Will your son need a circumcision for any reason? What do the numbers say?
Many parents tell us they chose to circumcise their child so that he won’t have to have it done as an adult.
Let’s set ethical arguments about pain, consent, divine design, etc. aside for now. Let’s just look at the math. What are the odds that your son will actually need to have a circumcision later?
According to Sneppen and Thorup, Danish researchers whose article “Foreskin Morbidity in Uncircumcised Males” appeared in Pediatrics in April 2016, the odds are pretty low.
In the study, they looked at all of the boys in and around Copenhagen, Denmark in 2014 who underwent foreskin surgery of any kind – 181 boys – to see why they were referred and what had to be done. Their report includes this key phrase:
“The cumulative risk of undergoing foreskin operation before 18 years of age was 1.7%“
Let’s unpack that. If 181 is 1.7% of x, then x is approximately 10,600. This means that out of 10,600 boys ages 0-17, only 181 were referred for problems of any kind that required surgical correction. They go on to say that out of these 181, only 44 received a full circumcision in order to correct their referred issue. The other 137 were treated with some other type of correction, such as a frenuloplasty, in order to save the foreskin.
Why save the foreskin?
The short answer: because Danish doctors understand that the foreskin is a valuable and beneficial part of the body, and if it can be saved, it should be. Contrast that to the United States, where we hear time and time again about someone’s friend or relative or cousin or roommate ‘having’ to be completely circumcised due to some infection or pathologic phimosis. Many doctors and nurses trained in the United States would admit that they were not taught anything in medical school about the foreskin – other than how to remove it.
Speaking of phimosis, this was the reason for 95% of the 181 cases in the study, or 172 of the boys. (The remaining 5% was for frenulum breve, or ‘tight frenulum.’)
What about phimosis?
Phimosis includes two different subtypes: pathologic phimosis and physiologic phimosis. Physiologic phimosis simply means boys cannot retract their foreskins before they reach a certain age. As a boy gets older, the tissues that keep the foreskin connected to the glans (head) of the penis dissolve, allowing the foreskin to retract. This can happen at any time between infancy and adulthood, and the average age of retraction is 10.4 years old according to a Danish study.
After all, why does a boy need his foreskin to retract at all? It’s there in the early years for protection, as it is designed it to be.
Causing phimosis
Pathologic phimosis, on the other hand, is usually caused by someone forcibly retracting a boy, ripping those bonded tissues prematurely. The body tries to repair itself, but the boy can end up with scar tissue. This can cause problems later on. Premature forcible foreskin retraction, or PFFR, is an epidemic in the United States that is a direct result of incorrect information being taught to some doctors and nurses. These professionals then do it to unsuspecting boys and teach parents to do the same. Doctors Opposing Circumcision estimates that this happens about 100,000 times per year.
If your doctor suggests that you ‘pull the skin back to clean under it’ at each diaper change, run for the hills. This is incorrect advice that could hurt your son. Politely inform the doctor what they are actually supposed to do, or contact Little Images and we’ll make sure the doctor’s office receives a packet of information on how to correctly care for an intact boy.
Make sure that any medical professionals examining your son know proper intact care.
With a few cases of phimosis, however, there is a physical problem with the opening of the foreskin. This makes it too tight for the foreskin to be pulled back. This affects only about 1% of boys by 7th grade, according to the Department of Urology at UCSF.
So whether caused by premature forced retraction or not, this “pathologic phimosis” is where those 172 boys in the Sneppen and Thorup study came from. Luckily, phimosis is not a major issue. Almost all of the boys were able to avoid circumcision by receiving a much less invasive treatment instead.
So, in summary: Don’t allow anyone to pull back your son’s foreskin for any reason, and the chances are excellent that he’ll never have any problems with it at all.
On the other hand, if he is circumcised, he is at risk for many possible undesirable side effects.
What about circumcision complications?
There are many possible unfortunate side effects from circumcison, including:
- skin bridges
- meatal stenosis (quoted here as occurring in up to 10% of circumcised boys)
- keratinization of the glans
- erectile dysfunction
- excessive scarring
- too much skin removed
The Global Survey of Circumcision Harm shows that side effects are more common than you might think. But there is minimal reporting for these types of damage.
