The Eternal Debate Over Circumcision

Though circumcision has been practiced since at least 2300 BCE, the merits of using the procedure on newborn boys continue to be fiercely debated today. Boys are born with a sheath of skin, called the foreskin, that covers the end of the penis. Circumcision surgically removes the foreskin and exposes the tip of the penis.

Parents decide to have their newborns circumcised for a variety of reasons. While circumcision is not vital to a child’s health, scientific studies indicate that circumcision may lower the risk of a number of adverse health conditions.

Circumcision is sometimes chosen for religious practices and ethnic identity. Other reasons include hygiene and health care, cultural tradition or the desire to conform to social norms.

A common procedure

Circumcision is one of the oldest and most commonly performed surgical procedures in the world. Among religions, it is most common among the Muslim and Jewish faiths. Men also have high rates of circumcision in the United States, the Middle East, Africa, and parts of Southeast Asia.

Most circumcisions are performed under local anesthesia using one of several open surgical methods, including forceps-guided, dorsal slit and sleeve resection. Doing the surgery soon after birth is a simpler procedure than during adolescence or adulthood, because newborn boys experience a very low rate—0.2 to 0.4 percent—of adverse events, which usually are minor.

Complications are more likely when the procedure is performed by an inexperienced surgeon, in unsterile conditions or on older children. These issues may include bleeding, infection, too much or too little foreskin removed, unsatisfactory cosmetic effect, penile or scrotal skin scratches, and meatal stenosis, a narrowing of the opening of the urethra, the tube through which urine leaves the body.

Potential benefits of circumcision

Circumcision helps protect against several diseases, including herpes (simplex virus 2), urinary tract infections, chancroid (a sexually transmitted infection), penile and cervical cancer, and human immunodeficiency virus (HIV). Circumcision also is used to treat balanitis xerotica obliterans, a chronic, inflammatory skin disease that usually appears as whitish spots on the penis.

General genital hygiene is increased in circumcised men, due to the ease of access to the head of the penis, making it easier to wash.

The effect of circumcision on sexual function is another source of debate. Some studies indicate that while circumcision doesn’t negatively affect function, some circumcised men may feel less sensitivity and satisfaction in their sex lives; other studies show there is no difference in sexual satisfaction for circumcised and uncircumcised men.

Two sides to the argument

Circumcision remains a controversial surgical procedure. Opponents argue that circumcision bears no health benefits and brings substantial risks, such as medical complications and reduced penile sensation. Proponents say circumcision does offer health benefits, such as improving hygiene and reducing the risks of urinary infections, STIs, penile cancer and cervical cancer for women with circumcised partners.

The American Academy of Pediatrics (AAP) suggests that the health benefits of newborn circumcision outweigh the risks. However, the AAP does not recommend routine circumcision of all male newborns but rather leaves that choice to parents, who should discuss the health risks and benefits with the child’s physician and make up their own minds about what will be best for their child.