American Urological Association's circumcision policy analysed

The American Urological Association
Circumcision policy analysed

 

The original of this is at the AUA's website.

 

American Urological Association

Policy Statements ...


Circumcision
The American Urological Association, Inc. (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks. [The American Academy of Pediatrics' policy statement, which this echoes, goes on to say that these benefits do not justify routine infant circumcision.] Neonatal circumcision is generally a rapid and safe procedure when performed by an experienced operator. [But you get no guarantee of that. It is often farmed out to interns, for practice.] There are immediate risks to circumcision such as bleeding, infection and penile injury, as well as complications recognized later that may include [but are not confined to] buried penis, meatal stenosis, skin bridges, chordee and poor cosmetic appearance. Some of these complications may require surgical correction. Nevertheless, when performed on healthy newborn infants as an elective procedure [...unlike all other elective procedures, it is not elected by the patients...], the incidence of serious complications is low (usually isolated case reports). Minor complications are reported to be three percent. [Not including poor aesthetic outcomes, skin bridges and the like, only those complications that the parents notice and bring back for more treatment.]

Properly performed neonatal circumcision prevents phimosis, paraphimosis and balanoposthitis [Duh, duh and duh - these are all (rare) disorders of the foreskin that can be readily treated without surgery], and may be associated with a decreased incidence of cancer of the penis among U.S. males. In addition, there appears to be a connection between the foreskin and urinary tract infections in the neonate. For the first three to six months of life, the incidence of urinary tract infections is at least ten times higher in uncircumcised than circumcised boys. [Even if this unsourced figure were accurate, the actual rates are very low in both cases, and lower for all boys than any girls.] Evidence associating circumcision with reduced incidence of sexually transmitted diseases is conflicting. [The commonest, chlamydia, may even be more prevalent among circumcised men.] Circumcision may be required in a small number of boys when phimosis, paraphimosis or recurrent balanoposthitis occur and may be requested for ethnic and cultural reasons [...for girls also...] after the newborn period. Circumcision in these children usually requires general anesthesia. [The standard of care for girl babies is, of course, refusing to operate.]

When circumcision is being discussed with parents and informed consent obtained, [...sounds like circumcision is a foregone conclusion, doesn't it...] medical benefits and risks, and ethnic, cultural, religious and individual preferences should be considered. [And the individual whose preference should be most considered is...? The default preference is that he will prefer to keep all his body. If he does not, he can alter it to his own choice in his own time.] The risks and disadvantages of circumcision are encountered early whereas the advantages and benefits may be prospective. [Any sexual downside to circumcision occurs much later.]

[Unsurprisingly, the AUA offers no discussion of ethics or human rights, nor of the sexual effect of removing part of a person's genitals, and no reference to whose penis it is.]

Board of Directors, May 1989
Board of Directors, October 1996 (Revised)
Board of Directors, February 1998 (Revised)

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