BERKELEY: Attorneys for the Rights of the Child

Attorneys for the Rights of the Child
August 22, 2012

Attorneys for the Rights of the Child Condemns American Academy of Pediatrics for Hiding the Truth, Putting Doctors Ahead of Patients in its Circumcision Statement

Berkeley, CA – The human rights group Attorneys for the Rights of the Child (ARC) has condemned the American Academy of Pediatrics (AAP) for its upcoming “Circumcision Policy Statement,” due out on August 27, 2012, which ignores and minimizes the truth about male circumcision and places doctors’ interests ahead of patients’ needs.  J. Steven Svoboda, ARC’s Executive Director, commented today, “Based on comments that have appeared in the media attributed to members of the task force preparing the statement, the AAP appears to endorse a disproven procedure that violates the infant patient’s rights and removes functional tissue without providing any proven benefit.”
The AAP position statement ignores the wealth of medical evidence that painfully amputating functional tissue from newborns is a dangerous and outmoded practice.”

Not a single study has ever proven that circumcision has actually decreased any disease in the United States. Svoboda observed, “Rather than objectively evaluating all available evidence, the AAP selectively quotes and references highly contested and controversial studies to attempt to justify an entrenched yet outmoded cultural—not medical—practice.  Over a hundred boys die each year from this needless procedure, yet the AAP quotes an absurdly low overall complication rate overall and fails to mention the deaths stemming from the practice.”

The AAP released a policy statement in 2010 in Pediatrics defending certain forms of female circumcision if performed for “cultural” reasons.  Physicians who had followed the AAP’s suggestion at that time would have thereby violated federal law protecting females from such procedures.  After ARC and other organizations opposing genital cutting pointed out the errors, the AAP quickly retracted its statement and replaced it with a new statement calling for the elimination of all forms of female genital cutting.  Svoboda commented, “Boys deserve no less protection from the AAP than girls received. If circumcision is so great, why have no European countries adopted it, and why do their males enjoy better average health than Americans?”

The AAP statement demonstrates its ignorance of the fact that European men don’t circumcise and yet enjoy better health outcomes including the areas the statement cites as improved after circumcision.   Moreover, medical organizations and politicians in Finland, Sweden, Norway, the Netherlands, Germany, Switzerland, Austria, and other countries are calling for the practice to stop.  Even in the US, the American Medical Association (AMA) agrees that there is insufficient justification for performing the procedure on newborns absent specific medical indications.

Svoboda noted that studies of adult males in Africa have numerous methodological flaws and that even if valid, given vast differences in health conditions and modes of transmission between the US and Africa, the results can hardly be applied to justify infant male circumcision in the United States.  “Babies don’t get HIV and AIDS from sexual contact,” Svoboda added.

“Male circumcision,” Svoboda said, “is a disfigurement that carries risks without providing benefits.  It violates a child’s right to bodily integrity, not to mention numerous civil and criminal laws.”  Malpractice awards are mounting up including a recent $700,000 settlement reported in the Massachusetts Lawyers Weekly.  Svoboda noted, “Although the AAP’s statement regarding male circumcision is presumably influenced by its desire to protect its members who perform the outmoded procedure, the AAP has no business promoting a harmful and discredited cultural relic masquerading as a medical procedure.  In these days of rising medical costs and scarce resources, we simply cannot afford to continue to carry out such a harmful and outmoded practice.”

Americans are getting the message, as according to the Centers for Disease Control and Prevention (CDC), rates have dropped substantially in recent years.

Attorneys for the Rights of the Child is a non-profit organization founded in 1997 to protect children from unnecessary medical procedures to which they do not consent.

TARRYTOWN, NY: Intact America

Intact America
August 22, 2012

INTACT AMERICA CONDEMNS ANTICIPATED CIRCUMCISION STATEMENT FROM AMERICAN ACADEMY OF PEDIATRICS

Group Opposed to the Non-Therapeutic Genital Cutting of All Children Calls AAP “Shockingly Biased and Out of Touch with Medical Ethics and Children’s Rights”


TARRYTOWN, NY—Intact America, an organization founded in 2008 to ensure that all children are protected from permanent bodily alteration inflicted on them without their consent, is criticizing the anticipated August 27 release by the American Academy of Pediatrics (AAP) of its new “Circumcision Policy Statement.” Based on comments to the press made by members of the AAP’s Task Force on Circumcision, which authored the document, Intact America deplores the Statement’s focus on selective evidence supporting medical benefits of removing normal foreskins from baby boys.

