Should you circumcise your son?

I distinctly remember the day my newborn son was circumcised. I can picture his tiny body lying on the kitchen table, scrawny legs splayed as the doctor/rabbi (mohel) performed the procedure. My baby bawled. I bawled. Two years later, we repeated the whole thing when my second son was born. Being Jewish, I had always assumed that if I had sons, they’d be snipped (it’s also routine for Muslims), but, for others, circumcision is a loaded topic.

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Take Daniel Kennedy, a Newfoundlander who married a Jewish woman from Toronto. Kennedy isn’t Jewish and says where he comes from, circumcision — a surgical procedure to remove the foreskin, which covers the head of the penis — “isn’t even a conversation.”

“I was as much against it as one person could be,” he says. “I was using phrases like ‘unnecessary mutilation.’” But Kennedy ultimately changed his stance and circumcised his son after finding an oft-cited 2007 joint World Health Organization/United Nations report touting its health benefits. “I decided that circumcision is either neutral or beneficial,” he says.

Vancouver physician Neil Pollock estimates he’s done about 35,000 circumcisions over the course of his more than 20-year career. He points to the American Academy of Pediatrics’ (APA) 2012 policy statement that says the health benefits of newborn male circumcision outweigh the risks. “Circumcision significantly reduces the risk of urinary tract infections,” he says, “as well as the transmission of sexually transmitted diseases. The inner lining of the foreskin acts as a portal of entry for pathogens, so when you remove the foreskin, you remove that significant doorway for those organisms to enter the body.”

The Canadian Paediatric Society’s current stance is that circumcision of newborns shouldn’t be routinely performed, but it plans to issue a new statement in the next few months, which will be its first update in 17 years.

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Pollock says there has been a surge in the number of circumcisions performed in his clinics over the past year — which he links to the release of the APA’s 2012 statement — and guesses that rates are also likely rising across Canada. But accurate statistics are hard to come by, as the circumcisions done in hospitals are the only ones that are tracked, and the procedure is more typically performed in doctors’ offices or during religious ceremonies. It isn’t covered by any provincial or territorial health programs, and the cost varies widely, ranging anywhere from $200 to $1,000.

Pierre Crouse, a family doctor in Calgary who performs up to 20 circumcisions a week, points to familial reasons as another driving factor. “Granddad and Dad had it, so little Johnny is going to have it as well,” he says.

Ashley Goode is very familiar with this argument. Circumcision was important to her husband, who wanted his son Lachlan to “look like him.” Lachlan was circumcised, but looking back, Goode doesn’t think she’d make the same decision again. “I believe you’re born a certain way, so why would you need to change that?” she says.

Douglas Black, an Ottawa OB/GYN and past president of the Society of Obstetricians and Gynaecologists of Canada, echoes that sentiment.

“The only medical argument I can make for circumcision would be about four percent of little boys may need to have it for medical reasons,” he says. “For the rest of the male population, it’s unnecessary.”

Still, even Black concedes the matter isn’t simple. “I always give the example that even the American and the Canadian Society of Paediatrics are at loggerheads,” he says. “People will eventually have to make their own decision for themselves.”

A version of this article appeared in our October 2013 issue with the headline "The first cut," p. 72.