According to American Academy of Pediatrics Benefits of Circumcision Outweigh Risks

[Anonymous]

Anonymous wrote:Allow me to break it down for you.

This is not a sea change in AAP recommendations. They went from saying that the risks outweigh the benefits to saying that the risks do NOT outweigh the benefits. They based this off of no real new information. This was done because medicaid in several states was refusing to cover the procedure, calling it cosmetic. While this redefines the procedure as medical in nature (and not cosmetic) in no place does the AAP say it is necessary for all boys. In fact, the AAP makes explicit that the benefits are not so great as to recommend it routinely. So how are you all telling us "anti-circ" nuts that we're anti-science? Are you also calling the AAP anti-science because it DOES NOT RECOMMEND this procedure "routinely?"

I don't really blame anyone for feeling confused. The AAP's language is wobbly and waffling, stopping short of defining a clear, compelling benefit that would spark routine recommendation, but saying basically, that there are sufficient benefits that they think parents, who make the decisions for their own boys, should be able to get coverage for the procedure.

We started off pretty neutral on circing. I felt somewhat opposed but not vehemently. It was our OB, who performed thousands of them (without incident) who ultimately discouraged us. He said "any procedure introduces risk, and I do not find the benefits compelling in any way." I asked him if he used a numbing agent and he said yes, he did, but that in his view it was not sufficient and that the procedure was still incredibly painful for babies. After hearing that, my husband, who was leaning circ (he is) became the more vocal parent opposing it. My dad, who is a doctor also (though not a pediatrician) was initially surprised that we did not circumcise, but became interested in the issue after hearing our views. He did research, and concluded that he now thinks the procedure is unnecessary and potentially ill-advised. He's hardly anti-science!

What the AAP seems to be saying is that there are scenarios there might be a good reason, but that ROUTINELY, this is not the case. Therefore, no blanket recommendation to circ routinely.

So, the bottom line is that nothing has really changed. The AAP has tweaked, very slightly, its recommendation from "we don't recommend it" to "we don't recommend it routinely, but parents can still choose, and yes, there are legitimate health reasons that persons can cite when asking insurance to pay for it" But people, this is not at all the same thing as the AAP suggesting that parents SHOULD do this routinely. They've explicitly said they still do not recommend that. So those of you who are so pleased with yourself for doing all along what the AAP is now "recommending" need to realize that the AAP is still not "recommending" it. They are simply saying it is a legitimate option, if you want to do it.

I think what's happening here is that a lot of pro-circ posters on this forum are really pleased that the AAP finally caught up with what they have "just known" all along was right. It's ironic that they're castigating the non-circ people as anti-science when they, themselves, have been outside the recommendation for the past decade.

FWIW, we vaccinated fully, including the optional vaxes (flu, H1n1, etc). And had some extra vaccinations when we traveled. Seems like most of the posters on this forum are similar.

As someone who did not circumcise her son, thanks for this reasonable post. I was conflicted about what to do beforehand and with most things, I wring my hands about it after the decision has been made. For a lot of women on this forum, seems to be an "I told you so" moment or they are taking it as such, anyway.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Allow me to break it down for you.

This is not a sea change in AAP recommendations. They went from saying that the risks outweigh the benefits to saying that the risks do NOT outweigh the benefits. They based this off of no real new information. This was done because medicaid in several states was refusing to cover the procedure, calling it cosmetic. While this redefines the procedure as medical in nature (and not cosmetic) in no place does the AAP say it is necessary for all boys. In fact, the AAP makes explicit that the benefits are not so great as to recommend it routinely. So how are you all telling us "anti-circ" nuts that we're anti-science? Are you also calling the AAP anti-science because it DOES NOT RECOMMEND this procedure "routinely?"

I don't really blame anyone for feeling confused. The AAP's language is wobbly and waffling, stopping short of defining a clear, compelling benefit that would spark routine recommendation, but saying basically, that there are sufficient benefits that they think parents, who make the decisions for their own boys, should be able to get coverage for the procedure.

We started off pretty neutral on circing. I felt somewhat opposed but not vehemently. It was our OB, who performed thousands of them (without incident) who ultimately discouraged us. He said "any procedure introduces risk, and I do not find the benefits compelling in any way." I asked him if he used a numbing agent and he said yes, he did, but that in his view it was not sufficient and that the procedure was still incredibly painful for babies. After hearing that, my husband, who was leaning circ (he is) became the more vocal parent opposing it. My dad, who is a doctor also (though not a pediatrician) was initially surprised that we did not circumcise, but became interested in the issue after hearing our views. He did research, and concluded that he now thinks the procedure is unnecessary and potentially ill-advised. He's hardly anti-science!