Georganne Chapin, Executive Director of Intact America, stated today, “From the AAP Circumcision Task Force’s pre-publication comments, it is clear that the group has chosen to feature only literature (almost exclusively focused on adult men in Africa) that supports its predisposition toward circumcising boys; the Task Force has failed to consider the large body of evidence from the developed world that shows no medical benefits for the practice, and has given short shrift, if not dismissed out of hand, the serious ethical problems inherent in doctors removing healthy body parts from children who cannot consent.”

In 2010, Intact America responded similarly when the AAP issued a new Policy Statement on Ritual Genital Cutting of Female Minors; this statement called for doctors to be allowed to inflict a “ritual nick” on infant girls’ genitalia for “cultural” reasons, in contravention of Federal law prohibiting any such cutting. The AAP’s policy statement also acknowledged that, “Some forms of FGC [performed in African cultures] are less extensive than the newborn male circumcision commonly performed in the West.” Pressure from Intact America and other groups opposing Female Genital Mutilation resulted in the quick retraction of the AAP’s call for tolerance of and doctors’ participation in the ritual cutting of baby girls, and in the issuance of a revised policy condemning “all types of female genital cutting that pose risks of physical or psychological harm.” Intact America maintains that any alteration or cutting performed on the normal, healthy genitalia of minors is an unethical act that ignores the well-established right of all individuals to bodily integrity.

“It is clear,” said Ms. Chapin, “that the AAP is blind to the mounting worldwide movement against the genital cutting of boys. This American physician organization is disregarding the risks and harms of the procedure. It also is ignoring the fact that circumcision is rare in Europe, with no negative health consequences, and that European politicians and physician groups—in increasing numbers—are calling for doctors to refuse to perform the procedure, on the basis that it is harmful and violates children’s rights and bodies. In its selective blindness, the AAP has failed to put the wellbeing of the infants and children it is supposed to protect ahead of that organization’s cultural bias and interest in perpetrating a medically unnecessary, harmful, and unethical practice.”

About Intact America
Intact America was formed in 2008 to change the way America thinks about neonatal male circumcision. Intact America believes that painful and medically unnecessary surgery to remove healthy genital tissue from non-consenting baby boys violates medical ethics and human rights. Intact America is based in Tarrytown, N.Y. Visit Intact America at www.intactamerica.org, on Facebook, and on Twitter.

SEATTLE: Doctors Opposing Circumcision

Doctors Opposing Circumcision
August 22, 2012

AAP Announces Intent to Release its Sixth Major Circumcision Policy
Doctors Opposing Circumcision reaffirms its Genital Integrity Policy

The American Academy of Pediatrics (AAP) revealed that it intends to publish its sixth major circumcision policy on Monday, August 27, 2012 and in the September 2012 issue of Pediatrics, its house journal. This will be its sixth position statement on male circumcision, as it has previously published position statements in 1971, 1975, 1983, 1989, and 1999.

The new AAP policy has been five years in the making. The intent to publish a new statement was announced in 2007, however internal disagreement on its content has prevented publication. The new statement likely will be a compromise between positions.

The AAP, despite its high sounding academic name, actually is a trade association of pediatric doctors. Its primary duty is to advance the business and professional interests of its 60,000 members who are called "fellows". The interests of its child-patients are a distant second to their primary interest.

There is a severe and intractable conflict of interest between the financial interests of its fellows and the best interests of the child-patient. Most of its fellows perform non-therapeutic circumcisions on children and profit thereby. These members do not want anything to interfere or disrupt their steady income stream. The AAP will not publish a statement that would harm that income stream. The AAP ensures the outcome of its circumcision statements by appointing doctors who are known to have a pro-circumcision position. The current task force, like previous task forces on circumcision, is stuffed with pro-circumcision doctors, including its chairwoman. Obstetricians and family doctors also profit by doing unnecessary circumcisions. The presence on the task force of a representative from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Doctors (AAFP), as well as Dr. Stephen Wegner, MD, JD, representing the AAP Health Care Financing Committee, highlight the business and financial nature of the forthcoming circumcision policy statement. We anticipate a very self-serving statement that protects doctors' income.

