The cultural and religious ritual of male circumcision has been practiced for thousands of years. Circumcision as a medical procedure arose in Britain and the United States in the late 19th century. The historical medical benefits of neonatal circumcision have included ease of genital hygiene, diminished risk of disease and avoidance of circumcision later in life. In the middle of the last century, most Canadian boys were circumcised. However, the rate of neonatal circumcision has declined over time to the current Canadian average of 32%, with significant regional variability.
· The Canadian Paediatric Society (CPS) published a position statement in 1996 stating that circumcision was not recommended as a routine procedure for male newborns because the benefits and harms were evenly balanced. A similar viewpoint was expressed by the American Academy of Pediatrics (AAP) in 1999 and reaffirmed in 2005.
· More recent evidence regarding the beneficial role of male circumcision in preventing urinary tract infection (UTI) in infancy and some sexually transmitted diseases (STIs) in adult life has prompted the CPS to review the current medical information on the circumcision of newborn males.
· Male circumcision rates vary widely by region due to tradition, religion and standard practise. Many countries (Europe, India, China, SE Asia, Japan, South America and Mexico) have rates below 20%. Africa and the Middle East have rates from 80-100%. The USA has rates ranging from 40% in the western states to above 70% in the Midwest with an average of 58.5% in 2010.
1. What factors have influenced your attitudes and might be considered biases?
2. What are factors for and against that can be taken into account by parents making this decision? By governments thinking about intervention? Are they all “legitimate”?
3. How do we balance a parent’s duty to make decisions for their infant children and the child’s right to body autonomy, to choose and to be protected from harm?
4. Denmark, Sweden, Germany and more recently Iceland have passed into law, limitations on non-medical male circumcisions. Should Canada pass similar limitations? Would Canada’s Charter of Rights & Freedoms and Constitution prevent similar limitations?
5. Would passing limitations represent an indirect form of anti-Semitism or anti-Muslimism?
6. Does allowing non-medical male circumcision provide cover for proponents of female circumcision? Is there hypocrisy in maintaining this sex-based distinction?