize that the decision to circumcise children lies with the parent, so, consequently, just as with AAP-recommended vaccinations, an option not to circumcise must be made available. But the AAP concludes that sound science dictates the goal of universal male circumcision, regardless of the race, nationality, religion, age, or economic status of the male. A requirement by schools that all boys be circumcised before puberty is recommended, subject to exception for religious or deeply-held objection, or a rare medical necessity. But like the eradication of polio and measles through a policy of universal vaccination, the public health benefits of circumcision are best conferred when adopted by all.

This position in no way impugns the decision of many parents in recent years that left their sons uncircumcised. The decision not to circumcise was perfectly understandable, particularly in the context of the AAP’s former position. But medical science advances, and health care requirements must change with that evidence. Boys left uncircumcised, particularly as they become sexually active, increase their own risks and those with whom they are intimate. That is why the AAP encourages both public and private health insurers and health providers to establish cost-effective options to circumcise both young and older males. And we encourage parents of uncircumcised boys to take advantage of those options as quickly as possible.

Finally, we believe that the evidence for universal male circumcision is so compelling that the United States Government, through the Surgeon General, the Public Health Service, the Centers for Disease Control, Centers for Medicare & Medicaid Services, and all other relevant agencies, needs to engage in a public information campaign and improve affordable access to circumcision for all American males of every age. Under the leadership of the World Health Organization, many other governments have taken such a pro-active lead. The American Academy of Pediatrics urges the U.S. Government to do the same. A country with the greatest medical scientists, practitioners, and institutions should once again take the lead on this critical public health mission.

33 comments:

  1. The anti-circumcision groups are a relic of the last century just as the old Soviet Union. For example, the video of the screaming baby. That video is what we call "the ventriloquist baby". If you notice the baby is not screaming or crying at all, the sound is dubbed to make you think that. The choice of circumcision for one's sons is at the discretion of the parent. A parent has a duty to make choices for a child until he/she reaches the age of majority which is 18. If a parent chooses to have a son circumcised, that is none of anyone else's business. The statistics that the circumcision rate is going down is a complete myth of the last century. The rate is actually going up and the figures are anywhere between 85% and 89% of all male babies being circumcised in the USA. But if the anti-circers repeat an untruth long enough, they get to believing it. They should in this 21st Century, wake up and understand that circumcision is here to stay and nothing they can do will change that fact.

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  2. Excellent observations, Anon. Not only is circumcision here to stay -- after all, it's been with us for thousands and thousands of years -- once the Academy of Pediatrics reaffirms the value of neonatal circumcision will see a surge in the circ rate to near 100 percent. As far as I can see, the only reason to leave a boy uncircumcised is the sheer vanity and ignorance of the parent.

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  3. Make up your minds, you two. Is circumcision right up to the minute, or a relic of the stone age? It can't really be both.

    18? No, a court in Oregon has just ruled that a 14 year old has the right to refuse an unwanted circumcision. Speed the day when he has to be 18 before he can consent to it - and nobody else can do it for him. After all, whose penis is it?

    "Ventriloquist baby"? Oh you wish!

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  4. That court decision was not a higher court decision and it can be overturned. The court made that decision so that the higher courts could get involved in making the decision. So don't place all your marbles on that one. And yes Ventriloquist Baby it is. Of course if you are so wrapped up in the propaganda that the anti circers try to perpetuate, you will never see through what is a fraud pepetuated on the public to scare them. spartan206

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  5. I have never had any kids, but if I had I would have had them circumcised. I have experienced so many men with foreskin problems (medical industry)which would have been obviated by an infant circumcision. I have observed many infant circumcisions and have never heard any baby "scream"; most rest quite comfortably as a trained professional relieves them of a quite unnecessary piece of skin.
    This is a surgical operation that literally goes back to the days of pre-history (perhaps not quite the Stone Age), Egyptian mummies are circumcised, the Bible speaks of circumcision in theological terms but it's quite clear that the subtext is hygienic, and other ancient cultures show similar evidence of this operation. But it is also very 21st century. Modern hygiene, modern anesthetics, and modern methods (such as the Plastibell - IMHO quite the best there is) make circumcision as modern as twitter (LOL). The aesthetic of a well circumcised penis is without compare. The modern first world has a duty and responsibility to promote this simply and effective means of health control which is also a thing pof beauty!

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  6. I have experienced so many men with foreskin problems (medical industry)which would have been obviated by an infant circumcision.

    Either you are with a lot of men who need help in the shower or you are with extremely unfortunate men. Everyone in the world has access to this procedure, yet the USA is the only country who does this for non religious reasons. Other countries used to do this, but they stopped when they realized the supposed benefits were bullshit. I have observed many infant circumcisions and have never heard any baby "scream"; most rest quite comfortably as a trained professional relieves them of a quite unnecessary piece of skin.

