Circumcision in boys: medical reasons and parents' options

Circumcision in boys is surgery to remove the foreskin. It is sometimes needed for a medical reason, and it is sometimes requested for religious, cultural or personal reasons. The two are treated very differently by the NHS and by medical ethics guidance. This guide sets out what the NHS, the British Association of Urological Surgeons (BAUS) and the British Medical Association (BMA) say, with Birmingham and Solihull NHS policy as the local reference. It does not recommend a provider or a decision.

1. A tight foreskin is usually normal in boys

The NHS says it is normal for boys under 5 not to be able to pull back their foreskin, that it usually separates from the head of the penis by itself over time, and that this can sometimes take until puberty. On the page about tight foreskin (phimosis) the NHS says most boys’ foreskins do not retract before the age of 5 and sometimes not until 10 or older. It advises never to force a child’s foreskin back because this may be painful and cause damage. Ballooning of the foreskin when a boy passes urine can happen as it starts to separate, and should stop by itself; if it does not, it can be a sign of a tight foreskin.

The NHS says to speak to a GP if you think there may be a problem with your child’s foreskin, for example if it is tight and swollen or painful, if there is bleeding or a thick discharge from under it, if there is pain or difficulty passing urine, or if there are frequent urinary tract infections.

2. Medical reasons for circumcision

The NHS says circumcision is used to treat men and boys, and is usually only offered when other treatments have not worked or it is the only option. Reasons include repeated swelling, itching or soreness or infection of the foreskin or head of the penis (balanitis), a tight foreskin that causes problems, scarring or tightness from conditions such as lichen sclerosus, and other differences in how the penis has grown. For a tight foreskin the NHS lists steroid creams or gels first, antibiotics for infection, and surgery. It describes surgery as either circumcision or a procedure where small cuts are made in the tip of the foreskin so that it can be pulled back more easily, which it says is usually only suitable for children.

Paraphimosis is an emergency. If the foreskin has been pulled back and cannot be returned over the end of the penis, the NHS says to call 999 or go to A&E.

3. Circumcision for non-medical reasons

The NHS says circumcision is only available on the NHS for medical reasons. Birmingham and Solihull ICB’s published policy says the commissioner does not commission male circumcision for cultural, social and religious reasons, and refers to a separate leaflet on circumcision services for baby boys. The policy page still uses the older term CCG, so confirm current arrangements with your GP or the ICB.

For children, the BMA’s ethics toolkit for children and young people under 16 (February 2025) explains the position for doctors. It says that circumcision undertaken for any reason other than a current physical clinical need is termed non-therapeutic, and that the case law confirms it is lawful if it is in the child’s best interests, if there is valid consent from both parents (or, in a dispute, authorisation by a court), and if it is performed competently. It also says:

• A parental request alone does not constitute sufficient grounds. Parents are asked to explain how the benefits outweigh the risks for their child, considering health, social and cultural circumstances.
• Doctors should discuss that the procedure is irreversible and ask whether it can be deferred until the child can make his own decision.
• Where a child can express a view, even without the competence to consent, his views are important, and the BMA cannot envisage a situation in which it is ethically acceptable to circumcise a child who refuses.
• Consent should be sought from both parents where both have parental responsibility.

The toolkit quotes the General Medical Council (GMC) as saying both the GMC and the law permit procedures without immediate therapeutic benefit if they are in the child’s best interests and performed with consent.

4. What the operation involves

The NHS says circumcision is usually done in hospital and the person should be able to go home the same day. It is usually done under general anaesthetic, though a local anaesthetic or an epidural-type anaesthetic is sometimes used, and a clinician will discuss this. The surgeon makes a circular cut around the foreskin just below the head of the penis and removes the foreskin, and dissolvable stitches are used. The NHS says the procedure takes about 30 minutes and is the same for adults and children. There may be fasting beforehand, and the hospital gives instructions. Before any procedure, consent has to be voluntary and informed, and the NHS says someone with parental responsibility may need to give consent for a child up to the age of 16.

5. Recovery and aftercare

The NHS says it takes 4 to 6 weeks for the penis to heal, although sometimes longer, and that swelling, bruising and some minor bleeding for 1 to 2 weeks are normal. Its advice for a child includes loose-fitting clothing and underwear, paracetamol or ibuprofen for pain following the leaflet, washing the area gently and patting it dry, and keeping children off school for a week. It says not to give aspirin to children under 16, and not to swim, ride a bike, play sport or lift heavy things for at least 2 weeks. Stitches should dissolve after 2 to 6 weeks. The BAUS leaflet, which is written for urology patients generally rather than children, says a dressing should fall off within 24 hours and that applying a little Vaseline can help the exposed glans.

6. Risks and effects

The NHS says most people have only minor complications such as bleeding. It says circumcision usually leads to loss of sensitivity of the head of the penis and that the skin of the penis no longer moves in the same way. Sometimes another operation is needed, for example to stop bleeding or remove more skin because of swelling, and rarely the urethra can be narrowed or damaged, which can cause difficulty passing urine and may need surgery. The BAUS leaflet gives infection needing antibiotics or drainage, and bleeding needing a further procedure, as between 1 in 50 and 1 in 100 patients each. Ask the surgeon for the figures that apply to your child.

7. When to seek help after circumcision

• Always call NHS 111 for a child under 5, according to the NHS.
• The NHS says to ask for an urgent GP appointment or call NHS 111 for bleeding that does not stop, a wound that is red or feels warm, a high temperature or feeling hot, cold or shivery, great difficulty passing urine, blood in the urine, or a penis that is very painful or whose pain is not improving.
• Call 999 or go to A&E if the child cannot pass urine at all.
• See a GP if stitches have not dissolved after 6 weeks, if there is pus, discharge or a smell, if the wound re-opens, or if the tip of the penis looks narrower or urine comes out slowly.

8. Cost

No published price for circumcision in boys was found in the sources read for this guide, so none is given. If a provider quotes a fee, ask for a written quote that states who will operate, which anaesthetic is planned, what follow-up is included, and who deals with complications. The adult hospital prices discussed in adult circumcision cost in Birmingham do not apply to children and are not a guide to what a child’s procedure costs.

9. Questions to ask a surgeon or paediatric team

• What is the medical reason, and have creams or other treatments been tried?
• What are the alternatives, including waiting?
• Which anaesthetic is planned, and who will give it?
• Who will perform the procedure, and are they registered with the General Medical Council?
• What are the risks for my child, and what is the plan if there is bleeding or infection?

Related reading

• Paediatric circumcision: the procedure
• Child circumcision: Birmingham guide
• Phimosis and a tight foreskin
• NHS or private circumcision in Birmingham