The Circumcision Debate: Beyond Benefits and Risks.

Abstract

In 2007, following a flurry of reports describing a benefit of circumcision in the fight against HIV, the American Academy of Pediatrics reconvened the task force on circumcision to update its policy statement of 1999.1 Rather than simply incorporating this new information, the committee chose to start from scratch and rereview the medical literature. The task force’s work culminated in a policy statement published in 2012, the centerpiece of which was the statement that “the health benefits of newborn male circumcision outweigh the risks.”2 This formulation of the debate, “benefits versus risks” rather than “medical necessity,” resulted in wide-ranging ramifications. To many, especially in the lay press, this was interpreted as moving the needle from a neutral stance, as the 1999 guidelines were viewed, to being pro circumcision. It was vigorously criticized by anticircumcision activists, as well as many, primarily European, physicians and medical societies. Difficulties with this approach included the lack of a universally accepted metric to accurately measure or balance the risks and benefits. In particular, there was insufficient information about the actual incidence and … Address correspondence to Andrew L. Freedman, MD, Department of Surgery, Cedars Sinai Medical Center, 8635 West Third St, Ste 1070, Los Angeles, CA 90048. E-mail: andrew.freedman{at}cshs.org