American Academy of Pediatrics to Come Out More Strongly in Favor of Circumcision, Suggests Dr. Doug Diekema, Member of Task Force

Categories: Activism, Health
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Elijah Caleb Tan via Flickr
To circumcise or not to circumcise? That's a question that few people ever ponder -- until their little bundle of joy is about to arrive and it's a boy.

For years, the American Academy of Pediatrics has said that "the existing scientific evidence is not sufficient to recommend routine circumcision." But that may change any day now, according to Dr. Doug Diekema, who sits on a task force that was created in 2007 to revisit the academy's stance.

We caught up with a him a few weeks ago to research this week's feature story on circumcision and asked what the heck was taking the panel so long to come to a conclusion.

"Your frustration is shared by many," Diekema said. He said that it had been hard to coordinate schedules of the busy task force members but that they had finally completed an exhaustive review of all relevant studies, and now "our work is 95 percent done. To my knowledge, the [new] statement and technical report have been drafted and are being reviewed by other members of the task force. We expect that this will be released sometime this spring." Said Diekema: "Our starting point was the existing policy statement from 1995, which took a fairly neutral stance -- it said there were modest medical benefits and some risks. Since then, data has been generated that might alter that recommendation. It's fair to say that there are much more clear medical benefits than there were at the time of the last report, although no radical change in the data regarding risk. I expect that the academy will come out with a somewhat stronger statement."

Most notably, he said, studies indicated that circumcision had a protective effect against some sexually transmitted diseases. "The big ones are HIV and HPV," he said. "The data is the clearest." In addition, he said, "There is some good evidence for a protective effect against herpes as well as syphilis... and circumcision does reduce the likelihood of urinary tract infections in little boys who are circumcised as infants."

He went on to say, "If you talk to reasonable people about what the data shows... it's real. [Circumcision] does carry some risk and does involve the loss of the foreskin, which some men are angry about. But it does have medical benefit. Not everyone would trade that foreskin for that medical benefit. Parents ought to be the decisionmakers here. They should be fully informed.

"Based on the data, last time around, the academy said there was no real compelling reason for the procedure. Some insurance companies and Medicaid [in some states] stopped paying for it. So one of the changes you may see this time around is that there is sufficient data to suggest a substantial public health benefit -- that it's the sort of thing that insurance should be paying for."

Diekema is aware that there is a movement of "intactivists," or people who believe that it's wrong to cut off part of a baby's body if not medically necessary. "I get huge mailings with FedEx boxes, summaries. I do look at it -- I have a file of all of that -- but I am not about to let them do the evaluation for me."

Diekema said that "hundreds of papers were reviewed and judged for their quality" and that people from the anticircumcision camp "will quote you all kinds of studies -- which were frequently terrible and didn't prove anything because they were so methodologically flawed."

"They don't like what we're doing. I get hate mail from them all the time, trying to paint what we're doing as pro-circumcision. I am conflicted about circumcision personally. It's a hard choice; it's a hard decision, and there are good reasons for almost any decision you want to make." He described his task force as "a moderate group -- not pro, not anti. We're trying to uncover what's real here."

He did concede a few points to the anticirc crowd: "It's true that many pediatricians leave training without adequate training in circumcisions to be really be good at doing them, but it varies from program to program, resident to resident... [Generally, medical students] don't have a lot of opportunity to do these."

He acknowledged that some circumcisers do not use any sort of pain control to numb the baby's skin before performing the procedure, particularly Jewish mohels who let the baby suck on a rag with wine or sugar water. "Circumcisions should not be done without lidocaine or some kind of local anesthetic," Diekema said.

And he noted that circumcision became popular in the United States because "at the turn of the century, a few fairly influential individuals were convinced it would be an antimasturbation technique -- like eating Kellogg's corn flakes and graham crackers. Kellogg and Graham -- the inventors of those products -- said it would prevent masturbation if you feed young boys bland food. Those products were no accident."

He said that circumcision removes "maybe 1/3" of the skin on a male's penis but said that may or may not affect sexual experience. "What you really want to know -- ," he says, "it's fine and dandy to say circumcision removes all kinds of nerve cells, but more nerves doesn't necessarily equate to more pleasure -- so what you really want to know but can't look under a microscope and get the answer is: How has the sexual experience changed?"

Ultimately, "we don't have any good data. Circumcised men may experience sex differently than uncircumcised men -- intuitively that makes sense -- but it's simply not the case that we have an epidemic of uncircumcised men that don't get pleasure or can't function sexually." When some men who were circumcised as adults in Africa were asked about the change in sexual function, Diekema says, "most men reported no difference -- a small percentage report that it's worse, and a small percentage report that it's better. There's such a psychological component."

