"I hear from parents who don't feel it's right to remove a piece of someone's body, and who believe it might be there for a good reason, and from those who want their son to match Daddy, who worry about cleaning the penis properly, and who acknowledge the slight medical advantage. I've even had adult men arguing with each other in class over which one feels sex better."
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Delicate decision
To circumcise or not? As the practice grows less common in the U.S., parents weigh the medical, social and religious pros and cons.
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Medical considerations
Those crunching the numbers consider the benefits and risks of newborn circumcision to be slight. Medical benefits include a reduced risk of urinary tract infections, penile cancer, sexually transmitted diseases and phimosis (closure of the foreskin over the tip of the penis). Risks include a chance of excessive bleeding or infection. Even rarer are surgical mishaps that may require a later surgical repair.
In the first year of life, 1 in 100 uncircumcised boys will develop a urinary tract infection. Only 1 in 1,000 circumcised boys will. "While that's a tenfold reduction, you have to keep in mind that the risk was only 1% to begin with," says Dr. Andrew Freedman, pediatric urologist at Cedars-Sinai Medical Center. Proper hygiene can prevent most infections.
In noncircumcised populations, phimosis occurs in 4% of males. Of those who develop this problem, half get circumcised. The other half use stretching creams and noninvasive treatments, Freedman says. Penile cancer affects only 1 in 100,000 men, but circumcised men are three times less likely to get that disease.
Those who strongly oppose infant circumcision believe the procedure violates a child's human rights. Some call it "male genital mutilation" and rather than cite circumcision rates, they track "genital integrity rates." Others argue that this is a decision sons should make for themselves when older. Internet support groups give voice to men who lament the loss of their foreskin and help to those seeking to restore it.
The downside of letting the child make the decision later is that adult circumcision is more expensive, painful and extensive. During an infant circumcision, practitioners numb the site with local anesthesia, then attach a bell-shaped clamp to the foreskin and excise the skin over the clamp. The clamp helps prevent bleeding. In adults, the procedure involves two incisions, above and below the glans (tip of the penis), stitches and a longer recovery. The cost is about 10 times that of a newborn procedure.
