- The background: It appears the AAP has taken the same body of evidence they've used for the past 13 years plus one new study and somewhat reversed their stance. Despite the hype that the AAP now "recommends" routine circumcision, what the AAP has done is take into account one new study on HIV transmission and is now saying that "the benefits may outweigh the risks." While this is a stone's throw from actually recommending routine male circumcision, it's close enough, and future parents will take it to heart. Sidebar: The AAP is now the only major pediatric association in the world that does not clearly oppose routine infant circumcision.
- While they have added a single study on HIV transmission, the study they are actually referencing cites VOLUNTARY male circumcision, as in, by choice at an adult age, in areas of the world where HIV rates are astoundingly high. This has led to the idea that circumcision at birth somehow protects men from contracting STIs later in life. However, among industrialized countries, the U.S. ranks high in both STI transmission rates (including HIV) and percentage of boys circumcised at birth. In other words, we don't even have correlative evidence to back up this claim. Of course STI transmission is a big concern to me personally, but I don't see how removing a functional part of a boy's penis at birth is going to somehow protect him from contracting an infection later in life. To address this issue, I'd advocate instead for a) comprehensive sex education in schools, b) more funding for youth programs that encourage and increase access to safer sex practices, and c) a society that isn't so sex-negative that things like condoms and penises can't even be discussed in a frank and honest manner.
- Regarding the "penile cancer" risk: Penile cancer is extremely rare.
When it does occur, it usually manifests in what we call the "foreskin" of the penis. So by removing the foreskin at birth, a male infant will grow up
to be less likely to develop a cancer that he was already unlikely to
develop in the first place. By this logic, we should also be removing the breast buds of baby girls. Think about it... breast cancer manifests in the functional breast tissue, the basis for which is present at birth. And seeing how breast cancer is far more common than penile cancer, we should be taking every possible precaution. We'll do it when they're two days old, so they won't remember it. We'll use anesthesia, so they won't feel it. And if they want to have kids later in life, well, they can just feed their babies with infant formula. And besides, women can still get some sexual pleasure without their breasts being involved. (See how ridiculous this sounds?)
- This is just speculation, but... given the fact that more and more insurance companies (and Medicaid) is seeing infant circumcision as a cosmetic procedure, they tend to not cover the costs. Perhaps the AAP is changing their position so they can continue performing the procedure regularly (cough cough cha-ching cough cough). Again, just speculation.
Further Reading:
Doctors Opposing Circumcision: Commentary on American Academy of Pediatrics 2012 Circumcision Policy Statement (pdf)
Intact America
The Whole Network
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