Saturday, August 25, 2012
Doctors Opposing Circumcision - Public Notice
AAP Announces Intent to Release its Sixth Major Circumcision Policy
Doctors Opposing Circumcision reaffirms its Genital Integrity Policy
The American Academy of Pediatrics (AAP) revealed that it intends to publish its sixth
major circumcision policy on Monday, August 27, 2012 and in the September 2012 issue of
Pediatrics, its house journal. This will be its sixth position statement on male circumcision,
as it has previously published position statements in 1971, 1975, 1983, 1989, and 1999.
The new AAP policy has been five years in the making. The intent to publish a new
statement was announced in 2007, however internal disagreement on its content has
prevented publication. The new statement likely will be a compromise between positions.
The AAP, despite its high-sounding academic name, actually is a trade association of
pediatric doctors. Its primary duty is to advance the business and professional interests of
its 60,000 members who are called “fellows”. The interests of its child-patients are a
distant second to their primary interest.
There is a severe and intractable conflict of interest between the financial interests of its
fellows and the best interests of the child-patient. Most of its fellows perform nontherapeutic circumcisions on children and profit thereby. These members do not want
anything to interfere or disrupt their steady income stream. The AAP will not publish a
statement that would harm that income stream. The AAP ensures the outcome of its
circumcision statements by appointing doctors who are known to have a pro-circumcision
position. The current task force, like previous task forces on circumcision, is stuffed with
pro-circumcision doctors, including its chairwoman. Obstetricians and family doctors also
profit by doing unnecessary circumcisions. The presence on the task force of a
representative from the American College of Obstetricians and Gynecologists (ACOG) and
the American Academy of Family Doctors (AAFP), as well as Dr. Stephen Wegner, MD, JD,
representing the AAP Health Care Financing Committee, highlight the business and
financial nature of the forthcoming circumcision policy statement. We anticipate a very
self-serving statement that protects doctors’ incomes.
Previous AAP circumcision statements have exaggerated the alleged, but unproved
prophylactic benefits of non-therapeutic circumcision while minimizing the risks,
complications, drawbacks, permanent irreversible physical, sexual, and emotional injury of
male circumcision. We expect that this one will use prevention of HIV sexual transmission
as a reason to circumcise boys, even though the African studies that indicate circumcision
prevents HIV infection in adult males have been shown to be trash and,1 2 in any event, not
applicable to infant boys in North America.
In recent years, 46 percent of boys born in the United States have left the birth facility with
intact foreskins. There is not a shred of evidence that these boys are less healthy than the
54 percent of boys who were circumcised.
Doctors who perform circumcisions have had their income stream curtailed by the
decision of eighteen state Medicaid agencies to terminate payments for medically
unnecessary non-therapeutic circumcision of children. The AAP is expected to call for
restoration of those taxpayer-funded Government payments to doctors, so as to restore
the income of their fellows.
The AAP, thus far, has consistently refused to recognize that children are human beings,
who have legal rights to bodily integrity and the security of their person under both
American law and international human rights law, which are trampled by the unnecessary
amputation of the functional body part called the foreskin. The AAP has consistently
misapplied legal rules regarding surrogate consent for therapeutic operations on children
to non-therapeutic circumcision. By so doing, it has tried to protect the alleged parental
right to cut body parts from boys at will for religious/cultural reasons or no reason at all.
As noted above, the AAP is simply a trade association, which advances the perceived
interests of its fellows. Its position statements are not legal or medical imperatives and do
not have the force of law or public policy. This statement on circumcision is going to be all
about money, not about child health or welfare.
The Royal Dutch Medical Association has called male circumcision a human rights
violation and an unethical practice. The AAP’s forthcoming pro-circumcision policy is not
supported by foreign medical associations.
A court in Cologne, Germany says parents may not grant consent for unnecessary
circumcision. We will see shortly whether the AAP will reform its abusive practices. We
are not hopeful.
Doctors Opposing Circumcision believes that circumcision of children violates numerous
legal rights of the child and is highly unethical, if not unlawful. We believe that genital
integrity provides the highest level of health and well- being for the child. We do not know
what the AAP is going to say in their new statement, but we are circumcision experts and
we are convinced that non-circumcision is best for children. We reaffirm our Genital
Integrity Policy Statement of 2008, which advocates genital integrity for boys.
We urge parents to ignore this latest statement from the AAP and to continue to protect
their sons’ whole and complete bodies.
George C. Denniston, MD, MPH John V. Geisheker, JD, LLM
President Executive Director & General Counsel
Wednesday, August 22, 2012.
1 Van Howe, Storms MS. How the circumcision solution in Africa will increase HIV infections. Journal of
Public Health in Africa 2011; 2:e4 doi:10.4081/jphia.2011.e4.
2 Boyle GJ, Hill G. Sub-Saharan African randomised clinical trials into male circumcision and HIV
transmission: Methodological, ethical and legal concerns. J Law Med (Melbourne) 2011;19:316-34.