Circumcision

[Ian]

circumcision has been practiced throughout history. Jesus was circumcised, “when eight days were accomplished.” circumcision is no longer required for salvation, but the practice has continued over the centuries for various reasons, including cleanliness and health.

over the past decade or two, a political movement has developed against circumcision. the internets are now flooded with misinformation circulated by people labeling themselves “intactivists.” about five years ago, a measure qualified for the san francisco city ballot that would have criminalized the circumcision of boys under age 18, punishable by one year in jail or a $1,000 fine. a judge ultimately removed the measure from the ballot, but “intactivists” continue to push for the illegalization of circumcision.

their tactics are familiar. first, seize control of the vocabulary. rather than use the word circumcision, use terms like “male mutilation,” “genital cutting” and “barbaric violation.” next, spread false and misleading information everywhere. eventually the web becomes so cluttered with falsehood and sophistry that a casual researcher cannot distinguish real scientific evidence from “science falsely so called.”

the preponderance of current scientific evidence indicates that the health benefits of circumcision outweigh the risks. the decision to circumcise newborn boys should be left to parents. i believe that circumcision is the right decision, and that it should be performed soon after birth, unless the baby is born with certain health problems that would increase risk of complication.

[John]

I remember the agony my father was compelled to endure when, for health and hygienic reasons he was compelled to be circumcised later in life. Much better that this take place in the first days of life when it is obviously painless and non-traumatic. It has not been any sort of problem physical, mental, or emotional for any of my brothers or sons or myself. I believe it to be a wise choice for parents...not just of my own or countless previous generations.

[James]

I began this evening’s reading on the issue by doing a quick comparison: the American company, webMD, and the NHS website from across the pond. The contrast was pretty interesting.

WEBMD

“When is circumcision done?
Circumcision is usually performed on the first or second day after birth. (Among the Jewish population, circumcision is performed on the eighth day.) The procedure becomes more complicated and riskier in older babies, children, and men.”

Is circumcision necessary?
The use of circumcision for medical or health reasons is an issue that continues to be debated. The American Academy of Pediatrics (AAP) found that the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision. The procedure may be recommended in older boys and men to treat phimosis (the inability to retract the foreskin) or to treat an infection of the penis.
Parents should talk with their doctor about the benefits and risks of the procedure before making a decision regarding circumcision of a male child. Other factors, such as your culture, religion, and personal preference, will also be involved in your decision.
What are the benefits of circumcision?
There is some evidence that circumcision has health benefits, including:
• A decreased risk of urinary tract infections.
• A reduced risk of some sexually transmitted diseases in men.
• Protection against penile cancer and a reduced risk of cervical cancer in female sex partners.
• Prevention of balanitis (inflammation of the glans) and balanoposthitis (inflammation of the glans and foreskin).
• Prevention of phimosis (the inability to retract the foreskin) and paraphimosis (the inability to return the foreskin to its original location).
Circumcision also makes it easier to keep the end of the penis clean.
Note: Some studies show that good hygiene can help prevent certain problems with the penis, including infections and swelling, even if the penis is not circumcised. In addition, using a condom during sex will help prevent STDs and other infections.


Then I looked at the NHS website:


Why circumcision is carried out in boys
Circumcision in boys may be carried out for:
• medical reasons – for example, as a treatment of last resort for conditions such as a tight foreskin (phimosis) and recurrent infection of the foreskin and head of the penis (balanitis)
• religious or cultural reasons – it's a common practice in Jewish and Islamic communities, and it's also practised by many African communities; most cultural circumcisions are carried out in young boys
How the foreskin develops
It's normal for a baby boy's foreskin not to pull back (retract) for the first few years of life.
Around the age of two – or later, in some cases – the foreskin should start to separate naturally from the head of the penis (glans). Full separation occurs in most boys by the age of five years.
For some boys, the foreskin can take longer to separate, but this doesn't mean there's a problem, it will usually just detach at a later stage.
As the foreskin starts to separate from the head of the penis, you may see the foreskin "ballooning out" when your son passes urine. This can occasionally lead to infection (balanitis), but this ballooning usually settles down with time.
Never try to force your son's foreskin back, as it may be painful and damage the foreskin.
Medical reasons for a boy to have a circumcision0

It's rare for circumcision to be recommended for medical reasons in boys. This is because other less invasive and less risky treatments are usually available.

