To cut or not to cut, that is the father's question


  • Ask Dr G
  • Sunday, 16 Jun 2019

Dear Dr. G,

I am a proud father of two boys aged 12 and 13.

When I was in my early teens, my dad started telling me about sexual matters, including sexually transmitted diseases and contraception.

But when it came to circumcision, there wasn't any discussion. I remember being taken to hospital, accepting the family tradition, and had the cut.

I was traumatised during and after the operation, and I promised myself that I would not let any of my children go through the same experience.

Being a dad myself now, I am giving sex education with the boys earlier. I even discussed the "necessity" of circumcision to keep the penis clean and free from infection. However, the boys are asking questions about the long-term implications of being circumcised.

My dad asked me to just continue with the family tradition and force the kids to have the cut, but I want to know the pros and cons first.

In light of Father's Day, I would like to put Dr. G on the spot for more advice on risks and benefits of circumcision.

What is the origin of circumcision?Is it true the removal of foreskin is intended to dampen sexual desire for adolescents?

I look forward to reading your response on Father's Day!

Traditional Timothy

Circumcision has ancient roots amongst many ethnic and religious groups. The origin of the practice is uncertain, but commonly thought to be part of the coming-of-age ritual. Other schools of thoughts include religious sacrifice and a form of sympathetic magic to ensure virility and fertility.

There are many reasons for non-ritual or elective non-medical removal of the foreskin among different cultures. Proponents argue that circumcision ensures hygienic practices and the reduction of infection, including sexually transmitted infections. Others may treat it as a means of discouraging masturbation or reducing sexual pleasure in young adults.

The renowned psychoanalyst Sigmund Freud believed circumcision allowed senior men to constrain the incestuous desires of their juniors, and play a role to mediate tensions inherent in the father and son relationship.

Circumcision has become a controversial issue in modern days. Many parents are breaking generations-old family traditions and questioning the need for it.

Circumcision rates among newborns in the United States has declined from 65% in 1981 to 55.9% in 2008, according to the National Hospital Discharge survey. Of the more than 1,000 parents surveyed about their views, 81% of the respondents still agree it was the right decision for the family and 7% consider it a bygone tradition that is no longer relevant.

Medical professionals would rather remain neutral on the subject. The American Academy of Pediatrics published policy statements declaring that the medical benefits of circumcision outweigh the risks. However, the Academy also highlighted that the advantages were not substantial enough to make circumcision a routine practice.

There are minimal immediate complications from circumcision, and the Journal of American Medical Association published data supporting less than 0.5% adversity.

Opponents of circumcision argue that the removal of foreskin can lead to long-term decrease in sexual sensitivity and sexual function into adulthood. However, the evidence is not believed to be compelling.

On the other hand, many scientific journals have published evidence of that circumcision is associated with a lower risk of urinary tract infections and sexually transmitted infections.

Some studies also pointed out the circumcised adult men in Africa have HIV transmission risk reduced by 60%. However, data also notes that 3% of uncircumcised boys will end up needing the op later in life due to a non-retractable foreskin, or recurrent infection.

The Germen parapsychologist, Hans Bender once stated: "Free yourself from the rigid conduct of tradition and open yourself to the new forms of probability".

It is always a difficult decision whether or not to circumcise – more open discussion and scrutiny of the real indications for the operation is often the right option. When Dr. G is often put on the spot to cut or not to cut the family tradition of routine circumcision, his response is to have a dialogue with the boys.

If they promise to keep their foreskins clean, then they can free themselves from the traditional cut.

On that note, here's wishing all the fathers (circumcised or not) an amazing Father's Day!

Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my