For Diekema, who practices emergency medicine at Seattle Children's Hospital and has never performed a circumcision outside of his medical residency, it's been a long five years thinking about the subject. "It comes up at parties. People do want to talk about it. People find it fascinating."
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160 comments
nepps
nepps

  Is it even sane to discuss   a  "ban" on traumatically injuring a healthy child for any reason whatsoever?.  Isn't the answer in the question?In other words, "Isn't it  plain logic you don't injure a healthy baby at birth"   .   An infant needs every advantage he can get at birth, and a penis reduction sure as hell is not an advantage.     Why would one normal thinking person argue health benefits of such obvious quackery? Is it just to kill time while more babies have their genitals skinned awake or asleep?  I would call that torture on any living creature, and to pick a tiny infant to do an unnecessary injury to is criminal and heinous.  The lines of religion, health,  ethics and morality are crossed when a  healthy protective VITAL FUCNTIONING foreskin is taken from an infant upon his birth.IT IS NOT YOURS TO TAKE!!!.      NO natural SANE INSTINCTIVE creature  skins its infants genitals.  It is. maniacal, deviant injurious aggression toward the helpless  and America should be up in arms, but as usual they are meek and quiet until one comes out of the garage with a machine gun.. ..  Most of the world will not let anyone cut off part of their babys heathy genitals FOR ANY REASON.. (no person  in the world should have any inclination for any reason  to make  one tiny cut on ANY  healthy babys GENITALS)   If you are ethical and decent, you PROTECT babies,   Americas forefathers did not think they needed to write in the laws "Please don't cut infants healthy genitals for any reason"  I am sure they just thought it good common sense, just like telling them to not skin off any other body part.. .   The whole debate  discussing "benefits"  of  baby trauma is sickening.  .How is this allowed? .      

postword1
postword1

Jackno The problem with  circumcised (as infants) men's opinions is they have nothing to base them on unless they have had sex with an uncut man. ( In that case, a different issue and we will keep it hetero just for simplicity since he prefers sex that does not procreate,  another topic)  But the reality of the situation is the guys who have been cut have a reason to be very upset (no, not swept under the rug and buried like most mistakes, hopefully, anyway) and this issue not minimized as I hear happen so often.  A lot of cut guys even say "oh, sex is fine this way".   I am sorry, but a man circumcised at birth who talks about sex being just as good is like a blind man telling a seeing man how nice it is to be blind.  I guess being blind could have an appeal to some since they don't have to see the light,, but I will pass on the blindness for the vision.  In other words, a cut guy can't make a rational correct analysis of something he has never experienced because his rights ignored and his foreskin stolen from him at his birth.  I would call the police on somebody strapping an infant in a molded board and skinning his little penis (AWAKE, GASP).  iF THAT IS NOT TORTURE AND ASSAULT, WHAT IN THE H*LL IS?  I almost fell out of my chair when I accidentally watched a dr. perform that terrible assault.   I wish I had not watched it, but I did and will never say it is ok to do to an infant. There are not enough ssri's to numb us down to being ok with this procedure on an infant.  And, even if a grown man who can consent  wants his penis  circumcised, he shouldat least be enlightened to the consequences.  This  PUNISHING  procedure should never be done to AN INFANT UNLESS HE SAYS ITS OK, and I have not heard a newborn speak a word yet, so he must be protected until he is old enough to consent..  Penis cutting is not like giving him a shot or some medicine, it is ALTERING HIM AND REDUCING HIM FOR LIFE and sex is just part of it, BUT A VERY BIG PART OF IT.  Sex is life, and a brand new baby boy is the brand new bud opening up and you certainly don't put a knife on him before he can talk.  A cut guy can only fantasize about the difference in sex with or without the protective, moving. and very sensual nature made irreplaceable foreskin. The sexual connection between cut and uncut are night and day.  I am abobut to tell you the difference, if any of you want the truth.  A cut mans penis creates too much friction and makes it very uncomfortable for his partner and it is more like passionless friction than sensual connection.  The foreskin moves and protects the partner from discomfort of his frantically trying to get sensation the way a cut guy has to do,  due to his unfortunate trauamatic disfiguring loss.  The sensual sensitive foreskin makes for completeness  that adds sensistivity and size to an erection that only an intact guy feels and a woman experiences the benefits that make sex pleasurable because of it.  The trend I have noticed, is most women chose to ignore what has happened to a lot of Americans, but a lot of them are very unhappy and don't know why, and most will stay in the dark because the light is awfully bright when they open their closed eyes to see why there is so much friction, divorce and disunity between the sexes.  And the friction  is not all mental.   This severe abuse of infants has created such sexual dysfunction and injustice to circumcised males and their females as well, and it is very understated and under researched but I hope if we can't help the victimized people (both men and women)  today, we can at least insure that future infants AT VERY LEAST,  have a right to decide if they want their penis cut down to suit somebody elses image of what is and isn't pretty.   So hopefully, people will give the newborns a chance to come into the world gently, grow up healthy and sexually intact (Its their right) and the guys who have been cut get some help as well.   Make a human feeling rubber foreskin, as thin and sensual as possible, that can be attached to the cut penis and cause movement like the real thing, at least that is a start that helps the female enjoy sex and possibley the male.   I always hate to try to explain why I am opposed to something if I cant offer up at least one idea to help.  I really wish we could all wake up tomorrow and this never happened to even one precious human life, but it did, and we are not drawing in kindergarten where we can just wipe the slate clean and start over. These are real human beings with real feelings and reality must come into focus for all concerned.   We have to try and help these guys in any way we can and I guess a good beginning is trying to stop it from happening to their offspring, and being there for them emotionally. Hopefully, we can come up with some help for these guys so their pleasure isn't just a fantasy, and just as importantly, stop it from happening to another infant, because I can't put a price tag  on the injustice of this amputation that I can't for the life of me begin to justify, no matter what I read or hear. Lets begin by prioritizing and putting the infants life and heath above everything, including opinions, religion, public health, infections or any other superficial silly excuse for skinning a babys penis down to a size that suitsWHO?  How can anything be more important than the life and health of a new infant in a normal society, and who rightully says a baby should be cut before he can talk?    