What the AAP seems to be saying is that there are scenarios there might be a good reason, but that ROUTINELY, this is not the case. Therefore, no blanket recommendation to circ routinely.

So, the bottom line is that nothing has really changed. The AAP has tweaked, very slightly, its recommendation from "we don't recommend it" to "we don't recommend it routinely, but parents can still choose, and yes, there are legitimate health reasons that persons can cite when asking insurance to pay for it" But people, this is not at all the same thing as the AAP suggesting that parents SHOULD do this routinely. They've explicitly said they still do not recommend that. So those of you who are so pleased with yourself for doing all along what the AAP is now "recommending" need to realize that the AAP is still not "recommending" it. They are simply saying it is a legitimate option, if you want to do it.

I think what's happening here is that a lot of pro-circ posters on this forum are really pleased that the AAP finally caught up with what they have "just known" all along was right. It's ironic that they're castigating the non-circ people as anti-science when they, themselves, have been outside the recommendation for the past decade.

FWIW, we vaccinated fully, including the optional vaxes (flu, H1n1, etc). And had some extra vaccinations when we traveled. Seems like most of the posters on this forum are similar.

As someone who did not circumcise her son, thanks for this reasonable post. I was conflicted about what to do beforehand and with most things, I wring my hands about it after the decision has been made. For a lot of women on this forum, seems to be an "I told you so" moment or they are taking it as such, anyway.

I hear you. It's so hard to make the right decision when you get conflicting information from experts. We were really wishy washy on it down to the wire, and occasionally I think, gee, what if we were wrong? For me, what helps is that I dated a brit for a year and a half, lived in England part time for the same amount of time. Nobody was circ'd over there. And HIV is not rampant, they don't have scores of penile cancer. When you decide not to do it, in the states, you DO have an added layer of concern in that some doctors don't know what to do with an un-circ'd penis. This is simply reprehensible to me, and it will change, but it is a factor. So if your child goes to a new ped or an ER doc even, you have to be vigilant and you have to tell them not to pull the foreskin back. This isn't just related to new docs, either. Some people on a listserv I'm on were talking about how their child had to have a late circ (at 7 I think) because his foreskin was "still" not retracting. Thing is, that's totally within the range of normal!!! And stories like that are not as uncommon as they should be. Once you make a decision to not circ, you have to be prepared to know more than some doctors will know about how to care for it. This is RIDICULOUS. I think this is where we non-circ'ers get lumped in with the non-vaccinating circus, because it DOES question a procedure that some view as "standard." (remember, standard for Americans, not many other places, really). But the difference is that AAP has said it's unnecessary (now it's okay to do but still not strictly necessary, at least ROUTINELY). So it's not like you are outside of the science, as some misinformed folks want to suggest. It's that you need to know things. You also have to be prepared for anything related to the penis that goes wrong (UTI, for instance) to get blamed on the fact you didn't circ. This has never happened to us, but it did happen to a friend. The ER doc at children's forcibly retracted the boy's foreskin, and basically shamed my friend for not circ-ing. HIs colleague came in and corrected him on both counts. What a freaking circus.

Seems to me that a lot of the non-STD, but so-called "problems" related babies with foreskins are actually problems with American doctors not knowing how to provide care for intact boys. That is changing, but it is not changing fast enough.

[Anonymous]

PP here, and I meant to supply more info. Friend with the child with UTI gave her kiddo a bubble bath daily. Some kids are really sensitive to that. When she stopped the bubble baths, they never had another UTI. My sister had the same problem when she was little - obviously as a girl she's not circ'd! So it wasn't related to the circ at all. But if she had only listened to the first doctor, they wouldn't have even bothered asking her about other things that might be going on.

[Anonymous]

Thank goodness my boy was born in the UK.

[Anonymous]

This is nothing more than a "good ole boys" decision; men perpetuating something that was done to them. Currently, about 80-90% of all adult males are circumcised in the US. Since the rates have been plummeting for the past decade, in another 10-20 years, the majority of adults - including doctors and hospital administrators - will themselves be intact. Once the majority of pediatricians, OBs, and AAP policy makers are intact, there is no way they will continue to encourage this procedure to be performed.

