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Tenets of Osteopathic Medicine

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Osteopathic medicine is practiced in parallel along with allopathic medicine in the United States.

The American Osteopathic Association (AOA) is the medical trade association for osteopathic doctors (DOs). The AOA has not enunciated a position regarding male circumcision, however the AOA has adopted four Tenets of Osteopathic Medicine that may be applied to both child circumcision and adult circumcision. The Tenets of Osteopathic Medicine express the underlying philosophy of osteopathic medicine and were approved by the AOA House of Delegates as policy.[1] The tenets were last reaffirmed by resolution of the Ad Hoc Committee on 22 July 2023.[2]

Tenets of Osteopathic Medicine

1. The body is a unit; the person is a unit of body, mind and spirit.

The harmful, adverse effects of circumcision upon the human person had, until recently, been ignored for many decades. Now there is increasing evidence of the harm of the pain, trauma, and amputation of the multi-functional foreskin upon the sexual and psychological well-being of the human person.[3][4]

2. The body is capable of self-regulation, self-healing and health maintenance.

Charles Darwin (1859) observed that survival of the fittest caused evolution. The foreskin was created and improved by evolution to provide protection of the penis from both trauma and infection. Fleiss, Hodges & Van Howe (1998) enumerated numerous ways in which the foreskin protects against infection.[5]

The foreskin develops throughout childhood usually without medical intervention.[6] Forced foreskin retraction is harmful, inappropriate, traumatic, and inconsistent with the tenets of osteopathic medicine. The practice frequently causes a complaint to be filed with the medical authority.

3. Structure and function are reciprocally interrelated.

The human penis and its foreskin are excellent examples of the truth of this tenet. The penis and foreskin consist of specialized tissues ideally suited for their functions.[7]

4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation and the interrelationship of structure and function.

When these basic principles are applied, it will quickly be seen that harmful, medically-unnecessary, non-therapeutic amputation of the foreskin of boys is contraindicated.[8] [9] [10] Boys are unable to grant consent due their immaturity. Parental surrrogates must protect the interest of the child patient. They are limited to grantinng surrogate consent for diagnosis and treatment of disease. There is no person who is empowered to grant consent for non-therapeutic amputation of the foreskin of a minor.[11] There are no valid indications for circumcision in the neonatal period.[12]

Myers & Earp (2020) concluded that the best age to circumcise is after the patient reached the age at which he could grant consent for his own circumcision.[13]

Amputation of a healthy child foreskin without medical indication and without valid effective consent is equivalent to criminal battery.[14] While there are no reports of a provider being criminally charged, the changing view of child circumcision has altered the atmosphere around child circumcision, so a criminal charge may be more likely than in the past.

It is more likely that a parent would bring a cvil suit for injury caused by wrongful circumcision.[15]

See also

References

  1. ↑   Anonymous. Tenets of Osteopathic Medicine, American Osteopathic Association. Retrieved 19 March 2026.
  2. ↑   Sunset Res. No. H608 - A/2023  , American Osteopathic Association. (22 July 2023). Retrieved 19 March 2026.
  3. ↑   Hill G. The case against circumcision  . Journal of Men's Health and Gender. 2007; 4(3): 318-23. Retrieved 18 March 2026.
    Quote: Finally, we must remember that males are the more vulnerableand sensitive of the two genders and, therefore, deserve the greater degree of protection from traumatic, invasive, injurious, and unnecessary surgery.
  4. ↑   Andersen-Giberson D. Circumcision and forced disability: Routine male neonatal circumcision and the consequences of amputation within a critical disability studies framework  . Critical Disability Discourses. December 2025; 10(2): 1-37. DOI. Retrieved 12 March 2026.
    Quote: In a critical disability studies framework, it is argued that the act of amputating healthy erogenous tissue and the consequences of that amputation cause disability, particularly from a counter-hegemonic lens.
  5. ↑   Fleiss PM, Hodges FM, Van Howe RS. Immunological Functions of the Human Prepuce. Sex Transm Infect. October 1998; 74(5): 364-7. PMID. DOI. Retrieved 18 March 2026.
  6. ↑   Agarwal A, Mohta A, Anand RK. Preputial retraction in children. J Indian Assoc Pediatr Surg. April 2005; 10(2): 89-91. DOI. Retrieved 18 March 2026.
  7. ↑   Cold CJ, Taylor JR. The prepuce. BJU Int. January 1999; 83, Suppl. 1: 34-44. PMID. DOI. Retrieved 8 July 2021.
  8. ↑   Tye MC, Sardi LM. Psychological, psychosocial, and psychosexual aspects of penile circumcision  . Int J Impot Res. May 2023; 35(3): 242-8. PMID. DOI. Retrieved 19 March 2026.
  9. ↑   Fendereski K, Horns JJ, Driggs N, Lau G, Shaeffer AJ. Comparing Penile Problems in Circumcised vs. Uncircumcised Boys: Insights From a Large Commercial Claims Database With a Focus on Provider Type Performing Circumcision. J Pediatr Surg. November 2024; 59(11): [161614]. PMID. PMC. DOI. Retrieved 19 March 2026.
  10. ↑   Andersen-Giberson D. Circumcision and forced disability: Routine male neonatal circumcision and the consequences of amputation within a critical disability studies framework  . Critical Disability Discourses. December 2025; 10(2): 1-37. DOI. Retrieved 14 March 2026.
    Quote: In a critical disability studies framework, it is argued that the act of amputating healthy erogenous tissue and the consequences of that amputation cause disability, particularly from a counter-hegemonic lens.
  11. ↑   Hill G. Informed Consent for Circumcision  . South Med J. August 2002; 95(8): 946. PMID. Retrieved 19 March 2026.
  12. ↑   Preston EN. Whither the foreskin?. JAMA. 14 September 1970; 213(11): 1853-58. PMID. DOI. Retrieved 19 March 2026.
    Quote: Routine circumcision of the newborn is an unnecessary procedure. It provides questionable benefits and is associated with a small but definite incidence of complications and hazards. These risks are preventable if the operation is not performed unless truly medically indicated. Circumcision of the newborn is a procedure that should no longer be considered routine.
  13. ↑   Myers A, Earp BD. What is the best age to circumcise? A medical and ethical analysis  . Bioethics. 2020; 34(7): 645-63. PMID. DOI. Retrieved 27 May 2020.
    Quote: Based on a careful consideration of the relevant evidence, arguments and counterarguments, we conclude that medically unnecessary penile circumcision-like other medically unnecessary genital procedures, such as 'cosmetic' labiaplasty-should not be performed on individuals who are too young (or otherwise unable) to provide meaningful consent to the procedure.
  14. ↑   Buckner, Susan (13 January 2026). What Is the Crime of Battery?, Findlaw. Retrieved 19 March 2026.
  15. ↑   Adler PW. Is circumcision legal?  . Richmond Journal of Law and the Public Interest. 2013; 16(3): 439-86. Retrieved 19 March 2026.
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