Should Circumcision Become Public Health Policy?

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Typical for medicos, they look at the science, but ignore law and ethics. I expect more from the nation's highest health authority.
It is illegal to forcibly cut the genitals of a female in the United States. Whether or not male circumcision is as horrible as female circumcision isn't the issue here. The law prohibits something as minor as a pinprick to extract a drop of blood from an unwilling female. I'm sure everyone will agree that male infant circumcision is worse than a pinprick.
The 14th Amendment to the Constitution guarantees equal protection under the law, and this applies to baby boys, too. Either boys are protected, too, (and the crime is going un-prosecuted) or the federal law protecting girls is unconstitutional. You can't have it both ways, boys and girls.

Dan Bollinger of IN 9:28PM September 01, 2009

"√We have laws against modifying female genitalia, why not protect males as well? This is a double standard. The female genitalia is responsible for spreading and harboring disease, yet we protect females. "Circumcised" females would also be cleaner and lead to higher reductions in transferring disease."
What? Though I agree that male circumcision is unnecessary, painful and something I would never subject my baby boy to , there is no comparision between routine male circumcision and female genital mutilation. FGM is more comparable to chopping off the entire glans of the penis.

k of NY 8:34PM September 01, 2009

I propose that a study be conducted to look into the potential benefits of female circumcision as it relates to STDs. NOTE: I am not talking about the more extreme forms, but the more "minor" forms such as removal of the clitoral hood.
It's time we look into the health benefits of both male and female circumcision.

Vince of SC 7:03PM September 01, 2009

Foreknowledge above the cut is healthy!
I attended a beautiful home bris that did not bother the baby, who had been given a little alcohol. Feeding a baby alcohol would be unconscionable in other circumstances, but that is preferable to the San Francisco Kaiser hospital circumcisions I observed that were performed on newborns without anesthesia. Those babies screamed in rigid terror as they were physically and psychologically tortured while their parents were kept outside, unaware. About half of U.S. parents no longer choose circumcision, including some rabbis.
Could lower sexually transmitted disease rates of circumcised men be due to socioeconomic factors? Many circumcised men are less comfortable using condoms. If that is factored in, there may not be a potential HIV reduction advantage.
While circumcision is an option that parents of newborn males should be offered and continue to be able to choose freely, without stigma, it would be premature for the CDC to recommended it routinely for all baby boys. Parents should also be informed of the exact nature of the procedure. It is not yet clear whether benefits outweigh disadvantages for this irreversible elective procedure.

Treat Babies Humanely of CA 6:23PM September 01, 2009

you're right to raise doubts about CDC.
other comments have pointed out the irony of use of the term 'voluntary' to describe a forced amputation, so i'll ask a question instead.
should baby girls have their genitals cut in response to evidence published in egyptian medical journals that female circumcision protects against STD's?

Jono 5:11PM September 01, 2009

Why is this still being done at all to infants? Even religious ritual traditions should perhaps re-visit their historic practice to embrace more current knowledge/understanding of the lack of medical necessity and the physical reality that,indeed, circumcision is removal of part of the sexual apparatus of men, the penis foreskin. Sexual function and psychological impact is permanent....as well as the confusing inferred meanings of such acts. My teen is happy to be an intact male. He is also admired by his peers and adults as one of the most amazing youths, as a male teen, that they have ever met...mature, no ADD, and possesses extremely "male" attributes and behavior that are documented in historic references about men, but that we see less of in our more feminine, metro-sexual males today. Any coincidence? Do we really know if circumcision affects testosterone levels? Male confidence/lack of fear ? Are there any pain/victim associations in deep cellular memory of such early surgery? It reminds me of the surgical removal of female breasts to "prevent" breast cancer! Shall we do that optionally to our little girls? Interestingly, those parents (me) who elected NOT to circumcise, are usually the same who raised our boys w/out pesticide/estrogen laden chicken and beef products, thalate (estrogen-releasing) plastic baby bottles, and PVC toys(which affect hormones). Thus, our boys are usually the most dominant scholar-athletes in our communities, that are leaders in our churches and volunteer activities.

nettie of DE 2:34PM September 01, 2009

Let's see the study results in laymens language which show just how significant the circumsized/uncircumcised ratios are for heteros, homos, committed men.

