(feel free to contact her with any questions)
Posted with Permission from Author
A good friend gave birth to her first son the day before my wedding. It was so much fun to be a part of her pregnancy and then to watch her son grow. I was only about 2 months pregnant when I found myself lending her a hand with a diaper change. I noticed that her son didn’t look circumcised, so I asked her why she didn’t have that done. She responded that while she was pregnant, a friend of hers had her son circumcised and the baby boy died of an infection that was thought to be related to the circumcision. That was enough for her and she left her son intact.
Well, it wasn’t enough for me because I had always just assumed I’d have a baby boy circumcised and I figured it wasn’t just as simple as blaming the death on the circumcision. That same day, I went online to my favorite baby resource (BabyCenter.com). I found myself on a circumcision debate board, where I lurked for several days before building up the gall to post something. The debates were heavily dominated by anti-circumcision advocates. It seemed that every person who planned to have their son circumcised (or already did) was getting attacked, called a bad parent and other horrible things. Although I was taken aback by this cult-like online congregation, I was also intrigued because I had no clue there was such controversy over circumcisions. I just thought pretty much everyone did it because it was more hygienic and looked better.
After reading up on some of the “benefits” of circumcision, I decided to pose as a curious poster who was on the fence about circumcision. I spent many hours over the next couple of weeks debating circumcision from the perspective of someone leaning toward having it done and constantly losing my arguments to factual data and ethical boundaries. I was shocked by how difficult it was to find medical websites that supported circumcision. The facts were all there, it was clearly not a necessary procedure, the health benefits were practically non-existent (medical resources only claimed "possible" benefits), but I couldn’t help but feel like I should still have it done. I soon realized that my pro-circ stance was only still hanging around due to cultural pressures. I put my guard down, stepped out of my comfort zone, and focused on making a logical decision.
Leading up to the birth of our son, Jeremy and I were both in complete agreement that he would not be circumcised. I continued to have this strange feeling in the pit of my stomach telling me that maybe I was making the wrong decision. I knew that was my own cultural uncertainty ringing its bell and I knew now to ignore it because the facts were clear and the decision was clear. It did NOT feel like maternal instinct urging me to take action. Every instinct in my body told me that he was born with it for a reason and to simply leave it alone. When Nathan was born, all hell broke loose…it was just such a difficult birth experience. After 33 hours of unmedicated labor, Nathan was cut out of me in emergency fashion and rushed to a different hospital where he spent the next 5 days in the NICU. Inflicting further stress on my son’s body was the furthest thing from my mind. When I finally saw his naked little body (days after he was born), it was so perfect…every last piece of my son was beautiful. I have NEVER doubted my decision to leave his penis intact and I know I never will. I’m so glad that I took the time to learn about circumcision because I cannot imagine learning all of this after the fact.
Here is a list of common reasons, in no particular order, that people present to support the decision to have their son circumcised followed by the responses I feel made the biggest impact on me. Please realize that I am not including both sides of the debate here, just what helped change my mind.
1) I want my son to look like his daddy.
Today, doctors perform “loose circumcisions.” This is done because in the past, "tight circumcisions" were the norm and oftentimes too much skin was removed. As an adult, many men suffer from tight erections that can be crooked and painful. As a result of removing less skin, some babies don’t really look circumcised, and few will look like Daddy. [Note: in the Jewish tradition, a Mohel performs the circumcision; traditional, tight circumcisions are apparently still the norm despite the increased risks.] A problem that commonly arises with loose circumcisions is that unless Vaseline is applied for 10 days after circumcision, the skin tends to re-adhere in an attempt to heal back to and protect the glans (head of the penis). The parents have to decide whether to leave it alone to separate when it is ready or to have it forcefully and painfully separated a second time. Sometimes a second surgery isn’t even optional since the skin can grow back in an unnatural way that can cause problems (such as a skin bridge). The reason I mention all of this is because many parents end up feeling like they shouldn’t have put their son through such a terrible procedure just to be slightly circumcised, especially if the loose circumcision subjects them to ongoing problems or lifelong deformations. This “look like daddy” reason hits me funny because after Nathan was born, we found out that Jeremy’s dad wasn’t circumcised, either. Jeremy never knew! All in all, I decided that I’d rather have to one day explain to Nathan why his penis doesn’t look just like Daddy’s then have him come to me and ask why we cut part of his penis off.
