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Pediatricians Group Praises Benefits of Circumcision for Male Infants

The views expressed are those of the author and are not necessarily those of Scientific American.


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benefits male newborn circumcision

Image courtesy of iStockphoto/HannamariaH

Evidence for the long-term health benefits of circumcision for newborn boys has been mounting for years. Today the influential group the American Academy of Pediatrics (AAP) declared that the procedure is, indeed, beneficial—and that it should be covered by public and private health insurance plans. The recommendation was published online August 27 in Pediatrics.

Previously the group was less committal on the subject of circumcision, their last guidelines noting that it was not “a medical necessity for the well-being of the child.” But “since that time, substantial contributions have been made to the peer-reviewed literature,” The AAP noted.

The new statement comes after five years of work by the group’s Task Force on Circumcision and an analysis of 15 years of the medical literature on circumcision. The new recommendations are also backed by the American College of Obstetricians and Gynecologists.

With the removal of part or all of the penis’s foreskin, a male child’s risk of urinary tract infections, sexually transmitted infections including the human papillomavirus (HPV) and penile cancer are reduced, the organization noted. Removing the skin reduces the areas that infectious bugs can linger. A study published earlier this year in Cancer linked circumcision to a 15 percent lower risk of getting prostate cancer. Circumcision has also been shown to drastically reduce the spread of HIV, and the World Health Organization now recommends it as a preventive strategy. A 2011 study found that circumcision, including that of adults and adolescents, in many African countries could prevent millions of new HIV infections—in both men and women—on that continent over the next decade, saving lives and billions of dollars in future health care costs.

With all of this evidence, “the procedure’s benefits justify access to this procedure for families who choose it,” the task force concluded. The group recommends that circumcision should be performed by trained medical workers, using sterilized equipment and adequate pain management. It acknowledges that the procedure does carry risks, but most of them are minor—such as local infection—and more major complications are rare. And circumcising a newborn appears to carry the lowest risk of complications compared to other age groups.

The rate of male newborn circumcisions has been declining in the U.S. since the late 1990s, from roughly 62 percent in 1999 to 57 percent in 2008, according to the National Hospital Discharge Survey. Without insurance coverage, newborn male circumcision can cost upward of $600, and public and private health plans do not always cover the procedure.

The group does not go so far as to insist every male baby be circumcised, despite the medical evidence for its benefits. “Parents should weigh the health benefits and risks in light of their own religious, cultural and personal preferences,” the task force noted in their more detailed technical report, also published online August 27 in Pediatrics. It also might not be appropriate for infants who have other medical complications, or it might be delayed for health or cultural traditions.

“Ultimately, this is a decision that parents will have to make,” Susan Blank a pediatrician affiliated with the New York City Department of Health and Mental Hygiene and who chaired the task force, said in a prepared statement. But “parents are entitled to medically accurate and non-biased information about circumcision,” and should talk with their doctors early in pregnancy to ensure adequate decision making time—and to establish whether they can get insurance coverage for the procedure, she noted.

Katherine Harmon Courage About the Author: Katherine Harmon Courage is a freelance writer and contributing editor for Scientific American. Her book Octopus! The Most Mysterious Creature In the Sea is out now from Penguin/Current. Follow on Twitter @KHCourage.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. Glendon Mellow 2:18 pm 08/27/2012

    Interesting. Before having a child, I couldn’t find compelling answers on why circumcision was a good idea. Despite the hysteria against circumcision from some men online, concluded it mostly just seemed unnecessary to do.

    I’m not religious and without a specific cultural cue to follow one way or the other, it was a surprisingly difficult decision.

    Link to this
  2. 2. craiggarrett@gmail.com 3:23 pm 08/27/2012

    The AAP is now a disgrace. They are going to be the laughing stock among the international community; this new statement is way out of line with statements from other modern nations with advanced medical systems. The AAP should withdraw this statement immediately.

    The foreskin is an important part of male anatomy, and circumcision has serious negative consequences for not only the man, but his female partner as well. Men who were circumcised at birth have never known what a foreskin is like and don’t know what they are missing.

    The foreskin is erogenous tissue, containing thousands of erogenous fine-touch nerve endings. The most sensitive and pleasurable parts of the penis are removed by circumcision. These are color-coded diagrams showing the areas of sensitivity for both circumcised and intact anatomy:
    http://www.circumstitions.com/Sexuality.html#sorrells

    The boy is the one who should be able to choose what happens to his body once he is an adult. Bodily integrity is a fundamental human right. Clearly the AAP doesn’t understand that.

