The Social Construction of Scientific Knowledge: The New AAP Policy on Male Circumcision

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2 Responses

  1. Hugh Young says:

    Very interesting. I annotate the policy here .

    Its faults began well before the taskforce set the criteria of its literature search. It was a taskforce “on circumcision” and that was its focus and its goal. A taskforce “on infant male urogenital health” would have looked first at the foreskin in its context as a protective and later erogenous organ, an integral part of the male genitalia, then at what pathologies it is subject to and how they are best treated, with circumcision as a last resort, and cultural circumcision only as a medical curiosity.

    All of the taskforce were culturally biased towards circumcision, with probably not a foreskin-owner among them. One has said
    “I circumcised [my son] myself on my parents’ kitchen table on the eighth day of his life. But I did it for religious, not medical reasons. I did it because I had 3,000 years of ancestors looking over my shoulder.”

    So it is hardly surprising that everything in the policy is loaded towards circumcising, and pushing parents towards deciding to circumcise.

    Their literature search had some notable failures: it does not, for example, cite Taylor’s groundbreaking 1996 paper, “The prepuce: Specialized mucosa of the penis and its loss to circumcision” that details the structure of the highly innervated ridged band. While it does cite a study showing that “circumcision ablates [removes] the most sensitive part of the penis” and another reporting a marked worsening in overall sex life (6% better vs. 20% worse), it ignores both those findings. It dismisses major complications and death from circumcision because it did not find any statistical studies of them. It discusses the action of the Mogen circumcision clamp without mentioning that the clamp has caused too much of several boys’ penises to be cut off; lawsuits have driven the company out of business.

    Little surprise then, that they claim “benefits of circumcision outweigh the risks” when they never actually weighed them in any numerical way.

    In 2010, the AAP unveiled a new Female Genital Cutting policy in which it wanted to allow a token ritual nick to girls (“much less extensive than neonatal male genital cutting”) but the howls of protest made them back down within a month. It is now a month since it released its circumcision policy …

  2. Brother Kind says:

    Here’s the link to “The Circumcision of Benjamin”

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