To snip, or not to snip

In 2012, the American Academy of Pediatrics published a statement regarding newborn male circumcision. The statement made more than a few waves - both in the medical community and beyond. The statement has been published, re-published, agonized over and interpreted down to the letter.

The statement is more or less summarized by the following sentence, taken directly from the AAP website:

Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. 

Since then, researchers have been cranking out piles of literature. A very large cohort of European scientists were quick to publish this review after the statement had been published, calling attention to some of the weaker statistics and pointing out what they identified as cultural bias. The debate rages on two years later, with the New York Times publishing this blog post recently, in response to a recent paper in the Mayo Clinic Proceedings.

And so the question remains; to snip, or not to snip?

When I first came across the AAP Statement, my interpretation was (I believe) similar to that of the masses; that this was the AAP's way of subtly recommending newborn male circumcision. But the more I thought about it, I realized that this was not necessarily the case.

The AAP had been decidedly neutral on newborn male circumcision prior to 2012, and America saw a steady decline in newborn circumcision rates. Health insurance companies took note of this. As important as health insurance is, companies will not waste a second to cease coverage if a procedure is not deemed to be medically necessary.

The above statement may or may not provide sufficient evidence in favor of newborn male circumcision. But it undoubtedly provides evidence for the continuation of health insurance coverage of the procedure. In publishing their statement, the AAP is not so much saying that individuals should circumcise their children as they are protecting the individual's ability to do so without breaking the bank.

What do I think? Well, I've done quite a bit of research, and have given it a lot of thought. I haven't been practicing long, and as a Pediatric Nurse Practitioner I don't know much about the long-term sexual effects of the procedure. But in terms of medical complications, I have seen far more in individuals with in-tact foreskins than I have in individuals without foreskins. I have not noticed any significant difference in breastfeeding or maternal bonding, and the literature seems to agree with me. So as for now, my vote is for the snip.