For the first time in more than a decade, the American Academy of Pediatrics has modified their stance on male circumcision, saying it may offer health benefits.
But, the group stopped short of recommending the procedure for all baby boys. So where does this leave parents?
When Maria Moser gave birth to her first baby boy she had a decision to make.
"Most people don't think of circumcision until they have their own child. They just don't think of it," said Moser.
After hours of research and discussion, Maria and her husband decided not to circumcise Jude or his little brother Blaize.
"We're talking about putting them through a very painful procedure with little to no anesthesia for no reason other than cosmetics, really," said Moser.
Maria says her sons should make the decision themselves. In the 1980s, almost 80 % of baby boys had their foreskin removed. Today - it's less than 55 %t. But Johns Hopkins doctor Aaron Tobian found this decline has increased health care costs by $2billion. He says studies show circumcision decreases risk for HIV, herpes, HPV, urinary track infections and penile cancer.
"The medical benefits of male circumcision are abundantly clear," said Aaron Tobian, MD, PhD, Assistant Professor of Pathology, Medicine and Epidemiology at Johns Hopkins University
But critics argue that much of the research on circumcision and STDs was conducted in Africa, among adult males. Two studies have also found circumcision might actually increase the risk of HIV. Then, there are the risks. Serious complications occur in about one in every 500 procedures.
"Parents should discuss with their physicians both the risks and benefits of male circumcision and then make their own choice based on the best interest of their child," said Dr. Tobian.
Maria is happy with her decision and believes her boys will be too
Last year, a circumcision ban made it on the ballot in San Francisco, but a judge ruled against including the measure. In the U.S., it is illegal to circumcise baby girls.
HISTORY: The practice of male circumcision goes back thousands of years. The earliest records of male circumcision date back to Egypt's sixth dynasty, with an image on a sarcophagus depicting males being circumcised before entering the priesthood.
Circumcision is also an important practice in Judaism that is linked to a covenant with God dating back to the time of Abraham. Muslims have also adhered to the ceremonial practice of circumcision for a long time. Circumcision is thought to be a rite of passage in some African and Oceanic societies. However, circumcision has also been used to identify and punish these groups, such as in Nazi Germany a man's circumcision status was often used to determine if he was to be sent to a concentration camp. During the Armenian genocide in 1915, Armenian men and boys were forcibly circumcised. Circumcision was banned in Bulgaria in the 1930's and then again in the 1980's because of its connotations with the earlier Turkish occupation of the country. Presently, circumcision remains a debatable topic in the United States. (Source: Peter Aggleton, Professor at the University of London)
RISKS & Benefits: Understanding the risks can help determine if circumcision is the right choice for you or your child. The risks of circumcision today are:
* The most common complications in the U.S. are minor bleeding and local infection. The majority of complications are minor and large studies of male circumcision in the U.S. have found inpatient complication rates between 0.2% and 2%.
There are also potential benefits of circumcision:
* Research has documented a decreased risk of HIV transmission for men who are circumcised, and another study discovered the risk of HIV transmission from a man to a woman is higher if the man is uncircumcised. This is thought because the inner mucosa of the foreskin has a higher density of target cells (Langerhan cells) for HIV infection than penile tissue.
* It is also believed that circumcision reduces a man's risk of syphilis, herpes, chlamydia, as well as other sexually transmitted diseases.
* Studies have found circumcision to be very cost-effective considering the number of infant UTIs, HIV infections, and other infections averted. (Source: The CDC)
For More Information, Contact:
David March, MHA
Senior Media Relations Representative/Assistant Director
Johns Hopkins Medicine