TIME, Monday, August 31, 1981.

A Son's Rite

Circumcision is unnecessary

It is probably the most common operation in the U.S. today, performed about 1.5 million times a year. Yet doctors increasingly acknowledge that it is extremely short on medical justification. Circumcision has a long history. Ancient Egyptians may have been the first practitioners, possibly using it to mark slaves. Jews adopted it as a religious rite in observance of the covenant between God and Abraham. For many Jews today, circumcision of an infant boy is a joyous family celebration. In the U.S. the operation found favor in the late 1800s as a deterrent to masturbation, then popularly considered the source of much physical and mental illness. During World War II, military surgeons concluded that circumcision was necessary for hygiene, particularly in the tropics, and snipped the foreskins of uncircumcised soldiers and sailors. After the war, circumcising infant boys became routine, and not only for hygienic reasons. Circumcised males were said to be less susceptible to penile cancer and their sexual partners less likely to get cancer of the cervix.

These justifications have gradually been debunked. Cleanliness can be assured by teaching a boy to wash his penis. Cancer of the penis, a very rare malignancy, occurs about equally in circumcised men and in those with foreskins intact who wash thoroughly. Studies indicating that women married to circumcised men have a lower incidence of cervical cancer have been either inadequate or flawed. Review of one study, for example, revealed that about half the women had incorrectly answered questions regarding whether their husbands were circumcised. A sizable portion of the men were also wrong in assessing their condition. Circumcision will correct two conditions that occur in a fraction of uncircumcised children: phimosis, a narrowing of the foreskin hampering erection and urination; and paraphimosis, retraction of the foreskin resulting in a cutoff of blood to the end of the penis.

The operation is done without anaesthetic, usually within the first two weeks of life, and is painful. Doctors also point out that there is some risk of infection and hemorrhage. One reason for the damage is that the operations are often performed by doctors who are not adept in the procedure. The American Academy of Pediatrics concluded in 1971 and again in 1975: "There is no absolute medical indication for routine circumcision of the newborn."

Still, the practice persists. Last year about 80% of newborn males in the U.S. were circumcised. Some parents think the law or hospital requires the operation. Many choose circumcision so that the baby will look like Daddy or siblings. Clearly, doctors have not done too vigorous a job of informing parents of their option. Says one critic: "Who's going to pass up 75 bucks for three minutes' work?"

Consumer groups are now taking up the slack. The Massachusetts Women's Council on Obstetrical Practices attempts to sway parents with a novel approach. It shows pictures of a circumcision in progress while playing a record of the baby's screams.

(File created 4 November 2007)