Aug 29, 2012 | April McCarthy
As the percentage of circumcised boys continues its gradual and steep decline since the 1980s, the next generation of infant males will have the lowest routine circumcision rates in 40 years. More than 30 percent fewer U.S. boys will be circumcised in 2012 than just a few decades ago. Part of the reduction is due to informed parents learning the truth about the actual risks of the surgery in contrast to the myths propagated by mainstream medicine. Despite the current and overwhelming trend against circumcision, an influential group of pediatricians is proposing new statements in an attempt to revive the practice among westerners.
From the 1980s through today, as the tide has been turning against male circumcision, misleading medical information has begun to surface (yet again) in support of circumcision. This information supports the belief that men with foreskins are more likely to get viral or bacterial infections and pass them on; that the foreskin is tender and thin, and therefore more prone to tiny cuts through which germs can be transmitted. New justifications, such as circumcision to prevent penile and cervical cancer, too often receive the blessing of the medical establishment. But these are justifications that science has been unable to support. Nor is there any scientific proof that circumcision prevents sexually transmitted diseases.
"It’s not a verdict from on high," said policy co-author Dr. Andrew Freedman. "There’s not a one-size-fits-all-answer." But from a medical standpoint, circumcision’s benefits in reducing risk of disease outweigh its small risks, said Freedman, a pediatric urologist in Los Angeles.
Those risks lie in those that interpret them. For example, in recent studies done in Kenya, South Africa, and Uganda by Ronald H. Gray, a professor at Johns Hopkins University, he recently reported that men who were circumcised were less likely by half to contract HIV virus and less likely by one-third to become infected with HPV and herpes.
While this sounds promising, I agree with my colleague George Denniston, M.D., who said, "The United States has high rates of HIV and the highest rate of circumcision in the West. The "experiment" of using circumcision to stem HIV infection has been running here for decades. It has failed miserably. Why do countries such as New Zealand, where they abandoned infant circumcision 50 years ago, or European countries, where circumcision is rare, have such low rates of HIV?"
Similarly, one of the main reasons people choose to have their child circumcised is they believe that it's nearly impossible to keep an uncircumcised penis clean. This also isn't true. And people make the mistake of thinking that they have to retract the foreskin to keep it clean. They don't. In fact, retracting the foreskin before it's meant to be retracted creates adhesions and infections. It sometimes doesn't retract on its own until a boy is as old as seven. Often, there isn't an opening between the glans penis and the foreskin. So you gently retract it every year on the child's birthday until it's fully retractable. Only then does it need to be cleaned, and you can teach a boy exactly how to do this.
Emotions run very high around the subject of circumcision, a perfect example of the strength and influence of our cultural programming on our beliefs and emotions. This programming is so ingrained that many people cannot even discuss the subject of circumcision without guilt, denial, or other strong emotions. Even addressing the subject of the baby boy's bodily integrity, choices, and pain isn't enough to change a belief that's been ingrained in the child's parents from their own birth.
Jewish and Muslim groups recently condemned a court ruling that deemed the procedure equivalent to grievous bodily harm, claiming the ruling trampled on religious freedom and could lead to "circumcision tourism".
A court in the city of Cologne said circumcision violated a child's "fundamental right to bodily integrity" and that this right outweighed the rights of the parents. The ruling was inspired by a groundbreaking case, where a doctor circumcised a four-year-old Muslim boy at the request of the boy’s parents. When the boy was hospitalized for hemorrhaging four days after the procedure, prosecutors were notified and the doctor was charged with grievous bodily harm.
"The religious freedom of the parents and their right to educate their child would not be unacceptably compromised, if they were obliged to wait until the child could himself decide to be circumcised," the court added.
The vast majority of the world's men, including most Europeans and Scandinavians, are uncircumcised. And before 1900, circumcision was virtually nonexistent in the United States as well--except for Jewish and Muslim people, who've been performing circumcisions for thousands of years for religious reasons. Believe it or not, circumcision was introduced in English-speaking countries in the late 1800s to control or prevent masturbation, similar to the way that female circumcision--the removal of the clitoris and labia--was promoted and continues to be advocated in some Muslim and African countries to control women's sexuality.
According to the AAP, their old stance said potential medical benefits were not sufficient to warrant recommending routinely circumcising newborn boys. The new one says, "The benefits of newborn male circumcision justify access to this procedure for those families who choose it."
The other push is one health care costs. According to one study, the hypothetical drop in circumcision rates would increase lifetime health care costs by $407 per man and $43 dollars per woman in the U.S., mainly due to the easier spreading of sexually transmitted infections that accompanies being uncircumcised. That adds up to an extra cost of about $505 million dollars yearly, the researchers said.
Although close to 80 percent of U.S. boys born in the 1970s and 1980s were circumcised, that number decreased to 62.5 percent in 1999, and 54.7 percent in 2010 and is now below 50%. The drop is mostly due to informed parents and not decreases in insurance coverage for circumcision.
Researchers and statisticians have conjured all sorts of studies attempting to validate myths about circumcision that have never been proven. In one study, Dr. Aaron Tobian of Johns Hopkins University created a computer program that assumed 10 percent of males born in a given year were circumcised. Despite no scientific evidence related to causation between circumcised and uncircumcised males and HIV, the study erroneously concluded HIV infections would increase by an estimated 12.2 percent, compared with the current number of cases among sexually active men. The study also found that HPV infections would increase by an estimated 29.1 percent, and genital herpes infections would increase by 19.8 percent. Additionally, 26,800 more boys would develop urinary tract infections during infancy than currently do, the researchers found. All statistics and finding were based on assumptions and unscientific correlations.
The American Medical Association and American Academy of Family Physicians have neutral policies similar to the pediatrics academy’s previous position.
Philadelphia social worker Shannon Coyne (in image above) examined medical research on circumcision before her son was born last September and said she and her husband ultimately decided against circumcision, because she didn’t want her baby to have what she considers cosmetic surgery without being able to consent.
Her advice to other parents is "just make an informed decision. Do your research, be open-minded."
Many past surverys suggest that a majority of parents who say yes to circumcision end up less satisfied with their decision than those who opt out of the procedure.
Please help support two organizations that are working to protect infant boys from unnecessary surgery. The first is Doctors Opposing Circumcision in Seattle, WA; the second is Intact America, a grass roots organization in Tarrytown, NY. The time has come for us to look at this common practice with fresh eyes and do what we can to stop this dangerous and unnecessary medical intervention.
April McCarthy is a community journalist playing an active role reporting and analyzing world events to advance our health and eco-friendly initiatives.