Saturday, August 30, 2008

Spare Him The (Un)Kindest Cut!

I have debated writing about this topic for awhile but I have decided I am going to go ahead and throw it out there since it is a hot topic and something I feel is very important to research and discuss.

What do 85% of the men in this world have but it removed in the most common surgery performed in America?

Answer: A foreskin!

When I was in high school I had to do volunteer hours and I chose to do mine in a newborn nursery at a local hospital. I remember seeing this thing that looked like a torture device for infants, and I didn't know what it was for:

Little did I know that I would be subjected to hearing many baby boys being circumcised. Their cries were enough to turn my stomach.

I would scoop up the newly circumcised boys and try to soothe them. I would pray that I would never have a boy because I never ever wanted to subject him to that pain. At the time I didn't know I had a choice. It became a sore spot in my heart and an experience that would forever shape me.

So many of you are reading this and saying "And.....???"

Well, did you know that no health organizations in the world recommend circumcision? It has no proven medical benefits, the benefits are regarded as "potential." North American culture has adopted circumcision as "normal" and we often see it as "cleaner" and want our boys to look more like their fathers. What is so interesting to me is that so many of us don't bother to question the practice of circumcision on our tiny infant sons but if our children needed a tonsillectomy or ear tubes we would be weighing the pros and cons and getting second opinions. We are told the procedure is simple and the baby won't feel much pain. We hand our little boys to the doctor trusting that we are doing the right thing. But what if we aren't?

The practice of circumcision is fear-based and excuses for circumcision always have been consistent with the dreaded disease of the day. For instance, in the late 1800s it was thought to cure masterbation (now we all know that isn't true). As time went on it was thought to cure tuberculosis, insanity, hip joint diseases, convulsions, bloody noses, and night terrors. For a long version of this history please click here. Now there are studys that are trying to prove that circumcision prevents HIV/AIDS.  These studies have been regarded as flawed by many but the media continues to advertise these claims in an irresponsible manner.  If this is true why does America have one of the highest HIV/AIDS rates as well as one of the highest circumcision rates? What a false sense of security to those who will use that in lieu of safe sex. It also doesn't prevent penile cancer and is not recommended by the American Cancer Society. Urinary Tract Infections (UTIs) are also a reason a lot of parents site for circumcising their sons. Unfortunately, this claim holds no water as it would take 195 circumcisions to prevent one UTI, which can easily be treated with antibiotics. See this link for more info. Yeast and bacterial infections can occur if the forskin is not properly cared for or if the foreskin is prematurely retracted. These can be treated with antibiotics and creams without unneccesary surgery. Keep in mind that girls get far more infections than boys and our first resort is never to cut their genitals.

So now that we have moved past that issue, what about the hygiene issue? Is a foreskin really that hard to keep clean? As a mom of two intact boys I can tell you it is not at all. Before your son is retractable you do not have to wash under the foreskin at all. In fact you should not attempt to retract the foreskin. It will retract on it's own sometime between two years and puberty. Premature retraction can lead to infections and other complications that can lead a doctor to recommend circumcision. You just clean it like a finger. After the foreskin is retractable all that has to be done is a quick splash of water with the foreskin pulled back and that is it. No harsh soaps needed! We live in a country with running water and there is no reason to be scared of the "unclean" penis. Little boys can be taught to clean their private areas just like little girls. No harsh bristles or clorox bleach needed...just rinse and go!

So let's talk about the father/son penis mismatch scenario. How important is it that a son's penis look like his father's? When a boy sees his father naked and compares himself for the first time the first thing he will probably notice is hair. Should we run out and make a mini-penis toupee so father and son match? Mothers and daughters don't match either. Should we run out and involve plastic surgeon so daughter has breasts to match mom? Of course not! We often project our own insecurities on our children and it is so easy just to say "Back when daddy was a baby he had his foreskin taken off. Now we know that wasn't the best thing to do so we left yours alone so you could have all of your penis." And while we are on the topic let's talk locker room teasing. Who is going to point out somebody's penis is different for fear of being teased for being gay? In the unlikely event it does happen you can teach your son to say "Eww, dude why are you looking at my junk anyways?"

Is the foreskin just a little piece of skin? Not at all! It is a highly sensitive and functional sexual organ.

A foreskin protects the head of the penis, which is by design an internal organ. When the foreskin in removed the head of the penis becomes calloused and desensitized. When the foreskin is removed sexual pleasure in the male is reduced and in women it takes away the gliding action that reduces the need for lubricants. So don't let someone convince you that the foreskin is "just a piece of skin." It is a functional part of the male penis that is an important part of their sexual well being.