postword1
postword1

Jackno The problem with  circumcised (as infants) men's opinions is they have nothing to base them on unless they have had sex with an uncut man. ( In that case, a different issue and we will keep it hetero just for simplicity since he prefers sex that does not procreate,  another topic)  But the reality of the situation is the guys who have been cut have a reason to be very upset (no, not swept under the rug and buried like most mistakes, hopefully, anyway) and this issue not minimized as I hear happen so often.  A lot of cut guys even say "oh, sex is fine this way".   I am sorry, but a man circumcised at birth who talks about sex being just as good is like a blind man telling a seeing man how nice it is to be blind.  I guess being blind could have an appeal to some since they don't have to see the light,, but I will pass on the blindness for the vision.  In other words, a cut guy can't make a rational correct analysis of something he has never experienced because his rights ignored and his foreskin stolen from him at his birth.  I would call the police on somebody strapping an infant in a molded board and skinning his little penis (AWAKE, GASP).  iF THAT IS NOT TORTURE AND ASSAULT, WHAT IN THE H*LL IS?  I almost fell out of my chair when I accidentally watched a dr. perform that terrible assault.   I wish I had not watched it, but I did and will never say it is ok to do to an infant. There are not enough ssri's to numb us down to being ok with this procedure on an infant.  And, even if a grown man who can consent  wants his penis  circumcised, he shouldat least be enlightened to the consequences.  This  PUNISHING  procedure should never be done to AN INFANT UNLESS HE SAYS ITS OK, and I have not heard a newborn speak a word yet, so he must be protected until he is old enough to consent..  Penis cutting is not like giving him a shot or some medicine, it is ALTERING HIM AND REDUCING HIM FOR LIFE and sex is just part of it, BUT A VERY BIG PART OF IT.  Sex is life, and a brand new baby boy is the brand new bud opening up and you certainly don't put a knife on him before he can talk.  A cut guy can only fantasize about the difference in sex with or without the protective, moving. and very sensual nature made irreplaceable foreskin. The sexual connection between cut and uncut are night and day.  I am abobut to tell you the difference, if any of you want the truth.  A cut mans penis creates too much friction and makes it very uncomfortable for his partner and it is more like passionless friction than sensual connection.  The foreskin moves and protects the partner from discomfort of his frantically trying to get sensation the way a cut guy has to do,  due to his unfortunate trauamatic disfiguring loss.  The sensual sensitive foreskin makes for completeness  that adds sensistivity and size to an erection that only an intact guy feels and a woman experiences the benefits that make sex pleasurable because of it.  The trend I have noticed, is most women chose to ignore what has happened to a lot of Americans, but a lot of them are very unhappy and don't know why, and most will stay in the dark because the light is awfully bright when they open their closed eyes to see why there is so much friction, divorce and disunity between the sexes.  And the friction  is not all mental.   This severe abuse of infants has created such sexual dysfunction and injustice to circumcised males and their females as well, and it is very understated and under researched but I hope if we can't help the victimized people (both men and women)  today, we can at least insure that future infants AT VERY LEAST,  have a right to decide if they want their penis cut down to suit somebody elses image of what is and isn't pretty.   So hopefully, people will give the newborns a chance to come into the world gently, grow up healthy and sexually intact (Its their right) and the guys who have been cut get some help as well.   Make a human feeling rubber foreskin, as thin and sensual as possible, that can be attached to the cut penis and cause movement like the real thing, at least that is a start that helps the female enjoy sex and possibley the male.   I always hate to try to explain why I am opposed to something if I cant offer up at least one idea to help stop it or help the situation, especially for the ones injured.  I really wish we could all wake up tomorrow and this never happened to even one precious human life, but it did, and we are not drawing in kindergarten where we can just wipe the slate clean and start over. These are real human beings with real feelings and reality must come into focus for all concerned.   There has to be help for  the people adversly affected by this sexuality manipulation control scheme where punishment is inflicted on infants to right societal misbehaviour and infections. A  good start is trying to stop it from happening to the  offspring of cut people, and being there for them emotionally. Hopefully, we can come up with some help for these guys so their pleasure isn't just a fantasy.  Everyone deserves basic human rights not afforded to infants who were cut.  And for the sake of the future, and infants are the future, routine infant cutting  should be stopped, because I can't put a price tag  on the injustice of this amputation that I can't for the life of me begin to justify, no matter what I read or hear. Lets begin by prioritizing and putting the infants life and heath above everything, including opinions, religion, public health, infections or any other superficial silly excuse for skinning a babys penis down to a size that suitsWHO?  You can't go wrong prioritizing the health and well being of a newborn as opposed to believing there is one thing in this world as important.  BECAUSE THERE IS NOT.    