    This is an excellent video narrated by Dr. Dean Edell, a pediatrician:
    http://www.youtube.com/watch?v=h_bEBAdhjGg

    Link to this
  3. 3. ml66uk 3:26 pm 08/27/2012

    The AAP are way out of line with other national medical organizations, and it’s very disappointing that they say this:
    “Parents are entitled to factually correct, nonbiased information about circumcision”

    but they provide information that is both biased and highly selective. They simply don’t seem to consider that the foreskin might actually be valuable.

    It’s really easy to find circumcised doctors who are against circumcision, but surprisingly difficult to find male doctors in favor who weren’t circumcised themselves as children.

    How strange that all the health benefits the AAP claim don’t seem to exist in Europe, where almost no-one circumcises unless they’re Jewish or Muslim.

    The AAP is the same organization that changed its policy on female cutting in 2010 btw saying “It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual [clitoral] nick as a possible compromise to avoid greater harm.”
    They were forced to retract this about six weeks later:

    Dr Diekema, the chair of the committee said “We’re talking about something far less extensive than the removal of foreskin in a male”.

    I suppose it’s a good thing they didn’t look at operating on girls to prevent breast cancer. 11% of women get breast cancer, and 3% die of it, so the health benefits to the girls would massively outweigh the risks.

    Meanwhile, other national health organizations including the Canadian Paediatric Society and the Dutch Medical Association continue to recommend *against* circumcising newborns.

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  4. 4. phalaris 4:46 pm 08/27/2012

    Yes, what the great designer had in mind when he provided this appendage is a real mystery if these doctors are to be believed.
    It’s not possible that they have some pecuniary interest in performing these operations, is it?

    Link to this
  5. 5. mentisflux 6:40 pm 08/27/2012

    Oh great, male genital mutilation is making a comeback!

    Link to this
  6. 6. elderlybloke 7:00 pm 08/27/2012

    mentisflux,
    Please don’t get hysterical about this.
    You seem to be confusing a minor procedure with the Female Circumcisum which is NOT .
    My minor procedure was done over 80 years ago.
    It did not handicap me in any way(and NOT at all in the most important way).

    Link to this
  7. 7. oldvic 3:39 am 08/28/2012

    What I’d like to know is: can we get the benefits of circumcision by other means, such as proper hygiene and commonsense precautions regarding sex? Because mutilating a child doesn’t give him a chance to make an informed decision about his body.
    Chaining people to their beds would instantly eliminate driving fatalities, but perhaps there are better ways to tackle that problem?
    The AAP is making a classic mistake: obsessing about the statistics while ignoring the bigger picture.

    Link to this
  8. 8. PastLife TherapyCenter.com 4:06 am 08/28/2012

    Circumcision Myths Debunked/ “Anxiety & Male Sexual Issues Reinforced by Past-Life Traumas & Circumcision”

    Learn more at Past Life Therapy Center®: http://www.pastlifetherapycenter.com/anxiety_male_sexual_issues_past_life_circumcision.html

    Link to this
  9. 9. domfischer 4:42 am 08/28/2012

    A simple experiment: compare STM and HIV between Muslim countries and non Muslim countries. Apply the same test to Prostate cancers, HPV, etc.

    Should not hard to do.. at no cost.
    Surprisingly, I still have never seen this.

    Link to this
  10. 10. janvones 1:48 pm 08/28/2012

    Why just stop with genital mutilation? Castration offers all the same benefits, as well as helping prevent the risks of developing testicular cancer, of fathering children out of wedlock, of contributing to overpopulation, and even of becoming a rapist.

    Link to this
  11. 11. ImproperUsername 2:23 pm 08/28/2012

    I cannot understand why anyone chooses to harm an infant like this. “If it aint broke, don’t fix it.”

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  12. 12. HubertB 6:05 pm 08/28/2012

    In answer to domfischer the research has been done. It was done in India between Muslims and Hindus. It comes from the 1940s. Of course the unstated assumption was made that men of both religions had equal contact with the same women. The Muslim men had far fewer sexually transmitted diseases and far less prostrate cancer.
    (I personally think there was a fallacy in the research in that the assumption concerning the equal contact with the same women was false. While I have no doubt that muslim men used prostitutes, I have doubts that premarital, post marital, and adulterous patterns of sexual behaviors exactly matched.)