George Stimmel of FL 1:42PM September 01, 2009

Wow. Circumcision of adults may be an option here, but permanently removing healthy, functioning tissue from an infant, assuming he'll engage in risky behavior later, in order to *possibly* lower risk of an otherwise-preventable disease years down the road? This can never be ethically justified.
The HIV/AIDS fight has many promising battles ahead. But it would not be a victory to permanently alter a generation of American boys, especially based on a few flawed African studies and ignoring many other studies which do NOT suggest that circumcision reduces HIV. It's an ethical disaster, not to mention one which makes no sense religiously (for Christians or Jews; research "milah" in the Oxford Dictionary of the Jewish Religion and the 1906 Jewish Encyclopedia). Nor does it make sense medically, legally, or financially.

Peter of PA 8:20AM September 01, 2009

The three African RCTs are of dubious validity due to the pro-circumcision bias of the North American doctors who conducted the studies. Regardless of their validity, studies carried out in sub-Saharan African on adult heterosexual males are not relevant to the circumcision of children in North America.
Children do not engage in sexual intercourse and have zero risk of HIV infection, however, they do have risk of staph infection in the newborn nursery through the open circumcision wound. Circumcision of boys is contraindicated.
The CDC is part of the federal government. The United States is a state-party to the UN Covenant on Civil and Political Rights. The United States is pledged to protect the human rights of its citizens. Among those rights is the right to security of the person. Circumcision, which excises and amputates a body part from a person, violates that right. The CDC, as part of the federal government has a duty to protect an promote human rights. If the CDC promotes circumcision of minor children, it violates its duty to protect human rights.
The CDC says that circumcision would be voluntary. It does not explain how an infant boy would volunteer for a circumcision.

George Hill of LA 10:55PM August 31, 2009

Circumcision is surgery. It carries risks. Those include excessive bleeding, meatal stenosis, MRSA infection, skin bridges, and death. The CDC has no business recommending unnecessary surgery for anyone. Have they forgotten the oath they took to become doctors, "first, do no harm"? Even if circumcision was beneficial, from a health perspective, it removes more than 50% of the skin of a penis. The two most sexually responsive parts of a man are the inner foreskin and the frenulum, not the penis head. The inner foreskin and frenulum are either removed or damaged in circumcision.
As far as health, there is not a medical organization in the entire world, which recommends circumcision for health reasons, not even Israel. In case you believe those poorly designed, poorly executed African studies, as the CDC and WHO appear to, ask yourself these simple questions, Which country has the highest percentage of its males circumcised?
If you answered the United States, you would be right. If, as the African studies state, that circumcision lowers the man's chances of contracting HIV by 60%, than why does the circumcised US have a much higher HIV infection rate than any European country, where circumcision is unusual? All those American men who have died of AIDS, how much did their circumcisions help them? Studies published in the last couple of weeks have said that circumcision does not lower the HIV infection rate in American men. They also said that African studies have shown no difference in the rate of HIV infection, between circumcised and uncircumcised men. They also showed that circumcision increases the rate of HIV infection of females, whose partners are circumcised, in Africa. Is this really the direction that we, as a country, want to take? Nobody has the right, ethically, to remove a healthy body part from someone who has not given consent. Is this really the best use of our scarce medical resources? Britain, Canada, Australia, and New Zealand all used to routinely circumcise, but now no longer do it. Are we heading forward, or backward, as a society? I believe the CDC is dragging us backwards, with no valid evidence which is accepted by medical societies outside the US. We have a choice...continue this peculiar American obsession, which has changed the condition it cures more than the reasons we invaded Iraq, or leave babies whole, which poses no danger.
If you have to wear a condom to be safe, even if you are circumcised, than why subject someone to a painful operation they don't need, and still have to wear a condom anyway?

Tom Tobin of MA 9:14PM August 31, 2009