Thirty years ago, two thirds of all parents of baby boys made the decision to have their sons circumcised before leaving the hospital. What was once standard protocol for male newborns, is a topic of controversy among healthcare providers and parents alike.
In the last thirty years, circumcision rates have fallen by ten percent, with just over half of all male newborns undergoing the procedure.
Several factors have played a role in the decline in the popularity of circumcision in the United States. Parents have access to more information and are more likely to research issues that were accepted in years past.
Circumcision is more common in the heartland of the country, where San Francisco and Santa Monica healthcare officials proposed a ban to eliminate the procedure entirely.
Insurance companies have played a part in the drop in circumcision rates as well. Medicaid refuses to cover the procedure for low income families in eighteen states. Other insurance companies deny coverage for circumcisions unless the decision is based on purely medical reasons.
As parents prepare for the arrival of their sons, they are wondering, “Is circumcision really necessary?”
7 The CDC’s Stance on Circumcision
The CDC maintains that,”the benefits of circumcision outweigh the risks”. In a report released at the end of 2014, the CDC encouraged healthcare providers to encourage parents to circumcise their newborn sons before leaving the hospital.
They summed up their reasoning as follows,” These recommendations are based on an evaluation of available information on health risks and benefits associated with high quality, medically performed male circumcision and were developed to pertain to men and male newborns in the United States.”
The new guidelines came as the result of a seven year study, that involved researching statistics among African males, who lived in areas where HIV is at near epidemic levels.
John Hopkin’s researcher, Aaron Tobian had this to say after taking part in the seven year study,” The benefits of circumcision have become more and more clear over the last ten years.”
What Exactly is Circumcision?
Circumcision comes from the Latin word circumcidre, which literally means “to cut around”.
The circumcision begins by immobilizing the newborn on a specially made board to prevent injury from sudden movements. A sterile environment is created using surgical drapes and cleaning the genital area with an antibacterial and antimicrobial solution.
Locally injected or topical anesthesia is administered before the surgical procedure begins to minimize pain and emotional stress to the baby. Most research indicate that some pain for the baby is still an issue, as is evident by the newborn’s cries and body cues.
The foreskin is cut and separated from the glans. Some doctors use a device to aid them in removing the foreskin, this is believed to provide a cleaner cut.
Once the foreskin is removed, the penis is covered with petroleum jelly and bandaged. Special care needs to be taken to prevent irritation and infection for three to four days after the surgery is done.
6 What Are the Benefits of Circumcision?
The US National Library of Medicine, under the guidance of the National Institutes of Health, organized a listing of the information the CDC used to issue it’s official recommendation of circumcision for all male newborns and males in general.
Here are some of the reasons listed:
- Circumcision is believed to reduce the risk of HIV in hetrosexual men. Recent studies revealed that circumcision lowered heterosexual male’s risk of acquiring HIV by sixty percent. The World Health Organization now recommends circumcision as part of a protocol for HIV prevention. It was hypothesized that the decrease in HIV rates could be due to several factors. Uncircumcised men with poor foreskin hygiene habits were believed to be a factor. Another thought was that abrasions and open areas in the foreskin itself could make transmission of HIV easier. Researchers also explored a theory that the HIV virus itself may be present in the mucosal surface of the foreskin.
- Urinary tract infections almost four percent less in circumcised males than their uncircumcised counterparts. While this may seem like a minor difference, the fact that three to five percent of infants who suffer from a UTI go on to develop meningitis is a cause for concern. Occasionally, a urinary tract infection in an infant can cause kidney failure or even death.
- Circumcision lowers the risk of sexually transmitted diseases.A 2006 study found that circumcised men suffered from fewer instances of genital ulcer diseases as well as HIV.
- Studies show that circumcision lowers the risk of penile cancer. Of the 592 men studied with penile cancer, none were circumcised. When taking into consideration other factors, an uncircumcised penis was the only thing the cancer patients had in common.
- In cases of men with multiple sex partners, circumcision was shown to reduce the risk of HPV and cervical cancer in their female partners.
- Circumcision prevents ectopic pregnancy, chlamydia, and infertility due to pelvic inflammatory disease. Because the instances of chlamydia are reduced in circumcised men, the development of pelvic inflammatory disease is also lowered. PID is a leading cause of infertility in women, so it is hypothesized that chlamydia indirectly lowers the risk of infertility.
- Circumcision eliminates the risk of issues with the foreskin later in life. Almost four percent of uncircumcised males develop swelling or irritation of the foreskin at some point in their lives. While this is readily treated in most individuals, occasionally this results in the need for adult circumcision to relieve the issue.
- Some studies show circumcision offers men and their partners increased sexual gratification.
5 The Downside to Circumcision
Intact America is an organization that is committed to educating the public on the dangers of circumcision. The group feels that circumcision is a completely unnecessary procedure that utilizes millions of medical dollars that could be spent on “necessary medical services”.
Here is a list of the reasons they give for opting out of this surgical procedure:
- Routine circumcision is completely unnecessary, medically speaking. The American Academy of Pediatrics has never recommended circumcision in it’s seventy five years of existence. No medical organization in the United States, or abroad recommends the procedure. The only organizations that endorse circumcision are government run agencies who benefit monetarily from the procedure.
- Female genital mutilation is viewed as barbaric all over the world. How is altering male genitalia any different? In the United States, girls are protected from female circumcision by law, do our sons deserve any less?
- The presence of foreskin isn’t a birth defect that needs correction. The foreskin is a normal part of the male anatomy and serves to protect infants and young boys from urine and feces and other contaminants, that can entry into the urinary tract and introduce infection causing bacteria.