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  13. 13. tucanofulano 8:45 pm 08/28/2012

    Mutilation is mutilation, whether foisted on males or females.

    Link to this
  14. 14. Ronald Goldman, Ph.D. 9:35 pm 08/28/2012

    For an insightful, surprising, and informative response to the AAP report on circumcision, see http://www.circumcision.org/aap.htm . Also see http://www.circumcision.org/media.htm for information on media reporting of circumcision.

    Link to this
  15. 15. mentisflux 9:50 pm 08/28/2012

    @elderlybloke

    I won’t get hysterical, promise – and I do acknowledge that “female circumcision” (as we know it) is a brutal and crippling horror to impose on any poor soul.

    At the same time, I will ask you to acknowledge that Western male circumcision is still “genital mutilation”, no matter how you slice it. ;)

    I’d also like you to acknowledge that the practice is not without risks; and that the long term physical and psychological consequences of male circumcision are barely studied – nor even considered in the recommendations made by the AAP.

    It is a fact that many males DO report of long term consequences, which is well elucidated in the progressive literature on the matter.

    Cheers

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  16. 16. em_allways_right 10:03 pm 08/28/2012

    Foreskins are for the birds. Cut and happy.

    Link to this
  17. 17. DickScalper 12:18 am 08/29/2012

    They brand men like a herd of cows. American men are such wimps to let their sons be subjected to this absurd surgery. If it were women tied down & cut, the Feminists would be howling all over the world. The male genitals are a cheap commodity. There is no argument too absurd for the circumcisers. They insult the appearance of the intact penis, claim that circumcision heals everything from body warts to HIV, and draw an illogical distinction between female & male genitals. Circumcision is the mark of a slave, my friends.

    Top Ten Tortures Less Painful Than Circumcision

    10. Get knocked out by Mohammed Ali.
    9. Pull out your fingernails.
    8. Eat a pile of steaming bear crap.
    7. Skin yourself alive.
    6. Fall into a vat of molten iron.
    5. Get run over by a train.
    4. Go through a sausage grinder.
    3. Saw off your legs.
    2. Poke out your eyes.
    1. Go To Hell

    ~Dick-Scalper

    Link to this
  18. 18. Poppa beer 2:31 am 08/29/2012

    this study is flawed………..the group studied was in africa using only africans

    Link to this
  19. 19. yachia@zahav.net.il 2:53 am 08/30/2012

    As a urologist of more than 4 decades of experience I decided not to comment for or against circumcision. I have a lot to say, but this is not the subject I am interested to rise. What I want to request from all people debating the subject of male circumcision to stop comparing male circumcision, which is the removal of the foreskin, a skin fold covering the head of the penis (glans), to the so called “female circumcision” which is a really mutilating procedure removing the labia and the clitoris which is correctly named “female cutting”. If one wants to do a “male cutting” similar to the “female cuting”, the entire penis and the scrotal sac have to be removed. This is not a circumcision. In medical terms it is a “penectomy + scrotectomy”.

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  20. 20. David Marjanović 9:55 am 09/2/2012

    How strange that all the health benefits the AAP claim don’t seem to exist in Europe, where almost no-one circumcises unless they’re Jewish or Muslim.

    Yeah. I only learned a few years ago that most male Americans (and many male Canadians, apparently) are circumcised. I was quite baffled. Why would anyone perform a medically unnecessary amputation, except for religious reasons?

    Turns out it’s an idea from the late 19th century. The idea was to prevent boys from masturbating, which was universally thought to be horribly harmful.

    I have it on good authority that this doesn’t even work…

    The foreskin protects the sensitive glans from drying out and keratinizing. It’s also sensitive itself.

    Hygiene? Nothing ever gets under my foreskin. Take a shower once in a while. :-|

    the so called “female circumcision”

    There are several forms. The least mutilating one, cutting off the foreskin of the clitoris (the clitoral hood), is exactly equivalent to male circumcision; but it’s not the most common one, which involves cutting much of the clitoris off. The most extreme form is, as you say, to remove the whole apparatus, equivalent to a penectomy + scrotectomy.

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  21. 21. David Marjanović 9:58 am 09/2/2012

    The idea was to prevent boys from masturbating, which was universally thought to be horribly harmful.

