Should Men Be Circumcised?

In the not too distant past, circumcision (i.e., surgical removal of the foreskin from a penis) was a routine procedure performed on virtually all infant boys in the United States. However, circumcision has become increasingly controversial in recent years and the number of parents opting to perform this procedure on their male children has dropped considerably. The Centers for Disease Control currently estimates that 55-57% of newborn boys in the U.S. are circumcised [1]. The percentages differ greatly around the world, with higher rates in the Middle East and lower rates in Europe. So is circumcision a good idea? Unfortunately, there is not a definitive scientific answer to this question. Thus, the goal of this article is not to advocate one position or another, but rather to present you with some different perspectives and allow you to come to your own conclusions.

One of the arguments in favor of circumcision is that it frequently serves religious and cultural purposes. For instance, this procedure is commonplace in the Jewish religion, where it has a basis in scripture and is performed during a bris eight days after a male birth. Circumcision is frequently practiced in Muslim cultures as well, although as opposed to occurring in infancy, it is typically performed at puberty as a rite of passage.

The other major argument in favor of removing foreskin from the penis is that it provides hygienic and health benefits. For example, circumcision is a medical treatment for certain conditions, such as phimosis. Phimosis occurs when the foreskin is too tight and is not easily retracted, thereby creating pain and discomfort during sexual activity. In addition, circumcision is linked to a reduced risk of contracting sexually transmitted infections, including HIV. In fact, a clinical trial in Africa in which adult men were either circumcised or not (on a voluntarily basis, of course) had to be called off because the rate of contracting HIV was so much lower among circumcised men that ethical concerns were raised about withholding circumcision from men who still had their foreskin [2]! Other studies have shown that circumcision is linked to a reduced risk of contracting HPV [3] and syphilis [4], as well as a lower likelihood of developing penile cancer [5]. All of this research, combined with a low rate of side effects and no definitive evidence of reduced sexual satisfaction in adulthood, have resulted in significant support for circumcision within many corners of the medical community.

On the other hand, there are some who argue that circumcision should almost never be performed unless there is a true medical need and that routine circumcision amounts to nothing more than male genital mutilation. One of the common arguments on this side is that everyone has the right to an intact body, and that includes their sexual organs [6]. As a result, it is seen as cruel to irreversibly modify another person’s body, especially when they cannot consent to the procedure themselves. Likewise, others have focused on the pain and trauma that circumcision is likely to cause those who undergo it, given that anesthetics are not always used (particularly when the procedure occurs as part of a religious or cultural ritual). Yet one additional argument is that if delaying circumcision until adulthood can still yield health benefits, such as reducing HIV risk [2], why not let men evaluate the pros and cons themselves when they are old enough to comprehend them so that they can decide whether they actually want the procedure?

As you can see, there are compelling arguments on both sides of this issue that make it difficult to state whether circumcision is categorically good or bad. The important thing here is to educate yourself about the different perspectives so that if and when the time comes for you to decide whether circumcision is appropriate for your own child, you are prepared to do so.

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[1] Centers for Disease Control and Prevention. (2011). Trends in in-hospital newborn male circumcision — United States, 1999–2010. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6034a4.htm?s_cid=mm6034a4_w

[2] Roehr, B. (2007). Dramatic drop in HIV infections halts circumcision trials. British Medical Journal, 334, 11. doi: 10.1136/bmj.39073.473634.DB

[3] Larke, N., Thomas, S. L., Dos Santos Silva, I., & Weiss, H. A. (2011). Male circumcision and human papillomavirus infection in men: A systematic review and meta-analysis. Journal of Infectious Diseases, 204, 1375–90. doi: 10.1093/infdis/jir523

[4] Weiss, H. A., Thomas, S. L., Munabi, S. K., & Hayes, R. J. (2006). Male circumcision and risk of syphilis, chancroid, and genital herpes: A systematic review and meta‐analysis. Sexually Transmitted Infections, 82, 101–9. doi: 10.1136/sti.2005.017442

[5] Larke, N. L., Thomas, S. L., Dos Santos Silva, I., & Weiss, H. A. (2011). Male circumcision and penile cancer: A systematic review and meta-analysis. Cancer Causes Control, 22, 1097–110. doi: 10.1007/s10552-011-9785-9

[6] Hammond, T. (1999). A preliminary poll of men circumcised in infancy or childhood. British Journal of Urology International, 83(Suppl. 1), 85–92. doi:10.1046/j.1464-410x.1999.0830s1085.x

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