vCircumcision Benefits Outweigh Risks, CDC Says

[teflepi]

Was this posted? I figured might as well post it as we have discussed it a lot. I didn't realize this was not weighed in on before.

The first federal guidelines show benefits to circumcision — even as rates of newborn male circumcision drop. (Getty Images)

U.S. health officials on Tuesday released a draft of long-awaited federal guidelines on circumcision, saying medical evidence supports having the procedure done and health insurers should pay for it.

The Centers for Disease Control and Prevention guidelines stop short of telling parents to get their newborn sons circumcised. That is a personal decision that may involve religious or cultural preferences, said the CDC’s Dr. Jonathan Mermin.

But “the scientific evidence is clear that the benefits outweigh the risks,” added Mermin, who oversees the agency’s programs on HIV and other sexually transmitted diseases.

These are the first federal guidelines on circumcision, a brief medical procedure that involves cutting away the foreskin around the tip of the penis. Germs can grow underneath the foreskin, and CDC officials say the procedure can lower a male’s risk of sexually-transmitted diseases, penile cancer and even urinary tract infections.

The CDC started working on the guidelines about seven years ago, when a cluster of influential studies in Africa indicated circumcision might help stop spread of the AIDS virus.

"The benefits of male circumcision have become more and more clear over the last 10 years," said Dr. Aaron Tobian, a Johns Hopkins University researcher involved in one of the African studies.

But the guidelines are important, because the rates of newborn male circumcision have been dropping, he added.

Related: 5 Medical Procedures You May Not Actually Need

The guidelines are being published in the federal register Tuesday. For the next 45 days, the CDC will receive public comment before finalizing them next year.

They are likely to draw intense opposition from anti-circumcision advocacy groups, said Dr. Douglas Diekema, a Seattle physician who worked on a circumcision policy statement issued by the American Academy of Pediatrics in 2012.

"This is a passionate issue for them and they feel strongly that circumcision is wrong," said Diekema, a professor of pediatrics at the University of Washington.

The CDC guidelines largely mirror the pediatrician group’s statement, but the CDC’s document incorporates more research and comes from an organization that many may see as more neutral on the topic, Diekema said.

The thinking on circumcision has swung wildly over the years. It’s been practiced by Jews and Muslims for thousands of years, but didn’t become common in this country until the 20th century. By one estimate, only 25 percent of U.S. male newborns were circumcised in 1900.

Related: Report: 17% Drop in Hospital Patient Harm

It gradually became the cultural norm, and in the 1950s and 1960s surpassed 80 percent. But then the trend reversed. Part of it had to do with changing demographics, as the U.S. population grew to include larger numbers of Mexican-Americans and other ethnic groups that didn’t traditionally circumcise their children.

Also, opposition to the procedure grew from advocates who decried the pain, bleeding and risk of infections to newborns. Their message was aided by the Internet and by the neutral stance of physicians groups — including, for a time, the American Academy of Pediatrics.

A wave of state Medicaid programs stopped paying for newborn circumcisions, which cost roughly $150 to $200. The list eventually rose to 18 states, according to CDC numbers.

www.yahoo.com/health/circumcision-benefits-outweigh-risks-cdc-says-104161436012.html

[epphd]

Eeenteresting. I feel about circumcision the way I feel about, say, flossing. Sure, any individual can opt not to do it and be just fine. They can opt not to do it, have gum disease and whatevs - not *my* problem. But the evidence is the evidence and on a population level, flossing=better dental health.

So circumcise, don't circumcise. But it sounds more and more like like circumcision is, on a population level, a safER thing to do.

[stealthmom]

I saw this earlier today. I'm still cool with our decision.

I'm not sure what it would take for me to be on board with removing a healthy part of my child but this isn't it.

[irishbride2]

Dec 3, 2014 5:26:19 GMT -5 stealthmom said:

I saw this earlier today. I'm still cool with our decision.

I'm not sure what it would take for me to be on board with removing a healthy part of my child but this isn't it.

I'm fairly circ ambivalent. When DD was born, if she had been a boy, we would not have circed (based on the research at the time). We did end up doing it with DS, however. 

But to me its comparable to any prevention procedure. Your wording seems weird to me. I get why people do not circ and I have no problem with that. But your wording seems to imply you would be pretty anti most things that are prevention related. 