Sadforbabys
Sadforbabys

It doesn't matter what cutting part of a childs penis off prevents cures or cleans, A babys health and best interest is much more important than bad sexual decisions made by adults. The baby is disfigured and sexually cut down to size and traumatically injured for life, all because of high ingnorance and greed out of control.   If cutting to prevent disease, such as penile cancer a rare form, then why would doctors not cut off a girls breasts to prevent a much more prevalent breast cancer?  And a girl is as hard or harder to clean than a boy but we don't cut off important skin to leave it exposed and cleaner, as a matter of fact we cringe at the thought.    This lack of common sense and greed is destroying babies and most of them don't even know they were mutilated.   They just think it is natural to not have the moving sensitive part of their penis that makes sex smooth and comfortable for them and their partner, and that I can't believe humans have reached a point of greed to allow any such. Circumcised males who say they are Ok with it don't even know what they are talking about since most of them were assaulted as babies.   Now what age do human righta apply?   If a doctor was tied down and part of his penis skinned off with no anesthesia, all hell would be to pay and what price woiuld he put on his loss? Would he just ignore it and be fine with the fact he was severely assaulted and traumatized for life and rendered  sexually disfigured and inept compared to an intact male?  Does a baby not have rights to protection (and sometimes even  his life)  just because he is newborn and can't talk?   There is no justification for taking any babies parts from him unless he is old enough to OK it.  His parents can't legally  Ok him drinking a beer as a teen ager, but they can ok part of his penis  cut off for looks or religion or some other fabricated crock of bull? THIS IS NOT LAWMAKING.  THIS IS MAYHEM AND MUST STOP FOR THE PROTECTION OF SOCIETY. 

Shelly
Shelly

How about an article that discusses what the foreskin is, what its structure and function is, and the value of being intact sexually and otherwise, and that it does not require any special care? Please interview those of us who know the facts. thanks.

Cheryl
Cheryl

According to an article in The Columbus Dispatch today, circumcision remains enormously popular in the Midwest, particularly in Ohio, which has an 84% circumcision rate.

http://www.dispatch.com/conten...

Nobody
Nobody

It's long overdue.  The evidence for the health benefits of circumcision is overwhelming.

Gregory Boyle, PhD, DSc
Gregory Boyle, PhD, DSc

Re: Flawed African Studies into Male Circumcision and HIV Sexual Transmission‏

Re: Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns. J Law Med 2011;19:316-34.The Journal of Law and Medicine, has published a new critique of those three randomized clinical trials from Africa that have purported to find that male circumcision reduces female-to-male sexual transmission of HIV by 60 percent.This critique finds numerous flaws in the execution of these studies and finds that the actual reduction in HIV transmission is about 1.3 percent, not the claimed 60 percent. The 1.3 percent is not considered to be clinically significant.This is offset by a 61 percent relative increase in male-to-female HIV transmission when the male partner is circumcised.Given this, the three RCTs should not be used in the formulation of public health policy. See the attached Pdf.http://www.salem-news.com/articles/de...

Shelly
Shelly

Absolutely not true. The evidence is overwhelmingly against any health benefits of removing functional healthy tissue from newborns or children.

RolandDay
RolandDay

Diekema is one of 12 members on the AAP circumcision task force. While he may believe that a statement in favor of circumcision should be issued, he cannot guarantee that it will happen.

He is expressing his personal opinion here, but not necessarily future AAP policy.

Jennifer Morse
Jennifer Morse

It's unlikely that religious communities will tolerate a ban on male circumcision.  If there is one, it would likely be overturned.  Parents will continue to circumcise their boys regardless of what the anti-circumcision activists say.