    Would you like to explain a study done 10 years ago that stopped prematurely becuase the pain caused by circumcision was so traumatic to the baby, they couldn't bear to keep doing it? They even tested the topical creams and found them to be inadequate. Also would you like to explain a study done in by the BJU when women overwhelmingly reported the intact partner as the better lover? Would you like to explain why the only country that demands copious quantities of erectile dysfunction is the other country that circumcises? Would you like to explain why we are the other country where there is a market for artificial sexual lubrication? Of course you can't. This is a surgical operation that literally goes back to the days of pre-history (perhaps not quite the Stone Age), Egyptian mummies are circumcised, the Bible speaks of circumcision in theological terms but it's quite clear that the subtext is hygienic, and other ancient cultures show similar evidence of this operation.

    Yes this operation goes back really far, but who cares? Female circumcision goes back thousands of years. Human sacrifice goes back thousands of years. The age of the procedure is irrelevant. No mummies are not circumcised. No circumcised mummies have ever been found. Where are you getting this information? Where do you get the impression that circumcision in the Bible was hygienic? Are you just making this up as you go along? Modern hygiene

    You mean like running water? Shoot if the ancients can keep their foreskins clean I sure hope we can. modern anesthetics

    Most of which are considered unsafe for newborns, hence most newborns being circumcised without anesthetics. Topical anesthetics have already proven to only take a little of the edge off. They are clearly inadequate once the foreskin is pried away from the glans. (such as the Plastibell - IMHO quite the best there is)

    You mean that method where the skin is crushed rather than cut? Yeah that is so much better. (insert sarcasm) make circumcision as modern as twitter (LOL).

    Make up your damn mind!!!! Is circumcision ancient or modern? Are you just a dumbass? You have yet to say anything that makes ANY sense. The aesthetic of a well circumcised penis is without compare. The modern first world has a duty and responsibility to promote this simply and effective means of health control which is also a thing pof beauty!

    So we should cut off organs you deem as not aesthetically pleasing? How arrogant are you. I suppose all girls should have their ears pierced when they are a few weeks old should they? After all it looks so much better! Shouldn't the owner of the penis decide what is beautiful for his own penis rather than your shallow ass? Also what is the crap about the modern first world? We are the ONLY country is the first world that circumcises babies. The only other places that circumcise is the middle east and some parts of Africa. Unless you want to count Israel in the first world it is the third world that performs this. PNED

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  7. "That court decision was not a higher court decision and it can be overturned. The court made that decision so that the higher courts could get involved in making the decision."

    I think you're a few steps behind. The Oregon Supreme Court sent it back to this one to find out what the boy wanted. He made it very clear that he does not want to be circumcised (or, indeed, to live with the father who wants him circumcised) and the Judge has ruled that he need not be, subject to appeal by the (very litigious) father, but she couldn't change his custody immediately.

    Before you go any further with this unsupported "ventriloquist baby" allegation, give a reference to which of several videos of shrieking babies being circumcised you are referring to. Or are they all ventriloquists?

    If "so many" men have "foreskin problems" how come the lifetime risk of circumcision in Finland is less than one in 6000?

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  8. Excellent work on this site. I hope the AAP decision eventually reads just like your 'dream version'. I too promote full, tight, circumcisions for all boys regardless of their age.

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  9. Oh dear... I'm not really sure I should ask this, but what does artificial lubrication have to do with a circ'ed penis?

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  10. Oh dear... I'm not really sure I should ask this, but what does artificial lubrication have to do with a circ'ed penis?

    The foreskin produces secretions that lubricate. Also the extra skin creates a "roller bearing" effect... lessening the need of artificial lubrication.

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  11. why are some people so concerned with the need to circumcise a baby ? having this complex and thinking about it in the fixated way you do has to be a mental problem surly ,a fixation with babies genitals must be some sort of perversion after all it nobody elses business at all so why the permanent interest ? i dont' have it and i think its unhealthy and borders on an interest in child porn .
    and another thing all those promoting cicumcision are cut while many people against circumcision are cut and think its wrong and feel disadvantaged by it and they would know its was a mistake from experience ,in truth are any pro-circs uncut ? find me one

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  12. "A requirement by schools that all boys be circumcised before puberty is recommended,"

    Thats one point I wanted to highlight. If they made it a requirement that all boys attending public school be circumcised in order to attend, that would be basically a mandatory circumcision policy on most american boys.

    Do you really think that the American government, or the AAP would ever actually make that a requirement? And would you really want to see that happen?
    I kind of laughed when I read this part because I cam imagine how hard the first day of middle school would be for a boy, but to also learn there is a new policy, and he and a few other boys had to miss the first day to get cut, only to come back and all the boys and girls know why your walking funny.

    Public health policy aside, thats a bit too much to ask from a school aged kid.

    I would like to hear more about this from you. How seriously would you support that? What if a school boy did not want to be cut? Would you really think it would be a good idea to ban him from school. I could easily see a court case saying such an action would unfair on the very least on gender, since there would be no restriction on entry if that boy was a girl.

    I guess I am highlighting this portion because it seems like that most extreme part of that statement.