2) I don’t want my son to be teased.
The circumcision rate has dropped drastically in the U.S. It is practically non-existent apart from religious-reasons in the rest of the world. Over 80% of the world’s men are intact. Approximately 45% of America’s baby boys were left intact as of 2004 (this tends to be regional). As of 2010, hospital circumcision rates in the U.S. have been found to be as low as 32%, so the numbers are definitely dropping quickly and I'm confident Nathan will never feel like he is the odd man out. A big part of that is awareness, but I think a bigger part might have to do with fewer insurance companies covering this elective surgery. I actually have to wonder if the circumcised boys will soon be the ones being chastised because they are missing out on the benefits of a full penis. When he becomes sexually active, girls will probably have experience with both as well. So rejection is unlikely for either group since there will be a true mix. Even if we end up living somewhere with high circumcision rates, Nathan will unlikely be the only intact boy. If he ever did get teased for the way his penis looks, there are all kinds of great comebacks I’m prepared to arm him with. I want him to be happy and proud of who he is. I’m not going to alter his body in anticipation of kids being kids. All kids get made fun of at some point. I’m going to focus on teaching him how to be a strong and happy individual regardless of what other people think, whether they are making fun of his hair-do, the way he walks, a goofy laugh, or his body. I see little to no chance that my son will be anything but happy and relieved that he escaped this cultural trend. The following link shows a world map with circumcision rates: http://www.circumstitions.com/Maps.html
3) My doctor recommends it.
The cultural influence is so strong in this country, that even doctors will recommend circumcision, despite admitting that it is not medically necessary. It turns out that there is no official medical organization in the world that recommends routine infant circumcision. The potential medical benefits do not outweigh the risks and circumcision is recognized worldwide as either a religious or cosmetic surgery. Not only do many American doctors recommend circumcision, but many American pediatricians give out bad information on the care of intact boys. Clearly they are not up-to-date on their medical literature! Many pediatricians will not only forcefully retract a boy’s foreskin just to take a look underneath, but they recommend that parents do the same to clean and check for problems. This is by far the number one problem for intact boys because the foreskin should NEVER be forcefully retracted. It will do so on its own when it is ready. By retracting it early, you can cause great pain to your son and subject his penis to scarring, UTIs and other painful infections. You are also committing yourself and your son to having to retract to clean sooner than necessary.
Here is a document that can be presented to pediatricians who are not aware of the problems with forceful retractions:
And here is a link from the same website talking about forceful retraction:
Unfortunately, doctors are also generally bad about telling parents of circumcised boys how to best care for the penis and lots of circumcised boys are suffering from re-adhesions that could have been prevented.
It really bothers me to consider this, but circumcision is a multi-million dollar industry. Some hospitals charge as much as $2,000 for this brief surgery. Insurance companies are gradually refusing to cover this procedure as it is more widely accepted as cosmetic. Either way, there is a lot of money to be made off of this quick procedure, so I could not discount the idea that doctors might have an ulterior motive.
After my father was unable to put aside his cultural influences to focus on the actual medical information regarding circumcisions and after watching a 70-year old pediatrician scare a roomful of expecting parents into getting their kids circumcised as quickly as possible so their kids don’t get made fun of, I realized just how powerful the cultural influence is. I want my doctor to give me up-to-date medical facts, not their biased opinions (unless I ask for them). I need a safe place to find out the truth about circumcision and I should be able to trust any licensed physician to provide me with that information.
4) It’s just a snip.
Circumcisions are a delicate and dangerous procedure on a tiny, little nub of a penis. Not only is very functional and sensitive tissue being removed, but there is always the risk of taking too much off, excessive bleeding, nerve damage to the remaining parts, and infection. Some doctors are even still using the Mogen clamp, which has been known to accidentally remove the tip of the penis along with the foreskin. Complication rates of circumcision are up to 35% as stated by the AAFP. http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html Late complication rates are at least 4.7% or more according to this study (done at one hospital): www.ncbi.nlm.nih.gov/pubmed/20155423 Adult complication rates are generally unknown as there are not many studies done, (but include hairy shaft, scars, painful erections, and more). The complication rate of meatal stenosis though is as much as 10%. http://emedicine.medscape.com/article/1016016-overview
At least parents don’t have to worry about the side affects of general anesthesia on their infant; none will be used because general anesthesia is too dangerous on a newborn. While there are doctors who choose to use no pain relief at all, most use a topical cream called EMLA and others will use nerve blocks (nerve blocks can also be very painful and have their own set of risks, but are considered the most effective form of pain management). Unfortunately, most doctors who do use the EMLA cream do not give the topical analgesic time to penetrate (recommended to wait at least 30 minutes after application). Many babies actually go into shock because they aren’t able to cope with the pain. This explains why some babies seem so calm after the procedure. Their little bodies just shut down. Simple monitoring of their heart rate reveals the state of shock—this scares the hell out of me.
