Male Circumcision at Birth Does Not Increase Autism Risk

Young boys who undergo circumcision just after birth do not face an increased risk of developing autism, according to a nationwide study published in JAMA Pediatrics.

What the ECHO Cohort Study Discovered About Neonatal Circumcision

Researchers analyzed data from the Environmental influences on Child Health Outcomes, known as the ECHO Cohort study, examining 2,771 boys enrolled across 14 different sites in the United States. Among that group, roughly 66%—or 1,840 boys—were circumcised before being discharged from the maternity hospital. By a mean age of 3.8 years, about 7% of the total cohort, or 192 boys, had received a documented or parent-reported autism diagnosis.

When looking at the raw numbers within the study, the risk of an autism diagnosis was actually lower among boys who underwent neonatal circumcision at 6%, compared to 9% among uncircumcised boys. After researchers adjusted for likely confounding factors such as parental age and a family history of autism, they found no statistically significant association between the procedure and the neurological condition.

We observed no association between circumcision and autism in boys…

Johns Hopkins University

Addressing Earlier Research and Parental Concerns

Public discussion and comments from administration officials last year resurfaced two observational studies published over a decade ago—one in 2013 and another in 2015—that had suggested a possible link between circumcision and autism. That renewed attention prompted investigators at the ECHO Cohort study to run their own comprehensive analysis using a larger, contemporary dataset.

Mothers and fathers have worried regarding this possible link between circumcision and autism, yet it is anticipated that these results will assist in easing their anxieties,

Monica McGrath, senior author of the study, research professor in the Johns Hopkins Bloomberg School of Public Health’s epidemiology department, and director of the ECHO Data Analysis Center, notes that the team recognized they had the exact data needed to investigate the question.

Broader Context on Autism Prevalence and Declining Circumcision Rates

The new findings arrive against a backdrop of shifting public health trends in the United States. Circumcision rates have been steadily declining nationwide, while the number of reported autism diagnoses in children has increased dramatically over recent decades. According to reports from the Centers for Disease Control and Prevention, roughly one child in 150 had an autism diagnosis in 2000, but by 2022 that prevalence rose to one child in 31 among 8-year-olds.

Public health authorities emphasize that it remains unclear whether this upward trend represents an actual increase in the prevalence of autism or simply reflects greater awareness, more comprehensive testing, and subsequent diagnoses. Beyond the circumcision analysis, researchers also attempted to look at neonatal acetaminophen exposure, but found it too uncommon, appearing in less than 5% of the cohort, to permit evaluation of its potential association with autism.

While we found no link tying circumcision to autism among male children, assessing the safety of routine medical interventions continues to be essential,

Monica McGrath

Support for the research was provided by the National Institutes of Health. McGrath and her colleagues at the ECHO study are continuing to evaluate other biological and environmental factors that may help explain the ongoing rise in autism diagnoses.