The removal of non-pathogenic foreskin from the penis of healthy neonates and infants for non-religious reasons is routinely practiced in many parts of the world. High level data from well-designed randomized controlled trials of circumcision in neonates and infants does not guide clinical practice. Reliable counts of immediate and short term circumcision complications are difficult to estimate. Emerging evidence suggests routine neonatal circumcision could lead to long term psychological, physical, and sexual complications in some men. The stigma associated with discussing circumcision complications creates a prevalence paradox where the presence of significant circumcision complications is higher than reported. Prior to the Internet, there were very few forums for men from diverse communities, who were troubled about their circumcision status, to discuss and compare stories. To investigate the long term consequences of circumcision, we reviewed 135 posts from 109 individual users participating in a circumcision grief subsection of Reddit, an internet discussion board. We identified three major categories of complications: physical such as pain during erections and lost sensitivity, psychological such as anxiety and violation of autonomy, and sexual such as feeling that the sexual experience was negatively altered or being unable to complete a sexual experience. We also identified a “discovery process” where some men described coming into awareness of their circumcision status. These findings suggest that neonatal circumcision can have significant adverse consequences for adult men. The removal of normal foreskin tissue should be limited to adult men who choose the procedure for cosmetic reasons or when medically indicated.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
Additional supporting information can be found in the online version of this article at the publisher’s website.
Alanis MC, Lucidi RS. Neonatal circumcision: a review of the World’s oldest and most controversial operation. Obstetrical Gynecol Surv. 2004;59:379–95.
Jacobson DL, Balmert LC, Holl JL, Rosoklija I, Davis MM, Johnson EK. Nationwide circumcision trends: 2003 to 2016. J Urol. 2021;205:257–63.
Niku SD, Stock JA, Kaplan GW. Neonatal circumcision. Urol Clin North Am. 1995;22:57–65.
Eisenberg ML, Galusha D, Kennedy WA, Cullen MR. The relationship between neonatal circumcision, urinary tract infection, and health. World J Mens Health. 2018;36:176.
Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005;90:853–8.
Blank S, Brady M, Buerk E, Carlo W, Diekema D, Freedman A, et al. Male circumcision. Pediatrics. 2012;130:e756–85.
Feudtner C. A Trade-off analysis of routine newborn circumcision. Obstetrical & gynecological survey [Internet]. 2000 Jan 1 [cited 2022 May 10]; Available from: https://www.academia.edu/60674605/A_Trade_Off_Analysis_of_Routine_Newborn_Circumcision
Frisch M, Earp BD. Circumcision of male infants and children as a public health measure in developed countries: A critical assessment of recent evidence. Glob Public Health. 2018;13:626–41.
Sorokan ST, Finlay JC, Jefferies AL. Newborn male circumcision. Paediatrics Child Health. 2015;20:311–5.
Jagannath VA, Fedorowicz Z, Sud V, Verma AK, Hajebrahimi S. Routine neonatal circumcision for the prevention of urinary tract infections in infancy. Cochrane Database of Systematic Reviews [Internet]. 2012 [cited 2021 Aug 1]. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009129.pub2/abstract
U.S. Preventive Services Task Force Ratings | United States Preventive Services Taskforce [Internet]. [cited 2022 Jan 31]. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/us-preventive-services-task-force-ratings
Fakjian N, Hunter S, Cole GW, Miller J. An argument for circumcision: prevention of Balanitis in the adult. Arch Dermatol. 1990;126:1046–7.
Spilsbury K, Semmens JB, Holman CDJ, Wisniewski ZS. Circumcision for phimosis and other medical indications in Western Australian boys. Med J Aust. 2003;178:155–8.
Krill AJ, Palmer LS, Palmer JS. Complications of circumcision. Sci World J. 2011;11:2458–68.
Pandya I, Shinojia M, Vadukul D, Marfatia YS. Approach to balanitis/balanoposthitis: current guidelines. Indian J Sex Transm Dis Aids. 2014;35:155–7.
McGregor TB, Pike JG, Leonard MP. Pathologic and physiologic phimosis. Can Fam Physician. 2007;53:445–8.
Varghese V, Mathew A. Evaluating the role of topical steroids as a primary intervention for treatment of phimosis in pediatric age group. Int Surg J. 2020;7:3586.
Liu J, Yang J, Chen Y, Sihang C, Xia C, Deng T. Is steroids therapy effective in treating phimosis? A meta-analysis. International Urology and Nephrology. 2016;48.
Osmonov D, Hamann C, Eraky A, Kalz A, Melchior D, Bergholz R, et al. Preputioplasty as a surgical alternative in treatment of phimosis. Int J Impot Res. 2021:1–6.
Smith DK, Taylor A, Kilmarx PH, Sullivan P, Warner L, Kamb M, et al. Male circumcision in the United States for the prevention of HIV infection and other adverse health outcomes: report from a CDC consultation. Public Health Rep. 2010;125:72–82.
Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet. 2007;369:643–56.
Gray RH, Kigozi G, Serwadda D, Makumbi F, Watya S, Nalugoda F, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369:657–66.
Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PLoS Med. 2005;2:e298.
Wawer MJ, Makumbi F, Kigozi G, Serwadda D, Watya S, Nalugoda F, et al. Circumcision in HIV-infected men and its effect on HIV transmission to female partners in Rakai, Uganda: a randomised controlled trial. Lancet. 2009;374:229–37.