Previous AAP circumcision statements have exaggerated the alleged but unproved prophylactic benefits of non-therapeutic circumcision while minimizing the risks, complications, drawbacks, permanent irreversible physical, sexual, and emotional injury of male circumcision. We expect that this one will use prevention of HIV sexual transmission as a reason to circumcise boys, even though the African studies that indicate circumcision prevents HIV infection in adult males have been shown to be trash and, in any event, not applicable to infants boys in North America.

In recent years, 46 percent of boys born in the United States have left the birth facility with intact foreskins. There is not a shred of evidence that these boys are less healthy than the 54 percent of boys who were circumcised.

Doctors who perform circumcisions have had their income stream curtailed by the decision of eighteen state Medicaid agencies to terminate payments for medically unnecessary non-therapeutic circumcision of children. The AAP is expected to call for restoration of those taxpayer-funded Government payments to doctors, so as to restore the income of their fellows.

The AAP, thus far, has consistently refused to recognize that children are human beings, who have legal rights to bodily integrity and the security of their person under both American law and international human rights law, which are trampled by the unnecessary amputation of the functional body part called the foreskin. The AAP has consistently misapplied legal rules regarding surrogate consent for therapeutic operations on children to non-therapeutic circumcision. By so doing, it has tried to protect the alleged parental right to cut body parts from boys at will for religious cultural reasons or no reason at all.

As noted above, the AAP is simply a trade association, which advances the perceived interests of its fellows. Its position statements are not legal or medical imperatives and do not have the force of law or public policy. This statement on circumcision is going to be all about money, not about child health or welfare. The Royal Dutch Medical Association has called male circumcision a human rights violation and an unethical practice. The AAP's forthcoming pro-circumcision policy is not supported by foreign medical associations.

A court in Cologne, Germany says parents may not grant consent for unnecessary circumcision. We will see shortly whether the AAP will reform its abusive practices. We are not hopeful.

Doctors Opposing Circumcision believes that circumcision of children violates numerous legal rights of the child and is highly unethical, if not unlawful. We believe that genital integrity provides the highest level of health and well being for the child. We do not know what the AAP is going to say in their new statement, but we are circumcision experts and we are convinced that non-circumcision is best for children. We reaffirm our Genital Integrity Policy Statement of 2008, which advocates genital integrity for boys.

We urge parents to ignore this latest statement from the AAP and to continue to protect their sons' whole and complete bodies.

George C. Denniston, MD, MPH
John V. Geisheker, JD, LLM
President Executive Director & General Counsel
Wednesday, August 22, 2012.

BERLIN: Israel's chief rabbi discussing law change

Never mind protecting babies...

L A Times
August 22, 2012

German lawmakers work on legislation to protect circumcision

By Renuka Rayasam
BERLIN - Israel’s top rabbi is in Berlin to rally support among German political leaders regarding legislation to protect the practice of ritual circumcision in Germany, which was called into question earlier this year by a controversial court ruling that Jewish and Muslim leaders said threatened their religious freedom.

In June, after a Muslim boy suffered health complications from the practice, a court in the western German city of Cologne declared nonmedical circumcision to be criminal because it causes children bodily harm. Amid outrage from some religious groups, lawmakers quickly passed a resolution promising legislation guaranteeing legal protection for circumcision.

This week, officials have been meeting with Yona Metzger, chief rabbi of Israel's Ashkenazi Jews, to craft legislation on the issue. But the stakes were raised further Tuesday after a doctor in the southern German city of Hof, in Bavaria, reportedly filed charges with local prosecutors against a rabbi there to stop the practice. Prosecutors must still decide whether to act on the charges, which the Council of European Rabbis described as a “grave affront to religious freedom.”

“This latest development … underlines the urgent need for the German government to expedite the process of ensuring that the fundamental rights of minority communities are protected,” the council said in a statement on its website. [Never mind the fundamental rights of children.]
 
... But finding a compromise hasn’t been so simple, with opponents of the practice saying that what they see as protecting the rights of children should come above religious freedom. [Note the loaded language, and the assumption that freedom of religion entails the freedom to cut parts off non-consenting people's genitals - not just what some other people "see it as".]
 
The European rabbis’ council says that using anesthesia or having a doctor perform circumcision instead of a mohel would not be in accordance with Judaism. Metzger told reporters Tuesday that he suggested establishing a school for mohels in Germany with both religious training from rabbis and medical training from doctors in case of complications from circumcision.