Is circumcision safe? I find that most people have heard a foreskin horror story but never a circumcision horror story. The truth is that baby boys are harmed by circumcision. Not only is the penis size and sexual fucntions reduced but there are risks of bleeding, infection, scarring, skin tags, removing too much skin, bowed penis, meteal stenosis, buried penis, skin bridges, loss of penis, and death. These things are 100% preventable by chosing not to circumcise. 

Does circumcision cause pain? Yes, it absolutely does. Babies feel pain when they are circumcised. Even if the numbing patch (EMLA) is used the sensation of the foreskin being torn from the glans is like ripping your nail off of your finger. Using any kind of local anesthetic is painful because needles and lidocaine hurt. The recovery is also painful as a raw penis is rubbing up against a soiled diaper and can cause great pain and discomfort. No matter how you slice it (pun intended) this procedure is not pain free.  There have been studies that have shown that infants who are circumcised have increased stress hormones and are more sensitive to pain later in life.  If a circumcision has to be done as an adult he can be given anesthesia and pain medication.  Generally speaking most men don't have to be circumcised as adults.  The horror stories that people are eager to share about foreskins often involve a doctor who is not familiar with how to care for the foreskin or problems originating from premature retraction of the foreskin.

Lastly, is circumcision ethical? Is is okay to remove a healthy, functioning body part from someone who is not able to consent? This procedure, once done, cannot be undone. Should we perform surgery to prevent potential disease?  We do not perform routine tonsillectomies because we might get recurrent throat infections. We don't pull our teeth out in case we get cavities. Why remove a healthy organ? It makes no sense. Because a circumcision has no proven medical benefits it is technically a cosmetic procedure. Why should it be okay to perform a cosmetic procedure on an unconsenting newborn? And why is it considered a birth defect when a baby is born without a foreskin but "normal" when we take it off a week later?  The truth is that people in America have seen the foreskin as a problem for many years when in reality we are the ones that are creating the problem.  I have always liked the bumper sticker that says "If a baby was meant to have a foreskin he would have been born with one."

Of course I am not writing this as a criticism or a guilt-laden lecture. I merely want to share with my readers my thoughts and feelings on circumcision based upon my research and personal choices. I highly encourage you to do your own research. Watch a circumcision video and read as much as you can get your hands on. Remember that it is okay for you to make a choice that is against tradition or culture.

Here are some informational websites:

American Academy of Pediatrics' stance on circumcision:

I also want to let you know that if you have chosen to circumcise your boy I am not placing any judgement on you. It is not my intention to make you feel guilty for the choices you have made for your children.  I just want to encourage you to question this procedure and do some research on it's benefits and risks.

Off to bathe my baby boy!


specialaffinity said...

I'm one of six brothers and we're all intact. I couldn't imagine having sex not being natural(circumcised).
My wife says there is so much more to play with and enjoy.
Thanks for taking a stand on this issue. It should be up to the owner, if he wants to make any changes to his penis.

TLC Tugger said...

If Dad thinks it's important that father and son have matching genitalia, he should first shave his body hair, no?

Better yet, Dad can just undertake non-surgical foreskin restoration for himself. Foreskin feels REALLY good.

Frank said...

I want to congratulate you on a well written and erudite summary of this issue and to assure you that what I write below is not a criticism but just additional detail.

You wrote about the current controversy about circumcision and HIV/AIDS. We only have to look at populations around the world and other interventions to see that this study holds no water.

For instance, there have been four studies this year in Australia, New Zealand, The US and England showing absolutely no difference in the HIV/AIDS rate between circumcised and intact men. If there were the 61% protective effect claimed by the recent studies, the different would be demonstratable and significant.

Consider another epidemic that once plagued us, the polio epidemic of the 1940's and 1950's and the current HIV/AIDS epidemic. Polio is a virus that exists in nature and is easily communicable by casual contact. HIV/AIDS is relatively difficult to transmit and contract requiring intimate contact and exchange of bodily fluids. HIV/
AIDS does not exist outside the body more than moments.

The polio vaccine has an effective rate of just 70% yet wiped the disease out of the population in just a single generation. If circumcision had a protective effect of 61% as claimed, the evidence shows us that the disease could have never become established in our population with a circumcision rate among sexually active men of 80% - 85%. Indeed, the sub-population with the highest circumcision rate, African Americans, also has the highest HIV/AIDS infection rate. As a matter of fact, it is estimated that African American women constitute 80% of all infected women. If circumcision provided an effective means of protection, this is just impossible. The vectors of transmission would be effectively broken and HIV/AIDS would be something that happens somewhere else like the ebola plague in Africa.

