One of the more controversial topics in children’s healthcare is the issue of male circumcision. Steeped in tradition, circumcision is now a hot button debate topic with some referring to it as “genital mutilation.” Its proponents point to mild advantages, such as slowing the spread of AIDS, as far outweighing any rare downfalls. These debates make it hard for new parents to know what action to take with their newborn boy.
Circumcision is a minor medical procedure most often performed within a few days of a child’s birth. A special circumcision device is used to remove the foreskin of the penis after it is separated from the glans and clamped. For adults, the procedure is typically performed without the use of clamps and can even be performed without surgery. Minor complications from circumcision occur in about 3% of procedures. The mortality rate is about 1 in 500,000 in the United States.
Circumcision: Steeped in Tradition
About one-third of the world’s males are circumcised. This can be attributed to traditions rooted in religion. Circumcision is almost universally performed on males in the Middle East where Islam (and Judaism in Israel) is practiced. It is also prevalent in the United States and parts of Africa and Southeast Asia. It is rare in most of Asia, Europe, Latin America, and Southern Asia.
Though the procedure predates biblical times, the widespread practice of circumcision among Jews, Christians, and Muslims can be attributed to the story of Abraham. In chapter 17 of Genesis in the Hebrew Bible, Abraham, his relatives, and his slaves all undergo the procedure. In the myth, God then tells Abraham that all of his descendants must also be circumcised on the eighth day of life.
In modern times, for those who do not adhere to the Abrahamic religions, circumcision is less common due to most health insurance companies considering it an elective procedure and therefore not covering it. In Europe, it is rare for the national health systems to cover the procedure, so most citizens of those countries do not have it done.
Potential Costs and Benefits of Circumcision
The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS have stated that circumcision is effective in slowing the transmission of HIV. They also caution that the procedure should be carried out by qualified medical professional and recipients must first provide informed consent.
WHO considers circumcision to be a cost effective public health intervention in Africa, where there are significant HIV-infected populations. Additionally, in the United States, the Centers for Disease Control and Prevention agrees that newborn circumcision is a cost-effective way to combat the spread of HIV in the U.S.
Circumcision has also been shown to reduce the risk of penile cancer, a very rare form of cancer affecting only one out of every 100,000 men. It also reduces the risk of cervical cancer in female sexual partners of circumcised men.
When carried out by a trained professional, it is rare for there to be any adverse effects from circumcision. It is rumored that circumcision leads to decreased sensitivity in the penis, reduced sexual satisfaction, and stunted sexual function. But, there is no research backing this up.
There is vigorous, ongoing debate in the United States over the ethics of circumcision. Since newborns are not able to decide for themselves if they would like the procedure done, some argue the procedure should not be performed. This is because they believe the procedure only has marginal health benefits while it has the (extremely rare) potential of killing the child. They believe the child should decide whether he wants the procedure once he is old enough to provide informed consent.
Many argue that circumcision is based on a barbaric biblical tradition and does not produce health benefits to it recipients. This ignores the studies done by WHO and the CDC.
It all comes down to the parents making an informed decision based on the facts. Parents may want to talk to their health care provider to get the most up-to-date information on circumcision and the ethics surrounding the procedure.