The XX Factor

Should the CDC Push Circumcision?

On the Daily Dish, Hanna waded into fearsome waters when she suggested that the reaction to the CDC’s consideration of promoting routine circumcision for babies in the United States has been hysterical. I generally find the anti-circumcision advocates to be on the crazy and rabid side, too. I have two circumcised boys, and I thought at the time that getting snipped bothered my kids a little more than their newborn vaccines and a little less than the spinal tap my older son had when he was a few days old. Plus, I’m prone to be defensive of this ancient Jewish carnal practice.

But on scientific grounds, I still think neutrality on circumcision is the way to go. Yes, the results of circumcising adult men in South Africa were stunning, in terms of HIV prevention. But as I wrote when those findings came out :

Circumcision is a lot trickier to implement widely than other preventive measures like vaccines. This is surgery, after all, which when done on adult men involves weeks of recovery. If the South African findings are borne out, says Seth Berkley, president of the International AIDS Vaccine Initiative, it may make sense to mount a public-health campaign to circumcise as many men as possible in places like South Africa where AIDS is rampant. But that says little about the United States, where the risk of contracting HIV is low for most people. Which is why the American circumcision debate probably will never be settled by science.

For babies, of course, there are no weeks of recovery (just ineradicable trauma, the antis would retort!) And so the CDC doctors who want to raise declining circumcision rates in the U.S. talk about this as one more “tool in the toolbox” of AIDS prevention. If it’s a harmless enough intervention, why not? That rationale works for me, personally. But I don’t think it really makes sense as medical policy. The CDC shouldn’t push circumcision on American parents who don’t want it until the agency has a better answer than, hey, it might help here, too - it just might.