The following conditions affect the penis and, in rare cases, may require a circumcision:
• tight foreskin (phimosis) – where the foreskin is too tight to be pulled back over the head of the penis; this can sometimes cause pain when the penis is erect and, in rare cases, passing urine may be difficult
• recurrent infection (balanitis) – where the foreskin and head of the penis become inflamed and infected
• paraphimosis – where the foreskin can't be returned to its original position after being pulled back, causing the head of the penis to become swollen and painful; immediate treatment is needed to avoid serious complications, such as restricted blood flow to the penis
• balanitis xerotica obliterans – a condition that causes phimosis and, in some cases, also affects the head of the penis, which can become scarred and inflamed
• repeated urinary tract infections (UTIs) – in very rare cases, circumcision may be recommended as a treatment of last resort if a boy has repeated UTIs
These conditions can often be treated successfully with non-surgical treatments, which will often be tried first before circumcision is considered.
Mild cases of phimosis can be treated with topical steroids to help soften the skin and make it easier for the foreskin to retract.
However, circumcision may be necessary if the foreskin is damaged and won't slide back over the head of the penis. This is very rare before the age of five.
In paraphimosis, a healthcare professional may rub a local anaesthetic gel on to the head of the penis (glans) to help reduce pain and inflammation. They may then apply pressure to the glans while pushing the foreskin forward.
In severe cases of paraphimosis, local anaesthetic gel can be applied and a small slit made in the foreskin to help relieve the pressure.
Balanitis and balanitis xerotica obliterans can sometimes be successfully treated using corticosteroid ointment, gel or cream, antibiotic creams or antifungal creams.
Most UTIs are mild and can be treated with antibiotics. However, repeated UTIs can occasionally cause kidney damage.
For example, if a boy has a birth defect that causes urine to leak back up into the kidney, bacteria can spread from the foreskin, through the urine, and infect the kidney. Circumcision may be recommended in these cases.



NHS says that circumcision is done for medical reasons (only after less invasive options have been exhausted) or religious/cultural reasons.

They never even mention that it might be beneficial or recommend that healthy babies be circumcised.

However, in America circumcision is generally advised.

Circumcision rates are highest in certain African regions where it is performed for cultural reasons. After Africa it is most common in North America and Australia. It is rare in the rest of the world.

John says it is painless WebMD says,
“Circumcision doesn't have to be as painful for your baby as it sounds. There are pain management methods that can help to significantly reduce the pain of the procedure for your newborn.”

George C. Denniston, M.D., president of Doctors Opposing Circumcision Says that the perception that foreskin is unhygienic is a myth. "Foreskin protects against disease; it doesn't cause disease. If foreskin is unhygienic, eyelids should be considered unhygienic."

http://www.doctorsopposingcircumcision.org


In my second pass at webMD I found the following. It’s a little less bold than the first webMD page I looked at

“An uncircumcised penis is easy to care for and keep clean. So improved hygiene isn't a reason to choose circumcision.
There are some potential health benefits of circumcision. While uncommon, circumcised males do have slightly lower risks of:

• Urinary tract infections (UTIs) in little boys
• Certain STDs in men
• Penile cancer
Since men don’t have a high risk of these in the first place, lowering their risks isn't a huge benefit.”

Most of the world remains uncircumcised and the majority of the medical community does not recommend circumcision for hygienic or health reasons. Since I do not have any cultural/religious reason to circumcise I am not in favor of the practice unless it is recommended for a medical condition.

