Circumcision, Revisited

Hi Mamas,

I’m in my 36th week of the longest pregnancy on record — at least it seems like it, and Baby Daddy and I are butting heads on the subject of circumcision. We’ve known we’re having a boy since the second trimester and it’s been ‘game on’ ever since.

My dad and three brothers were all circumcised and I always assumed if I had a son he would be, too. My partner is Latino and he’s uncircumcised and pretty emotional on the topic. Whenever I bring it up he says he doesn’t want his son to be mutilated (like I do?) and it would be wrong to do it. Besides, he doesn’t want our baby to look different from him.

I’m trying to stay objective and stick to the facts, but it seems like lately I’ve read more medical evidence pro than con. Can you help me out here? How can I convince him that we should go ahead and circumcise? If we don’t do it I’ll worry that he’s more likely to get all kinds of nasty infections. Don’t you agree?

Wanda

 

Dear Wanda,

As you’ve discovered, circumcision can be one of the most emotionally charged parenting decisions out there, especially when couples have different expectations. There are often cultural norms at play and it seems like that’s a big part of what’s going on with the two of you.

Circumcising newborn males became routine in many American hospitals, but that trend has reversed in recent years. Depending on which part of the country you live in, as many as 80% or as few as 35% of baby boys have the procedure done.

Medical studies have shown some health benefits, but these are not compelling enough for the American Academy of Pediatrics to recommend the procedure, which involves surgical removal of the foreskin, for all healthy newborn boys. The official position on the question is — whichever you prefer.

Some of the medical benefits:

- A lower risk of urinary tract infection. A circumcised infant has about a 1 in 1,000 chance of developing a UTI in the first year of life; an uncircumcised infant has about a 1 in 100 chance. Pretty low in either case.

- Lower risk of getting penile cancer, an uncommon malignancy that accounts for only 0.5% of cancers in the US.

- Lower risk of HIV and other sexually transmitted diseases (a huge consideration in regions of Africa and the developing world, but less so for most groups in the US).

- Prevention of foreskin infections and phimosis, a condition that makes retraction of the foreskin difficult and requires circumcision after the newborn period. 

- Easier hygiene.

While these are not insignificant, for many parents they don’t make a strong enough case for what can be considered an elective surgery.

Some reasons parents choose not to circumcise: 

- Fear of risk. Complications are rare and usually minor but may include bleeding, infection, cutting the foreskin too short or too long, and improper healing.

- Belief that the foreskin is needed. Some people feel the foreskin is needed to protect the tip of the penis from irritation.

- Belief it can affect sex. Some feel that circumcision makes the tip of the penis less sensitive, causing a decrease in sexual pleasure later in life.

- Belief that proper hygiene balances health risks. Boys can be taught proper hygiene that can lower their chances of getting infections, cancer of the penis, and STDs.

There’s no obvious right answer here. The final decision for the two of you may come down to who feels more strongly about it. Sit down with your guy and talk about the pros and cons — health wise. Then be open about your own bias based on your family history. If there are religious or cultural factors, put them on the table and encourage him to share his own. Try to check the emotional charge at the door and you might find that the answer becomes clear.

Whatever you decide, know that circumcision may be more risky if done later in life, so the choice should be made before or shortly after your little guy’s arrival.

Good luck, and congrats on your (soon to be) new babe!

~ The Mamas

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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2 responses to “Circumcision, Revisited”

  1. Frank

    Think about it the positives…..you’re having a boy. All those nasty infections you’re talking about? Girls are more susceptible to them. Baby girls are 5 times more like to develop a UTI than uncircumcised male infants. Furthermore, hygiene is a bigger issue in females of all ages. Edward Wallerstein called circumcision a solution looking for a problem. I couldn’t agree any more. In your case, I believe your social, sexual, and cultural biases are influencing you more than any potential “health benefit” truly is. Basically, you’re looking for a reason to cut him.

  2. Frank

    Let’s not forget that cutting him is far from necessary and it is HIS body. Maybe you should leave him with what he’s born with and let him decide.

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