Dr. Sears Statement on Circumcision

By William Sears, M.D.
Read more from Sears at AskDrSears.org
Sears' The Baby Book also makes an excellent gift to expecting and new moms!

Circumcision is a decision that many parents face, and there is a lot of misconception and out-of-date information that parents read today. Here is a summary of the pertinent issues that you should consider when making this decision.

1. Medical benefits - THERE ARE NONE! Do not circumcise your baby because you think there are some medical benefits. A recent review by the American Academy of Pediatrics looked at all the data from the past decades to see if there truly were any medical benefits. Their conclusion - NO. There are no significant medical benefits that make circumcision worth doing.

Here are a few benefits that we used to think were true, and now know are not.

* Cleanliness - although a circumcised penis does not produce any of its own antibodies or natural lubrication like an intact ('uncircumcised') penis does, THIS IS NOT A MEDICAL BENEFIT. As an infant the foreskin is tightly adhered to the glans (head) of the penis and does NOT produce anything anyway. As an adult, the intact penis can be rinsed in the shower just like a woman rinses her genitals. In addition, there are many health benefits for the antibodies and natural lubrication produced by the intact penis.

* Decreased risk of STD's - this was a myth that we now know is not true.

* Decreased risk of penile cancer - it used to be thought that circumcised men had a much lower chance of cancer of the penis. We now know that this benefit is much smaller than previously thought. The AAP determined that this benefit is so tiny, it is not worth circumcising for this reason.

* Avoiding infections in the foreskin - occasionally intact foreskins get irritated. This is easily treated with warms water and washing. Rarely, the irritated foreskin becomes infected. This requires antibiotics, but is easily treatable. Even if this does happen in a person's lifetime, it is not a reason to circumcise at birth.

* Avoiding the need to do it later on - VERY RARELY, someone has a problem with recurrent infections in the foreskin that need antibiotic treatment. Some of these men then need to be circumcised in an operating room under general anesthesia. This is extremely rare, however, and is not a reason to circumcise everyone at birth.

* Avoiding bladder infections (or UTIs) - it used to thought that circumcised boys and men had a much lower chance of bladder infections. The AAP now knows that this benefit is very small, and is only true for the first year of life. After that, there is no difference in the number of bladder infections. Again, not a reason to circumcise.

THEREFORE, IF YOU DECIDE TO CIRCUMCISE YOUR CHILD, DO NOT DO SO BECAUSE YOU THINK THERE IS ANY MEDICAL BENEFIT.

2. Religious reasons - some people choose to circumcise for religious or cultural reasons. This is a personal decision.

3. Don't want to be teased - while this may have been true in the U.S. decades ago, the truth is that your intact kids will be in good company in the locker room when they are teenagers. Less and less people in the U.S. are now circumcising their boys and we currently see the majority of baby boys leaving the hospital intact (uncircumcised). In addition, almost 90% of the rest of the world's men are intact.

4. Too much trouble to take care of - some people think that an intact penis is too much trouble to pull back and clean, especially during childhood. Well, the truth is, you are not even supposed to pull back the foreskin until it naturally comes back on its own sometime between the ages of 3-years to the teenage years (depending on the boy). So there really isn't anything to even take care of until then. Intact = Don't Retract! Only Clean What is Seen.

5. Want your boy to look like dad - the main difference that your child will notice between him and dad is the hair. He won't even notice any difference in the penis until he is old enough that you can then explain to him the difference. At that point, what man and his son compare genitals?

Intact

vs.

Circumcised

So, what are the reasons TO circumcise that have not been scientifically dispelled as myths?

Here is the list:

Religious reasons - as discussed above. That is all. There really is no good reason to circumcise other that personal preference and religious reasons.

What are the reasons NOT to circumcise?

Consider these:

1. Leave nature alone - whether you believe God created all men and women with a prepuce organ (nicknamed 'foreskin' in men), or nature simply evolved all men and women this way, there must be some reason that all mammals have foreskins. Why change something that God/nature has created?

2. Sensation and sexual pleasure - the foreskin is filled with nerves (70,000+ which is more than any other body organ), and is therefore extremely sensitive to touch. This enhances sexual pleasure. The foreskin is also the only part of the penis that has muscle - 'smooth muscle tissue' - which is not found anywhere else on the genitals.

3. Protects the glans (head) of the penis - the glans is another highly sensitive area and meant to be an internal organ. The foreskin protects the glans from constant rubbing and chaffing against clothing that desensitizes and calluses it over the years. This preserves sexual pleasure.

4. Ethical issues - there are groups of people worldwide, including highly esteemed medical societies, that oppose routine circumcision because they feel it is unethical for anyone to decide to alter the penis of a child without the child's consent. Parents who are deciding whether or not to circumcise their son may wish to consider the impact this may have in the future if the child decides they wish they were not circumcised.

So, when making this decision, the first thing to ask yourself is this - "Do I have any good reason to circumcise my baby?" If your answer is for religious reasons, then follow your faith. If not, and you can't think of any other significant reason other than just "because", then consider the above information as you make your decision.


For more answers to common parenting questions, see Ask Dr. Sears or check out a copy of his hugely popular book, The Baby Book: Everything You Need to Know About Your Baby From Birth to Age 2.

Hear from another physician, Dr. Dean Edell, on infant circumcision:

Dr. Bob Sears on circumcision: 

[END NOTE]

While we appreciate Dr. Sears' direct and simplified version of an answer to this often pondered question, we are not in agreement in terms of genital cutting for religious reasons. Baby girls are currently protected (by law) against any form of circumcision because of the religious views of their parents. Baby boys deserve the same legal protection. If it is not okay to cut one child, it is not okay to cut another - no matter the personal religious views of those advocating for the genital mutilation. When a girl or boy reaches an age when s/he can decide upon the religion of his/her choosing, s/he can at that point also decide what to do with her/his own genitals.

For more resources written by Jews on the topic of Judaism and Circumcision, see these links.

For more resources written by Christians on the topic of Christianity and Circumcision, see these links.

For more resources written by Muslims on the topic of Islam and Circumcision see:
http://www.quranicpath.com/misconceptions/circumcision.html
http://www.quran.org/khatne.htm

Going into more detail on proper intact care and the many reasons to keep boys intact would be a good idea in Sears' statement -- for their own health/immunological benefits, to avoid the impact that circumcision has on breastfeeding, development, stress hormones, pain response, colic, sleep, attachment, fussiness, post-traumatic stress, brain function, sexual experience later in life, etc. There are so many reasons to protect babies' wholeness and they are not covered in enough detail in this brief response.

Further information: Should I Circumcise? The pros and cons of infant circumcision