In new recommendations it plans to announce Monday, the group doesn't go as far as suggesting that all babies should have the operation. But when parents choose it for their sons, insurance companies and state Medicaid programs should pay for it, the academy now says.
"There is enough benefit that parents should be allowed to do it and not feel like they're committing some horrible crime against their family," said Dr. Andrew Freedman, a Los Angeles-based pediatric urologist. "If families don't want to do it they shouldn't feel bad either."
The doctors' group has remained neutral on the controversial issue for years. It last updated its position in 2005, reaffirming a stance from 1999 that there wasn't enough scientific evidence to show medical benefits to recommend circumcision.
The change in opinion puts it at the forefront of a polarizing topic that pits those who think circumcision is necessary to ward off disease against those who call it a painful and unnecessary cosmetic procedure with no real health benefits.
Physicians use the academy's recommendations to help decide how they treat and advise their patients. The group also can be highly influential at the policy level, with local and federal government officials looking for its insight on legislative health issues.
The academy said in a more than 30-page report that scientific studies in the past 13 years on the health benefits of circumcision helped drive its decision, including three recent studies that found circumcision reduced the spread of HIV in Africa. It formed a task force in 2007 to study the issue as growing evidence showed circumcisions prevent urinary tract infections in infants and protect against sexually transmitted diseases in adults.
Freedman said the newest recommendations aren't much different than previous stances, but people on both sides of the debate saw them differently.
Proponents of circumcision welcomed the academy's new recommendations, saying they have the potential to have a huge public health impact and over time could save the country billions of dollars in medical costs.
"They have clearly reversed their policy on male circumcision and recognized the public health benefit of the procedure and that is very good news," said Dr. Aaron Tobian, a Johns Hopkins University epidemiologist and pathologist, who said parents will now get a full picture from doctors of the benefits of circumcision.
Tobian co-wrote a study released last week that found that a 20-year decline in male circumcision has cost the country $2 billion in medical costs that could have been prevented. Some studies have found uncircumcised men are more at risk for cancer-causing HPV, HIV, herpes, bacterial infections and other sexually transmitted diseases. It is believed bacteria and viruses can get trapped in the extra layers of skin left on the penis.
Those on the other side of the debate said the academy is ignoring just as many studies that dispute that men who are circumcised are better protected from certain illnesses. Many said it shouldn't be the parents' decision and instead boys should decide later in life whether to be circumcised.
"There is so much information that contradicts what they say that it is just mind-boggling," said Georganne Chapin, executive director of Intact America, a group that advocates against circumcision of boy babies.
Chapin and other opponents of the procedure said that it is painful and unnatural and in the long term results in decreased sexual pleasure and psychological problems. They said there are complications with circumcisions that can also be costly, including botched procedures.
Meredith Lovell-Thayer, a 27-year-old apprentice midwife from Frostburg, decided not to have her son circumcised after reading literature about the pain babies endure.
"I couldn't consciously do that to my child," said Lovell-Thayer, whose son is now 20 months old.
She said she is disappointed in the academy's stance. In Europe, where only 10 percent of men are circumcised, she said, STDs aren't rampant.
Support for circumcision in America has been declining since the 1970s. Today, about 55 percent of the 2 million baby boys born each year are circumcised, compared with a peak of 79 percent in the 1970s and 1980s.