Since this has come up in the news again, I'd like to present evidence in favor of allowing the choice to circumcise or not.
First, I don't think anyone these days would advocate a blanket policy of "all male children should be circumcised", and I am certainly not. Overall I agree with the official position of the American Academy of Pediatrics:
Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child
I do not think the evidence is compelling in either direction, but I believe there are "enough" mild medical benefits to circumcision that I support it for my child, at least. But I would certainly not fault any other parents for deciding otherwise. It is hardly a life threatening or even important decision in the big scheme of things. At best it is minor, on the scale of the deciding to keep your appendix or pierce your ears.
The Wikipedia page Medical Analysis of Circumcision has tons of great citations. Specifically the ones I found compelling in my decisionmaking are:
Ewings and Bowie performed a case-control study of 159 cases of prostate cancer, and found a reduced rate among circumcised men (odds ratio 0.62). The authors noted: "...some statistically significant associations were found, although these can only be viewed as hypothesis generating in this context."
A 1988 New Zealand study of penile problems by Fergusson et al., in a birth cohort of more than 500 children from birth to 8 years of age found that by 8 years, circumcised children had a rate of 11.1 problems per 100 children, and uncircumcised children had a rate of 18.8 per 100. The majority of these problems were for penile inflammation including balanitis, meatitis, and inflammation of the prepuce.
Three studies that have found that boys with foreskins tend to have higher rates of various infections and inflammations of the penis than those who are circumcised:
- Fakjian, N; S Hunter, GW Cole and J Miller (August 1990). "An argument for circumcision. Prevention of balanitis in the adult". Arch Dermatol 126 (8): 1046–7.
- Herzog, LW; SR Alvarez (March 1986). "The frequency of foreskin problems in uncircumcised children". Am J Dis Child 140 (3): 254-6.
- O’Farrel, Nigel; Maria Quigley and Paul Fox (August 2005). "Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study". International Journal of STD & AIDS 16 (8): 556-588.
Singh-Grewal (2005) performed a meta-analysis of 12 studies (one randomised controlled trial, four cohort studies, and seven case–control studies) looking at the effect of circumcision on the risk of urinary tract infection (UTI) in boys. Circumcision was associated with a reduced risk of UTI (OR = 0.13; 95% CI, 0.08 to 0.20; p<0.001).
According to the American Medical Association, "There is little doubt that the uncircumcised infant is at higher risk for urinary tract infection (UTI)."
Researchers from the Imperial College School of Medicine, Chelsea & Westminster Hospital, London, England reported the results of their study of 357 patients referred for genital skin disease. Most cases of inflammatory dermatoses were diagnosed in uncircumcised men, suggesting that circumcision protects against inflammatory dermatoses.
On Wednesday, March 28, 2007, the World Health Organisation (WHO) and UNAIDS issued joint recommendations concerning male circumcision and HIV/AIDS. These recommendations are:
Male circumcision should now be recognized as an efficacious intervention for HIV prevention. Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men.
So for me, I want my child to have the best chance of not having these problems associated with foreskins, even if the incidences are quite rare.
Also, having this procedure completed at day 2 of your life when you won't remember it, and as a part of all the other crazy-ass things that happen when you're born (and obviously performed with anasthetic in any case) is preferable to the risk, however small, that you might need a medical circumcision later at an age where you will remember the procedure and the recovery.