[Steve]

Listen to the words of Christ, your Redeemer, your Lord and your God. Behold, I came into the world not to call the righteous but sinners to repentance; the whole need no physician, but they that are sick; wherefore, little children are whole, for they are not capable of committing sin; wherefore the curse of Adam is taken from them in me, that it hath no power over them; and the law of circumcision is done away in me.

(Moroni 8:8) ↗

There was much controversy in the early church with regard to the obligation of circumcision (Acts 15:1–31). The Church under direction of Peter and the Twelve, and acting under the guidance of the Spirit, declared that circumcision was not obligatory for gentile converts. However, it apparently did not settle the matter of whether or not Jewish members of the Church should have their children circumcised. As one reads the scriptures on the matter, it becomes evident that the real issue was not circumcision only but also the larger question as to continued observance of the law of Moses by members of the Church. The word circumcision seems to have been representative of the law in these instances. The controversy was renewed later on in Galatia, as we read in Gal. 2:1–15; 5:2–6, 11; 6:12–16. These passages, along with Rom. 2:25–29; 3:1–2; Philip. 3:3; and Col. 2:11, contain Paul’s teaching on the subject.

The Jewish part of the church membership, especially in Jerusalem, appears to have been very reluctant to cease from the rituals and ceremony of the law of Moses (Acts 21:17–25). This is a marked contrast to the Church among the Nephites, in which there seems to have been a cessation of the law immediately upon their awareness of the death and resurrection of Jesus Christ.

(Circumcision, Bible Dictionary) ↗

I lean toward circumcision, but that's my personal opinion.

[Ian]

scientific evidence also seems to lean toward circumcision. prior to the recent “intactivist” trend, much of the medical community was neutral with regard to circumcision. now, in light of the recent trend, several major medical organizations have published guidelines favoring circumcision. in 2012 the american academy of pediatrics (AAP) issued a revised policy statement, stating that “the health benefits of newborn male circumcision outweigh the risks.” in 2014 the united states centers for disease control and prevention (CDC) released draft federal guidelines, indicating that scientific evidence supports circumcision. according to their recommendation, circumcision provides various health benefits with low risk. in 2016 the world health organization (WHO) published a policy brief advocating voluntary male medical circumcision. their recommendation promotes circumcision as “part of an essential package of health services for men and boys,” and as critical “for improving the overall health of young men and women.”

medical research indicates that uncircumcised infants are more likely than circumcised infants to experience urinary tract infections and genital warts. during adulthood, uncircumcised males are more likely to experience penile or possibly prostrate cancer. certain conditions generally occur only in uncircumcised males, including balanitis, balanoposthitis, phimosis and paraphimosis. a 2014 review published by mayo clinic found that over a man’s lifetime, the benefits of circumcision exceed risks by at least 100 to 1, and approximately half of uncircumcised males will require treatment for a medical condition associated with retention of the foreskin.

circumcision of newborns is a very simple procedure. i don't believe it’s completely painless, but it seems nearly painless with little recovery time and no trauma. circumcision becomes more complicated when a boy gets older.

as a matter of health and hygiene, i believe that circumcision is generally in the best interest of a baby boy.

[James]

The AAP says, “An uncircumcised penis is easy to care for and keep clean. So improved hygiene isn't a reason to choose circumcision"
CORRECTION This statement was made by WebMD and found on their baby circumcision page.

Ian, who also referenced the AAP, said, "as a matter of health and hygiene, i believe that circumcision is generally in the best interest of a baby boy"

Ian said, “over the past decade or two, a political movement has developed...”

I think Ian is on to something. Politics play significant role in the circumcision question. The organization called doctors opposing circumcision addresses some of the political nature surrounding circumcision. Politics is the reason my previous post on this thread was organized around a comparison of two medical groups. Why would two groups, part of the same discipline, have such striking differences in their recommendations?

