5 October 2011
Efforts to ban infant male circumcision are "ethically questionable," claim medicos
by George Atkinson
Johns Hopkins infectious disease experts say that banning male circumcision is a mistake, as it protects men and their female partners from a number of sexually transmitted infections. Their pro-circumcision editorial in the Journal of the American Medical Association appears at a time when an increasing number of states are considering revoking Medicaid insurance coverage for male circumcision.
Editorial co-author Aaron Tobian argues that implementing policy or financial barriers to safe circumcision could potentially disadvantage people most in need of publicly financed services to improve their health. These groups include minorities and the poor, among whom sexually transmitted infection rates are often the highest.
Critics of infant circumcision claim, among other things, that the procedure should not be considered until males can give legal informed consent at age 18. But Tobian and co-author Ronald Gray point out that there are medical benefits during childhood, as many young men are already sexually active before age 18, and at greater risk of infection from sexually transmitted infections. Circumcision at older ages is also associated with more complications and cost than having the minimal surgery in infancy.
"Our goal is to encourage all parents to make fully informed decisions on whether to circumcise their infant boys based on medical evidence and not conjecture or misinformation put out by anti-circumcision advocates," says Tobian.
Among the research cited by Tobian and Gray are multiple studies conducted within the last five years showing that in heterosexuals, circumcision reduced HIV infection risk by 60 percent, genital herpes by 30 percent and HPV by 35 percent in men. Additionally, females benefit from a 40 percent or greater reduced risk of bacterial vaginosis or parasitic trichomonas spread during sex, as well as HPV infection.
As far as sex goes, Tobian and Gray say that research shows no reduction in sexual satisfaction or male performance. Indeed, they add, circumcised men reported no difference or even increased penile sensitivity during intercourse and enhanced orgasms compared to uncircumcised men. The majority of female partners also reported either no change or increased sexual satisfaction, largely because of improved hygiene.
The medicos argue that delaying circumcision until adulthood, when young men can legally decide for themselves, not only carries added risk of infection, but also challenges the long-held rights and responsibilities of many parents to make decisions about the long-term health of their children, including vaccinating them against hepatitis B, measles, polio, whooping cough and influenza.
They conclude their argument by comparing circumcision to a vaccine. "If a vaccine comparable in disease-prevention benefits to male circumcision was available, with the same disease-preventing benefits, the medical community would rally behind the immunization, and it would be promoted as a game-changing public health intervention. Banning it would be ethically questionable."
When Circumcision Was The Cure For Everything
The Long And Painful History Of Circumcision
The American Penis: In Circumcision We Trust
Source: Johns Hopkins Medical Institutions