Male circumcision entails the removal of the penis foreskin, the flap of skin that covers the penile glans. (Male circumcision does not usually include such practices as piercings of the penis or scrotum, penile implants, gender modifications, or an Aboriginal Australian tradition of splitting the penis.) Male circumcision is most widely practiced among Jewish, Islamic, African, and North American populations. It is uncommon in Asia, South America, Central America, and most of Europe (American Academy of Pediatrics 1999). Approximately 60 percent of males in the United States are circumcised, compared to only 6 percent of males in the United Kingdom (Smith 1998). An estimated 1.2 million newborn males are circumcised annually within the United States (American Academy of Pediatrics 1999). For both cultural and medical reasons, the percentage of newborn infants being circumcised in the United States has been decreasing since the mid-twentieth century.
The surgery is usually performed on children ranging from newborns to adolescents. In secular and Christian North American culture, no explicit ceremony surrounds the operation, which physicians perform in clinical settings as elective procedures. Increasingly, physicians administer local anesthesia during the procedure. Complication rates range between 0.2 percent and 0.6 percent and include such problems as postoperative bleeding and unintended surgical damage to the penis (American Academy of Pediatrics 1999). Circumcision is occasionally performed on uncircumcised adult males when the foreskin becomes infected and adheres to the glans.
The claimed medical advantages of circumcision include decreases in occurrences of penile cancer, local infections, urinary tract infections in the first year of life, and STD/HIV infection later in life. The medical disadvantages described include the chance of postoperative bleeding, pain during the operation, and loss of sexual sensitivity. For claimed advantages and disadvantages both, great controversy surrounds the veracity and magnitude.
Among other populations, circumcision is tied to religion. A Jewish circumcision ceremony is called a brit milah or bris and is performed on the eighth day after birth by a mohel. An Islamic circumcision ceremony is referred to as khitan. In Islam this practice is supported by Sunnah teachings, as opposed to teachings directly from the Qur'an. Traditional African ceremonies vary greatly among cultural groups, with circumcision being performed as part of a coming-of-age ritual at puberty. In these circumstances, traditionally trained males from within the community perform the surgery.
Several common themes run through the cultural and religious reasons for circumcision. Ceremonially, circumcision marks membership in a particular group of people, a shedding of femaleness in order to become fully male, and at times an agreement with, or pledge to, a deity. The circumcised penis is understood as being a cleaner state of a male both in a ceremonial and physical sense. Beyond this is an aesthetic argument that the circumcised penis is more attractive and natural looking than an uncircumcised penis, even though all healthy males are born with a foreskin.
Although carried out infrequently, there are procedures that aid circumcised adults in redeveloping parts of the foreskin. These include various methods of stretching the foreskin not removed during the original circumcision. Circumcised males may undergo this procedure to become fully intact and unmutilated or to regain sexual sensitivity of the glans.