Frank K. Robinson
Frank K. Robinson

It may well be true that some religion-blinded parents "will continue to [circumutilate] their boys regardless" of the indisputable facts.  But how can anyone who claims to be religious possibly approve of torturing and mutilating infants ostensibly to appease some cruel, supposed deity?  (And, by the way, the New Testament explicitly renounces circumcision for Christians, who represent a huge proportion of religionists in the world.)  Where are parental sense, intelligence, rationality--and above all, basic lovingkindness of parents for their children?   ~~~  N.B.: "Anti-circumcision activists" (read: Intactivists) hold the moral, humane high ground...as well as the de jure (legal) position, if the nation's laws against crimes of physical assault and injury were to be enforced in the case of male genital mutilation.  They advocate love, care, and  protection of helpless infants.  Circfanatics (okay, read: circumcision proponents, if you will) argue for some imagined, barbarous (non)right of adults to torture and mutilate children.  Even more outrageously and illegally, some warped proponents are now calling for enforced mutilation of every American male, adults as well as minors--all in the name of public health, of course of course..... 

John Rawls
John Rawls

The problem is that these countries are signatories of international treaties and declarations committing them to protecting basic human rights and not engaging in torture. When presented with the practice of infant male circumcision, they can easily rule that it is a human rights violation, which it is. Hard to overturn such a ban when you country has committed to protecting basic human rights, including the right to bodily integrity. The dilemma that some religions face is that one of their "required" rituals meets the criteria of a human rights violation and possibly torture. In a secular forum, human rights will be protected. In theocracy, human rights are secondary to religious concerns.

Shelly
Shelly

Not in Sweden, Finland, and other European countries. 

Oceanblue20
Oceanblue20

When are the anticircs going to accept the SCIENTIFIC FACTS !!! NEVER I suspect

CIRCUMCISION REDUCES the risk contracting HIV AIDS by at least 60% and of women developing cervical cancer by 39 %

Their constant denial of these critically important research findings means that the anticircs are left with ZERO credibility

The anticircs could not care less about the people who WILL DIE from these lethal diseases !! So much for their moral and ethical standards At least the WHO is trying to save millions of lives in Africa

Hugh x
Hugh x

 The Relative Risk Reduction (RRR) is a great way of making a small difference in a rare event look big. The fact is that overall about 2.5% of non-circumcised men (137 men) had HIV compared to 1.2% of circumcised men (64 men), less than two years after a total of 5,400 adult volunteers were circumcised in three trials, and similar numbers were made to wait. (2.5-1.2/2.5=0.52. Some other tweaking pushed it up to 0.6 or 60%)Look at these devastating critiques of the methodology and ethics of the African trials.http://tinyurl.com/7deqtaphttp://www.publichealthinafric...  and http://www.salem-news.com/fms/...

Oceanblue20's "of women developing cervical cancer by 39 %" sounds like the meta-analysis of seven studies in five different countries by Castellsague et al. Only in one country, the Phillipines, were many men circumcised, so it was really a comparison of countries.and primarily a study of HPV. No signifiant difference in cervical cancer was found, except in a small, high risk subset (whose partners visited prostitutes, for example). This study was accepted uncritically and its "findings" blown out of all proportion by the media.

It is shroud-waving circumcision-advocates who lack credibility. Billions of men wordlwide live out their lives enjoying all their bodies without ever thinking twice about circumcision.

Hugh x
Hugh x

 "at least 60%"?The Relative Risk Reduction (RRR) is a great way of making a small difference in a rare event look big. The fact is that overall about 2.5% of non-circumcised men (137 men) had HIV compared to 1.2% of circumcised men (64 men), less than two years after a total of 5,400 adult volunteers were circumcised in three trials, and similar numbers were made to wait. (2.5-1.2/2.5=0.52. Some other tweaking pushed it up to 0.6 or 60%)Look at these devastating critiques of the methodology and ethics of the African trials.http://tinyurl.com/7deqtaphttp://www.publichealthinafric...  and http://www.salem-news.com/fms/...

Oceanblue20's "of women developing cervical cancer by 39 %" sounds like the meta-analysis of seven studies in five different countries by Castellsague et al. Only in one country, the Phillipines, were many men circumcised, so it was really a comparison of countries.and primarily a study of HPV. No signifiant difference in cervical cancer was found, except in a small, high risk subset (whose partners visited prostitutes, for example). This study was accepted uncritically and its "findings" blown out of all proportion by the media.It is shroud-waving circumcision-advocates who lack credibility. Billions of men wordlwide live out their lives enjoying all their bodies without ever thinking twice about circumcision.

