What to Know Before Making the Decision to Circumcise

Circumcision facts.

| May/June 1984

This issue's column was guest-written—for Dr. Tom Ferguson—by contributors to Medical Self-Care magazine. 

After the birth of a boy, one of the first and most difficult decisions faced by the parents is often the question of circumcision: the surgical removal of the foreskin that covers the head of the penis. Although few parents have given a lot of thought to the procedure in the past (many expectant couples routinely sign a consent form for the operation when they check into the hospital), the subject is becoming increasingly controversial as new findings contradict long-established medical beliefs. 

History of Circumcision

One of the most ancient of surgical procedures, circumcision is pictured in Egyptian bas-reliefs dating back to 4000 B.C. Tribal cultures around the world—including the Australian aborigines and many African and South Pacific people—circumcise their boys shortly after birth, or as part of later initiation rites. And, of course, Jews have a very long history of the practice . . . in the Old Testament, God commands Jews to circumcise boys eight days after birth as a sign of His covenant with Abraham. 

In this country, however, circumcision has spread far beyond those groups who connect it with religious or cultural beliefs: It has become a common medical procedure. Before the 1870's, very few non-Jewish American males were circumcised . . . but by 1910, 56% were. And today, about 85% of the boys born in the United States are circumcised. In fact, we're the only Western nation (besides Israel) that still practices circumcision on a large scale. (For example, in England the percentage used to be quite high, but has now dropped to less than one percent.)

Medical Facts and Fallacies

The foreskin, or prepuce, is a double layer of skin—similar to a lined sleeve—that fits snugly over the tip (glans) of the penis. The outer layer is continuous with the outer layer of the penis, and protects the glans (and the urinary opening in particular). The inner layer is more like a mucous membrane . . . it secretes smegma, a lubricating substance that allows the foreskin to slide back and forth easily over the head of the penis. Since the inner layer houses many nerve endings, it is highly sensitive and enhances sexual pleasure.

The foreskin starts developing during the third month of gestation, and by the fifth month is fused to the tip of the penis. By birth, it has usually begun to separate from the glans . . . a process that continues during the first years of life. By puberty, the foreskin should be fully retractable.

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