American Academy of Pediatrics (AAP) Affirms that Claimed Medical Benefits Do Not Justify Routine Infant Circumcision; At Last Recognizes the Pain and Stress of Circumcision; Tragically Omits Crucial Information Necessary for Parents to Make an Informed Decision
Harry Meislahn, Illinois Director of a national organization providing circumcision information to parents, today released the following comment in response to the AAP's revised position on circumcision.
With the new AAP policy in hand, no parent can honestly claim ``medical benefits'' as a legitimate reason to circumcise. Anyone making such a claim is out of step with the American Academy of Pediatrics, which says ``[Potential medical] benefits of circumcision are not compelling enough to warrant the AAP to recommend routine newborn circumcision.'' The AAP's policy is consistent with those of national medical organizations in Canada, the UK, and Australia, none of which consider infant circumcision necessary.
With its new statement, the AAP is finally acknowledging that circumcision causes pain and stress. For the first time, it also recognizes that the pain of circumcision may have a long-lasting impact. This is a major improvement over the AAP's 1989 statement on circumcision, which erroneously claimed that ``These behavioral changes [i.e., those associated with circumcision] are transient and disappear within 24 hours after surgery.'' Meislahn commented ``Now that the AAP has officially recognized that circumcision hurts baby boys, I wish they would apologize to the tens of millions of American males who were profoundly hurt at birth by doctors who mistakenly claimed that circumcision is painless.''
The AAP is also correct in carefully avoiding the false claim that analgesics eliminate circumcision pain. Analgesics can only reduce the pain of the procedure and they do nothing to relieve distress post-operatively. The head of the penis and the cornea of the eye are the two most pain sensitive parts of a male's body, and chafing of the head of the penis against the diaper is uncomfortable for the circumcised baby. Some circumcised men still experience significant discomfort more than 30 years later.
The AAP statement provides useful statistics to demonstrate that routine circumcision is unjustified. By enumerating high-end statistics on penile cancer, sexually transmitted diseases, and urinary tract infections, the AAP shows just how insignificant these figures are. If a new surgical procedure were to be proposed today based on such shaky grounds, any medical body would find its professional credibility seriously compromised.
The AAP is on less firm ground when it strays from its area of professional competence, which is the dispensing of medical advice, and asserts that ``it is legitimate for parents to take into account cultural, religious and ethnic traditions'' when making the circumcision decision. Non-medical rationales for circumcision undoubtedly influence some parents in making the circumcision decision, but destroying an important and irreplaceable part of a child's body without his consent and without medical justification can hardly be considered ``legitimate.'' Surveys suggest that about seven times as many circumcised men as intact men are unhappy about their circumcision status, and therefore parents who try to be guided by what their child would want if he could speak have a strong reason to say no to circumcision whatever pressure others may try to exert. Parents who decide against circumcision are preserving their son's right to decide for himself. Meislahn commented, ``After all, he will be living with the decision his parents make long after we are all gone. It should be his decision to make when he is a man.''
The AAP statement also ignores vital information about circumcision. It is important for parents to know that the foreskin is important sexual tissue, not a simple flap of skin. Recent professional articles have proven the existence of specialized touch receptors in the foreskin, and the foreskin also protects the head of the penis, keeping it at peak sensitivity.
The AAP statement is limited by the bounds of published data. The AAP did not commission special studies that might have closed major remaining gaps in understanding of circumcision. First, despite proof that circumcision destroys important sexual tissue, the American medical community has never systematically studied the physiological and psychological consequences of circumcision for adult males and for their sexual partners. Also, the circumcision wound is difficult to keep clean, and pathogens, particularly from feces, can enter the bloodstream through this wound causing septicemia, liver abscess, meningitis, and other potentially fatal medical disasters. But the root cause of these disasters is seldom recorded, and the true and total risk from circumcision therefore remains unknown. Clearly, the AAP's task force on circumcision failed to do some necessary homework.
The National Organization of Circumcision Information Resource Centers is a decades-old group led by physicians, nurses, and other health-care professionals. It provides education, research, and advocacy on behalf of the right of every child to the integrity of his or her own body. For more information, contact Harry Meislahn (847-441-8027), or the national headquarters of NOCIRC (415-488-9883). Useful web sites include www.nocirc.org, www.cirp.org, and www.noharmm.org.