AAP 1984 – or how circumcision causes amnesia

As told by Steven Svoboda of Attorneys for the Rights of the Child, on October of 2013 there was a debate at the Medical University of South Carolina in Charleston, South Carolina, during which, Dr. Michael Brady MD, one of the 8 members of the American Academy of Pediatrics’ task force on circumcision responsible for the Policy Statement and Technical Report of 2012, declared: “I don’t think anybody knows the functions of the foreskin,” and then reiterated, “Nobody knows the functions of the foreskin.”

That is strange, because just 29 years earlier the American Academy of Pediatrics had a pamphlet discussing the “Care of the uncircumcised penis”, which included a brief discussion of some of the functions of the foreskin, and a drawing clearly showing the anatomy of the intact penis.

The first edition of this 1984 pamphlet had the word “uncircumcised” spelled incorrectly: “uncircumcized”. There was a second batch printed with this misspelling corrected, but then, when a new batch was printed in 1990, the paragraph about functions of the foreskin and the anatomical drawing suddenly went missing.

Ronald Goldman, Ph.D., of the Circumcision Resource Center, started inquiring about this curious omission on January of 1996. He contacted the AAP eight times about this change. After having been passed by four  AAP officials, he finally obtained this response in September of 1996:

The reviewers felt it was not necessary to reinstate the paragraph because the revision of the brochure included a complete reorganization of the information contained in previous editions.”

According to Dr. Goldman, a comparison of new and previous editions did not show “complete reorganization of the information” and there was no reason why the removed information would have stopped being relevant to parents.

In fact, the AAP still has a page on the “Care for an uncircumcised penis” on their website. It is not a bad page, although there are some things that could be a lot better, and the functions of the foreskin are still missing.

Perhaps if they had listened to Dr. Goldman in 1996, Dr. Brady would have been able to describe some functions of the foreskin when asked about them, during the 2013 debate.

So… what was that controversial paragraph?

The Function of the Foreskin: The glans at birth is delicate and easily irritated by urine and feces. The foreskin shields the glans; with circumcision this protection is lost. In such cases, the glans and especially the urinary opening (meatus) may become irritated or infected, causing ulcers, meatitis (inflammation of the meatus), and meatal stenosis (a narrowing of the urinary opening). Such problems virtually never occur in uncircumcised penises. The foreskin protects the glans throughout life.

This is the anatomical drawing, prepared by Edward Wallerstein (author of the 1980 book “Circumcision: An American Health Fallacy“), which was included in the pamphlet:

wallerstein

It is important to note that no anatomical drawings are included in the 2012 AAP Policy Statement and Technical Report on circumcision. The word “Frenulum” (or “frenum”) does not even appear in either document.

This is a scan of the 1984 pamphlet, as shared by Dr. Goldman (click to enlarge).

AAP1

AAP2

Given these obvious omissions, it seems hypocritical from the AAP to claim, as they do, that “It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.

Our conclusion is that perhaps circumcision causes amnesia. Selective amnesia. That, or they have a vested interest in maintaining high rates of circumcision for financial gain, but that would be dishonest, wouldn’t it?

Dr. Goldman’s discussion of the pamphlet: http://circumcision.org/pamphlet.htm

CIRP page mentioning this pamphlet: http://www.cirp.org/library/normal/aap/

CIRCUMSTITIONS discussion of this pamphlet: http://www.circumstitions.com/AAP-care.html

Attorneys for the Rights of the Child telling of the 2013 debate: http://www.arclaw.org/our-work/presentations/charleston-debate-marks-turning-point-movement-recognize-circumcision-human-r

AAP Current page: Care for an uncircumcised penis. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Care-for-an-Uncircumcised-Penis.aspx

 

 

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