Evidence and Ethics on Circumcision
Frequently Asked Questions
What is the Evidence Based Birth® stance on circumcision?
Our core mission at Evidence Based Birth® is to put current, evidence-based information into the hands of communities so they can make empowered choices. EBB strives to present evidence-based information as clearly, completely, and objectively as possible. When research is controversial, we cite sources with opposing views so that readers can critically evaluate the information for themselves. As with all of our articles, we endeavored to leave our personal opinions out of this article on circumcision and highlight the voices of experts in the medical and bioethics literature.
Why did you write this article? Are you taking a pro- or anti-circumcision stance?
We stand for providing parents and their communities with evidence-based information on routine male newborn circumcision. Importantly, we want parents to take a close look at the major ethical arguments around the practice and to understand how routine circumcision fits in a global and historical context. Parents in the U.S. are usually offered routine circumcision in the hospital without having complete information on the ethical debate, risks, limitations of the research on proposed benefits, or alternatives. For many years, parents and professionals have been asking us to shed light on circumcision. We do not shy away from hard topics, and we feel a great responsibility toward our community who trust us to provide quality information.
How did you attempt to keep your bias out of this article?
It is incredibly hard to remove all bias from pieces of writing. However, we have an extensive review process to help us produce as impartial a piece as possible. This Signature Article was peer reviewed by a variety of researchers in the field, as well as providers who do and do not perform circumcisions.
I want to talk more about this!
Thank you for engaging with this topic! We invite you to send research questions to email@example.com. However, due to the volume of responses we will receive on this topic, it is unlikely that we will be able to respond. Our best conversations about the evidence happen inside our Professional Membership, we invite you to join us there!
I have a follow up question.
We encourage readers to follow the citation links in the article for a deeper dive into specific subtopics. You may email further research questions to firstname.lastname@example.org. However, due to the volume of responses we will receive about this article, as well as the expense associated with paying our research team, we cannot guarantee any response.
I wish you would have covered another angle.
This article aims to present the diverse views around the ethics and evidence on circumcision. We understand there are many facets of this topic, and we focused the scope of our research on relevant literature to the topic of ethics and evidence for routine male newborn circumcision.
This article is so long!
It is detailed! However, we felt it would be a disservice to not go into depth about the evidence and ethics of this issue. We plan on releasing a one-page handout on this topic in the future.
If you prefer to learn via audio, we encourage you to check out the Evidence Based Birth® Podcast, Episode 88, for an audio summary of our findings.
What about religious male circumcision? What is your stance on that? Are you anti-Semitic, or anti-Muslim?
No, we are not anti-Semitic or anti-Muslim. This article focuses on the ethics and evidence for male newborn circumcision as a routine medical procedure at the hospital after birth. There are key differences between religious/ritual circumcision versus hospital circumcision. Because religious circumcision was not our focus, we did not review the evidence on religious circumcision. For example, we excluded religious circumcision from our literature search on recent case reports. We also did not review the ethics literature about the ethics of religious circumcisions performed on children.
Why don’t we have any data on the U.S. male newborn circumcision rate beyond 2010?
The last time the U.S. Centers for Disease Control (CDC) published a report on male newborn circumcision was in 2013 and it included data from 1979-2010. The report used data from the National Hospital Discharge Survey (NHDS)- a nationally representative probability survey. The NHDS was discontinued in 2010, so there will not be any more reports using this data source. We contacted the CDC and they informed us that researchers can obtain the unweighted number of hospital inpatient discharges with circumcision using the National Hospital Care Survey (NHCS) for 2013-2016 if they submit a proposal (with a fee) through the Research Data Center (https://www.cdc.gov/rdc/b1datatype/Dt1224h.htm). Alternatively, researchers can use the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) query system to assess recent trends for circumcision for selected criteria (https://hcupnet.ahrq.gov/#setup). We encourage students and researchers to explore these options!
What about when circumcision is a medical necessity?
In this article, we did not focus on the evidence for circumcision when there is an actual medical need. Instead, our literature review was narrowed down to focus on routine circumcision on healthy male infants. All major medical organizations, as cited in our article, agree that routine infant circumcision is not a medically necessary procedure. Since routine circumcision does not treat or cure an existing disease, it meets the definition of non-therapeutic treatment. Our article reflects this consistent position, and focuses on evidence for the practice of routine, non-therapeutic, infant male circumcision.
I am experiencing strong thoughts, feelings, or opinions about this article.
Newborn circumcision is a highly sensitive topic that evokes strong emotions in many people. We understand that your own personal experiences and beliefs will inform how you take in this information, and we invite you to consider your emotional response and potential reaction to triggers when reading this article.
Our entire team at EBB recognizes that circumcision is an emotionally charged topic. We talk all about how to discuss controversial topics in Episode 87 of the Evidence Based Birth® Podcast, available at the links below. This episode contains an interview with Cristen Pascucci, an expert communications, all about “How to Disagree on Birth Topics – Respectfully!” (iOS) (Android)