Do Canadians circumcise their males?

There were several postings a few months ago concerning (%) rates of Circumcision in the various provinces of Canada. I had the impression that circumcision was a much less common practice in all but Ontario prov. This past weekend I met a colleague who practices in Alberta and is preparing a study. He shared with me the perceptions of adolescent males he treats concerning circumcision. It seems that, at least in southern Alberta, in a radius of 100 miles around Calgary, most teenage males identified themselves as being circumcised and perceive the practice to be universal in Canada. The opinions sampled included athletes who compete in Canadian national sports. I quizzed him specifically on this point and his reaction was, "listen, while Canadians may differ from Americans in many respects, they are still North Americans with regard to this subject". He, incidentally, identifies himself as an uncircumcised male born in the francophone (Montreal) region.

While routine infant circumcision is no longer paid for by the Canadian government, the incidence of routine infant circumcision did not change and may have increased after the procedure was delisted.

OBJECTIVE: To determine the prevalence of neonatal circumcision immediately following delisting of the procedure in Ontario and to examine parents' knowledge, attitudes, and behaviours regarding circumcision.

PARTICIPANTS: Of the 151 mothers approached, three were excluded because they did not speak English and two declined participation; 112 of 146 mothers of healthy male newborns responded for a response rate of 77%.

RESULTS: The circumcision rate before delisting had been 56.2%; in the months immediately after, the rate was 59.8% (95% confidence interval was 51%, 69%). Mothers of infants in the outcome groups did not differ significantly in any demographic feature other than education, where the group deciding against circumcision reported higher education levels (Wilcoxon nonparametic two-sample test: zeta = 2.29, P = 0.02). Mothers who chose circumcision listed medical (59%) and sociocultural considerations (40%) a most important to their decision. Father's circumcision status was strongly associated with the infant's (chi 2[df 1] = 25.13, P = 0.0001). 74% discussed circumcision with their family physicians prior to requesting the procedure. Anesthetic use during circumcision was reported by 29%, but 48% did not know whether any had been used.

CONCLUSIONS: The prevalence of neonatal circumcision did not change significantly after delisting.

The Canadian Medical Association (CMA) came out opposed to Routine Infant Circumcision. By 1985, government health plans in almost every province stopped paying for the operation when it was not deemed medically necessary. The one thing about Canadians, we love our free health care system (Medicare). When parents realized they had to pay for it out of their own pockets, the dynamics changed. Currently the Canadian Routine Infant Hospital circumcision rates are below 10%.

Be very careful of the 'official statistics' regarding circumcision. The anti's are very fond of quoting so called official statistics to show that the circumcision rate is falling. These statistics don't tell the whole story by any means.

It is almost certainly true that neonatal circumcision in hospitals is falling. However, more parents are having their sons circumcised in the 2nd to 6th weeks at home or in the local doctor's office since they want to allow better bonding and avoid the 'production line' method of circumcision whilst still giving their sons the benefits of the operation.

Furthermore, as the number of infant circs drops so the number needing it in childhood, teens or young adulthood rises - so there is another group of circumcisions that doesn't appear in the statistics. Finally if not actually 'needed' by early adulthood a significant number of young men realise that they missed out at birth and choose to get it done as soon as they have the funds to pay for it.

The 'official' statistics, having covered only hospital performed circumcisions - generally neonatal - are therefore erroneous when it comes to recording the true circumcision rate. My casual observations suggest that the true rate has not changed much over the last 30 years.

Despite repeated recommendations by the Canadian Paediatric Society that neonatal circumcision not be performed, and despite the fact that the procedure is no longer covered by the Ontario Health Insurance Plan, Ontario still has one of the highest rates in Canada. In 1994-95, Essex County had the highest rate of circumcisions (performed in hospitals on male children under the age of 28 days) among the 33 health districts in Ontario. Some ofthe rates include:

Source: Canadian Institute for Health Information, Ontario Ministry of Health.
District Health Council	# of procedures	age-adj. rate
Durham region	1727	47.1%
Essex county	1639	70.0%
Hamilton-Wentworth	52	1.6%
Kingston, Frontenac and Lennox & Addington	42	3.8%
Metropolitan Toronto	3806	21.2%
Niagara Region	1224	50.0%
Ottawa-Carleton Region	2262	45.1%
Peel Region	1178	16.2%
York Region	937	22.8%

As a Canadian physician who's worked for 10 years with venereal diseases, I'd say that circumcision is absolutely necessary. People who don't circumcise their boys are playing with fire. I've seen incredible infections in uncircumcised males, and I think it's crazy not to do the procedure. I circumcise all boys in my care.

I'm a busy family doctor in Southern Ontario. I think the real issue here is why we're fussing about circumcisions at all. Women want their breasts propped up and their facial skin tightened. Men want penile prostheses and hair transplants. If people want circumcisions, providing the risks are controlled, let them pay and let them have it.

