Circumcision in the 21st Century: Pros and Cons

Circumcision today

Circumcision – the removal of the foreskin from the head of the penis – has been around for thousands of years. We know it was done as a puberty ritual in ancient Egypt, because there are stone engravings of the procedure.

Moses may have brought circumcision to the Jews from Egypt. In Jewish tradition, circumcision became a religious practice for male babies and is part of the Covenant of the Old Testament. In Islam, the Old Testament is part of the religious tradition. Therefore, circumcision also became part of Islamic religious practice. In early Christianity, circumcision was required for converts to the new religion.

In modern day America, circumcision is becoming less common. Up until the 1980s, about 80 percent of male babies were circumcised. Since then, there has been a growing debate over circumcision. Those against circumcision argue that it is outdated, unnecessary, and painful. They say it should be a choice a man makes on his own, not one dictated by culture. Today, somewhere between 50 and 60 percent of male babies are circumcised.

In an attempt to put the debate in perspective, the American Academy of Pediatrics reviewed all the literature and issued a policy statement in 2012. Essentially, the statement says that the benefits of circumcision outweigh the risks. But, not enough to recommend routine circumcision. Parents should make the choice based on the risks, benefits, and their preferences or beliefs.

The Pros and Cons

If you become the parents of a male baby, you have to choose when it comes to circumcision. It is not required. It is an elective procedure. In fact, you should check your insurance coverage to see if you are covered. If you have a strong religious or cultural view of circumcision, your choice may already be made. But for many parents, weighing the pros and cons is an important part of this decision.

Here are the pros:

  • Circumcised males have a lower risk of urinary tract infection, especially in the first year.
  • In later life, circumcised males have a slightly lower risk of HIV and other sexually transmitted diseases.
  • In later life, circumcised males have a lower risk for penile cancer, although this is a rare cancer.
  • Circumcised males do not need to retract the foreskin of the penis for good hygiene.
  • Risks from the procedure are low. The procedure is usually done shortly after birth. Anesthesia (injected or topical) reduces the pain. Complications are rare and can be managed.

Most of the cons are the opposite of the pros, a slightly higher risk for urinary tract infection, HIV, sexually transmitted diseases, and penile cancer. Here is more to consider regarding the cons:

  • Although the procedure is safe, rare complications can occur. They include bleeding, infection, and scarring.
  • After the procedure, you will have to do wound care and some dressing changes for several days. You will need to watch for bleeding or infection.
  • If you decide against circumcision, you will need to learn how to pull back your son’s foreskin between age three and five for cleaning. Before age 3, the foreskin is too tight and should not be pulled back. Once your son is old enough, he will have to learn to retract the foreskin and clean the penis.
  • If you choose to let your son decide on circumcision at an older age, you should know that circumcision in young men is more painful and has a higher risk of complications.

The bottom line is that circumcision is an option. There is no right or wrong decision. You may want to discuss the pros and cons with your obstetrician or with a pediatrician.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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