Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

Morten Frisch; Yves Aigrain; Vidmantas Barauskas; Ragnar Bjarnason; Su-Anna Boddy; Piotr Czauderna; Robert P E de Gier; Tom P V M de Jong; Günter Fasching; Willem Fetter; Manfred Gahr; Christian Graugaard; Gorm Greisen; Anna Gunnarsdottir; Wolfram Hartmann; Petr Havranek; Rowena Hitchcock; Simon Huddart; Staffan Janson; Poul Jaszczak; Christoph Kupferschmid; Tuija Lahdes-Vasama; Harry Lindahl; Noni MacDonald; Trond Markestad; Matis Märtson; Solveig Marianne Nordhov; Heikki Pälve; Aigars Petersons; Feargal Quinn; Niels Qvist; Thrainn Rosmundsson; Harri Saxen; Olle Söder; Maximilian Stehr; Volker C H von Loewenich; Johan Wallander; Rene Wijnen

doi:10.1542/peds.2012-2896

Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

Morten Frisch, Yves Aigrain, Vidmantas Barauskas, Ragnar Bjarnason, Su-Anna Boddy, Piotr Czauderna, Robert P E de Gier, Tom P V M de Jong, Günter Fasching, Willem Fetter, Manfred Gahr, Christian Graugaard, Gorm Greisen, Anna Gunnarsdottir, Wolfram Hartmann, Petr Havranek, Rowena Hitchcock, Simon Huddart, Staffan Janson, Poul JaszczakChristoph Kupferschmid, Tuija Lahdes-Vasama, Harry Lindahl, Noni MacDonald, Trond Markestad, Matis Märtson, Solveig Marianne Nordhov, Heikki Pälve, Aigars Petersons, Feargal Quinn, Niels Qvist, Thrainn Rosmundsson, Harri Saxen, Olle Söder, Maximilian Stehr, Volker C H von Loewenich, Johan Wallander, Rene Wijnen

Department of Clinical Medicine

74 Citations (Scopus)

Abstract

The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

Original language	English
Journal	Pediatrics
Volume	131
Issue number	4
Pages (from-to)	796-800
Number of pages	5
ISSN	0031-4005
DOIs	https://doi.org/10.1542/peds.2012-2896
Publication status	Published - Apr 2013

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https://pediatrics.aappublications.org/content/pediatrics/131/4/796.full.pdf

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Frisch, M., Aigrain, Y., Barauskas, V., Bjarnason, R., Boddy, S-A., Czauderna, P., de Gier, R. P. E., de Jong, T. P. V. M., Fasching, G., Fetter, W., Gahr, M., Graugaard, C., Greisen, G., Gunnarsdottir, A., Hartmann, W., Havranek, P., Hitchcock, R., Huddart, S., Janson, S., ... Wijnen, R. (2013). Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision. Pediatrics, 131(4), 796-800. https://doi.org/10.1542/peds.2012-2896

Frisch, M, Aigrain, Y, Barauskas, V, Bjarnason, R, Boddy, S-A, Czauderna, P, de Gier, RPE, de Jong, TPVM, Fasching, G, Fetter, W, Gahr, M, Graugaard, C, Greisen, G, Gunnarsdottir, A, Hartmann, W, Havranek, P, Hitchcock, R, Huddart, S, Janson, S, Jaszczak, P, Kupferschmid, C, Lahdes-Vasama, T, Lindahl, H, MacDonald, N, Markestad, T, Märtson, M, Nordhov, SM, Pälve, H, Petersons, A, Quinn, F, Qvist, N, Rosmundsson, T, Saxen, H, Söder, O, Stehr, M, von Loewenich, VCH, Wallander, J & Wijnen, R 2013, 'Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision', Pediatrics, vol. 131, no. 4, pp. 796-800. https://doi.org/10.1542/peds.2012-2896

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title = "Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision",

abstract = "The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.",

author = "Morten Frisch and Yves Aigrain and Vidmantas Barauskas and Ragnar Bjarnason and Su-Anna Boddy and Piotr Czauderna and {de Gier}, {Robert P E} and {de Jong}, {Tom P V M} and G{\"u}nter Fasching and Willem Fetter and Manfred Gahr and Christian Graugaard and Gorm Greisen and Anna Gunnarsdottir and Wolfram Hartmann and Petr Havranek and Rowena Hitchcock and Simon Huddart and Staffan Janson and Poul Jaszczak and Christoph Kupferschmid and Tuija Lahdes-Vasama and Harry Lindahl and Noni MacDonald and Trond Markestad and Matis M{\"a}rtson and Nordhov, {Solveig Marianne} and Heikki P{\"a}lve and Aigars Petersons and Feargal Quinn and Niels Qvist and Thrainn Rosmundsson and Harri Saxen and Olle S{\"o}der and Maximilian Stehr and {von Loewenich}, {Volker C H} and Johan Wallander and Rene Wijnen",

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AU - Aigrain, Yves

AU - Barauskas, Vidmantas

AU - Bjarnason, Ragnar

AU - Boddy, Su-Anna

AU - Czauderna, Piotr

AU - de Gier, Robert P E

AU - de Jong, Tom P V M

AU - Fasching, Günter

AU - Fetter, Willem

AU - Gahr, Manfred

AU - Graugaard, Christian

AU - Greisen, Gorm

AU - Gunnarsdottir, Anna

AU - Hartmann, Wolfram

AU - Havranek, Petr

AU - Hitchcock, Rowena

AU - Huddart, Simon

AU - Janson, Staffan

AU - Jaszczak, Poul

AU - Kupferschmid, Christoph

AU - Lahdes-Vasama, Tuija

AU - Lindahl, Harry

AU - MacDonald, Noni

AU - Markestad, Trond

AU - Märtson, Matis

AU - Nordhov, Solveig Marianne

AU - Pälve, Heikki

AU - Petersons, Aigars

AU - Quinn, Feargal

AU - Qvist, Niels

AU - Rosmundsson, Thrainn

AU - Saxen, Harri

AU - Söder, Olle

AU - Stehr, Maximilian

AU - von Loewenich, Volker C H

AU - Wallander, Johan

AU - Wijnen, Rene

PY - 2013/4

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N2 - The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

AB - The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

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DO - 10.1542/peds.2012-2896

M3 - Comment/debate

C2 - 23509170

SN - 0031-4005

VL - 131

SP - 796

EP - 800

JO - Pediatrics

JF - Pediatrics

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ER -

Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision

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