What is circumcision?

Circumcision is a surgical operation to remove skin or tissue from the genitals.

All forms of female circumcision are illegal in Australia. This article refers only to male circumcision.

What circumcision involves

At birth, most boys have a loose covering of skin over the end of the penis. This is called the foreskin. During a circumcision, this loose skin is cut away, exposing the glans (head) of the penis.

Circumcision is sometimes done a few days after birth. It can be done later, including in adolescence or adulthood.

The uncircumcised penis: appearance and care
At birth, the foreskin is joined to the underlying glans of the penis, so the foreskin can’t be pulled back to expose the glans. The foreskin usually separates from the glans during childhood and can be pulled back to expose the glans.

You and your child don’t need to do anything special to care for an uncircumcised penis.

The circumcised penis: appearance and care
After the circumcision scar has healed, the glans will be permanently exposed. The appearance of the penis will depend on how much skin has been removed and where the cuts into the foreskin have been made.

You and your child don’t need to do anything special to care for a circumcised penis once the scar has healed.

Many parents worry about their child’s penis, circumcised or not. They worry that their child will feel or look different from other children or that their child’s penis is untidy or unusual. Children themselves usually aren’t so bothered. An uncircumcised child might ask a circumcised friend why they look different or vice versa, but it’s unlikely to be a big issue for either of them. But if you or your child are worried about their circumcision, it’s a good idea to talk to your GP.

Reasons for not choosing circumcision

Circumcision comes with health and medical risks, even when an experienced doctor does the operation:

• Short-term problems include bleeding after the operation and another trip to hospital.
• Long-term problems include issues with the urethra and urination and concerns about the appearance of the penis, particularly if too much or too little skin has been removed, or if more skin has been removed from one side than the other.
• In rare cases, these problems can lead to damage to the urethra, a buried or trapped penis, gangrene, loss of the penis, or even death.

Doctors, parents and others say that there are physical and ethical reasons for not choosing circumcision:

• Children should be able to make informed decisions about their own bodies. They can do this only when they’re older.
• The foreskin protects the glans, which is sensitive. Removing the foreskin might change the sensitivity of the glans. This might affect sexual sensation in the future.
• The foreskin protects the opening of the urethra, which is very delicate early in life.

Reasons for choosing circumcision

Circumcision before puberty has some health and medical benefits:

• It reduces the risk of urinary tract infection (UTIs), particularly in babies who have other problems with their kidneys.
• It can prevent foreskin problems, including foreskin inflammation and foreskins that are too tight in puberty.

In adolescence and adulthood, circumcision has some benefits:

• It might reduce the risk of HIV and AIDS and possibly some other sexually transmitted infections. But there are other ways to reduce these risks.
• It helps to reduce the risk of adults developing cancer of the penis, but this is a very rare condition.

Some parents might also choose circumcision for religious or cultural reasons – for example, Jewish or Islamic customs.

When you’re making decisions about circumcision, you can trust evidence published by official medical bodies, like the Royal Australasian College of Physicians (RACP) or the Urological Society of Australia and New Zealand (USANZ). It’s sensible to treat other information with caution.

What experts say about circumcision

Many expert medical bodies have reviewed the evidence relevant to circumcision in Australia.

The RACP, the Royal Australasian College of Surgeons, USANZ, and state health departments have all concluded that the risks of circumcision performed for non-medical reasons, including preventing future diseases, outweigh the benefits.

This means circumcision in healthy boys might cause more problems than it prevents.

Circumcision isn’t performed in Australian public hospitals unless it’s to treat conditions like repeated UTIs, severe congenital urinary tract problems or foreskin problems.

Internationally, most major paediatric medical and surgical colleges don’t recommend routine circumcision.

Circumcision: making an informed choice

When you’re weighing up the risks and benefits of circumcision, it’s important to consider trustworthy evidence and information. You could ask your GP or paediatrician or a urologist to explain the risks and benefits.

Planning for circumcision

If you choose circumcision, it’s important to make sure the operation is done safely.

Ensure that whoever is doing the surgery is experienced. Ask how many procedures the doctor has done and how many complications have occurred. All doctors are required to give you balanced information and to respect your decision.

Ensure that your child receives enough pain relief during and after the procedure. Local anaesthetic might be appropriate for children under 6 months, but it’s recommended that children over 6 months have either general anaesthetic or spinal anaesthetic.

Check that you have good access to the doctor for follow-up after the surgery.

Also ask about the costs of the procedure.

If your child has been or will be circumcised, it’s a good idea to talk with them about circumcision if you can. Use simple, factual explanations. This can help them understand why they might look different from some of their friends. If your child is too young to understand, you can talk about circumcision when they’re older.

Trends in circumcision

From 1920-1970, circumcision was actively promoted in Australia. Most boys born in Australia around 1950 were circumcised. Since then, there has been a big move away from circumcision. Now most boys in Australia aren’t circumcised.

The only major western country where circumcision is very common is the United States. Circumcision is uncommon in the United Kingdom, most of Europe and Asia, South America and Central America.