category of mutilation. The individuals proposing such legislation are being insensitive and ignoring cultural traditions which have been in place for centuries. — Michael Klein, MD When performed in a hospital, it is performed with the same standards required for other minor surgical procedures. Studies suggest benefits in protection from certain STIs, and I am not aware of any major side effects of the procedure. All this ballot initiative will do is increase costs of the procedure because now doctors will have to write a justification for doing it. — Olivia Kasirye, MD, Health Officer, El Dorado County Circumcision is not only an important cultural practice for many in San Francisco, but also has been shown to be protective against STIs, making it a potential tool for public health. — Katherine Crabtree, MSII My strongly-positive position on infant circumcision began in my Air Force tour when, once a week, a group of young men were lined up, given a general anesthetic (with attendant risks), and had an adult circumcision performed using incisions and sutures. Their post-op pain was intense. These men had phimosis or chronic/recurrent balanitis (about three percent of uncircumcised males have the latter). Particularly since the introduction of the PlastiBell, a careful, judiciously-performed circumcision the day after birth is a quick, minimally painful procedure to prevent the more dangerous and painful adult circumcision. In addition, there are the public health hazards of transmission of STDs, including HIV. Questions of decreased sensitivity are very debatable. — James Affleck, MD I came to the conclusion several years ago that routine circs are inappropriate. Since they are legal, it is hard to call the procedure child abuse. I’ve done over 1,000 circs in the past for which I feel a lot of remorse. About ten years ago I refused to do any more, and I speak aggressively against them if I’m asked. We at Kaiser still provide circs without charge if done within the first 30 days of life. I consider male circumcision, like female circumcision, to be genital mutilation. There is NO justification
for routine circumcision and I support the San Francisco initiative to ban them. — Maynard Johnston, MD What constitutes abuse is some of the actions that the people of San Francisco dream up from time to time. This is blatant anti-Semitism and if you weren’t convinced before, go online and view some of the stereotyping of Jews in this group’s advertising that is clearly reminiscent of Germany circa 1936. No exaggeration – view it yourself. — Steven Polansky, MD According to a 2007 report by the World Health Organization, 30 percent of males worldwide are circumcised. Circumcision is perhaps civilization’s oldest known surgery, with Egyptian wall carvings from 6000 years ago (predating Abraham) depicting the procedure. That’s a tough sell to me that a custom this steeped in history and religion can be abuse. And what’s with the double standard? From the amount of body piercings I see (and the ones I don’t see!) on SF folks, obviously they feel it is ok to mutilate the body after 18 years of age! — Nathan Hitzeman, MD Circumcision is a rite that has been practiced for millennia. It is inconceivable that Jews would not be able to circumcise their sons, nor others who do so on behalf of their children. — Richard Gray, MD First of all, it is another attempt to intrude government into medicine – this is a medical issue. I really resent anybody setting up rules for medicine; we need to do this. It reminds me of Berkeley passing an anti-shock treatment measure. Some have approached this as anti-Semitic – this is not a Jewish issue, but a medical one. There is no evidence that (it) is traumatic to young children. From a health standpoint – there is ample evidence that shows that circumcised males have lower HPV and their wives lower cervical Ca; it has also been shown in third-world countries that the incidence of AIDS is much lower in circumcised males. — James Margolis, MD I would want religious and cultural exceptions to this law. The circumcision of male infants is an important part of Jewish and
July/August 2011
According to a 2007 report by the World Health Organization, 30 percent of males worldwide are circumcised.
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