The Circumcision Decision
by Dave Gross
Having a baby boy today means having to face an important decision:
Should your son be circumcised. Only 25 years ago, in the United States
anyway, it was an easy decision to make -- 95% of baby boys born in this
country were circumcised, and the operation was considered a necessity.
But then the American Academy of Pediatrics (AAP) declared circumcision
unnecessary, and today only about 60% of American boys are circumcised
That still makes circumcision the most common surgical procedure in
the United States. Over one million baby boys were circumcised this year.
Worldwide, the practice is much less common. Only about 20% of the world's
male population is currently circumcised, and the United States is the
only nation to continue routine circumcision for other than religious
For some parents, the choice to circumcise is a religious one. In
Jewish and Moslem custom, circumcision is evidence of a covenant with "God."
Other parents have more vague reasons for deciding on circumcision for
their boys. Some believe that there are health benefits. Others want
their sons to look the same as the circumcised father. Others see the
circumcised penis as a cultural norm, and more aesthetically appealing.
Still others see circumcision as a cure for masturbation in youths or for
premature ejaculation later on in life.
In the last few years, there has been a great deal of controversy about
circumcision. About two years ago, the AAP declared that there were some
medical benefits as well as risks to circumcision. Most of this change of
policy came from studies showing lower rates of penile cancer and urinary
tract infection in circumcised men and boys. Although the AAP stopped well
short of endorsing circumcision, many people interpreted this change in
policy as an absolute reversal of the previous AAP stand. Not so, says
Donald W. Schiff, M.D., president of the AAP, "We have not reversed our
position. We've changed it a bit, but it's really just a bit."
Circumcision foes compare removing the foreskin to prevent penile
cancer or urinary tract infections in infants to pulling teeth at birth to
prevent cavities. One doctor, in a presentation to the California Medical
Association, wondered why, if circumcision was justified to prevent penile
cancer, nobody was suggesting infant breast removal in girls to prevent the
more-common breast cancer in women.
Groups opposed to circumcision warn that not only are the benefits
dubious, but the risks are very real. Edward Wallerstein, author of the
award-winning "Circumcision: An American Health Fallacy," found that one in
500 circumcisions result in significant complications and that possibly 225
deaths per year can be attributed to the circumcision operation.
In one of many such horror stories, an Arizona boy has had to undergo surgery
eight times since a botched circumcision. He was awarded $1.5 million dollars
in damages last August, but it is unknown whether he will ever have normal
sexual functioning. For another boy, whose penis was completely burned off in
a 1985 circumcision accident, there is little hope of a normal sex life.
And new studies on infant pain have breathed new life into the debate over
whether even a successful operation can harm a child physically or psycho-
logically. In October, Los Angeles Times writer Ann C. Roark reported that for
many operations, including circumcision, infants are not given any pain-
killers or anesthetics. Doctors feel that the risks of giving these drugs
to infants outweigh the benefits. In addition, many doctors are skeptical
that infants do in fact feel pain, or if they do, that they remember it.
New studies challenge this view. Ann Roark quotes Dr. Myron Yaster, an
expert on pediatric pain at Johns Hopkins Medical Institutions in Baltimore,
as saying that "most adults would be shocked if they saw what was done to
children in hospitals without anesthetics. It's like roping and holding
down a steer to brand it."
Studies now show that infants do feel pain and that their bodies go
through the same sorts of changes that adults' bodies go through when they
experience pain. Circumcised boys are more irritable, eat less, have
disrupted sleeping patterns and crying patterns, and show changes in infant-
mother interaction. In addition, infants who have been anesthetized during
surgery seem to recover more quickly and have fewer post-operative
complications than those who have not.
But circumcision appears to be a dying custom in the United States. Since
the 60's, the rate of circumcision has been dropping, and insurance
companies are increasingly refusing to cover the operation. Since care of
the uncircumcised penis is simple, the only remaining reasons seem to be
custom and conformity -- this last reason diminishing in value as fewer boys
And ultimately, as Dr. James L. Snyder said in a presentation to the
California Medical Association, a boy's penis is his own. "The part of the
baby we have been throwing out with the bathwater is the birthright of the
child and should not be destroyed by the collusion of physicians and