I had a bad feeling leading up to the decision that the American Academy of Pediatrics made recently to endorse circumcision. I knew that they were going to do it, I just wasn’t really sure what sort of statement they would make. Prior to the statement, their position was that they didn’t have a position. If you read the original paper, it’s about eight pages long and it basically stated that there wasn’t enough information to conclude that there were benefits to the procedure, one way or the other.
But then, the AAP made the statement that the benefits of circumcision outweigh the risks, and that it should no longer be thought of as an elective, cosmetic procedure, so insurance should pay for it.
And I heaved a heavy sigh.
In the interest of full disclosure, I have two sons, a 2.5 year old and a 9 month old. Neither of them is circumcised. When I was pregnant with my oldest son, my husband and I spent a great deal of time after my 20 week ultrasound debating the pros and cons, and we concluded it was not in our son’s best interest to have the procedure done. It wasn’t even brought up when my second baby was born, because we were very happy with our decision.
I was curious as to why the AAP decided to take an actual stance on the procedure, given that up until now, they had been reluctant to do so. And really, seeing as how 80 percent of the world isn’t circumcised, why is there suddenly such a push to do it here? So I wanted to take a look at the main reasons that the AAP has given, and take a good hard look at the research surrounding those reasons. I will be doing a series of posts on what the AAP states are reasons for the procedure, and I will be taking a look at the reasons against.
According to the AAP, circumcision reduces the risk of heterosexual transmission of the HIV/AIDS virus. This is an extremely misleading statement, and here’s why: there were three inconclusive studies done that showed that it’s possible that circumcision may reduce the risk of HIV/AIDS transmission up to 60%, which is part of the reason that there is such a push for young, sexually active men ages 15+ in Africa to get circumcised. Except as a prevention intervention, it doesn’t really work. I think that it’s especially telling that recently the health adviser to Zimbabwe’s President Mugabe, Timothy Stamps, issued a statement that circumcision “did not make any difference to the adult prevalence rate,” noting researches had shown that countries with a higher number of circumcised men, like the US, also had a high HIV prevalence rate.
He said instead of channelling funds towards circumcision, the money must be used to save pregnant mothers who die in huge numbers in this country.
“When we are losing 960 mothers for every 100 000 pregnancies, should circumcision be a priority?” said Stamps.
He said circumcision had led to men being more reckless in sleeping around.
“Young men are happier to take risks and chances without the use of condoms or any other preventive measures because they are told circumcision will protect them,” he said.”
My other issue with making the statement that circumcision prevents HIV stems from where I live. You see, I live about 20 miles outside of Washington, D.C., where the HIV/AIDS virus is at epidemic levels. According to a study published in the New England Journal of Medicine, HIV levels in the District were at 1 in 30. This was a higher rate than recorded in some of the countries in Africa with the highest levels of infection. Last July The Washington Post reported that the demographic with the highest levels of new HIV infection were monogamous black females. The current estimate is that 80% of grown men are circumcised, and it seems rather ludicrous to state that circumcision prevents HIV when the District has a ridiculously high percentage of the population infected for a developed country.
But what about the rest of the world? Surely in areas like Europe, where the majority of men are uncircumcised, the HIV/AIDS virus must be more prevalent than in the United States? One writer from THE WHOLE NETWORK puts it better than I ever could:
“One would expect for there to be a lower transmission rates in the United States, and for HIV to be rampant in Europe; HIV transmission rates are in fact higher in the United States, where most men are circumcised, than in various countries in Europe, where most men are intact. It is telling that the HIV epidemic struck in our country in the 1980s, 90% of the male population was already circumcised. Somehow, we’re supposed to believe that what didn’t worked in our own country, or anywhere else, is going to start working miracles in Africa.”
Overall, I suppose the AAP’s statement is correct, that circumcision may reduce the risk. But “may” is subjective, and when you look at the rest of the world, their case for circumcision as a method of HIV prevention definitely seems pretty flimsy.
What are your thoughts? Should circumcision in the U.S. be a standard procedure?
Image: Nutdanai Apikhomboonwaroot