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Circumcision Ban Debate Blurs Proven Health Benefits

 

Fittingly, Judge Loretta Giorgi ordered the removal of the proposed San Francisco initiative to criminalize infant circumcision from the ballot.  However, supporters of the measure continue to voice their undocumented and erroneous claims that circumcision has harmful emotional effects and no medical benefits.

These “intactivists” ignore the overwhelming evidence and the multiple health benefits of circumcision from infancy through old age, including a 60% protection against the heterosexual transmission of HIV/AIDS. 

Circumcision has been endorsed as a method to fight HIV/AIDS by the World Health Organizations (WHO), the UN (UNAIDS), and the US Center for Disease Control (CDC).  Many African countries, including South Africa, Uganda, Rwanda, Nigeria and Swaziland have instituted mass circumcision programs supported by funds from the US government, the Gates Foundation and others, and they have already seen tangible results, including a 76% drop in HIV acquisition rates.

Additional preventive health benefits of circumcision from infancy through old age include a tenfold protection against severe infant kidney infections, lifetime prevention of foreskin infections, retraction problems and sexually transmitted infections, as well as ease of genital hygiene.  Penile cancer is found almost exclusively in uncircumcised men and cervical cancer is more common in women with uncircumcised partners.

The foreskin is at risk of infection because it is a mucous membrane, similar to the lining of the cheek, and it tears easily, allowing infectious agents to enter. Bacteria and viruses, including HIV, have been shown to selectively attach to this membrane, and the area under the foreskin provides an ideal environment for the accumulation and growth of infectious agents.

The neonatal period is ideal for performing the procedure, as circumcision is quicker, less traumatic and has fewer complications than when performed on older patients. Newborns are very resilient and uniquely equipped to deal with stress, having high levels of stress hormones as well as pain-relieving hormones.  The thin foreskin means that sutures are not usually needed like in older patients, and local anesthesia is effective at numbing the area to further minimize pain.

Opponents of circumcision have no problem making up unintended side affects that can result from this safe and accepted procedure.  Exaggerated risks should not justify criminalizing doctors, especially when stacked up against the mountain of evidence showing legitimate health benefits. 

As study after study shows the benefit of circumcision throughout the male life span, one has to wonder what motivates supporters of this extreme initiative.  No one is forcing them to circumcise their child, yet they will continue to take that choice away from other parents regardless of the available medical evidence.

While a ban goes too far and is illegal under California law, the supporters have been successful at removing Medicaid coverage for circumcisions in 18 states, including California.  This means that many poor families are unable to choose to receive a circumcision, potentially causing even greater hardship down the road.

I am confident that San Francisco’s voters would have overwhelmingly rejected this initiative for being too extreme, and I am pleased that Judge Giorgi removed it from the ballot because it violates a state law that protects the medical profession.  In addition to these reasons, circumcision remains a procedure with proven health benefits that should be fully considered by parents when making an informed choice for their sons.

 

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