To cut or not to cut

Friends of mine had a baby boy a few weeks ago. When their doctor asked them if they wanted to circumcise their child, my friends asked if there were any health advantages to snipping off the foreskin. “None,” the doctor answered matter-of-factly. When they told me this story, I had to gasp for air.

I had just returned from the International Aids Conference in Mexico City where male circumcision was discussed as one of the hot topics for HIV prevention. Research has shown that men without a foreskin have 60% less chance of contracting the HI virus during heterosexual sex than their uncircumcised peers. (It’s still necessary to practise safe sex, of course!)

And this is not even particularly new — the research results had already been announced at the previous Aids conference, in Toronto in 2006. What has not been widely known is this: circumcision also lowers the risk of men getting the human papilloma virus (HPV) that causes genital warts and cervical cancer. This is good for men as well as for women who have sex with circumcised men — they run a much lower risk of contracting various sexually transmitted infections, not only HIV, and of getting cervical cancer.

Those who have been afraid that together with their foreskin they have to say goodbye to a whole lot of nerve endings can relax, too. Unlike commonly believed, studies have now shown that cutting off the foreskin has no effect on sexual sensitivity or performance.

All the above is not to say that circumcision is the right decision for everyone. The decision to cut or not to cut is not necessarily a straightforward one. Some people have cultural and religious aspects to consider, some want to let their child make an autonomous decision (later in his life) about opting for or against the procedure, and so forth.

But whatever people’s concerns are and whatever their final decision on the topic, it is important that a) doctors and health carers are aware of all the latest research regarding male circumcision; and b) they inform their patients in detail about the pros and cons so that they can make up their own minds.

Presenting them with one-sided, one-word answers to an extremely complex issue that, who knows, might one day be the deciding factor for someone’s health is simply not acceptable.