European Pediatricians: American Academy of Pediatrics' Recommendation to Circumcise Baby Boys Is "Questionable, Weak"

Categories: Health
circumcision_emilio.jpg
Deirdra Funcheon
After years of studying all the studies about circumcision, the American Academy of Pediatrics last year updated its policy about circumcision of infant boys. Whereas it had previously been neutral on the matter, the organization started recommending the procedure, advising that the benefits outweigh the risks.

This put the AAP at odds with pediatric groups in other countries, especially European ones.

See also:
- Interview With Dr. Doug Dietkema of the American Academy of Pediatrics

- Anti-circumcision Activists: Trimming a Bit off the Top Is Too Much

Yesterday, European doctors struck back in a scientific journal article, saying that "only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance" and that the other claimed health benefits "are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves."

Yesterday, the AAP, in its own scientific journal, Pediatrics, published the rebuttal article, called "Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision." It was written by representatives from the British Association of Paediatric Surgeons, the Swedish Paediatric Society, the Ethics Committee of the German Academy of Pediatrics and Adolescent Medicine, and dozens of other such groups from Iceland to Denmark to Latvia.

Only the abstract is avalable online for free; the full report states that:

- Preventive procedures on healthy people should follow "more and stricter justification" than medically necessary procedures, and even stricter justification should be required for children, "who cannot weigh the evidence themselves and cannot legally consent to the procedure."

- While the AAP says circumcision prevents urinary tract infections (UTIs), the European doctors counter that only one percent of boys will get these in their first years of life, and there are no randomly-controlled clinical trials proving that circumcision prevents them.

- The AAP says circumcision can stave off penile cancer, but the European docs counter that "the evidence is not strong; the disease is rare and has a good survival rate; there are less intrusive ways of preventing the disease; and there is no compelling reason to deny boys their legitimate right to make their own informed decision when they are old enough."

- The AAP says circumcision can offer protection against genital herpes and genital warts. The Europeans say that conclusion was based on studies in Africa that don't apply in the West; doesn't take into account syphilis, gonorrhea and chlamydia; and again is only relevant to adults, so "the decision of whether to circumcise can be postponed to an age when boys are old enough to decide for themselves."

- Perhaps most importantly, the AAP, relying on three studies done in Africa, suggested circumcision can have a preventive effect against HIV/AIDS. The Europeans argue that conclusion has been "contradicted by other studies, which show no relationship between HIV infection rates and circumcision status. The African findings are also not in line with the fact that the United States combines a high prevalence of STDs and HIV infections with a high per- centage of routine circumcisions. The situation in most European countries is precisely the reverse: low circumcision rates combined with low HIV and STD rates... There are alternative, less intrusive, and more effective ways of preventing HIV than circumcision, such as consistent use of condoms."

- The Europeans also noted the possible problems with circumcision -- infections, hemorrhages, metal strictures, deaths and (partial) amputations. (And if you want to be majorly grossed out, you can see pictures of circumcisions gone wrong here.)

- And lastly, the foreigners say not to underestimate the foreskin's role in sexy time: "the foreskin is a richly innervated structure that protects the glans and plays an important role in the mechanical function of the penis during sexual acts. Recent studies [which the AAP did not take into account] ..suggest that circumcision desensitizes the penis and may lead to sexual problems in circumcised men and their partners." (Translation: anteaters won't need so much Viagra.)

Yesterday's article is great ammunition for people who oppose circumcision of babies, such as the Florida moms protesting outside of Babies R Us or the groups who will be convening in Washington for an annual anti-circumcision rally later this month.




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11 comments
jenncvw
jenncvw

The AAP has intentionally written a misleading statement on circumcision. Despite the fact that they have somehow come to the conclusion that the supposed benefits outweigh the risks, they clearly state that they still do not recommend the routine circumcision of infant boys.

Check out our group to learn more about the dangers and ethical issues surrouding routine infant circumcision, or come out and join us at one of our upcoming events in South Florida. www.facebook.com/southfloridaintactivistsunite

brinxster
brinxster

AAP misled people by intentionally not mentioning all the cons of foreskin amputation and only said "the benefits outweigh the risks"... however they don't outweigh the massive cons. And the AAP also neglected to mention the human rights of the child as if you can decide to chop off any body part as long as your religion is cool with it... sorry but no, that's extremely unethical.  Circumcision may be useful to treat rare conditions and should be considered on a case by case basis where it is absolutely the last resort solution such as cancer removal in the foreskin which is very rare but most guys don't need it and is damaging to their sexual health.

keith.h.rutter
keith.h.rutter

Circumcision is a multimillion dollar industry in North America where the boys have no rights to their own bodies..  Boys in Europe do, and are happier and healthier as a result. As the owner of a penis ruined by non-therapeutic cutting, done purely to make the doctor wealthier.  A worldwide ban is needed.

circesadreim
circesadreim

Actually, the headline is a bit misleading. The AAP did NOT outright 'recommend' that baby boys be circumcised. As it stands now, there is still NO medical organization in the world that recommends infant circumcision.

