Except within the small Muslim and orthodox Jewish communities, people in Denmark wonder why on Earth any parents would want to have their precious newborn child held down to have a part of his healthy, yet immature, penis cut off. According to a nationally representative poll from the summer of 2016, 87% of Danes favor a legal ban on non-therapeutic circumcision of boys under the age of 18 years. So far, politicians have been hesitant, but increasingly willing to listen.
Doctors and medical organizations in Denmark, the other Nordic countries and, with one notable exception, elsewhere in the Western world agree that circumcision of healthy boys is ethically problematic. It is considered an operation seriously and patently at odds with the Hippocratic oath (”first do no harm”) and one that is in conflict with a variety of international conventions, most notably the U.N. Declaration of the Rights of the Child.
The one Western country that is out of sync with its international peers is the United States, whose federal health authorities and national associations of pediatricians, obstetricians, family physicians and urologists endorse and perform most of these medically unnecessary operations in the country. Amputation of healthy infant foreskins constitutes the single most common surgical procedure in the United States – a several hundred million dollars a year industry.
Internationally, several medical associations have issued policies and recommendations that contradict the popular belief in the United States that infant male circumcision is a harmless, health-promoting procedure. In fact, not one medical association in the whole world recommends circumcision of healthy boys.
In December of 2016, the Danish Medical Association published its revised policy on circumcision. Speaking on behalf of its 29,185 members, the new policy came out in an unusually clear voice. Its central passage goes like this (my unofficial translation):
“Circumcision of boys without a medical indication is ethically unacceptable when the procedure is carried out without informed consent from the person undergoing the surgery. Therefore, circumcision should not be performed before the boy is 18 years old and able to decide whether this is an operation he wants.”
Many Americans, who grew up in a culture whose medical authorities and mass media promote the view that an intact penis is dangerous, prone to infection, ugly and difficult to keep clean, may wonder what the penile health situation would be like in a country like Denmark, where few boys undergo circumcision. Of course, occasional intact men will encounter penile problems during their lifetime, just like people with natural teeth or appendices may develop cavities or appendicitis at some point later on. However, removing such healthy body parts on every child to prevent rare conditions in adulthood, that may be easily and effectively treated if and when they occur, is outright bad medical practice and ethics. So, why remove a healthy, functional and sensitive part of a child’s penis?
Indeed, a study published in Pediatrics in 2016 documented that only around one in 200 intact boys will develop a medical condition necessitating a circumcision before the age of 18 years. In other words, the chance is around 99.5% that a newborn boy can retain his valuable foreskin throughout infancy, childhood, and adolescence and enter adulthood with an intact penis. Simple information like this should urge parents to abstain from unnecessary infant surgery and let their sons decide for themselves about the size, sensitivity, functionality and appearance of their manhoods once they get old enough to understand the consequences.
In the fairytale “The Emperor’s New Clothes” by Danish author Hans Christian Andersen, a child too young to understand the desirability of keeping up the pretense that the emperor is wearing costly, elegant clothes when, in fact, he has nothing on, blurts out that the emperor is wearing nothing, and the cry is taken up by others. By speaking out frankly and without the usual diplomacy of such position papers, the Danish Medical Association impersonates that uncorrupted child shouting out against the falsehood, vanity and greed that has upheld the Empire of Circumcision for far too long.
In 2015, I urged U.S. parents to reconsider the moral acceptability of cutting a healthy, erogenous part off their sons’ penises. Now, at the beginning of 2017, I expand my call, and urge health professionals and payers, such as health insurers and Medicaid, to discourage circumcision of healthy boys and work to end the practice. No individual too young to provide informed consent to elective surgery should be subjected to an irreversible procedure that is painful, comes with risks, alters a natural, functional body part, has no relevant health benefits during childhood, causes pathological narrowing of the urethral opening in 5%-20% of boys, and – as stated by the Danish Medical Association – is ethically unacceptable.