VICTORIA, BRITISH COLUMBIA–(Sept. 9, 2015) – A just released policy on infant male circumcision by the Canadian Paediatric Society (CPS) was judged today by the Children’s Health & Human Rights Partnership (CHHRP) to be a step in the right direction, but was “nevertheless ‘predictably inadequate’ with respect to several specific issues.”
CHHRP Medical Director Dr. Christopher Guest, MD, FRCPC, said the new policy is consistent with international paediatric associations that affirm infant boys should not have their healthy foreskins routinely removed.
Citing the position of the CPS that recognizes the unique sensory functions of the male foreskin, Dr. Guest asserted that, “A growing number of medical associations now recognize that an intact penis with a foreskin contributes to sexual pleasure for the male and his partner.” According to Guest, in 2010 the Royal Dutch Medical Association concluded, “the foreskin is a complex erotogenic structure that plays an important role in the mechanical function of the penis during sexual acts.”
“Circumcision alters the structure of the penis, which inevitably alters function. Long term harm to men from infant circumcision has never been studied” Guest said. Despite this, Guest says men are reporting long-term adverse consequences at the Canadian-based online Global Survey of Circumcision Harm. Although the CPS failed to include it, Guest says scientific evidence has emerged that supports these men’s claims. In 2011, Dr. Morten Frisch published findings in the International Journal of Epidemiology showing that in Denmark, where circumcision is rare, ‘circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in their female partners, notably orgasm difficulties, dyspareunia [difficult or painful sexual intercourse] and a sense of incomplete needs fulfilment.’
Guest faulted the CPS for inclusion of “convenient untruths,” most notably a discussion of HIV being lower in circumcised men. He says such claims are based on methodologically weak African trials, which contradict global HIV trends, for example the United States, which has a high circumcision rate, yet a significantly higher rate of HIV infection than Sweden and Japan where circumcision is rare. “Even if the African trials were scientifically valid, they cannot be used to justify infant circumcision because infants are not sexually active persons,” he said. “Soap and water and safer sex practices, including condoms, can prevent disease.”
According to Guest, the CPS failed to include crucial information from a 2012 report by the International NGO Council on Violence Against Children, which CHHRP sent to the CPS in 2014. The report stated that “non-consensual, non-therapeutic circumcision of boys, whatever the circumstances, constitutes a gross violation of their rights, including the right to physical integrity, to freedom of thought and religion and to protection from physical and mental violence.”
“Medical associations in the Netherlands, Finland, Sweden, Norway, Denmark, Germany, and others confirm that there is no justification for circumcising infants in the absence of medical urgency,” Guest stated. “The CPS is out of step with those medical associations, who also urge an end to the practice due to ethical and human rights concerns.”
Although the CPS concluded that routine infant circumcision is not recommended, and that the benefits of the surgery do not outweigh the risks (contrary to a 2012 claim by the American Academy of Pediatrics), Guest contends that the position statement is still insufficient due to its ambiguity in leaving the decision up to parents. “Parents are not physicians. They do not have the medical knowledge to decide if surgery is medically indicated for their child,” Guest asserted. He went on to say that, “Leaving a decision about medically unnecessary surgery up to parents is an ethical failure on the CPS’ part. Where else in medicine do physicians place this burden on parents, in order to obviate their own professional responsibility?”
“Preservation of bodily integrity is a basic and universal human right that the CPS must articulate clearly in future statements,” Guest said. “We Canadians, as well as our institutions and government, have an obligation to protect that right for all citizens, regardless of gender or age.”
The Children’s Health & Human Rights Partnership was established in 2012 as a partnership of professionals in the fields of medicine, ethics, and law to further public education regarding non-therapeutic genital surgery on Canadian children.