The American Academy of Pediatrics has changed its stance on circumcision after publishing a controversial paper on its journal Pediatrics. According to the AAP, the benefits of circumcision outweigh the risks. This comes from data that show that circumcision may protect from STDs, which in turn add a huge cost to the healthcare system in the United States. I argue that even if the data are true and accurate, these are not valid arguments for recommending routine circumcision in newborn babies.
Keywords: circumcision, newborn, males, American academy ofPediatrics, AAP, STD, Medicaid, religion
It troubles me that while most ofthe western world views female circumcision as a barbaric and intolerableritual, the United States of America is still pushing for male circumcision on unwilling newborn males.
Following a recent study on circumcision, the American Academy of Pediatrics (AAP) has changed its policy on circumcision (1) . After 1999, the agency had an on-the-fence stance, explaining that there were some benefits and some risks to circumcisions. Now, the claim is that the benefits of circumcision clearly outweigh the risks. The AAP has even gone as far stating that circumcision doesn't hurt sexual pleasure or performance in adulthood. Of course, the reasoning behind circumcision advocacy is loosely based on STD prevention, including the supposed protection from HIV. I am not convinced that cutting off a part of your body in order to protect from a disease which is product of a behavior you will not partake inthe next 16-17 years of your life, merits the surgery on an unwilling infant. However, the AAP is not completely without heart. Short of mandatingthis medieval procedure in every pediatric office across America, they are letting the parents have the final word (2) . Aren't they generous?
I am not going to argue against the data in the paper “Male Circumcision” (3) published on AAP’s journal Pediatrics. I am even going to concede that, provided that the data is valid, and male circumcision does indeed provide great health benefits, the idea of circumcising newborn boys is not only illogical, but it actually harms the autonomy and welfare of the infant.
Circumcision of newborn boys is a surgical event. No surgery comes without risks. Even the most routine surgery will always have a certain amount of risk attached to it. Indeed, circumcision is a surgery that is usually performed in copious amounts around the world, and there are very few reported cases of circumcision which had an unexpected negative outcome (4) ,and much less a fatal one (5) .There is an estimated 117 neonatal circumcision-related deaths every year inthe United Stated alone (6) .
What is the problem with getting rid of a perfectly healthy part of the human body in order to prevent diseases that can be contracted as soon as the boy starts having sexual intercourse? Theforeskin of the penis actually protects the penis during babyhood. It stops feces and other contaminants from introducing themselves into the urinary tract. So getting rid of it because in some years, the baby might not engage in safe sex and has a slightly higher chance of contracting an STD is a ridiculous argument that is used in order to excuse the continuance of this barbaric ritual. One could argue that female circumcision reduces the amount of sexual pleasure, therefore diminishing the chance of a woman engaging in sexual intercourse which could result in unwanted pregnancy or an STD. Just like with male circumcision, female circumcision cannot be justified with this line of reasoning.
The new justification for circumcision is closely related to the STD “argument”. This time, advocates for baby genital mutilation argue that intact men will most likely get and STD, thus increasing healthcare costs for everybody—in the BILLIONS of dollars. And, they are upset because Medicaid does not provide circumcisions for baby boys. That’s right. They are actually upset that the government does not want to pay for genital mutilation of those who benefit from the entitlement program.
If the concern is that a certain body part which is perfectly healthy, and has a real use may cause infections in the future, we can argue that we might as well just start taking out the female uterus as well. No female uterus means no uterus cancer. Imagine all the money we can save in healthcare costs! Or, following that same reasoning, we could just remove the breasts of women who no longer plan on having children. After all, you can still have sex without them and they could be the host of very aggressive breast cancer. Then again, they could not, but the point is not whether you have the right to make decisions on your own body, it is about how much it will cost to the American tax payer.
This brings me to my conclusion which is quite simple. Parents have no right to remove, mutilate, modify, sell, destroy or otherwise tamper with the healthy bodies of their children. You do not have this right if you can prove that the baby may engage in sexual activity in the future, which could result in an infection. You do not have this right even if you can prove that avoiding such infections would reduce costs in the healthcare system. The only person who can make that call is the person getting circumcised; a decision which cannot be made by an infant or toddler. “Culture” is not an argument. “Religion” is not an argument. “Tradition” is not an argument. I am embarrassed for the AAP which should know better. If you begin recommending circumcision based on possible infections which may occur due to sexual activity, or you justify it by explaining it will save us a few dollars, you are not only wrong, but immoral. Oh, and in case you haven’t heard, condoms are much more efficient to protecting from STDs than genital mutilation.
References
1. American Academy of Pediatrics. Newborn MaleCircumcision. American Academy of Pediatrics. [Online] 8 27, 2012.[Cited: 8 27, 2012.]http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Newborn-Male-Circumcision.aspx.
