Parents reconsider routine circumcision

When Sarah Altemus was expecting her first child, she had an important decision to make: Whether the baby should be circumcised if it was a boy.

For months, she and her husband grappled with the pros and cons before they decided to have their son circumcised.

"His father is circumcised, so we wanted him to look like his father," says Altemus, 27, of Jennersville, Pa. "Also, we knew friends who didn't circumcise their son and he felt so different from everyone else that he decided to have it done when he was in his teens."

Circumcision used to be a routine step in the birthing process, much like cutting the umbilical cord.

Advocates of the procedure point to research showing that circumcision lowers the risk of developing urinary tract infections and sexually transmitted diseases including AIDS.

But foes of removing the penis foreskin argue that the procedure provides minimal benefits, causes extreme pain and produces long-term psychological and sexual trauma.

"Circumcision violates every major tenet of medical practice, which is 'First, do no harm.' And secondly, modern medical ethics say parents do not have the right to ask for a medical procedure that is not in the best interest of their children," says Dr. Mark D. Reiss, retired physician and executive director of Doctors Opposing Circumcision in Seattle.

The American Academy of Pediatrics has maintained a fairly neutral policy since 1999, saying that while circumcision has some potential health benefits associated with it, the procedure isn't medically necessary. Since then, Medicaid programs in 16 states have stopped covering circumcisions.

Experts believe that the warm, moist area under the foreskin may be a breeding ground for infections, though they point out that lifestyle and hygiene have the biggest impact on health.

"These studies have generated enough thought and concern for us to say we need to go back and review our policy and to do that earlier than we had planned," says Dr. Jay Berkelhamer, president of the pediatrics academy.

Despite the lack of a clear medical mandate, the United States leads the world in circumcisions, although the numbers are trending downward. Thirty years ago, 90 percent of American newborn boys were circumcised. Currently, around 60 percent undergo the procedure, according to 1999 data from the National Hospital Discharge Survey. Worldwide, 85 percent of males are uncircumcised.