AAP says benefits of circumcision outweigh risks

[kc8tbe]

The American Academy of Pediatrics has just effectively endorsed male circumcision. Compare their new position:
http://pediatrics.aappublications.org/c ... .2012-1989

Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.

With their previous position from 1999:
http://pediatrics.aappublications.org/c ... 3/686.long

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.

I am particularly struck by the strong wording (emphasis mine): "...health benefits... outweigh the risks... and included prevention of urinary tract infections, penile cancer, and transmission of... HIV."

Despite the AAP's new position, I haven't seen enough data from Western cohorts to make me want to circumcise my own (hypothetical) male infants. On the other hand, a rationally held position can change in the face of new evidence, and the AAP does carry some authoritative weight. Did anyone on the forum change his or her mind about circumcision with the new AAP position? If you continue to advocate against the routine circumcision of male infants, what impact do you expect the new AAP position will have on your efforts?

[Borgholio]

I had always supported getting my (hypothetical) sons snipped. I've heard the same arguments go back and forth over the years, but I've never heard any new evidence saying getting snipped is bad. On the other hand, more and more reports surfaced over the years saying it was healthier, which almost mirrored what my own parents said when I asked about it years ago. I'm sure it will take a long while for the general population to support it, but that's how these kinds of things usually go...slowly.

[kc8tbe]

I've never heard any new evidence saying getting snipped is bad.

The studies the AAP reviews focus on immediate complications (e.g. bleeding), but ignore longer term complications. Probably TMI, but I suffer from chafing against underwear and needed corrective surgery for meatal stenosis. Is this better than getting HIV? Yes, but I have condoms for that.

I would point out that my own personal experience does not equal a systematic study, but on the other hand, despite numerous anecdotal reports there aren't any systematic studies that look at long-term complications. I don't think the AAP or anyone else has any business claiming the medical risks of circumcision outweigh the benefits until those risks have been systematically evaluated (and not in underdeveloped Africa).

[Jub]

I had always supported getting my (hypothetical) sons snipped. I've heard the same arguments go back and forth over the years, but I've never heard any new evidence saying getting snipped is bad. On the other hand, more and more reports surfaced over the years saying it was healthier, which almost mirrored what my own parents said when I asked about it years ago. I'm sure it will take a long while for the general population to support it, but that's how these kinds of things usually go...slowly.

So major loss of sensation and violating your hypothetical son's body integrity isn't considered bad in your eyes?

[Borgholio]

I have no issues with sensation, I am satisfied with my integrity, I have never had any UTIs or infections of any kind, and I do not blame my parents one bit for the decision they made because I was too young to make the decision myself.

[Flagg]

I have no issues with sensation, I am satisfied with my integrity, I have never had any UTIs or infections of any kind, and I do not blame my parents one bit for the decision they made because I was too young to make the decision myself.

Really, they couldn't have waited until you were able to give informed consent? Have fun mutilating your children, I guess.

[Borgholio]

Really, they couldn't have waited until you were able to give informed consent? Have fun mutilating your children, I guess.

Strange, I don't feel mutilated.

[darthdavid]

I have no issues with sensation, I am satisfied with my integrity, I have never had any UTIs or infections of any kind, and I do not blame my parents one bit for the decision they made because I was too young to make the decision myself.

But what if your kid doesn't feel the same way? Just because you have no problems with the decision that was made for you doesn't mean any kid you had wouldn't and it doesn't make the downsides and potential complications of getting circumcised any less real. If it's such a great thing to have done to you then surely any kid you had would make the choice to have the operation done when he was old enough to make an informed decision and there's no reason for you to force your will on the lad before he's even old enough to crawl...

[Jub]

I have no issues with sensation, I am satisfied with my integrity, I have never had any UTIs or infections of any kind, and I do not blame my parents one bit for the decision they made because I was too young to make the decision myself.

How do you know you wouldn't have more fun uncut? How do you know you would have had a UTI is you were left whole?

[Alyeska]

Really, they couldn't have waited until you were able to give informed consent? Have fun mutilating your children, I guess.

Strange, I don't feel mutilated.

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

[Borgholio]

But what if your kid doesn't feel the same way? Just because you have no problems with the decision that was made for you doesn't mean any kid you had wouldn't and it doesn't make the downsides and potential complications of getting circumcised any less real. If it's such a great thing to have done to you then surely any kid you had would make the choice to have the operation done when he was old enough to make an informed decision and there's no reason for you to force your will on the lad before he's even old enough to crawl...

Well that's definitely one way to look at it, and my wife and I will more than likely discuss it if / when the time comes. But in my day, it was a parent's job to decide this for their kids shortly after birth, and I don't criticize them for it. Now when it's time for me and my wife to make that decision, we'll certainly do our research before deciding what to do. It's not an automatic "Oh it's a boy, ok *snip*". If a boatload of new evidence comes out to support the idea that getting snipped is bad or highly risky, then we'll likely defer to the health of our child. If more evidence comes out supporting the benefits, then the only question is not "whether", but "when".

[Borgholio]

How do you know you wouldn't have more fun uncut? How do you know you would have had a UTI is you were left whole?

I don't bother with the "what-ifs". I know that I have enough fun as it is, and getting cut certainly did not GIVE me a UTI so I have no qualms about it.

[General Zod]

You could almost make the same argument about appendectomies, but you don't see anyone arguing that everyone should have their appendix cut out at the soonest possible opportunity.

[Borgholio]

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

I'm sorry. Question, do you feel angry about the countless other decisions regarding your life that your parents made without your consent? Other medical care, food, clothing, entertainment, exercise, who you are and are not allowed to play with, etc...?

[Jub]

Really, they couldn't have waited until you were able to give informed consent? Have fun mutilating your children, I guess.

