Circumcision in Infants and Children: Weighing the Benefits and Risks

Written By Carly Hupfeld

As a Gold Coast GP specialising in circumcision and tongue-tie releases, I’m often asked by parents about the benefits and risks of infant circumcision. With so much information, and misinformation, online - it’s essential to base decisions on the best available medical evidence and guidelines. Here’s what you need to know if you’re considering circumcision or tongue tie procedures for your child.

What is a Circumcision?

A circumcision is a surgical procedure that involves the removal of the foreskin, which is the fold of skin covering the tip (glans) of the penis. This procedure is often performed for medical, cultural, religious or personal reasons. In infants and children, circumcision is typically done under local anaesthesia by a trained medical professional in a sterile environment to minimise risks.

Figure 1: The Penis before and after circumcision

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Circumcision in Infants and Children: What are the Benefits?

  • Reduced Risk of Infections

    • Urinary Tract Infections (UTIs): Circumcision lowers the risk of UTIs in infants, especially those with urinary tract or kidney abnormalities. The Association of American Physicians (AAP) reported that circumcised infants have a 10x lower risk of urinary tract infections in their first year.

    • Sexually Transmitted Infections (STIs): There is evidence that circumcised males have a reduced risk of acquiring HIV and certain other STIs, including HPV and herpes simplex virus. Some studies have shown a 50 -60% lower risk of HIV and HPV transmission in adulthood. However, these benefits are most relevant in regions with high STI prevalence, and this is far less pronounced in Australia.

  • Reduced Risk of Cancer

    • Penile Cancer: Circumcision is associated with a slightly lower risk of penile cancer, and the benefit has been shown to be most significant when circumcision is performed in infancy or childhood, before potential exposure to human papillomavirus (HPV) and other risk factors. However, this cancer is extremely rare in Australia and New Zealand, and the absolute reduction in risk is very small.

    • Prostate Cancer: Some studies suggest that circumcision may be linked to a lower risk of prostate cancer due to reduced risk of sexually transmitted infections that may contribute to prostate inflammation and subsequent cancer risk. However, again, the evidence for a protective effect against prostate cancer is less robust than for penile cancer, and the association is not considered strong enough to recommend circumcision solely for prostate cancer prevention

  • Prevention of Foreskin-Related Conditions

    • Circumcision can prevent conditions such as phimosis (tight foreskin), balanitis (inflammation of the glans) and recurrent infections. Over a lifetime, more than half of uncircumcised males may experience a foreskin-related issue.

  • Easier Hygiene

    • Removing the foreskin makes penile hygiene simpler, reducing the risk of smegma buildup and infections and irritation.

Risks and Considerations of Circumcision

  • Surgical Risks

    • Complications are rare when performed by experienced professionals, but can include bleeding, infection, scarring (1–2% of cases, usually minor), and very rarely, injury to the penis (<0.1% risk).

  • Pain and Recovery

    • While the procedure is generally quick, pain management is important.

    • Topical anaesthesia is used prior to local anaesthesia to minimise discomfort during the procedure

    • Post operatively, most infants recover within 7–10 days while older boys can take up to 2 weeks and simple analgesia is usually more than adequate.

  • Ethical and Cultural Considerations

    • Infant circumcision involves important ethical considerations because it is a non-therapeutic procedure performed on babies who cannot consent, and it permanently removes tissue.

    • While the procedure is generally safe and may offer some health benefits, as discussed, it also carries risks and raises questions about respecting the child’s future autonomy and bodily integrity.

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What do Medical Organisations say?

Most medical organisations agree the health benefits slightly outweigh the risks, but not enough to recommend routine circumcision for all newborns.

The Royal Australasian College of Physicians (RACP) reviewed the current evidence and found that while circumcision is generally safe, the frequency of diseases it can prevent is low in Australia and New Zealand. Therefore, the RACP does not recommend routine infant circumcision for healthy boys, stating that “the benefits do not clearly outweigh the risks”. They acknowledge there are clear benefits in certain circumstances – for instance, for infants with significant urinary tract abnormalities or recurrent infections.

The RACP supports parental choice provided:

  • The procedure is performed by a qualified, experienced practitioner.

  • Accurate, unbiased information about risks and benefits is provided.

  • Appropriate anaesthesia and a child-friendly environment are ensured for safety.

The Urological Society of Australia and New Zealand (USANZ), and other bodies support the RACP statement, emphasising that the risks of non-medical circumcision generally outweigh the benefits for well infants.

Conclusion

Circumcision is a safe and effective procedure with well-documented benefits for certain medical conditions. However, for most healthy infants in Australia, the risks and ethical considerations mean routine circumcision is not universally recommended. The decision is personal - parents should weigh the evidence, consider their values and consult with a trusted, experienced GP.

If you have questions about circumcision or tongue-tie procedures for your infant or child, I am located on the Gold Coast at Medical On Robina and you can book a consultation for expert, compassionate advice.

Circumcision and Tongue Tie Services on the Gold Coast

As a GP with a focus on circumcision and tongue-tie releases, I provide:

  • Evidence-based advice tailored to your child’s needs and your family’s values.

  • Safe, gentle procedures using the latest techniques and pain management protocols.

  • Comprehensive aftercare to ensure the best outcomes for your child.

Frequently Asked Questions

  • Is circumcision covered by Medicare?
    In Australia, circumcision is only covered by Medicare if medically necessary (e.g., for recurrent infections or phimosis).

  • Are there alternatives to circumcision?
    Yes - good hygiene, safe sexual practices and regular medical checkups can prevent most foreskin-related issues in uncircumcised boys.

  • What about tongue ties?
    Tongue-tie (ankyloglossia) can affect feeding, speech and oral health. If you have concerns about your child’s tongue movement or feeding, an assessment by an experienced provider can determine if a release may be appropriate.

Resources and Further Reading

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Carly Hupfeld
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Understanding Tongue Tie (Ankyloglossia): A Comprehensive Guide for Parents and Healthcare Professionals