How to Make the Circumcision Decision

Albon was trained in Baltimore, where circumcision was the norm. When she worked in Arizona, it was uncommon. In her current practice in California, it’s about 50-50, she says.

According to the National Center for Health Statistics, the rate of male newborn circumcision declined 10% between 1979 and 2010. During that 32-year period, the rate was highest in 1981, at 64.9%, and lowest in 2007, at 55.4%.

In the Northeast, the rates stayed steady during that time. In the Midwest, fluctuation in the rates followed the national trend, steadily declining until the middle of the 1980s, then going up until 1998, until finally going back down through 2010. In the South, they increased and then declined. But in the West, they dropped 37%, hitting a low of 31.4% in 2003.

If all of this has your head spinning, you’re not alone. The circumcision decision can feel like a difficult one to make for your newborn. Here are some facts that may help make the choice a more informed one.

The Health Benefits to Circumcision vs. the Risks

According to the American Academy of Pediatrics (AAP), there are some potential medical benefits of circumcision, including a decreased risk of:

• Urinary tract infections
• Acquiring HIV
• Transmission of some sexually transmitted infections
• Penile cancer

Of course, there are circumcision risks as well, says board-certified pediatrician Edward Kulich, M.D., who practices in New York City. Bleeding, infection, and damage to organs are standard risks of nearly any surgical procedure, he says.

“There’s also the risk that you might not be happy with the cosmetic outcome,” he says. Some parents do opt for revision surgeries in that case (which he suggests completing before the baby is 15 months old).

The AAP last updated its position on circumcision in 2012. Its Task Force on Circumcision, weighing the most current evidence at that time, concluded that the health benefits to circumcision of newborn males outweighed the risks.

That conclusion notwithstanding, it also said that “parents should weigh the health benefits and risks in light of their own religious, cultural, and personal preferences, as the medical benefits alone may not outweigh these other considerations for individual families.”

They stopped short of universally recommending male circumcision—which means that in terms of a solid yes or no, it’s a wash. However, parents’ cultural beliefs and norms ultimately influence them more than anything else.

Cultural Considerations

If you’re in a part of the country where circumcision is very common, the assumption may be that you will circumcise. It’s likely that you or your partner or the men around you are circumcised. Taken together, these factors can make circumcision feel like the natural choice.

“‘I don’t want them to feel different in the locker room’ is not an unrealistic thing to say,” Kulich points out.

There’s also a strong religious tradition attached to circumcision. For example, the rate of circumcision in Muslim nations is between 90% and 100%, and it’s an important tradition for American Muslims, too. It’s also an important ritual in the Jewish tradition, particularly for Orthodox families (though they only make up about 10% of American Jews).

There are racial and ethnic differences in circumcision practices as well, with rates of circumcision averaging 91% among white males, 76% among Black males, and 44% among Latinos. “It adds to the cultural part of it when relatives are or are not circumcised,” Albon says, noting that the rates were very low when she worked in the Latino community near the U.S. border with Mexico. Families in general tend to do what others around them are doing.

Making the Right Choice for Your Family

In California, the circumcision decision tends to be more of a risk-benefit discussion, she says. Parents seem to choose based on their personal preferences and not what everyone else is doing. “Some parents regard it as an unnecessary surgery,” Albon says. And because California hospitals aren’t reimbursed for circumcisions, there's potentially a financial disincentive.

Kulich says it’s rarely a discussion in New York. “I can’t recall ever in my career being asked by a parent if I thought they should circumcise their child or not,” he says.

The best advice is to talk to your partner and your doctor and make an informed decision together.

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