Researchers: U.S. Circumcision Decline = Rises in STD Infections, Healthcare Costs

Researchers from Johns Hopkins University reported that newborn baby boys in the U.S. are less likely to get circumcised than in years past, which may leave them susceptible to sexually transmitted diseases and increase heath-care costs by billions of dollars, Bloomberg reported.

In 1980, 79 percent of baby boys were circumcised but now, only about 55 percent of the 2 million males born each year in the U.S. undergo the procedure, the Archives of Pediatrics & Adolescent Medicine report.

When a newborn male is circumcised, the foreskin from the tip of the penis is removed. Bacteria and viruses are said to gather in the foreskin and the removal of foreskin has been linked to fewer cases of HIV, herpes, genital warts and genital cancers for men and their sexual partners, the newspaper points out.

"If there were a vaccine that reduced HIV infection, genital herpes and warts, penile cancer, cervical cancer and bacterial vaginosis, it would be promoted as a game changing intervention, and all physicians would encourage their patients to get it," Aaron Tobian, a health epidemiologist and pathologist at Johns Hopkins and senior researcher on the study, said. "The difference is this is a surgery with very minor complications, and it also has a cultural tone to it."

Researchers say that there are 18 state Medicare programs that eliminated the coverage of circumcision and some private insurance agencies have done the same. This could increase the U.S. health-care costs by $4.4 billion, "if rates plunge in the next decade to levels seen in Europe," Bloomberg writes. Health economists at Johns Hopkins say that only 10 percent of boys are circumcised in Europe.

"All state Medicaid and private insurers should cover male circumcision and we should eliminate all of the current barriers," Tobian said. "Families should discuss the risks and benefits of the procedure with their physicians and decide what is best for them."

Arieen A. Leibowitz and Katherine Desmond from the University of California-Los Angeles' Center for HIV Identification, Prevention and Treatment Services, wrote that male circumcision will reduce lifetime treatment costs and "provide compelling arguments in favor of infant male circumcision." Medicaid covers two-fifths of all 4 million births each year in the U.S but if they were to cut the plans, only one in three newborn boys would get circumcised.

"Indeed, the groups that Medicaid covers are precisely those that experience the greatest prevalence of HIV and other STIs, which male circumcision can effectively avert," Leibowitz and Desmond wrote.

Circumcision, however, has become controversial. Many men -- especially many gay men -- equate male circumcision with the female genital mutilation still practiced in several African societies. They claim that the procedure is invasive, traumatic and reduces sensitivity.

An attempt to put an initiative to voters in San Francisco to ban the procedure became a flash point for groups for and against the procedure. Jews, for whom infant circumcision is one of the pillars of their religious practice, condemned the initiative. Several politicians joined them.

Many perceived a cartoon put out by one of the main proponents of the initiative showed a mohel, who performs ritual Jewish circumcision, as an evil baby abductor as anti-Semitic. A judge eventually ruled the initiative was not valid.

A German regional court in Cologne revived the debate earlier this summer when it ruled that infant circumcision was illegal. Jewish and Muslim groups rallied to fight the injunction. They were joined by Angela Merkel, who heads the German government.

"Freedom of religious practice is a very important legal right for us," Merkel's spokesman told the media.

"I do not want Germany to be the only country in the world where Jews cannot practice their rituals," Merkel reportedly said. "Otherwise we will become a laughingstock." Merkel also reportedly alluded to Germany's unfortunate history in relation to Jews in a conversation with leaders of her party that having Germany uniquely ban circumcisions.

A European Jewish newspaper reported that German diplomats were concerned that the ruling was proving "disastrous" to the country's image in light of its Nazi past. But secular groups rallied behind the verdict and called the operation inhumane.