Shelly
Shelly

Please provide the facts that are scientific. I'm waiting. Fifteen of 16 studies on cervical cancer showed no evidence of increased cervical cancer risk associated with the presence of the foreskin. That is scientific fact. Japan and other non-circumcising countries have much lower rates of STD's, cervical and penile cancer, and UTI's. Those are the facts. Circumcision does not and will not lower HIV risk. The absolute risk reduction is only about 1-2% in the RCT's published and that is IF the data is even accurate, which is yet to be seen as the authors refuse to publicly disclose the data. The relative risk reduction they state is about 50-60%, but this is overstated as they ended the studies early and it is not clinically significant.  About half the males in the studies reported no sexual contact or always using condoms, so they did not acquire HIV through sexual means. Therefore, the studies are meaningless. Most Africans are getting HIV through non-sterile injections and equipment. Many more will die from these ill-advised and poorly executed studies on poor Africans along with those already dying from the circumcisions alone. Tuskegee and Mengele live!

Mimi
Mimi

Sweden just called for a ban on male circumcision of minors. Hooray for a country who recognizes the human rights violation involved with this issue.

Pamela Morrow
Pamela Morrow

Many American women prefer circumcised men, and this is one of the reasons that they have their boys circumcised.  That may stop at some point, but for now that is still a common a preference for many women I talk to.

Hugh x
Hugh x

 Women of today have no idea what the women (and men) of 20-odd years hence may prefer, so they should not try to second-guess those people. With the US circumcision rater now under 60% and falling, they will have a much greater likelihood or experiencing both and deciding that they prefer one with all its moving parts.

Frank K. Robinson
Frank K. Robinson

Intact America reports that the CDC's own figure (which it allegedly did not mean to make public) is for verifiable, reported cases now a fraction under 33%.  ~  I agree that we should not try to second-guess future preferences.  Leave that to people of the future.  But regardless, either now or then, no one person's preference can be a legal reason for altering another person's body.  That decision belongs only to an individual himself.

John Rawls
John Rawls

Somali men prefer circumcised women and this is one of the reasons that women circumcise their daughters in that culture. Despite international efforts to curb female circumcision, it is still a common preference for many men there.

Mimi
Mimi

This is a cultural/societal response based on what women are told and what they are familiar with. Ask women in Europe and you will likely get the opposite response. Women who have had sex with intact men understand the difference from a sexual standpoint. 

Rodrigo Girão
Rodrigo Girão

Circumcision should not be a choice, just as clitoridectomy is not a choice. It should be automatically rejected, the very idea abhorred.

Roland Day
Roland Day

Dr. Dikema was born in the United States and circumcised as an infant.  Because of this experience, Dr. Dikema is biased in favor of circumcision. He has not been able to overcome his bias and apply international law of human rights and medical ethics to the practice of non-therapeutic male circumcision, even though he claims to be a medical ethicist.

Bradley
Bradley

Misandry is alive and well. Men have no rights. A man has no right to decide whether or not part of his dick is chopped off and no one thinks there's a problem with that. This quack and anyone who performs unnecessary surgery on the genitals of a person who does not, and cannot consent, needs to be in prison for life, if not executed for disfiguring child rape and molestation. 

Frank K. Robinson
Frank K. Robinson

Although I am not a lawyer, my understanding is that male genital mutilation is de jure already clearly illegal in the United States.  The de facto problem is that for over a century medical organizations and "experts" like Diekema have misled the general public into unquestioning acceptance of this medieval atrocity's obvious violation of children's human and civil rights.  Thus pitifully few lawyers and judges (most of them probably mutilated and ignorant of, or unwilling to admit to themselves, the extent of their loss) have either the courage or the desire to enforce the law. They simply turn a willingly blind eye to it.  The combined weight of public, official, and medical indifference and/or resistance therefore negates the actual law--in effect, becomes the unlawful law.       

Sarah
Sarah

I'm a married woman and circumcision affect MY SEXUAL EXPERIENCE.    My husband causes me pain actual pain because he is circumcised.  I won't go into specifics but lack of female pleasure is well documented so read about it.  

Hugh x
Hugh x

 Even if this were not common, the fact that it is an outcome of a deliberate act (by people who have no idea what long-term effects they cause) implies that the act should not be done.

Mimi
Mimi

Absolutely! circumcision of males affects female satisfaction. Sex with an intact man is much less abrasive, more lubricating, more pleasurable. Nature knows what is right. The U.S. has the biggest market for Viagra and other sex aids.

Barefoot Intactivist
Barefoot Intactivist

Diekema vaguely criticizes, in one fell swoop, all research that is critical of circumcision. Then he quotes the recent sexual satisfaction survey out of Africa... you should read that "study"! It's one of the most absurd pieces of "science" I've ever seen published!

The "researchers," who had a vested interest in showing that circumcision was not harmful, told a bunch of men how great circumcision was, and all the benefits they were going to get out of it. Then shortly after healing, they asked the men how they liked their beautiful new circumcised penises. Unsurprisingly, most said they were happy! Of course all of the rational people who wouldn't let a doctor near their genitals with a scalpel, wouldn't volunteer for this kind of "study" in the first place. These "studies" only take place in cultures where circumcision is already an ingrained practice -- and bias against normal genitals already rampant.

