Circumcision: Medically Unnecessary

There is no more precious moment in a mother’s life than that first gaze into the eyes of her newborn baby. The surge of love, the desire to protect—all of these emotions are part of the universal mothering experience. How strange then, that when that baby is a boy, one of the first things American mothers are asked to do is hand him over for an unnecessary, painful and inherently risky surgery that will take away a healthy, normal part of his body, forever.

The surgery is called “circumcision,” and it is carried out a million times a year in the United States, mostly in hospitals or doctors’ offices, and sometimes in homes or other places. The American Medical Association calls it “non-therapeutic.” The American Academy of Pediatrics and the Centers for Disease Control have never recommended the surgery, having always maintained a neutral position because they know that the motivations underlying the surgery are not medical.

However, for the past couple of years, both the AAP and the CDC have indicated that they might change their neutral stance on neonatal male circumcision, and instead recommend in favor of the surgery.

Their purported reasoning stems from studies of adult males and the role male circumcision might play in retarding the transmission of HIV/AIDS. But while those studies, conducted in Africa, found some evidence that circumcised men contracted HIV at lower rates than uncircumcised men in control groups, no benefit was found for women, and neither has any benefit been found for male-to-male transmission.

Extrapolating from studies of adult men in Africa to justify removing healthy, functioning tissue from infant boys in America on the chance those babies will engage in unsafe behavior decades into the future requires a blind leap over a huge ethical chasm. For one thing, while the African studies were conducted with presumably consenting adults, neonatal circumcision in this country involves babies, who cannot consent. And the medical ethics are clear: For an intervention as invasive as surgery to be justified, the procedure must carry medical benefit to the patient, and there must be informed consent. Parental consent is inadequate if the baby is not sick, and doesn’t need the surgery.

There is good news, however. Parents in this country have begun to disregard the medical-industrial establishment, and are rejecting circumcision in larger and larger numbers as they learn the facts of just how unnecessary it is.

In July 2010, a CDC researcher presented a report at an AIDS conference in Vienna, based on a survey of more than 6.5 million boys born in American hospitals over three years. It showed the rate of neonatal male circumcision had dropped precipitously— from 56 percent in 2006 to under 33 percent in 2009. When asked for confirmation, the CDC quickly tried to back off from the data, saying it had been collected for another purpose. But the CDC could not deny what growing numbers of health and human rights activists have known for years: American families are increasingly making their own choices about the health and wellbeing of their babies. “What we can tell you is that male infant circumcision rates have declined somewhat in this decade,” a CDC spokeswoman grudgingly told The New York Times.

The change in circumcision rates, in fact, has been dramatic. Just 30 years ago, an estimated 90 percent of baby boys born in the United States underwent the surgical removal of their foreskins, whether in hospitals or in religious ceremonies. Now, the CDC’s most recent number tells us that the natural anatomy is becoming the norm for American boys.

I am not shocked by how quickly the rate has fallen. After all, it only takes a moment to decline to circumcise your baby, and that moment is happening thousands of times a week throughout the U.S. In the two years since Intact America began serving as the go-to group for the anti-circumcision movement in this country, I have been interviewed by The New York Times, the Today show, The Washington Post, the Associated Press, the Chicago Tribune, FOX News, The Huffington Post, the Los Angeles Times and countless radio shows, including stations in Canada, England, Spain and Ireland. The call-ins, the mail, the exploding social media presence of “intactivist” groups…all of this confirms that parents are getting the message that circumcision is unnecessary and harmful. And they are saying no.

Contrast the falling rates—a result of common sense and the growing realization of just how remarkably well-designed babies are—with the persistent efforts of the U.S. medical establishment to justify and promote circumcision. The reasons for the latter are both simple and complex. They include “tradition” (i.e. conformity), money (doctors get paid for procedures, but not for leaving patients alone), and doctors’ fear of acknowledging that something they have done for years is useless or even harmful.

Just 30 years ago, an estimated 90 percent of baby boys born in the United States underwent the surgical removal of their foreskins. Now, the CDC’s most recent number tells us that the natural anatomy is becoming the norm for American boys.