American Academy Of Pediatrics Changes Stance On Circumcision

The physician's group says that medical insurers should pay for the procedure.

Even as the circumcision rate for newborn baby boys in the United States reaches its lowest level in decades, the American Academy of Pediatrics reported Monday that the health benefits of circumcision outweigh, or are at least equal to the risks.

A review of medical literature published Monday in the journal "Pediatrics" finds that circumcision may protect heterosexual men against HIV infection. The policy shift comes as circumcision becomes a charged political topic, following a German court ruling in June that circumcision is illegal. Jewish groups are asking the German government to pass legislation that protects the practice

Critics are deriding the policy shift for a number of medical and ethical reasons, including citing the relatively small body of HIV studies on African men that indicate a preventative benefit from circumcision.

The academy's position does not endorse circumcision, but suggests that it should be an option available to parents, according to an article in the New York Times. It’s the first time that the influential medical group has updated its circumcision policy since 1999. The academy said that medical insurers should cover the procedure and that cost should not be a barrier.  According to the Seattle Times, Washington Medicaid spokesman Jim Stevenson said coverage decisions are based on scientific research, and the new AAP study likely would be reviewed with other findings.

Circumcision rates range widely across the U.S., with the West having the lowest rate as a region as of 2009, and Washington state the second-lowest rate of circumcision, at 15 percent, according to federal data reported by The Jewish Daily Forward (see the chart on page 4).

What's your opinion on this subject? Should circumcision should be banned, or should parents be allowed to have the choice, as the American Academy of Pediatrics suggests? 

Sarah Weinberg August 28, 2012 at 09:35 PM
I am a retired pediatrician, and over the years I gave a lot of thought to the issue of routine newborn circumcision of boys. I'm not surprised that studies show small, but real, benefits in disease prevention, from infant urinary tract infections to HIV in heterosexual adults. I thought about why this custom not only started thousands of years ago, but has persisted in many different cultures. I figured that there must be some survival benefit. I have no proof, but I do have a theory: clothing. Back when humans wore no clothing, it was probably useful to have a foreskin protecting the head of the penis against dirt and injury as the boy/man moved through underbrush, hunted, fought, and slept. However, once people began to cover themselves with clothing, the warm, moist environment inside the clothes would be a fine place for bacteria and other germs to breed and invade the body. Underneath the foreskin would then become especially nice for bacteria and viruses to hang out waiting for an opportunity to invade the inside of the body. It woud be interesting to find out if infant boys in places like Papua New Guinea where they wear no clothes and aren't circumcised have a similar rate of urinary tract infections as uncircumcised infant boys in, say, Europe or North America. Meanwhile, parents should be free to choose what they want for their infant boys. Their choice should not be limited by issues relating to insurance coverage.
Kendall Watson August 28, 2012 at 10:25 PM
Thanks Sarah for such a thoughtful response. Our own pediatrician relied on the previous guidelines, which stated that there was no medical benefit,


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