The Pros and Cons of Circumcision

Firstly, newborn circumcision is a procedure that surgically removes the foreskin — skin that covers the tip of the baby’s penis — a few days after birth. Although circumcision after is possible, it becomes a little more complicated.

While the practice dates back to ancient Egypt and was likely due to hygiene and religious reasons, in the intervening years it has become more of a U.S. cultural norm rather than any overarching worry about health or hygiene. In fact, although circumcision has been decreasing for the last thirty years in the U.S, for many other families — especially for those in the Jewish and Muslim faith traditions — circumcision is expected.

Like all things in life, there are a lot of pros and cons to circumcision and it’s not a decision to be made lightly. For many parents, the health benefits of circumcision are a leading factor in their choice.

According to a 2012 task force report by the American Academy of Pediatrics (AAP), there are potential medical advantages of circumcision. However, though the AAP claims the benefits of circumcision outweigh the risks, the organization ultimately encourages parents to make their own decisions based on their particular family values, religion, and culture.

Some reduced risk of urinary tract infections (UTIs)
Compared to uncircumcised boys, there is some evidence that circumcised boys have a lower occurrence of serious UTIs during their first year. If untreated, UTIs can possibly lead to introducing bacteria into the bloodstream or cause kidney damage. However, boys are already at low risk for UTIs, so for some this is not a strong enough benefit for circumcision.

Fewer incidents of sexually transmitted infections (STIs)
According to the Centers of Disease Control and Prevention (CDC), the results from three randomized clinical trials suggest that male circumcision can decrease a man’s risk of HIV infection by 50% to 60% during sex with HIV-infected female partners. In addition, compared to uncircumcised men, circumcised men have shown in clinical trials to be less likely to get new infections of the following:

• Syphilis (42%)
• Genital ulcer disease (48%)
• Genital herpes (28% to 45%)
• High-risk strains of human papillomavirus (HPV) associated with cancer (24% to 47%)

Of course, circumcised or not, practicing safe sexual practices and using a condom is the most important part of preventing STIs.

In addition, due to the foreskin, uncircumcised teenagers and young adults may be less likely to notice STI symptoms.

“I’ve seen many uncircumcised male patients during routine physical examinations who have asymptomatic discharge from the urethra due to either gonorrhea or Chlamydia that would have otherwise gone undiagnosed,” Arik Marcell, M.D., M.P.H. told Johns Hopkins Medicine. “This is a threat to the health of the male as well as his partners since STDs can cause ascending infections into the reproductive tract.”

Protection against penile cancer and other foreskin-related issues
Because penile cancer only occurs in the foreskin, the removal of the foreskin can provide some protection (although this cancer is very rare). Plus, due to the lack of foreskin, there will be no risk for developing foreskin infections or phimosis, a rare condition where the foreskin cannot retract.

Given that there are some medical benefits to infant circumcision, why do some parents choose against it?

The foreskin has a role in penile health and pleasure
For many parents, the penis in its natural state has a foreskin and thus should stay that way barring some medical need. The foreskin provides four major benefits in penile health:

• Protection
• Sensation
• Provides “glide” during sexual intercourse due to the additional skin
• Provides immune system functionality due to immune cells in its inner mucosal layer

A common question is, "Does circumision affect sexual pleasure?“ Some say yes. "Down the road, the sex will be better because of having all the nerves and all the skin for extension and movement and the protection over the head to keep it sensitive,” homeschooling mom Sabrina Lee told Mom.com.

However, some experts disagree. "If you’re uncircumcised, it’s not likely that sex will feel any better or worse if you pull your foreskin back," Attia Taylor wrote for Planned Parenthood. "Uncircumcised and circumcised penises both work the same way, they just look a little different."

It’s a matter of bodily autonomy
For mom of four Amy H., she and her husbands opted against baby circumcision. “We strongly feel that babies should be respected enough to keep all of their own body parts and to make the choice themselves if they want to be circumcised when they get older,” she told Mom.com.

The procedure is permanent
Other reasons parents choose not to undergo the procedure is because circumcision is permanent and there is no way to completely restore the foreskin.

“It can’t be reversed if my kid wishes it wasn’t done,” added Lee. “My kid can make that decision if they want to be circumcised down the road. Globally, most men are not circumcised. There are no cons to leaving nature as it is, as far as I am concerned.”