Despite a series of reviews over the past few years aimed at containing costs and simplifying the system, there have been no significant changes to Medicare coverage of circumcision. The only changes have been to reduce the number codes (from four to two) and to make them unisex. This had had the unfortunate effect of making it impossible to calculate the number of circumcision procedures by age (thus obscuring the fact that the vast majority are of infants and young boys) and allowing circumcision of girls, as preciously documented on this site. The latest report from one of the working groups, the Urology Clinical Committee, has proposed no changes to the circumcision codes at all, except for the requirement for analgesia (pain control). This is a desirable reform, but a less important issue than the fact that Medicare will continue to fund non-therapeutic (medically unnecessary) circumcision, including circumcision desired for religious, cultural and other social/cosmetic reasons. This is contrary to the provisions of the Health Insurance Act and the Medicare guidelines, which state clearly that benefits are payable only for “clinically relevant” services – i.e. procedures for which there is a demonstrated medical need.
For further information, see detailed critique on this site.
Response by Australian Institute for Genital Autonomy
An article in The Conversation (UK) claims that there may be a correlation between neonatal circumcision (i.e. within the first month) and Sudden Infant Death Syndrome. SIDS or cot death is a poorly understood problem in which an apparently healthy baby suddenly stops breathing and dies in his sleep; it has been the subject of several awareness campaigns in Australia, notably the famous Red Noses. Surveying statistics in 15 countries, the author found that SIDS was more common in boys than girls, and less common among Hispanics (with a lower circumcision incidence) in the United States than in the general population. In previous research author suggested that the cause could be chronic stress, leading to increased blood pressure, heart rate and breathing. The author, Eran Elhaik, a lecturer in medical genomics at the University of Sheffield (UK), emphasises that at this stage the evidence is inconclusive and that no firm link has been shown; nonetheless, he suggests that there is sufficient smoke to warrant further research into the question. Our view is that the evidence of a link is extremely thin; and further that is not necessary to raise dangers of this kind as a reason not to circumcise: as we have always stressed, it is not up to critics of non-therapeutic circumcision to prove the harm, but up to advocates to prove the benefits; in the absence of firm proof as to significant net benefit (i.e. benefits exceed risks and harms to a significant degree), circumcision is a breach of the principles of both evidence-based medicine and bioethics.
Eran Elhaik. Neonatal circumcision could increase the risk of sudden infant death syndrome in babies – new research. The Conversation, 11 January 2019.
A contribution to Areo Magazine offers a well-informed account of the early history of circumcision and a moving personal story about how injured the author felt by what had been done to him. The author, Charles Strebor (Australian, living in Melbourne), writes: "I began restoring my foreskin over five years ago, as I was becoming increasingly dissatisfied with the way my penis looked and functioned. I have never been happy with the visible scar from the circumcision, which I could see when urinating, showering, having sex or merely being in the nude. As I grew older, my glans was becoming less sensitive due to the chafing that the foreskin would normally prevent." From the author's point of view, it was not only the physical damage that distressed him, but the absence of consent and the denial of his right to control his own body. Like thousands of men in the USA (and some in Australia) he is attempting to undo both kinds of damage by a slow and laborious process of stretching the remaining skin.
Charles Strebor. Because I was a Boy. A Personal Account of Foreskin Restoration. Areo Magazine, 8 February 2019.
[ Back to Top ]