{"id":4711,"date":"2025-10-24T17:36:36","date_gmt":"2025-10-24T16:36:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4711"},"modified":"2025-11-12T17:10:50","modified_gmt":"2025-11-12T16:10:50","slug":"circumcision-and-autism-when-medical-institutions-not-conspiracy-theorists-undermine-trust","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/10\/24\/circumcision-and-autism-when-medical-institutions-not-conspiracy-theorists-undermine-trust\/","title":{"rendered":"Circumcision and autism? When medical institutions, not conspiracy theorists, undermine trust"},"content":{"rendered":"

By Max Buckler<\/p>\n

Headlines over the last two weeks featured a strange-sounding claim linking newborn circumcision to autism. Robert F. Kennedy Jr., the controversial US secretary of health and human services, claimed at a White House cabinet meeting that \u201c<\/span>two studies<\/span><\/a>\u201d show circumcised boys are twice as likely to develop autism or autism spectrum disorder (ASD), saying it was \u201chighly likely\u201d this was due to infants being given Tylenol (acetaminophen) for pain control following the procedure.\u00a0<\/span><\/p>\n

It was not immediately clear what studies he was referring to, but it is possible he had in mind a <\/span>2013 correlational study<\/span><\/a> by University of Massachusetts Lowell researchers Anne Z. Bauer and David Kriebel, which reported \u201c<\/span>a strong correlation between country-level (n\u2009=\u20099) autism\/ASD prevalence in males and a country\u2019s circumcision rate (r\u2009=\u20090.98).\u201d\u00a0<\/span><\/p>\n

The other may have been a <\/span>2015 study published in the <\/span>Journal of the Royal Society of Medicine<\/span><\/i><\/a> which found, using a large national dataset from Denmark, that \u201c<\/span>regardless of cultural background circumcised boys were more likely than intact boys to develop ASD before age 10 years (HR\u2009=\u20091.46; 95% CI: 1.11\u20131.93) [with a] particularly high [risk] for infantile autism before age five years (HR\u2009=\u20092.06; 95% CI: 1.36\u20133.13).\u201d<\/span>\u00a0<\/span><\/p>\n

The authors of both papers acknowledge that these findings are preliminary and based on correlations: they don\u2019t prove causation, as various fact checkers and medical experts were also <\/span>quick to point out<\/span><\/a>.\u00a0<\/span><\/p>\n

Medical authorities are right to push back on Kennedy\u2019s misleading assertions about circumcision, Tylenol, and autism. Even so, in their rush to counter Kennedy\u2019s inapt statements, some mainstream voices have been glossing over a deeper set of controversies around the health-related implications of newborn circumcision.\u00a0<\/span><\/p>\n

For example, <\/span>New York Times <\/span><\/i>writer Jessica Grose <\/span>penned an article<\/span><\/a> sharing her worries that Kennedy\u2019s claims risk \u201cconfusing and shaming\u201d parents as they navigate the issue. According to Grose, citing a 2012 policy from the American Academy of Pediatrics (AAP), the best available scientific research suggests that newborn circumcision is a kind of medical toss up. Kennedy\u2019s latest round of chaos, she says, risks deterring parents from considering circumcising their male children\u2014a choice she says may be right for some children so long as their parents are \u201cadequately informed about the risks and benefits.\u201d<\/span><\/p>\n

I\u2019m sympathetic to Grose because her concerns center on protecting the average parent from misinformation. But the medical status of newborn circumcision was a confusing topic long before Kennedy weighed in. In fact, as I detail in <\/span>my forthcoming article in the <\/span>Journal of Medical Ethics<\/span><\/i><\/a>, perhaps the greatest source of confusion on the subject is not the half-baked musings of a Trump appointee, but an otherwise presumptively reliable source of health information: the American Academy of Pediatrics itself.<\/span><\/p>\n

By suggesting that their (long expired) 2012 policy on newborn circumcision represents the highest-quality medical assessment on the topic, Grose ends up confusing parents too.\u00a0<\/span><\/p>\n

