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.

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7 Responses

  1. Brett Bellmore says:

    Ok, I’m puzzled: If the facts actually support circumcision, (And you don’t seem to be disputing that.) what’s the AAP supposed to do? Ignore the facts?

  2. Sarah Waldeck says:


    To be clear, I have never written that “the facts” support endorsing circumcision in the United States– although I’m not certain what “facts” you are referring to. Here’s what I’ve written most recently about the connection between HIV and circumcision, which is the primary relevant medical “fact” that prompted the shift in the AAP’s stance:

    “On the medical front, new data about HIV is the big development since the AAP last affirmed its neutral stance in 2005. Studies from Africa have found that circumcision reduces the risk of a man becoming infected from an HIV-positive female partner and the evidence on this front is strong enough that the World Health Organization has deemed circumcision “an important intervention to reduce the risk of heterosexually acquired HIV.” It is not clear, however, what impact circumcision has on HIV rates in the United States, because the health systems are vastly different and the disease spreads through different routes here than in Africa. Most significantly, there is little to no evidence that circumcision protects men who have sex with HIV-infected men and it is unclear whether a circumcised HIV-infected male is less likely to infect his healthy female partner.”

    My post today, however, is not a criticism of the AAP for changing its position. Rather my point is that–at least in some parts of the country–what the AAP says may make little difference.

  3. Brett Bellmore says:

    We can certainly agree with that much; People generally do not have their children circumcised, or not, for medical reasons, save at the margin.

  4. nidefatt says:

    I wasn’t circumcised but my father who was from Portland was. When I was 13 I briefly thought about doing it in order to fit in. Eventually I decided I could care less, partly motivated by claims from those who had had the procedure later in life, after having had sex, that sex was not as good afterward.

    Frankly, men are idiots, and just stating my reasoning out loud shames me a bit. If you’re getting AIDS when you have sex, you have bigger problems than the skin on the tip of your dick. The AAP is a joke, the scientific community, like the art community and every other group that doesn’t make money unless they can find a donor, is utterly corrupt. I have no doubt that this stupidity will have bad consequences that a more advanced age will laugh at. Humanity. Such a waste.

  5. Richard Scalper says:

    They brand men like a herd of cows. American men are such wimps to let their sons be subjected to this

    absurd surgery. If it were women tied down & cut, the Feminists would be howling all over the world.

    The male genitals are a cheap commodity. There is no argument too absurd for the circumcisers. They

    insult the appearance of the intact penis, claim that circumcision heals everything from body warts to

    HIV, and draw an illogical distinction between female & male genitals. Circumcision is the mark of a

    slave, not a free man.

    Top Ten Tortures Less Painful Than Circumcision

    10. Get waterboarded.
    9. Pull out your fingernails.
    8. Eat a pile of steaming bear crap.
    7. Skin yourself alive.
    6. Fall into a vat of molten iron.
    5. Get run over by a train.
    4. Go through a sausage grinder.
    3. Saw off your legs.
    2. Poke out your eyes.
    1. Go To Hell


  6. Christopher Sewell says:

    A circumcised penis is a crippled penis. That’s it in a nutshell. Done and dusted.