Male Circumcision Is Medically Beneficial, Experts Say
EmailMale circumcision continues to be debated in America.
This spring ABC News tracked the war waged on the procedure in San Francisco as anti-circumcision “inactivitsts” attempted to ban infant circumcision altogether. This summer Colorado became the 19th state to defund Medicaid coverage for infant circumcision, following in the footsteps of South Carolina, which made the cut in February.
With more states considering defunding as a way to cut health care costs, two Johns Hopkins epidemiologists decided it was time to speak up for circumcision. In an editorial published today in the Journal of the American Medical Association, Dr. Aaron Tobian and Dr. Ronald Gray argue for the medical benefits of circumcising boys in infanthood, citing several observational studies and recent clinical trials that show it reduces the transmission of sexually transmitted diseases such as HIV, HPV and herpes by about a third in both men and their female sexual partners.
“This is a simple surgery that’s been performed for over 6,000 years. Clearly it’s safe to perform, and it has clear medical benefits,” says Tobian.
Just 20 years ago as many as 67 percent of all male infants born in U.S. hospitals were circumcised. Today, that number hovers around 32 percent, in part due to decreased funding for the poor and a rise in controversy over the ethics of the practice. Opponents claim circumcision is a form of genital mutilation without medical benefit.
“The foreskin is there for a reason,” Lloyd Schofield, who spearheaded the San Francisco anti-circumcision bill, told ABC News in May. Shofield called circumcision an “unnecessary surgery” with no “sound medical evidence” behind it.
Recent studies suggests otherwise, Gray and Tobian argue.
“The evidence for the long-term public health benefits of male circumcision has increased substantially during the past five years,” the authors write. “If a vaccine were available that reduced HIV risk by 60 percent, genital herpes risk by 30 percent, and HR-HPV risk by 35 percent,” as recent studies have shown, ”the medical community would rally behind the immunization.”
Tobian is among those who have reconsidered their views on circumcision in light of these recent studies, he says. Before his first child was born, in 2005, he and his wife had decided against circumcision, although when the child was a girl, the question became moot. When his son was born in 2008, however, there was no question in his mind that he would be circumcised.
Despite these recent studies, public opinion of circumcision has continued to waver as anti-circumcision “inactivists” continue to campaign, Tobian says.
“It’s like the anti-vaccine campaigns,” Tobian says. “The more vocal you are, the more press coverage, and people believe what people are yelling, despite what the medical evidence shows.”
The historically neutral stance on circumcision taken by the Centers for Disease Control and the American Academy of Pediatrics only bolsters opponents’ questioning of circumcision, he notes. This is why Tobian and Gray are calling for medical associations to review the recent evidence and reconsider their stance on male circumcision.
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I would love to know what Tobian and Gray think about The Royal Dutch Medical Association which has stated very clearly that circumcision is harmful, the benefits are sparse, that it is mutilation and that it should end. After all The Royal Dutch Medical Association deals with the same type of research that Tobian and Gray do except they came to a vastly different conclusion.
Posted by: Nathan | October 4, 2011 October 4, 2011, 6:19 pm
This is just about health care insurance cutting costs. It is clearly a beneficial practice, cleaner, and often medically necessary even in male adulthood. I have no tolerance for people who don’t know what they are talking about and cannot point to statistical research. Look into the background of Lloyd Schofield, who spearheads this. He is very vague for a reason.
Posted by: Victor | October 4, 2011 October 4, 2011, 6:30 pm
I want to see if the data behind these statements. I wonder if those health risks really arent coincidental and should really be attributed to the socio-economic factors of men who do not get circumcised. There are seinsitive nerve endings in a foreskin that are lost forever. I would rather raise a chiled with good hygiene and morals, than mutilate him to ease the conscious of doctors trying to impose their own belliefs as medically necessary.
No different than female circumsicion in Africa to prevent promiscuity.
Posted by: Anthony | October 4, 2011 October 4, 2011, 6:34 pm
@Victor: I can’t say much about the coincidental aspects or socio-economic factor here. Otheriwse, I see you are repeating what I keep hearing and believed for a while. I want to tell you differently, since I actually know, as an adult who had this procedure a few years ago. “Sensitive nerve endings lost forever” — an exageration to say the least. I’d actually say sex is slightly better… if I lost anything, it’s quite subtle. I actually do think it is a bit strange to perform what I’d consider plastic surgery on children — but I’m tired of hearing the line about nerves being lost and sensation dulled since it’s patently false.
