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Circumcision: To Snip or Not to Snip?

Posted by Harry Fisch, MD on with 4 Comments

By Harry Fisch, MD

Circumcision is the surgical removal of the foreskin of the penis. It is part of religious custom for Jews and many Muslims, for reasons that have been lost to history. The popularity of circumcision in other groups of men has waxed and waned depending on prevailing notions of health, cleanliness and parental preference. For example, the percentage of US men who were circumcised rose steadily from about 30 percent in the 1930s to 90 percent in the 1970s. Since then, the rate has been dropping: about 64% of American male infants were circumcised in 1995.

 

Until recently, I was among those who viewed non-religious circumcision as a medically unnecessary procedure and, thus, one not worth the (admittedly minor) pain and risk of complications. But I’ve changed my mind about this in light of a number of recent studies showing that circumcision does have some clear medical benefits.

 

The most dramatic benefit is that circumcised men have a much-reduced risk of acquiring HIV from women, which is a significant factor in countries with a high general prevalence of HIV. (Whether circumcision reduces HIV transmission between men is still an open question.)

 

In addition, a recent study found that circumcision reduced the risk of genital herpes by 28 percent and the risk of human papilloma virus (HPV) by 35 percent. Other studies have shown that circumcision reduces the risk of penile cancer. Finally, removing the foreskin also allows men to avoid medical problems of the foreskin, the most common of which is phimosis, the inability of the foreskin to retract from the head of the penis. This can be a painful condition that can interfere with both sexuality and fertility.

 

Why removing the foreskin can help prevent some sexually transmitted diseases is still not certain, but is probably due to the fact that the inner foreskin is thinner and more permeable than the outer skin of both the foreskin and the penis itself. In addition, the inner foreskin’s relative fragility means men may get small cuts or abrasions there, which would increase the chances of blood-to-blood transfer of diseases.

 

Circumcision has only been shown to reduce a few STDs, however.  It doesn’t protect against diseases such as syphilis, gonorrhea, or herpes simplex virus type 2. In no way should circumcision be seen as providing the kind of protection from STDs that a latex condom confers:  condoms are the best protection against such diseases, whether you are circumcised or not.

 

Of course, infant circumcision is one thingp – it is almost always safe, rapidly-healing and non-traumatic (particularly if anesthetic is used).  Adult circumcision is a more involved matter – healing is much slower and can be complicated by erections. Adult circumcision typically requires abstinence from masturbation or intercourse for between 4 and 6 weeks. Still, I believe that adult circumcision may be medically warranted in populations at very high risk for the diseases (i.e. HIV) it is known to protect for. It is also, of course, advisable in cases of painful or dysfunctional phimosis or other, rarer, problems related to the foreskin.

 

The American Academy of Pediatrics has not yet revised its current stance against infant circumcision, but I believe the evidence in favor of circumcision is building and that the AAP may shift its position in the future. In the meantime, I’m comfortable with the position of the American Urological Association, which says that infant circumcision has potential medical benefits and advantages as well as potential disadvantages and some very small risks; therefore, the decision about whether to snip or not to snip should be left to the parents in consultation with their health-care provider.

 

Comments

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Teresa Vaughan Oct 5, 2011 7:02pm

"condoms are the best protection against such diseases, whether you are circumcised or not"

If this is the case why not encourage condom use and leave baby's penises alone? Let them decide whether to become circumcised when they become an adult, which is more likely when risky behaviors would begin anyway.

If you could site your references I am sure folks would be grateful; it's hard to know what to believe in a blog post such as this when we don't know what studies you are referring to.

Erin Bell Oct 5, 2011 10:30pm

I am literally flabbergasted with this post. Like Teresa, I believe you should have cited your sources where you got your information from. There is much research out there that would show you how this procedure is nothing but a barbaric ritual that has become the default in this country (USA) because of the hang ups of people who have not been educated in how detrimental the procedure is on so many levels. I can not believe that this post would even show up on a site for people who have struggled to have children and then to mutilate a brand spanking new baby they worked so hard to get? To send that baby off to slaughter within hours of them making it into this cruel world? For WHAT? You need to do some more research and then come back and take back everything you have written here. I hope to G-D that the people who read this stuff do not take your advice. An infant may "belong" to a parent but that penis does NOT belong to the parents. That should be a decision that is left for the child to make.
www.drmomma.org is a good source to help learn more about how horrific and traumatizing circumcision is. How much it TAKES Away from a child who will eventually become a man. How many men are restoring their foreskin because it was taken AWAY from them for NO medical reason. Thanks for dumbing up the world a little bit more.

Erin Bell Oct 5, 2011 10:30pm

I am literally flabbergasted with this post. Like Teresa, I believe you should have cited your sources where you got your information from. There is much research out there that would show you how this procedure is nothing but a barbaric ritual that has become the default in this country (USA) because of the hang ups of people who have not been educated in how detrimental the procedure is on so many levels. I can not believe that this post would even show up on a site for people who have struggled to have children and then to mutilate a brand spanking new baby they worked so hard to get? To send that baby off to slaughter within hours of them making it into this cruel world? For WHAT? You need to do some more research and then come back and take back everything you have written here. I hope to G-D that the people who read this stuff do not take your advice. An infant may "belong" to a parent but that penis does NOT belong to the parents. That should be a decision that is left for the child to make.
www.drmomma.org is a good source to help learn more about how horrific and traumatizing circumcision is. How much it TAKES Away from a child who will eventually become a man. How many men are restoring their foreskin because it was taken AWAY from them for NO medical reason. Thanks for dumbing up the world a little bit more.

Michael Archangel Oct 6, 2011 8:17am

The people deceiving Circumcisers and their victims who in this case are also the deceived parents and people in general, are obviously not aware that circumcision is outlawed. Everybody needs to know that they are breaking the most basic laws of every Democracy, the US Constitution and the International Laws of the United Nations' Universal Declaration of Human Rights and the Rights of the Child which clearly state that inflicting preventable injuries on others is a Human Rights violation and a severely punishable crime.

THE GREATEST CRIME AGAINST HUMANITY IS THE
TORTURE & MUTILATION OF CHILDREN


The First International Symposium on Circumcision in Anaheim, CA on March 1-3, 1989 and again at the Fourth International Symposium on Sexual Mutilations held at the University of Lausanne, Lausanne, Switzerland on August 9-11,1996, affirms that the genital mutilation of children is torture and is in violation of Article 5 of the Universal Declaration of Human Rights that states: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment; and Article 37 of the U.N. CONVENTION ON THE RIGHTS OF THE CHILD: (a) No child shall be subjected to torture or other cruel, inhuman or degrading treatment or punishment.

U.S. Federal Law makes female genital mutilation a crime and baby boys/children are protected by "the equal protection of the laws" of the 14th Amendment to the U.S. Constitution.

Awakened people from all over the world are uniting to bring all perpetrators to justice if they don't stop preaching and committing this crime immediately. All their further actions are being recorded and their data is being kept as evidence for the day when they are getting sued, arrested and trialed by the people. Nobody will be exempt from punishment if they further preach, promote, enable and commit this crime on defenseless and non-consenting children.