Pediatricians: Circumcision pluses outweigh risks
CHICAGO (AP) - The nation's most influential pediatricians group says the health benefits of circumcision in newborn boys outweigh any risks and insurance companies should pay for it.
In its latest policy statement on circumcision, a procedure that has been declining nationwide, the American Academy of Pediatrics moves closer to an endorsement but says the decision should be up to parents.
"It's not a verdict from on high," said policy co-author Dr. Andrew Freedman. "There's not a one-size-fits-all-answer." But from a medical standpoint, circumcision's benefits in reducing risk of disease outweigh its small risks, said Freedman, a pediatric urologist in Los Angeles.
Recent research bolstering evidence that circumcision reduces chances of infection with HIV and other sexually spread diseases, urinary tract infections and penis cancer influenced the academy to update their 13-year-old policy.
Their old stance said potential medical benefits were not sufficient to warrant recommending routinely circumcising newborn boys. The new one says, "The benefits of newborn male circumcision justify access to this procedure for those families who choose it." The academy also says pain relief stronger than a sugar-coated pacifier is essential, usually an injection to numb the area.
The federal Centers for Disease Control and Convention has estimated circumcision costs range from about $200 to $600 nationwide. Coverage varies among insurers and several states have stopped Medicaid funding for circumcisions.
The new policy was published online Monday in Pediatrics. It comes amid ongoing debate over whether circumcision is medically necessary or a cosmetic procedure that critics say amounts to genital mutilation. Activists favoring a circumcision ban made headway in putting it to a vote last year in San Francisco but a judge later knocked the measure off the city ballot, ruling that regulating medical procedures is up to the state, not city officials.
In Germany, Jewish and Muslim leaders have protested a regional court ruling in June that said circumcision amounts to bodily harm.
Meantime, a recent study projected that declining U.S. circumcision rates could add more than $4 billion in health care costs in coming years because of increased illness and infections.
Circumcision involves removing foreskin at the tip of the penis. The procedure can reduce germs that can grow underneath the foreskin, and complications, including bleeding and infection, are rare, the academy says.
Despite the U.S. decline, about half of baby boys nationwide still undergo circumcision, or roughly 1 million each year. The country's overall rate is much higher than in other developed nations, but U.S. rates vary by region and are higher in areas where it is a cultural or religious tradition, including among Jews and Muslims.
Psychologist Ronald Goldman, director of an anti-circumcision group, the Circumcision Resource Center, said studies show circumcision causes loss of sexual satisfaction - a claim the academy said is not supported by the research it reviewed - and can be psychologically harming. Goldman contends medical studies showing benefits are flawed and that the academy's new position is "out of step" with medical groups in other developed countries.
The American Congress of Obstetricians and Gynecologists took part in the research review that led to the new policy and has endorsed it. Circumcisions in hospitals are typically performed by obstetricians or pediatricians.
The CDC also participated in the review, and will consider the academy's updated policy in preparing its own recommendations, a CDC spokesman said. The agency has a fact sheet summarizing circumcision's potential health benefits and risks but no formal guidelines.
The American Medical Association and American Academy of Family Physicians have neutral policies similar to the pediatrics academy's previous position.
Philadelphia social worker Shannon Coyne examined medical research on circumcision before her son was born last September and had a tough time making a decision. She learned that a relative's boy needed reconstructive surgery after a botched circumcision, and that another's son who wasn't circumcised developed urinary infections.
Coyne said she and her husband ultimately decided against circumcision, because she didn't want her baby to have what she considers cosmetic surgery without being able to consent.
Her advice to other parents is "just make an informed decision. Do your research, be open-minded."
Some 18 states have eliminated Medicaid coverage for circumcision, a trend that could contribute to rising health care costs to treat infections if circumcision rates continue to decline, according to a study published Aug. 20 in Archives of Pediatrics & Adolescent Medicine.
Dr. Aaron Tobian, a Johns Hopkins University assistant professor who co-authored the study, said the academy's updated policy "is a very good step."
In its latest policy statement on circumcision, a procedure that has been declining nationwide, the American Academy of Pediatrics moves closer to an endorsement but says the decision should be up to parents.
"It's not a verdict from on high," said policy co-author Dr. Andrew Freedman. "There's not a one-size-fits-all-answer." But from a medical standpoint, circumcision's benefits in reducing risk of disease outweigh its small risks, said Freedman, a pediatric urologist in Los Angeles.
Recent research bolstering evidence that circumcision reduces chances of infection with HIV and other sexually spread diseases, urinary tract infections and penis cancer influenced the academy to update their 13-year-old policy.
Their old stance said potential medical benefits were not sufficient to warrant recommending routinely circumcising newborn boys. The new one says, "The benefits of newborn male circumcision justify access to this procedure for those families who choose it." The academy also says pain relief stronger than a sugar-coated pacifier is essential, usually an injection to numb the area.
The federal Centers for Disease Control and Convention has estimated circumcision costs range from about $200 to $600 nationwide. Coverage varies among insurers and several states have stopped Medicaid funding for circumcisions.
