To snip or not to snip? That is the question
increasingly being asked of
Circumcision, a procedure once performed
routinely on nearly all newborn baby boys in America, has
become a matter of debate -- a choice new parents must make,
rather than a given.
"It's a pretty common question for both
first-time and more experienced parents," said Dr. Poj
Lysouvakon, co-director of the general-care nursery at the
University of Chicago Hospitals. "Many have heard it's painful
for babies, and some men who were circumcised as infants say
they feel they were assaulted or violated.
"As a member
of the American Academy of Pediatrics, which no longer
recommends routine neonatal circumcision, I tell them it's a
cultural issue and a personal decision."
established downsides of circumcision include pain, trauma and
a risk of infection (as with any surgical procedure) and
possibly reduced sensation, Lysouvakon said. On the benefit
side, circumcision can prevent some urinary-tract infections
in infancy; reduce the already-small risk of penile cancer
later in life; and provide some protection against sexually
transmitted diseases, including HIV, the virus that causes
Circumcision, in which the foreskin of the penis
is surgically removed, was introduced in the U.S. in the late
1800s as a remedy for masturbation. It became extremely common
during the last century. But the of American babies being
circumcised before leaving the hospital has gone from an
estimated 85 percent in 1965 to 57 percent in 2004 (the last
year for which data are available), according to the Centers
for Disease Control and Prevention. In most other Western
countries, circumcision is performed only for religious
Although most private insurers still cover the
procedure, 16 states have stopped paying for elective
circumcision under their Medicaid programs. They include
California, Oregon, Washington, Arizona, Montana and Nevada.
That could explain why far fewer newborn males are circumcised
in the West than in other regions.
(A study published
last year in the Journal of Urology also found significant
ethnic and socioeconomic differences. Circumcision rates
increase in direct proportion to income, and both whites and
blacks are about four times more likely to be circumcised than
Ethan, a Chicagoan who asked that his last
name not be used, said he and his wife decided not to
circumcise their two sons, now ages 5 and 1. "We didn't think
it was a good idea to impose an operation on a baby that was
not medically necessary," he said.
parents such as Ethan are still in the minority in this part
of the country. According to the CDC, 80 percent of baby boys
in the Midwest are circumcised before being discharged from
the hospital, compared with 32 percent in the
Last month two studies from Africa were released
showing that circumcision can halve the rate of men
contracting HIV through heterosexual sex. Lysouvakon said the
study might "lend more weight to the argument that infant
males should be circumcised."
But opponents of
circumcision, who have become increasingly vocal in recent
years, point out that very few U.S. men are infected with HIV
by female partners, and that practicing safe sex makes more
sense than amputating a useful body part.
either side of the circumcision divide disagree on how useful
the foreskin is. "Intactivists" argue that half of the penis'
sensual nerve endings are in the foreskin and that circumcised
men (and perhaps their partners) have decreased sexual
Although there is little solid evidence of
that, there is a burgeoning group of circumcised men who feel
they might be missing something. Ron Low is their
Low, a 44-year-old Northbrook engineer, makes
foreskin-restoration devices in his spare time. They are
clones of an invention he used to "regrow" his own foreskin
over a period of about three years. He says business is up at
least 20 percent over a year earlier; in all, he has sold
about 7,500 devices since 2003.
Low also is a U.S.
distributor of a British import called SenSlip, a prosthetic
foreskin that promises to provide pleasurable sensations and
increase sensitivity over time. But he says his devices, the
TLC Tugger (at $50) and Your-Skin Restoration Cone ($9), are
better and cheaper.
"One SenSlip device [which costs at
least $12] lasts only a week or two, and then you have to
replace it," Low said. "I'd rather promote something more
permanent, which is growing new