Reply to According to American Academy of Pediatrics Benefits of Circumcision Outweigh Risks

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]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.  [/quote]

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. [/quote]

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.

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