The Circumcision Decision: Factors to Consider

The Circumcision Debate

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Male circumcision is the surgical removal of the foreskin covering the tip of the penis. It’s a procedure usually performed in the first two to 10 days after birth, either at the hospital or as part of a religious ceremony at home. Though this practice is widely accepted across the U.S., circumcision is actually pretty rare worldwide. Only 10 percent of boys get the snip around the globe, with rates steadily declining in the States—from 80 percent in 1980 to an estimated 60 percent at present. These numbers reflect the current debate over the pros and cons of the practice. Let’s take a look at some of the social, cultural, historical and medical reasons for male circumcision, as well as why it has recently fallen out of favor.

Why Circumcise?

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In rare cases, circumcision is performed out of medical necessity if the foreskin becomes infected, is unable to retract (phimosis) or if it cannot be pulled over the penis again once retracted (paraphimosis). But more often the procedure is carried out for social, cultural or religious reasons. It is most common within Muslim and Jewish communities with the practice dating back thousands of years and detailed in religious texts. It became popular in the U.S. in the 1920s when doctors believed it would reduce the rates of STDs like syphilis and lessen the urge for masturbation. The belief that circumcision is more hygienic remains the prevailing reason behind the practice, especially in Christian and secular communities. But is that really the case?

Health Benefits of Circumcision

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Some studies show that circumcision prevents against urinary tract infections, with intact men 10 times more likely to contract them. According to the CDC, the cells of the foreskin may be more susceptible to some STDs—including HIV in heterosexual partnerships—and may increase the risk of penile cancer. Though many people believe that the uncircumcised penis is too difficult to keep clean and therefore can lead to problems, this is actually not true. The foreskin can be easily pulled back and cleaned with soap and water as part of a regular washing routine.

Health Concerns of Circumcision

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Between two and 10 percent of circumcisions result in complications, though the exact number is not known. Bleeding and post-op irritation can sometimes lead to infection—one of the most common side effects. Scarring that causes pain or numbness is more rare, though discomfort and pain during erection around the cut is not uncommon.

The biggest push against circumcision comes from the American Academy of Pediatrics. They base their opposition on studies that indicate psychological damage to circumcised men and strongly object to the CDC guidelines that promote the practice. Studies on cognitive development have shown that experiencing such intense pain at such a young age can cause changes in brain chemistry which can result in increased anxiety, attention problems, and hyperactivity. (Nope, anesthesia is rarely used.) According to some studies, anger, shame and even PTSD can be long-term consequences of circumcision.

Sexual Side-Effects

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Though older studies claim that long-term side effects of circumcision include decreased sexual sensitivity, a recent study indicates this is not the case. A reluctance to use condoms and needing to use lubricant was also cited in the past as evidence of the procedure’s side effects. However, the new research challenges the widely held belief that the foreskin holds the majority of sensitivity and therefore its removal takes away from male pleasure.

A Question of Ethics

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Perhaps the trickiest question to answer is whether circumcision is the right thing to do. With various groups (including the CDC) supporting the practice and others hoping to criminalize it, the choice is often based on personal beliefs. A physician’s job is to do no harm, so if the patient can’t give consent and the procedure is not medically necessary, is it ethical to do it anyway?

On one hand, decreasing the chance of getting cancer, HIV and other STDs even by a little can be reason enough for some parents to choose to cut. For others, even the small risk of post-surgical complications and psychological damage is too high. Cultural trends, traditions and customs may be the determining factor for many families, as the risks and benefits can appear evenly weighted.

To Snip or Not To Snip

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Given that this is a one-time decision, it is important to carefully consider all sides of the argument. It is vital to be educated about the potential risks and consequences of either decision. Do your own research; don’t just rely on what you remember from health class or on the advice or pressure of your peers. At the end of the day, it is a very personal choice you are making as parents for your child, one that he will carry with him the rest of his life. Above all else, make the decision that is right for you as a family.

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