I also recently read that burn unit wards use foreskins for skin grafts…the skin removed during a circumcision of an infant can cover a 12”x12” area on a burn victim! At least that skin is occasionally being used for something good. Foreskins are also used in making certain kinds of very pricey make-up, including those promoted by Oprah Winfrey. *Shiver*
5) The foreskin is an unnecessary part of the penis, just like the appendix.
The foreskin is far from unnecessary or useless. It not only protects the glans (preventing it from drying out and becoming less sensitive, preventing infection, and protecting it from the elements) and serves as a pleasurable gliding mechanism during sex and masturbation, but it is covered in sensitive nerve endings that increase pleasure. Unfortunately, many circumcisions don’t just remove foreskin, but they also remove part or all of the frenulum (this is the area of the penis where the foreskin attaches itself to the shaft. It is considered to be one of the most sensitive parts of the penis). Though it is not necessary to enjoy sex, the foreskin is a natural and functional part of the penis that has over 20,000 specialized nerve endings that are not found anywhere else on the body. Fortunately, every man seems to be born with a unique love for Mr. Happy, so even if he is missing out on some added fun, they’ll still be best of friends. http://www.circumstitions.com/Works.html
6) Uncircumcised boys aren't as clean.
Neither are uncircumcised girls. All boys and girls need to learn how to keep their privates clean. Intact boys should plan on spending an additional 5 seconds “playing” with their penis in the shower; however since the normal natural retraction rate doesn't occur for an average of 10 years, this isn't something the parents will need to be concerned about for most kids. I recommend that all men and women take a shower daily and especially after breaking a sweat if they don’t want to be stinky down there. I’ll be the first to admit that I don’t go sniffing around my hubby’s crotch at the end of the day and especially not after he’s been working out. Of course, if I’m being honest, I usually don’t smell all that much better than him…erm…I mean…I smell like roses. :o)
I found this quote from an Islamic website interesting because it sounds just like the argument I used to use in support of circumcision: "The secretions of the labia minora accumulate in uncircumcised women and turn rancid, so they develop an unpleasant odour which may lead to infections of the vagina or urethra. I have seen many cases of sickness caused by the lack of circumcision. "
7) I’ve heard that uncircumcised boys are at higher risk for cancer, STDs, and urinary tract infections.
There is a lot of misleading information regarding health benefits. While some studies show that intact men are at higher risk of contracting STDs because the virus survives longer in the moist, protected environment under the foreskin, other studies show that the dried out (or “keratinized”) glans has a tendency to crack and allow for easier transmission. All men should be advised to practice safe sex regardless of circumcision status.
The small increase of UTIs can be explained by the number of babies who have their foreskin forcefully retracted. Those boys who do get UTIs should be given antibiotics just like their female counterparts. Overall, the potential “protective” quality of being circumcised is so small that hundreds of baby boys would need to be circumcised to spare just one baby an infection that can be treated with antibiotics. Similar infections and problems tend to occur in girls and there is always an alternative to surgery. Here is an article that discusses how the foreskin protects against UTIs: http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html
As for cancer, penile cancer is by far one of the rarest forms of cancer and usually only occurs in the elderly. I certainly wasn’t about to subject Nathan to a life without part of his penis for that risk. If he wants to lower his cancer risk when he’s an old man and not able to even get an erection anymore, I suppose he could choose to have the surgery. Of course, I’m at such high risk for cancer that I’m being told to have a full hysterectomy and mastectomy to improve my chances of survival. These contradictory studies can be debated all day, but in the end, there is STILL no official medical organization in the world that recommends routine infant circumcision, including the American Cancer Society. Here is a recent article that discusses some of these concerns: http://www.nytimes.com/2011/08/23/health/23consumer.html?_r=1
8) It’s a personal choice.
