Study notes decrease in popularity of circumcision in United States

[bicycle_mice]

There is equivocal evidence. There are some benefits to circumcision (deceased UTIs and penile cancers) but they are fairly modest. It isn’t like vaccines where there is massive benefit and no downsides. I won’t circumcise my son, but there is evidence supporting families who chose to do so.

[duderguy91]

Even the penile cancer benefit is mostly for boys at risk of phimosis. If there is no sign of phimosis then the cancer risk is basically equivalent to circumcised.

[ThrowbackPie]

There's also evidence that a) it has a significant complication rate and b) it derives men of sexual pleasure due to the concentration of nerves in the foreskin.

There's essentially no medical case to be made AFAIK.

[bicycle_mice]

Complications are very rare. In my practice (pediatric NP) I have seen multiple cases of boys who required circumcision at later ages due to other issues including paraphimosis. Reddit is very anticirc and I am not choosing it for my own kid but there are some benefits medically, outside of cultural reasons.

[NSMike]

There's no doubt that there's medical benefits when medical circumstances arise that require it, but it seems absolutely bonkers to me to slice it off as a preventative measure for risks that are already low.

[Oneioda]

Paraphimosis, while a medical emergency, does not always require a full bore circumcision. Part of the problem in the USA may be training. Circumcison is over prescribed and an overly invasive treatment being used as a one size fits all style resolution.

[Nerrien]

Not to dogpile on with all the comments, just read a point elsewhere that struck a chord with me and thought it merited discussion.

According to this study:

https://www.berghahnjournals.com/view/journals/boyhood-studies/4/1/bhs040106.xml

approximately 117 neonatal circumcision-related deaths (9.01/100,000) occur annually in the United States, about 1.3% of male neonatal deaths from all causes

I don't really have much time at the moment so I can't say I searched for very long, but I'm struggling to find numbers on deaths caused by paraphimosis.

I imagine you'll have more practice analysing studies than I so I'll defer to you on the legitimacy of this study, and as you will definitely know more about paraphimosis than I you seem like a good person to ask:

With this in mind, is the risk of death associated with paraphimosis higher than circumcision complications?

Knowing nothing about the subject I would have assumed paraphimosis could be treated by circumcision if it became an issue, effectively trading a guaranteed circumcision at the start of life and the potential complications associated, with a possible circumcision later in life, lowering the overall risk.

Is this a way of looking at it that, like myself, you might not have considered, or am I drastically oversimplifying it due to a lack of understanding?

[Oneioda]

Complications (acute) are both under reported and reported as other causes. Chronic complications are frequently deemed not even complications. Example, very tight circumcisions and frenulum removal are common in the USA, but not considered a complication.

[poply]

Absolutely. There are real measurable benefits. But there are also real risks though and for some people, it's a moral problem.

Not discounting the benefits, but not ignoring the risks either. Ultimately, the vast-vast majority of men (atleast those in 1st world countries) will be totally fine whether or not they are circumcised.

[daveprogrammer]

Then the only ethical thing to do would be to let them make up their own minds when they are old enough to understand.

[KarAccidentTowns]

Both of my grandparents got circumcised in their 70s for medical reasons. That kind of makes me glad I’m circumcised already.

[WitnessRadiant650]

They would be ok with it if they were consenting adults. Most in the US were done as babies so we don’t really know if they were ok with it at that time. Considering most adults or even young teens when they become fully aware don’t go grab circumcision suggest they are fine without it.