Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision

• Published in: Pediatrics (Evanston) Vol. 131; no. 4; pp. 796 - 800
• Main Authors: FRISCH, Morten, AIGRAIN, Yves, GAHR, Manfred, GRAUGAARD, Christian, GREISEN, Gorm, GUNNARSDOTTIR, Anna, HARTMANN, Wolfram, HAVRANEK, Petr, HITCHCOCK, Rowena, HUDDART, Simon, JANSON, Staffan, JASZCZAK, Poul, BARAUSKAS, Vidmantas, KUPFERSCHMID, Christoph, LAHDES-VASAMA, Tuija, LINDAHL, Harry, MACDONALD, Noni, MARKESTAD, Trond, MARTSON, Matis, MARIANNE NORDHOV, Solveig, PÄLVE, Heikki, PETERSONS, Aigars, QUINN, Feargal, BJARNASON, Ragnar, QVIST, Niels, ROSMUNDSSON, Thrainn, SAXEN, Harri, SODER, Olle, STEHR, Maximilian, VON LOEWENICH, Volker C. H, WALLANDER, Johan, WIJNEN, Rene, BODDY, Su-Anna, CZAUDERNA, Piotr, DE GIER, Robert P. E, DE JONG, Tom P. V. M, FASCHING, Günter, FETTER, Willem
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL American Academy of Pediatrics 01-04-2013
• Subjects: Analgesia - methods; Associations; Bias; Biological and medical sciences; Boys; Circumcision; Circumcision, Male; Cultural differences; Folkhälsovetenskap; General aspects; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Medicin och hälsovetenskap; Methods; Pediatrics; Penile diseases; Physicians; Planification. Prevention (methods). Intervention. Evaluation; Public Health Science; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sexually transmitted disease research; Sexually Transmitted Diseases - prevention & control; urinary tract infection; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States; North America; America; United States > US; Pediatrics; Male; Genital herpes; Prevention; Urinary tract infection; Health policy; penile carcinoma; Penis cancer; Cultural aspect; Male genital diseases; Public health; Immunopathology; Urinary system disease; Report; AIDS; male circumcision; Urinary tract disease; Malignant tumor; Immune deficiency; Infection; Penile diseases; Penis carcinoma; Sexually transmitted disease; Viral disease; Technique; HIV infection; Circumcision; Cancer
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2012-2896

The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.