Earlier story

HESSE, GERMANY: Rabbi charged for circumcising

The Times of Israel
August 21, 2012

Criminal charges filed against German rabbi for performing circumcisions

By Raphael Ahren
David Goldberg, who oversees a 400-member strong community in northern Bavaria, is the first mohel to be charged since Cologne court banned the ritual
 
For the first time, criminal charges have been pressed against a German rabbi for performing circumcisions, a Jewish weekly reported on Tuesday.

A doctor from Hesse filed a criminal complaint against Rabbi David Goldberg, who serves in the community of Hof, in Upper Franconia (northern Bavaria), according to the Juedische Allgemeine weekly newspaper. The chief prosecutor of Hof confirmed that charges had been filed against the rabbi. The charges are based on the controversial decision of a Cologne district court, which ruled in June that circumcisions for religious reasons constitute illegal bodily harm to newborn babies.

“I am shocked,” said Cologne Rabbi Yaron Engelmayer, co-chairman of the national umbrella group of Orthodox rabbis in Germany, in a first reaction to the report. This marks the first time that a court in the Federal Republic of Germany is investigating a rabbi for performing a religious ritual, Engelmayer told the paper.

Goldberg, a qualified mohel (ritual circumciser) who says he has performed more than 3,000 circumcisions, was informed about the criminal charges against him by journalists, the paper said.

Born in Jerusalem, the 64-year-old has been the rabbi of Hof since 1997. Before World War II, about 3,000 Jews lived in Hof. Today, the community counts about 400 members.

“This latest development in Hof is yet another grave affront to religious freedom and underlines the urgent need for the German government to expedite the process of ensuring that the fundamental rights of minority communities are protected. We call upon the Minister of the Interior to take immediate action to secure those rights in the short term,” Conference of European Rabbis, Chief Rabbi Pinchas Goldschmidt said.

The Cologne court decision caused a major uproar in Germany’s Jewish and Muslim communities, leading the Bundestag to pass a joint resolution calling on the government to ensure legal certainty for ritual circumcisers. “A medically professional circumcision of boys, which does not cause unnecessary pain” should be “generally permissible,” the resolution read.

While the Jews in Germany feared the implications of the Cologne ruling, they expressed confidence last month that they would be able to continue performing the rite.

“At the moment — in our view — the verdict formally does not severely affect the ability to perform circumcision since the decision of the court is formally not binding for other cases,” the secretary-general of the Central Council of Jews in Germany, Stephan Kramer, said.

Rabbi Engelmayer, from Cologne, told The Times of Israel in July that the court decision had “enormously” impacted Jewish life in his community. “De facto it looks as if doctors across the country are afraid [to perform circumcisions],” he said.

“The mohels are inquiring, and we tell them: without circumcision, there is no Judaism,” he said at the time. “Therefore it is hard to imagine how the courts could criminalize a correctly performed Jewish circumcision ceremony. It would be too harsh a sign, especially from Germany.”

Engelmayer added: “I think that Germany will refrain [from permanently outlawing circumcisions], also in light of the chorus of outrage, the criticism and the damage it could do to Germany’s image in the world.”

---

New York Times
August 21, 2012

Accord Sought in Germany Over Circumcision Issue

BERLIN — German officials have been meeting here with Israel’s chief Ashkenazi rabbi over the past two days as they seek a way to enshrine some sort of legal protection for Jews and Muslims who circumcise infant boys as a religious rite, officials said Tuesday. 

... Hof prosecutors could not be reached for comment, and it was unclear whether any decision had been made to open an investigation and press charges.

David Goldberg, the rabbi reported to have been named in the file, said in a telephone interview that the prosecutor’s office had not yet contacted him and that he had learned of the petition against him only from local news media. Rabbi Goldberg said he had not carried out any circumcisions in Germany since June 26, but had been called abroad several times to perform the rite. “There is not so much demand in Germany,” he said.

On Thursday, Germany’s Ethics Council, an independent body made up of 26 members who specialize in various scientific, ethical, social and legal concerns, is to hold a public discussion on the circumcision debate.

BALTIMORE: "Oh noes, leaving babies intact will cost billions!"

