The AAP’s New Circumcision Policy
I sighed heavily at last week’s news that the American Association of Pediatrics (AAP) had changed its policy on routine neonatal circumcision. Nearly everyone expected the AAP to move away from its neutral stance and state that the health benefits of the procedure outweigh its medical risks. So it wasn’t the substance of the policy that made me sigh, although I wish that the AAP had at least remained neutral. Rather, it was the extent to which, although details change, the central arguments remain the same.
I have written a lot on this blog about how non-religious circumcision is no longer a medically-motivated phenomenon. Instead, it is a practice driven largely by social norms and a desire to make boys look like their fathers and peers. (If you want to read old posts, start with this one, which also explains some of the medical research behind the new policy.)
Because routine neonatal circumcision is mostly about conformity, I’ve previously questioned to what extent a new policy will actually change parental behavior. Circumcision rates in the United States have been declining for more than a decade; at present they hover just under 55 percent nationwide. But in some areas of the country, like the Pacific Northwest, less than 20 percent of male newborns are routinely circumcised. If conformity is what parents care about, I’m not sure that a new policy from the AAP will make much of a difference—at least in parts of the country where non-circumcision is the norm.
What should most worry non-circumcision advocates is the language in the new policy stating that third-party coverage of circumcision is warranted. Many experts partly attribute the low circumcision rates in the Pacific Northwest to decisions to remove the procedure from Medicaid funding in the 1980s and 1990s. If lack of insurance coverage helped launch the trend toward non-circumcision, a change in coverage may lead to a slow reversal in favor of circumcision.
Or maybe not. Once non-circumcision is the norm, will the AAP’s new policy—which states the health benefits of the procedure outweigh its risks, but also that the decision whether to circumcise should be left to parents—meaningfully change behavior? I doubt it, but I will be closely watching what happens in the Pacific Northwest to find out.