It's a boy! Congratulations! Now, when you take him home from a medical facility, there's just one decision to create: Will he be having surgery today?

 

If you choose to have him circumcised, he'll need to be put on a "papoose board" and tied down, his upper half swaddled in an umbrella, his bare legs fastened with Velcro straps. The pediatrician or obstetrician cleanses your baby's genital area with iodine, then reaches the duty at hand, cutting away the foreskin and then clamping or stitching together what remains. Afterward a waterproof dressing is applied. The complete operation takes about five minutes.

 

Meanwhile, you're out in the hall, holding yourself.

 

Circumcision can be carried out without much pain; some babies even sleep through the procedure. But still, should it be done? Its supporters indicate a large number of years of tradition and potential health benefits.

 

Opponents say it's a crude custom and the explanation for male rage. The American Academy of Pediatrics has a neutral position. They say: You decide. Hey, moms and dads, it's totally around you. So just how are you currently supposed to learn?

 

Each year in America about 60 percent of all newborn males are circumcised. That fact alone is sufficient for many parents to provide the go-ahead; they need their kid to appear like other kids and not get razzed in the locker room. What started out, eons ago, as a religious rite for Jews and Muslims is becoming, by the end of the twentieth century, a cultural custom.

 

Customary although it is, additionally it is favored by many doctors because of its medical advantages. Edgar J. Schoen, M.D., Professor of clinical pediatrics at the University of California at San Francisco, was the chairman of the American Academy of Pediatrics Task Force on Singapore circumcision clinic when it last examined the problem in the 1980s. Since that time, he says, even additional information favorable to circumcision has arrived at light. He calls the task "an important preventive health measure with benefits throughout life."

 

Let's begin with infancy. In the 1980s, studies done at U.S. Army hospitals involving more than 200,000 infants showed that the uncircumcised boys got urinary tract infections at a rate 10 to 20 times that of circumcised boys. In adults such infections happen mostly in women, for whom the typical prescription is vast quantities of cranberry juice. But in babies it's much more serious, and the younger the infant, the more devastating the infection. A serious infection during the very first month of life can lead to a higher fever, a bloodstream infection in one-third of infants, meningitis in 3 percent and death in 2 percent of all cases. Dr. Schoen says widespread circumcision in America prevents 20,000 severe urinary tract infections each year.

 

Here's another reason infection is much more serious for infants, says Dr. Schoen. Often in young babies the foreskin hasn't fully separated itself from the end of the penis. (The foreskin is fully retractable in 80 to 90 percent of uncircumcised boys by the time they reach age three.) The forms of bacteria that cause severe urinary tract infections find a home in the warm, moist environment underneath the baby's foreskin. From there they ascend the urethra. If they climb entirely around the kidneys, permanent kidney damage can result-very rare but with the consequence later in life of high blood pressure and decreased kidney function.

 

Next stage: preschool (ages three to five). In uncircumcised boys these are the peak years for balanoposthitis, contamination of the foreskin and glans marked by soreness and inflammation. It occurs usually at the moment of life either because boys aren't vigilant in retracting their foreskins to clean themselves daily or their foreskins still haven't separated fully yet. Circumcised children obviously don't face this problem.

 

Nor do they need to worry about phimosis, a condition that afflicts, for the most part, 1 percent of uncircumcised men. It simply ensures that the opening of the foreskin is too small and causes erections to be painful, usually starting around puberty. The French king Louis XIV experienced phimosis; he was circumcised at age 22, causing circumcision to become fashionable among European aristocracy for generations afterward.

 

Whether uncircumcised men are more susceptible to catching sexually transmitted diseases is a matter of fierce debate, but Dr. Schoen says that some 50 scientific reports have established a connection. Studies which range from the patrons of Nairobi prostitutes to gay men in Seattle reveal that uncircumcised men are at least twice as likely as circumcised men to catch syphilis, herpes, papillomavirus and HIV during unsafe sex.

 

Finally, says Dr. Schoen, cancer of the penis strikes men of middle age and older. Although comparatively rare-only 1,000 cases a year nationwide-it is almost exclusively a disease of uncircumcised men. Actually, he says the ratio of uncircumcised to circumcised men getting cancer of the Pews is 6,000 to 1.

 

But how about sexual satisfaction? Male mythology decrees that the foreskin allows greater ejaculatory control- i.e., makes a man less of a Quick-Draw McGraw. That's just phallic fallacy, say William H. Masters, M.D., and Virginia E. Johnson, of the former Masters and Johnson Institute in St. Louis: 35 of the 312 men in their classic study were uncircumcised, and they enjoyed no special edge. In 29 of these 35 the foreskin retracted fully during intercourse (as it should), revealing the end of the penis in every one of its exquisite sensitivity. "Thus," they concluded, "a retained foreskin probably contributes little, if anything, to the patient male's ejaculatory control."