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Rebuttal: Should newborns be circumcised?

YES

Correspondence to: Dr Edgar J. Schoen, 280 W MacArthur, Oakland, CA 94611, USA; telephone 510 752-6485; fax 510 752-6754; e-mail edschoen{at}gmail.com

Dr Andres agrees that circumcision is a potent preventive measure against infant kidney infections and HIV, but downplays the significance. Infant kidney infections cannot be dismissed; they occur when the kidney is still developing and often result in renal damage with scarring. As for HIV protection, HIV is a serious plague of our times, resulting in more than 20 million deaths over the past 2 decades, mainly in sub-Saharan Africa. Even in developed countries such as the United States and Canada, with a lower prevalence than Africa, there is public health concern. In April 2007 the Centers for Disease Control and Prevention convened a conference of experts to take up the question of adult circumcision for high-risk men in the United States.

The protective effects of circumcision against other serious disorders have been well documented in major medical journals in recent years.^1–4 These include lowering the risks of human papillomavirus, penile cancer, cervical cancer in female sexual partners, Chlamydia infection, syphilis and chancroid, phimosis, local infection, and genital dermatoses. Circumcised men have easier lifetime genital hygiene. Depending on how you lump these, there are 7 to 11 proven preventive health benefits of circumcision versus the single risk of surgical complications, which the American Academy of Pediatrics lists as occuring in 0.3% to 0.5% of cases and as usually minor. That is at least a 7:1 benefit-to-risk ratio. How can Dr Andres conclude that the risks outweigh the benefits?

In bringing up the issues of masturbation, female genital surgery, and human rights, Dr Andres is echoing the mantra of the lay anticircumcision groups that dominate the media and the Internet. The masturbation myth is ancient history that no one takes seriously today. The ritual of "female circumcision" consists of removal of the clitoris and labia, comparable to removing the entire male penis and part of the scrotum.

Parents have the right, if not the duty, to agree to a proven preventive health measure for their infants. The proven medical benefits of circumcision far outweigh the risks, and a circumcised newborn boy has a lifetime health advantage.

Footnotes

Competing interests

None declared

References

1. Schoen EJ. Ed Schoen, MD, on circumcision: timely information for parents and professionals from America’s #1 expert on circumcision. Berkeley, CA: RDR Books; 2005.
2. Weiss HA, Thomas SL, Munabi SK, Hayes RJ. Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis. Sex Transm Infect 2006;82:101-10.[Abstract/Free Full Text]
3. Castellsagué X, Bosch FX, Muños N, Meijer CJ, Shah KV, de Sanjosé S, et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med 2002;346:1105-12.[Abstract/Free Full Text]
4. Schoen EJ. Ignoring evidence of circumcision benefits. Pediatrics 2006;118:385-7.[Free Full Text]

This Article Full Text (PDF) CFPlus Traduction en français Rapid Responses: Submit a response Rapid Responses: View responses Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Schoen, E. J. Search for Related Content PubMed PubMed Citation Articles by Schoen, E. J.