Should Circumcision Be For Older Boys?

For families that choose circumcision, most will have the procedure done on their sons within the first week of life. But is it better to wait until they are older before performing the operation? One Canadian expert says so.


Dr. Noni MacDonald, professor of pediatrics at Halifax’s Dalhousie University, is bucking the circumcision trend by suggesting that parents wait until their sons are older before performing the operation. According to MacDonald, the benefits of the circumcision only really begin once a person becomes sexually active. Waiting until that time, he says, is the better option for parents.

“The (infant) isn’t at risk of HIV and sexually transmitted diseases, because they’re not sexually active, so why are we rushing to do it at that time?” MacDonald said.

“If you’re really going to do this, we need to think of the timing. Why aren’t we offering it to prepubertal boys, when it’s going to be relevant?”

MacDonald is basing his opinion on research into how circumcision can affect HIV rates in some African countries. According to the World Health Organization, there is compelling data on how the procedure may reduce the risk of HIV and AIDS in some men. Though many experts have said the same safety can come from using condoms and other safe sex practices, in many countries in Africa these things are routinely not used due to lack of education and cultural ideas.

Many parents may feel squeamish about doing the painful procedure on an older boy. However, MacDonald points out that a newborn can feel the same pain that an older boy can feel. A newborn is also less aware of what is happening, or why. Choosing to perform the procedure on older boys would mean the child is able to grasp what is happening to them and for what purpose. They may also get to have a say in the matter that newborns do not get.

“Why are we fine with doing it to a baby but not a young man?”

“It’s curious that a painful elective procedure of no major benefit to the infant until years later would ever be deemed more acceptable than the same procedure for a prepubertal boy,” MacDonald writes in the CMAJ.

MacDonald also says that despite the studies in Africa, there would not be a huge decrease in risk for countries such as the US and Canada where there are already lower HIV rates. He also says that the HPV vaccine is a better option than circumcision in reducing the risk of this virus among boys and men.

Currently, the Canadian Paediatric Society and the American Academy of Pediatrics are in the process of deciding what to say about the topic. Last year, the Royal Australasian College of Physicians concluded that the research was not enough to warrant routine infant circumcision in Australia and New Zealand. For now, the decision on whether or not to circumcise is still a personal decision that many parents have to make themselves. – Summer, staff writer

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About the author


Summer is a mom of three, living life in the slow lane along historic Route 66. She writes, homeschools, gardens, and is still trying to learn how to knit.


  • Seriously? Wait till they are older? That is just cruel!

    Granted its a choice. But I left the choice up to my HUSBAND – who w/o blinking said we would opt for circumcision on our son. If not a preference, then its a religious aspect. All things considered, the only reason it would be declined is due to single Moms making the decision.

  • More than when, WHY.

    If the child is not in need of surgery, how is it doctors are making parents feeling entitled to this “choice?”

    Without medical or clinical indication, can a doctor even be performing surgery on healthy, non-consenting individuals, let alone be eliciting any kind of a “decision” from parents?

    Who is going to be having sex? The child, or the parents?

    Shouldn’t it be up to the CHILD when he’s older whether he wants this measure of “protection” or not?

    By the way, even the “experts” in Africa have to admit that circumcision fails to the degree that men still have to wear condoms. The circumcision “campaigns” in Africa are becoming a problem, because men now think they don’t have to wear a condom, exacerbating the problem.

    And what does “religion” have to do with anything?

    Since when are doctors obliged to perform religious rituals on healthy, non-consenting children?

    This article misses the mark.

    The only time a child should undergo surgery is if and when there is a medical necessity for it, and only when and if all other methods of treatment have failed. (And this is actually very rare.)

    Surgery should be a very last resort. This logic is absolutely backwards.

  • The *only* person who should have a say in whether or not to circumcise is the person whose body it is when he’s a consenting adult and can make that choice maturely, rationally, and hopefully based on at least some experience. Until then, *no one* should be performing cosmetic surgery on children — boys or girls, infants nor older children.

  • @Rachel H: Why is performing this surgery on a consenting young adult male “cruel” but it is not cruel to perform it on a non-consenting, helpless newborn baby boy???? Worse still, it is often performed with inadequate pain relief on the poor infant. Even today, people still actually believe that newborns feel less pain than older children and adults do. What kind of mediavel society are we living in?

    Circumcision is a non-medically necessary, cosmetic surgery of doubtful, certainly disputed, benefit. How on earth can an educated and advanced industialized nation actually condone this to be performed on non-consenting people? And yet, people actually believe it would be *kinder* to perform this surgery on a helpless newborn infant than to wait until that infant is a consenting adult who can make up his own mind about it? And for the record, those who would argue the surgery carries greater risks for an adult than for a newborn, this is categorically UNTRUE. The risks are every bit as high for a newborn baby as for a grown man, perhaps even higher, as newborns have a smaller blood supply and are more vulnerable to infection.

    I just cannot wrap my mind around the idea that circumcision is less cruel when performed on a newborn baby. And one more thing…this is NOT the father’s choice anymore than it is the mother’s. This is the choice of the individual on whom this cosmetic surgery is to be performed!

  • mutilating children is wrong. it should be illegal to mutilate the genitals of children. i do not understand how this is still an issue, makes me sad.

  • Unfortunately my son was not circumcised when he was born. The reason that he was not was due to him being born in Malaysia. We didn’t know any doctor who would perform the procedure. He is 8 years old now and at some point he will have to get circumcised. It’s a ritual belief in our religion to be circumcised. Even at the age of eight he wishes that he was already circumcised. It’s quite a bit easier to go to the bathroom. “He would hit the target much better if he was circumcised.”

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