At least a vasectomy is reversible, circumcision is not.
Two recent announcements advocating for the necessity of male newborn circumcision (MC) are based on indefensible objectives when compared to the integrity and sanctity of the body. The first from researchers and economists at John Hopkins University rationalizes that the potential future medical costs associated with uncircumcised men outweighs the integrity of their foreskin. The second by the American Academy of Pediatrics bases their male circumcision advocacy on their determination that men are not intelligent enough to make sound sexual decisions.
Both positions assert arrogance only capable of academicians that feel they have a calling to protect society from ourselves.
I have no doubt that the measurements of cost and incidence related to uncircumcised men for sexually transmitted infections (STIs), urinary tract infections (UTIs) and penile cancers are correct for those studies. In addition, I will be the first to admit that certain government regulations and advice are necessary to limit or reduce future public and private medical expenditures. However, it is an entirely different matter to advocate for an irrevocable procedure based on speculation of cost or behavior.
What’s the value of a body part?
From the John Hopkin’s article Costs and Effectiveness of Neonatal Male Circumcision, “Reducing the MC rate to 10% will increase lifetime health care costs by $407 per male and $43 per female.” It is nice that they could determine the opportunity cost of a foreskin down to a dollar figure. Perhaps they should propose that every child be given $407 when their foreskin is cut off as a “Thank you” gift for the preemptive cost saving procedure.
Adult decisions
As a friend pointed out, not all preemptive procedures are bad, such as the extraction of wisdom
Prevention of disease starts with education. You don’t pull all the teeth to avoid cavities.
teeth. At the age of 21 I had to take out a loan to have my wisdom teeth pulled before they caused problems. However, there was no reason to extract the wisdom teeth until, in consultation with my dentist; we determined that within a short time those impacted teeth were going to cause me issues.
Many women at high risk for hereditary breast cancer have made the decision to have double mastectomy. Their decision will, in their estimation, save their lives and ultimately the pain and potential cost of cancer treatment. They made the decision to alter their bodies as an informed adult. I am not convinced that a preemptive procedure, of any kind, without a clear and imminent health threat to the child should be considered if the decision is based on future medical expenses that may or may not arise.
Historical statistics are not the future
The American Academy of Pediatrics (AAP) Task Force on Circumcision based its advocacy of MC from statistics involving illness and disease. Unfortunately, most of the health issues associated with intact men revolves around behavioral decisions. Download pdf document->[wpdm_package id=34]
The task force conclusion, page e764, AAP article states, “Evaluation of the current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it.”
Trust me, I know best
The increased risks, detailed on pages e764 – e767, of contracting a STI because the man is not circumcised are virtually all a result of adult decisions to engage in unprotected sex. This may be the ultimate example of an organization acting as a “helicopter parent”. It is unethical to advocate for an irrevocable procedure based on future behavioral decisions. In effect, they are saying that men will never be sufficiently educated or motivated to protect themselves or their partners from the transmission of STIs.
The diaper of convenience
Based on studies published since 1995 (page e767), the AAP also noted that there was an
Super absorbent diapers, being worn longer, might enable bacteria to grow.
increasing risk of incidence for UTIs among boys under 2 years of age who were not circumcised. There is no statistical data on UTIs in young boys when cloth diapers, or no diapers, were the norm. They specifically state, “There is a biologically plausible explanation for the relationship between an intact foreskin and an increased association of UTI during infancy. Increased periurethral bacterial colonization may be a risk factor for UTI.114 ”
Is it possible that in the age of ultra-absorbent diapers, which are not wet to the touch, and are therefore changed less frequently by the parent, might be the source of the bacteria colonization? It is possible that if the parent or care giver cleansed the penis during each routine diaper change UTIs might decrease. AAP seems more inclined to make decisions from historical studies as opposed to offering alternatives or proposing further research.
Cancer curiosity
In a bit of contrarian information, the article noted that penile cancer was actually declining even though fewer baby boys are being circumcised. From page e767, “Declines are not explained by changing patterns in circumcision utilization; it is thought that socioeconomic and economic development factors (including effects on hygiene habits) may have an important role.”
If socio-economic and economic development factors might play a role in declining penile cancer rates, might one also expect similar declines in STIs with proper education and information? Absent from the AAP article was any proposed research or hypothesis that diseases associated with intact men could be reduced through methods other than circumcision. Cosmetic surgery is not always the answer unless you are an aging movie star.
Government approved!
One of the most disturbing parts of the article was the AAP’s position that MC should be covered
Hair grows back, foreskins don’t.
by insurance. From page e777, “The preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement of the procedure.” There is no better way to legitimize a discriminatory and unnecessary practice than to institutionalize it. U.S. history is replete with misguided laws that legimitized the taking of civil rights, liberties and property based the flawed logic to protect the public.
Preempting respect
The AAP article even mentions the necessity for respect on page e758,”The practice of medicine has long respected an adult’s right to self-determination in health care decision-making.” I can only conclude that the AAP views children as the personal property of the parents or guardians. How else can they blatantly ignore the rights of the child, who will eventually, grow up to be an adult male.
A more perfect race
The whole advocacy for male newborn circumcision has shades of the eugenics movement in the early 20th century. In a sense, the medical community is working to influence public policy to create a population of ideal human bodies that has as little social costs as possible. In a country where we have fought so hard to in grain all policies with a healthy respect for individual privacy rights, it is astonishing that John Hopkins and AAP can so cavalierly ignore the integrity of the human body in favor of economic considerations.
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[schema type=”review” url=”http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Newborn-Male-Circumcision.aspx” name=”Male newborn circumcision flawed endorsements” description=”Two recent announcements, John Hopkins University and American Academy of Pediatrics, used flawed reasoning to advocate for continued male newborn circumcision above personal privacy rights.” rev_name=”John Hopkins, American Academy of Pediatrics flawed endorsement of circumcision” author=”Kevin Knauss” pubdate=”2012-08-28″ ]