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Keeping Circumcision on the Table

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In early 2011 Beryl Lieff Benderly, writing in the pages of Miller-McCune (the precursor to Pacific Standard, described circumcision as a “surgical AIDS vaccine.” She described the stances of both the charmingly named “intactivists” who argued against circumcising male babies, and health officials who found dramatically higher rates of HIV infection among the uncut.

Her piece was built around a proposed city of San Francisco initiative that a judge ultimately struck from last November’s ballot after determining that health issues were the province of the state, not municipalities. A German court this summer this year ruled that circumcision based on religion and not a compelling medical reason amounted to “bodily harm,” and banned the practice in the Cologne area; predictable umbrage ensued. (Less predictably, the Bundespost intends to release a stamp showing a page from the New Testament that described Jesus’ circumcision. The commemorative, since you ask, was designed to honor the 200th anniversary of the German Bible Society.)

The argument over circumcision came to a head, so to speak, last week when the Archives of Pediatrics & Adolescent Medicine published a paper that reported lower rates of circumcision would mean more infections and thus greater health costs for both men and women, an alarming finding given that the U.S. male circumcision rate has fallen from 79 percent to 55 percent since 1992. Today, the American Academy of Pediatrics released new guidelines that backed availability of circumcision for baby boys. In a policy statement accompanying its guidelines, the organization said:

Benefits include significant reductions in the risk of urinary tract infection in the first year of life and, subsequently, in the risk of heterosexual acquisition of HIV and the transmission of other sexually transmitted infections. … Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.

Not quite the same as calling its a "surgical AIDS vaccine," but not that far off.