I am deeply conflicted about this report. Offhand, I don't believe the figures. Thus, I am disinclined to use them myself for any reason. I also doubted the WHO's figure of 30% circumcision a couple of years ago when every other reliable source was quoting from 15% to 25%. They inflate or deflate the numbers to suit whatever agenda they have.
I met with Dr. El Bcheraoui in Vienna, along with his colleague. He is a nice guy, a young doctor, who totally believes in the tremendous health benefits of circumcision. He says that he has no conflicts, which may be true in a professional sense; but he was circumcised at the age of 4 and says that he is eternally grateful to his parents for making a decision that improved his health for life. I spent more than half an hour talking to them both, and it was apparent that the CDC is on an irreversible trajectory to pronounce on the myriad health benefits and minimal risks of neonatal circumcision.
At the conference, the CDC was tossing around a figure of 43% current neonatal circumcision rate in the US. This report now uses a 33% figure. I doubted the higher number, and I really doubt the lower number. There is no question that the CDC is tremendously alarmed about the 16 states that do not fund routine infant circumcision through Medicaid. The CDC sees this as a public health emergency, compelling it to act. After they issue their recommendation, the CDC will lobby Congress and the CMS (Centers for Medicaid and Medicare Services). [They stressed this will not be a recommendation to circumcise, only a recommendation that: circumcision has important health benefits and few risks; should be affirmatively discussed with and offered to all parents of newborn boys; and should be equally available to all Americans by a level playing field of HMO coverage, health insurance coverage, and Medicaid coverage.] If the 16 renegade states do not act on their own to reinstate automatic infant circumcision on their own, the CDC may have to lobby Congress and HHS to attach a rider to federal Medicaid funding, stating that unless a state offers universal infant circumcision coverage to all Medicaid recipients, it will lose the rest of its federal Medicaid funding. I don't know how they plan to threaten the private plans, but all have enough federal ties that there must be some leverage there.
The CDC officials I spoke with said that circumcision proponents had been bombarding the CDC with exhortations to act for the past 2 years. The division that is gathering input and will issue a recommendation is the HIV/AIDS division. This is particularly ironic, because Robert Bailey, the lead researcher on one of the 3 African RCTs, told me just 2 weeks ago that it would be absurd to circumcise an American infant for HIV concerns.
Unfortunately, the division in question is solidly pro-circumcision. The CDC head is Thomas Frieden, the former NYC health commissioner, who repeatedly refers to "circumcised men" and "males who lack circumcision". The HIV/AIDS head is Peter Kilmarx, who has frequently mentioned the effectiveness of neonatal male circumcision. And below Kilmarx is Dr. Jason Reed, who spoke glowingly in Vienna of the excitement building as they ramp up to circumcise 38 million African adults & teens and all the neonates. He is one of the project directors.
Trust me, I did my best in Vienna. I cited chapter and verse the Dr. John Taylor published studies, the Sorrells sensitivity study, all of the research on complications (major and minor), the pain studies, and the overwhelming evidence about Europe's STI health vs. the United States. I carefully deconstructed the African RCTs and highlighted their weak points. I emphasized what a colossal waste of money mass circumcision programs are, when funding is urgently needed for cancer, Alzheimers, diabetes, HIV, etc. I cited several polls where intact men were overall happier to be intact than circumcised men were to be circumcised. And most profoundly, I drove home the point that NO studies have EVER demonstrated a measurable health benefits to the United States from its 100-year experiment with infant circumcision. It is a fad, a human rights violation and an egregious waste of precious healthcare dollars. And we all pay for it through taxes (to fund Medicaid) and higher insurance premiums.
All I got in response was, "We're going with the handful of studies we have." One CDC officer said that circumcision has been the topic of intense debate within his own family (as it is in many American families, but almost none in Europe or S. America), so he appreciated that there is controversy. But at the end of the day the CDC is science-driven, and apparently science favors circumcised penises -- or so they're prepared to say.
Bottom line: I think the 33% figure is bogus, though to some extent it reflects the undeniable US trend to rush mama and baby out of the hospital and schedule circumcision for a later date, sometimes out-of-pocket. Since traditionally our data sources come from hospital data, we may never know the real figures under current conditions. My guess is it's 60-70%.
And the CDC's ulterior motive for promulgating 33% is to sound an alarm.