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Not exactly. The AAP has waffled for years, putting their thumb on the scales of every guideline to include a “cultural factor” to the cost- benefit analysis w

Not exactly. The AAP has waffled for years, putting their thumb on the scales of every guideline to include a “cultural factor” to the cost- benefit analysis which is literally “but people really want this for religious reasons.” They generally aimed for neutral, until the 2012 task force statement. Accordingly, if you look up their most recent position statement (2012) they headline with “benefits outweigh risks.” But if you go -into- the actual statement they phrase it more delicately: “ Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.” The benefits are sufficient to -still ask insurers to pay for it-. If health benefits -actually- outweighed risks, they’d recommend it for all infants routinely. Accordingly, they got raked over the coals by pediatric organizations outside the US, which aren’t accustomed to cosmetic circumcision: “ To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.” (https://pediatrics.aappublications.org/content/131/4/796?utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_TrendMD_0 https://pediatrics.aappublications.org/content/131/4/796?utm...)

RHSeeger 6y ago
I agree there's some room for argument as to whether it should be recommended or not, but - The headline includes "benefits outweigh risks" - The text notes that "the benefits of circumcision are sufficient to ... warrant third-party payment for circumcision of male newborns" I got downvoted to claiming they said "the benefits of circumcision outweigh the risks". I'm sorry, but... they do. Literally and unambiguously. Assuming you trust the AAP (which many Americans probably do), comparing it to FGM is patently absurd.
- arkades 6y ago
  Their statement for "third party payment" is industry jargon for "don't ban it," because Americans equate "uninsured service" with "unavailable service." Outside the headline, their strongest position is "don't make it unavailable." And what argument do they make for it? They trawled the data for things like reducing the transmission of HIV - which it does, in third-world country where condom usage is low, antiretroviral usage is low, pre-exposure prophylaxis is low. In first-world countries, circumcisions have not been shown to be protective, because in a setting with a higher baseline level of antiretroviral and condom usage, its effect is somewhere between negligible and non-existent. The AAP is writing recommendations for America, not the third world. Likewise, the reduction in cancers is a tiny effect. Small to begin with and, again, negligible in first-world countries. As other pediatric bodies outside the AAP noted, including these "benefits" is a reach, and the AAP got raked over the coals for doing so. So, no, not literally - the AAP made a strong political soundbite headline, and then walked it back in the text of their position paper, because they couldn't defend that headline. And certainly not unambiguously, when they were widely criticized for relying on weak studies that didn't apply to the population in question. The AAP isn't a terrible organization, but it's not immune to politics, and this shift in their official stance was political, not data-driven.
  - RHSeeger 6y ago
    I said > The American Academy of Pediatrics (AAP) says the benefits of circumcision outweigh the risks. You said > Not exactly. And then proceeded to write up why you believe they are wrong. I said > I agree there's some room for argument as to whether it should be recommended or not, but and > I'm sorry, but... they do. Literally and unambiguously. You replied, once again, indicating why you believe they are wrong. To be very clear here... 1. They do say the benefits outweigh the risks. Period. That they say this is a fact. 2. I'm not arguing they are right. I'm saying they say it and a lot of people value what they say. 3. I also think that comparing it to FGM is patently absurd, but that is completely orthogonal to your argument that they didn't say what they very clearly did.
    - arkades 6y ago

RHSeeger 6y ago

I agree there's some room for argument as to whether it should be recommended or not, but - The headline includes "benefits outweigh risks" - The text notes that "the benefits of circumcision are sufficient to ... warrant third-party payment for circumcision of male newborns" I got downvoted to claiming they said "the benefits of circumcision outweigh the risks". I'm sorry, but... they do. Literally and unambiguously. Assuming you trust the AAP (which many Americans probably do), comparing it to FGM is patently absurd.

arkades 6y ago
Their statement for "third party payment" is industry jargon for "don't ban it," because Americans equate "uninsured service" with "unavailable service." Outside the headline, their strongest position is "don't make it unavailable." And what argument do they make for it? They trawled the data for things like reducing the transmission of HIV - which it does, in third-world country where condom usage is low, antiretroviral usage is low, pre-exposure prophylaxis is low. In first-world countries, circumcisions have not been shown to be protective, because in a setting with a higher baseline level of antiretroviral and condom usage, its effect is somewhere between negligible and non-existent. The AAP is writing recommendations for America, not the third world. Likewise, the reduction in cancers is a tiny effect. Small to begin with and, again, negligible in first-world countries. As other pediatric bodies outside the AAP noted, including these "benefits" is a reach, and the AAP got raked over the coals for doing so. So, no, not literally - the AAP made a strong political soundbite headline, and then walked it back in the text of their position paper, because they couldn't defend that headline. And certainly not unambiguously, when they were widely criticized for relying on weak studies that didn't apply to the population in question. The AAP isn't a terrible organization, but it's not immune to politics, and this shift in their official stance was political, not data-driven.
- RHSeeger 6y ago
  I said > The American Academy of Pediatrics (AAP) says the benefits of circumcision outweigh the risks. You said > Not exactly. And then proceeded to write up why you believe they are wrong. I said > I agree there's some room for argument as to whether it should be recommended or not, but and > I'm sorry, but... they do. Literally and unambiguously. You replied, once again, indicating why you believe they are wrong. To be very clear here... 1. They do say the benefits outweigh the risks. Period. That they say this is a fact. 2. I'm not arguing they are right. I'm saying they say it and a lot of people value what they say. 3. I also think that comparing it to FGM is patently absurd, but that is completely orthogonal to your argument that they didn't say what they very clearly did.
  - arkades 6y ago