Does circumcision cause long-term anxiety or depression in adults?

1. Why some researchers say circumcision links to later anxiety or depression — a troubling pattern in multiple papers

Several analyses and studies claim neonatal circumcision can produce long-term psychological sequelae, including heightened anxiety, depression, PTSD symptoms, lower attachment security, and altered emotional stability. Authors cite mechanisms such as traumatic pain during infancy affecting infant–maternal interactions, disrupted feeding, or long-term changes in socio-affective processing identified through self-report measures and psychological testing ^{[1] [2] [3]}. A 2020 study reported associations between neonatal circumcision and lower attachment security, lower emotional stability, and higher perceived stress in adults, suggesting possible enduring effects on socio-affective functioning ^[3]. Proponents of this view emphasize clinical reports and retrospective symptom clusters in circumcised men, arguing that emotional and relational difficulties observed in some cohorts are consistent with trauma-related pathways ^{[2] [7]}. These claims often rely on cross-sectional surveys or case series that report elevated symptom scores among circumcised participants.

2. Why systematic reviews and comparative studies find little or no long-term psychological harm

Contrasting evidence comes from systematic reviews and cohort research concluding that neonatal circumcision shows limited or no short-term or long-term adverse psychological effects, including no clear increase in adult anxiety or depression. A 2017 translational psychiatry study specifically reported no differences in long-term glucocorticoid accumulation or trauma-related psychological disorders between circumcised and uncircumcised males ^[4]. A systematic review that synthesized 24 studies with over 11,000 males found overall weak or null associations after accounting for confounders and methodological flaws, highlighting that many positive associations arise from small, biased, or poorly controlled studies ^[5]. Advocates of this interpretation emphasize larger sample sizes, longitudinal designs where available, and the critical role of controlling for socio-demographic and cultural confounders in producing null or inconclusive results.

3. Evidence from adult circumcision studies complicates the picture — improvement, harm, or no change?

Studies of circumcision performed in adulthood add another layer: some clinical studies report reduced social anxiety and improved body satisfaction after adult circumcision, suggesting context and timing matter ^[8]. These findings differ from neonatal circumcision research because adult procedures involve conscious decision-making, different psychosocial dynamics, and immediate postoperative outcomes. Meanwhile, neonatal-focused papers cannot directly translate adult circumcision outcomes to infant procedures. The mixed adult-study results underline that age at circumcision, voluntariness, cultural meaning, and the psychosocial environment strongly influence psychological outcomes, so pooling neonatal and adult evidence without distinction risks conflating distinct phenomena ^{[8] [3]}.

4. Methodological limits explain much of the disagreement — what to watch for in studies

Across contrasting papers, recurring methodological concerns explain divergence: cross-sectional designs, reliance on self-report instruments, retrospective recall bias, lack of randomization, and unmeasured confounders such as family environment, cultural practices, socioeconomic status, and preexisting mental health all weaken causal claims ^{[6] [5]}. Some positive studies are small or use non-representative samples, while null findings often come from larger, better-controlled analyses. The literature also mixes different outcomes (PTSD symptoms, attachment, cortisol measures, generalized anxiety, depression), complicating synthesis. Evaluating future research requires prioritizing prospective cohorts, objective biomarkers where applicable, standardized outcome measures, and careful control for confounders to move from association toward causation ^{[5] [6]}.

5. Bottom line and where the evidence should steer clinicians, policy makers, and parents

The body of published analyses presents no unanimous verdict: credible studies report both associations and null results. Current evidence supports treating claims of long-term anxiety or depression after neonatal circumcision as plausible but unproven, contingent on study quality, cultural context, and individual vulnerabilities ^{[1] [5] [3]}. Clinicians and policymakers should weigh the conflicting evidence, communicate uncertainty, and emphasize mitigating factors—adequate analgesia, informed parental consent, and psychosocial support—while funding prospective, methodologically rigorous studies that can disentangle causation from correlation. Consumers of the research must note who conducted each study, sample composition, and whether limitations likely biased findings when interpreting claims about lasting psychological harm ^{[6] [5]}.