Circumcision is one of the oldest and most common surgical procedures in the world. Whether done for religious, cultural, or medical reasons, the “when” is just as important as the “why.” Newborn circumcision is a common choice, but many men undergo the procedure later, when the process, risks, healing time, and costs can look very different.
In some cultures, the procedure is performed shortly after birth as part of a religious rite. In others, it’s done during early childhood or adolescence, possibly as a coming-of-age ritual or a response to medical issues like phimosis or recurrent infections.
From a medical perspective, and regardless of the reasons one would choose it, the American Academy of Pediatrics (AAP) and other organizations note that the potential health benefits of newborn circumcision are meaningful enough to justify access to the procedure for any family who chooses it.¹
Given how much the timing can influence the experience, it’s helpful to start by looking at why infancy is often considered the optimal stage for circumcision and what it entails later in life.
Circumcision In Infancy
Performed in the newborn stage, ideally within the first week of life², the procedure is generally viewed by most medical professionals as quicker, less invasive, and easier on both the baby and the family.
According to the Centers for Disease Control and Prevention (CDC), the first week postpartum is considered ideal for circumcision, as it precedes the natural thickening and increased vascularization of the foreskin, a process that begins around week 4. During this early window, the foreskin is thin and tiny, making removal more straightforward and reducing the risk of bleeding. At the Newborn Circumcision Center, our current rhythm is every two weeks, and we do them up to two months old.
Healing is typically quick, and complications are uncommon, especially when circumcision is performed in the first year of life. A clinical trial involving over 600 children found that those circumcised under 12 months had the lowest rates of anesthesia-related complications, the shortest recovery times, and the lowest procedure costs.³ Nearly all children in this group were sedated successfully with just a small dose of anesthesia, avoiding the need for more complicated cocktails of medications that would be necessary for older children and adults.
Circumcision In Childhood
Some families delay circumcision until early childhood for reasons that could include uncertainty at birth, changing medical needs, or cultural timing. However, by this age, the procedure has become somewhat more complex.
At this stage, older children often need more than just topical pain relief. The same study mentioned earlier found that only 6% of children aged 2-7 could be sedated with midazolam (a mild sedative) alone. The majority needed ketamine or even general anesthesia to keep them still and comfortable for the procedure.3 In the same study, this group had the longest post-anesthesia recovery time and the highest rate of anesthesia-related complications. They also stayed in the hospital longer and incurred higher costs.
Older children are also more likely to be active, making healing a bit more complicated and increasing the likelihood of re-injury to the surgical site. There’s also the added emotional element: older kids are usually aware enough to feel nervous or scared about surgery, which can impact their overall experience.
Circumcision In Adolescence or Adulthood
Adolescent and adult circumcision is not uncommon, especially in response to chronic issues like phimosis or recurrent balanitis. Some teens and adult men also choose it for cosmetic or hygiene reasons, or because they weren’t circumcised as infants and later decided it was right for them.
By the time someone reaches adulthood, the foreskin is fully developed, thicker, and more vascular – this makes the procedure more complex. General anesthesia is recommended, and the surgery involves sutures, which can leave more noticeable scarring. There’s also more post-operative discomfort, a higher risk of bleeding or infection, and a longer healing window, sometimes up to six weeks.
Something to think about when trying to decide as a parent if circumcision is right for your newborn son: The CDC and AAP both note that delayed circumcision may interfere with work, education, intercourse, or other responsibilities and that these factors often discourage people from following through with the procedure later in life.⁴
Timing Can Be a Deciding Factor
It’s not exactly an equal-experience operation as boys get older – the earlier it’s done, the simpler and smoother the process tends to be. As children grow, physical and emotional factors add complexity: the foreskin becomes thicker, anesthesia requirements increase, and healing can take longer.
The AAP recognizes that, although newborn circumcision isn’t universally recommended for all infants, its health benefits are substantial enough to ensure families have access to the procedure if they wish. What matters most is that parents receive clear, balanced information to help guide a decision that reflects their values and beliefs.
At the Newborn Circumcision Center, we support families in making informed, confident choices. Our team provides compassionate, expert care at every stage, whether you’re exploring the option, ready to schedule, or just have questions.
References:
- Blank, S., Brady, M., Buerk, E., Carlo, W., Diekema , D., Freedman, A., Maxwell, L., & Wegner, S. (2012). Male circumcision. PEDIATRICS, 130(3), e756–e785. https://doi.org/10.1542/peds.2012-1990.
- Morris, B. J., Kennedy, S. E., Wodak, A. D., Mindel, A., Golovsky, D., Schrieber, L., Lumbers, E. R., Handelsman, D. J., & Ziegler, J. B. (2017). Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy. World journal of clinical pediatrics, 6(1), 89–102. https://doi.org/10.5409/wjcp.v6.i1.89.
- Bicer, S., Kuyrukluyildiz, U., Akyol, F., Sahin, M., Binici, O., & Onk, D. (2015). At what age range should children be circumcised?. Iranian Red Crescent medical journal, 17(3), e26258. https://doi.org/10.5812/ircmj.26258.
- Morris, B. J., Kennedy, S. E., Wodak, A. D., Mindel, A., Golovsky, D., Schrieber, L., Lumbers, E. R., Handelsman, D. J., & Ziegler, J. B. (2017). Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy. World journal of clinical pediatrics, 6(1), 89–102. https://doi.org/10.5409/wjcp.v6.i1.89.