Circumcision Decision

With the U.S. circumcision rate at an all-time low, parents grapple with whether to have the procedure done.

By Jacqueline Stenson

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For my husband and me, an even bigger decision than naming our son Nicolo or Dante—and this was huge—was whether we'd have him circumcised.

To be honest, neither of us had ever actually seen an "intact" penis in the flesh, so we Googled it. Along with checking out photos (yes, some were on porn sites), we read extensively about the pros and cons of foreskin removal, queried parents and sought advice from doctors.

There were wildly divergent opinions and no easy answers for us about a subject that was a no-brainer for our parents. When my brother and my husband were born in the late sixties, circumcision was routine; by 2003 the newborn circumcision rate in the U.S. had dropped to 57 percent, according to the National Center for Health Statistics. (The procedure is most common in the Midwest, least in the West.) So like us, more and more expectant parents are grappling with the decision.

The pros and cons of cutting
During the 5- to 10-minute circumcision procedure, which is usually done in the hospital before the newborn goes home, a pediatrician or OB-GYN surgically removes the foreskin covering the end of the penis. A numbing cream or a local injection is used to minimize pain. While the American Academy of Pediatrics says the procedure is not medically necessary, proponents argue that circumcised penises are easier to clean. They note that circumcision is linked with fewer urinary tract infections in infants—1 in 1,000 versus 1 in 100 for babies with intact penises. It also may protect against sexually transmitted diseases: At the end of 2006, studies in Africa were stopped early, after showing that circumcising adult men reduced the risk of contracting HIV through heterosexual sex by up to 60 percent.

Opponents point out that in the U.S. there is a lower overall risk of HIV. Regarding hygiene, they say, an intact penis really isn't that difficult to keep clean. And urinary tract infections and many STDs (other than those caused by viruses such as herpes and HIV) are treatable with antibiotics. "We don't cut off eyelids because they attract gunk in the morning or cut off girls' breasts so they don't someday get breast cancer," says Mark D. Reiss, M.D., executive vice president of the Seattle-based Doctors Opposing Circumcision. "The bottom line is that circumcision is being done for conformity and custom."

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From October/November 2007