Circumcision

Hi Dr Ryen. I’m just wondering if you could address circumcision. My husband and I recently had our first baby. Theo is just a couple weeks old and my husband wants him to get circumcised, just like all the men in his family are. I didn’t mind the idea at first, but now just the thought of his little penis getting operated on freaks me out! I mean, it can’t be safe, can it? Jerry, my husband, is trying to tell me it’s healthier for boys to be circumcised, but I’m not sure. I’d just love to hear your opinion on it. 

- Suzette, Salem, OR

Suzette! Congratulations on your new baby boy! I hope Jerry is helping out around the house so you can get some sleep. The first few months of having a new baby is a blur. Most new moms (and dads!) are zombies until the kid starts sleeping a bit longer.

Infant circumcision is a hot topic. I’m sure you’ve already discovered there are a lot of strong opinions for and against it. I’ll try to stick with the facts so you and your husband can make an informed (not emotional) decision about such a sensitive issue.

First, the risks. Any minor surgery carries the risk of bleeding, infection, and damage to surrounding structures. For infant circumcision, when performed by a qualified doctor, the risks are very low. The penis is typically numbed with local anesthetic (i.e. freezing) so the baby doesn’t feel anything. Little boys often cry through the procedure, but not because of the pain - it’s just scary to get strapped down and surrounded by strangers for twenty minutes. I’m not aware of any evidence for lasting psychological trauma from the procedure. In fact, baby boys tolerate the whole ordeal remarkably well. Within a feed or two, they’ve forgotten all about it.

Second, the medical benefits. There is a small reduction in the rate of chronic sexually transmitted infections in certain populations. For example, in sub-Saharan Africa, the risk of contracting HIV is a tiny bit lower for circumcised males than for uncircumcised. The risk of penis cancer, which is rare, may also be reduced. However, in Western populations, the medical benefit for any reason is virtually nil. 

Third, circumcision is a family, religious, and/or cultural tradition for many people, as it is for your in-laws. Unfortunately, I can’t help you with this part of the decision. Needless to say, people feel very strongly about such issues.

Fourth, the cost. Generations ago, the majority of newborn boys would be circumcised before being discharged from hospital. It was just part of the routine. Most of the doctors who delivered babies were qualified and experienced at circumcisions too. Nowadays, it’s typically done at a separate encounter. And it’s not cheap. Many health care plans don’t cover the procedure, so it can cost hundreds, if not thousands, of dollars to get it done. Many families simply can’t afford it.

Overall, the risks of circumcision are very low. The medical benefits are similarly very low. If you can afford it, and it’s important for you from a family tradition perspective, go for it. But justifying or villainizing circumcision for medical reasons isn’t reasonable. 

Good luck!

© D. B. Ryen Incorporated, August 2021.  

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