Diekema is a complete, hypocritical fraud, who is apparently in denial about the sad state of his own circumcised penis and what he has done to his own children. Pathetic!

REX BULLINGTON,BSW
REX BULLINGTON,BSW

AS A RETIRED CPS SOCIAL WORKER,ROUTINE INFANT CIRCUMCISION IS ONE OF THE WORST FORMS OF CHILD ABUSE,SEXUAL,PHYSICAL,EMOTIONAL CHILD ABUSE SIMILAR TO SHAKING BABY SYNDROME AND TORTURE.GREED,$$$$,IGNORANCE AND MISGUIDED RELIGIONS AND FEAR OF HUMAN SEXUALITY PERPETUATE THIS ABOMINATION TO OUR BOYS IN 44% OF AMERICAN NEWBORNS AMPUTATED MUTILATED AND LEFT SEXUAL CRIPPLES,THEN THEIR SOLD VIAGRA TO MAKE UP FOR THEIR SEXUAL MUTILATION.www.noharmm.orgwww.nocirc.org

Mimi
Mimi

The men in Africa were paid well to participate in the RCT's. It is highly unlikely that they would then state that circumcision adversely affected their sex life. They risked losing 1-2 years of free medical care.

Barefoot Intactivist
Barefoot Intactivist

Diekema is a circumcision fanatic who has been on a 3-year media campaign promoting infant circumcision. In an NPR interview last year, he laughed openly at the idea that humans have a right to protection from genital mutilation. The NPR reporter laughed with him, and the site later had to issue an apology for it.

Every time he talks, he says the AAP is about to recommend the procedure, yet it never happens. Meanwhile more and more countries outside of the US Circumcision Distortion Zone are speaking up against child genital mutilation.

Diekema is hanging is hat on flawed HIV 'studies' of circumcised adults, from Africa. Babies are not even sexually active!

Genital mutilation makes me sick to my stomach. Diekema has zero ethics and zero credibility.

Rosanna Lopez
Rosanna Lopez

They seem to have been taking forever to make a decision & sitting on the fence for years.  The confusing policy in recent years has left a lot of parents unsure what to do.Parents need more guidance, and if there are more medical benefits, a recommendation in favor of circumcision would help parents decide to have their boys circumcised.  I think more Latinos would have their boys circumcised if the AAP  were to recommend it.  At the moment, people are unsure where the medical community is going on this.

Frank K. Robinson
Frank K. Robinson

Indeed parents DO need more guidance from Diekema & Company:  TO LEAVE INFANTS' FORESKINS ALONE...!!!  To choose circumutilation for a child is NOT a parental right...!!!Circumcision is mutilation and a criminal violation of human rights...!!!

John Rawls
John Rawls

I don't think a recommendation would that make that much difference for the Hispanic community. The full-court press to circumcise has been going for decades, yet Hispanics have been very resistant. There are other communities, like those of Greek heritage who have also resisted. It is because the foreskin is part of what it means to be a man. Family trumps outside culture.

The CDC and AAP cannot recommend it because if they recommend it they own it. So, when the next baby dies from a circumcision, the doctor will say he recommended it because the AAP recommended it. So some crafty attorneys, and we know who you are, will sue the AAP based on its recommendation. Then it can be pretty easily demonstrated that their recommendation was not based on the medical evidence, but because everyone on the committee that made the recommendation was circumcised or every male member of their family was circumcised, or because there was pressure on them to get Medicaid to pay for the procedure, or because they failed to listen to the people who told them this was a bad idea. In each of these situations, the AAP is hosed, especially since every other country that has looked at this has come to the opposite conclusion.

Rosanna Lopez
Rosanna Lopez

Many Hispanics do end up circumcising their boys in the United States.  I know many families who have and there are some prominent Hispanic celebrities in the US who are circumcised.  Once a Hispanic family has been in America for several generations, they become more Americanized and more accepting of circumcision.  It is true that the large majority of first generation Hispanics do not circumcise, but the farther the connection from the original country, the more likely they are to become open to circumcision.  Therefore, my point is that a recommendation in favor would accelerate this process.

Mimi
Mimi

Don't look to the AAP and CDC for guidance on this controversial topic because these groups are catering to a small, well-financed, vocal minority who believe circumcision should persist for religious, financial, and/or psychological reasons. They do not represent the larger medical community. As a physician, I can tell you that most physicians wish infant circumcision would just go away. They are uncomfortable with it and many have not circumcised their own children. That alone should tell you something. This procedure frequently gets pawned off to other docs or to residents in training, etc. etc. I can't tell you the number of times I have heard physicians from differing specialties say they don't want to do it. Most physicians know at a very basic level that circumcision of infants is wrong, but parents continue to demand it be done. It is difficult to stand up to this kind of pressure and say no. So, physicians need the AAP, AAFP, CDC, etc. to say that it doesn't need to be done and shouldn't be done. Then the blame will shift and relieve physicians from this untenable situation. Do not trust the CDC and the current AAP task force on circumcision to give you the facts. Look to other countries such as the Dutch, Australia, Finland. Look at Intact America, No Circ, and other websites.