Schoen EJ, Oehrli M, Ctr, Colby CJ, Machin G. The highly protective effect of newborn circumcision against invasive Penile Cancer. Pediatrics. 2000;105:e36–6.
Larke N, Thomas SL, dos Santos Silva I, Weiss HA. Male circumcision and human Papillomavirus infection in men: a systematic review and meta-analysis. J Infect Dis. 2011;204:1375–90.
Larke NL, Thomas SL, dos Santos Silva I, Weiss HA. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control. 2011;22:1097–110.
Blank S, Brady M, Buerk E, Carlo W, Diekema D, et al. Circumcision Policy Statement. Pediatrics. 2012;130:e756–85.
Freedman AL. The circumcision debate: beyond benefits and risks. Pediatrics. 2016;137:e20160594.
Bellieni CV. Neonatal Infant Pain Scale in assessing pain and pain relief for newborn male circumcision. Int J Impot Res [Internet]. 2022. https://doi.org/10.1038/s41443-022-00551-x.
Bliss DP, Healey PJ, Waldhausen JH. Necrotizing fasciitis after Plastibell circumcision. J Pediatr. 1997;131:459–62.
Earp BD, Allareddy V, Allareddy V, Rotta AT. Factors associated with early deaths following neonatal male circumcision in the United States, 2001 to 2010. Clin Pediatr (Philos). 2018;57:1532–40.
Hammond T, Carmack A. Long-term adverse outcomes from neonatal circumcision reported in a survey of 1,008 men: an overview of health and human rights implications. Int J Hum Rights. 2017;21:189–218.
Bossio JA, Pukall CF. Attitude toward one’s circumcision status is more important than actual circumcision status for men’s body image and sexual functioning. Arch Sex Behav. 2018;47:771–81.
Miani A, Di Bernardo GA, Højgaard AD, Earp BD, Zak PJ, Landau AM, et al. Neonatal male circumcision is associated with altered adult socio-affective processing. Heliyon. 2020;6:e05566.
Wondwossen Fantaye A, Konkle AT. Social media representation of female genital cutting: a YouTube analysis. Women’s Health (Lond Engl). 2020;16:1745506520949732.
CircumcisionGrief [Internet]. [cited 2021 Aug 1]. Available from: https://www.reddit.com/r/CircumcisionGrief/
Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Socio. 2001;27:363–85.
Kumar A, Hessini L, Mitchell EMH. Conceptualising abortion stigma. Cult, Health Sexuality. 2009;11:625–39.
Taher M. Understanding Female Genital Cutting in the Dawoodi Bohra Community: An Exploratory Survey. 2017 Feb [cited 2022 Mar 20]; Available from: https://erepository.fmesinstitute.org/handle/123456789/1497
Hart B, Shakespeare-Finch J. Intersex lived experience: trauma and posttraumatic growth in narratives. Psychol Sexuality. 2021;0:1–19.
Tye MC, Sardi LM. Psychological, psychosocial, and psychosexual aspects of penile circumcision. Int J Impot Res [Internet]. 2022. https://doi.org/10.1038/s41443-022-00553-9.
Facebook, Twitter, options S more sharing, Facebook, Twitter, LinkedIn, et al. David Reimer, 38; After Botched Surgery, He Was Raised as a Girl in Gender Experiment [Internet]. Los Angeles Times. 2004 [cited 2021 Aug 1]. Available from: https://www.latimes.com/archives/la-xpm-2004-may-13-me-reimer13-story.html
News ABC. Man Sues For Loss of Foreskin [Internet]. ABC News. [cited 2021 Nov 13]. Available from: https://abcnews.go.com/GMA/story?id=127183&page=1
Toureille C. Jewish man who endured a botched circumcision as a baby reveals it left him with years of pain and drove him to contemplate suicide. DailyMail.com [Internet]. 2019 Jul; Available from: https://www.dailymail.co.uk/femail/article-7261193/Man-admits-botched-circumcision-baby-led-consider-suicide.html
Massie L. Male circumcision and unexplained male adolescent suicide. 2021 [cited 2021 Nov 13]; Available from: https://www.bmj.com/rapid-response/2011/11/02/male-circumcision-and-unexplained-male-adolescent-suicide
Ladenhauf HN, Ardelean MA, Schimke C, Yankovic F, Schimpl G. Reduced bacterial colonisation of the glans penis after male circumcision in children – a prospective study. J Pediatr Urol. 2013;9:1137–44.
To T, Agha M, Dick PT, Feldman W, Walsh PC. Cohort study on circumcision of newborn boys and subsequent risk of urinary-tract infection. J Urol. 1999;162:1562–62.
Simforoosh N, Tabibi A, Khalili SAR, Soltani MH, Afjehi A, Aalami F, et al. Neonatal circumcision reduces the incidence of asymptomatic urinary tract infection: a large prospective study with long-term follow up using Plastibell. J Pediatr Urol. 2012;8:320–3.
Frisch M, Simonsen J. Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: national cohort study in Denmark. J R Soc Med. 2015;108:266–79.
Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Br J Urol. 1997;80:776–82.
Lerman SE, Liao JC. Neonatal Circumcision. Pediatr Clin North Am. 2001;48:1539–57.
The authors declare no competing interests.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Uberoi, M., Abdulcadir, J., Ohl, D.A. et al. Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum. Int J Impot Res (2022). https://doi.org/10.1038/s41443-022-00619-8
This article is cited by
Foreskin restorers: insights into motivations, successes, challenges, and experiences with medical and mental health professionals – An abridged summary of key findings
International Journal of Impotence Research (2023)