The new policy was published online Monday in Pediatrics. It comes amid ongoing debate over whether circumcision is medically necessary or a cosmetic procedure that critics say amounts to genital mutilation. Activists favoring a circumcision ban made headway in putting it to a vote last year in San Francisco but a judge later knocked the measure off the city ballot, ruling that regulating medical procedures is up to the state, not city officials.
In Germany, Jewish and Muslim leaders have protested a regional court ruling in June that said circumcision amounts to bodily harm.
Meantime, a recent study projected that declining U.S. circumcision rates could add more than $4 billion in health care costs in coming years because of increased illness and infections.
Circumcision involves removing foreskin at the tip of the penis. The procedure can reduce germs that can grow underneath the foreskin, and complications, including bleeding and infection, are rare, the academy says.
Despite the U.S. decline, about half of baby boys nationwide still undergo circumcision, or roughly 1 million each year. The country's overall rate is much higher than in other developed nations, but U.S. rates vary by region and are higher in areas where it is a cultural or religious tradition, including among Jews and Muslims.
Psychologist Ronald Goldman, director of an anti-circumcision group, the Circumcision Resource Center, said studies show circumcision causes loss of sexual satisfaction - a claim the academy said is not supported by the research it reviewed - and can be psychologically harming. Goldman contends medical studies showing benefits are flawed and that the academy's new position is "out of step" with medical groups in other developed countries.
The American Congress of Obstetricians and Gynecologists took part in the research review that led to the new policy and has endorsed it. Circumcisions in hospitals are typically performed by obstetricians or pediatricians.
The CDC also participated in the review, and will consider the academy's updated policy in preparing its own recommendations, a CDC spokesman said. The agency has a fact sheet summarizing circumcision's potential health benefits and risks but no formal guidelines.
The American Medical Association and American Academy of Family Physicians have neutral policies similar to the pediatrics academy's previous position.
Philadelphia social worker Shannon Coyne examined medical research on circumcision before her son was born last September and had a tough time making a decision. She learned that a relative's boy needed reconstructive surgery after a botched circumcision, and that another's son who wasn't circumcised developed urinary infections.
Coyne said she and her husband ultimately decided against circumcision, because she didn't want her baby to have what she considers cosmetic surgery without being able to consent.
Her advice to other parents is "just make an informed decision. Do your research, be open-minded."
Some 18 states have eliminated Medicaid coverage for circumcision, a trend that could contribute to rising health care costs to treat infections if circumcision rates continue to decline, according to a study published Aug. 20 in Archives of Pediatrics & Adolescent Medicine.
Dr. Aaron Tobian, a Johns Hopkins University assistant professor who co-authored the study, said the academy's updated policy "is a very good step."
This all boils down to personal preference or religious beliefs. There are benefits and risks to every procedure out there. When my son was born, this became a very heated debate between his father and I. He wanted our son circumsized however I did not want my little 24 hour old baby to have to go through something so traumatic.
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After doing my research, asking advice from multiple doctors and asking the opinion of every man I knew, we went ahead with the circumcision. I was surprised at how many men who were not circumsized had health and self esteem issues. I even had a few uncircumsized men tell me that they had wished they had it done when they were young because they can't imagine getting the procedure done as an adult.
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I found the absolute best doctor I could find to perform the procedure. Parents, just do your research before making a decision one way or another because this is something they will have to live with for the rest of their lives.
Parents should do their job and teach their kids what personal hygiene is and it's importance and let the child decide when he is old enough to make their own informed decisions. Cutting into the human body for no good reason is mutilation.Â
No, no, no. Genital mutilation is not a valid choice unless for a predefined medical reason (i.e. someone didn't have proper hygiene and removal of the skin was necessary due to infection). Nature puts a protective covering there for a reason, and the parent ISN'T the one who will have to live with decreased sensitivity for their entire life from a procedure that can't be undone.
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I'm thankful every day that my parents decided not to perform this outdated, barbaric, needless procedure and instead taught me the proper use of soap and water.
 @Lykos There is no decreased sensitivity. Quite contrarily, many studies show that circumcision increases sensitivity.
The benefits are minimal enough that I don't feel the need to permanently alter the sexual organs of my children.
"Child's Consent" should be two words that never are together. Parents should always make decisions for their child, because they are (presumably) more learned and have more wisdom than any child. The whole "my child will make all his own decisions and nobody should influence him/her in life" movement is causing the complete destruction of this country.
 @A Believer Should parents be allowed  to have their daughter circumcised too?
 @IslandAtheist  @A Believer There is no medical reason for girls to be circumcised, and it does affect their sexual capability in the negative, so no â it has been proven that it is harmful.
 @IslandAtheist  @A Believer And the parent's decision should be to not circumcise their daughter.
 @IslandAtheist Yes, and you know full well I was saying that the parents should make decisions for the child â not the child.
 @A Believer You said, "Parents should always make decisions for their child"?
The kid's expression looks like someone just described the procedure to him.