Posted by: Jim | October 4, 2011 October 4, 2011, 7:26 pm
This article is bologna. EVEN IF you prevent the 1% risk of UTI with circumcision, you still have a 38% risk of the child wishing he hadn’t been circumcised. In the end, you have NO RIGHT to circumcise your child, in the same sense you have no right to molest him. This is clearly child abuse, and already unconstitutional under the Equal Protection clause of the Constitution. I should NOT have been circumcised.. yet here I am, forced to endure a life in a body that is permanently modified against my will. This is clearly wrong.
Posted by: Jaden | October 4, 2011 October 4, 2011, 7:27 pm
There are plenty of doctors that disagree with Tobian and Gray. The Royal Dutch Medical Association just released a statement condemning newborn circumcision and calling for an end to the practice.
Also, Tobian and Gray fail to discuss the functions of the foreskin itself. The foreskin is erogenous tissue, containing thousands of erogenous fine-touch nerve endings. The most sensitive and pleasurable parts of male anatomy are removed by circumcision.
Additionally, the foreskin acts as a linear bearing during intercourse, making the experience more comfortable and pleasurable for women.
Google ‘foreskin anatomy’ for more information.
Posted by: Craig Garrett | October 4, 2011 October 4, 2011, 7:35 pm
What Aaron Tobian and Ronald Gray fail to mention in their misguided circumcision quest is that the clinical trials were based in African countries, where HIV prevalence and incidence is very high, and transmission is primarily heterosexual. No Western medical association promotes foreskin amputation as a way of preventing STDs. Though now I guess Drs. Aaron Tobian and Ronald Gray have their few minutes of fame.
Posted by: Jarek K | October 4, 2011 October 4, 2011, 8:04 pm
Why is it so easy to find circumcised doctors who are against circumcision, but so hard to find male doctors in favor of it who weren’t circumcised themselves as children?
Posted by: Mark Lyndon | October 4, 2011 October 4, 2011, 8:54 pm
Safe? More than 100 baby boys die each year from their circumcisions. And circumcised men are 5 times more likely to acquire erectile dysfunction. These are facts that aren’t being mentioned in the news and certainly aren’t being told to parents.
Posted by: Dan Bollinger | October 4, 2011 October 4, 2011, 9:39 pm
If anyone wants to be circumcized in SF, let them pay for it! Simple.
Posted by: Howard Feinski | October 4, 2011 October 4, 2011, 9:50 pm
The only thing that genital cutting on children benefits is the bottom line of the for-profit medical industry. The American medical industry (it stopped being a profession about 35 years ago) has a long and sordid history with genital cutting on children — both male and female and lately intersex children — and it all needs to stop.
Posted by: Kirsten | October 5, 2011 October 5, 2011, 12:50 am
…If the benefits of male circumcision only appear later in life (as opposed to at birth), then why have circumcision done at infancy? Why can’t it be done, consciously, when male is an adult and is able to make his own decision regarding that? (this is disregarding religious circumcision)
Posted by: ??? | October 5, 2011 October 5, 2011, 5:36 am
Most of these comments are from people who didn’t read the actual editorial by Tobian and Gray. Their editorial answers all of these issues with objective medical facts:
*The studies being cited were randomized trials (so there’s no concern about ‘coincidental factors’ of who gets circumcised).
*The same randomized trial showed no decrease in sexual satisfaction for men or women partners after circumcision
*The procedure is safer to perform in infants than adults, so it is harmful to wait until adulthood to do the procedure.
Go read it yourself instead of believing propaganda or shooting the messenger
Posted by: JAMA MD | October 5, 2011 October 5, 2011, 11:03 am
These studies come and go.
I do not need one single piece of evidence to claim the right to my natural, healthy, intact body.
This is a human rights issue. I was circumcised at birth—and it wasn’t to prevent HPV or HIV. The reasons to do it change each year. 29 years later I have never had sex. I don’t choose to have sex. If I wanted to protect myself from disease I would use a condom, which works a lot better than what they are claiming circumcision provides as benefit from disease.
The harm circumcision has caused me physically and psychologically is immeasurable. Circumcision is a “solution” that’s been in search of a solution for a long time. It started in the US because doctors believed masturbation led to a host of diseases and they rightly said that the foreskin was the most erogenous part of the body. They purposefully did not use anesthesia as punishment. I was born in 1982 and anesthesia still wasn’t used. Girls were circumcised up until the 1930s as well and it didn’t become illegal in the US until 1997. Girls often had carbolic acid applied to their genitalia as well.
