A Review of the Current State of the Male Circumcision Literature

Abstract

Introduction Male circumcision is one of the most commonly performed surgical procedures worldwide and a subject that has been the center of considerable debate. Recently, the American Association of Pediatrics released a statement affirming that the medical benefits of neonatal circumcision outweigh the risks. At present, however, the majority of the literature on circumcision is based on research that is not necessarily applicable to North American populations, as it fails to take into account factors likely to influence the interpretability and applicability of the results. Aims The purpose of this review is to draw attention to the gaps within the circumcision literature that need to be addressed before significant changes to public policy regarding neonatal circumcision are made within North America. Methods A literature review of peer-reviewed journal articles was performed. Main Outcome Measures The main outcome measure was the state of circumcision research, especially with regard to new developments in the field, as it applies to North American populations. Results This review highlights considerable gaps within the current literature on circumcision. The emphasis is on factors that should be addressed in order to influence research in becoming more applicable to North American populations. Such gaps include a need for rigorous, empirically based methodologies to address questions about circumcision and sexual functioning, penile sensitivity, the effect of circumcision on men's sexual partners, and reasons for circumcision. Additional factors that should be addressed in future research include the effects of age at circumcision (with an emphasis on neonatal circumcision) and the need for objective research outcomes. Conclusion Further research is needed to inform policy makers, health-care professionals, and stakeholders (parents and individuals invested in this debate) with regard to the decision to perform routine circumcision on male neonates in North America.

Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury

“…Nevertheless, studies performed in impoverished third-world settings cannot justify NTC in a first-world setting with populations having dramatically different HIV profiles [40]. In Western countries, HIV primarily infects men who have sex with men, a cohort that has not been reliably proven to be protected by NTC [41,42].…”

Does Male Circumcision Adversely Affect Sexual Sensation, Function, or Satisfaction? Critical Comment on Morris and Krieger (2013)

“…In giving such a subjective interpretation, however, Morris and Krieger misrepresent the information that is included in their own review. As Bossio et al (2014Bossio et al ( , p. 2854) go on to state, "The conclusion they draw-that circumcision has no impact on sexual functioning, sensitivity, or sexual satisfaction-does not necessarily line up with the information presented in their review, which is mixed".…”

“…As Bossio et al (2014) . In giving such a subjective interpretation, however, Morris and Krieger misrepresent the information that is included in their own review.…”

Infant circumcision and adult penile sensitivity: implications for sexual experience

“…In this way, parents who may be facing 'the circumcision decision' can be adequately informed about the potential consequences of the surgery for their child, at least along this dimension. Due in part to the polarised nature of scientific research on circumcision, 3 the medical literature to date has offered conflicting answers to the question of sensitivity, 4 prompting a recent turn to quantitative analyses relying on putatively objective measures. In the latest such study, 5 This conclusion was subsequently disseminated via a university press release, 6 garnering significant coverage in both traditional and online media outlets, including the New York Times.…”