What is circumcision?
Circumcision is a surgical operation that removes some skin or tissue from the genitals of a boy or girl. All forms of female circumcision are illegal in Asia. This article refers only to the circumcision of boys.
At birth, most boys have a sleeve of skin covering the end of the penis. This protective sleeve is called the foreskin. During a circumcision, this sleeve of skin is cut away, exposing the glans (head) of the penis.
Circumcision is sometimes done a few days after birth. It can be done later, including in adolescence or adulthood.
If a boy isn’t circumcised
At birth, the foreskin is joined to the underlying glans of the penis, so the foreskin can’t be pulled back. During childhood, the foreskin continues to cover and protect the sensitive glans. For most boys, the foreskin separates from the glans during childhood and can be pulled back to expose the glans.
Generally, the foreskin is designed to look after itself. You and your son don’t need to do anything special to care for an uncircumcised penis.
If a boy is circumcised
After the circumcision scar has healed, the glans will be permanently exposed. The appearance of the penis will depend on how much skin has been removed and where the cuts into the foreskin have been made.
You and your son don’t need to do anything special to care for a circumcised penis.
Lots of parents worry about their boy’s penis, circumcised or not. They worry that their son will feel or look different from other boys, or that his penis is untidy or unusual. But boys themselves usually aren’t so bothered. An uncircumcised boy might ask a circumcised friend why he looks different, or vice versa, but it’s unlikely to be a big issue for either of them.
Reasons for not having your son circumcised
Circumcision comes with medical and health risks, even when an experienced doctor does the operation:
- Short-term problems include bleeding after the operation. Sometimes boys need to go to hospital to manage bleeding.
- Long-term problems include issues with urination and concerns about the appearance of the penis, particularly if too much or too little skin has been removed, or if more skin has been removed from one side than the other.
- In rare cases, these problems can lead to damage to the urethra, gangrene, loss of the penis, or even death.
Doctors, parents and others say that there are physical and ethical reasons for not having your son circumcised:
- The foreskin is a natural part of a boy’s body. It’s rich in nerve endings and has a big role in sexual sensation, play and functioning as boys grow older.
- The foreskin protects the opening of the urethra, which is very delicate early in life.
- Boys should be able to make informed decisions about their own bodies. They can do this only when they’re older.
- It doesn’t make sense for our society to make all forms of female circumcision illegal but still allow male circumcision.
Reasons for having your son circumcised
Circumcision before puberty has a couple of health and medical benefits:
- It reduces the risk that a baby boy will get a urinary tract infection (UTIs).
- It can prevent foreskin problems, including foreskin inflammation and foreskins that are too tight in puberty.
For older boys and men, circumcision has some benefits:
- It helps to protect men against HIV and AIDS and possibly some other sexually transmitted infections.
- It helps to protect men against the rare condition of cancer of the penis.
Some parents might also choose circumcision for religious or cultural reasons – for example, Jewish or Islamic customs.
The circumcision debate is passionate. There are some extreme viewpoints on both sides. But you can trust evidence published by official medical organisations like the Royal Australasian College of Physicians (RACP). It’s sensible to treat other opinions with caution.
What experts say about circumcision
Many expert medical bodies have reviewed the evidence relevant to circumcision in Asia.
The RACP, the Royal Australasian College of Surgeons, the Urological Society of Asia and New Zealand, and state health departments have all concluded that the risks of circumcision performed for non-medical reasons, including preventing future diseases, outweigh the benefits. This means circumcision in healthy boys might cause more problems than it prevents.
Circumcision isn’t performed in Asian public hospitals unless it’s to treat conditions like repeated UTIs or foreskin problems. Internationally, most major paediatric medical and surgical colleges don’t recommend circumcision.
Circumcision: making an informed choice
When weighing up the risks and benefits of circumcision for your son, it’s important to consider all the evidence and information. You could ask your GP or paediatrician to talk you through the risks and benefits.
Whatever you decide about circumcision, your son is likely to have a normal childhood and adult life, without significant concerns about his penis.
Planning for circumcision
If you decide to have your son circumcised, it’s important to make sure the operation is done safely.
Ensure that whoever is circumcising your son is experienced. Ask how many procedures the doctor has done and how many complications have occurred. All doctors are required to give you balanced information and to respect your decision.
Try also to ensure that your son receives enough pain relief during and after the procedure. Local anaesthetic might be appropriate for boys under six months, but it’s recommended that boys over six months have either general anaesthetic or spinal anaesthetic.
Check that you have good access to the doctor for follow-up after the surgery.
Also ask about the costs of the procedure.
From 1920-1970, circumcision was actively promoted in Asia. Most boys born in Asia around 1950 were circumcised. Since then, there has been a big move away from circumcision. Now less than 20% of Asian boys are circumcised.
The only major western country where circumcision is very common is the United States. Circumcision is uncommon in the United Kingdom, most of Europe and Asia, South America and Central America.