2. —. New BenefitsPoint to Greater Benefits of Infant Circumcision, But Final Say is Still Up toParents, Says AAP. American Academy of Pediatrics. [Online] 8 27, 2012.[Cited: 8 27, 2012.]http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/New-Benefits-Point-to-Greater-Benefits-of-Infant-Circumcision-But-Final-Say-is-Still-Up-to-parents-Says-AAP.aspx.
3. MaleCircumcision: Taks Force on Circumcision. American Academy ofPediatrics. 2012, Pediatrics.
4. AFP. GoogleNews. US judge awards payout for botched circumcision. [Online] 7 2011.[Cited: 8 28, 2012.]http://www.google.com/hostednews/afp/article/ALeqM5hWUCGBeU-LVsEGdRXbENDYZozXFg?docId=CNG.bdac60bc01523cb81732d8109017db35.7b1.
5. The HuffingtonPost. Baby Dies From Herpes After Controversial Circumcision Ritual, ReportSays. The Huffington Post. [Online] 3 6, 2012. [Cited: 8 28, 2012.]http://www.huffingtonpost.com/2012/03/06/baby-dies-circumcision-ritual-herpes_n_1322420.html.
6. LOST BOYS: ANESTIMATE OF U.S. CIRCUMCISION-RELATED INFANT DEATHS. Bollinger, Dan.1, 2010, THYMOS: Journal of Boyhood Studies, Vol. 4, pp. 78-90.
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The AAP simply rejects your notion of ethics, because that notion would put too much of the traditional doctor-parent relationship at risk. Doctors, like all professionals, value extremely highly their traditional professional autonomy.
American medicine wants doctors to be completely free to perform procedures they recommend and that patients consent to. They detest the risk of being sued for malpractice. They detest even more having their health care decisions second guessed and vetoed by insurers. The recent AAP position paper (which is a literature review and not original research) should be read in light of this.
The AAP's new stance is that parents and doctors should be completely free to decide the fate of the American foreskin. Parents need not justify their views either way on scientific grounds. If what they agree to costs money, health insurers should cover the cost without question. Doctors who circumcise should not be at risk of tort law. This stance amounts to American medicine trying to be all things to all people.
The AAP's report admitted that there is no evidence bearing on the possible long term adverse effects of routine infant circumcision on adult sexual pleasure and functionality. Hence a huge part of the potential risks of RIC cannot be determined. Hence those risks cannot be weighed against the claimed benefits. Hence the AAP's recent report is nonsense.
The male bits that circumcision cuts off have sexual value for common sense reasons. But that value cannot be demonstrated by the scientistic canons of "evidence based" medicine. Hence the AAP passes over that sexual value in silence, pretending it does not exist.
Every American and Canadian woman who blogs and comments on the internet that she's been with both and prefers intact, is doing a great public service. I have noticed that circumcision defenders are completely silent in the face of this growing internet reality. Nobody wants to be guilty of shaming or silencing women when they speak about their sex lives.
50 years in the future, it will be possible for volunteer couples to engage in intercourse while inside a scanning machine that monitors the nerve traffic in both parties between the genitalia and the brain. This technology will finally make it possible to quantify how intact male genitalia ameliorate the human sexual experience.
The AAP is silent about a whole host of everyday realities in other developed countries. This is typical of the provinciality and smug triumphalism of American medicine. Growing up in the midwest a half century ago, I heard it asserted over and over, that when other countries did X and the USA did Y, the USA was right and other countries were wrong. An especially common notion was that other nations had deficient hygiene standards. The truth is, of course, that Americans are among the least healthy western peoples.
Don't be impressed with Aaron Tobian's claim that routine circumcision will save a lot of healthcare dollars by reducing genital cancer and STIs. Those claims are based on extrapolating dubious studies on third world populations to the American population.
American circumcision advocacy silently assumes that American boys and young men will not wash their penises properly if said penises are intact. Silently assumes that American young men cannot be trusted to use condoms. Silently assumes that American young women are too embarrassed and intimidated by their sex partners to initiate condom use. This is especially curious because in my experience, women have become the mistresses of the erotic realm. The average woman under 30 is much more sexually sophisticated than the average man of her age. If women insist on condoms, I don't see how men have the nous to overturn that.
When I was young, we teenage and college boys deemed it very cool to charm a person of the opposite sex out of her clothes and into a bed. It was also deemed totally uncool to do this without using a condom. Every unwanted pregnancy, every case of clap was deemed a nail in the coffin of sexual freedom. I was astounded to discover that this manly consensus of 40-50 years ago has completely collapsed. We need to restore that consensus, and I am confident that circumcision will not move us one inch closer to that goal.
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