Circumcision was once a routine and unquestioned part of having a baby boy. It is now a hotly debated topic with people firmly entrenched on either side of the debate. For some families, religion dictates whether or not the child will be circumcised. Other families have no religious reason for the procedure. This is known as routine infant circumcision.
Whether or not there is a religious reason for circumcising an infant, many parents still have firm convictions, either in favor or against the procedure. It can be very difficult to find information that is not biased one way or the other. Couples often argue over the issue, with each parent on opposing sides of the issue. This climate makes the decision even more difficult. I will attempt to show both sides of the debate here.
First, let’s start with the experts. The American Academy of Pediatrics has released several statements on routine infant circumcision over the years. The first was released in 1975. At that time, the AAP said there is no medical reason for routine infant circumcision. In 1983, The AAP along with the American College of Obstetrics and Gynecology released a joint statement that basically restated the 1975 position.
The debate raged on with studies done by both sides to back up the argument of whether or not parents should circumcise their infants. In 1999, The American Academy of Pediatrics formed a task force on circumcision to study the data. They released a statement saying that there is no sufficient data to recommend routine infant circumcision to parents.
Over the years, the circumcision rates have changed. In the late 19th century, very few infants were circumcised at birth. Early in the 20th century, the idea of cleanliness became popular. A circumcised penis became a sign of cleanliness. In the 1930s, the military began to require circumcision. With World War II, many men were circumcised and the rates climbed from there.
Circumcision rates in the United States reached an all time high in 1979, when 90% of all infants born in the USA were circumcised. Since then, the rates have steadily fallen. At the current time, about 60% are circumcised. The highest rates of infant circumcision are in the Midwest and Northeast, at about 60%. The West Coast has the lowest rates, at about 35% of newborns being circumcised. This is still much higher than the worldwide rate of circumcision. Worldwide, about 80% of babies are not circumcised.
There are many arguments in favor of circumcision. For every argument, the anti circ side has an opinion. One of the most common arguments for circumcision is the cleanliness factor. The pro side thinks that a circumcised penis is cleaner. The con side does not consider this to be a problem. As long as the child is taught how to clean himself properly, cleanliness is not an issue.
Another factor is a lower risk of urinary tract infections in circumcised children. There is a slightly higher risk of a UTI if a child is not circumcised. However, the rates of urinary tract infections are low and they are easily treated with less extreme methods. The anti circumcision side points out that girls get urinary tract infections and they are easy to heal.
The pro side says that there is a lower risk of penile cancer in circumcised men. The con side states that there is very little difference in actual rates, if good hygiene is practiced. Penile cancer is very rare, affecting only 1 out of 100,000. Most of these are elderly men.
Some studies have shown a slightly lower risk of HIV or other sexually transmitted diseases in circumcised men. Again, the rates are not that much different. Circumcision is not protection against STDs. Lifestyle and behavior is more indicative of actual risk than circumcision status.
Often, fathers want their little boys to look like them. Parents worry that the boy will be different from his friends in the locker room. As circumcision rates continue to fall, this is not likely to be a problem with babies born now. About half the boys will not be circumcised, so he won’t be alone. If he lives on the west coast, he will be in the majority.
The anti circumcision side has its own set of arguments. Predictably, the pro side has rebuttals for these as well. The first is the pain factor associated with circumcision. At one time, medical professionals didn’t think the baby felt pain. Another argument was that the pain wouldn’t be remembered. The con side feels that the pain experienced at the time is just as significant as for an older person.
Complications are another factor the anti circumcision side points to in recommending against circumcision. Complications include infections of the skin or bloodstream, scarring, bleeding and other surgical accidents. It is believed that about 1 in 500 babies will experience a complication.
The cost is another issue. Many insurance companies are no longer covering this procedure. Some do still cover it and the surgery isn’t very expensive if you do have to pay for it. Check with your insurance company about your coverage.
If you do decide to circumcise your baby, make sure some type of anesthesia is used. The AAP recommends pain relief be used in all circumcisions. Whether or not the baby will remember, he does feel pain now. There are a few choices in pain relief. A numbing cream called EMLA or a local anesthetic can be used. In the end, the decision is really up to the parents.