He probably won’t need to get it done later: another circumcision myth busted

You may have heard Australian parents justify circumcising their baby ‘to save him from having it done later’. They will quote the story of ‘a friend of a friend who knew someone who had a son…’, but how many boys actually need to have it done later for a medical reason? And of those that were done for a medical reason, how many could have been treated with a less invasive method? To attempt to answer those questions we can look at the overall circumcision rate in countries where they respect the genital autonomy of their children. Countries such as Spain, Denmark and Finland have a an overall circumcision prevelance of less than 2%. This includes men who were circumcised as children, or circumcised later for religious, medical or other reasons. In other words, there are at least 98% of men in these countries who will never need to be circumcised. The situation in Australia is slightly different. Circumcision was so prevelant that generations of Australians have forgotton how a normal penis is supposed to function, and they, at the suggestion of their doctors who are likely to be circumcised themselves, are too quick to circumcise when a less aggressive treatment is available. But even in this ‘pro-cutting’ culture, a recent analysis of data extracted from the National Morbidity Database, the Australian Studies of Health and Relationships research database and the Australian Bureau of Statistics has concluded that:

“…at least 93 per cent of boys will never require a circumcision, so inflicting (routine infant circumcision) on them to avoid such a possibility is at best pointless and at worst a criminal infringement of their human rights and bodily integrity.”

Read more at this bubhub forum post.

3 thoughts on “He probably won’t need to get it done later: another circumcision myth busted

  1. In my Bubhub piece I did not attempt any comparisons with other non-circumcising societies. As it turns out, the figure for boys aged < 15 years (3.2%) is almost exactly the same as the most recently reported figure for the UK of 3.3% (in Cathcart 2006).

    This is probably higher than Finland or Denmark, but I would urge caution about making such comparisons since we simply have no reliable data in most cases. For instance, the Wikipedia page quotes Spain as having a prevalence of 1.8%, which it sources to Castellsagué (2002). But that Spanish study group actually had a prevalence of 11.5%, and that does not tell us what the real national prevalence is, let alone anything about the incidence of therapeutic circumcision, and at what ages.

    On the other hand I was pleasantly surprised by a recent Canadian survey (Metcalfe 2010) which indicated a very strong preference for conservative management of childhood foreskin problems.

    The point is, I suppose, that we should avoid falling into the trap of making generalisations on the basis of little or no actual evidence. Facts are our friends in this debate :)

  2. Hi John. Thanks for the clarification. Perhaps Wikipedia is not the most reliable source for statistics (no real surprise there). The purpose of this post was to counter the ‘it will save him from having it done later’ argument. While the available statistics may not be 100% reliable, they at least give some indication of how unlikely that is.

    • The issue I think is that your post is operating on the *assumption* that countries without a history of RIC will be less aggressive in diagnosing and treating foreskin problems than Australia. My own reading of European medical literature has not left me with that same impression.

      As far as the limited evidence goes, we know that France, Germany and Spain have levels of circumcision prevalence of between 10 and 15 per cent. We can estimate ritual circumcision rates from their religious demographics. And the result in all three cases implies a level of therapeutic circumcision *higher* than in Australia at the moment.

      Part of reason this does not surprise me is that it has been the UK (and Australia) that have produced most of the literature about over-diagnosis of phimosis. And the observed fall here in circs for phimosis begins to occur shortly after the publication of the widely discussed Spilsbury paper (2003) on this issue..

      The driver, I suspect, is the nature of the different national medical cultures, but the whole issue is one that requires further study, including better data about the incidence of non-retractile foreskins in adults.

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