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Circumcision Decision: Weighing the Risks and Benefits

Male circumcision reduces HIV, cervical cancer, syphilis, and chlamydia. Is it time to reconsider its merits?
By Arthur Allen
WebMD Feature
Reviewed by Sheldon Marks, MD

If there was a cheap, safe, one-dose vaccine that gave your newborn boy significant lifelong protection against AIDS and other sexually transmitted diseases, as well as protection against cancer and various annoying infections, would you get it for him? Well, there is one. It’s called neonatal circumcision.

In studies published in the past decade, the removal of the foreskin provided a 50% reduction in HIV transmission, a threefold reduction in human papillomavirus (HPV) infections in female partners of circumcised men (HPV can cause cervical cancer), and lower rates of syphilis and chlamydia, which causes sterility and is the main sexually transmitted disease among teenagers. Circumcised infants were also roughly 10 times less likely to suffer urinary tract infections and the high fevers associated with them. And circumcision virtually eliminates serious penile cancers, which invade about 1 in 100,000 uncircumcised men.

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The evidence from Africa of circumcision’s potential role in AIDS prevention led the New York City Health Department in April to begin considering outreach programs to promote circumcision among gay adult men and drug addicts.

My unscientific justifications for circumcision

I didn’t know about any of this in 1996 when my son, Ike, was born, but I sure as hell wasn’t going to have any son of mine sporting a flesh hood over his ding-dong. Since I’m half of a mixed-faith marriage, the decision to circumcise wasn’t without controversy.

My wife’s golden California family, God bless them, aren’t remotely in favor of character-building suffering, whether Biblical or the not. My sister-in-law, a family practitioner whose wisdom in things medical (and other things) is deep, felt the cut wasn’t necessary. My wife, Margaret, was uncomfortable with the idea of inflicting pain on her newborn firstborn.

I, however, was as inflexible as a nose ring. Ike was going under the knife. For a cultural, non-practicing Jew such as myself, circumcision was one of the only ways I had of proclaiming the tribal allegiance of me and mine. Sound primitive? Well, yeah.

When the time came, Margaret tearfully abandoned the operating theater. Dr. Blank, our obstetrician-cum-mohel, stretched the foreskin with a pair of clamps and deftly snipped with the aplomb of a man about to enjoy a fine Cuban cigar. Ike screamed and flailed his arms for five seconds, then fell soundly asleep. That was it.

The ancient Egyptians were the first to circumcise because sand under the foreskin was itchy and caused infections. The Jews and Muslims incorporated the practice as a ritual mainstay, and it spread through the United States a century ago because, along with other reasons, reformers thought it would prevent masturbation.

Over the past couple of decades, circumcision has come under growing scrutiny in the U.S. because it’s obviously painful and is perceived by some as a form of mutilation. Since the dawn of the Dr. Spock age, when people began to agree that it’s a good thing to diminish kids’ pain, circumcision has come to be portrayed as a pointless bloodletting ritual, like something commemorated on the wall of a Mayan temple. A plethora of passionately anti-circumcision web sites proclaim things such as, “Bring your boy home whole!”

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