Personal choice SHOULD mean that the person attached to the penis should get to choose. Every man should have the right to decide whether or not he wants the full penis that he is born with. His mother and father’s biased opinion of his penis should not be the deciding factor before he is even old enough to hold his own head up. If later in life Nathan decides that he wants to have a circumcision, he can go to the doctor, choose the style, size, and shape, method of surgery, types of anesthetic, and type of post-op pain relief. If he had been circumcised, he could never undo our decision. Nathan's father reached the conclusion early on in these discussions that he was wronged. He now wishes that he was not circumcised and while he is not comfortable speaking out against circumcision the way I am, he fully understands that it is unnecessary, that there are clear benefits to having an intact penis, and that parents should not be allowed to make this decision for their sons unless there is a medical reason to intervene. And really, that's why most anti-circumcision advocates speak out...this isn't just about making a decision for your son, it's about taking away his rights to decide what he prefers based on HIS personal experiences, not ours as parents, which are greatly affected by the culture we grew up in, a culture that has already changed drastically. It never even occurred to me before beginning this research that there are men who wish they were never circumcised and I was shocked when someone had me run a search for "foreskin restoration" online. There are a large number of websites discussing ways to get some of those protective and functional features that the foreskin provides back, proving (along with forums filled with men upset about having this decision taken from them) that there are an incredible number of men unhappy they were circumcised. So, while you may believe you've never met a man who wishes he wasn't circumcised, there's a decent chance you have and he just has no interest in discussing it with you. While the true foreskin with all of its nerves and inner mucosa can never be replaced, there are ways to regenerate skin to protect the glans. The Penn & Teller episode on circumcision delves into this in quite a bit of detail:
9) It is better to have it done at birth because it is much more difficult to have a circumcision later in life.
To the contrary, the older your son is when he is circumcised, the better the pain relief and recovery can be controlled and the less likely that errors will be made since the penis will be larger. Infections aren’t likely to be as much of a problem later because the foreskin will have already separated from the glans naturally (the glans won’t be raw and vulnerable to infection) and his immune system will be more developed. Some people say it’s better to have the circumcision done in infancy because when they are older, they will have to undergo general anesthesia, thus it is a more complicated procedure due to prep time and the inherent dangers that come with anesthesia. I find this a very disturbing rationale since the reason infants don’t get general anesthesia is because it is too dangerous at that age, not because they feel less pain.
I’ve also heard people use the reasoning that recovery time is longer and more painful for an adult. Recovery is about 2-3 weeks for both infants and adults. During that time, an adult has far more options in terms of pain relief (and the ability to verbalize the extent of that pain) and their wound isn’t being exposed to runny feces and urine in a diaper. An adult will probably experience the additional frustration of not being able to be sexually active until fully recovered.
While there are attempts to restore the foreskin, circumcision cannot be undone. It is a permanent decision. I’ve come to the conclusion that any permanent, non-medical surgery should be delayed until the child is old enough to make his own, educated decision.
10) I want to have it done now because my son won’t remember the pain.
There have been plenty of studies showing that there is lasting psychological damage that can occur from the trauma an infant undergoes during circumcision. This damage includes trust and attachment issues, problems establishing breastfeeding, as well as reduced pain tolerance over the long-term. Although I personally found these things too subjective to sway me one way or the other, given the rest of the arguments, it’s just not worth the risk. Another thing that bothers me about this issue is that I can’t help but think that we are simply convincing ourselves that the pain an infant feels is not real or just somehow taking advantage of this pre-bonding period to let our child deal with the pain. A two-year old won’t remember being circumcised either, but can you imagine not providing adequate pain relief during circumcision to your 2-year old? I personally do not see how we can compare an adult’s level of pain with an infant’s pain when the infant cannot communicate with us what he is experiencing.
This argument also typically assumes that an intact child will need to be circumcised later in life. There are all kinds of anecdotal stories of an older child needing to be circumcised due to infections or other problems, but in reality, the true medical need to be circumcised is very rare. Almost every case of infections or other problems is caused by forceful retraction...avoid that and chances are you will never have to worry about needing to circumcise your son. Most boys in the U.S. (and some in other countries I am sure) were forcefully retracted at some point and many still are due to the doctors being misinformed on proper care, so those anecdotal stories no longer have such an effect on me. Plus, it has become obvious that many American doctors will rush to circumcision as a solution to any problem related to the penis when there is almost always a far less invasive approach available. Recently, it has been discovered that even with the continued practice of forceful retraction, a circumcised boy has about the same risk of needing to be re-circumcised due to a botched circumcision or adhesions as an intact boy has of ever needing to be circumcised.