At any rate, this is great ... American doctors could stand to learn a thing or two from other countries when it comes to the subject of non-therapeutic circ.

winkelr
winkelr

All babies should be circumcised.  Their consent is implied by their helplessness.  And their hearts should be cut out to protect them from future heart attacks.  Allopathos medicine uber alles!

TLCTugger
TLCTugger

Foreskin feels REALLY good.  Seriously, it;s the best part. 

The AAP's panel has not one foreskin among them, and they clearly didn't bother to ask one intact man about his.  Turns out only about 1 in 500 would give up his healthy normal foreskin. 

glharryman
glharryman

It might be beneficial to consider what we are talking about:

What we call "male circumcision" amputates the mobile portion of the penis and thousands of the most specialized pressure-sensitive cells in the human body; Meissner’s corpuscles for light touch and fast touch, Merkel’s disc cells for light pressure and texture, Ruffini’s corpuscles for slow sustained pressure, skin tension, stretch, and slip, and Pacinian corpuscles for deep touch and vibration are found only in the tongue, lips, palms, nipples, fingertips, the clitoris, and the Ridged Band of the male foreskin. These remarkable cells process tens of thousands of information impulses per second! These are the cells that allow blind people to "see" Braille with their fingertips. Cut them off and it's like trying to read Braille with your elbow. Information from tactile sensitivity gives humans environmental awareness and control. With lack of awareness comes lack of control. Luckily, for those who have them, Nature has mandated that these four types of mechanoreceptors do not age-degrade like the rest of the body's cells. To say that amputation of the clitoris or the mobile roller-bearing-like portion of the natural penis and consequently thousands of these specialized nerve cell interfaces does not permanently sub-normalize one's natural capabilities and partially devitalize one's innate capacity for tactile pleasure is grossly illogical denial of the bio-mechanical and the somatosensory facts of human genital anatomy. The foreskin also forms an organic seal keeping natural lubricants inside the vagina during intercourse. Millions of years of trial and error evolutionary forces have synchronously engineered the human sex organs. The natural penis perfectly compliments the natural female body. Like some other organs and limbs, a man can live without it, but he's certainly better off with it – all of it. And so are his sexual partners.

docdirector.geisheke
docdirector.geisheke

To be fair to the AAP, they did NOT recommend circumcision. They suggested the "benefits outweigh the risks," without an assessment of the risks or poor outcomes. (They admitted in their 9/2012 statement  that the morbidity (complications) of circumcision is unknown, whether for infants or older children.) And there are no long-term 'longitudinal,' (decades or more) studies of circumcision outfall. They simply do not exist (and in the USA, would not be welcome.)

The AAP  second salvo this week--declaring in the journal 'Pediatrics,' their European critics are "biased,' is even more interesting. 

All ethical medical professionals must be 'biased' against surgery. It is not the steady-state or default position of the human body to be cut into or have working parts removed. The case for cutting a minor must be made, individual by individual,  as a necessary, and unavoidable, therapeutic measure. This the AAP did not and cannot do.

The 'bias' of the Europeans is the correct ethical stance. The bias of the AAP is tilted toward cutting children unnecessarily ---for profit.

John Geisheker, JD, LL.M.

Exec. Director

DOCTORS OPPOSING CIRCUMCISION

Seattle, Washington, USA

jackoper
jackoper

How can people have an opinion on this when they think the THOUSANDS of specialized nerve endings and their connection to BRAIN is not meaningful? The parts cut of are the most innervated parts of the male genitals. When the parts are cut off a huge part of the kid’s/man’s sensory system is SHUT DOWN. 

The nerves are real.  The dynamic action of the NATURAL genitals is real.  The discussion as to this topic needs to get REAL.   This practice is a real WOUNDING, it is real harm to the baby and the man he becomes.

The AAP should withdraw its circumcision policy the way it withdrew its female genital cutting policy after a storm of outrage two years ago, when it recommended a token ritual nick to baby girls, much LESS extensive than neonatal male genital cutting. Shame on the AAP for not considering the harm! Have they no sense of decency? Especially pediatricians should First do no harm!

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