Dr. Anthony Chin is severely biased on circumcision

Anthony Chin, MD

Anthony Chin, MD

U.S. News Healthcare published an article (“Circumcision: Why it May Be as Important as Vaccines to Your Child’s Health“) by one Anthony Chin, MD, pediatric surgeon and director of surgical critical care at Children’s Hospital of Chicago. This article is so biased and willfully blind to facts that it is not even worth the cost of the pixels used to display it on your screen.

The author claims that science is clear, that circumcision is a matter of good medicine and smart prevention. I don’t know of any other kinds of “prevention” that remove normal parts of the body without taking into consideration the wishes of the patient, particularly when there is no reason to expect any major pathology of said part (i.e. genetic reasons, preexisting symptoms, etc).

The doctor claims that as physicians “we must respect [the family's] choice“. But, why? What other reductive surgeries are performed for “family’s choice” and -again- without consideration to the wishes of the actual real patient?

He then says “we have a professional obligation to educate parents and help them make as informed and as safe as call as possible“. Well, if one is to educate a parent on the removal of the foreskin, one should be willing and able to discuss what the foreskin is and what it does. And this doctor fails at that, as we will see.

Just to compare, a recent policy for labiaplasties on teenagers, by the American College of Physicians and Pediatricians, recommends appropriate counseling, screening for body dysmorphic disorder, and recommends that the obstetrician-gynecologist be ready to discuss normal sexual development, wide variability in appearance of genitalia, nonsurgical treatment options and autonomous decision making. None of this basic elements is discussed when it comes to circumcising male children.

Then, to support the “science behind an ancient ritual“, he tells us that studies indicate that circumcised males have fewer urinary tract infections. Of course he omits that this UTIs are rare, that the “protective” effect applies only to the first year of life -while circumcision is for life-, that UTIs are generally easy to treat, that with the exception of the first year of life females have more UTIs than males and we don’t perform surgery on them, and that over 100 circumcisions have to be performed to prevent a single UTI -which again, would be easy to treat. So it is hardly proportional to what it is supposed to prevent.

He then says that circumcised males have a lower risk for sexually acquiring and transmitting certain infections. While some studies show a reduced incidence of some STDs on circumcised males, there are far more factors than the presence or absence of foreskin, such as appropriate sexual education, safe sex practices, and the specific risk groups and behaviors the individual moves in, which is why anyone promoting circumcision for STD prevention without educating on safe sex is actually endangering people. Anyone, circumcised or not, can contract an STD. Many STDs are transmitted in the semen, so circumcised or not, an infected male will transmit the STD unless a proper barrier is used.

The next predictable claim is the infamous 60% risk reduction of contracting HIV. As always, he misses the fact that this applies only to female to male transmission through unprotected penetration, that this does not apply to males who have sex with males, to unprotected oral or anal sex, or to any non-sexual form of HIV transmission. Besides, there are numerous questions about the methodology used in the African trials and about their significance in non sub-Saharan environments.

He then tells us that “the biological mechanism behind the protective effect is not entirely clear“. Well, after about 150 years of “medical” circumcision in the United States, something as simple as this is still not clear? He goes on to repeat a biological feasibility that has not been demonstrated, meaning that it is nothing but speculation.

The one good point is the acknowlegding that circumcision is no “silver bullet“, no “replacementĀ  for practicing safe sex” etc.

Then he goes on to try to dispell some “myths” about circumcision.

The first “myth” of course is that circumcision interferes with penile sensitivity. He calls it pernicious and persistence, and says research has found that it doesn’t. I wish that was the case. For one, the 2007 study by Sorrells showed that the foreskin is the most sensitive part of the penis to soft touch. A 2016 study and thesis by Jennifer Bossio that tried to contradict Sorrells actually corroborated it – even if the author then failed to recognize it. She did write that the foreskin was significantly more sensitive to touch stimulus.

Besides, it’s simply logic. If the foreskin is alive, if it is any sensitive, removing it by definition removes any amount of sensitivity provided by the foreskin. Thus, there is a loss in sensitivity no matter what.

His second myth is that only newborns can get circumcised. He claims that the optimal time is before 3 months of age (when the individual is not competent yet so cannot refuse – ethical issue), but that children and even adults can be circumcised safely. Then he says some families “choose to defer circumcision until a child is older and can decide for himself” but he cautions these families that “circumcision later in life tends to be more emotionally scarring“. Interesting that he cautions families AGAINST respecting the individual’sĀ  bodily autonomy. Did he even consider what he was writing?

The third “myth” is that circumcision can damage the penis. His first sentence is that “circumcisions can go bad, but they very rarely do“. But since they do, then myth has not been dispelled. How many lives does your child has? How many penises can he afford to lose? There are frequent case reports of partial and total amputations. Unsightly scarring, skin bridges, loss of too much tissue, re-circumcisions, all these happen and frequently. Dr. Chin then provides us with an optimistic rate of complications of “fewer than half percent of newborn circumcisions” developing complications. Well, 0.5% applied to 1.2 million newborn circumcisions in the United States every year amounts to 6,000 babies experiencing complications from a surgery that they didn’t need. I wouldn’t qualify that number as small. At least 2 or 3 die each year, per official estimates – some estimate a lot more. Imagine a room large enough to host 6,000 babies with complications from their circumcision.

One of the most common complications is meatal stenosis, and this is not even factored into that “half percent“.

He says that circumcision is “safe, inexpensive and relatively simple” and that it can “protect individual health, alleviate collective suffering and curb health care costs reducing the number of preventable infections“. What about the preventable complications? The preventable deaths? What is the cost of 1.2 million circumcisions? What is the cost of providing proper sexual education? What is the cost of treating 6,000 baby boys with complications, some requiring transfussions, some requiring additional surgeries…

What about the cost of violating the bodily autonomy and genital integrity of 1.2 million baby boys every year?

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