From the drs opposing circumcision website:

“Medical organizations outside the U.S. have taken official positions on medical circumcision, despite the rarity of this practice in most non-English-speaking countries. European pronouncements, for instance, are noteworthy for scientific caution, reliance on evidence-based medicine, rejection of mere tradition or parental preference, and a thoughtful concern for the human rights of the child.
By contrast, U.S. medical associations – especially the American Academy of Pediatrics, the lead broker of this cultural practice for decades – have been strategically deferential to parental choice and tradition. The AAP has been equivocal on the medical evidence since declaring circumcision “unnecessary” in 1971 – then walking that disavowal back ever since. The AAP has consistently dangled the specter of unpleasant, even dangerous (but highly unlikely) outcomes for intact boys, while disingenuously leaving it up to frightened young parents to make an immediate ‘decision.’ The rare mention by the AAP of the human rights of the child to an intact body has been, at best, parenthetical, and at worst, disdainful and dismissive.
The AAP’s 2012 statement – (Ian referenced this) its most pro-circumcision statement to date – is drastically out of line with numerous ethical, legal, and medical authorities in Europe and Australasia that have looked at the exact same evidence and come to opposite conclusions.”

Further, they provide statements from numerous medical organizations:

“Canadian Paediatric Society (CPS) (2015)
The CPS does not recommend the routine circumcision of every newborn male. It further states that when “medical necessity is not established, …interventions should be deferred until the individual concerned is able to make their own choices.”
Royal Dutch Medical Association (KNMG) (2010)
The KNMG states “there is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene.” It regards the non-therapeutic circumcision of male minors as a violation of physical integrity, and argues that boys should be able to make their own decisions about circumcision.
The Royal Australasian College of Physicians (RACP) (2010)
The RACP states that routine infant circumcision is not warranted in Australia and New Zealand. It argues that, since cutting children involves physical risks which are undertaken for the sake of merely psychosocial benefits or debatable medical benefits, it is ethically questionable whether parents ought to be able to make such a decision for a child.
British Medical Association (BMA) (2006)
The BMA considers that the evidence concerning health benefits from non-therapeutic circumcision is insufficient as a justification for doing it. It suggests that it is “unethical and inappropriate” to circumcise for therapeutic reasons when effective and less invasive alternatives exist.
Expert statement from the German Association of Pediatricians (BVKJ) (2012)
In testimony to the German legislature, the President of the BVKJ has stated, “there is no reason from a medical point of view to remove an intact foreskin from …boys unable to give their consent.” It asserts that boys have the same right to physical integrity as girls in German law, and, regarding non-therapeutic circumcision, that parents’ right to freedom of religion ends at the point where the child’s right to physical integrity is infringed upon.
In addition, medical organizations and children’s ombudsmen from a number of other countries, including Finland, Norway, Slovenia, South Africa, Denmark, and Sweden, have gone on record in opposition to non-therapeutic circumcision of boys.”

They continue, and refer to the HIV issue related to Ians WHO paper and Africa:

