While there are some medical indications for circumcision, the main reasons for having a newborn boy circumcised are religious, cultural, and to be in accord with family tradition.
Until 1999 the American Academy of Pediatrics (AAP) went on record as saying that there were no medical reasons compelling enough to recommend routine surgical removal of the foreskin. But that year new data resulted in the AAP changing its position on newborn circumcision:
“Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not significant enough to recommend routine neonatal circumcision. It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision”.
The current American Academy of Pediatrics policy on circumcision has evolved since 1999 and now states the following:
“Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified include prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.”
What health benefits does circumcision provide?
The following health advantages accrue to boys/men who are circumcised:
- A decrease in infant urinary tract infections
While urinary tract infections are rare in men, they are not uncommon in baby boys up until about one year of age and occur almost exclusively in boys who are not circumcised - Decreased spread of viral sexually transmitted diseases
Circumcised men are less likely than uncircumcised men to infect their partners with HIV or high-risk strains of the human papilloma virus (HPV), a cause of cervical cancer and abnormal Pap smears. Female partners of circumcised men have much lower rates of both of these conditions then do partners of uncircumcised men.
Penile cancer, while uncommon, is almost never seen in circumcised males - Phimosis—adherence of the foreskin to the head of the penis—can cause pain, infection, and can interfere with sexual function. This does not occur in circumcised men.
The issue of phimosis came up frequently in WWII during the North African campaign, in Vietnam, and in the recent wars in Iraq. Uncircumcised soldiers, unable to exercise adequate hygiene and who are exposed to dust and sand experienced phimosis in high numbers making adult circumcision a common procedure for military surgeons in combat areas.
Like father, like son
Another reason to perform circumcision is so that a boy growing up will look anatomically like his father, his older brothers (if he has any), and other boys. Not only are most Jewish boys circumcised but in the United States the majority of all newborn male babies are as well.
Arguments against circumcision
There are individuals and groups that argue against the performance of circumcision. They claim:
- The procedure is not medically necessary
- Circumcising an infant violates a child’s autonomy because an infant is in no position to give or withhold permission for a permanent surgical modification of his body
- Circumcision is barbarous genital mutilation.
- Being circumcised decreases sexual pleasure.
For many people, the arguments against circumcision are not compelling. Are a child’s rights violated when infant girls have their ears pierced as is the custom of many nationality groups in the United States? As for genital mutilation, it is difficult to take that claim seriously when the majority of males in the United States are circumcised, when experts detail health benefits for circumcision, and when there are no negative functional consequences of the procedure. As for the claim of “decreased sexual satisfaction”, there is no reliable published data in the medical literature to support this. Moreover, it would be hard to see how such data could be obtained given an area as subjective as the “sensitivity of the penis” during sexual relations between different individuals.
For most parents, however, whether or not to have their son circumcised is a decision that depends on many factors involving the cultural and social indications already discussed. And, as shown above, responsible physician groups now do acknowledge the health benefits of having a circumcision.