Thursday, July 31, 2008

A tough topic

This post turned in to a book, and I'm sorry. If you don't have time to read the whole thing, I tried to make each point easy to find so you can skim through the rest. It also reads like a term paper. I don't know why I took such a monotone approach to this.



Some friends and family members have discovered (either by seeing his diaper being changed or by outright asking) that we have decided not to have Connor circumcised. Now, many parents consider this a very private matter and they choose not to discuss it. I, on the other hand, am fine with talking about it to anyone who is curious about our choice. So, I thought I would share some of my research with you so that you can see why we made this choice. I am more than happy to answer any questions anyone might have, and I can expand on any of this information if anyone is interested. I really have done my homework on this because surgery on my infant son, no matter how minor, is a big deal to me and I wanted to understand everything there was to understand about it. I started to research it when I first got pregnant because I assumed we would be doing it, so I wanted to understand what was going to happen. Needless to say, what I found changed my mind.




I would also like to say that circumcision is still legal and common in the United States, and therefore it is up to each parent to decide what they should do for their child. The American Medical Association refuses to take a hard stance on the issue, and basically leave it that they don't recommend routine infant circumcision, but they think parents should research it themselves and make their own choice. Some of my views on the subject teeter on the edge of insulting those who choose to do it. But you see, I'm one of those kind of people who can disagree with someone and still love and respect them. Just because you might have made a different choice doesn't mean I feel you are a bad parent or that I don't love and respect you just as much as I did before. So please, if anything I say hurts anyone who is reading this, I offer my heartfelt apologies. My goal is to inform, not to insult.


Point blank, there is no medical reason for it. It is cosmetic surgery, plain and simple. Insurance companies (including private and government funded state insurances) are dropping it all over the country. I will attempt to counter some of the reasons you may often hear in favor of the surgery.





~The Bible says we should circumcise.


It's true that the Old Testament orders boys to be circumcised as their first covenant with God (Genesis 17: 10-14). However, the New Testament does away with this law. Here is a quote:


Galatians Chapter 5

2 Mark my words! I, Paul, tell you that if you let yourselves be circumcised, Christ will be of no value to you at all. 3 Again I declare to every man who lets himself be circumcised that he is obligated to obey the whole law. 4 You who are trying to be justified by the law have been alienated from Christ; you have fallen away from grace. 5 But by faith we eagerly await through the Spirit the righteousness for which we hope. 6 For in Christ Jesus neither circumcision nor uncircumcision has any value. The only thing that counts is faith expressing itself through love.





~I don't' want my son to be teased for being different.


Today, about 50% of boys are being left intact. (More or less depending on what part of the country you live in. Blue states tend to have less circumcisions, while the Bible belt tends to have more. Regardless of region, the numbers are dropping nationwide in every part of the country) This means that by the time Connor is in a position where others would see his penis (the locker room, with a girl, etc) he won't be "different." He will be just like half of the boys in his age group. It would be like teasing someone for having brown hair.





~I want my son to look like his daddy.


Connor won't look like his daddy in the first place. Just talking about genitals alone, he will be smaller and have no pubic hair. Of course that's not even mentioning the rest of his body, which is smaller, chubbier, and far less hairy. ;) If he ever does ask, I will simply tell him that when daddy was a baby, they thought it was good to cut off part of the skin on his penis. Now we know that we don't have to do that so I decided not to do it to him.





~I don't want my son to get infections.


The risk of urinary tract infections raises by less than 1% during the first year of life if the foreskin is left intact. After the first year the numbers are the same. We don't surgically alter any other body part simply for infection prevention. Ear infections are very common in babies, but we don't put tubes in their ears as a preventative measure at birth. We wait until there is a problem and then we treat it.





~If my son is uncircumcised, his future wife will get infections.



That's a lot of power to give to a flap of skin. I honestly don't understand the logic behind this idea, but I've heard some very intelligent women claim that it happened to them. What is more likely is that they were passing an infection back and forth between their partner. When one partner gets an infection, many times both people need to be treated even if they don't both show symptoms. The fact is that the labial folds on a woman are a MUCH better breeding ground for bacteria than the foreskin, and women should always urinate and shower after being intimate. Men need to keep themselves clean, whether they are circumcised or not. Yes, it's more important for an uncircumcised man to be careful with his hygiene because bacteria can breed inside the foreskin, but I wouldn't want to be with a circumcised man who didn't wash himself either.



Besides, 80% of the worlds men are intact. If they were walking infections, America wouldn't be the only country in the Western world so still perform routine infant circumcision.





~Uncircumcised men have a higher risk of cancer.


Yes, if I circumcise Connor he won't be able to get cancer on that particular piece of skin. If you cut off your finger, you won't be able to get cancer in your finger either. The comparison is sadly accurate. The foreskin is the only place on the whole body that is surgically altered for reasons of cancer prevention. It's true that some women who are predisposed to breast cancer and who have tested positive for several factors will have a mastectomy in order to prevent cancer. But these women, like I said, have a higher risk of breast cancer than the rest of the population. I suppose if there was a long line of penile cancer in our family that would make me weigh this topic more heavily.





~Uncircumcised men have a higher risk of contracting HIV


The study that suggested this idea is the basis of a lot of debate on it's own, and is not recognized by any major medical community. The first flaw is that it was performed in Africa, where poverty and a lack of information are undeniably at the base of the AIDS problem. Men who are of a higher social standing are more likely to be educated about safe sex, and they are also more likely to be circumcised. The fact that they have less instances of AIDS and the fact that they are circumcised are more socio-economic related than health related. Even if the study weren't so fatally flawed, I certainly wouldn't want my son thinking that he's safe from AIDS simply because he was missing a piece of skin. The simple fact is that AIDS is transferred by bodily fluids, not extra skin.





