"Ethical and human rights concerns have been raised regarding elective infant male circumcision because it is recognized that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent. After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand."
Promoting an unnecessary surgery when much less invasive, less costly, and more effective methods are available is a dangerous distraction in the fight against HIV/AIDS. Read more about Circumcision and HIV and HIV, AIDS and Circumcision.
Penile cancer is a rare disease in the United States (0.9 to 1 per 100,000). Among intact men the incidence is estimated to be 2.2/100,000. Identified risk factors for penile cancer include genital warts, infection with human papilloma virus, a large number of sexual partners and cigarette smoking. The American Medical Association states "because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified."
The AAP cites a study stating that 322,000 newborn male circumcisions would be required to prevent one case of penile cancer and that 644 circumcision complications could be expected for every case of penile cancer avoided.
Each year approximately 117 neonatal (first 28 days after birth) circumcision-related deaths occur in the United States or one out of every 77 male neonatal deaths. This number is likely higher than reported because cause of death can be listed as 'hemorrhage' or other related complication, instead of the circumcision itself. To put this in perspective, about 44 neonatal boys die each year from suffocation, and 8 from auto accidents. About 115 boys die annually from SIDS, nearly the same as from circumcision during the same neonatal period. One hundred percent of circumcision deaths are preventable.
The absence of the foreskin significantly affects sexual function for a man and his partner. The foreskin provides a gliding function that reduces friction while having sex, making it more comfortable for both partners. With tens of thousands of nerve endings, the foreskin has the majority of fine touch nerve receptors in the penis. The foreskin also houses the Ridged Band, one of the most sensitive areas on the male body. This band has a function in stimulating the female sexual partner and is the reason why ribbed condoms were invented.
A 2011 Danish research article found that circumcised men are three times as likely to experience frequent inability to reach orgasm and their partners are at a three-fold risk of frequent difficulties in achieving orgasm and an eight-fold risk of feeling pain during intercourse.
Genital integrity and human rights:
I've heard women say that they prefer circumcised men and cite this as a reason for circumcising their sons. But what if the situation were reversed and men expressed a preference in women's genitals? Would we then tolerate that preference being imposed on their baby daughters?
I'm not entirely sure why circumcision is such a taboo subject and why people seem to be afraid to question it. Science has certainly not shown it to be medically necessary and the tradition has robbed millions of men of one of the most sensitive parts of their bodies without their consent. But this is exactly why we must start talking about circumcision.
For the record, I want to make it clear that this post is not intended to make readers feel guilty about decisions made in the past. Rather, this information is provided for the benefit of baby boys yet to grace us with their presence in the hope that new parents will be fully informed when faced with this decision. Because when it comes to circumcision, the decision should be clear - bring home the whole baby. Like girls, baby boys arrive perfect just they way they are. No disassembly required.
|Handle with care indeed!|
Circumcision Decision Maker
Myths About Circumcision You Likely Believe
50 Reasons to Leave it Alone
The Case Against Circumcision
Having read the lengthy new statement, I found it rife with problems. For example, it relies on a limited number of studies within a five year period (the 1999 statement studied forty years of research), it inflates the benefits of circumcision for UTIs, penile cancer and HIV and it cites controversial studies. Furthermore, it glosses over sexual impacts, consent issues and concerns regarding pain and then fails to mention at all the function and anatomy of the foreskin, ethical issues involving amputation, a child's right to bodily integrity and it barely mentions the issue of risk and complications. The report states that “the health benefits of newborn male circumcision outweigh the risks,” and yet elsewhere in the paper the AAP admits that “the true incidence of complications after newborn circumcision is unknown.” If the risk of complications is unknown, then it cannot be stated that the benefits outweigh the risks. The AAP lacks the evidence it needs to make this claim.
The addition of a recommendation regarding funding for the procedure highlights the fact that the AAP is not an advocacy group for pediatric patients - rather they are a professional trade organization that exists for the benefit of its members - pediatric doctors and hospitals - and the new recommendations ensure that insurance companies keep the dollars flowing to a billion dollar per year industry. This revised statement is an awkward attempt at saving face with other medical societies around the world while at the same time insuring that their members can still profit from the practice. A medical position statement and the organization issuing it lose credibility when the paper includes a section on financing newborn circumcision by third-party payers.
The new statement includes several quotes that would appear in favor of leaving baby boys intact. For example, "Newborn males who are not circumcised at birth are much less likely to elect circumcision in adolescence or early adulthood." This suggests that men appreciate their foreskins and actually possess the ability to keep them clean and healthy!
Finally, it's worth mentioning again that The Canadian Paediatric Society, the British Medical Association, the Royal Dutch Medical Association, and the Royal Australasian College of Physicians have issued statements that oppose this new position of the AAP.
AAP and Circumcision: What’s a Parent to Think?
Intact America's Response to the American Academy of Pediatrics 2012 Report on Circumcision
Response to the American Academy of Pediatrics (AAP) Circumcision Policy Statement
Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision (pdf) in the Journal of Medical Ethics