Strange, I don't feel mutilated.

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

I feel the same way.

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

I'm sorry. Question, do you feel angry about the countless other decisions regarding your life that your parents made without your consent? Other medical care, food, clothing, entertainment, exercise, who you are and are not allowed to play with, etc...?

I feel like she was a single Mother who did a decent job, but I don't agree with a lot of the choices she made.

[Esquire]

You could almost make the same argument about appendectomies, but you don't see anyone arguing that everyone should have their appendix cut out at the soonest possible opportunity.

Actually, you do - appendectomies are easy and quick enough that surgeons will often add them on to other stomach-region procedures simply to possibly save time and energy down the road.*

*Secondhand information, but from multiple trustworthy people in a position to know.

[Alyeska]

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

I'm sorry. Question, do you feel angry about the countless other decisions regarding your life that your parents made without your consent? Other medical care, food, clothing, entertainment, exercise, who you are and are not allowed to play with, etc...?

You are comparing body mutilation with entertainment?

Apples and oranges.

[Flagg]

You could almost make the same argument about appendectomies, but you don't see anyone arguing that everyone should have their appendix cut out at the soonest possible opportunity.

Actually, you do - appendectomies are easy and quick enough that surgeons will often add them on to other stomach-region procedures simply to possibly save time and energy down the road.*

*Secondhand information, but from multiple trustworthy people in a position to know.

Yeah, they do that, that's how I had mine out. But they don't remove it at birth is what he's getting at. The same should be true of foreskin.

[General Zod]

You could almost make the same argument about appendectomies, but you don't see anyone arguing that everyone should have their appendix cut out at the soonest possible opportunity.

Actually, you do - appendectomies are easy and quick enough that surgeons will often add them on to other stomach-region procedures simply to possibly save time and energy down the road.*

*Secondhand information, but from multiple trustworthy people in a position to know.

Yeah, they do that, that's how I had mine out. But they don't remove it at birth is what he's getting at. The same should be true of foreskin.

Kinda, yeah. I actually didn't know anyone advocated removal like that, but I've never had mine taken out.

[Borgholio]

You are comparing body mutilation with entertainment?

Apples and oranges.

Hardly. Parents make many decisions for their child over the first few years of their lives with no consent from the child. What you call body mutilation could also be considered a preventative medical procedure. It's no different than having the doctor perform any number of other surgeries to help affect the health of the child. If you are dissatisfied with how your penis looks compared to other men, well that's certainly a valid opinion. But to blame your parents for doing what they honestly thought was best for you...I can't see the validity in that.

[kc8tbe]

And yet it turns out the appendix isn't totally useless, and so surgeons need to get informed consent before removing it as part of another procedure.

I mean, I guess you could argue that removing the little toe from each foot at birth is a great idea. It would be a relatively uncomplicated procedure, you don't really need the little toe for much, and you could avoid future complications like bunions or cellulitis of the little toe. Now sure, you could also avoid those things by wearing shoes that fit properly...

[Col. Crackpot]

Really, they couldn't have waited until you were able to give informed consent? Have fun mutilating your children, I guess.

Strange, I don't feel mutilated.

I was circumcised. I do feel mutilated. I am quite angry that such a decision was made without my consent.

Indeed. I did NOT have my sons circumcised. My wife was indifferent however i was quite adamant. If they want to chop off a chunk of their dick when they grow up then fine, but i'm not doing it to them.

[Dark Hellion]

You could almost make the same argument about appendectomies, but you don't see anyone arguing that everyone should have their appendix cut out at the soonest possible opportunity.

Actually, you do - appendectomies are easy and quick enough that surgeons will often add them on to other stomach-region procedures simply to possibly save time and energy down the road.*

*Secondhand information, but from multiple trustworthy people in a position to know.

I can offer firsthand info, when I had appendicitis I was exhibiting odd symptoms (basically I wasn't puking my guts out or running much fever) so they did a laproscopy to check for obstructions and where going to take out the appendix anyways.

On the topic, I was circumcised and have never felt that violated (I have been told it makes it look more impressive so I figure that balances it out) but on the other hand the medical evidence I have seen from sources previously posted on this board mean I would not choose to have a hypothetical son circumcised since there seems a pretty poor balance between any benefit and the complications possible and it seems like a good general principal to have as few surgeries as possible.

[Simon_Jester]

I look at it this way.

If there really is a measurable difference in health outcome, it's going to be a lot more obvious 20 years from now than it is now. Why make the decision for a baby boy now, when he'll have better information to make the same decision when he's a grown man?

Besides, the non-measurables (sexual pleasure, aesthetics) play a big role here; I don't even know how we'd measure those, so I can't think of a just way to deal with them except informed consent.

[Borgholio]

I look at it this way.

If there really is a measurable difference in health outcome, it's going to be a lot more obvious 20 years from now than it is now. Why make the decision for a baby boy now, when he'll have better information to make the same decision when he's a grown man?

Well what's the rate of getting UTIs over the next 20 years with snipped males vs un-snipped? I think waiting 20 years to let him decide is a bad move if (and I mean if, since there are no numbers either way), he could get a greater number of infections over those 20 years.

Besides, the non-measurables (sexual pleasure, aesthetics) play a big role here; I don't even know how we'd measure those, so I can't think of a just way to deal with them except informed consent.

That tends to be how I see it. Most of the negatives in this thread are subjective (not-measurable)...feeling violated, feeling mutilated, lack of sexual sensitivity, etc... All the positives are measurable scientifically and statistically. I'm not so "pro-snippage" that I'm going to back the position regardless of evidence. If by the time I have a son, there's evidence that says snipping will cut 5 years off your life...well hell, my boy ain't getting snipped. But based on my personal history and on current evidence, I see no reason to be against it outright.