“The American Academy of Pediatrics’ (AAP) Policy Statement and Technical Report on male circumcision, released in August 2012, are culturally biased and seriously flawed.
• AAP Circumcision Policy Statement
• AAP Technical Report: Male Circumcision
Doctors Opposing Circumcision calls on the AAP to withdraw its policy, and to replace it with an evidence-based statement guided by respect for genital wholeness and the human rights of the child.
The following commentary highlights some of the many problems with the AAP’s statement, with hyperlinks to further discussion on the evidence. See below for other critiques of the AAP’s statement.
Anatomy
• The AAP fails to consider the structure or functions of the foreskin, a normal, healthy body part, focusing only on its amputation. It does not even define the foreskin, let alone describe its anatomy. The statement ignores the protective functions of the foreskin, and categorically dismisses its sexual functionality. p. e769
• It treats normal intact penile features as pathological.
For example, natural, unforced separation of the prepuce from the glans might take as long as 17 or more years, with 10 years the average,[1,2] but the AAP claims, without citation, that it should separate within 2 to 4 months. p. e763
It associates “preputial wetness” with disease, when it is actually normal, just like wetness of the mouth or eye.
• It bases its conclusions about sexuality on two satisfaction surveys of African adult volunteers for circumcision, in the context of HIV prevention (and therefore subject to bias [3]), while ignoring anatomical evidence and a variety of studies demonstrating detriment to sexual function.
Benefit vs. Risk
◦ The AAP makes the key claim, repeated numerous times, that “the benefits of newborn male circumcision outweigh the risks,” without ever quantitatively comparing them. Indeed, it admits multiple times that the true rate and impact of circumcision complications is unknown, but still illogically makes this claim.
▪ “The true incidence of complications after newborn circumcision is unknown.” p. e772
▪ “It is unknown how often these late complications require surgical repair; this area requires further study.” p. e772
▪ “Based on the data reviewed, it is difficult, if not impossible to adequately assess the total impact of complications.” p. e775
▪ “Financial costs of care [after complications], emotional tolls, or the need for future corrective surgery are unknown.” p. e775
A guiding principle of medicine, however, suggests that a procedure should not be recommended until its complications, losses, and harms are fully understood.
• It exaggerates the benefits of circumcision and minimizes its risks and harms. It selectively cites or emphasizes studies that favor circumcision, and omits or rejects those that disfavor it, e.g.:
◦ It citesSorrells et al.’s (2007) penile touch-testing study, but ignores its key finding that “circumcision ablates [removes] the most sensitive parts of the penis.”
◦ It fails to cite Taylor’s (1996) groundbreaking anatomical paper, “The prepuce: specialized mucosa of the penis and its loss to circumcision.”
◦ It admits the African HIV findings may not be applicable to the USA, but applies them anyway. It admits that many of the diseases studied vis à vis circumcision are rare in the USA, but nonetheless cites these to pad its ‘benefits’ discussion.
◦ In three pages discussing STIs and HIV, it fails to mention the word “condom” as a preventative even once.
◦ It cites a study suggesting circumcising men increases the HIV risk to women, and ignores that finding in its risk:benefit conclusion.
◦ It dismisses major complications and death from circumcision as “anecdotal.” Case reports were excluded from the AAP’s review, so individual reports of deaths and catastrophic outcomes of circumcision were simply ignored. It further fails to admit that there is no national reporting system for serious outcomes of circumcision, and fails to call for such a system.[4]
◦ It ignores psycho-emotional harms, and the possibility that men circumcised as infants might be distressed that their genitals had been diminished unnecessarily without their consent.
◦ It discusses the use of the Mogen circumcision clamp as a “commonly used technique” without mentioning that the manufacturer has been driven out of business due to a number of multi-million-dollar lawsuits following amputation of the glans penis with this method.
Costs
• The AAP’s report calls repeatedly for “access” and “third-party reimbursement” for circumcision, based on its flawed risk:benefit analysis, ignoring its own acknowledgment of insufficient information on the costs of circumcision. The report fully ignores the costs of follow-up care for complications and repeat procedures. p. e775
• It repeats the common claim that it is safer to circumcise babies than adults, but offers no evidence for that claim. It compares the costs of circumcising at birth versus later in life, but fails to compare these with the option of doing nothing at all.
• The only cost-effectiveness study cited did not consider circumcision complication rates. The report ignores a recent comprehensive cost:utility analysis that concluded, “Neonatal circumcision is not good health policy and support for it as a medical procedure cannot be justified either financially or medically.”
Ethics
• The AAP’s discussion of the ethical questions relating to removing healthy genital tissue from a non-consenting person – versus leaving it for him to decide himself – assigns no value to the child’s future autonomy or his human rights to bodily integrity.
• It explicitly argues against deferring circumcision until the child can make his own decisions (p. e760), without providing information on the disadvantages of immediate circumcision. Informational manipulation of this kind – particularly for a procedure that is medically unnecessary and elective – violates medical ethics. Furthermore, it contravenes the AAP’s own statement on pediatric proxy consent.
• The AAP’s ethical consultant has said elsewhere that “circumcision is not medically essential and poses a risk of harm,” and that a parental request is not sufficient to justify doing any surgery, and the statement ignores these.
The CDC’s draft guidelines on male circumcision
Following the AAP’s lead, in December 2014, the Centers for Disease Control and Prevention (CDC) released draft guidelines on circumcision, which were similarly biased and flawed.
• Draft CDC Recommendations for Providers Counseling Male Patients and Parents Regarding Male Circumcision and the Prevention of HIV Infection, STIs, and Other Health Outcomes
Many of the same problems, omissions, and biases found in the AAP policy are also found in the CDC’s draft guidelines. The guidelines seek to promote universal circumcision by recommending that all parents of intact boys – and, indeed, all intact males of any age – be specifically counseled that “the benefits of circumcision outweigh the risks.” During the public commentary following the release, the CDC logged more than 3200 comments on the draft, 97% of them opposed. To date, the draft has not been approved.
For other critiques of the CDC’s draft guidelines, see the links below.
Conclusion
Doctors Opposing Circumcision calls on the AAP to withdraw its circumcision policy, in the same way it withdrew its 2010 female genital cutting policy, in which it had recommended allowing a token – and illegal – ritual nick to baby girls. D.O.C further calls on the CDC to reject its draft guidelines.
The 2012 AAP’s male circumcision policy and the CDC’s draft guidelines seem bent on ignoring the healthy intact penis, while promoting an obsolete cultural practice that is outside evidence-based medicine. In doing so, it is out of step with numerous medical, legal, and ethical bodies in Europe and Australasia that have looked at the exact same evidence and concluded that there is no medical value to neonatal circumcision, that it violates the principles of medical ethics and human rights, and indeed, that it should probably be banned.[5,6,7] The AAP and the CDC, with their flawed policies, do a disservice to the growing number of boy babies being left intact, and to their parents. They do an even greater disservice to those boys who will be circumcised as a result of this ill-informed and misplaced advocacy – and to the men those boys will become.”

