Can a man’s health boil down to whether or not he’s snipped?
While the procedure carries risks, some say that circumcising a male ultimately benefits his health. Such declarations have had many new parents –- and even full-grown men –- wondering if it’s in their best interest to be cut. But between a lack of evidence and conflicting research when it comes to a male’s risk of cancer and infections, others are saying, "Not so fast."
Male circumcision is the removal of the foreskin of the penis. It is a procedure that has gradually become less popular in the United States for a number of reasons, including:
— Many medical practitioners consider it an unnecessary medical procedure.
— Health insurance companies often don’t cover the procedure.
— Some worry about the risk of infection, excess bleeding or poor cosmetic result.
— Some people believe that circumcision is a form of genital mutilation.
— Worry over physically or psychologically traumatizing the child.
— Fears that the head of the penis will suffer abrasion, which can result in scarring and a loss of sensation.
In recent years, however, we’ve heard a renewed call for circumcising males. This has been driven mostly by results from three research trials in African countries that found circumcision lowers a heterosexual male’s risk of getting HIV. One study found that the risk was lowered by as much as 76 percent.
Since then, we’ve heard public health officials encourage large-scale circumcision programs in AIDS-ridden Africa, and some people in the United States have wondered if it wouldn’t hurt us to follow suit.
But is circumcision truly medically necessary? Individuals need to think about this critically, given that doctors used to recommend circumcision for hygienic reasons. We now know, however, that an uncircumcised male can avoid health problems by regularly washing the foreskin and the area underneath.
So what does the evidence say about the medical benefits of circumcision?
Circumcision proponents like to point out that the procedure reduces a baby's risk of urinary infection by 90 percent. This is great if you live in a developing country, but this condition is rare in the United States.
Cancer of the Penis
Circumcision proponents claim that circumcision reduces the incidence of penile cancer in older men by at least 50 percent. But there is no evidence that the procedure itself prevents penile cancer.
In fact, when a man has this rare form of cancer, the cancer usually breaks out on the circumcision scar. Like urinary infections, this cancer is rather rare in the U.S.; men have a higher chance of getting breast cancer.
Sexually Transmitted Diseases
A recent major, long-term study in Pediatrics reports that circumcised males are less likely to acquire a sexually transmitted disease (STD), especially HIV, syphilis and genital ulcers. Yet a study in the Journal of Pediatrics indicates otherwise.
Researchers in New Zealand found that circumcision doesn’t appear to protect a man in a developed country from certain STDs. By following nearly 500 men since the 1970s, investigators found the same percentage of cut and uncut men developed bacterial and viral STDs, like genital warts and chlamydia.
Statistics from Europe support the New Zealanders’ findings. European men, most of whom are uncircumcised, have no higher incidence of STDs and HIV than American men, most of whom are circumcised.
As mentioned earlier, studies out of Africa indicated that circumcision appears to have a protective effect. This may be due to the male no longer having the cells inside the foreskin that seem especially susceptible to HIV. The warm and wet environment of the area beneath the foreskin may also increase a virus’ chance of survival.
Yet a new analysis of the data, published in a recent issue of the Journal of the American Medical Association, finds that being snipped doesn’t always provide protection. In reviewing 15 studies involving more than 53,500 gay and bisexual men in eight countries, researchers found little support that being cut has a protective effect against HIV among men who have sex with men. Why this is, however, can only be speculated.
So how do we make sense of all this? Overall, we can definitely say there is no compelling evidence either way that circumcision benefits a man's health. To go ahead with this procedure comes down to every male’s or parent’s feelings about the pros and cons.
One thing we do know for certain is that circumcision is considered a good idea if a male has recurrent health problems related to the foreskin. The medical community does recommend circumcision when it comes to recurring infections or phimosis (a tightening of the foreskin that makes urinating and sex very uncomfortable).
We also all know that, in the midst of this great debate, circumcised or not, it’s in a man’s best interest to use a condom if he’s worried about health risks. And that won’t change, no matter what this debate decides.
Dr. Yvonne K. Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."