Position statements on infant circumcision

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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,[1] 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

American Medical Association

“ 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)[2]

The trade associations pact

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 Academy of Pediatrics

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 monetary intent of the AAP, ACOG, and AAFP is made clear by the appointment of medical insurance specialist Steven Wegner, M.D.[a 1], J.D.[a 2], representing the AAP Committee on Child Health Financing, to the task force.

The AAP released its two-part statement[3] [4] 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,[5] including Doctors Opposing Circumcision (D.O.C.),[6] an association of European doctors,[7] and others.[8] [9]

The AAP standard policy is for their policy statement to expire after five years unless re-affirmed. The AAP circumcision policy statement expired in September 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 representative of the opinion of those trade associations? No one knows.

American College of Obstetricians and Gynecologists

Obstetricians are doctors for female patients. They deliver babies so they get the first opportunity to profit from doing circumcision of a baby boy. Although males are outside of the scope of practice of OB/GYN[a 3], although its embarrassingly bad statement regarding non-therapeutic infant male circumcision now has been deleted from its website, ACOG still prints and sells promotional pamphlets to its member physicians.

American Academy of Family Physicians

Many family physicians profit from providing non-therapeutic circumcision on infants. The AAFP continues to provide its egregiously inaccurate, misleading policy statement (based on the former discredited 2012 AAP policy) on its website.

Canada

College of Physicians and Surgeons of British Columbia

“ 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

Canadian Paediatric Society

The Canadian Paediatric Society has issued three statements on non-therapeutic neonatal circumcision. Not one supports the practice.

1975

The Canadian Paediatric Society (CPS) took a position against non-therapeutic circumcision of boys in 1975, declaring it to have "no medical indication" and to be an "obsolete operation".[10]

1996

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.[11]

2015

The CPS again considered non-therapeutic infant circumcision in 2015. The CPS stated:

While there may be a benefit for some boys in high-risk populations and circumstances where the procedure could be considered for disease reduction or treatment, the Canadian Paediatric Society does not recommend the routine circumcision of every newborn male.[12]

Canadian Urological Association

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[13]

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[14]

The National Health Service performs circumcision only for medical reasons. It does not offer non-therapeutic circumcision.[15]

The General Medical Council has disciplined several medical doctors who performed male circumcision unethically or improperly.

See United Kingdom.

Australia

Australasian Association of Paediatric Surgeons

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[16]

Royal Australasian College of Physicians

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."[17]

See Australia

Netherlands

Royal Dutch Medical Association

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."[18]

See Netherlands

See also

External links

  • REFweb (March 2016). Medical Organization Statements, www.doctorsopposingcircumcision.org, Doctors Opposing Circumcision (D.O.C.). 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.

Abbreviations

  1. ↑ REFweb Doctor of Medicine, Wikipedia. Retrieved 14 June 2021. In the United Kingdom, Ireland and some Commonwealth countries, the abbreviation MD is common.
  2. ↑ REFweb Juris Doctor, Wikipedia. Retrieved 13 October 2021. (Also known as Doctor of Law or Doctor of Jurisprudence.)
  3. ↑ REFweb Obstetrics and gynaecology, Wikipedia. Retrieved 5 October 2024. Obstetrics and gynaecology (also spelled as obstetrics and gynecology; abbreviated as Obs and Gynae, O&G, OB-GYN and OB/GYN) is the medical specialty that encompasses the two subspecialties of obstetrics (covering pregnancy, childbirth, and the postpartum period) and gynaecology (covering the health of the female reproductive system – vagina, uterus, ovaries, and breasts). The specialization is an important part of care for women's health.
    Note: "OB-GYN" (or "OB/GYN") is most commonly treated as an initialism and pronounced as five individual letters, even though it only represents two different words.

