Update: New York City Department of Health on Circumcision

Found via RealityBias’ diary at Daily Kos, this follow-up on last week’s news from Thomas Frieden and the New York Department of Health.

Recent media reports misrepresent the Health Department’s response to recent studies showing that circumcision significantly reduces HIV transmission in some contexts. We do not yet know what impact circumcision could have on HIV transmission in New York City, and we have not suggested or planned any initiative or campaign. Quite to the contrary, I indicated in an interview with the New York Times (the source of the misrepresentation) that I very much doubted that even 1% of men at high risk in NYC would undergo the procedure.

Commissioner Frieden claims he was misrepresented. Maybe, and if so, I retract my statements implying as much. But that’s a conditional retraction, for I think he’s trying to save face while forging ahead with his push for circumcision. Saying that he doubts “even 1% of men at high risk in NYC would undergo” circumcision is different than saying “we are not pushing circumcision. Regardless of how he gets to office, Commissioner Frieden is acting like a politician. I don’t trust him.

As evidence, consider this further down in his memo:

Our goals are the following:

  • Inform the community of the facts regarding what is known and what is not known about circumcision’s effects on HIV transmission;
  • Promote discussion among community groups and health care providers to explore how circumcision may be relevant in New York City;
  • Increase access to circumcision for men who want the procedure.

I don’t know how Commissioner Frieden interprets that, but it sounds a lot like what the New York Times reported last week:

His department has started asking some community groups and gay rights organizations to discuss circumcision with their members, and has asked the Health and Hospitals Corporation, which runs city hospitals and clinics, to perform the procedure at no charge for men without health insurance.

A spokeswoman for the corporation said it was “having conversations” with the health department but had not reached a decision.

Again, I’m more than willing to retract my original criticism¹ of Commissioner Frieden. But it’s clear how this will be used, regardless of his new protest. This looks more like he got caught reaching for the nanny-state public heath wish list than anything. Would he have sent this memo if Mayor Michael Bloomberg hadn’t challenged him?

Link to Commissioner Frieden’s memo pdf here, via LifeLube.

¹ I do not retract my analysis over his hypothetical plan, as reported. It’s too similar to what other public health officials are pushing to be irrelevant.