Position statements on infant circumcision

THE CONTENT OF THIS ARTICLE IS OUT OF DATE AND NEEDS TO BE UPDATED

Perhaps the most shocking fact is that circumcision continues to be practiced in the United States even though no official western medical organization in the world recommends it. The Royal Dutch Medical Society, The British Medical Association, the Canadian Pediatric Society, and the Royal Australian College of Physicians have all made official policy statements against circumcision.

The American Academy of Pediatrics, the American Medical Association, the American Academy of Family Physicians, and the American Urological Association all do not recommend circumcision, but deceptively claim "potential" benefits. (The word potential means to exist in possibility, but not in actuality, so a "potential benefit" is an imaginary benefit.)

The trend of opinion on non-therapeutic male circumcision is overwhelmingly negative in industrialized nations. No respected medical board in the world recommends circumcision for infants, not even in the name of HIV prevention. They must all point to the risks, and they must all state that there is no convincing evidence that the benefits outweigh these risks. To do otherwise would be to take an unfounded position against the best medical authorities of the West.

United States of America

“

The British Medical Association has a longstanding recommendation that circumcision should be performed only for medical reasons... Recent policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns. – American Medical Association (official website)

The circumcision policies of American medical trade associations are currently in chaos.

The three trade associations, whose member profit by carrying out non-therapeutic circumcision of boys formed a pact in 2007 to create a circumcision statement that would protect third-party payment for non-therapeutic circumcision. The three trade associations are:

• American College of Obstetricians and Gynecologists (ACOG)

• American Academy of Family Physicians (AAFP)

• American Academy of Pediatrics. (AAP)

The American Academy of Pediatrics (AAP) would take the lead and create a task force to draft a new statement. It would have representatives from AAFP and ACOG. The intent of the AAP, ACOG, and AAFP is made clear by the appointment of medical insurance specialist Steven Wegner, MD, JD, representing the AAP Committee on Child Health Financing, to the task force.

The AAP released its two-part statement in 2012 and it was immediately endorsed by ACOG and AAFP, who put up similar statements on their websites.

The statement immediately received scathing, withering critical comment from many sources, including Doctors Opposing Circumcision, an association of European doctors, and others.

The AAP standard policy is for their policy statement to expire after five years unless re-affirmed. The AAP circumcision policy statement expired in 2017 but has not been re-affirmed, so the AAP now has no official position on circumcision, although it continues to quote from the expired statement.

The other two trade association have statements that are based on the expired AAP statement. Are they still valid? No one knows.

“	...benefits are not sufficient for the American Academy of Pediatrics to recommend that all infant boys be circumcised. – American Academy of Pediatrics (AAP) (official website)

“

...the association between having a sexually transmitted disease (STD) - excluding human immunodeficiency virus (HIV) and being circumcised are inconclusive... most of the studies [of the effect of circumcision on HIV] ...have been conducted in developing countries, particularly those in Africa. Because of the challenges with maintaining good hygiene and access to condoms, these results are probably not generalizable to the U.S. population – American Academy of Family Physicians (AAFP) (official website)

Canada

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Current understanding of the benefits, risks and potential harm of this procedure no longer supports this practice for prophylactic health benefit. Routine infant male circumcision performed on a healthy infant is now considered a non-therapeutic and medically unnecessary intervention. – College of Physicians and Surgeons of British Columbia

The Canadian Paediatric Society (1996) stated:

[We] do not support recommending circumcision as a routine procedure for newborns. Circumcision of newborns should not be routinely performed.

The Canadian Urological Association issued its statement on circumcision in February 2018.

“

Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version) Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available. – Sumit Dave

See Canada

Britain

The British Medical Association updated its guidance for physicians in 2019.

“	The BMA considers that the evidence concerning health benefits from non-therapeutic circumcision is insufficient for this alone to be a justification for doing it. – The British Medical Association

The National Health Service performs circumcision only for medical reasons. It does not do non-therapeutic circumcision.

Australia

The Royal Australasian College of Physicians stated in 2010 that the foreskin "exists to protect the glans" and that it is a "primary sensory part of the penis, containing some of the most sensitive areas of the penis."

According to the Australasian Academy of Paediatric Surgeons:

“

The Australasian Association of Paediatric Surgeons does not support the routine circumcision of male neonates, infants or children in Australia. It is considered to be inappropriate and unnecessary as a routine to remove the prepuce, based on the current evidence available. We do not support the removal of a normal part of the body, unless there are definite indications to justify the complications and risks which may arise. In particular, we are opposed to male children being subjected to a procedure, which had they been old enough to consider the advantages and disadvantages, may well have opted to reject the operation and retain their prepuce. Neonatal male circumcision has no medical indication. It is a traumatic procedure performed without anaesthesia to remove a normal functional and protective prepuce. At birth, the prepuce has not separated from the underlying glans and must be forcibly torn apart to deliver the glans, prior to removal of the prepuce distal to the coronal groove. – J. Fred Leditshke

See Australia

Netherlands

In the Netherlands, the Royal Dutch Medical Association (KNMG) issued a statement in 2010 stating that "The official viewpoint of KNMG and other related medical/scientific organizations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity." Circumcision can cause complications, including infection and bleeding, and are asking doctors to insistently inform parents that the procedure lacks medical benefits and has a danger of complications. In addition to there not being any convincing evidence that circumcision is necessary or useful for hygiene or prevention, circumcision is not justifiable and is reasonable to put off until an age where any risk is relevant, and the boy can decide himself about possible intervention, or opt for available alternatives. They went on to say "There are good reasons for a legal prohibition of non-therapeutic circumcision of male minors, as exists for female genital mutilation."

External links

• (March 2016). Medical Organization Statements, www.doctorsopposingcircumcision.org, Doctors Opposing Circumcision. Retrieved 26 June 2020.
  Quote: By contrast, U.S. medical associations – especially the American Academy of Pediatrics, the lead broker of this cultural practice for decades – have been strategically deferential to parental choice and tradition. The AAP has been equivocal on the medical evidence since declaring circumcision “unnecessary” in 1971 – then walking that disavowal back ever since. The AAP has consistently dangled the specter of unpleasant, even dangerous (but highly unlikely) outcomes for intact boys, while disingenuously leaving it up to frightened young parents to make an immediate ‘decision.’ The rare mention by the AAP of the human rights of the child to an intact body has been, at best, parenthetical, and at worst, disdainful and dismissive.