What the Doctor Orders 

Given the recent findings that suggest circumcision dramatically reduces the chances of getting HIV, do you recommend that a newborn boy be circumcised or not?

We have a policy statement. It was first written in the late ’ 90s and is reviewed every three years. It was reaffirmed twice. We came out, after looking at all the evidence and research, the American Academy of Pediatrics came out and said there is some indication that kids who are uncircumcised have increased rates of sexually transmitted diseases. Ultimately, though, we think parents need to be informed and make the decision of what’s best for their child.

Because of the paper in Pediatrics about the increased risk of STDs in uncircumcised males, we’re going to go back and look at not just that study, but all the evidence to see if we want to change that position.

For parents who have studied both sides of the issue and are still confused, can you give them advice?

I can’t speak from a personal point of view since I represent the Academy. But I will say the majority of people in the United States choose to have their children circumcised. That’s not the case worldwide.

It is recommended that if you do decide to circumcise your child, you do it when he is first born. If you’re not going to do it then but are still considering it, you should wait until the child is old enough to participate in the decision. … It seems to me that to understand what is being done, a child needs to be school age, at least 6 years old.

I’ve heard that the older the child is when he is circumcised, the more painful it is. Any truth to that?

We’ve gotten to the point where almost all procedures are painless. For a circumcision, local anesthesia is used and it can be done in the office.

What is the worst that can happen if the child is circumcised?

There can be complications (for example if the child has a bleeding disorder, if the procedure is done improperly, or if there is difficulty with healing) but that is rare. There is very little risk with this procedure.

Many people, especially in San Francisco, have organized, arguing against circumcision. They call it a form of mutilation and say it decreases sexual pleasure later in life. What do you think of this?

There are more activist type groups on the West Coast all together. … There is also a great deal of cultural diversity on the West Coast. The number of people coming from Mexico and other parts of South American cultures, coming from the Middle East and the Orient—with that cultural diversity … a much larger number of people are accustomed to not circumcising…

Circumcision does seem to create passion on both sides. It isn’t like people are indifferent. Some people say all children should get circumcised; others people say it’s a terrible mutilating ordeal. I’ve been practicing since 1967 and it’s always been a polarizing issue.