Male circumcision, the surgical removal of foreskin from the penis, has become almost a societal norm in the United States, with nearly four out of five males reporting that they’ve been circumcised. Recent reports of the health benefits of circumcision have come up against arguments that the procedure violates infants’ autonomy.
The controversy leaves parents asking the question: To cut or not to cut?
A commentary in last week’s Journal of the American Medical Association by Dr. Aaron Tobian and Dr. Ronald Gray outlines “The Medical Benefits of Male Circumcision.” They reference trial studies which showed that male circumcision reduces the risk of HIV acquisition in heterosexual men by half and the risk of genital herpes or high-risk HPV acquisition by one-third.
Some of these trials were conducted in Africa in order to inform the HIV prevention strategies there, but observational studies in the United States have shown similar reductions.
The 1999 circumcision policy statement of the American Academy of Pediatrics lists additional studies associating infant male circumcision with reduced risk of penile cancer or infant urinary tract infection. However, the AAP did not deem the data sufficient to recommend routine circumcision.
Earlier this year, citizens in San Francisco proposed a “Male Genital Mutilation” bill to ban infant male circumcision. Their reasons included surgical risk, potential sexual dysfunction, a lack of medical benefit or necessity and violation of autonomy.
As for the health risks, appropriate foreskin hygiene can significantly reduce them.
The bill did not make it to the ballot.
Courts ruled that local jurisdictions are not allowed to regulate health care professionals and that the ban would violate religious freedoms. Then Gov. Jerry Brown signed a bill to prevent local authorities from instituting such a ban.
Though a ban seems out of the question, more parents are opting out. A report by the Centers for Disease Control and Prevention said that the rate of hospital circumcisions fell from 56 percent in 2006 to 32.5 percent in 2009.
I think that I would opt out as well. The evidence of reduced health risks is persuasive but hardly definitive, and I do not agree with Tobian and Gray’s comparing circumcision to a “vaccine.”