Los Angeles Times
August 21, 2012

As circumcision declines, health costs will go up, study projects

By Eryn Brown
A team of researchers estimates that every procedure not performed could lead to significant increases in lifetime medical expenses because of STDs.

Declining rates of circumcision among infants will translate into billions of dollars of unnecessary medical costs in the U.S. as these boys grow up and become sexually active men, researchers at Johns Hopkins University warned.

In a study published Monday in the Archives of Pediatric and Adolescent Medicine, a team of economists and epidemiologists estimated that every circumcision not performed would lead to significant increases in lifetime medical expenses to treat sexually transmitted diseases and related cancers — increases that far surpass the costs associated with the procedure.

Circumcision is a hotly debated and emotional issue in the U.S., where rates have been falling for decades. In the 1970s and 1980s, about 80% of baby boys were routinely circumcised in hospitals or during religious ceremonies; by 2010, that figure had dropped below 55%, according to the Centers for Disease Control and Prevention.

Some of that decline is due to shifting attitudes among parents, but at least part of it can be traced to the decision by many states to eliminate Medicaid coverage for the procedure in order to save costs. Today 18 states, including California, do not provide Medicaid coverage for the procedure, which is considered cosmetic by many physicians.

But in the last decade, studies have increasingly shown that removing the foreskin of the penis has significant health benefits, said Dr. Aaron Tobian, senior author of the new study.

Three randomized trials in Africa have demonstrated that circumcision was associated with a reduced risk of contracting HIV, human papillomavirus and herpes simplex in men. One of those studies documented a reduced risk of HPV, bacterial vaginosis and trichomoniasis in the female partners of men who were circumcised.

Circumcision is believed to prevent STDs by depriving pathogens of a moist environment where they can thrive. The inner foreskin has been shown to be highly susceptible to HIV in particular because it contains large numbers of Langerhans cells, a target for the virus.

Tobian and his colleagues developed a computer-based simulation to estimate whether declining circumcision rates would lead to more STDs and thus higher medical costs.

If circumcision rates remained about 50% instead of the higher rates of years past, the lifetime healthcare costs for all of the babies born in a single year would probably rise by $211 million, the team calculated.

[This has not been the experience of the rest of the developed world, such as the English-speaking world, where the experiment of mass circumcision was tried and abandoned.]
 
If circumcision rates were to fall to 10% — which is typical in countries where insurance does not cover the procedure — lifetime health costs for all the babies born in a year would go up by $505 million. That works out to $313 in added costs for every circumcision that doesn't happen, the report said.

In this scenario, nearly 80% of the additional projected costs were because of medical care associated with HIV infection in men, the team wrote.

The model includes only direct medical costs such as treatment for penile and cervical cancer, which are associated with HPV infection. It doesn't consider nonmedical or indirect costs, such as transportation to doctors' appointments or lost income.
[Nor does it include costs for revision surgery or other sequelae of botched circumcisions.]
 
To Tobian, the message is clear: Government efforts to save money by denying coverage for circumcision are penny-wise but pound-foolish.

"The federal Medicaid program should reclassify circumcision from an optional service to one all states should cover," he said.
[So much for states' rights.]
 
That sentiment was echoed in an editorial accompanying the study. UCLA health economist Arleen Leibowitz wrote that by failing to require states to cover circumcision in Medicaid plans, the U.S. reinforces healthcare disparities.

"If we don't give poor parents the opportunity to make this choice, we're discriminating against their health in the future," she said in an interview. "If something is better for health and saves money, why shouldn't we do it? Or at least, why shouldn't we allow parents the option to choose it?"

Ellen Meara, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice who was not involved with the study, praised the researchers for conducting a careful analysis. But she questioned whether data from HIV studies in Africa were generalizable to the U.S. Medicaid population.

Still, it's "the best information we have," she said. "There's nothing better to plug in."
[It's rigged, but it's the only game in town. No US study has found sufficient evidence of a connection between circumcision and HIV to justify doing it to babies.]
 
The analysis comes a week before the American Academy of Pediatrics is scheduled to release a new policy on circumcision. Since 1999, the doctors group has taken a neutral stance on the procedure, saying that "the scientific evidence demonstrates potential medical benefits" but that it's not strong enough to say that circumcision should be routine.

