"Circumcision is the most commonly performed surgical procedure in the United States. As a pediatrician and neonatologist, I am a child advocate and try to do what is best for children. For many years I was an outspoken opponent of circumcision and believed there was no justification for its routine performance in the newborn. However, over the past four years I have gradually changed my opinion. Several factors have influenced this change.
  There is irrefutable evidence that circumcised boys have far lower risk for urinary tract infections during infancy than their uncircumcised counterparts. In addition, circumcision leads to almost complete protection against penile carcinoma. Furthermore, important but controversial data show an apparent link between the state of uncircumcision and a higher risk for many of the sexually transmitted diseases."
Taken from:
T.E. Wiswell, MD, Do you favor routine neonatal circumcision? Yes., Postgrad. Med. 1988; 84: 98-104.

  "... the benefits of circumcision accumulate over a lifetime and help to prevent numerous diseases, while the risks are immediate and generally short-term. My own views are that the long-term medical benefits are greater than the risks.
Taken from:
Richard M. Parker, MD, Pediatric Urologic Information Resources http://www.pedsurologic.com/Parker/Home.html

  "Circumcision is like a substantial and well-secured annuity; every year of life you draw the benefits. Parents cannot make a better paying investment for their little boys."
Taken from:
Dr. P.C. Remondino, The History of Circumcision, published in 1891.

  "The lifetime health benefits of neonatal circumcision—including the long-known benefits of genital-hygiene improvement and prevention of local infection and penile cancer—far exceed the risks of the procedure. Circumcision prevents serious kidney infections, particularly in infancy; and there is strong evidence that it has a protective effect against some serious STDs, especially HIV infection, syphilis, and chancroid. A one-week-old circumcised boy has a significant health advantage over his uncircumcised contemporary. And being without a foreskin won't dent his sex life."
Taken from:
E.J. Schoen, MD,  Is Circumcision Healthy? — Yes.

  "The beneficial effects of newborn circumcision are multiple and cumulative during a lifetime. During the 1950s and 1960s, when 90% of US newborn boys were circumcised, major benefits of newborn circumcision were considered to be improved lifetime genital hygiene, elimination of phimosis, and the prevention of penile cancer. Currently, newborn circumcision may be considered a preventive health measure analogous to immunization in that the side effects and complications are immediate and usually minor, but benefits accrue for a lifetime.

  The benefit of immunization is long-term, constant protection form disease. The multiple benefits of newborn circumcision vary with age. In infancy, circumcision protects against UTI [Urinary Tract Infections]; in the 3- to 5-year age group, local foreskin infection (balanoposthitis) is prevented; and at puberty, with onset of erections and sexual activity, problems of phimosis are prevented.

  Circumcised men have improved genital hygiene during their lifetime. Uncircumcised young men are predisposed to certain sexually transmitted diseases, including HIV, and uncircumcised middle-aged men have propensity for penile cancer. In old age, uncircumcised men are not only more likely to contract penile cancer, but those with indwelling catheters have increased prevalence of local infection. Thus, the specific benefits of newborn circumcision depend on age; this fact explains the conflicting attitudes of medical professionals toward the procedure."
Taken from:
E.J. Schoen, MD, Circumcision Updated - Indicated? Pediatrics 1993; 92: 860-1.

  "... For at least the last 10 years I have been doing circumcision on request and recording the effects of all operations in a questionnaire. One would expect men circumcised for medical reasons to be satisfied with the improvement in their sex lives even if the operation was badly performed. In fact these men and their partners often said that their sex lives were better than before the trouble occurred. Equally one would expect patients circumcised for trivial reasons (e.g. long prepuce, smelly in the Summer) or who were done on the suggestion of someone else (e.g. shipping company, fiancée) to be more critical about the operation. In practice nearly all these patients and their partners found that their sex lives were improved by the operation. I have been surprised how many patients volunteered that they were more comfortable after circumcision even though they did not complain of discomfort before operation. Irrespective of whether circumcision was done to cure a problem or as a preventive measure no one has ever regretted having the operation, or found it has spoiled his sex life. My observations on the effects of circumcision in about 1,000 cases over the last 25 years have converted me from anti- to pro-circumcision.
Taken from:
J. Smith, MD, Circumcision: A Guide to a Decision
Article available online at ICIRC http://www.circinfo.com.

  "The question to be answered is; īdo the benefits [of circumcision] outweigh the risksī. When considering each factor in isolation there could be some difficulty in choosing. However, when viewed as a whole, in my opinion the answer to whether to circumcise a male baby is YES. ..." Taken from:
B.J. Morris, PhD, Medical Benefits from Circumcision
Paper available online: http://www.circinfo.net

  It is our conclusion that, as the safest and most commonly performed surgical procedure in this country, the benefits of posthetomy, which include a reduction in some kinds of cancer and sexually transmitted diseases, well outweigh the risks cited by those who oppose it.
Taken from:
Gerald N. Weiss and E.B. Weiss, A Perspective on Controversies over Neonatal Circumcision, Clinical Pediatrics 1994: 33; 726-730.
Paper available online at ICIRC: http://www.circinfo.com.

