Circumcisions: they’re back


Imagine that there was a simple, safe and highly effective treatment that prevents the spread of AIDS and other sexually transmitted diseases, not to mention cervical cancer and penile cancer.

Sounds too good to be true, right? But it is true. It’s not a medication, it’s not a vaccine, it’s … circumcision!

I’ve taken a lot of heat over the years for my stance on circumcision: that it is a matter of parental choice and that it has medical benefits. As far back as 2008, in discussing a just published paper on circumcision and HIV transmission, I pointed out:

The new study does not change what we already know: circumcision dramatically reduces the risk of transmitting HIV.

It was only a matter of time, therefore, before the American Academy of Pediatrics reversed its stance on circumcision to acknowledge the weight of the scientific evidence. The new recommendations were released on line today in advance of publication in the September issue of the journal Pediatrics:

Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.


Systematic evaluation of English-language peer-reviewed literature from 1995 through 2010 indicates that preventive health benefits of elective circumcision of male newborns outweigh the risks of the procedure. Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections.

Contrary to the claims of anti-circ activists:

The procedure is well tolerated when performed by trained professionals under sterile conditions with appropriate pain management. Complications are infrequent; most are minor, and severe complications are rare. Male circumcision performed during the newborn period has considerably lower complication rates than when performed later in life.

Infections disease experts and public health officials have been pushing for years to have the health benefits of circumcision acknowledged and widely publicized. The AAP has finally responded albeit somewhat tepidly:

Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.

Anti-circ activists have been repeatedly thwarted in their efforts to ban circumcision.

The San Francisco initiative was struck off the ballot:

udge Loretta M. Giorgi ordered San Francisco’s director of elections to strike the measure from the city’s ballot because she said that it is “expressly preempted” by the California Business and Professions Code.

Under that statute, only the state is allowed to regulate medical procedures, and “the evidence presented is overwhelmingly persuasive that circumcision is a widely practiced medical procedure,” the ruling said.

After a brief hearing, Giorgi also found that the proposed ban would violate citizens’ right to the free exercise of religion, said Deputy City Atty. Mollie Lee, because it targets Muslims and Jews, whose faiths call for circumcising males.

And the recent decision by a German court was overturned:

In Europe, a government ethics committee in Germany last week overruled a court decision that removing a child’s foreskin was “grievous bodily harm” and therefore illegal. The country’s Professional Association of Pediatricians called the ethics committee ruling “a scandal.”

Does the change in the AAP’s stance mean that parents should circumicize their sons? That decision is best left to parents … but at least parents will now receive accurate information with which to make the decision.