Sunday, August 30, 2009

San Francisco Chronicle Joins Boston Globe: Circumcise All Newborns

In a Sunday editorial, the San Francisco Chronicle has joined the Boston Globe in urging the Centers for Disease Control to stick to its original position that now is the time for all American newborns to be circumcised. It comes at a time when the anti-circumcision fanatics have become almost hysterical about the medical science that points to universal male circumcision. The editorial addresses the fanatics calling them what they are -- "hysterical intactivists." The editorial is so good that I am repeating it word for word:


CDC should recommend routine circumcision
Sunday, August 30, 2009

The Centers for Disease Control and Prevention are weighing a proposal to recommend routine circumcision for all baby boys born in the United States to curb the spread of HIV and other infections. The CDC should ignore the cries of outrage from so-called "intactivists" and recommend the procedure. The evidence shows that the benefits of circumcision outweigh the risks.

This shouldn't even be controversial. Nearly 80 percent of adult American men are already circumcised, and they seem to be getting through life just fine. Studies have shown that circumcision can reduce HIV infection rates for heterosexual men by half. Observational studies have also shown that circumcised men have lower rates of other sexually transmitted diseases (like herpes and syphilis), cancer of the penis and urinary tract infections. What's the problem, again?

Well, the problem centers on the hysterical intactivists, who believe that: A. circumcision is "mutilation"; and that B. baby boys should be able to "decide for themselves," as though families have no right to make decisions about their children's health, treatment and culture. (Not to mention the health and safety of the larger society.)

The CDC should recommend routine circumcision.

CDC Appears to Backtrack on Universal Newborn Circumcision

Score one for the foreskin lovers. Their hyperbolic fanatic reaction to earlier reports that the Centers for Disease Control was about to do the sound medical thing -- recommend the universal circumcision of all male newborns in the USA -- seems to have taken a toll on some cowardly bureaucrats at the CDC.

Late last week, the CDC issued a clarification that shows all the signs of "political" intervention into the "health" decisions of this agency. If you read their most recent statement, issued last Thursday, it appears that Rush Limbaugh's accusation on radio that President Obama wants mandatory circumcision so scared political officials in the federal government that the big word now is "voluntary," to wit: "Whatever the content may include, CDC’s final circumcision recommendations will be completely voluntary."

Of course, newborn circumcision was ALWAYS going to be voluntary with the decision left, where it should be, with American parents. While it's medically desirable to have every newborn boy leave the filthy foreskin behind in the hospital, we are not a fascist state that can order that happy event, no matter how beneficial to society as a whole.

The larger question, it seems to me, is whether the CDC retreats from the sound medical evidence in the face of the anti-circumcision movement's effort to put the foreskin on a pedestal. The CDC's recent statement sounds like it was written by politicians in Washington, not Atlanta (where CDC is headquartered), to be all things to all people: "With respect to infant circumcision, it is important to recognize that many options are still being considered in this process, including simply recommending that health-care providers educate parents about the potential benefits and risks to ensure that parents have the information they need to make an informed decision."

This is a classic case of sound science & medicine versus a powerful political lobbying group, now well-funded by a multi-millionnaire, that wants to preserve the foreskin at all costs to public health. I feel sorry for CDC's medical doctors and researchers. They know that all the evidence leads to a recommendation that every male be circumcised, but their hands are being tied by political intervention from the White House and the Department of Health & Human Services and other government bureaucrats who want to keep Rush Limbaugh and the anti-circ lobby "happy."

Throughout his campaign and even into the early days of his presidency, President Obama insisted that "sound science" would not be trampled on by political ideology and expediency. The CDC's call for universal newborn circumcision will be a true test of whether Obama means it. If the CDC does the right medical thing and recommends (not mandates) that all baby boys be clean-cut, then we shall know that Obama meant what he said. Otherwise, it's the same old political interference that we've come to expect from the federal government. Let's hope the CDC doctors have the spine and fortitude to stand up to those who are politicizing an important decision that will protect the health of every male, his partners, and society as a whole.

Thursday, August 27, 2009

Boston Globe Endorses Newborn Circumcision for all Males

In another dramatic sign that America may be returning to its clean-cut, foreskin-free tradition, the Boston Globe has editorialized its view that all American boys should be circumcised at birth.

Entitled "Circumcision: A Cut against HIV," the Globe hailed the Centers for Disease Control's call to circumcise all American infant boys. "Such a tactic makes sense against a virus that infects more than 50,000 Americans each year," the editors wrote.

