Male circumcision continues to be debated in America.
This spring ABC News tracked the war waged on the procedure in San Francisco as anti-circumcision “inactivitsts” attempted to ban infant circumcision altogether. This summer Colorado became the 19th state to defund Medicaid coverage for infant circumcision, following in the footsteps of South Carolina, which made the cut in February.
With more states considering defunding as a way to cut health care costs, two Johns Hopkins epidemiologists decided it was time to speak up for circumcision. In an editorial published today in the Journal of the American Medical Association, Dr. Aaron Tobian and Dr. Ronald Gray argue for the medical benefits of circumcising boys in infanthood, citing several observational studies and recent clinical trials that show it reduces the transmission of sexually transmitted diseases such as HIV, HPV and herpes by about a third in both men and their female sexual partners.
“This is a simple surgery that’s been performed for over 6,000 years. Clearly it’s safe to perform, and it has clear medical benefits,” says Tobian.
Just 20 years ago as many as 67 percent of all male infants born in U.S. hospitals were circumcised. Today, that number hovers around 32 percent, in part due to decreased funding for the poor and a rise in controversy over the ethics of the practice. Opponents claim circumcision is a form of genital mutilation without medical benefit.
“The foreskin is there for a reason,” Lloyd Schofield, who spearheaded the San Francisco anti-circumcision bill, told ABC News in May. Shofield called circumcision an “unnecessary surgery” with no “sound medical evidence” behind it.
Recent studies suggests otherwise, Gray and Tobian argue.
“The evidence for the long-term public health benefits of male circumcision has increased substantially during the past five years,” the authors write. “If a vaccine were available that reduced HIV risk by 60 percent, genital herpes risk by 30 percent, and HR-HPV risk by 35 percent,” as recent studies have shown, ”the medical community would rally behind the immunization.”
Tobian is among those who have reconsidered their views on circumcision in light of these recent studies, he says. Before his first child was born, in 2005, he and his wife had decided against circumcision, although when the child was a girl, the question became moot. When his son was born in 2008, however, there was no question in his mind that he would be circumcised.
Despite these recent studies, public opinion of circumcision has continued to waver as anti-circumcision “inactivists” continue to campaign, Tobian says.
“It’s like the anti-vaccine campaigns,” Tobian says. “The more vocal you are, the more press coverage, and people believe what people are yelling, despite what the medical evidence shows.”
The historically neutral stance on circumcision taken by the Centers for Disease Control and the American Academy of Pediatrics only bolsters opponents’ questioning of circumcision, he notes. This is why Tobian and Gray are calling for medical associations to review the recent evidence and reconsider their stance on male circumcision.