What is circumcision?
Circumcision is the surgical removal of the foreskin, the sleeve of skin that normally covers and protects the glans (head) of the penis.

Are there medical benefits to circumcision?
Some studies suggest that circumcision may produce a benefit on occasion, but these potential benefits do not outweigh the health risks of circumcision, which include infection, excessive bleeding, and the need for repeat surgery. Because of this, no medical organization in the world recommends infant circumcision, including the American Academy of Pediatrics (AAP) and the American Medical Association (AMA). The current AAP policy on circumcision states 1) circumcision is not essential to a child’s well-being, 2) it is an elective procedure, 3) doctors should not coerce parents into choosing circumcision, and 4) parents should make a fully informed decision (www.aap.org). The AMA endorses the AAP policy and calls circumcision 'non-therapeutic'. Medical studies cited by the AAP and AMA indicate that circumcision may provide a benefit on occasion, such as reducing the already low chance of a boy developing a urinary tract infection in the first year of life, helping prevent the extremely rare condition of cancer of the penis in elderly men, and possibly reducing the transmission of certain sexually transmitted diseases. However, these studies indicate that only a small minority of boys would experience a benefit from circumcision, and these conditions can be prevented or treated in other ways without circumcision.

What about hygiene?
Circumcision was once believed to improve male hygiene, but current medical information shows this is not true. Circumcision does not make the penis any cleaner or healthier. Contrary to myth, hygiene is simple and easy for intact men. Good hygiene through normal bathing is recommended for all men, intact or not.

What is the foreskin?
The intact (uncircumcised) penis is covered by a single continuous skin sheath. The forward part of the skin sheath that folds over on itself and covers the glans is called the foreskin. The foreskin is an integral part of the penile skin system, containing sexually sensitive nerves, blood vessels, and muscle. The average adult foreskin is about 15 square inches, the size of a 3x5 index card, and makes up about 1/2 of the skin the penis naturally has. With a foreskin, the skin sheath is very mobile and is able to easily move over the glans and shaft of the penis.

What does the foreskin do?
First, the foreskin covers and protects the glans and urinary opening from abrasion, irritation, and foreign material. Second, the foreskin provides sufficient skin length to accommodate penis growth and allow for comfortable erections. Third, the foreskin is the most sexually sensitive and pleasurable part of the penis. (Because most adult men in America were circumcised at birth, it is a common misconception that the glans is the most pleasurable part of the penis. See this page for a description of why most circumcised men seem satisfied.) A specialized ridged band of tissue encircling the tip of the foreskin contains thousands of erogenous nerve endings which provide intact men with the majority of their sexual sensation, making the foreskin vital to a man's healthy sexual response. Circumcision removes this highly erogenous tissue, resulting in a dramatic reduction in sexual sensation. Fourth, during intercourse, the intact penis glides back and forth inside its skin sheath, greatly reducing the friction between the penis and vaginal walls. Because of this, women report improved sensation and comfort with an intact penis.

These facts become very important when one considers that a baby boy will grow up to be an adult. Be sure to learn about this special and beneficial part of male anatomy as part of your decision-making process. Diagrams of the foreskin and how it works can be found at www.cirp.org/pages/anat

Is circumcision painful?
Yes, circumcision is very painful. Studies cited by the AAP show that baby boys experience extreme pain during the surgery. Unfortunately, most infant circumcisions are still performed without any pain relief according to this study. The emotional and psychological impacts of such a traumatic experience on a young mind are not yet fully understood. According to the AAP, if circumcision is chosen, it is vital that pain relief be provided to your son.

Shouldn't a boy look like his father?
If the father is circumcised, he may be concerned that his son, if not circumcised, will feel uncomfortable being "different" from his dad. Don't worry. Many circumcised fathers are raising intact sons without any feelings of awkwardness in father or son. If a boy ever notices and asks why his father is different, the reason is easily explained. A father should teach his son to appreciate and feel good about his own body.