    Even the idea behind Kellogg’s Cornflakes was to give boys something else to play with! The obsession with “self-abuse” was flat-out incredible.

    Link to this
  22. 22. tefish 7:24 pm 11/13/2012

    “Evidence for the long-term health benefits of circumcision for newborn boys has been mounting for years.”

    Indeed it has! From its inception in American medicine, male circumcision has been “clinically proven” to treat or prevent the following ailments: nocturnal emissions (1832; 1879), masturbation (1845; 1871; 1888; 1891; 1953; 1969), syphilis (1855), epilepsy (1865; 1870; 1902; 1930), spinal paralysis (1870), bedwetting (1873), curvature of the spine (1875), paralysis of the bladder (1875), clubfoot (1875), abdominal neuralgia (1879), eye problems (1881), crossed eyes (1886), blindness (1890), deafness (1890), dumbness (1890), rape tendencies in negroes (1894), urinary and rectal incontinence (1894), overly sensitive penis (1900; 1901; 1935; 1941), tuberculosis (1914), penile cancer (1926; 1932), prostate cancer (1942), cancer of the tongue (1949), cervical cancer in women (1951; 1954), bladder cancer (1971), rectal cancer (1971), urinary tract infections (1985), neonatal group B streptococcal disease (1988), HIV/AIDS (1986, 1993, 2003, 2005-7).

    Literally all of these studies, even the very recent ones, have been thoroughly debunked. It is only the Americans and their partners at WHO and UNAIDS who have not yet moved forward, a testament to the stubbornness of our cultural bias toward cutting males. No other medical organization in the world is praising any benefits at all to circumcision, and a growing number downright oppose the practice. Additionally, 48 industry leaders in Europe have joined forces to issue a statement against the AAP’s new circumcision policy, which the AAP has yet to publish.

    Lest we forget, female circumcisions also used to occur in American medical settings for a variety of purported health benefits and were even covered by Blue Shields until 1977, but fortunately we phased those out and eventually made them illegal. Interestingly, in 2005, Stallings and Karugendo unexpectedly found that circumcised women in Tanzania had significantly lower HIV rates. Should we implement the findings of that study and cut our little girls as well as our little boys?

    The human genitalia, with all their intricate features, have been perfected by 50 million years of sexual co-evolution. It is rather boisterous for American doctors to think they can improve upon either male or female sex organs without consequence to sexual pleasure or function.

    Link to this
  23. 23. tefish 9:34 pm 11/13/2012

    A note on female medical circumcision: This surgery was coded as “orificial surgery” or “clitoridectomy” in American medical journals (including The Journal of Orificial Surgery). It took the feminist movement to rename female circumcision “female genital mutilation” and subsequently illegalize it in the U.S. Likewise it will take a powerful political movement to get people — including doctors — to call male circumcision out for what it truly is.

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  24. 24. brinxster 3:32 pm 03/21/2013

    Most recent non-biased studies show that circumcised men are actually more prone to HIV and other STD infections, this correlates with the US having higher HIV infections than Europe where genital cutting of boys is rare. The old studies that claimed there is a HIV prevention were likely biased and only show that in Southern Africa where water is scarce, likely being dirty may increase risk of disease. Which is totally irrelevant to most of the world.

    Having a scientific mind means you have the ability of critical thinking, you simply should not accept a study’s findings if the people involved have monetary reasons for a specific outcome, that is a conflict of interest. The people who tout these pro-circumcision studies often profit of it, there is over $1,000,000,000 that has come from the US and much of it is spent promoting circumcision in Africa… Why not promote Condoms? That is the logical, scientifically supported method to prevent HIV… not amputation of a perfectly healthy body part that likely has no if not a negative impact on the HIV epidemic.

    Link to this
  25. 25. domino8515 12:13 am 07/24/2013

    Interesting how they neglected to mention the greater medical costs circumcision, which would total $6 billion over ten years compared to an estimated $4 billion for the costs of not doing it.

    If the costs of not doing it indeed were higher than doing it, doctors would all be saying we need to stop this insanity.

    Link to this
  26. 26. DougWells 1:55 am 02/2/2014

    Your lack of citing EU and other reports and recommendations on MGM that directly contradict that of the AAP is indicative of your lack of decency and honor. If the AAP recommended FGM, would you publish the same bigoted drivel? Your post is nothing more than an attempt to rationalize the forcible sexual mutilation of baby boys.

    Link to this

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