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Article: AAP to revise circumcision statement and release it in 6-12 months - Page 2

post #21 of 74
Thank you for this information. Dr. B should be getting my letter by week's end.

This makes me want to either or .
post #22 of 74


I will definitely be writing a letter.
post #23 of 74
You know the thing is even if the point blank came out against it people would still insist on having it done. Idiots, plain idiots. The sort of idiots who say 'my son didn't feel any pain.' Until doctors start living up to the 'do no harm' part of the deal and it's made illegal then they will continue to do it.

The AAP doesn't recommend it now, but that doesn't stop people.
post #24 of 74
I sincerely hope the AAP remembers that circ has not really helped much with the AIDS problem in America so far.
post #25 of 74
Logically, it wouldn't make any sense for them to recommend circumcision to prevent HIV (NO ONE would go out and tell their son "go out and have all the unsafe sex you want...you are circumcized".) Especially with this study and how many inconsistencies it has (and the debates that it has sparked) But of course, here in the US, NOTHING surprises me anymore in regards to what people will justify doing/having done to their babies for the sake of "tradition".

Sometimes I am so embarassed to live here. I am sure everyone in Europe thinks its just hilarious that Americans think circumcision is the big answer to HIV, while they are intact with much lower instances of HIV infection. I just hate to be associated with the country wide idiocy associated with circumcision here.

And anyone else think they will somehow "forget" to include all the info about sensitivity lost that has come out within the last year?
post #26 of 74
Quote:
I sincerely hope the AAP remembers that circ has not really helped much with the AIDS problem in America so far.
EXACTLY!!!!!!!!!!!!!!!!!!!!!!!!!!!
post #27 of 74
Ummm... if they do come out w/some "circ your kid so he doesn't get/spread AIDS" statement, wouldn't it still be smarter to come out with a "educate your son as a teenager on abstinance/safe sex/how STD's are spread?" It just seems akin to removing your daughter's cerevix so she doesn't get cervical cancer... there are other ways you can make babies these days, you know ......
post #28 of 74
Quote:
Originally Posted by gridley13 View Post
I sincerely hope the AAP remembers that circ has not really helped much with the AIDS problem in America so far.
True, but, playing devil's advocate here.......

In the U.S., the majority of men who have AIDS got it from homosexual sex and/or drug use, so the circ status may not really apply as much to the current AIDS statistics.


Frankly Speaking, who used to be a very active member here and is now on another pro-intact board I visit, said that the AAP won't listen to what we have to say, unfortunately. He said that there are some members of the AAP board who are of a religious persuasion that would make them more likely to recommend circumcision.

BUT he said that circumcision is doing a free-fall in this country and will continue to do so, even if the AAP recommends it. I hope he's right on that one. Unfortunately I'm not so sure.
post #29 of 74
I agree that there may be physicians with vested interests or ingrained pro-circ attitudes for religious reasons, but even then, recommending routine circumcision of infants for medical reasons should be a conflict (if the information isn't there to back it up.) I guess they could want to strengthen the prevalence of circumcision or reasons that non-religious people circ, so that the culture supports it and there is less chance of legislation against it, which would be problematic for some religions. But when it comes down to information on which they base their policy statements, I'd have to say it would be really bad to make recommendations if that (protecting the religious right by perpetuating the cultural practice) is the goal. (I'm just writing in response to Frankly Speaking's thoughts.)

Bottom line, I feel fearful and annoyed and upset, but I have to feel that the studies, the problems with them, the logic (or lack of) that others point out about the STDs issue where infants are concerned, and the FACT of the sensitivity study all are worth presenting to them. I figure, if people are pointing out that they know of these factors and expect any AAP task force to consider them, won't it make it harder to ignore? I feel skeptical and fearful and still would be nervous to read the new statement, but absolutely have faith that pointing out the facts (in a letter) is an action that has some merit and worth.