I have no doubt that mutilating female genitalia would cause scar tissue that transmits less disease. Why don’t they study that now? Because it’s cruel? That’s how I feel about MGM. It started for the wrong reasons. It causes harm. And they will keep finding more reasons. But none of them hold a candle to the fact that *I* was born with a foreskin and it was part of *my* body and I did not want it removed and it was taken without my consent. I have a right to my body.
Posted by: Marcus Andersson | October 6, 2011 October 6, 2011, 4:52 am
I meant “solution in search of a problem”
Posted by: Marcus Andersson | October 6, 2011 October 6, 2011, 4:53 am
I am not circumcised and happy for it! Any permanent alteration to an individual’s body should not be made until the child is an adult. If I recall correctly, a couple of parents were arrested last year for giving their children tattoos when they were under age. How is infantile circumcision ethically different? There is such a thing as tattoo removal but is there a procedure to reattach foreskin later in an individual’s life? Obviously, there is not. How can parents be forbidden from tattooing their children (even with their child’s consent) but physically mutilating them is OK because it’s tradition? I mean, really? Reality check, please!
Posted by: Hollis | October 6, 2011 October 6, 2011, 12:24 pm
me as a wife has lovely relation with circumcised husband because it is more beauty than of uncircumcised and it has more easy drive and foreskin caused sexual diseais and difficult to clean it
Posted by: susan | October 6, 2011 October 6, 2011, 12:58 pm
Do the studies showing a health benefit on one continent apply to another continent? Have the studies included any information on the re-adherence complication? That a lot of times boys have to be circumcised multiple times because the foreskin tries to re-adhere? This complication takes place after babies leave the hospital, and is dealt with largely in pediatrician’s offices, so there are no statistics on it. But when a surgeon says “he performs these surgeries [re-circumcisions] every week” that tells me it is a common problem. When I see some numbers about this issue, then I will know we have all the information. Until then, I will consider circumcision an unnecessary cosmetic surgery.
Posted by: Renee | October 6, 2011 October 6, 2011, 1:22 pm
Seems more like a rationalization for the act rather than a reason for circumcision being medically necessary. The (possible, but highly questionable) benefit of some degree of protection against spreading diseases which are very much preventable through other means, does not equate to circumcision being necessary surgery. After all, cutting off a woman’s breasts also has the benefit of reducing her chance of getting breast cancer buy 100 percent, but that does not mean we should start regularly giving preteen girls mastectomies before they ever have a diagnosis just because if they don’t have breasts to begin with, there will be much less of a risk for developing breast cancer.
Posted by: TL | October 6, 2011 October 6, 2011, 4:12 pm
Let the man decide himself if we wants to have the most sensitive part of his anatomy chopped off. Of course, the vast majority of men when they turn 18 won’t choose to have this done, any more so than might randomly consider to have their eyelids cut off. Circumcision will then become extinct finally, which would be a great thing. Forcing it on infants in the name of whatever reason should of course be illegal. It is already illegal (in any form) to do in this country to women by an act of congress in 1996. Idiots who argue in favor of it can have it done to themselves all day long, but they have NO RIGHT to force it on others (and infants are others. Infants grow up to be men). That is violence plain and simple.
Posted by: jonesHanson | October 6, 2011 October 6, 2011, 4:30 pm
I thought they were referring to themselves as “INTACTIVISTS” not inactivists.
Posted by: Hob Lunk | October 6, 2011 October 6, 2011, 5:19 pm
As for freedom of religion and “private in home circumcisions” where freinds & family come over to watch their son get held down by grown men while they spread his legs & cut off part of his genitals…What about this is OK?? Absolutley sickening…
Posted by: Jayne | October 7, 2011 October 7, 2011, 1:40 pm
Almost every medical organization recommends AGAINST circumcisions as a routine procedure. The WHO, which are desperate for anything to fight HIV in Africa jumped on this study too quickly while ignoring how ill-conceived the study was.
By the way, in western societies, there is absolutely no difference between the percent of men who get HIV who are cut vs uncut. At that was a larger study.
Posted by: david | October 9, 2011 October 9, 2011, 3:02 am
If you want to avoid getting an STD and avoid spreading it, the solution is to be chaste and not have sex before marriage, adulterous sex, or homosexual sex. The solution is not male circumcision.
Posted by: Holly Williams | October 11, 2011 October 11, 2011, 12:55 am
Surgery on a non-consenting minor without immediate medical need is highly unethical and should be illegal.
Posted by: Danielle Netherton | October 15, 2011 October 15, 2011, 2:47 pm
Let young boys decide on this procedure when they grow up .Educate them and stop cutting them
Posted by: Similo | March 16, 2012 March 16, 2012, 4:00 am