Unnecessary alarm over circumcision

The idea that parents should defer circumcision until their sons can make their own decisions is impractical and unnecessary, argue two medical experts.

In his article Why I didn’t circumcise my second son Dr Ariel Kagan writes about why he came to oppose infant circumcision.

The writer’s concern about “damaging” his son is unwarranted as long-term adverse effects are known to be exceedingly rare, as attested to by the Centers for Disease Control and Prevention (CDC)¹ and the American Academy of Pediatrics² . There are also health benefits of infant male circumcision (IMC) which include reduction in the risk of urinary tract infection, cancer of the penis and possibly prostate cancer.  While effective vaccines to prevent human papilloma virus (HPV) are available not all children receive these; circumcised men are less likely to acquire HPV from an infected sexual partner or transmit it if they are carriers³.  The duration of vaccine protection is not known but there is good evidence that the protection enjoyed by circumcised men (and their sexual partners) is life-long. The long-term benefits include, of course, the cultural issues of “looking like Dad” and enhancing the belonging to a Jewish community.

He states that “medical interventions” should cause no harm and patients should make their own decisions about what happens to their bodies. Circumcision for cultural, religious or social reasons is most appropriately performed in early infancy when it does not require general anaesthesia and the associated risks, costs and logistic burden are minimised.  Deferral of circumcision to provide autonomy is impractical for these reasons; the health benefits of course are not achieved till the procedure is performed. Circumcision must always be performed with local or general anaesthetic to achieve adequate pain control but serious complications of infant male circumcision performed by an appropriately trained physician are almost unknown⁴. Parents have the responsibility and the opportunity to make the decision for IMC for their newborn son.