References

  1. ↑ REFweb (2012). Potential, https://medical-dictionary, The Free Dictionary by Farlex.. Retrieved 26 June 2020.
  2. ↑ REFweb (2000). Report 10 of the Council on Scientific Affairs (I-99): Neonatal Circumcision, American Medical Association. Retrieved 25 June 2020.
  3. ↑ REFjournal Task Force on Circumcision. Circumcision Policy Statement. Pediatrics. September 2012; 130(3): 585-6. PMID. DOI. Retrieved 26 August 2020.
  4. ↑ REFjournal Task Force on Circumcision. Male circumcision. Pediatrics. September 2012; 130(3): e756-e785. PMID. DOI. Retrieved 26 June 2020.
  5. ↑ REFweb Young, Hugh (August 2012). Intactivism News, www.circumstitions.com. Retrieved 26 June 2020.
  6. ↑ REFweb (April 2013). Commentary on American Academy of Pediatrics2012 Circumcision Policy Statement, www.doctorsopposingcircumcision.org, Doctors Opposing Circumcision (D.O.C.). Retrieved 28 June 2020.
    Quote: The 2012 Circumcision Policy Statement was created by a team put together for the specific purpose of protecting the goose that lays golden eggs for the American medical industry. None of the members had any specific expertise in circumcision and their document suggests they knew little or nothing about the anatomy and utility of the human foreskin. They claimed to have studied voluminous literature, but ignored older and more useful studies, and cherry-picked the medical oeuvre.
  7. ↑ REFjournal Frisch M, Aigrain Y, Barauskas V, Bjarnason R, Boddy SA, Czauderna P, de Gier R, de Jong T, Günter F, et al. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision. Pediatrics. April 2013; 131(4): 796-800. PMID. DOI. Retrieved 25 June 2025.
  8. ↑ REFjournal Steven JS, Van Howe RS. Out of step: fatal flaws in the latest AAP policy report on neonatal circumcision. J Med Ethics. 2013; 39(7): 434-41. PMID. DOI. Retrieved 25 June 2020.
  9. ↑ REFjournal Van Howe RS. Response to Vogelstein: How the 2012 AAP Task Force on circumcision went wrong. Wiley Bioethics. January 2018; 32(1): 77-80. PMID. DOI. Retrieved 26 June 2020. Example
  10. ↑ REFjournal Swyer PR, Boston RW, Murdock A, Paré C, Rees E, Segal S, Sinclair JC. FN 75 Circumcision in the newborn period. CPS News Bull Suppl. 1975; 8(2): 1-2. Retrieved 27 June 2020.
  11. ↑ REFjournal Outerbridge E. Neonatal circumcision revisited. CMAJ. March 1996; 154(6): 769-80. PMID. PMC. Retrieved 25 June 2020.
  12. ↑ REFjournal Sorokin ST, Finlay JC, Jeffries AL, et al. Newborn male circumcision. Paediatr Child Health. August 2015; 20(6): 311-20. PMID. PMC. DOI. Retrieved 27 June 2020.
  13. ↑ REFjournal Dave S, et al. Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version). Can Urol Assoc J. February 2018; 12(2): 18-28. PMID. PMC. DOI. Retrieved 26 June 2020.
  14. ↑ REFdocument Non-therapeutic male circumcision (NTMC) of children — practical guidance for doctors PDF, British Medical Association (BMA House, Tavistock Square, London WC1H 9JP). (2019). Retrieved 25 June 2020.
    Quote: Doctors can refuse to perform NTMC if they do not believe it is in the overall best interests of a child. Doctors are under no obligation to comply with a request to circumcise a child. In these circumstances, doctors should explain this to the child and his parents, and, if appropriate, explain their right to seek a second opinion.
  15. ↑ REFweb (20 November 2018). Circumcision in Boys, National Health Service. Retrieved 27 June 2020.
  16. ↑ REFweb (1996). Guidelines for Circumcision, Australasian Association of Paediatric Surgeons. Retrieved 25 June 2020.
  17. ↑ REFweb (September 2010). Circumcision of infant males, RACP. Retrieved 25 June 2020.
  18. ↑ REFweb (27 May 2010). Non-therapeutic circumcision of male minors, KNMG. Retrieved 25 June 2020.
    Quote: The official viewpoint of KNMG and other related medical/scientific organisations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity.
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