Published: November 29, 2018
Revised: August 1, 2022
Anti-circumcision activists often claim that just 1 out of 16,667 men (0.006%) will require a circumcision for medical reasons. This is one of the most cited intactivist statistics, up there with the 16 functions, 117 deaths, and 20,000 nerve endings. It was even cited by the president of Doctors Opposing Circumcision in a 1996 medical journal. [1] This post will answer the questions: What is the source for this statistic? And is it valid?
It's important to note the distinction between circumcision as medically required versus medically beneficial. The 16,667 statistic is based entirely on circumcision as a required therapeutic treatment for phimosis and paraphimosis. It doesn't take into account the cases in which the procedure would be beneficial in preventing future complications. Infant circumcision reduces a man's risk for several adverse medical conditions, including urinary tract infections, HIV and other sexually transmitted diseases, and penile cancer. [2] In other words, many infant boys who won't require a circumcision nevertheless would benefit from the procedure during the course of their lives.
"I will prevent disease whenever I can, for prevention is preferable to cure." - Hippocratic Oath
While intactivists often present the statistic as the result of a study conducted by the Finnish National Board of Health, the truth is a bit different. The Board of Health counted a total of 409 cases of phimosis and paraphimosis for males ages 15 and over, about 0.023% of the population for that age group. The Board had no record of what percentage required surgery, but when pressed, offered a “guesstimate" of 10%. For the sake of argument, the guesstimate was inflated to 25% of the 409 cases – or 102 patients requiring circumcision. In other words, out of the entire population of Finnish men, 102 - approximately 0.006% or 1 in 16,667 – were guestimated to have needed circumcision for medical reasons.
The Finnish study was based on data from 1970, and the supposed reference for this statistic is a 1973 private communication from Dr. A. S. Haro. It was reported by Edward Wallerstein - who is described as "an intactivist pioneer" - in his 1980 book “Circumcision: An American Health Fallacy. [3] Even Hugh Young, an anti-circumcision activist in New Zealand, admitted that the 16,667 figure “is self-evidently spuriously exact.” [4]
The statistic contrasts sharply with three European studies that demonstrate medical benefits of circumcision. A 1953 study found that 35% of uncircumcised British soldiers would have benefited from circumcision and 14% needed it. [5] A 1966 study found that 8.8% of young German men had phimosis. [6] And a 2016 study reported that 5% of Danish boys under 18 suffered a foreskin complication significant enough to require treatment at a medical center. About 31% of the patients required surgery, and the average age at the time of surgery was 11 years. [7]
The president of Brazil has said that his government must warn men about the dangers of poor hygiene. President Jair Bolsonaro said, "In Brazil, we have 1,000 penis amputations a year due to a lack of water and soap." [8] While first world nations have better sanitary conditions, the fact that a man can wash his genitals doesn't mean that all men do. For example, a 24 year-old with a history of STDs visited a medical clinic in Great Britain, complaining of pain, irritation, and a "nasty smell" emanating from the tip of his penis. The man reported that he was unable to retract his foreskin. He was diagnosed with a huge buildup of smegma, which made his foreskin too sensitive to pull back. He revealed to a doctor that "he was unaware he was meant to clean down below." [9] While the treatment for this condition did not include circumcision, had he been snipped in infancy it's unlikely he would have suffered due to lack of hygiene in the first place.
In conclusion, the 1 in 16,667 statistic is based on an anti-circumcision activist’s reference to an unverifiable source for a 48 year-old study that requires broad assumptions and ignorance of actual medical studies about foreskin complications. It's a wisp of magic pixie dust that tells us nothing about the percentage of males who will suffer a foreskin-related complication over the course of their lives.
[1] George C. Denniston; "Circumcision and the Code of Ethics". Humane Health Care International; April, 1996
[2] Susan Blank et al; American Academy of Pediatrics Task Force on Circumcision Technical Report; Pediatrics; September, 2012
[3] Intact Mississippi Facebook post; "But what if he has to be circumcised later?"; October 6, 2016
[4] Hugh Young; "Intactivism in Books"; Circumstitions
[5] T.E. Osmond; “Is routine circumcision advisable?”; Journal of the Royal Army Medical Corps; 1953
[6] Werner Schöberlein; “The significance and frequency of phimosis and smegma”; Münchener Medizinische Wochenschrift 7, pp 373-377; 1966
[7] Ida Sneppen, Jørgen Thorup; “Foreskin Morbidity in Uncircumcised Males”; Pediatrics; April, 2016
[8] Gabriel Stargardter; "Brazil's Bolsonaro shocked by high number of penis amputations"; Reuters; April 25, 2019
[9] Alexandra Thompson; "Man who has NEVER cleaned his penis: 24-year-old who claims to have slept with 40 women tells TV doctors investing his foul smell he 'didn't know he was supposed to wash it'"; Daily Mail; February 6, 2019
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