  "The overwhelming evidence, therefore, leads to my conclusion that the common American practice of neonatal circumcision is an important prophylactic operation, even though the practice was not previously well founded."
Taken from:
James R. Roberts, MD, Neonatal Circumcision: An End to the Controversy?, Southern Med. J. 1996; 89: 167-170.

Sexual Sensitivity and Dysfunction

  "Clinical and neurologic testing has not detected differences in penile sensitivity between men who were circumcised and those who were not. I know of no data indicating that circumcised men have more long-term genital-related problems with either psychological, social, emotional, and sexual function of sexual pleasure."
Taken from:
T.E. Wiswell, MD, Circumcision Circumspection, New England J. of Med. 1997; 336: 1244-5.

Anti-Circumcision Activities

  "The current anti-circumcision crusade can be attributed to a concatenation of factors old and new. From a phylogenic viewpoint the oldest of these factors is manīs high valuation of the genitals and the guilt-induced anxiety leading to a fear of genital injury. Since the individualīs dread of genital injury or castration is usually resolved by relegation to the unconscious, it may later emerge as a sincere effort to have every penis remain intact. Potentiating this primordial anxiety is a quite understandable backlash against the originally unscientific origins of circumcision and against the lavish claims that were made regarding the benefits accruing to those who underwent the procedure. Like all backlashes, the reaction has been excessive and the anti-circumcision camp now attempts to demolish fact as well as fancy. The analogy of throwing out the baby with the bath water was never more applicable."
Taken from:
R. Dagher, M.L. Selzer and J. Lapides, Carcinoma of the Penis and the Anti-Circumcision Crusade, J. of Urology 1973; 110: 79-80.

  "The anti-circumcision craze has developed because groups of conservative, sensitive, medically misinformed individuals, some with fanatical emotionalism, have not seen the consequences of a society where males are not circumcised. While medical prophylactic measures are readily accepted by our society, surgical prophylaxis is in danger of being discarded by an overemphasis on the return to the "natural". The intense pain of natural childbirth is seen as a reward while the minor discomfort, if any, of circumcision is magnified beyond reason."
Taken from:
G.N. Weiss, MD, Neonatal Circumcision Is Necessary, Information Sheet available online at ICIRC: http://www.circinfo.com.

  "At the height of the anti-circumcision sentiment during the early 1980's formal groups opposed to the procedure were formed. These incude BUFF (Brotherhood United for Future Foreskins). INTACT (Infants Need To Avoid Circumcision Trauma), and the largest organization, NOCIRC (National Organization of Circumcision Information Resources Center). The latter group sends out a newsletter periodically to its members and to physicians. In addition, it has sponsored several symposia on circumcision. These latter meetings have been forums for anticircumcision advocates to vocalize their positions. Members of the anticircumcision movement generally refer to the procedure as "rape, butchering, amputation, or torture." During the past decade, the literature and letters I have received from these organizations have made many claims. These include: that circumcision encodes the brain with violence...which is why America is the "murder capital" of the world; that long-term effects of the procedure include suicide, sudden infant death syndrome, and homosexuality; that male circumcision should be considered equivalent to elective removal of the clitoris and labia in female children: that men without prepuces feel a loss, relive the violence, are not "whole" and have a "diminished penis"; that the loss of erotic tissue in the prepuce diminishes sexual pleasure and function; and that the reasons physicians advocate neonatal circumcision are twofold-to make money and to "pay back" for the pain they had when they were circumcised themselves. There is no scientific foundation for any of these claims or for the myriad other assertions of these organizations. The groups attempt to support their conjectures with a handful of testimonials."
Taken from:
T.E. Wiswell, Neonatal Circumcision: a Current Appraisal   Focus & Opinion Pediat 1995; 2:93-9.

Issues involving Informed Consent

  "Informed consent concerns a patient's rights of self-determination for medical or surgical treatment. The ability to make medical decisions requires the intellectual and emotional capacity to understand risks and benefits. Parents are the logical surrogates to give proxy consent for their children. Parents have the legal right to authorize medical care and treatment for their children, including surgical procedures. It has never been otherwise. The overriding bioethical principle is to act in the childs best interest. Thus, parents may only give proxy consent for interventions they believe will further the childs well-being. For them to make such a decision they need unbiased, full disclosure of information.

  For any type of informed consent (including circumcision), patients (or parents) need to be told in comprehensive language the nature and purpose of the treatment, the risks and the benefits of such therapy, prognosis if treatment is declined, and any alternative methods of therapy. The counseling physician is required to disclose all information that any reasonable physician would disclose under similar circumstances, as well as all information that a reasonable patient (or parent) might want to know. The information must be objective, not subjective, in nature.

  Inspired by the anticircumcision movement, I am aware of a handful of lawsuits filed by the families of circumcised boys years after the procedure. The family claims that the child did not give his personal informed consent (although the parents gave theirs before the procedure). The plaintiffs have invariably lost cases in which the parents gave their informed consent as legal proxies at the time of the original counseling. The fact that they apparently changed their minds later does not change the fact that their original consent was legally binding."
Taken from:
T.E. Wiswell, Neonatal Circumcision: a Current Appraisal Pediatrics 1995; Volume 1 (2).

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