Marc
Marc

"Fine and dandy," huh?  It just so happens infant circumcision is opposed or not recommended by every national medical association in the world except in the U.S.   The Dutch Medical Association, representing 46,000 physicians and students, recently issued a report backed by 7 other medical associations that declared male circumcision an infringement of a child's bodily integrity rights, disputed the distinctions between female and male circumcisions, and said the foreskin is an important erotogenic structure for which no medical benefit justifies its routine removal.  www.norm-uk.org/news.html?acti...  The British and Australian medical associations both recently denounced any medical justification for routine infant male circumcision. www.smh.com.au/national/letter...

A recent study using fine-touch medical instruments found the male foreskin is the most sensitive part of the penis.  www.livescience.com/health/070...   http://onlinelibrary.wiley.com...   

A subsequent study in China confirmed that the foreskin is the most sensitive part of the penis.  Yang DM, Lin H, Zhang B, Guo W. [Circumcision affects glans penis vibration perception threshold].  Zhonghua Nan Ke Xue 2008; 14: 328-30, Dept. of Urology, the First Hospital Affiliated to Guangzhou Medical College, Guangzhou,Guangdong 510120, China. 

Removing the male foreskin is gynecologically equivalent to removing the clitoral foreskin, one of several types of female circumcision all of which are illegal to perform on girls despite similar purported health benefits.  

Circumcision is extremely painful to an infant and can cause lifetime trauma.  www.youtube.com/watch?v=UAGNnq...  www.cirp.org/library/psych/boy...

New research also find circumcised men are five times more likely to suffer from premature ejaculation.  http://www.ncbi.nlm.nih.gov/pu... 

Fletch
Fletch

Why no mention of the loss of the function of "gliding-action" resulting from circumcision? It seems that they know exactly what not to mention when it comes to discussing the negative effects of circumcision. This, in my opinion, is the most negative consequence. This is what men try to get back with foreskin restoration.

Frank K. Robinson
Frank K. Robinson

Very true, Fletch and Keith!  The gliding, caressing, stimulating action is one of the most intense delights afforded by the foreskin.  Maimonides was thoroughly aware of that fact as far back as the medieval period--as were the Victorian antimasturbation crazies Kellogg, Graham, and their assorted medical-profession malefactors.  The gliding action alone gives the lie to Diekema and other circfanatics' disingenuous (or perhaps in some cases only ignorant) protestations that removal of the foreskin does not reduce sexual pleasure.  I discovered the enjoyment provided by the gliding action at an early age, and have prized it ever since.  And as an avid Intactivist, I am pleased and gratified that circ victims who restore are also able to experience a great deal of that pleasure. 

Keith Rutter
Keith Rutter

Since doing even a little restoration, I am only just discovering the delights of a gliding action. I'll let you know when I get more, it'll be a great day.

Mimi
Mimi

Why the sensational title? Why not: Circumcision of neonates may be harmful to health and well-being says .....

Marcella
Marcella

Diekema thinks that the people opposing circumcision aren't able to scientifically evaluate the medical literature. Problem is, he isn't capable of evaluating the evidence. If he was able to do so, he would have picked up that about half the males in the African RCT's did NOT get HIV through sexual contact. Some males actually became HIV positive apparently because of the circumcision they received in the Ugandan study. See the blog: Don't get stuck by David Gisselquist and Simon Collery's blog on HIV in Kenya. Tuskegee-style studies and propaganda do not make for good public health policy. It is appalling that U.S. tax money is funding these ill-fated research projects and mass circumcision programs. The AAP should be sued if they promote such outrageous pro-circumcision rhetoric. 

Joseph Lewis
Joseph Lewis

We also shouldn't buy into the idea that we can justify cutting off part of a healthy child's genitals with "science" and "research."

Would there ever be enough "benefits" and "research" that would cause us to consider female circumcision in our daughters?

Because, if people actually cared to look, there is actually data that shows that there is a lower prevalence of HIV transmission in circumcised women.

That being said, there is so much that is hidden behind the magic 60% number that Diekema and others tout. They will not say, for example, that this is only a relative number, that the absolute difference found was actually 1.37%; hardly significant.

No one is also talking about the fact that the 60% figure fails to manifest itself in other countries where men are already circumcised; IE, the Philippines, Malaysia, other countries in Africa, AMERICA...

It would be nice if news outlets investigated the science for a change.

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