A new study suggests a link between ritual circumcision and the development of autism spectrum disorder (ASD). The suggested causal connection lies in the great pain that the infant suffers during the procedure.
Here is the abstract of the paper Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark by Morten Frisch and Jacob Simonsen published in the Journal of the Royal Society of Medicine, January 8, 2015. (The full paper is also available at the link.)
Objective Based on converging observations in animal, clinical and ecological studies, we hypothesised a possible impact of ritual circumcision on the subsequent risk of autism spectrum disorder (ASD) in young boys.
Design National, register-based cohort study.
Participants A total of 342,877 boys born between 1994 and 2003 and followed in the age span 0–9 years between 1994 and 2013.
Main outcome measures Information about cohort members’ ritual circumcisions, confounders and ASD outcomes, as well as two supplementary outcomes, hyperkinetic disorder and asthma, was obtained from national registers. Hazard ratios (HRs) with 95% confidence intervals (CIs) associated with foreskin status were obtained using Cox proportional hazards regression analyses.
Results With a total of 4986 ASD cases, our study showed that regardless of cultural background circumcised boys were more likely than intact boys to develop ASD before age 10 years (HR = 1.46; 95% CI: 1.11–1.93). Risk was particularly high for infantile autism before age five years (HR = 2.06; 95% CI: 1.36–3.13). Circumcised boys in non-Muslim families were also more likely to develop hyperkinetic disorder (HR = 1.81; 95% CI: 1.11–2.96). Associations with asthma were consistently inconspicuous (HR = 0.96; 95% CI: 0.84–1.10).
Conclusions We confirmed our hypothesis that boys who undergo ritual circumcision may run a greater risk of developing ASD. This finding, and the unexpected observation of an increased risk of hyperactivity disorder among circumcised boys in non-Muslim families, need attention, particularly because data limitations most likely rendered our HR estimates conservative. Considering the widespread practice of non-therapeutic circumcision in infancy and childhood around the world, confirmatory studies should be given priority.
You can read more about the study at Machines Like Us.
In the paper, the authors state that circumcision creates a lot of pain and think that this could be a plausible mechanism to explain the correlation between circumcision and the later onset of ASD.
Negative long-term psychological consequences of pain- and stressful surgery in early childhood were described almost 70 years ago. Among children operated for a variety of conditions, Levy noted a strong association between the age at operation and the frequency and severity of emotional sequelae. Psychological problems were encountered in 42% of children aged < 3 years at the time of operation, as compared with 10% among older children. Until recently, it was believed that newborns are incapable of interpreting noxious stimuli in a manner comparable to that of older children and adults. This idea has now been abandoned with almost universal consensus that newborns and infants perceive pain and stress very much like older children and adults. … To our knowledge, no study has examined the possible association of circumcision-related pain and stress with boys’ subsequent risk of developing autism spectrum disorder (ASD). This is surprising, because painful experiences in neonates have been shown in animal and human studies to be associated with long-term alterations in pain perception, a characteristic often encountered among children with ASD.
One should be careful about taking action on the basis of one study and the authors rightly urge others to also to look into the issue. The single and now highly discredited study by the disgraced physician Andrew Wakefield that purportedly showed a link between the use of vaccines and the onset of autism in children has been seized upon by some and resulted in significant numbers of people not vaccinating their children. As a result, not only have efforts to completely eradicate many diseases been hindered, there has actually been a resurgence in diseases such as measles in countries like the US and the UK.
But the Wakefield study was methodologically problematic with a tiny sample and violations of normal research protocols. Furthermore, the consequences of the suggested remedy (not vaccinating) have been hugely deleterious. In this case, the study seems to be much better designed, with a huge sample, and the suggested action (not circumcising) not only has no negative consequences, it has many other things in favor of it, not the least of it is that a child, even an infant, has the right to bodily integrity and to not have others make decisions about it. If people want to get circumcised, they can do it to themselves as adults.
Of course, in this case not circumcising goes against the religious beliefs of Jews and Muslims so it will be interesting to see their reaction. Do they think that fidelity to their imaginary god is more important than the possible negative health consequences to their child?