In Pakistan almost every boy is circumcised — and almost none by a doctor. Circumcision (sunnat/khatna/musalmani) is near-universal (~96%+) among the ~96% Muslim majority as an Islamic rite; the small Hindu/Christian minorities (~1.6% each) don't. Pakistan is the South-Asian Muslim-majority counterpart to India.
The safety story is the angle: only ~5–10% of circumcisions are done by qualified doctors — the rest by barbers (hajjam)/quacks, often open-blade "bone cutter" without anaesthesia, ~20% at home — for a ~12% complication rate (vs 4.1% in a trained-provider programme). Real documented harm: Sialkot 2022 (two brothers, ages 3 & 1 — verified, Dawn); Mirali 2024 newborn (single-source, flagged). Mislabeled foreign cases (Israel/Thailand/India) excluded.
No circ-specific statute (absence-of-evidence); unqualified circumcisers fall under anti-quackery/PMC-Act law (weakly enforced). HIV is concentrated + injection-driven (~38% among PWID; the 2019 Larkana/Ratodero pediatric outbreak was IATROGENIC — reused syringes, NOT circumcision); circ plays NO role (already near-universal + not VMMC-priority; no protective claim). Male circ kept strictly separate from female khatna/FGC.
Switch to the in-depth article for the full picture and sources (#355–362).
In Pakistan almost every boy is circumcised, and almost none of them by a doctor. That single fact — near-universal practice meeting a near-absent medical safety net — is the whole story. Circumcision here is sunnat, an Islamic religious rite performed on effectively all of the country's Muslim majority, and for most families the question is never whether but only who holds the blade. The answer, far too often, is a barber.
The sources here are numbered references (#355–362) in the references library and against the Pakistan country profile. A scope note up front: this page is about male circumcision. Some Dawoodi Bohra Shia communities in South Asia practise female khatna (a form of FGC) — that is a completely separate practice, shares only the word "khatna", and is mentioned here solely to keep the two from being confused.
The near-universal rite
Pakistan is about 96% Muslim, and among Muslims male circumcision (sunnat / khatna / musalmani) is effectively universal — roughly 96%+ of boys, placing Pakistan in the highest prevalence band worldwide. It is done in early childhood, sometimes within weeks of birth, often as a family celebration, and the motive is overwhelmingly religious: Pakistani studies find 92–96% of parents citing religious reasons. This makes Pakistan the South-Asian mirror image of India, which we profiled as a Hindu-majority country where circumcision marks the Muslim minority; here the majority circumcises and the small Hindu and Christian minorities (about 1.6% each) do not.
The barber's blade
What sets Pakistan apart is not that it circumcises — many Muslim-majority countries do — but who performs it. Only an estimated 5–10% of boys are circumcised by a qualified surgeon or physician. The rest go to barbers (hajjam), traditional circumcisers, quacks and untrained paramedics. In one large study, 69.6% were circumcised by the open-blade "bone cutter" method without anaesthesia, about one in five at home, for a median fee of around three dollars. The structural reason is brutal arithmetic: Pakistan has on the order of 0.4 pediatric surgeons per million people — a couple of hundred nationally — against roughly 3.2 million boys born every year. The trained sector simply cannot absorb the demand, so the informal one does.
The result is a real, measurable harm load. Peer-reviewed Pakistani series report an overall complication rate around 12% — bleeding most commonly, then infection, with glans and urethral injuries (the catastrophic outcomes) concentrated among the barber and bone-cutter methods. One central-Pakistan study found nearly a quarter of circumcisions were done by quacks. The contrast that proves the point is a WHO-published programme that trained non-physicians to use the Plastibell device on infants: its adverse-event rate was 4.1%, with only 0.3% needing specialist care. The harm, in other words, is not inherent to the rite — it tracks the training of whoever is holding the instrument.
Real cases, honestly sourced
This is the first country in our Asian set with documented individual harm rather than an honest "none found." In Sialkot in May 2022, an unqualified practitioner at an unregistered facility — reputedly reusing instruments — damaged the genitals of two young brothers, aged three and one, both of whom developed infection; the case was reported by Dawn and the father lodged formal complaints. A second case, a newborn injured during circumcision at a public hospital in Mirali, North Waziristan, in 2024, is recorded here too but flagged as single-source and uncorroborated. We were careful to exclude several widely-circulated "Pakistan" circumcision-injury stories that are actually from Israel, Thailand, and India — they are not Pakistan, and misattributing them would be the opposite of honest.
No law for the rite, weak law for the quacks
Pakistan has no statute specifically regulating non-therapeutic male circumcision — unsurprising for a near-universal religious practice. What law exists targets not the rite but the practitioner: the Pakistan Medical Commission Act 2020 and provincial Healthcare Commission Acts let authorities seal unregistered clinics and prosecute unqualified "quacks." On paper that should bite on the barber-circumciser; in practice enforcement is weak, unregistered facilities operate openly, and the great majority of circumcisions happen entirely outside the regulated medical sector. (Specific penalty figures here rest on a single secondary source and are stated only as a general framework.)
HIV — a different blade entirely
Pakistan's HIV story is a cautionary tale about needles, not foreskins. General prevalence is low (~0.2%) but the epidemic is concentrated and rising, with HIV around 38% among people who inject drugs and a defining iatrogenic driver: unsafe medical injections, in a country where roughly one in three people receives an unsafe injection each year. The flagship tragedy was the 2019 Larkana/Ratodero outbreak in Sindh, in which some 1,353 people tested positive — about three-quarters of them children — traced to reused syringes and unsafe injections and infusions, not to circumcision. It is worth being precise here: one case-control study did list circumcision among the various unsterile-instrument exposures children had, but only as one possible contaminated-instrument route — never as evidence that circumcision is protective. Circumcision plays no role in Pakistan's HIV response: the country is already near-universally circumcised and is not a WHO VMMC-priority country, so prevention is rightly about injection safety, blood safety and harm reduction.
The honest bottom line
Pakistan is the near-universal Muslim-majority rite seen at its riskiest: a religious practice that virtually no family questions, delivered through a system that leaves most boys in the hands of untrained circumcisers. The bodily-autonomy lens here is less about whether the rite happens — it does, for almost everyone — and more about the gap between a near-universal procedure and a near-absent standard of safety. The clearest, best-evidenced reform is not abolition but training: when a trained provider holds the instrument, the harm rate falls by two-thirds.
Compiled from a June 2026 deep-research pass: prevalence (Morris et al. 2016; Anwer et al. 2017); the provider-mix safety story (Anwer 2017; J Sheikh Zayed Med Coll 2010; WHO Bulletin 2021); verified harm (Dawn 2022 — Sialkot; Daily Pakistan 2024 — Mirali, single-source/flagged); and HIV (CDC MMWR 2021 — Ratodero; CDC EID 2021; UNAIDS). Prevalence % is an estimate; the "no statute" finding is absence-of-evidence; anti-quackery penalty specifics rest on a single secondary source; mislabeled foreign cases (Israel/Thailand/India) were excluded; the Larkana outbreak is iatrogenic, NOT circumcision, and no protective/VMMC claim is made; male circumcision is kept strictly separate from female khatna/FGC. See references #355–362.