- Removing a part of a boy's penis is a surgical procedure and carries risks. Besides the unnecessary pain that circumcision causes newborns, there are other factors to consider. Bleeding,loss of the glans, removal of too much skin, infection and even death are all risks parents expose their child to during a circumcision.
- Attitudes toward circumcision are changing. Developed countries in Europe, Latin America and Asia fail to see the logic in circumcision. Worldwide, seventy five percent of all men are uncircumcised at birth and remain so throughout their lives.
- The rates of sexually transmitted disease among men in the United States are actually higher than in countries where circumcision is rare.
- No child should have to endure mutilation to appease societal norms, religious beliefs or parent’s personal preferences. Ethically, parents are only allowed to consent to surgeries that have medical benefit to the child, worldwide statistics fail to prove a direct link between circumcision and the health of the child.
4 What Does Science Say About Circumcision?
With emotions running high on both sides of the debate, scientific evidence in the form of cold hard facts can help clear things up a bit for parents who are looking for objective answers.
The arguments on either side are sometimes medically proven, but all in all can be considered dubious at best.
One of the biggest myths about circumcision is that the doctors who perform them are getting rich from the procedure. Money may play a factor in some cases, but there are many doctors who work on a fixed rate basis. In this case, circumcisions would just add to their already stressed workloads.
The argument that babies feel pain during circumcision is correct. But to what degree, no one knows. Babies react similarly to routine blood draws or immunizations. There is no surefire way to measure a baby’s pain level.
The claim that adult men suffer some sort of trauma from having their genitals mutilated is pretty out there. In most cases, the men have no memory of the surgery or life before their circumcisions. Concrete evidence that circumcision results in adult trauma is difficult to prove within the shadow of a doubt.
While complications do occur, procedures performed by a qualified healthcare professional in a sterile environment pose little risk to babies.
3 Science Debunks the Health Benefits of Circumcision
One of the CDC’s reasons for recommending across the board circumcisions for males is the decreased risk of HIV. In the studies performed in Africa, it was revealed that one circumcision prevented seventy two cases of HIV in females. When the studies took into consideration homosexual transmission, the results became less definitive.
The flaw in this research stems from the fact that simple hygiene and safe sex practices can prevent the spread of HIV. Circumcision alone can not do that. The concern of some scientists is that, instead of using circumcision as a tool in the fight against HIV, the population will see it as a complete preventative. Which could end in disastrous results, especially for areas where HIV is rampant.
Penile cancer occurs in one in one hundred thousand men in the United States. This means one in six hundred uncircumcised men will develop penile cancer. Penile cancer in countries where circumcision is rare have a ten to twenty percent rate of penile cancer in men. The statistics don’t take into consideration other factors such as smoking, HPV infection, multiple sex partners and poor hygiene. This led the American Cancer Society to shun the belief that penile cancer can be prevented by circumcision.
The benefits of circumcision for the prevention of UTIs failed to take into consideration other factors that can reduce the occurrence of UTIs as well. The percentage of those benefited by circumcision fell well within the margin of error for the studies and is considered inconsequential by most healthcare providers.
Medically, circumcision was shown to prevent irritation of the foreskin, and circumstances where the foreskin is unable to retract. Ten percent of males that were circumcised as newborns have the procedure done later in life. This puts them at greater risk for complications. Personal hygiene often plays a part in necessitating these procedures.
This scientific evidence has led the American Academy of Pediatrics to conclude, “ After a comprehensive review of the scientific evidence, the American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.”
2 Medical and Personal Reasons Parents Choose to Circumcise
Scientifically speaking, there is not enough medical benefit to circumcision to warrant the circumcision of newborn boys. Parents may choose to circumcise their newborn boys, in spite of that fact, for a number of reasons.
Here are some of the more common reasons parents choose to circumcise their sons:
- Parents fear that being uncircumcised will cause them to be made fun of by their peers. In the past, this may have been a valid concern. But with more and more parents electing to leave their sons intact, odds are your son won’t be the only one in the locker room who is uncircumcised.
- Some parents argue that it is better to have the son circumcised because his father is. Fathers and sons have many differences that define them as individuals. A child’s eye color, hair color, height, and body type can be completely different from his father. When a boy is old enough to notice the difference between his father and himself, he will be old enough to understand when you explain the difference to him.
- Some parent’s religious convictions lead them to believe that their son must be circumcised according to tradition. While it is within the rights of parents to make this decision, scientific evidence does not indicate that this practice is medically necessary.
1 If You Choose Circumcision
Circumcision is a personal choice for parents. If you choose to circumcise your newborn boy, here are a few things to keep in mind:
- Go over the circumcision procedure with your baby’s doctor. Talk about what forms of anesthesia baby’s doctor will be using, as well as the method your baby’s doctor uses to perform the circumcision. Doctors use various methods and appliances to perform circumcisions, be sure you find out what method your doctor will be using and why.
- After the circumcision, the tip of your son’s penis will be extremely sensitive. The tip may look yellow or raw for about ten days. It is very important that you wash the penis with soap and water and change diapers often to avoid infection. Your doctor may have applied petroleum jelly and gauze to the penis after circumcision. You will need to carefully replace it after each diaper change.Your doctor may have chosen to apply a plastic ring instead of gauze, this will fall off after about a week.
- Complications occur in one in three hundred newborns who are circumcised. Bleeding and infection are the most common complications. Call your baby’s doctor is baby hasn’t urinated eight hours after the procedure, has excessive bleeding, or there is redness present after three to five days.
- The decision to circumcise your son is a personal choice. There are no laws or hospital guidelines that dictate that the procedure has to be done. Your baby’s doctor may have his or her own opinion on circumcision, but the final decision always lies with baby’s parents. Be informed of the pros and cons of circumcision and make your decision based on fact, not fiction. You are your baby’s only advocate.