There are so many decisions that modern day parents must make immediately before your infant even leaves the hospital. If you are expecting a boy, one of the biggest, and possibly toughest, decisions you and your partner may have to contend with will be the age old question: "Will you be circumcising your son?"
There is so much information available regarding infant circumcision, however, many of it is out of date, and/or comes from a biased source. The purpose of this post is to arm you with up-to-date, relevant information based on medical studies, rather than opinion, to help you make an informed decision on an important matter. So if you have any of the following questions or concerns, this post is for you!
"I don't want my son to be the only uncircumcised boy in the locker room."
- According to the NY Times, only around 32% of infants are being circumcised globally, and less than half are being circumcised in the United States as of 2010. (1)
"I don't want to be responsible for properly cleaning the area if I do not circumcise my baby son."
- According to kidshealth.org, a child's foreskin should never be retracted (pulled back) by force, as there is no medical need to wash under the foreskin; simply washing the outside of the penis is adequate. (2)
- During the first few years of life, the foreskin is stuck to the head of the penis by a membrane (called the synechia). This membrane or connective tissue dissolves naturally – a process that should never be hurried. (2)
- Let your son discover retracting his own foreskin.
- Once the foreskin is easily retracted, your son should learn to do this as part of normal washing in the bath; make sure he rinses off any soap and pulls the foreskin back over the head of the penis afterwards. (2)
"My doctor told me that all doctors and medical associations recommend circumcision."
- The American Academy of Pediatrics revised their statement in 1999, saying that, "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child." (3)
- The AAP recently revised their statement in 2012 in an open letter to the insurance companies who were not willing to compensate for circumcisions. The new policy says that the health benefits of circumcision are not great enough to endorse it for all newborn boys, but "are sufficient to justify access to this procedure for families choosing it." (4)
"Aren't intact males more likely to develop penile cancer?"
- The American Cancer Society does not endorse circumcision as a valid way to prevent penile cancer. In the United States, the rate of penile cancer is low, even among uncircumcised males.
- The best way to prevent penile cancer is by practicing safe sex and avoiding the human papilloma virus (HPV) infection, and by not smoking. (5)
"Isn't it just a bit of skin? What's the big deal?"
- The foreskin is attached to a very sensitive sexual gland. While no exact number can be known definitively, it's estimated by Dr. Paul Fleiss, MD, that approximately 20,000 nerve endings, and a few feet of blood vessels can be found in the prepuce (foreskin). (6)
- It's difficult to pinpoint statistical information and data regarding sexual sensitivities of intact penises compared to circumcised males, since sexual preferences and experiences are so unique to the individual. (6)
"Won't uncircumcised boys be at a higher risk for urinary tract infections?"
- Statistically, yes. However, "six hundred and twenty-five infant boys would need to be circumcised to prevent one UTI hospitalization in the first 5 years of life." (7)
- UTI's are not common, nor are they life threatening. (8)
"Don't you have to be circumcised in some religions?"
- In Judaism, circumcision is performed on the 8th day of a boy's life. It comes from Genesis 17:10-14 where it commands that all fathers must insure that their son's are circumcised, and all adult males must obligated to perform the rite as well.
- Circumcision is performed by a mohel, an observant Jew who is trained in Jewish law and surgical techniques. In most traditions, circumcision performed by a physician is not valid even if a rabbi is present, although the Reform movement has begun to accept such circumcisions. (9)
- As a result of this, in order to convert to Judaism, an intact adult male must be circumcised with a Rabbi present. (10)
- Within the Islamic religion and culture, the mention of circumcision is never mentioned in the Qur'an, however, many Islamic cultures practice it at varying ages as a man's "rite of passage" into adulthood.
"Won't circumcision traumatize a baby and isn't it extremely painful?"
- This topic is very controversial, however, if you do choose to circumcise, know that a topical or local anesthetic is used to reduce the pain.
- Each baby will react differently, and many have even been known to sleep through the procedure, whereas some parents have reported their child crying and the area being sensitive to the touch during initial diaper changes.
"Doesn't keeping the foreskin intact pose problems in adulthood?"
- Circumcision prevents phimosis (the inability to retract the foreskin at an age when it should normally be retractable), paraphimosis (the painful inability to return the foreskin to its original location), and balanoposthitis (inflammation of the glans and foreskin). However, these conditions are rare, and only tend to happen in 1%-2% of adults. (11)
"Does circumcision prevent HPV?"
- There are recent studies conducted by the CDC that cancerous subtypes of the human papillomavirus (HPV) have been associated by a lack of circumcised males. These statistics are from an African study, and currently, American studies haven't proven this case one way or the other. (12)
"My husband is circumcised; won't my child notice the difference of their penis, compared to Daddy's?"
- The biggest and most noticeable thing that a young boy will question will be the presence of pubic hair. Once your son is old enough to comprehend the difference between a circumcised penis, and an intact one, you should have a conversation with them about it! Take the opportunity to talk to them about hygiene, as well as self experimentation and safe sex.
The fact of the matter is that this is a personal decision that should not be taken lightly. Being properly educated with facts, rather than a doctor's personal opinion is vital to you and the future of your son. Circumcision is irreversible. You have to make an individual choice about how it suits your family and your family's beliefs. While leaving your son intact is becoming more popular every day, you may still get backlash from a different generation, and even medical professionals. Equipping yourself with knowledge is vital, to both make an informed decision, or to prepare yourself to justify your decision to boundary-crossing individuals. The simple bottom line is that you are making the best decision for your family, because you are making it out of love, whether you choose to circumcise or not.