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Wednesday 21st August 2019

Benefits of circumcision outweigh risks

28th August 2012

The benefits of circumcision for male infants may outweigh the risks, according to a new evaluation of recent research by the American Academy of Pediatrics.


The body has changed its view on infant male circumcision, citing studies in African countries which show that that the procedure may protect heterosexual men against infection with HIV. It now recommends that the procedure should be covered by insurers.

However, it did not recommend circumcision for all infant baby boys outright, saying the decision should ultimately rest with a child's parents.

The statement was published alongside a lengthy review of current medical literature on the risks and benefits of circumcision, which it began five years ago.

It cites in particular 14 studies which suggest that circumcised adult males have greater protection against infection with HIV, but only if they are heterosexual.

The academy's move from its previously neutral stance on the issue is likely to fuel further debate on what has already become a controversial topic in the United States.

Writing the journal Pediatrics, the academy laid out its new policy statement, the first update in more than 10 years, which is likely to influence clinical decisions in paediatrics, as well as the coverage offered by health insurance providers.

Anti-circumcision groups in Europe and the US have become increasingly vocal in recent years, against a backdrop of falling circumcision rates in America, from 62.7% in 1999, to 54.5% in 2009. Medicaid, the healthcare insurance scheme for low-income families, has stopped paying out for routine infant circumcisions in a number of US states.

Last week, a German government ethics committee overturned a court ruling that circumcision constituted "grievous bodily harm" against a child, but the German paediatricians' group called the decision a scandal.

Meanwhile, in Austria, state-run hospitals in one province have been ordered by officials to stop performing circumcisions, while Denmark is currently investigating whether religious circumcision ceremonies are being carried out, as required by Danish law, in the presence of a doctor.

So far, there has been no official reaction to the academy's policy statement from the US Centers for Disease Control and Prevention (CDC) in Atlanta, which is also currently investigating the issue of infant circumcision.

According to policy author Douglas S. Diekema, the academy's statement was not so much pro-circumcision as pro-choice. Diekema said the experts had concluded that parents should be given a choice about whether or not to opt to have male babies circumcised.

However, he said that the HIV prevention benefits of male circumcision were likely to have less of an impact in the US than in sub-Saharan African countries.

Anti-circumcision campaigners say that the procedure is, quite simply, unethical, because no-one should have the right to remove a healthy body part from another human being.

Georganne Chapin, who heads the pressure group Intact America, says that boys should be given the same treatment as baby girls, and allowed to grow up as nature intended.

As well as conferring potential protection against HIV, circumcision can also protect against urinary tract infections during childhood, as well as against penile cancer in adult males.

However, complications and even deaths have occurred as a result of the procedure, and the academy said that reliable figures for such complications were unobtainable. Some have estimated that as many as 117 boys die every year from botched circumcision procedures.

Circumcisions rarely employ anaesthesia, and the academy suggested the use of pain relief, although anaesthesia may also make complications more likely.

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