RE: Penile Cancer: It has been claimed that one in 110,000 intact men contract this cancer. That is not men that died of the cancer, only the ones that contracted it. This cancer (squamous cell carcinoma in situ) is the same cancer that people get on their faces and arms from sun exposure and is effectively treated the same way. The cancer is simply removed in a simple and quick in-office procedure and the cure is virtually 100%. In contrast, the death rate of infant circumcision is .006 or about 1 in 18,000 procedures. That means that 7 babies will die from the procedure that is claimed to prevent one treatable cancer. That simply makes no sense at all but that's something the medical profession never tells parents.

Indeed, this cancer is caused by the human papilloma virus and there is now a vaccine for this infection that promises to relegate the infection to the annuls of medical history along with both cervical cancer and penile cancer.

RE: bacterial and yeast infections: These infections in boys are caused by the identical bacteria and fungals that cause infections in girls and are treated with the exact same medications with an equal prognosis for successful treatment. The only difference is that girls contract these infections at a multiple times greater rate than males. No one would recommend surgical amputation of girls genital parts as a preventitive intervention but it is among the greatest justification for boys.

RE: Looking like Dad. Where are all the damaged men? Circumcision did not become common until just before WWII and before that time, all circumcised men would have looked differently than their fathers. This is usually given as a dire warning that the child will be significantly psychologically harmed if his father is circumcised and he is not. Oddly, the reverse is not given as a warning and it becomes a difference in his peers that is the warning. Just what is this psychological harm? Will he become reclusive? Will he reject sex or women? Will he become psychotic? Oddly, no one has ever been able to answer those questions. Why is that? Could it be that there are no psychological implications? I suspect so for if there were any, someone would have been able to idenitfy them by now.

RE: Locker room. With a circumcision rate approaching 50% in The US and 6% in Canada, this is no longer an issue as there will be equal numbers at worst and more not circumcised at best so that circumcision is not the norm any longer and those that are circumcised will be in the minority. This has all changed in just the last 10 years. Those who are advocating circumcision often state that "every man I know is circumcised" and that may be true but they are looking at the trend of 20 - 40 years ago. Boys being born currently will not have the perspective of that age but of this age and by and large, most of his peers will possess a foreskin. With the rapid change of this issue, another question arises . . . How do you explain why you circumcised your child (to a teenaged child) when equal numbers or more are not circumcised. With the information available now and sure to increase in the future, I can imagine this will be a very difficult explanation for the parents of the future and one that I would not like to have to give.

RE: Damage of Circumcision. This is something that is held closely in families and reports of it have not been generally made public. However with the internet and the annomity it provides, men with severe problems caused by their circumcisions are coming out of the woodwork. Some of these preclude ever having normal sex or fathering children.

Circumcision is simply a cultural practice the same as ear piercing or tattooing. It is one that was initally medicalized with preposterous claims of disease prevention. All of those claims have been effective refuted and it is now known that it protects against nothing. Yet we continue to do it as a matter of momentum. I say if we can't find a justifiable and PROVEN reason to continue it, this sacred cow deserves to be killed.


Wendy said...

Thank you everyone for your comments. I am so pleased to see so many men step up and talk about circumcision.

Frank, I know exactly who you are! We've met on another message board. :-) I want to thank you so much for taking the time to add such valuable information to my blog. I think you made some excellent points and I love how you were able to expand on the topics I just touched on.


Anjie said...

I loved this post so much I linked it from my blog!

Mandy said...

Preach it sistah!

I was a nursing student and had a very bad incident with a newborn who had adhesions to the bandage around his penis. He bled a lot- mom, baby and I were very upset and scarred for life. I determined in my heart that day that I will never circumcise if I have a son.

UMDLAX4 said...

as frank said:
"If circumcision provided an effective means of protection, this is just impossible. The vectors of transmission would be effectively broken and HIV/AIDS would be something that happens somewhere else like the ebola plague in Africa"

this arguement msy be more appropriate if AIDS was only transmitted sexually.
don't forget IV drug users.

AllyJoneso7 said...

I know this is an old post..but I want you to know how happy I was to read this. I have a two year old son and when he was first born I was torn about what to do. My husband and I decided to wait and think about it...and at home sat and watched a circumcision video. It broke our hearts and we decided right then and there that we wouldn't put him through that. I couldnt see a good reason to do it. I figured if he was born with didnt need to be taken away. I did worry about keeping it clean...but with time realized that it wasnt a big issue at all. I'm 7 months pregnant with my second boy..and will be keeping him exactly the way he's born :D

Amanda said...

GREAT POST WENDY!! Congrats on having the courage to stand against it. Very well worded :-)