In fact, when I first heard last month that the AAP was intending to review and possibly revise their policy statement, I automatically thought "Whoo boy, here comes the recommendation against ROUTINE circumcision of newborn males because of the concrete info in the sensitivity study." Then I read that the studies that were making them revisit the issue were the AIDS/HIV stuff....and got nervous.
post #30 of 74
I posted this on the News & Current Events thread (linking to article on circ rate falling) this morning, but all the while intended to come here and see about AAP contact info, Task Force On Circumcision info, etc. Anyway, here it is:



I had seen articles mentioning that the AAP is reviewing its policy statement in light of "recent studies" and the HIV/AIDS study was mentioned, but I had assumed that the penile sensitivity study published in the British Journal of Urology, in Spring 2007, would be one of those "recent studies" reviewed, too. Especially since the current AAP policy statement DOES reference the issue of differences in sensitivity (limiting the comment to mentioning "anecdotal reports," then going right on to mention the Masters & Johnson study noting "no difference in exteroceptive and light tactile discrimination on the ventral or dorsal surfaces of the glans penis between circumcised and uncircumcised men.")

In another portion of the existing policy statement, they do acknowledge that keratinization (which is going to affect sensitivity, no matter what) occurs "on the skin of the penile shaft but not on the mucosal surface of the foreskin. One study suggests that there may be a concentration of specialized sensory cells in specific ridged areas of the foreskin but not in the skin of the penile shaft." Of course, they stop short of spelling it out any further, but that's there.

I had assumed, when I heard about the plans to review the statement, that the results of the recent sensitivity study would be considered and would be part of the new statement (especially since the current one already drops the "Masters & Johnson" name, and the results of the new study are verifiable and can be duplicated...) And I'd assumed that the flaws in the study in Africa would be sufficient for them not to claim that the results are somehow compelling.

For that matter, I'd thought that the now certain and quantified loss would necessarily trump ANY of the potential benefits suggested by circumcision, especially when the very slight rate of "potential protection" is considered. (As in penile cancer, UTIs, etc.) I mean, in the face of "do no harm," it would SEEM obvious that the reviewing physicians would (whatever their personal wishes or preferences are) realize that. Of course, I guess there's no guarantee that they're going to consider the BJU's published study. Maybe some letter-writing to the AAP's task force on circumcision is in order for people who care?
post #31 of 74
So, I'm totally up for writing a letter about why I believe the HIV/AIDS study is flawed (I will need info about responses in other countries and whatever stuff has "officially" debunked it, the whole condom use thing???) and will make the point that in the face of KNOWN, DEMONSTRATABLE, PROVEN loss of sexual sensititivity, "potential medical benefits" are not sufficient to recommend a procedure that we now know will lessen the sexual sensitivity of our sons.

Beyond that, I am sending the results of the study, the abstract, and the charts/graphs to my doctor's office. And making the point that this is new information, and I think it should be part of the information they give to expectant parents when they are "informing" them about the surgery. Would it be worth sending it to the hospital, as well? They do lots of births, but not sure if that last minute point is going to be effective, or who would be handing out the info. But they do have wall caddies with tons of birth/health/doula/etc. information...
post #32 of 74
Here we go again. Does anyone else remember the UTI craziness starting in the late 80's? It was still in the air when my first son was born, and almost (but not a whole lot) had me considering circ during my first pregnancy.

I had the impression that the UTI business was responsible for leveling off the then-declining neonatal circ rate, or increasing it in some areas. Of course, over time it blew over.

I still fail to fathom just what comparison can be made between conditions in central Africa and the average boy in Topeka or Tampa. People just don't get it.

Marnie
post #33 of 74
Quote:
Originally Posted by A&A View Post
Frankly Speaking, who used to be a very active member here and is now on another pro-intact board I visit, said that the AAP won't listen to what we have to say, unfortunately. ....
Here is a link on evidence-based medicine. http://en.wikipedia.org/wiki/Evidence-based_medicine

Double blind controlled studies are not possible because (DUH) the patient will notice if they have been circed or not.

We are (unfortunately) at the bottom of the list for "quality of evidence" Our claims are that:
* many complications happen that are not reported (if this happened to your child, be sure to write!) This goes to the "number to treat" IF they need to circ (putatively) 10,000 babies to prevent 1 HIV infection and 100 urinary tract infections. BUT if those 10,000 circs resulted in 1,000 cases of meatal stenosis and 500 buries penises (resulting in 2 suicides) then the harm outweighs the benefit.
* practitioners are not using adequate pain relief
* practitioners are not providing proper informed consent


Unfortunately, the AAP may be concerned about the liability exposure of all of the peds out there who have done circs in the past. IF they say circ is no longer recommended/suggested/ethical, then it will be easier for docs to be sued over what they have done in the past. Sound crazy? : Look at the American Dental Association's stance on amalgam. It is all about liability.
post #34 of 74
Quote:
Originally Posted by A&A View Post
BUT he said that circumcision is doing a free-fall in this country and will continue to do so, even if the AAP recommends it. I hope he's right on that one. Unfortunately I'm not so sure.