For one thing, Grose does not mention that the AAP policy, written by an 8-member task force, has itself been the <\/span>subject of significant controversy<\/span><\/a>. While she correctly explains that the policy \u201cstopped short\u201d of a <\/span>universal<\/span><\/i> recommendation in favor of the procedure, she leaves out its central claim — one that attracted <\/span>censure<\/span><\/a> from leading health authorities in other countries soon after its release — that \u201cthe health benefits of newborn male circumcision outweigh the risks.\u201d\u00a0<\/span><\/p>\n

As my research reveals, some of the original AAP task force members have since clarified that \u201cheadline\u201d assertion. They now acknowledge that the formulation was intended as a compromise between members of the task force who disagreed about the relative value of the benefits, and was significantly shaped by social and political considerations — including a desire to <\/span>\u201cprotect\u201d parental decision-making<\/span><\/a> around circumcision for cultural or religious reasons — and not scientific evidence alone.\u00a0<\/span><\/p>\n

Although social factors were mentioned in the final policy materials, the weight that was given to them in formulating the central claim about health benefits and risks was not transparent. As one AAP task force member explains, \u201cthe best analogy is that the AAP guidelines [were] a \u2018permission slip\u2019 for those who want to circumcise their children so that society cannot say they are bad parents or outlaw the practice.\u201d Another remarked that the tone of the policy improperly implied a recommendation, but that, \u201cIt was really a legal question for me\u2026my feeling was that there was not sufficient data to suggest that this is a procedure that should be outlawed, particularly given that there were multiple religious communities for whom this was an important practice.\u201d<\/span><\/p>\n

These frank reflections reveal how internal disagreement over the relevance of the evidence, and over the appropriate tone and objective for the recommendation, resulted in a position that has sown uncertainty <\/span>among doctors and parents<\/span><\/a> — and <\/span>New York Times <\/span><\/i>journalists — alike. Meanwhile, the AAP allowed the policy to expire by default in 2017 and (in spite of growing controversy and public interest) has not commented since.<\/span><\/p>\n

Families want and deserve the highest standard of medical guidance, not just protection from online bullies. When the average parent looks up circumcision (or any other medical topic, for that matter) they are counting on the hard-won expertise of researchers to find out, as much as possible, what\u2019s healthiest for their kid. To be adequately informed, parents deserve to know that the representative pediatric urologist on the AAP task force has now cautioned \u201cyou cannot recommend circumcision based on the medical benefit alone,\u201d and that, \u201cit\u2019s only a \u2018medical procedure\u2019 in the sense that medical professionals are performing it.\u201d<\/span><\/p>\n

In guarding against anti-science sentiment and RFK Jr.\u2018s chaos, defenders of science should not assume that the status quo is automatically acceptable by contrast. If public health authorities want the public to ignore misinformation, they must continuously earn trust by issuing policies that are scientifically accurate, ethically coherent, and clear about where medical evidence ends and social discretion begins.
\n<\/span><\/p>\n

Article<\/strong>: As controversies mount, circumcision policies need a rethink<\/a>
\nAuthor<\/strong>: Max Buckler<\/span><\/p>\n

Conflicts of Interest:<\/strong> None Declared<\/p>\n","protected":false},"excerpt":{"rendered":"

By Max Buckler Headlines over the last two weeks featured a strange-sounding claim linking newborn circumcision to autism. Robert F. Kennedy Jr., the controversial US secretary of health and human services, claimed at a White House cabinet meeting that \u201ctwo studies\u201d show circumcised boys are twice as likely to develop autism or autism spectrum disorder […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":503,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,8109],"tags":[],"class_list":["post-4711","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-paediatrics"],"yoast_head":"\nCircumcision and autism? When medical institutions, not conspiracy theorists, undermine trust - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2025\/10\/24\/circumcision-and-autism-when-medical-institutions-not-conspiracy-theorists-undermine-trust\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Circumcision and autism? 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