Circumcision rates in the U.S. are falling as more parents find that the risks outweigh any potential benefits. A closer look at the purported benefits of circumcision. Here are the most commonly given reasons for circumcising baby boys.

Hygiene

According to many sources, it’s easier to keep clean. Really? The vulva would be easier to keep clean without the labia but we don’t amputate that. Well, some cultures do and that is one of the reasons they give. Why do we cringe in horror at the thought of doing that to our daughters but not our sons?  Not to mention that the foreskin is a self cleaning organ and circumcision actually removes this function from the penis. http://www.circumstitions.com/Care.html

Urinary Tract Infections

Circumcision lowers the rates of urinary tract infections. Okay. But urinary tract infections are easily treated with antibiotics. Removing the lungs would prevent respiratory infections but that doesn’t seem like a good idea.

HIV

Circumcision is often touted as a way to decrease the risk of HIV. However, even those reports still caution that circumcision by itself isn’t enough and that there is still a need for a condom. So why not just use a condom and skip the circumcision?

Phimosis

Circumcision is sometimes necessary for boys or men who have Phimosis, so the logic is to preemptively circumcise. This falls a little flat when we look at the facts. It is difficult to find actual rates, there is very little research out there on Phimosis. The rate seems to be from 1 to 10 percent, depending on who you ask.

http://voices.yahoo.com/uncircumsized-penile-adhesion-information-advice-10989162.html

http://www.male-initiation.net/statistics.html.

It should be noted that the rates fall with age, as the prepuce separates on its own, the phimosis resolving  itself.  Only 1 percent of men still have it at age 17. Of that one percent, most responds to conservative treatment (not circumcision). http://emedicine.medscape.com/article/442617-overview.

It’s important to remember that the prepuce is not supposed to retract in infants. Being fused is normal at birth, it gradually loosens on its own by about age 13.

Penile Cancer Risk Decreased

Penile cancer is rare in the first place. While circumcision may decrease the risk, is it really worth the amputation of an organ to slightly decrease an already low risk? We would not consider that logical for any other organ. Remove the cervix to prevent cervical cancer? Remove the stomach to prevent stomach cancer?

So He’ll Look the Same

The other reason frequently give is the old locker room/look like dad argument. Seriously? With the risks associated with it and the minimal benefits to be had, this is the lamest and flimsiest excuse to date.

A previously posted article on circumcision rates seems to have stirred up a bit of a controversy, so I thought I would revisit it here.

What is in question is if newborn circumcision rates in the U.S. fell to 33% in 2009 or not. There is evidence that hospital circumcisions of newborns did indeed fall that low. The original study that claimed 33% was presented in Vienna http://www.medscape.com/viewarticle/809763. Here is a slide from that presentation: http://www.flickr.com/photos/intactivist/5323491644/

The CDC has stated that this study was used to track complication rates and not to track circumcision rates. Fair enough.

Exactly how much circumcision rates have fallen in the U.S. may be a topic of debate. What it not in question is that rates are, in fact, falling.  They are falling faster in some areas than others and though the rates in any given year may fluctuate up or down, the overall picture from 1979 to 2010 is a decline. http://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013.htm#fig1

The important point is, rates are falling, as they should be.  More and more parents are educating themselves on this unnecessary cosmetic procedure and declining circumcision.

What are the risks and benefits to circumcision? Why does anyone choose to circumcise their child? First, you have to understand that this is a cultural issue. For some, it is a religious issue, but for many Americans, it’s just what we’ve always done and they look no further than that.

To get an idea of how cultural ideas about circumcision change, consider the history of female circumcision: http://www.mtholyoke.edu/~mcbri20s/classweb/worldpolitics/page1.html

When we think of female circumcision (aka female genital mutilation) we react with horror and disbelief that anyone could do such a thing to a child they claim to love. However, when the belief is deeply embedded in the culture, they do it precisely because they love that child. They truly believe that she will be unclean, unable to attract a husband etc. And it’s what they have always done. I would like to think that in a modern country like America we can rise about the “but it’s always been that way” mentality and take an objective look at the facts.

Consider also, rates in other countries: http://www.photius.com/rankings/circumcised_men_country_ranks.html

Male circumcision is by no means a universal practice and there are more men worldwide that are intact than have been cut yet no epidemic of penile health problems associated with these populations. So again, why have your child circumcised?

One reason circumcision became so prevalent was to prevent masturbation (that seems a little extreme): http://www.huffingtonpost.com/ali-a-rizvi/male-circumcision-and-the_b_249728.html

One reason for the fluctuation in rates may be the AAP, which has revised their official position back and forth several times over the last few decades. Their current position is supportive of the practice: http://pediatrics.aappublications.org/content/130/3/585

However, the rest of the worldwide medical community disagrees and a report in their own publication calls the policy out for reflecting cultural bias: http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896

Each parent must educate themselves on the risks and benefits and make an informed decision for their child.