“Cutting off a functional, protective, and sensitive body part is a far-reaching decision that the vast majority of Europeans believe should be left to its owner when he becomes old enough to understand the consequences. Despite the recent, backward-looking statements by U.S. medical organizations, more and more Americans are beginning to agree.”
Morten Frisch, M.D., Danish epidemiologist

Links to the selected critiques are found on their website http://www.doctorsopposingcircumcision. ... tatements/

[Steve]

...should be left to its owner when he becomes old enough to understand the consequences.

Though I don't have a strong opinion about what others should do regarding circumcision, I'd say this quote by Morten is quite the slippery slope.

[Ian]

The AAP says, “An uncircumcised penis is easy to care for and keep clean. So improved hygiene isn't a reason to choose circumcision"

i have not been able to find this quote in any AAP publication. are you sure that the AAP says that?

[James]

oops that was webMD http://www.webmd.com/baby/guide/what-about-circumcision
My apologies for mixing the two up.
webMD says, "An uncircumcised penis is easy to care for and keep clean. So improved hygiene isn't a reason to choose circumcision"

Steve,
Given the context I don't think its a slippery slope. Sure, regarding medical choices parents obviously have to make choices. But for something that is permanent and cosmetic the boy should be allowed to decide.

[Ian]

webmd is simply a for-profit website that publishes editorial content. many of their articles are written by freelance writers. the first article you quoted was “Reviewed by Jennifer Robinson, MD.” the second article you quoted was “Reviewed by Trina Pagano, MD.” robinson seems to lean in favor of circumcision. pagano seems to lean against circumcision.

