Helping Parents Decide

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Helping Parents Decide Not to Circumcise

In the United States, expectant parents are routinely asked a question not heard in most countries: "If your child is a boy, do you want him to be circumcised?" It is simply assumed that if the parents desire their son to be circumcised, they will want this done immediately after his birth. However, when I talk to parents who are trying to decide this important issue, I point out that the medical evidence is overwhelmingly against circumcision in infancy.

In its most recent guidelines, the Australian Association of Paediatric Surgeons recommends that circumcision not be performed on infants under 6 months of age. This brings up the question: when is the best time to perform circumcision?

The reasons that circumcision should be postponed are simply common sense, and include the following:

1. When a boy is born, his foreskin and glans are held tightly together by connecting tissue (occasionally a newborn has a retractable foreskin, but this is quite rare). In order to circumcise an infant, the foreskin must be torn from the glans. This is extremely painful. Numerous medical studies describe this pain as "severe and persistent." If circumcision is postponed until the foreskin has become retractable, the procedure will be much less traumatic. As a boy grows, his foreskin will naturally separate from the glans and become retractable. This process is not usually completed for several years, and may take until puberty.
2. Anesthesia is difficult to use on infants, since they are so small. If the surgery is postponed until the patient is larger, it can be used with much greater effectiveness.
3. The penis of an infant is tiny. If postponed, the surgical result will be more precise, as less guesswork is required about how the penis will grow and develop. In fact, there is evidence that the outcomes of circumcisions on older boys are less prone to surgical mishaps and complications.

So, when is the best time to have a boy circumcised? Each of these points demonstrates that no decision should be made when the boy is still a baby. This gives parents plenty of time to educate themselves and learn what is best for their son. Expectant parents face challenging decisions. Many soon realize that this particular decision is best left to their son to make for himself, and that is the best reason of all to wait.