New circumcision guidelines highlight controversial procedure
Dr. Andrea Goins agrees with the American Academy of Pediatrics’ new guidelines on male circumcision but said the decision is one each family must make after gathering as much information as possible.
“The benefits outweigh the risks,” Dr. Goins, a pediatrician at Children’s Hospital at Erlanger, said of the controversial procedure, echoing the new stance.
This week, leaders with the American Academy of Pediatrics released updated guidelines on the procedure.
Leaders stopped short of recommending the routine circumcision for males.
And the new guidelines stray from the organization's first position that the risks and benefits of male circumcision were equal, Goins said.
She reiterated the academy’s position that circumcision has health benefits, such as prevention of urinary tract infections in a male’s first year of life and a lowered risk of sexually transmitted diseases and penial cancer later in life.
But it’s a controversial topic, mainly because of the religious and ethical associations, Goins said.
“Some cultures and religious groups have very strong opinions one way on the other on it,” she said.
The Centers for Disease Control and Prevention reported in 2011 that, according to a National Hospital Discharge Survey, incidences of newborn male circumcision decreased from 62.5 percent in 1999 to 56.9 percent in 2008.
The Philadelphia Inquirer reported that opponents of the procedure—which involves removing the foreskin from the penis, usually when the male is a baby—say boys have the right to keep their foreskin and that circumcision is comparable to female genital mutilation.
Goins said the procedures aren’t equal because of anatomical differences in the body parts.
Most complications of circumcision in the United States are minor, such as minor bleeding and local infection, according to the CDC.
Another factor that contributes to whether parents decide to have a child circumcised is insurance.
According to a 1995 report, private insurance paid for 61 percent of circumcisions. Medicaid paid for 36 percent, and 3 percent were self-paid by the parents of the infant, according to the CDC.
That report also found that people were 2 1/2 times more likely to be circumcised if private insurance covered the procedure.
Since 1999, 16 states have eliminated Medicaid payments for the circumcisions that aren’t considered medically needed, according to the CDC.
BlueCross BlueShield of Tennessee does cover circumcision, spokeswoman Mary Danielson said via email.
“We are always researching and evaluating recommended medical procedures and drugs to determine the benefits to and safety for our members,” she said.
And Goins said the recent guidelines are meant to highlight the need for additional access to circumcision and more insurance coverage of the procedure.
Ultimately, the decision comes down to each parent's beliefs.
"My advice would be to look at the medical evidence and look at what we now know and take that into account with all the other belief systems that you have," she said.
Updated @ 8:27 a.m. on 08/30/12 for clarity.