[James]

I mentioned in my first post above "the American company, webMD"

[Ian]

it seems to me that parents ought to weigh health benefits and risks, based on current scientific evidence. the findings published by the AAP, CDC, WHO, and other large organizations seem to be based on medical science. the AAP, for example, has the largest pediatric publishing program in the world. their 2012 policy statement regarding circumcision was based on evaluation of peer-reviewed literature from 1995 through 2010, conducted over a span of five years by a multidisciplinary task force using the american heart association’s template for evidence evaluation, and was endorsed by the american college of obstetricians and gynecologists. they published a lengthy technical report which demonstrates that, based on current evidence, “the health benefits of newborn male circumcision outweigh the risks.” i don't believe these organizations are unbiased, but taken together, their conclusions seem to reflect a majority scientific view.

so far, the arguments against circumcision seem to be based on something other than medical science. for instance, see doctorsopposingcircumcision.org, which appears to be the personal website of a retired planned parenthood doctor in seattle named george denniston. a pattern unfolds as we read the arguments taken from that website:

• medical associations “have been strategically deferential to parental choice and tradition.”

• the canadian paediatric society states that circumcision “should be deferred until the individual concerned is able to make their own choices.”

• the royal dutch medical association “argues that boys should be able to make their own decisions about circumcision.”

• the royal australasian college of physicians argues that “it is ethically questionable whether parents ought to be able to make such a decision for a child.”

• the president of the german association of pediatricians stated that there is no reason to circumcise “boys unable to give their consent.”

• furthermore, “the parents’ right to freedom of religion ends at the point where the child’s right to physical integrity is infringed upon.”

• circumcision policy should be guided by respect for “the human rights of the child.”

• men circumcised as infants “might be distressed that their genitals had been diminished unnecessarily without their consent.”

• the decision to circumcise “should be left to its owner when he becomes old enough to understand the consequences.”

the running theme of these arguments is that circumcision is wrong, because the decision is made by parents. at its core, this movement looks like an attack on parenting.

[James]

Ian said, "a pattern unfolds as we.." It looks like that when we are selective. Human rights is one of the focuses of Drs opposing circumcision, but the people and groups they reference also frequently discuss the other aspects of circumcision. The reality is that most medical associations in the world do not recommend non-therapeutic circumcision. Again from their website:

Anatomy

The AAP fails to consider the structure or functions of the foreskin, a normal, healthy body part, focusing only on its amputation. It does not even define the foreskin, let alone describe its anatomy. The statement ignores the protective functions of the foreskin, and categorically dismisses its sexual functionality. p. e769
It treats normal intact penile features as pathological.
For example, natural, unforced separation of the prepuce from the glans might take as long as 17 or more years, with 10 years the average,[1,2] but the AAP claims, without citation, that it should separate within 2 to 4 months. p. e763
It associates “preputial wetness” with disease, when it is actually normal, just like wetness of the mouth or eye.
It bases its conclusions about sexuality on two satisfaction surveys of African adult volunteers for circumcision, in the context of HIV prevention (and therefore subject to bias [3]), while ignoring anatomical evidence and a variety of studies demonstrating detriment to sexual function.
Benefit vs. Risk

The AAP makes the key claim, repeated numerous times, that “the benefits of newborn male circumcision outweigh the risks,” without ever quantitatively comparing them. Indeed, it admits multiple times that the true rate and impact of circumcision complications is unknown, but still illogically makes this claim.
“The true incidence of complications after newborn circumcision is unknown.” p. e772
“It is unknown how often these late complications require surgical repair; this area requires further study.” p. e772
“Based on the data reviewed, it is difficult, if not impossible to adequately assess the total impact of complications.” p. e775
“Financial costs of care [after complications], emotional tolls, or the need for future corrective surgery are unknown.” p. e775
A guiding principle of medicine, however, suggests that a procedure should not be recommended until its complications, losses, and harms are fully understood.