Circumcision Complications
These are some important things to consider when evaluating statistics for circumcision side effects:
- Although the AAP has said that “the benefits of circumcision outweigh the risks,” they admit in the same paper that the true incidence of side effects is unknown. And Andrew Freedman, a member of the AAP Circumcision Task Force, recently admitted that there is no meaningful medical benefit.
- Circumcision is an unregulated practice: there are no rules governing who can do it or how it is done.
- Many side effects do not show up until after puberty begins. So any parent who says their son is circumcised and is ‘fine’ cannot be assured that he will always be ‘fine.’
- Skin bridges (where the mucosal tissue tries to readhere in an attempt to heal itself, causing pain during erections and other discomfort) aren’t counted as side effects most of the time. In fact, many parents whose sons have had these report a nurse or pediatrician unexpectedly ripping them back. This causes additional pain and bleeding in many cases.
- Many men and boys feel uncomfortable discussing any issues they are experiencing with their genitals, out of embarrassment or denial. They might keep it a private frustration for years before it is dealt with.
- It is likely that a circumcised boy or man doesn’t know that the issues he is experiencing aren’t ‘normal,’ or how he was designed to function. After all, these issues are not discussed in public and are even taboo in many circles.
- Very little research has been done on the psychological effects of circumcision, although the evidence that exists clearly favors avoiding circumcision.
- Circumcision revisions are becoming increasingly more common (up to 1000% higher in some hospitals).
So, does the math in favor of circumcision add up?
What makes more sense? The math will always favor staying intact.
No. It doesn’t.
Sneppen and Thorup say the lifetime risk of needing any corrective foreskin surgery is 1.7%. Only about 1/4 of these, or 0.4%, require circumcision. That’s 4 out of every 1000.
The true rate of circumcision complications is unknown, but given the numbers above, 10% of circumcised boys will suffer from meatal stenosis alone. That’s 100 out of every 1000. And that’s ignoring other kinds of complications.
Which is greater? 4 or 100?
The odds are in favor of keeping boys whole. About 70% of the world’s men are all intact, and the vast majority of them will never have issues with their foreskin.
For Christians: Beware the Spirit of Fear
1 Timothy 1:7 instructs us that “For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.” That little voice that says, “well, what IF he is in the 1.7%?” is not from God. And, given the much more likely negative consequences of circumcision, it is not practicing a sound mind. God did not call us to fear the “what ifs.” He called us to love, and saying ‘no’ to circumcision is one of the first acts of love you can give your son here in the United States. It shows love by trusting that God will keep your son safe from harm and respecting his right to his whole body. It also shows love to God by trusting in His wisdom and His good design for the body.
***
If you have questions or concerns, or wish to share your story with us, please comment below, message us on Facebook, or contact us directly at [email protected]. If you are looking for more information, click around our website, or visit i2researchhub.org to see some research and scholarly articles associated with circumcision.
Joe
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ER nurse says
Excellent points! As an ER nurse, I have seen countless complications, including babies almost bleeding to death after circumcision, but also later complications that are MUCH more common- such as meatal stenosis- which causes painful urination and deceased urinary flow. (Because the urethral opening is supposed to be kept moist and soft, protected by the foreskin, NOT calloused and dry by exposure to clothing/diapers. One mom described the surgery for her sons meatal stenosis as “debilitating pain”. I rarely see problems in intact boys that are cared for properly. Thank you for warning parents about forced retraction- it definitely is a common problem in the USA where healthcare workers are NOT taught proper intact care. Again, leave it alone as it is self cleaning in babies and young boys- with older boys and men, only a quick rinse with warm water a few times a week is needed- that’s it! (No soap as it causes inflammation and irritation). Blessings to the ministry of Little Images!
Richard Russell says
Thank you, ER nurse, for speaking up. We need many more like you to pull the veil back on circumcision complications. I had a horribly botched one as a neonate and suffered with pain most of my life. No one takes you seriously because US doctors have persuaded the public that nothing ever goes wrong with any circumcision. In fact, there are estimated to be from 100 to 200 deaths a year from boy circumcisions. An exact number can’t be known because US medicine keeps the lid on it . . . in the name of “protecting” grieving parents . . . not mention of ever beginning to protect baby boys from being exposed to the risk.
Meghan Murray Viveiros says
Great summary
Ramona Shafer says
Yeah….so…..no circumcisions for us!
