CHHRP responds to the CDC

The Children’s Health & Human Rights Partnership is Canada’s premiere not-for-profit group of health care professionals and scholars devoted to protecting the genital health and human rights of Canada’s male, female, and intersex children. We realize that CDC recommendations can influence some Canadians and are pleased to provide public comment on your draft recommendations concerning male circumcision.

In Canada, the practice of infant circumcision was once as widespread as it is now in the U.S. For the past several decades, however, none of our provinces or private health plans pay for infant circumcision, since there is no medical necessity to perform surgery on a newborn male’s healthy penis. That’s why hospital circumcision rates here are less than 10%, compared to the U.S. national average of around 50%.

Like parents in most of the world, we don’t view our newborn sons’ genitals as being somehow defective and in need of immediate surgical improvement. We trust in our parental abilities to teach our children proper hygienic behaviours as well as adoption of safer sex practices to protect themselves from sexually transmitted infections, all while still enjoying intact genitals.

That’s why the vast majority of our intact boys and men do not suffer the laundry list of maladies described in your draft recommendations.

We invite you to review the attached report from the International NGO Council on Violence against Children (2012), which states, “…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” (p. 22). The report also notes, “The WHO review quoted three randomized controlled trials suggesting that circumcision reduces the risk of acquiring HIV infection in males. But this potential health benefit does not override a child?s right to give informed consent to the practice. The decision to undertake circumcision for these reasons can be deferred to a time where the risk is relevant and the child is old enough to choose and consent for himself” (p. 22).

Canadians are very much like Americans in many respects, except that Canada (like every other nation in the world except the U.S.) has ratified the U.N. Convention on the Rights of the Child. Article 24 of the Convention calls on signatory nations to protect their children from traditional practices prejudicial to their health and human rights. Infant circumcision exposes children to unnecessary risk and, by the CDC’s own admission, is a social custom and therefore a traditional practice covered in the Convention.

We call on the CDC to revise its recommendations that appear to condone the practice of infant circumcision and to include unequivocal language urging health professionals to reassure parents that the vast majority of intact men and boys do not suffer foreskin ailments and that in those rare occasions when a medical problem might arise during childhood, it can be conservatively treated medically, and only as a last resort surgically.

They can also offer reassurance that while parents are responsible for making a myriad of decisions on behalf of their child (vaccinations, nutrition, etc), circumcision is not one they need concern themselves with. Indeed, such an intimate personal decision is best left to each individual male to make when he is of an age to have his own reasons (if any), and to understand and give fully informed consent. To usurp such a decision is not within a parent’s responsibilities and is a violation of their child’s inherent human rights.

On behalf of the Board of Directors and Advisory Board,
Dr. Christopher Guest, MD, FRCPC
Copyright © 2016 Children’s Health & Human Rights Partnership