Circumcision is the process by which the foreskin is surgically removed to expose the head of the penis. If your baby is born with a penis, you’ll need to decide whether or not to have your child circumcised. For many parents, especially those who practice Judaism or Islam, circumcision is traditional for religious reasons. For other families, however, choosing whether or not to circumcise can be filled with anxiety and indecision.

 Some studies have demonstrated a link between the removal of the foreskin and certain possible health advantages. These include a lower chance of developing urinary tract infections (UTIs), some sexually transmitted infections (STIs), and penile cancer. However, as with any surgical procedure, there is some degree of risk or danger involved. 

Current Trends on Circumcision

These days, fewer American families are opting to circumcise their newborns. Across a three-decade period from 1979 through 2010, the national rate of newborn circumcision declined 10% overall, from 64.5% to 58.3%, according to the Centers for Disease Control and Prevention (CDC). This could be due to a number of reasons. For one thing, guidance on routine newborn circumcision has changed over the years. For another, fewer insurance companies are covering the cost of the procedure. Additionally, America’s evolving demographic composition may play into these numbers, as some racial and ethnic groups tend to be less likely to circumcise. 

In 2012, the American Academy of Pediatrics (AAP) issued an updated policy statement on circumcision, acknowledging the potential medical benefits of the procedure, but stopping short of routinely recommending it for all male newborns.

“Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.”

In short, they advise that “Parents ultimately should decide whether circumcision is in the best interests of their male child. They will need to weigh medical information in the context of their own religious, ethical, and cultural beliefs and practices.”

Still can’t decide whether or not to circumcise? Let’s take at what are some of the pros and cons of circumcision.

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The Possible Advantages of Circumcision

Proponents of circumcision cite a number of potential health benefits from the procedure.

Reduced risk of penile cancer

Male neonatal circumcision has been linked to a significant decrease in penile cancer rates in countries like Israel (where circumcision is widely performed), having the lowest incidence in the world at less than 0.1% of malignancies. Countries that suffer from economic disparity or have low rates of circumcision, such as Brazil, India, and African nations, have the highest reported incidence with rates as high as 6% of malignant neoplasms.

Decreased rates of sexually transmitted infections

Based on a number of randomized clinical trials, the World Health Organization (WHO) supports male circumcision as an effective method of lowering the risk of HIV in areas experiencing an HIV epidemic and having few circumcised individuals.

The reason is that the underside of the foreskin has immune system cells that bond easily with HIV cells. During intercourse, the foreskin frequently develops microscopic tears, thereby allowing HIV cells to easily enter the body. Circumcision eliminates these factors. While these studies were performed in Africa where the instance of HIV infection is extremely high, researchers believe the results are applicable to Americans as well.

Additional studies have demonstrated a connection between circumcision and a decreased risk of penile human papillomavirus infection (HPV) and herpes simplex virus type 2 (HSV-2). Research also points to a decreased risk of cervical cancer among female sexual partners of circumcised males. That said, sexually transmitted diseases clearly cannot be transmitted until an individual engages in sexual activity. Therefore, some may argue that a male could make a decision to be circumcised when he is older without losing this asserted benefit.

Lowered risk for urinary tract infections

The AAP cites “significant reductions in the risk of urinary tract infection (UTI) in the first year of life” as one of the major advantages of circumcision. Untreated UTIs may spread bacteria from the bladder to one or both kidneys, causing damage that can permanently reduce kidney function.

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The Potential Downsides of Circumcision

Like any surgery, circumcision has some risks and drawbacks. These are some of the reasons parents decide to opt out of circumcision for their children.

Pain and discomfort during and after the procedure

Although safe and effective medications are administered to reduce pain, circumcision is painful. Many parents don’t want to impose a distressing elective surgery on their baby when it’s possible to live a healthy life with the foreskin intact. During a newborn circumcision, an anesthetic is given via injection or cream to numb the penis. Afterward, the doctor will provide instructions on how to reduce any pain. It takes about a week to 10 days for a newborn’s circumcision to heal.

Possible reduction in sensation

While it’s scientifically impossible for someone circumcised at birth to make a comparison, some studies have been conducted among males who were circumcised as adults. Some subjects reported sexual intercourse was worse, others found it better, and most described it as the same as it was prior to surgery.

Potential surgical complications

While the risk of complications during circumcision is low (especially when performed by an experienced physician in a sterile environment), it’s not zero. These complications may include cutting the foreskin too long or too short, poor healing, bleeding, or infection.

The Takeaway

Ultimately, the decision of whether or not to circumcise for non-medical reasons is up to the parents. Some families believe it’s simplest to make a baby’s penis “match” dad’s, whether they’re intact or not. Other parents decide to hold off on surgery and leave it up to the child at a later time. However, it’s worth noting that the risk of complications is significantly higher for older children and adults than it is for babies. Weigh the medical information in the context of your own religious, ethical, and cultural beliefs and practices, and decide whether circumcision is in the best interests of your child.

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