to cut or not to cut
Circumcision: What used to be a routine decision is now a big quandary for many parentsÂtoÂbe.
New controversy has arisen over the ancient practice of circumcision. Depending on the source, the procedure is either much ado about nothing or the unkindest cut of all, and parents are taking another look at the procedure to determine whether it’s right — or necessary — for their sons.
At birth, a boy’s penis is protected by a sheath of skin called the foreskin. As he grows, the foreskin naturally loosens and slides easily back and forth over the head of the penis. Circumcision entails removing the foreskin surgically so the tip of the penis, or glans, and the opening of the urethra (through which urine passes) are exposed to air. People circumcise their babies for assorted reasons, including religious, health, societal and aesthetic.
Circumcisions have been performed for thousands of years; what began as an Egyptian religious rite eventually was adopted by Jews and Muslims, for whom circumcision remains an important ritual today. “For Jewish and Muslim parents, circumcision is a religious decision,” says Mary L. Brandt, M.D., a pediatric surgeon at Baylor College of Medicine in Houston. “But in other cases, it is a matter of choice, and many of my patients’ parents are deciding to decline the procedure.”
Indeed, in most of the world, circumcision is not routine. According to the National Center for Health Statistics, more than 60 percent of American men are circumcised, compared with 20 percent of men worldwide. Rates vary by ethnicity and geography. In the Midwest, 80 percent of infant boys are circumcised, while the rate is closer to 42 percent in the Western United States and about 68 percent in the Northeast. About 81 percent of non-Hispanic whites nationwide are circumcised vs. 54 percent of Hispanic males and 65 percent of black males, according to “The National Health and Social Life Survey,” which was reported in the April 2, 1997, issue of the Journal of the American Medical Association.
For most parents, the decision may be influenced by tradition — fathers wanting their sons to “look like them” — or aesthetics. But what are the medical implications of circumcision? The 53,000-member American Academy of Pediatrics remains firmly neutral. Although it has convened a special circumcision task force to pursue the matter, the AAP’s position statement simply says, “Circumcision has potential medical benefits and advantages, as well as inherent disadvantages and risks.”