What is especially interesting here is that there is no new study or research that influenced this updated policy. As others have mentioned, this is simply about getting Medicaid and private insurance companies to continue paying for it. Any willing parent can dig into the research and see that the scientific case for circumcision is extremely flimsy. Yes, cutting off an otherwise healthy body part can ensure that the body part will never have an infection later in life. But why the foreskin when there are so many other body parts that cause incurable disease? For example, men develop breast cancer at triple the rate they develop penile cancer. Why not remove all male newborn breast buds? Think of the medical benefits! Of course the difference is, so many adult males in this country have had their foreskin removed, that they simply do not understand that the foreskin could have any value, and they have a psychological need to justify their own circumcision by encouraging the continuation of the practice. Again, that is going to change as the younger generation of intact boys grows up.

In terms of circumcision, no other pediatric association in the developed world comes to the same conclusion that the AAP does; in fact many are now leaning towards prohibiting or outlawing the procedure in non-consenting newborns. The only reason this has continued to be acceptable here, is because the doctors themselves are cut. Oh, and because it is a multi-million dollar business for hospitals. Very difficult to undo that. I challenge any parent who is asking a pediatrician or OB for advice about this, to also ask the (yes, personal) question of whether the doctor is himself cut. I guarantee that those who are encouraging you to do it are cut themselves, and therefore can't actually understand from a personal perspective the benefits of having a foreskin.

[Anonymous]

Thank God I only have girls.

[Anonymous]

Anonymous wrote:This is nothing more than a "good ole boys" decision; men perpetuating something that was done to them. Currently, about 80-90% of all adult males are circumcised in the US. Since the rates have been plummeting for the past decade, in another 10-20 years, the majority of adults - including doctors and hospital administrators - will themselves be intact. Once the majority of pediatricians, OBs, and AAP policy makers are intact, there is no way they will continue to encourage this procedure to be performed.

What is especially interesting here is that there is no new study or research that influenced this updated policy. As others have mentioned, this is simply about getting Medicaid and private insurance companies to continue paying for it. Any willing parent can dig into the research and see that the scientific case for circumcision is extremely flimsy. Yes, cutting off an otherwise healthy body part can ensure that the body part will never have an infection later in life. But why the foreskin when there are so many other body parts that cause incurable disease? For example, men develop breast cancer at triple the rate they develop penile cancer. Why not remove all male newborn breast buds? Think of the medical benefits! Of course the difference is, so many adult males in this country have had their foreskin removed, that they simply do not understand that the foreskin could have any value, and they have a psychological need to justify their own circumcision by encouraging the continuation of the practice. Again, that is going to change as the younger generation of intact boys grows up.

In terms of circumcision, no other pediatric association in the developed world comes to the same conclusion that the AAP does; in fact many are now leaning towards prohibiting or outlawing the procedure in non-consenting newborns. The only reason this has continued to be acceptable here, is because the doctors themselves are cut. Oh, and because it is a multi-million dollar business for hospitals. Very difficult to undo that. I challenge any parent who is asking a pediatrician or OB for advice about this, to also ask the (yes, personal) question of whether the doctor is himself cut. I guarantee that those who are encouraging you to do it are cut themselves, and therefore can't actually understand from a personal perspective the benefits of having a foreskin.

This is a very, very weird way to frame this decision. I believe that male privilege and white privilege exist, but to assume that they made this decision based solely on a a "good old (circumcised) penises" club is to completely deny the science without being able to refute it. I've read both things: the science is not supportive and there are more studies coming out that will be even more supportive of circ.

Really what kind of conversations do you imagine took place?

[Anonymous]

There's probably a succinct and pithy word that describes the concept of feeling unusually over concerned with the genitals of little boys and men, so much so that you rant for pages on blogs or websites about it, or carry sandwich boards on the mall to gain attention... It's probably a German word... They have lots of good words...

[Anonymous]

Anonymous wrote:Thank God I only have girls.

Not so sure about that...you know the saying:

When you have a boy, you only have one d*ck to worry about.
When you have a girl, you have all the d*cks to worry about.

Food for thought

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is nothing more than a "good ole boys" decision; men perpetuating something that was done to them. Currently, about 80-90% of all adult males are circumcised in the US. Since the rates have been plummeting for the past decade, in another 10-20 years, the majority of adults - including doctors and hospital administrators - will themselves be intact. Once the majority of pediatricians, OBs, and AAP policy makers are intact, there is no way they will continue to encourage this procedure to be performed.