Katie Williams says
circ is brutal!
Johannes Archer says
let the children grow up and decide for themselves at 21.
Lauren Acosta says
if I have a son, I will gladly drive him to his circumcision appointment…..if that’s what he decides he wants when he’s 18
Jason says
I read about a man who had a circ done at 18 from peer pressure and only realised when it was too late that the pleasure sensations he knew came from his foreskin, not his glans. He said it was the biggest mistake he’d ever made and that teenagers do stupid impulsive things. Scientists say the adult brain isn’t fully formed till 26. I heard that from a Professor or neuroscience in a lecture years ago. I’ve heard a lot of very similar claims very recently.
roger desmoulins says
Joseph, I like the way you reason, especially the way you take readers through the important recent Danish findings about the rarity of therapeutic circumcision done in good faith.
The go-to profession for serious complications of RIC, is pediatric urology. This branch of American medicine has been strangely silent ever since RIC became fashionable among the urban middle class, early last century. Even stranger is how this silence persisted as RIC became the norm for all but Latinos, Native Americans born on reservations, and children of post WWII immigrants. Pediatric urologists know the truth about long term RIC complications and about the frequency of urological problems in intact boys; why won’t they reveal that truth??
Steinn Andersen says
“Only about 1/4 of these, or 0.4%, require circumcision.”
Actually, the number is even lower, 0,38 %.
In Norway it might be even lower still, as I’ve never heard of a boy ever needing it.
Good article though! 🙂
Ck says
just going to drop this here incase you forgot who Abramham is
Then God said to Abraham, “As for you, you must keep my covenant, you and your descendants after you for the generations to come. 10 This is my covenant with you and your descendants after you, the covenant you are to keep: Every male among you shall be circumcised. 11 You are to undergo circumcision, and it will be the sign of the covenant between me and you. 12 For the generations to come every male among you who is eight days old must be circumcised, including those born in your household or bought with money from a foreigner—those who are not your offspring. 13 Whether born in your household or bought with your money, they must be circumcised. My covenant in your flesh is to be an everlasting covenant. 14 Any uncircumcised male, who has not been circumcised in the flesh, will be cut off from his people; he has broken my covenant.”
Joe says
Hi CK,
We’re well aware of who Abraham is. We’re also aware of who Christ is, and why his death on the cross fulfilled the Abrahamic blood covenant of circumcision. We’re also aware of the Council of Jerusalem, which officially removed circumcision as a Christian practice, and we’re aware of how doctors in America revived the practice in the late 1800’s in order to “cure” a host of medical ailments such as bed wetting. Thanks for checking, though!
MA says
Quit cherry picking the Bible, the circomcision requirement was reversed in the New Testament.
AmayaSasaki says
Also, the circumcision for the Abrahamic covenant was vastly different than what is practiced today. That circumcision only took a small amount of skin extending past the glans, leaving the rest of the foreskin intact. That still doesn’t necessitate any form of it for Christians as Joe noted. The council of Jerusalem determined that circumcision was not necessary to follow Christ, as the Apostle Paul also notes in his letter to the Galatians. The revival of circumcision in the US was due to Dr. John H. Kellog deciding that if his cereal (corn flakes) wasn’t enough to deter young men from masturbation, surely circumcision would.
Whitney Helen Goetsch says
Thanks for sharing
Per Lindstrand says
A voice from Sweden: It is not offered here, noone is asking for it and foreskin problems are virtually unheard of at all ages. I am over 60 and have never heard of a man needing circumcision for a medical reason. Cutting foreskins from Babies seem like an American social disease and it is great that more end more Americans parents are questioning the practise.
Emily says
Your website was the final factor in my convincing my hubby to leave our son intact. I had been so stressed out about it that I was terrified of giving birth. I wanted him safe in my belly where he could be protected!
Hubby stated that he “loves me more than his own life” so he let me have this one. Whatever the reason, I’m grateful! Thank you for the work you do, it has made a huge difference in our family!
Joe says
That’s SO AWESOME! Thanks for sharing! <3
Jason says
I have spoken to men circumcised that cringe at anybody even discussing it. Surely the word and what it is has to be discussed. Men are resistant and we know often times reactive in a violent way if anyone speaks of it as anything other than a great procedure. In the US the cultural bias and non sense I n its favor is just a pathetic lie.