I agree. It's societal pressure, rather than medical considerations, which leads most people to circumcise now. If we succeed in changing America's perception of MGM--if we continue to insist that this is a human rights violation, a cultural perversion, and a form of child abuse--then the rates will continue to fall.

Consider this: About 90% of today's American dads are circumcised, yet only
about 50% of their sons are getting circumcised. In 20-30 years, we'll have nearly half of all dads being intact. Naturally, most of them will leave their sons whole, and if the trends contunue, a good percentage of the circumcised dads will leave their sons intact too. It's likely that when our grandchildren are born, US circumcision rates will look more like Canada's.
post #35 of 74
Quote:
Originally Posted by A&A View Post
True, but, playing devil's advocate here.......

In the U.S., the majority of men who have AIDS got it from homosexual sex and/or drug use, so the circ status may not really apply as much to the current AIDS statistics.


Frankly Speaking, who used to be a very active member here and is now on another pro-intact board I visit, said that the AAP won't listen to what we have to say, unfortunately. He said that there are some members of the AAP board who are of a religious persuasion that would make them more likely to recommend circumcision.

BUT he said that circumcision is doing a free-fall in this country and will continue to do so, even if the AAP recommends it. I hope he's right on that one. Unfortunately I'm not so sure.
I disagree that circ will continue to freefall if the AAP recommends it.

Remember that at one point everyone excepts Jews and Muslims in America were intact. Then "medicine" stepped in and said it was cleaner and healthier. If the AAP got behind that we'd be in trouble.

The AAP at the very least, HAS to keep a neutral stance.
post #36 of 74
I really can't afford airmail ATM, but could somebody(ies) else please cover me and write to that guy about the sensitivity studies?

This is really vital.
post #37 of 74
I do think letter-writing is helpful, particularly from a medical/scientific standpoint, although my gut feeling is that the AAP is just going to fence-sit on the issue again in a revised statement. I predict they add in another sentence about potential HIV prevention in African studies and then finish the statement up with the whole wishy-washy "there are benefits and drawbacks... take into consideration cultural and religious beliefs, etc., etc., etc." IMO, they don't want to rock the boat either way. Also notice that the AAP has been quoted in recent articles as listing decreased penile sensitivity as a drawback to circumcision (check out this week's circumcision rates articles on MSNBC and you should see it in the box). I'd like to see that fact end up in their revised statement, too.
post #38 of 74
K I really suck at being articulate when it comes to this subject. Would someone please shair a letter they are writing covering not only the HIV thing but senitivity studies so that I can have it to go by??
post #39 of 74
Thread Starter 
I havent written yet, but mine might look something like this:

Dr Sir,

I recently read that the AAP is currently beginning the process of revising its position on routine infant circumcision. By reports I have read in the media, it seems that this revision is being spurred by the HIV/AIDS studies. I ask that the AAP also consider new research concerning loss of penile sensation resulting from circumcision.

(insert where the study can be found- also write out citation- I may also look for that other study that came out at the same time about men in Korea who were circed as adults and the loss of sensation and "worse sex life" after circumcision)

In addition, a recent article in a Canadian pediatric journal tells about the death of a male infant from infection through his circumcision site. (again, citation and link). Given the increased dangers of drug resistant bacteria, I would hope the AAP considers taking a firmer stance on the risks of circumcision and points out the increased dangers of infection for infants. That very same article out of Canada calls on the medical community to re-examine infant circumcision risks in light of this boy's death.

[not sure how to end it or what else to say!]



Ok, that's a rough idea of what I'm thinking of saying.
post #40 of 74
It is really important that if your partner or child has complications from circ, that you write to them. I expect letters like the example below may have more weight than non-medical people reminding them of articles they have already read and ignored.

Example:
Quote:
"I am concerned that complications from this procedure are under-reported. My son was circed at 3 days of age, in 1996, at a hospital in xxxx. He has the following problems....."
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