I should circumcise my son, shouldn’t I?

One of the dilemmas that arises when a son is about to be born is about circumcision. To do it or not to do it? That’s the question. In many cases, the decision depends on factors that have nothing to do with the medical one: there are families that circumcise by religious tradition and, in other cases, it has to do with the custom of the father’s family.

The practice of circumcision varies considerably from country to country. According to the World Health Organization (WHO), in Nigeria, for example, 95% of men are circumcised while in Latin American countries it is around 11%. The world average, according to the same organization, is 30%.

What is circumcision?

“Circumcision is a medical procedure that consists of surgically removing the foreskin, which is the skin that covers the glans”, explains pediatrician Jaime Rodríguez, with a private practice in Mexico City.

This practice is usually carried out a few hours or days after the boy’s birth, when their families decide it. It is not recommended to do it immediately in babies who are premature or who have a problem with the penis that would require later surgery.

Last decades

Throughout the last decades there have been -and still prevail- various debates around this practice in the medical field. Some pediatric and health organizations recommend it; others speak against it, except in cases where it is necessary to solve a specific problem (for example, in patients the foreskin does not retract naturally and they present infections and discomfort).

According to the WHO, on average, 30% of men in the world are circumcised.

Pros:

One of the organizations that has spoken out most frequently in favor of circumcision is the American Pediatric Association. For years, these experts have studied the scientific evidence around this practice in newborns and concluded that the main benefits are:

• Helps prevent urinary tract infections.
• It is one of the factors that could reduce the possibility of suffering from penile cancer.
• It helps reduce the spread of sexually transmitted infections

Another group of experts that has spoken out in favor of circumcision is the World Health Organization (WHO); they have ensured that it is an important measure to prevent HIV and recommends it especially in countries where the disease is an epidemic, as it happens in several African nations.

Cons:

“Although organizations such as the American Pediatric Association have spoken in favor, they only recommend it for families who want it, they do not suggest that circumcision be mandatory for all newborns. This is because the evidence on its benefits is not definite enough”, explains Rodríguez.

For other organizations and expert groups, circumcision is an unnecessary practice, since healthy tissue is removed from the body, mainly for social, religious or aesthetic reasons.

“The foreskin is very tight during the first months of life. It is not tight just for the sake of it, this helps protect the glans, for example, so that it does not come into direct contact with the fecal matter that babies leave in their diapers”, says the pediatrician.

According to Rodríguez, some of the benefits of circumcision proposed by certain medical groups can be achieved in other ways.

“It is believed that without the foreskin, infections are prevented; however, with the correct hygiene of the area infections are not possible to happen. On the other hand, recommending it to prevent the transmission of HIV could misinform and motivate many men to have sex without a condom, a measure that is absolutely essential to avoid this disease”, says Rodríguez.

In Mexico, public health institutions do not practice circumcision on a mandatory basis.

The policy says that this should not be done, unless the boy presents a medical problem that requires it. In the end, the decision is yours. Don’t hesitate to ask your child’s pediatrician for guidance.

Circumcision consists of surgically removing the foreskin, which is the skin that covers the glans penis.

Translated by: Ligia M. Oliver Manrique de Lara

Spanish version