It exaggerates the benefits of circumcision and minimizes its risks and harms. It selectively cites or emphasizes studies that favor circumcision, and omits or rejects those that disfavor it, e.g.:
It citesSorrells et al.’s (2007) penile touch-testing study, but ignores its key finding that “circumcision ablates [removes] the most sensitive parts of the penis.”
It fails to cite Taylor’s (1996) groundbreaking anatomical paper, “The prepuce: specialized mucosa of the penis and its loss to circumcision.”
It admits the African HIV findings may not be applicable to the USA, but applies them anyway. It admits that many of the diseases studied vis à vis circumcision are rare in the USA, but nonetheless cites these to pad its ‘benefits’ discussion.
In three pages discussing STIs and HIV, it fails to mention the word “condom” as a preventative even once.
It cites a study suggesting circumcising men increases the HIV risk to women, and ignores that finding in its risk:benefit conclusion.
It dismisses major complications and death from circumcision as “anecdotal.” Case reports were excluded from the AAP’s review, so individual reports of deaths and catastrophic outcomes of circumcision were simply ignored. It further fails to admit that there is no national reporting system for serious outcomes of circumcision, and fails to call for such a system.[4]
It ignores psycho-emotional harms, and the possibility that men circumcised as infants might be distressed that their genitals had been diminished unnecessarily without their consent.
It discusses the use of the Mogen circumcision clamp as a “commonly used technique” without mentioning that the manufacturer has been driven out of business due to a number of multi-million-dollar lawsuits following amputation of the glans penis with this method.


Ian said, "the running theme of these arguments is that circumcision is wrong, because the decision is made by parents. at its core, this movement looks like an attack on parenting."

The movement's inclusion of human rights does not make it an attack on parenting. Rather, the movements arguments are that the foreskin is a functional anatomical unit, that its removal is not medically justified in healthy babies, that arguments about hygiene/health hold no water, that it is certainly appropriate to bring up human rights.

The NHS website outlines very well the question of newborn circumcision.
http://www.nhs.uk/conditions/Circumcisi ... ction.aspx

[Ian]

the AAP is the largest pediatric organization in the world. based on years of scientific research, they concluded that “the health benefits of newborn male circumcision outweigh the risks.” their position has been endorsed by other large medical research organizations. this appears to reflect the majority scientific view. so far the closest thing to a scientific response is made by a man named george denniston with a website called doctorsopposingcircumcision.org. rather than conduct an actual scientific review, he simply creates a website and states his opinion that the AAP is wrong for various reasons. where’s the science?

[Steve]

Steve,
Given the context I don't think its a slippery slope. Sure, regarding medical choices parents obviously have to make choices. But for something that is permanent and cosmetic the boy should be allowed to decide.

Again, I'm neutral as far as your choices regarding circumcision, though I have my own opinions on it. However, I do have to respond to some of these philosophies that are creeping in with the topic of circumcision. What is it about cosmetics that gives it authority over a parent—even if "permanent" as you say? I'm not sure I understand. Make no mistake: a man permanently alters a child's appearance, without their consent, when he contributes genetic code to the baby, or when he selects one woman to be his wife over another woman. The child did not choose the body that develops from this union. Perhaps the boy would have requested a smaller nose or an olive complexion. There are many things that a child does not decide. Parents must make choices and strive to do the best they can.

The plan of our Heavenly Father is perfect. Amidst this life's mix of choice and mandate, of undesired circumstances coupled with deliberate consequences, there remains sufficient for our Heavenly Father's children to progress toward eternal life. Deficiencies or perceived slights are swallowed up by the Atonement.

I find it interesting that one would strain at circumcision, and yet swallow paternal abandonment, true physical and/or sexual abuse, or any number of other "causes" that would hold actual consequence over these tiny ones. If circumcision were the grievous violation of human rights and blight on the human record it's claimed to be, you'd think the Lord would have very specific thoughts on this subject. And yet, I can find no counsel or prophetic declaration decrying the practice. Could it be that this is yet another smokescreen to hide the true problems of our day?