[pyramidsloth]

Up until yesterday, I belonged to a group on FB consisting of "crunchy" parents who vaccinate their kids. Someone posted this article, and everyone in the group went off an an anti-RIC rant. My husband and I decided to have our son circ'd, for a variety of reasons, but I understand and respect those who don't make the same decision. Apparently, our decision to circ our son was grounds for calling another member and I hypocrites, mutilators, oh and we lost the right to call ourselves "crunchy." So yeah, after that flame war I'm no longer a member of the group.

[MrsAggie]

All of these benefits have been known for years but not very publicly. If my patient's parents ask if there's an medical benefit then I'll tell them about these but say it's ultimately their decision. The foreskin is more susceptible to STDs, particularly from a study on HIV and AIDS, but the difference is small. Circumcisions will definitely not irradiate AIDS.

[pixy0stix]

I'm just glad that the debates here will hopefully be more moderate.

[mrsbro]

Dec 3, 2014 8:09:19 GMT -5 @mrsbecky said:

I think karinothing mentioned yesterday that this is similar to the AAP stance from 2012 so not really anything new.

We did not circ and I feel 100% comfortable with that decision for us but I can understand why someone would feel 100% comfortable circumcising.

This is my exact thought. I really can't get all debatey about this topic. You do, you don't, as long as we are all promoting safe sex and proper hygiene- do what you like.

[thejackpot]

Do people talk about this in real life? I am asking because this issue gets a lot of attention on the boards but it is not something that I have ever talked about with anyone.

My husband and I decided what to do with ds but I never felt pressure from anyone.

[wawa]

Dec 3, 2014 8:57:15 GMT -5 thejackpot said:

Do people talk about this in real life? I am asking because this issue gets a lot of attention on the boards but it is not something that I have ever talked about with anyone.

My husband and I decided what to do with ds but I never felt pressure from anyone.

No.  Not in my circles anyway.  I have absolutely no idea if my nephews or my friends boy's are circ'd.  I also have no idea if my brother or male friend's are circ'd.  whether somebody's penis wears a turtleneck is not a typical BBQ chitchat topic.

[mrsbro]

thejackpot I have never had anyone question why I did not circ our boys, nor did I ever ask why anyone did circ theirs. The only time anyone noticed was when I changed them as babes and it was only cursory 'oh you didn't circ - how does that work with cleaning, etc?' Hell as a mom of boys I asked about wiping baby girls nether regions when I babysat because I was concerned about uti's and discharge they had (I didn't know!) and I have the anatomy.

And my DH isn't circ'd he's all - who pays that close attention to someone else's junk!? <-- mature ;P

[thejackpot]

Ok, because I have a few friends with boys and it has never come up. Just wondering if my Mommy friends and I were off.

[lyssbobiss, Command, B613]

...backs out of thread, horrified that a scientist I respect compared circumcision risk to gum disease.

[saz]

Dec 3, 2014 9:26:11 GMT -5 @bunnybean said:

No, I doubt anyone voices any of the judgment aloud.

This seems to be reiterating what's been said before anyway, but like someone else mentioned, trying to get insurance companies to foot the bill again. It's not new information, nor is it put together in a compelling way.

None of it compels me to want to circumcise a future son. Countries where it's less prevalent certainly don't see more HIV.

I feel the same about other countries and there may be flaws with this study from Africa- like the males who were circumcised were instructed to abstain from sex while they healed, were given condoms, etc. while the men who were not just went on their merry way. My source for this information is the comment section of this article so who knows if it is legitimate. Lol

Regardless, no one in my current circle talks about it. I have no clue if my boys' friends are or are not and I don't care. I think it's one of those online only issues.

[heyjude]

Dec 3, 2014 9:32:59 GMT -5 lyssbobiss, Command, B613 said:

...backs out of thread, horrified that a scientist I respect compared circumcision risk to gum disease.

I read that last night and had to back out because it was affecting my blood pressure before bed.

[pixy0stix]

Dec 3, 2014 9:59:48 GMT -5 heyjude said:

Dec 3, 2014 9:32:59 GMT -5 lyssbobiss, Command, B613 said:

...backs out of thread, horrified that a scientist I respect compared circumcision risk to gum disease.

I read that last night and had to back out because it was affecting my blood pressure before bed.

I wonder if anti-vaccers feel this way when another piece of evidence comes out supporting vaccines.

[2curlydogs]

Dec 3, 2014 10:35:10 GMT -5 pixy0stix said:

Dec 3, 2014 9:59:48 GMT -5 heyjude said:

I read that last night and had to back out because it was affecting my blood pressure before bed.