Even though I'm Jewish, and I circumcised my son for religious reasons, I must admit I increasingly find myself having doubts about the necessity of it. Yet I think it's reasonable to leave it up to parents, because I don't believe that circumcising a child causes severe or lasting trauma or results in any major disadvantage. Still, I suspect that over time, although it may take a few generations, we'll see circumcision go by the wayside.

There are fads in medicine, just as there are in any other discipline, and today's evidence indicates that perhaps circumcision isn't a useful medical procedure. But circumcisions have been performed for thousands of years, and one thing we know is that the procedure carries no inordinate risk. If parents wish to have their child circumcised, I don't see how physicians can discourage them from doing it.

I think that circumcision should be done on all newborn Canadian boys. The risk of infection is real - one in 20 boys will require a circumcision at some time in their lives due to infection or other problems. As a psychiatrist, I've seen a number of boys and men who require circumcision later on; it's quite a traumatic experience. Furthermore, the African research of Helen Ronald at the University of Manitoba shows that males who've been circumcised have a much lower rate of AIDS than males who haven't undergone the procedure.

I'm a specialist who often deals with this area of medicine, particularly with problems which occur in uncircumcised adult males. If circumcision isn't adequately assessed by the general population, it's bound to fall into significant disfavour, which would be unfortunate. Healthcare professionals who discourage circumcision are generally only partially informed about the long-term risks and/or benefits of the procedure. For example, infections or penile cancer are a real concern, but they're not the major problem. The major problem is recurrent balanoposthitis, which is both physically and socially crippling for the uncircumcised.

I'm a family doctor who's been in solo practice for over 25 years. I have four children and one son who's circumcised. My husband is circumcised and I understand my son-in-law is circumcised. I'm a very strong advocate of circumcision. I see far too much suffering and problems with my male patients when they have to undergo adult circumcision. Or what about when people get older and need special attention? Orderlies aren't retracting foreskins to ensure proper hygiene when people come into institutional care. Also, most mothers, certainly by the time the child is three, four or five, say, don't touch the child's penis and are very reluctant to do so. Anyway, I think it's naive to assume that the average person practices good hygiene. Just look at the typical level of gum and teeth care in this country, for goodness sake!

I'm a pediatrician neonatologist in Oshawa, Ontario. I personally have nothing against circumcision. My main beef is that if it's going to be done, it should be done with an anesthetic, whether local or general. But I think people don't realize that babies feel a lot of pain, and that's why I've never done a circumcision. If parents really want a circumcision, I don't discourage them anymore, because now we have one urologist here who uses a local anesthetic. Before that, I didn't encourage it at all. Cosmetically, though, I feel a circumcised penis probably looks better.

I've seen posted CIRCLIST that Newfoundland is sometimes referred to as "Canada's foreskin." I've never heard this, but then my circle of friends is probably too polite to indulge in such crudities. The fact that Newfoundlanders generally are not circumcised, may have something to do with this comment.

Why not have male circumcision as a rite of passage as in many cultures, to take place between 10 -13 years. Boys could opt out if that is what they desire. Of course, there would inevitably be peer and parental pressure to conform, but if the kid could stick that out, he would be free to go go through life uncircumcised, if that is what he really wanted.

I've always been fond of this idea -- it takes something which has the potential to be profoundly meaningful and symbolic and allows it to be so. In North America where circumcision is so common, it's done in a way which strips it of all significance, which is to say at birth when the boy has no choice, no awareness of its significance, and finally no memory of the event. Many people today seem to be complaining that North American society has no rites of passage, and that whereas girls mark their impending adulthood by starting to menstruate, boys really have very little.

For a rite of passage to be truly effective it has to be a significant, transforming experience, and certainly having his foreskin removed is something that few 10 -13 year-olds are likely to forget or overlook. Circumcision has the benefit of being a significant body modification without being a mutilation, since a cut penis still functions more or less the same way an uncut penis does, and perhaps even better. There would certainly be peer pressure to conform to this ritual, but I would think it would still be possible to allow the boy a certain amount of choice in what type of circumcision he wanted, and even in how it would be done. It could thus be a sort of custom-made rite of passage.

My son who is now 7 months old , got circumcised @ 2 weeks old.. Ever since than it seems to be a big thing to me.. I look @ people and wonder if they are done or not.. I wonder why they didn’t do it.. I argue with my friends who seem to think that it doesn’t matter.. but in my head i think sure it does!! I’ve done so much studying online about it my boyfriend probably thinks I’m a weirdo.

1/2 hours away to get it done for my son.. however he is the only one in northern Ontario that I know does it and he’s about 80years old..