The editorial marks another sign that the anti-circ fanatics are losing the battle because the medical evidence is just so strong in favor of universal mandatory circumcision. The hope is that more major newspapers and media organizations will follow the Globe's example and encourage the CDC. The anti-circ foreskin lovers have mounted a strong PR campaign to dissuade the CDC from its sound science approach, but most Americans dismiss the foreskin lovers as whackos.

As I have repeatedly noted, the current "neutral" government policy hurts minorities, African Americans, and Hispanics because many have been denied health coverage for newborn circumcisions. The Globe notes that rates of HIV are higher among these groups because many more of them are uncircumcised.

While the overall tone of the editorial is quite positive, the Globe's editors can't quite say what we all know is obvious. It's not enough to call for universal male circumcision -- it should be mandatory. The editorial writers stop short of that, saying, "No one should be forced to circumcise a son. But where the health benefits are clear, the CDC should be equally clear in its recommendations. Circumcision is no panacea, but it deserves the CDC’s support."

In my view, if circumcision has clear health benefits that protect the male, his partners, and society, then it ought to be required for all. That's the editorial I really want to read. But the truth is that American parents are smart enough to follow the medical advice of the CDC, so the practical impact of promoting universal newborn circumcision will be to rid the filthy foreskin from the shores of this country.

Sunday, August 23, 2009

US Health Officials Closer to Pushing Universal Circumcision

Good news out of the NY Times today. The US Centers for Disease Control (CDC) appears closer than ever to recommending that every male in America be circumcised, preferably at birth. This, of course, is the logical outcome of all the studies over the last decade that demonstrate conclusively that circumcision has a positive health benefit on not only the circumcised male but also his partners and society as a whole.

The story published this Sunday quotes Dr. Peter Kilmarx, the CDC's chief of epidemiology, as saying, "What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.” The CDC is expected to make its recommendation public by the end of the year, although anti-circ foreskin lovers are waging an all-out effort to save the foreskin through a misleading campaign of lies and innuendoes.

The Times reporter also notes that "circumcision will be discussed this week at the C.D.C.’s National H.I.V. Prevention Conference in Atlanta, which will be attended by thousands of health professionals and H.I.V. service providers."

The United States was once a truly clean-cut country but circumcision rates have fallen because the American Academy of Pediatrics abandoned its pro-circ position in favor of "neutrality." That caused some insurance companies and state Medicaid programs to abandon payment for newborn circumcision.

But as the Times reporter noted, "The academy is revising its guidelines, however, and is likely to do away with the neutral tone in favor of a more encouraging policy stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics."

"He said the academy would probably stop short of recommending routine surgery, however. 'We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are,' he said."

Curiously, it's the CDC that is taking the lead to return America to a fully circumcised clean-cut status, while the AAP -- if Dr. Brady is correct -- seems more reluctant to just say what most baby docs know is true: a clean circumcised penis is the healthy choice.

You can read the full NY Times article at http://www.nytimes.com/2009/08/24/health/policy/24circumcision.html?hp

Saturday, August 1, 2009

Zambia Goal: 80% Circumcised

You have to admire some of the health ministers and governments in Africa that understand the health value of circumcision -- and, more importantly, are not afraid to set goals aimed at universal male circumcision.

The latest word from Zambia, reported in The Post, is that the country's health minister has embraced circumcision as an important HIV prevention strategy. Moreover, the World Health Organization's representative in Zambia, Dr. Olusegun Babaniyi, has said the country must achieve an 80% circumcision rate in 10 years to maximize the effectiveness of circumcision. The current rate is about 13% circumcised. This would require about 2.5 million males to be circumcised.

Of course, the most effective way to achieve universal circumcision is neonatal circumcision. Circumcising at birth is easier, less complicated, and much less costly. University Teaching Hospital urologist Dr. Kasonde Bowa says his hospital has begun a neonatal circumcision pilot program, but admits they have a long ways to go.

Taking a country that is only 13% circumcised up to 80% circumcised and, preferably, 100% circumcised takes a time and dedication. Countries like Zambia deserve world acclaim -- and our help -- to achieve their goal of a clean foreskin-free environment.

Here in the United States, where perhaps 75% to 85% of males are clean-cut, we need stronger government advocates for circumcision. The anti-circ fanatics are reportedly putting intense political pressure on the Centers for Disease Control and the American Academy of Pediatrics to ignore all the medical studies of recent years. Whether America's doctors cave in to political pressure when the medical evidence is so abundant remains to be seen. But there's no question that those who recognize the health benefits to both men and women of a clean-cut foreskin-free society need to speak up -- now!