Circumcision: Cruel Cut or Essential Slice of Life?
To slice or not to slice? For millenia, circumcision has been a largely religious or cultural decision. More recently, it's become an international health and ethics debate. On Monday, a study from the Fred Hutchinson Cancer Research Center in Seattle was reported to have found a link between circumcision and slightly lower levels of prostate cancer. According to Dr. Jonathan L. Wright, who led the research, the findings were noteworthy, but not enough to swing the pendulum one way or another. As he said to Reuters: "I would not go out and advocate for widespread circumcision to prevent prostate cancer. We see an association, but it doesn't prove causality."
According to the World Health Organization, today about 30 percent of men age 15 and older are circumsized, with 70 percent of those being Muslim. Numbers are dropping steadily: in Europe, around 15 percent of men are circumsized, and in the U.S. the rate has dropped from 91 percent in the '70s to just 60 percent today. Here in the states, prevalence varies widely depending on geographical location, with 81 percent getting the procedure done in the Midwest, 66 percent in the Northeast, 64 percent in the South and 37 percent in the West.
The downward trend arises out of growing concern by parents that the practice is akin to "genital mutilation," and could have lasting physical or psychological effects. Though not everyone agrees, according to the British Medical Association (BMA), "it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks." And according to the does not recommend routine neonatal circumcision, any evidence that the procedure lowers risk of urinary tract infections, rare and sexually transmitted diseases later in life isn't worth the immediate risks.
Advocates for circumcision cite the growing body of evidence showing its impact on curbing transmission of sexual diseases in developing countries. As Katherine Harmon of Scientific American wrote last November, some studies are finding circumcision can reduce the odds that a heterosexual man will contract HIV by 57 percent or more. Not surprisingly, there's an ongoing effort in 13 HIV-plagued countries in southern and eastern Africa to circumcise 80 percent of their men by 2015. Across the continent, circumcision rates have risen to 62 percent.
For most of us, however, circumcision should remain what it's always been: a parent's personal choice. With the health issue more or less a push, there's little reason why we shouldn't continue to feel comfortable raising our boys with or without their foreskins. Said Dr. Douglas S. Diekema, a member of the American Academy of Pediatrics' taskforce on circumcision, to the New York Times: “There’s no compelling medical reason to do it. There’s also no compelling reason that it’s not a valid choice for families to make. There are some small benefits, and these need to be weighed against the risks.”