I wonder if anti-vaccers feel this way when another piece of evidence comes out supporting vaccines.

What was that about debates being more moderate there septimu--... er. Pixy?

[josieposy]

Thank goodness I had girls. I still can't form an opinion on this.

[pixy0stix]

I've been really good lately! Let me have this!

[Scout'sHonor]

Can someone school me on why this practice started? Because it began long before the medical benefits/risks were known.

[pt716]

I kind of hope we do t have boys because I find myself very torn on this issue. On one hand, I tend to be very pro-preventative measures, such as vaccinating. On the other hand, I have a hard time with removing a body part. I still have my wisdom teeth even though I was told that they recommend everyone remove them because they may cause problems later in life when they are more difficult to remove.

[karinothing]

Dec 3, 2014 10:49:17 GMT -5 Scout'sHonor said:

Can someone school me on why this practice started? Because it began long before the medical benefits/risks were known.

@bunnybean - She knows!

[debatethis]

Dec 3, 2014 10:49:17 GMT -5 Scout'sHonor said:

Can someone school me on why this practice started? Because it began long before the medical benefits/risks were known.

Muslims and Jews have been doing it for eons as part of religious ceremony that I can't explain in a coherent way.
In more modern times (late 1800's forward) it was used as an attempt to stop everything from cholera and epilepsy to nymphomania and masturbation.

[2curlydogs]

Dec 3, 2014 11:01:27 GMT -5 debatethis said:

Dec 3, 2014 10:49:17 GMT -5 Scout'sHonor said:

Can someone school me on why this practice started? Because it began long before the medical benefits/risks were known.

Muslims and Jews have been doing it for eons as part of religious ceremony that I can't explain in a coherent way.
In more modern times (late 1800's forward) it was used as an attempt to stop everything from cholera and epilepsy to nymphomania and masturbation.

It was always explained to me as a hygiene reason cloaked in a "God told you to do this". You have people - some nomadic - living in an area with limited access to water and probably not the best personal hygiene to begin with.

But that may be poppycock.

[2curlydogs]

Dec 3, 2014 10:43:26 GMT -5 asdfjkl said:

Dec 3, 2014 9:59:48 GMT -5 heyjude said:

I read that last night and had to back out because it was affecting my blood pressure before bed.

That does strike me as a very poor analogy. The connection between flossing and gum health, as I understand it, is enormous. I also am not aware of a single recognized complication of flossing. And I'd assume that the reports of permanent injury secondary to botched flossing are few and far between. I bet they'd be fun to read though because holy hell how do you injure yourself with floss? Anyway, I didn't find it inflammatory. Just, not very appropriate.

Hemophiliacs flossing? I mean, I don't know about you, but I take pretty good care of my teeth and I still end up with bleeding gums on occasion.

In all seriousness, my understanding of the mortal risks with circ are those people who have a preexisting condition that makes them more vulnerable. So maybe my TIC comment above is relatively accurate?

[lyssbobiss, Command, B613]

I didn't realize that flossing required me to lop off a chunk of my clitoris before engaging.

[lyssbobiss, Command, B613]

Dec 3, 2014 11:26:59 GMT -5 @mrsbecky said:

I'm confused by the flossing analogy outrage. Are people mad because she implied that gum disease is analogous to STDs or that she compared the act of flossing (minimal effort and about zero risk) to the act of circumcising?

The latter. That was a flippant and shitty comparison.

[heyjude]

Dec 3, 2014 10:35:10 GMT -5 pixy0stix said:

Dec 3, 2014 9:59:48 GMT -5 heyjude said:

I read that last night and had to back out because it was affecting my blood pressure before bed.

I wonder if anti-vaccers feel this way when another piece of evidence comes out supporting vaccines.

It's okay. I bring up vaccines at inappropriate times too to make a broader point.

[mrs.jacinthe]

Dec 3, 2014 11:13:29 GMT -5 @juno said:

I believe mrs.jacinthe had a serious flossing mishap. Pictures were posted from urgent care and everything Though i'm fairly certain that thanks to modern medicine there was no permanent injury. On my phone or I'd find the post.

Eta: TIC (ha!). I just love it that I can actually cite a flossing injury.

Hey, now ... don't drag me into this.    But yes, I did, in fact, develop a semi-serious infection resulting in an urgent care visit due to overzealous flossing.  /rabbit trail

[saz]

I think the way I feel about the flossing = circumcision = good hygiene comparison is how many people felt about removal of pubic hair = good hygiene thing.