What’s going to happen when he passes away.. I don’t want to see circumcisions decline in future stats, and I think everyone should have the choice to have it done.. So I was even thinking of getting into Med school to become a Urologist and do routine circumcisions for all ages but that’s about 12 years of schooling.. I’m 25 right now.. so my child would be 12 before I started making any money and I don’t think its fair to him. !

I don’t know why I’m so intrigued with it being done, but to me it seems like something that should be done. but than we get the people who throw it back in our faces that its not needed... I even had talked to my ex boyfriend last night to see if there was lots of men in the army that has it done, he was telling me its like 50/50.. which is pretty cool. I’m hoping that by the time my son has kids that there will be more doctors in Ontario that does this.... I have told my friends who are having kids were to get it done if they want too!!!. I feel like a spokesperson on circumcision.

I've been looking online for stats on men who get circumcised later in life do to health issues or due to just wanting it done.. Couldn’t find anything so if anyone knows this just email me please..

I'm hoping later in life that this doesn’t wean its way out.. and that we'll find benefits that are backed by doctors and it will be more than 50/50!!!

I kept “statisics” on two occasions, during a period of November ‘93 to January ‘94, and then again from Sept. to November of ‘98 (after that I got tired of having to keep count). I live in southern Ontario and the gym I used belongs to a University.

Of the 297 observations in 1993, 71% were circumcised, and 29% were uncircumcised.

Of the 114 observations in 1994, 68% were circumcised, and 32% were uncircumcised.

Of the 307 observations in 1998, 62% were circumcised, and 38% were uncircumcised.

I also keep a tally of the status of my friends and acquaintances. 112 circumcised and 41 uncircumcised. This includes only people I have met directly, and does not include brothers I have not met, who in most cases would have the same status as my friends. The list does not include my Jewish or Moslem friends, of which I have had so many during the course of my life that, if I were to include them, the number of cuts would certainly be double. It also does not include a number of circumcised friends I knew in Junior High, High School and the YMCA, but whose names I can’t now remember. Easily 90% of them were cut and, if I could remember their names, they would add many points to the cut list.

However, the tally of uncuts DOES include a Jewish friend who was NOT circumcised. An interesting and rather amusing story.

I didn’t distinguish the types of circ, when I made those observations. My impression is that most people I saw were cut on the loose side (isn’t routine infant circ usually a bit loose?).

I believe that the circ rates in Canada have dropped considerably. The gym I attended was attached to a university, so the youngest persons I saw would have around 18. I guess you noticed that the rates of uncircumcised guys are higher in the 1998 observations than in the 1993-4 ones. This is due, I think, to the higher number of uncut undergraduates in 1998 (i.e., persons born about 1978, ‘79, ‘80). The last time I attended that gym was in the summer of 1999, and it seemed that among the guys that age, uncircumcision was almost as common, if not as common, as circumcision.

Circumcision rates in Ontario vary considerably from county to county. In some counties in Ontario circumcision rates remain very high, particularly in Western/ North-Western Ontario. This area borders on Manitoba, where the circumcision rates remain very high—I think the highest in Canada. In my county (York) I have read that the rates has fallen to about %20 (it used to be about 90%, if not more). Circumcision rates were always lower in New Brunswick and Nova Scotia, and always extremely low in Newfoundland and Quebec. They used to be in Prince Edward Island and everywhere west of Quebec.

1971 the official circ rate was 31% in Quebec, which drops to 25.8% for fiscal year 1974-75, and then drops off dramatically from there, down to only 5.7% in 1981-82.

Yes, as someone else said, in rural québec, circumcision never caughgt on to the same extent as in urban areas. Interestingly, it seems that there was a rise in circ in rural areas just as the decline began in urban ones, but it probably didn't last long.

My gut feeling is that be 1978 or 1979, dorctors had already begun to dissuade parents, and a few years later, the government cut the funding for baby circs and the rate dropped big time.

Hence, anyone about 20 and younger is extremely likely to be uncut in Québec, while older québecquers are split. I have been in situations where it was 70% cut, and in other where it was 70% uncut depending where you are for adults who were born before the 1980s.

What is interesting about Québec is that it is one of the first circumcising areas to have stopped, so the effects will show up here first. (eg: problem foreskins, increased adult circs etc).

Those effects however are being mitigated by "advances" in foreskin treatments such as those famous steroid creams and dorsal slit type treatments (the term use in french is "plastie de Duhamel" which is essentially 2 slits done at 9 and 3 o'clock instead of at noon. (6 o'clock being the ventral/frenulum side).

CIRCLIST Home Page	Medical Terms & Penile Anatomy	Considering Circumcision?	Styles & Results of Circumcision	Instruments & Techniques
CIRCLIST Home Page	Personal Preferences & Experiences	Rites & Practices Around the World	Circumcision Discussion Group	Circumcision Resources

Do Canadians Circumcise Their Males?

Do Canadians Circumcise
Their Males?