~I'm uncomfortable with the idea of cleaning under my sons foreskin.


The foreskin on an infant should never NEVER be forcibly retracted. At birth, the foreskin is attached to the glans (the head of the penis) by a tissue similar to the tissue that holds on your fingernails. By retracting his foreskin you are literally ripping his skin away from his glans. This can cause infections, adhesions, scar tissue, and later painful problems. Sometime between the ages of 2 and 10 (usually on the early side, and rarely as late as puberty) the foreskin will naturally separate and he will be able to retract it himself. He should be the first one to ever do this.

~I know someone who had to be circumcised later and it was horrible for him.


The most common reason for a pubescent boy to need a circumcision is because someone forcibly retracted his foreskin when he was a baby. Believe it or not, many doctors don't even know this because they weren't taught it in medical school. A friend of mine was told by her doctor to retract the foreskin of her infant. This is a problem with our health care, not with the male body. But like I said earlier, this can cause scar tissue and adhesions, which will prevent the foreskin from naturally disconnecting itself and will be very painful.


Another common reason is phimosis, which means the foreskin is too tight to retract even after is has disconnected. First, phimosis can't be diagnosed until puberty because it can be totally normal for the foreskin to wait that long to disconnect. It's rare, but it can happen and is considered normal. Second, the use of steroid creams can loosen up the foreskin and usually correct the problem without surgery. But still, sometimes it happens and circumcision is needed.


The last reason that is commonly heard is infections in elderly men who can't care for themselves any longer. This shouldn't be looked at as a problem with the male body, but as a problem with elderly health care in this country. If you don't clean any part of the body that isn't regularly exposed to air (the underarms, between the toes, etc) then infections can happen. If a man you know got regular infections in a nursing home or under the care of someone else, you should either educate that person in how to care for your loved one or you should fire them. This isn't a problem in countries where medical staff is trained in proper care of an uncircumcised man.


~Circumcision later in life is more painful.


It's true that any man who was circumcised later in life will tell you it is painful. But think of it this way. He was put under for his surgery, and he went home with pain medication. Babies are *sometimes* given an injection to numb the site (which takes away about 50% of the pain) and are sent home with no form of pain relief at all. Some doctors just give the baby a pacifier dipped in sugar water and call it good. Just because he doesn't remember it doesn't mean it's ok.



~Uncircumcised penises are dirty.


The care for an uncircumcised penis isn't nearly what some people make it out to be. Once it naturally separates from the glans, all he has to do is pull the foreskin back (it takes two fingers) and wash with soap and water. It's only one small extra step, since we would hope he will be washing his penis with soap either way.





~Circumcision is a simple little snip. It's not very painful and they won't remember it anyway.


While it's true that Connor wouldn't remember the surgery if we had chosen to have it done, the idea that it's not painful is very very untrue. Some doctors have started to use a local anesthesia, but even this is painful because it is a large needle inserted directly into the penis. Some babies scream in pain. Some don't make a peep and seem to be drifting off to sleep. Why the difference? Recent studies tracking brain waves show that the ones who seem to be calm are actually on the verge of passing out from shock. A needle and a pacifier dipped in sugar water are NOT enough to erase the pain. Studies show that even with anesthesia, the pain is only reduced by about 50%. If you're interested in how the procedure is done, you can click here for part one and here for part two. WARNING: This is extremely graphic footage of an actual infant circumcision. Please don't have the kids around and wear your headphones because the baby screams very loudly.





~Uncircumcised penises are ugly


First of all, penises aren't exactly pretty no matter what. Second, I think every part of my precious son is perfect, and I intend to leave him that way. :)

5 comments:

Jen said...

All penises are ugly!

Thank you for posting this. Most of these points I already knew but you've taught me some new things also!

I didn't watch the video. I could never see a child in pain. :(

Anonymous said...

Brava! Great blog and wise decision.

Here's another way of looking at urinary tract infections: Of every 1000 circumcisions, 991 are wasted - 990 because the boys never would have got them, and one because he gets UTI anyway - and that's IF the studies are accurate, and they probably aren't. (They were of boys born in military hospitals, where there was pressure to circumcise unless the boys were premature, and preemies get infections because they're catheterised, not because they're intact.)

Penile cancer is one of the rarest of cancers, rarer than breast cancer in men, and it mainly strikes very old men.

The African studies of HIV were experimental - large groups of men were randomly divided in two and half circumcised - but more than twice as many of the circumcised men dropped out, their HIV status unknown, as the men left intact who got HIV, so who knows what the real outcome was? Even if the studies were good, it averaged 39 circumcisions to delay one transmission in Africa, where HIV is rife. The figure would be much higher in the US.

Here is a leaflet for parents that starts from the point of view that intactness is normal.

All the best to you and the boy!

Burninghair said...

Well done, sistah!

IMO- it's the natural, intended state of the human male. Leave well enough alone.

Human beings have always found a reason to alter the natural state of things for aesthetic and social reasons- more than anything else. Finding ways of justifying it with religion- and by that link, incorporating it into medicine- spreading social fears more than legitimate, fact proven concerns.

You did your research well. I have even found Baby Magazines discussing the topic, showing the practice is on a very steady decline.

Anonymous said...

Congratulations on the birth of your son and for making one of the best decisions you can make for him, leaving intact! Connor is so lucky to have such thoughtful parents like you two. :) I am sure you've looked into this thoroughly but just in case I'll share the following links to intact care:

Cirp intact care
Cirp normal development
Cirp parents

Would you mind sharing your experience with this WRT the hospital/pedi/obgyn/family/friends/ect? I'am courious to know.

Again congratulations and good luck, what a lucky boy. :)

Anonymous said...

Hello. And Bye.