CDC 2014 proposed circumcision guidance

The CDC still has yet to adopt or act on its 2014 proposed guidance on circumcision. See all comments at this address:!docketBrowser;rpp=25;po=0;dct=PS;D=CDC-2014-0012. Adoption of the policy is unlikely at this point because it relied heavily on the AAP’s 2012 policy statement, which has now expired (and which was seriously flawed and heavily biased by an authoring panel with not a foreskin among them).

TLC Tugger’s comment:

The CDC should withdraw its recent proposed guidance on circumcision. The evidence they cite might – if true – affect a man’s decision about whether to be circumcised. It has no bearing on a family’s decision whether to force circumcision on a child too young to offer rational informed consent for the amputation of a healthy normal valuable body part.

The aspects of the CDC’s case which might seem to support rushing to cut in infancy are specious:

A) Early cutting supposedly affords some protection from UTI in early infancy.

– This effect is small and has NEVER been observed in a population where the caregivers knew NOT to fiddle with the infant foreskin or forcibly retract.

– UTI are treated with antibiotics in girls, who get far more of them. Why is a different radically invasive solution discussed for boys?

B) Cutting a child later is supposedly more risky.

– The odds of actually needing a circumcision later are vanishingly small.

– That extra risk is due to general anesthesia – which is required if the kid is old enough to kick and scream – but, wait LONG enough and the patient attains a maturity where he could be cut with a local anesthetic.

– The infant is often spared the risks of anesthesia at the cost of literally ENDURING TORTURE WITHOUT ANESTHESIA. Such early childhood trauma has been shown to correlate with negative effects on the psyche and interfere with breastfeeding and bonding.

C) Cutting later is supposedly more complicated and expensive.

– This is extremely offensive. It’s more expensive only because nothing could be cheaper than the violent simplistic haphazard methods tolerated for infants. The foreskin is brutally torn from the glans before cutting can commence, and sutures are rarely used to ensure a predictable result. If cutters took care to do the job right (impossible because the foreskin is fused to the glans at birth) it could cost just as much or more to cut a baby as it does to cut an adult. Of course doing the job “right” would also include finding out how much healthy normal slack skin the patient would like to keep.

– In fact the adult method of circumcision by PrepEx is FAR CHEAPER AND EASIER than infant circumcision, in part because the adult foreskin does not need to be violently torn from the glans. The adult can care for himself during recovery (as opposed to recuperating with an open wound in a fouled diaper) and he can verbally report anything that doesn’t “feel” just right while healing.

D) The CDC reports that in 2010 no circumcision-related deaths were found.

– A casual scan of news headlines proves this false. For example baby Joshua Haskins died of blood loss within hours of his non-therapeutic hospital circumcision. Another baby died from circumcision-related infection that year. (Five seconds of Googling is all it takes to catch the CDC’s lie? Why lie?) In Brazil, where careful records are kept, they report about 1 death per 7500 circumcisions. If the US kept careful records instead of blaming circumcision deaths on other factors studies show the rate would be about 1 death per 10,000 procedures. Tell families that.

But infant death is indeed rare and not the reason hundreds of thousands of men who are enduring non-surgical (partial) foreskin restoration object to forced genital cutting. Circumcision alters sex dramatically when done “right,” and haphazard unintended effects of US infant circumcisions are common and far under-reported because the population of victims often has no basis for comparison, no idea of how an intact penis normally works. Nobody has a right to meddle with someone else’s life irreversibly at birth like that.

Medical ethics dictates that an intervention may be imposed by force if waiting for the patient’s own rational informed consent would lead to net harm and when less-destructive options have been exhausted. Circumcision of healthy children fails this test dramatically. CDC staff should ask themselves why no other allowed procedure violates medical ethics like that.

If routine circumcision were unheard of and someone proposed it today for the treatment or prevention of anything, that person would rightfully earn the scorn of all. People would say the costs, risks, ethics violations, and known losses are too great and there are other less-invasive ways to attain the same supposed benefits. They would say informed adults can decide for themselves.

-Ron Low
Northbrook, IL