11) My son will thank me for circumcising him before he could remember.
Yes, this is possible. But, it's also possible he will resent you for it and as the circumcision rates continue to drop drastically, this is becoming far more likely. At the very least, this is a very controversial and irreversible decision you are making for your son and if you were wrong about what he and his future partner would prefer, leaving it intact leaves him options. It's so easy now for someone to go online and do the research themselves. When my son goes online and sees that this was such a huge debate, realizes the myths about it, and understands the functions of his foreskin, I have no doubt he'll be glad he dodged that bullet.
FGM A big piece of the circumcision debate is whether or not it can be compared to female genital mutilation (FGM). I have to admit that at first, I really couldn’t compare the two. It came across as a really extremist view and I was looking for all kinds of arguments to convince myself that circumcision and FGM have nothing in common. I was offended that someone might suggest that by planning on circumcision, I was just as barbaric as people who mutilated female genitals. The moment I stopped looking for ways to disrupt the comparison, I was able to see the big picture. Keeping in mind that there are various degrees of FGM, whether it is done for appearance, cleanliness, or to reduce sexual sensation, there really are remarkable similarities to male circumcision. This link shows a direct comparison: http://www.circumstitions.com/FGMvsMGM.html
I realize that this letter is quite one-sided, but it is my story and the facts have been verified. I'm not out to mislead anyone, I'm determined to make up for what our doctors are failing to provide us so that we as parents can make an educated medical decision with regards to surgery on a newborn. I was completely ignorant on this topic when I became pregnant with my first baby. I know how hard it is to step outside of the comfort zone of our culture and I am not angry with parents who choose to circumcise. Not only are doctors withholding details on the risks involved, but some doctors are even scaring us with potential medical risks that have long since been disproved. I am including a list of links below so that you can verify the facts that I have provided and continue educating yourself on circumcision.
The following are links to official medical associations and their statements on circumcision:
American Academy of Family Physicians (AAFP): http://www.aafp.org/online/en/home/clinical/clinicalrecs/children/circumcision.html
American Academy of Pediatrics (AAP): http://aappolicy.aappublications.org/cgi/content/full/pediatrics;103/3/686
American Urological Association: http://www.auanet.org/content/guidelines-and-quality-care/policy-statements/c/circumcision.cfm
British Medical Association, Medical Ethics Committee: http://www.bma.org.uk/ethics/consent_and_capacity/malecircumcision2006.jsp
Canadian Pediatric Society: http://www.cps.ca/english/statements/FN/fn96-01.htm
Royal Australasian College of Physicians: http://www.racp.edu.au/index.cfm?objectid=65118B16-F145-8B74-236C86100E4E3E8E
Central Union for Child Welfare in Finland: http://www.childcentre.info/10595/
The College of Physicians and Surgeons of British Columbia: https://www.cpsbc.ca/files/u6/Circumcision-Infant-Male.pdf
The Royal Dutch Medical Association (KNMG): http://knmg.artsennet.nl/Diensten/knmgpublicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm
http://www.mothersagainstcirc.org/ (this is an anti-circumcision site)
http://www.circumstitions.com/ (this is an anti-circumcision site)
http://www.mothering.com/discussions/showthread.php?s=5bf433f99b737d53a492f9189737dacb&t=112410 (Stories from mothers who regret having their son circumcised)
http://www.doctorsopposingcircumcision.org/ (this is an anti-circumcision site)
http://norm.org/ (Site for men trying to restore their foreskin)
http://www.lcshj.org/circum.html (Statement on Jewish Male Infant Circumcision and Brit Milah)
http://www.drmomma.org/2011/08/intact-or-circumcised-significant.html (This site contains graphic images of the head of the penis in an attempt to explain some of the benefits of the foreskin. The focus is on how the glans must adapt to being an external organ without the protective prepuce.)
https://members.kaiserpermanente.org/kpweb/healthency.do?hwid=aa41834 (Kaiser Permanente's stance on circumcision)
http://www.liveleak.com/view?i=416_1218124584 (Penn & Teller: Circumcision is BULLSH*T: for those of you who like to laugh through the pain)