Pros and Cons
During my 16 years of marriage, there have been very few issues on which my husband and I fervidly disagreed. Whether or not to circumcise our son, however, was one of them.
When we found out in early 1993 that we were having a boy, I just assumed he'd be circumcised. But my husband, Alain, was born and raised in France, where circumcision is not done routinely the way it is here, and he assumed exactly the opposite. We did not have a religious reason for circumcision, as Jews and Muslims do. "Why would you want to put a baby through a painful, unnecessary surgery?" Alain asked me, incredulous.
The real reason I wanted to do it was so our son wouldn't look different in the locker room when he got older. Alain didn't think that was a good enough reason to snip off the baby's foreskin, a fold of skin that covers the tip of the penis. Maybe I didn't think so, either. I heard varying rumors: Uncircumcised men have stronger sexual sensations because the tip of the penis is not constantly exposed to the everyday elements; it's hard to keep an uncircumcised penis clean. So I started doing research, looking for a solid, medical reason to warrant the procedure.
The Procedure's Pros and Cons
At that time, the American Academy of Pediatrics (AAP) said that circumcising newborn boys did have potential medical advantages, primarily related to preventing urinary tract infections (UTIs). But by 1999, the AAP had formed a task force on circumcision that decided the procedure shouldn't be routinely recommended. The task force based this policy on 40 years of studies of both circumcised and uncircumcised boys, and it concluded the following:
- Problems with the penis, such as irritation, can occur with or without circumcision.
- With proper care, there is no difference in hygiene.
- There may or may not be differences in sexual sensation in adult men.
- There is an increased risk for a UTI in uncircumcised males, especially babies under 1 year. However, the risk for a UTI is still less than 1 percent.
- Newborn circumcision provides some protection from penile cancer, which only occurs in the foreskin. However, the risk of this cancer is very low in developed countries such as the United States.
"We also looked at whether being circumcised prevents HIV in a man's partner," says Jack Swanson, MD, a pediatrician in Ames, Iowa, and a task force member. "There may be a slight benefit to being circumcised, but the statistics were inconclusive. There weren't any medical reasons that were convincing enough for us to say that all boy babies should be circumcised," he says.
However, in 2002, a study found male circumcision was linked to a reduced risk of penile human papillomavirus infection (HPV). The study also showed a lower risk of cervical cancer in the current female partners of circumcised men with a history of multiple sexual partners. (HPV is associated with an increased risk of cervical cancer.) But no medical evidence has been weighty enough to reverse the AAP's policy on circumcision. In fact, this past May it reaffirmed its stand that circumcision shouldn't be recommended unless the procedure is essential to the newborn's health.
The Bottom Line?
"If you want it done for nonmedical reasons, that's the parents' choice," says Dr. Swanson.
And most American parents choose newborn circumcision in spite of medical advice; in fact, for many it's a no-brainer. "My husband and I probably spent only 10 minutes discussing it," says Suzette MacKenzie, of Concord, Massachusetts, of their son's circumcision last year. "We didn't want Spencer to look different from his dad."
The MacKenzies aren't alone in their view. Gabrielle Horn, of Brooklyn, New York, delivered a boy in March and had him circumcised, too. "I went to high school in Marin County, California, in the early '90s. My friend's boyfriend was uncircumcised, and it was a topic of conversation among the girls," she recalls. "But if I lived in a place where 80 percent of the boys were not circumcised, then I probably wouldn't do it."