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The Problem of Circumcision in America
James L. Snyder, M.D.
The Truth Seeker, pp 39-42, July/August 1989
Presented in 1989 at the First
International Symposium on Circumcision
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"First, do no harm"
In the matter of circumcision of newborn males, it must be recognized that the child is normal as born, and that circumcision inflicts loss of a normal body part and leaves a scar. This is contrary to the motto of medicine which is "First, do no harm. " "There is no absolute medical indication for routine circumcision of the newborn." In the United States, alone among industrialized societies, and in the two generations born since about 1940, routine newborn circumcision has become such an accepted routine in the process of birth and delivery that for some people it is a surprise to discover that there is controversy over the desirability of the procedure. In 1975, The American Academy of Pediatrics (AAP) published the report of a committee formed to study circumcision, whose opinion was that "There is no absolute medical indication for routine circumcision of the newborn." This statement is contained in the body of the Report of the Ad Hoc Task Force on Circumcision from the Committee on Fetus and Newborn of the AAP (Pediatrics, Vol. 56 No. 4, October 1975, and modified in March 1989). The body of the report addresses most of the commonly voiced concerns, such as phimosis, hygiene, care of the penis, cancer, balanitis and venereal disease, surgical risks, and contraindications to circumcision. The Report also called for "true informed consent " and a "...program of education leading to continuing good personal hygiene (which) would offer all the advantages of routine circumcision without the attendant surgical risk. " And finally stated, "Therefore, circumcision of the male neonate cannot be considered an essential component of adequate total health care." "Circumcision of the male neonate cannot be considered an essential componentIn the case of adult circumcision, the operation is never performed unless the individual seeks the procedure for genuine medical need or for his own aesthetic reasons. This is a choice that less than 10% of uncircumcised adults will ever make. In Europe, more than 90% of men who are fortunate enough to have their normal anatomy will find no reason to seek a circumcision.
The fact is that circumcision confers no immunity to any of these diseases. The proponents of circumcision in recent years have published articles which are claimed to show as a scientific fact that uncircumcised males are at greater risk of acquiring a number of benign diseases and one rare malignancy. It has been stated, for instance, that circumcision would reduce the opportunity to acquire syphilis, gonorrhea, herpes, venereal warts, urinary infections, and other benign conditions. The fact is that circumcision confers no immunity to any of these diseases, which any physician treating large numbers of circumcised American men - as in the military services - can readily observe. If all men were circumcised, only circumcised men would contract these diseases, for most of which there are satisfactory antibiotic treatments. Most recently, there has been speculation that circumcision would offer protection from infection by Human Immunodeficiency Virus, the suspected causative agent of the disease AIDS. The stated basis for this is the observation of the AIDS infection pattern in a small number of African men who frequented AIDS infected prostitutes. The proponents of this speculation choose to ignore the obvious fact that AIDS infections were first recognized in American homosexual men who were overwhelmingly Caucasian, middle class, and circumcised. Thousands of men with AIDS fill the hospital beds of our major cities and are testimony to the failure of circumcision to offer any degree of immunity to AIDS infections. Thousands of men with AIDS...are testimony to the failure of circumcisionDes Moines Register (Iowa) Saturday, Nov. 20 1982, reported a grand jury investigation of the bleeding death of a Des Moines infant after circumcision.
East Cobb Neighbor (Marietta, Georgia) of Nov., 1985, reported that "In September, two male infants were burned and horribly mutilated in a 'routine circumcision' at Northside Hospital (Atlanta). One of the infants has had a necessary sex change operation and the other is still under doctors' care."
Lake Charles American Press (Louisiana) of Wednesday, May 28, 1986, reported a $2.75 million award in the case of a young boy whose penis had to be amputated after it was severely burned during a routine circumcision.
Times Picayune (New Orleans, Louisiana) of Thursday, May 15, 1980, reported on a Mineola, N.Y. boy who was mistakenly circumcised four days after his birth in 1976. It was reported that the family had not wanted the circumcision performed, and that the hospital officials tried to "cover-up" the error by falsifying records to show that the circumcision was done for "medical reasons." An out-of-court settlement for $15,000 was reported in a suit over the matter.
The above reports, drawn from the lay press, almost certainly represent only a small part of the number of unfavorable results of routine newborn circumcision, as most of the families in such incidents shun publicity.
On balance, circumcision is an unjustifiable preventive for penile cancer
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These two personal experiences in the career of one physician, together with a number of lesser complications of circumcision should be compared with the fact that in the same period of time I have only encountered four patients with newly diagnosed penile cancer, two of which were in men of truly advanced years or who died within a year of other causes. On balance, circumcision is an unjustifiable preventive for penile cancer with an unacceptable number of serious complications.
The
adverse long term consequences of infant circumcision
on the sexual health of American men must be recognized
by physicians, parents, and legislators.
In summarizing the complications of circumcision accidents, I would like to state that they are not uncommon. Because of their sensitive and confidential nature, however, they are usually unrecognized by outside parties and they have not been seriously studied in the medical literature except on an occasional or anecdotal basis. I believe that the cases I have presented in this paper represent only the tip of the iceberg in terms of the size of this problem.
The adverse long-term consequences of infant circumcision on the sexual health of American men must be recognized by physicians, parents, and legislators. The continued practice of infant circumcision must be recognized as the unjustified mutilation of the bodies of children largely for the cosmetic or aesthetic gratification of other persons - a serious assault and battery on children who are powerless to resist.
James Leigh Snyder, M.D., F.A.C.S., is a 1961 graduate of the Jefferson Medical College of Philadelphia, a member of the Alpha Omega Alpha Honor Medical Society, and a Fellow of the American College of Surgeons. He is a diplomate of the American Board of Urology and past President of the Virginia Urologic Society. He holds the rank of Commander in the Medical Corps of the United States Naval Reserve and practices Urology in Clifton Forge, Virginia.
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