Won't a boy be teased if he isn't circumcised?
Since circumcision is becoming less common in America, circumcised boys will soon be in the minority. However, with positive reinforcement from his parents that his body is normal, whole, and healthy, an intact boy will be able to keep a healthy perspective should he ever encounter a problem with his peers.

What about religion?
It's important to consider that the religious beliefs of the child once he becomes an adult will not necessarily be the same as the beliefs of his parents. Parents should keep in mind that their baby boy will one day be a grown man, with his own faith and spiritual beliefs.

The following information may be useful to address specific religious doctrines on this topic:

Circumcision is not required by Christianity. The following passages in the New Testament state that circumcision has no spiritual value and should no longer be practiced: Acts 15:1-31, I Corinthians 7:18-20, Galatians 6:15, and Colossians 3:11. Galatians 5:6 is very clear on the matter: "For in Christ Jesus neither circumcision nor uncircumcision has any value. The only thing that counts is faith expressing itself through love."

The only religions that officially support circumcision are Judaism and Islam. However, there are small but growing movements in both of those religions to end the practice (see www.JewishCircumcision.org).

How did circumcision start?
Circumcision is thought to have started thousands of years ago in the Middle East or Africa, but it was not introduced in the U.S. until the late 1800s. At that time, some doctors believed that it would curb masturbation, which was thought to cause insanity and many physical ailments.

How common is circumcision?
In the U.S., circumcision rates were as high as 90% during the 1970s, but since then the rates have been decreasing as parents become more informed. Currently, 55% of American baby boys are circumcised, though it varies by region, being as low as 33% in California. Circumcision is uncommon in most of the world, including Europe, Asia, and South America. The vast majority (80-85%) of men in the world are intact. Many famous men were not circumcised, including Adam (The Book of Genesis), William Shakespeare, Beethoven, Frank Sinatra, Elvis Presley, three of the Beatles, and Dr. Martin Luther King Jr. It's also interesting to note that every American President until the mid-20th century was not circumcised, including George Washington and Abraham Lincoln.

Can there be complications with circumcision?
Yes. While the procedure is generally considered "safe" if performed by an experienced medical professional, as with any surgical procedure, complications can and do occur. Most complications are minor, but some can be serious. While the true rate of complications is not known, the following problems have been well documented: pain, infection, excessive bleeding, removing too much skin, need for corrective surgery, interference with the start of breastfeeding, adhesions (fusing of the glans and remaining foreskin), meatal stenosis (ulceration and scarring of the urinary opening over time), damage to other parts of the penis, and in very rare cases, loss of the penis and even death.

However, the risks of the procedure should not be confused with the guaranteed consequences. Every circumcision results in the loss of a healthy and functioning foreskin, causing detrimental changes to sexual function and reduced sexual sensation.

How do I care for my son's intact penis?
A boy's intact penis needs very little care. The best advice is to simply leave it alone. At birth, the foreskin is normally attached or fused to the glans (like a fingernail to the finger), and slowly separates as part of normal development during childhood. The foreskin should never be forcibly retracted before it has naturally separated. Premature retraction of the foreskin can cause bleeding, infection, adhesions, and scarring. The first person to retract a boy's foreskin should be the boy himself and no one else.

All children should be taught to wash their genitals, circumcised or not. Before the foreskin is retractable, cleaning under it is not needed. Simply wash the outside of the penis during normal bathing. Once the foreskin is retractable, cleaning the intact penis is easy and can be remembered by the three Rs: Retract the foreskin, Rinse with warm water, and Replace the foreskin back over the glans. If you have medical questions, seek out a pediatrician who has a thorough understanding of the foreskin and intact male anatomy.

Additional Information:
www.circumcision.org
www.cirp.org
www.circumstitions.com
www.NoCirc.org
www.DoctorsOpposingCircumcision.org
www.MothersAgainstCirc.org