    I think for the AAP to make a statement like that, they would have to find out that foreskins created HIV, and other diseases. Then I could see them imposing such a serious sweeping policy because it would really benefit the country. But as is, I think most people tend to stop considering circumcision for their son, once he can think about it for himself. (meaning, we only really force it on them when they cant think about it, which is a understandable way of doing it)

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  13. "Ventriloquist baby?" That's a story made up by circumcison advocates. I've seen it before!

    The real story behind that video is that the producer contacted hospitals in his local area asking to video record a circumcision for educational purposes. A hospital agreed and one of their residents agreed and both signed the appropriate release. Then they asked their patients/parents for a volunteer and one accepted and also signed the appropriate releases.

    When the parents found out the educational purpose, they filed suit to stop it's use on the internet. The judge ruled that all the releases were in order and denied the claim. If the video had been modified, the release would be worthless and the judge would have found for the parent.

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  14. Annonymous said "That court decision was not a higher court decision and it can be overturned. The court made that decision so that the higher courts could get involved in making the decision. So don't place all your marbles on that one."

    The fact is that The Oregon Supreme Court remanded the case back to the lower court with instructions to consider the child's wishes in the matter. It later came out that the father, James Boldt, was trying to force the circumcision on the child. He was never circumcised.

    The Oregon Supreme Court saw that they were on the verge of a slippery slope. If they ruled that the child had the ultimate say in the matter, it would have virtually outlawed infant circumcision in Oregon. Whent the suit was brought before the original court, the child was 9 years old. If they had said the child had the ultimate say in the matter, it would have effectively banned all circumcisions without medical necessity of children older than their 9th birthday. That would have opened the question of 8 year olds, 5 year olds, 2 year olds and ultimately, newborns. Apparently, that was a place the court didn't want to go.

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  15. IF circumcision cured, prevented, or reduced any problem or disease, WHY & HOW is it that ALL of these "conditions, diseases, and/or problems" are lower in intact Europe than in the circumcising USA?

    It seems circumcision in the USA exists outside of logic and/or common sense that the rest of the modern world uses.

    Can we all say obsession?

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  16. I had my penis circumcised as adult for several reasons, mainly according to my urologist's advice, but also for better look and because I had very tight foreskin. In my country circumcision is not the norm and I needed a little effort and was also worried about the possible outcome to an extent, but everything went smoothly. When foreskin and frenulum are removed you get a little longer penis as erection is not limited with frenulum but you also get better lasting erection as penis gets less sensitive. My son will be circumcised, but not before he reaches puberty, as he needs to understand what will be done to him.

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  17. Chances of dyeing from Methicillin-resistant Staphylococcus aureus (MRSA) are one and half times grater than dyeing from AIDS. An infant has a twelve times grater chance of getting MRSA if circumcised. In a recent out break of MRSA (Beth Israel, Boston) of the 17 babies that died of MRSA 15 were circumcised.
    This preemptive operation is more dangerous than the future diseases it is intended to prevent.

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    1. according to a blogger up here that between 85 and 89 percent of all babies are circumcised than the fact that 15 out of 17 was circum is just reperesenting the jeneral baby population

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  18. I just think circumcised males do not want to feel different than the rest, so they promote and look for justifications for what their parents did to them. The truth is that if you practice good hygiene, you won't have any problem with your foreskin. This practice is very popular in USA, don't know why, but it's probably because of it's high Jewish population.

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  19. dear pro cutter, please also cut those long unsymetrical gross labia off the baby girls to. but first make sure to go back to the 3rd world creationist shit hole you crawled out of. you can all sing kumbya and cut each others genital up as much as you want there.

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    1. are all the nasty talkers uncut or its just you

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  22. I finished reading this blog entry. I'm currently not circumcised but am planning to get circumcised. My parents believed the anti-circ BS. I want to be cut for both health and personal reasons. I used to be anti-circ, but now I'm pro-circ. I have had 3 occurances of balanitis; 2 treated by natural methods and 1 by conventional medicine using antibiotics and anti-fungal steroid cream. This final round of balanitis convinced me of the value of circumcision. All uncircumcised boys and men should be educated about the benefits of circumcision. Circumcision should be made available to all and should be fully covered by both private insurance and public medicaid programs.No one should be denied getting circumcised because they can't afford to pay for it. I've read posts in many different forums from both teens and adult men who were uncut and got circumcised. Virtually all of them are glad to be circumcised and do NOT want their foreskins back. I've come to realize that much of the anti-circumcision propaganda is completely inaccurate. I practiced good hygiene; completely retracting my foreskin and washing underneath it, yet I had balanitis 3 times. So much for the idea that daily washing is all that is needed. While I still favor the idea of personal choice;especially with regads to one's health; universal circumcision of all males does have benefits. I wonder if circumcision ever becomes universal in the USA what style would be used? In educating myself about circumcision, the low and moderately tight style removes all the inner foreskin which is necessary for reducing the risks of infection. This is the style I'm considering because of my medical issues. What are circumcised guys missing out on? Fungal infections, balanitis, injuries to the foreskin and frenulum during sexual activity, phimosis and other penis problems. I'm looking forward to being circumcised!

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