What is especially interesting here is that there is no new study or research that influenced this updated policy. As others have mentioned, this is simply about getting Medicaid and private insurance companies to continue paying for it. Any willing parent can dig into the research and see that the scientific case for circumcision is extremely flimsy. Yes, cutting off an otherwise healthy body part can ensure that the body part will never have an infection later in life. But why the foreskin when there are so many other body parts that cause incurable disease? For example, men develop breast cancer at triple the rate they develop penile cancer. Why not remove all male newborn breast buds? Think of the medical benefits! Of course the difference is, so many adult males in this country have had their foreskin removed, that they simply do not understand that the foreskin could have any value, and they have a psychological need to justify their own circumcision by encouraging the continuation of the practice. Again, that is going to change as the younger generation of intact boys grows up.

In terms of circumcision, no other pediatric association in the developed world comes to the same conclusion that the AAP does; in fact many are now leaning towards prohibiting or outlawing the procedure in non-consenting newborns. The only reason this has continued to be acceptable here, is because the doctors themselves are cut. Oh, and because it is a multi-million dollar business for hospitals. Very difficult to undo that. I challenge any parent who is asking a pediatrician or OB for advice about this, to also ask the (yes, personal) question of whether the doctor is himself cut. I guarantee that those who are encouraging you to do it are cut themselves, and therefore can't actually understand from a personal perspective the benefits of having a foreskin.

This is a very, very weird way to frame this decision. I believe that male privilege and white privilege exist, but to assume that they made this decision based solely on a a "good old (circumcised) penises" club is to completely deny the science without being able to refute it. I've read both things: the science is not supportive and there are more studies coming out that will be even more supportive of circ.

Really what kind of conversations do you imagine took place?

I actually don't think it is weird at all. Circumcision has been a cure in search of a disease for the past 50 - 80 years, meaning that it was first done to curb masturbation, then every few years a new illness would be trotted out that circ supposedly cured, only to have that refuted a few years later. Over the years, circumcision has supposedly treated literally hundreds of various things -- the latest of which is now this UTI and STD business. (both of which, incidentally, can be either prevented or cured with far less invasive options, as they are in females). That said, no one is refuting the fact that if you amputate a body part, it can never become infected or diseased. However, the fixation on the foreskin is completely arbitrary. There are many other 'expendable' body parts which have the potential to cause much more severe damage to the person over the course of a lifetime. Consider this -- if we started cutting off labia, and continued to do so for decades, and spent 50 years trying to find a justification for it, we undoubtedly would find some benefit - case in point is that labial cancer occurs in far greater numbers than penile cancer. Removal of the labia at birth (when arguably it would be easier since the baby girl cannot remember the pain, and there is less skin to deal with) would completely eradicate labial cancer in grown women. Yet no one is suggesting that we start this practice. So science tries desperately to justify something that cut men already want to do to their sons and is already a strong (though fading, of course) cultural preference. Men who are not cut, or countries where the pediatricians and OBs are not cut, think that cutting their newborn sons is downright horrific. Again, the science itself is extremely flimsy, as proven by the fact that dozens of other industrialized (non-cutting) countries evaluate the same data and think there is absolutely no reason to recommend circumcision, and in fact that it is harmful and should be outlawed.

Men have a very deep psychological need to have both robust and "normal" genitalia. And, cut men very much need to justify what was done to them. For all of you women who say that you didn't necessarily have a strong opinion, but that your DH "felt strongly that he wanted it done to DS" -- I guarantee that your DS was cut himself. It changes the way they read the evidence. For a man on both individual or cultural levels, agreeing that circumcision is bad or even just unnecessary takes an enormous amount of courage. So, what I guess I'm proposing is that the bias is so intense that it strongly influences the policy writers. In fact, I would bet big money on the fact that the entire team of men writing this new policy -- which was not based on any new scientific research, by the way -- are cut men.

[Anonymous]

oops, meant to say that "I guarantee that your DH was cut himself".


As an additional note, I realize that there are outliers to all norms. Meaning, I'm sure there is the random intact guy who insists on cutting his son, probably because he felt teased or inadequate growing up in a country during a time that nearly all of his peers were cut.

[Anonymous]

Anonymous wrote:There's probably a succinct and pithy word that describes the concept of feeling unusually over concerned with the genitals of little boys and men, so much so that you rant for pages on blogs or websites about it, or carry sandwich boards on the mall to gain attention... It's probably a German word... They have lots of good words...

Unusually over concerned enough to try to justify cutting them? Yes, I agree.

[Anonymous]

Hahaha dirty dicks

[Anonymous]

Anonymous wrote:

Anonymous wrote:Thank God I only have girls.

Not so sure about that...you know the saying:

When you have a boy, you only have one d*ck to worry about.
When you have a girl, you have all the d*cks to worry about.

Food for thought

I'm the poster you quoted. LOL! You are so right.