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Circumcision evidence

Peggy Spear Contra Costa Times (Walnut Creek, Calif.)

Prince Charles is, but William and Harry aren’t. Jesus was, but Diego Rivera wasn’t. Louis XVI wasn’t, and that caused all kinds of problems with Marie Antoinette.

Circumcised, that is. And you can bet none of their parents went through the bewildering debate that faces parents today.

Here, in the 21st century, the most performed surgery in America is the subject of intense controversy and debate.

Some people say it’s a barbaric form of mutilation, medically unnecessary and extremely painful. Others say the simple operation is a lifesaver that helps stave off serious infections and even cancer and AIDS.

No matter what side of the circumcision issue you’re on, chances are if you have had a baby boy, you’re saying something — or at least hearing it.

“Circumcision is a very contentious subject,” says Dr. Edgar Schoen, the former head of pediatrics at Kaiser Oakland, Calif., whose new book “On Circumcision” is re-igniting the debate about circumcision. “After all, you’re talking about a subject that transcends psychology, medicine, religion and sex. It’s not merely a simple operation.”

Schoen, who lives in Point Richmond, Calif., is an outspoken proponent of performing infant male circumcision, and his new book is full of lively historical anecdotes and modern-day medical statistics that make the decision to have the operation performed seem like a no-brainer.

“Circumcision lowers the cases of urinary tract infection, cervical cancer and even AIDS,” he says. In fact, he lauds a recent report by French and South African researchers that found that male circumcision reduces by 70 percent the risk that men will contract HIV through intercourse with infected women.

Circumcision – the removal of the foreskin of the penis – became popular in the United States as a standard medical procedure around 1870. It was a way to curb many diseases, including syphilis. Some also claim that at the time it was used as a way to curb masturbation.

In America, however, circumcision rates have been on the decline since 2001. The National Hospital Discharge Survey says that only 55.9 percent of infant males left the hospital circumcised in 2003 (the last year data were available).

Schoen says those statistics are skewed, however, because they don’t take into account infants who have the surgery performed at a pediatrician’s office a few days after birth, or those who are circumcised in a religious ceremony.

Whatever the rate, many groups say it’s too high.

“There is no medical reason to put a child through that,” says Dan Bollinger, spokesman for the International Coalition for Genital Integrity. “Quite basically, it is a human rights violation.”

His and other groups, such as NOCIRC and Mothers Against Circumcision, as well as medical experts Penelope Leach, the late Dr. Benjamin Spock and Dr. Dean Edell claim the operation is unnecessary, especially in the United States. In fact, the United States is one of the only countries that has routine circumcisions of newborn boys.

Even the American Academy of Pediatrics says the “potential medical benefits” of infant circumcision aren’t significant enough to recommend it as a routine procedure. That alarms Schoen, who chaired the AAP’s task force on circumcision in the late 1980s.

“Once we started looking into all the research, it supported the medical benefits of circumcision,” he said. He believes the AAP’s lukewarm position on the procedure is “political,” since the group came out against circumcision in 1971, “and they don’t want to admit they made a mistake.”

In addition to all of the medical advantages he cites, Schoen says that there is another major reason he supports circumcision.

“It’s the American way,” he says. “Eighty percent of men in America are circumcised, and parents want their sons to look like their fathers.” He says most of the men and boys who aren’t circumcised are immigrants, children of immigrants, or from poor families who are not insured for the procedure.

Cultural differences played a huge role in the debate between Oakland mom Charlotte Axton and her husband, Brett Shellhammer, when their son, Raymond, was born three months ago. Axton, from the United Kingdom, did not favor circumcision.

“I feel that a baby is born the way nature intended, and I didn’t want anyone cutting my child,” he said.

Shellhammer, who is circumcised, disagreed, wanting his son to look like him.

“Things got pretty heated, but eventually, Brett realized that my feelings about it were stronger,” Axton says. “So we didn’t have Raymond circumcised.”

The social factor is a big reason Dr. Daniel Robbins of Lafayette, Calif.’s Lamorinda Pediatrics urges circumcision, and between 80 percent and 85 percent of infant boys in his practice have the operation.

“I suggest that boys be circumcised for two reasons,” he says. “Not only are there studies that say that it helps stop the spread of infectious diseases and urinary tract infections, but it’s what is socially acceptable here in the United States. And that’s very important, especially to young boys who don’t want to seem ‘different.’ “

The “social factor” doesn’t go far with anti-circumcision crusader Bollinger.

“It’s basic fear of not belonging,” he says. “And that’s not a good enough reason to mutilate someone.”

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