Canada

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The status of non-therapeutic circumcision in Canada has been poorly reported. This page is an attempt to correct that situation.

History

Non-therapeutic circumcision of children is offensive to many Canadian minorities. The French-speaking people of Quebec and elsewhere generally do not favor circumcision. Male circumcision is not part of the culture of Inuit, First Nations, and Métis populations (4.3% of the population).

Pirie (1927), in a presentation to the Canadian Society for the Study of Diseases of Children, described circumcision as "very common".[1]

Patel (1966) reported his findings on neonatal circumcision in Kingston, Ontario, Canada. Patel reported on the complications experienced in a series of 100 consecutive male infants. He also reported on the incidence of circumcision at Kingston General Hospital in Kingston, Ontario. Patel reported an incidence of circumcision of 48 percent. This is for one hospital in Kingston, ON but has been widely cited as the rate for all Canada.[2]

Canada, like other English-speaking nations formerly circumcised most of its boys, with circumcision rates in the 40 to 70 percent range in the 1960s.[3]

Position statements of medical societies.

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".[4]

The CPS revisited circumcision in 1996 and recommended, "Circumcision should not be routinely performed."[5]

The CPS again considered 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.[6]

The Canadian Urological Association (CUA) considered the matter of circumcision and issued a statement in February 2018. The CUA concluded, "Given the socioeconomic, educational status, and health demographics of our population, universal neonatal circumcision cannot be justified based on the current evidence available.[7]


Availability of third-party payment

Canada has fourteen single-payer health insurance plans — one for each of the ten provinces and three territories and a 14th plan for government employees. The British Columbia HIP stopped paying for non-therapeutic circumcision in the 1980s. Ontario HIP stopped payment for non-therapeutic circumcision in July 1995; Saskatchewan stopped in 1996. One by one, all other HIPs have stopped paying for non-therapeutic circumcision. Manitoba HIP was the last to stop, but only after the wrong boy was circumcised at St. Boniface Hospital.[8]

Third-party payment for non-therapeutic circumcision is not presently available anywhere in Canada. Parents who wish to have a son circumcised must pay out-of-pocket for the costs of the circumcision.

Reasons for circumcision

Rediger & Muller (2013) found "newborn male circumcision rates continue to be heavily influenced by the circumcision status of the child's father."[9]

References

  1. REFjournal Pirie, George R.. The story of circumcision. Can Med Assoc J. July 1927; 17(12): 1540-2. Retrieved 26 October 2019.
  2. REFjournal Patel, Hawa. The problem of routine infant circumcision. Can Med Assoc J. 1066; 95: 576-81. Retrieved 25 October 2019.
  3. REFjournal Wirth, John L.. Current circumcision practices: Canada. Pediatrics. 1980; 66(5): 705-8. PMID. Retrieved 25 October 2019.
  4. 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 25 October 2019.
  5. REFjournal Outerbridge, et al. Neonatal circumcision revisited. Can Med Assoc J. 15 March 1996; 154(6): 769-80. PMID. PMC. Retrieved 26 October 2019.
  6. REFjournal Sorokin, S Todd, et al. [10.1093/pch/20.6.311 Newborn male circumcision]. Paediatr Child Health. August 2015; 20(6): 311-20. PMID. PMC. DOI. Retrieved 26 October 2019.
  7. REFjournal Dave, Sumit, et al. [1]. Can Urol Assoc J. February 2018; 12(2): 18-28. Retrieved 26 October 2019.
  8. REFnews "Circumcision mix-up", Canada.com. Retrieved 26 October 2019.
  9. REFjournal Rediger, Chris, Muller, Andries J. Parents' rationale for male circumcision. Can Fam Physician. February 2013; 59(2): e110-5. PMID. PMC. Retrieved 26 October 2019.