Some reports have indicated that the new policy will state that the health benefits of circumcision outweigh the procedure's risks, but will stop short of recommending it for all baby boys. A spokeswoman for the academy declined to comment before the policy is formally released Monday.
A shift in position could boost support for circumcision, since both pediatricians and parents look to the academy for guidance, Leibowitz said.

USC health economist Joel Hay said the new study was inherently flawed because ethical concerns about the procedure trumped any economic analysis of its potential benefits.

"You're taking an asymptomatic individual and forcing a procedure on him," he said.

Hay also argued that Americans didn't need circumcision to prevent HIV infection because they had other options, such as using condoms. He said that just last month the U.S. Food and Drug Administrationapproved the use of a once-a-day pill called Truvada to reduce the risk of HIV transmission in high-risk groups.

"There's no reason why people have to engage in this irreversible procedure," he said.

TASMANIA: Non-religious circumcision should be illegal

Tasmania Law Reform Institute
August 20, 2012

Tasmania: Non-religious infant circumcision should be illegal

The Tasmania Law Reform Institute today released Final Report No 17 on the legal framework in Tasmania which governs the practice of non-therapeutic male circumcision. The report, Non-Therapeutic Male Circumcision, provides background on the divisive issue of male circumcision, examines the current law in Tasmania and other international jurisdictions and offers recommendations for reform of the law.

The TLRI produced an issues paper entitled Non-Therapeutic Male Circumcision in 2009 seeking public views on the merits of the current legal framework. The paper generated much interest, and submissions were received not only from Tasmania and other Australian states but from international respondents as well.

Analysis of the legal position reveals that the law is uncertain as to whether non-therapeutic infant male circumcision is lawful.  In the interests of certainty the Institute recommends that the law be clarified. The report  makes a series of recommendations. These include:

• a general prohibition on the circumcision of incapable minors with an exception for well-established religious or ethnicity motivated circumcisions.
• enactment of legislation clarifying the legality of circumcisions performed at the request of an adult or a capable minor and governing situations where parents disagree about the desirability of performing a circumcision.
• greater dissemination of accurate information on the known and potential effects and significance of circumcision.
• the imposition of criminal sanctions for a circumciser who fails to meet minimum standards of care: and
• setting of a uniform limitations period in which individuals can bring an action against their circumciser and extending the limitations period for individuals harmed by circumcisions as a minor.

The report is available on the Institute’s webpage: www.law.utas.edu.au/reform

---

The Australian
August 21, 2012

Circumcision ban closer in Tasmania

By David Beniuk
THE circumcision of boys could be banned in Tasmania following a report on the legality of the controversial procedure.

The Tasmanian Law Reform Institute has recommended the practice be deemed an offence unless it is performed for "well-established" religious or cultural reasons.

The institute says law reform is needed to clarify its legality and make unscrupulous practitioners face criminal sanctions.

"Analysis of the legal position reveals that the law is uncertain as to whether non-therapeutic infant male circumcision is lawful," the institute's director Professor Kate Warner said.

"In the interests of certainty the institute recommends that the law be clarified."

The 101-page report, titled Non-Therapeutic Male Circumcision, recommends a new offence: "generally prohibiting the circumcision of incapable minors".

An exception should be granted for traditions such as the Jewish and Muslim faiths, it says.

"The law ought to accommodate established religious and ethnic circumcising traditions," the report says.

[But who is to decide which traditions are established. Is Scientology established? The Unification Church (Moonies)? The Mormons? Pastafarians? Jedi?]
 
"It should also support measures to encourage individuals associated with these traditions to move away from loosely entrenched and particularly contentious practices."

Among the other recommendations is the need for a court order for a circumcision to take place if a child's parents disagree on it.

Pain and trauma affecting mental health can be associated with the practice, while the benefit of fighting some infections is not significant in developed countries, the report says.

Australia already has laws outlawing female genital mutilation but the circumcision of boys has largely been considered a decision for parents.

The report says more than 19,000 Medicare claims were lodged in 2010 for circumcisions performed on boys aged under six months throughout Australia.

The rate has dropped from around 90 per cent in the 1950s to around 12 per cent in recent years, and is only around 1.5 per cent in Tasmania.

Only Queensland public hospitals still perform the procedure, the report said.

International debate over the practice flared in June when a German court ruled that it represented the illegal harming of a child.

The Royal Australian College of Physicians said at the time the practice was medically unnecessary and a choice for parents.

The state government will consider its response to the report, a spokesman said.