To Circumcise or Not To Circumcise?
Once a proverbial given in this and a number of other countries, circumcision has become a hot button issue, intensely debated in both family and medical circles. For decades it was standard procedure for hospital births, but the numbers are quickly declining. Today, 56% of newborn boys are circumcised, although the rate varies considerably by geographic region in the U.S. In 1999, the American Pediatric Association revised their statement on circumcision to acknowledge the “potential medical benefits” of the procedure but concluded “these data are not sufficient to recommend routine neonatal circumcision.” Most of Canada has “de-listed” circumcision as a necessary (i.e. paid for) procedure.
In truth, the decision to circumcise isn’t purely medical even as it becomes increasingly controversial. Intangible aspects play as much or more of a role in parents’ choice as scientific research. For some families, circumcision is an age-old rite celebrating religious covenant. For others, it’s a venerated custom that manifests cultural identity. Families who aren’t influenced by religious or cultural values might choose circumcision for social or aesthetic reasons in an effort to allow junior to look like the other boys at school or like the father. However, other families and experts argue that the practice is a painful, unnecessary procedure that violates the physical dignity and even legal rights of the child.
The history of circumcision is imprecise, but the practice is thought to have its roots in the Middle East. Experts suggest a number of potential reasons behind the initial practice of circumcision, including figurative sacrifice, virility ritual, and cultural hygienic custom. In many tribal societies, circumcision was observed as a cultural rite of passage into manhood. Although circumcision predates religious directive, it eventually became a sacred practice in the early Jewish faith and for the followers of Islam. At various times in history, circumcision was also used to designate social status as well as religious identity. On an odder note, Western societies, particularly in the 19th and early 20th centuries, practiced circumcision to discourage masturbation. In these same centuries, the issue also became medicalized around tenets of basic hygiene. In the late 19th and 20th centuries, the rate of newborn circumcision increased as hospital births rose and the public accepted the medical argument for standard circumcision.
For our part, let’s delve into the medical side.
These days, one of the most commonly cited health reasons for routine circumcision is decreased STD risk. Numerous studies based in Africa show that circumcision reduces the risk of heterosexual HIV contraction by 50-60%. In response the assembled research, the World Health Organization/United Nations Joint Programme on HIV/AIDS issued their official recommendation of circumcision as one method to prevent the spread of HIV. Critics caution that the “context” of the African epidemic, which is as high as 25% of the population in some areas, is so different from the disease rate (as well as cultural and hygienic practices ) in the West that the protective factor of circumcision isn’t nearly as high in Western countries. Some experts estimate a 10% risk reduction in Western societies (PDF). Other Western-based research demonstrates reduced risk for other sexually transmitted disease like genital herpes and HPV as well as a decrease in bacterial vaginosis risk for female partners of circumcised men. Research exploring the impact of circumcision on infection reduction in homosexual men has been more limited but so far shows a mixed picture of protective influence. A review published this month indicates that circumcision appears to reduce risk in primarily “insertive” rather than receptive partners.
The physiological logic behind circumcision’s reduced infection risk involves the bacterial ecology of the inner foreskin itself, which harbors anaerobic bacteria that appears to fuel inflammation and infection. The inner foreskin is home to the highest concentration of so-called Langerhans’ cells, which facilitate HIV transmission and replication.
A less dangerous but more common problem for uncircumcised males, particularly boys, is recurrent urinary tract infection. Circumcision is considered a standard treatment option for those with recurring UTI or serious complications from an initial case of UTI. Some experts have questioned the usefulness and cost efficiency of routine circumcisions to prevent infections in a relatively small number of boys. According to a British study, 111 routine circumcisions must be performed to prevent a single UTI. However, other experts suggest that there’s more at stake than simple urinary infection risk. Another study found that 18% of young boys in the study who had UTI showed signs of kidney scarring. Follow-up circumcision in these boys substantially reduced subsequent UTI occurrence. As a research commentator noted (PDF) in light of this picture, “[I]f the circumcision had been done in the newborn period would the kidneys have been protected from damage in the first instance?”
In response to these infection-related findings, critics of the procedure counter that diligent safe sex and hygienic measures more reliably protect both the man and his partner from infection. Opponents say that circumcision (or at least the public message about its lower infection risk) can give men an inflated sense of protection against life-threatening diseases and discourage use of condoms, testing and other safe sex methods. Nonetheless, many physicians and public health experts maintain that circumcision is a practical strategy for reducing disease in males and their respective partners.
As for the other physical conditions circumcision is meant to prevent, many experts say that the evidence just doesn’t support the need for routine circumcision in every boy. The nonretractable foreskin in childhood is often a misdiagnosis, since separation of the glans happens over time (a protective feature) and may not even be noticeable until puberty. Common infections can be treated with a plethora of modern medications like antibiotics and steroid creams. As for penile cancer, the risk is so low (approximately 9-10 per million men) that circumcision choice shouldn’t be based on this concern.
Then there are the medical complications. They can be everywhere from aesthetic-based to functionally impairing. Infection rates hover close to five percent. Significant narrowing of the urethra occurs in anywhere from 5-10% of circumcisions and must be addressed with follow up treatment. Injury to the urethra can occur. The least common but most dramatic complications include partial to full penile amputation or even the rare death from serious infection.
On a considerably lighter note, critics also suggest that circumcision compromises sexual pleasure. They argue that the foreskin, as host to a dense network of nerves, is a functional erogenous zone in itself.
Although it’s likely impossible to reach any definitive conclusions regarding the issue, self-report research on men who are circumcised in adulthood show mixed results. In one such study, the majority of men did not experience a decrease in libido or pleasure. Eighty-two percent reported the same (44%) or enhanced (38%) penile sensitivity. A smaller study (PDF), however, recorded patients’ written comments about the impact of the procedure on their sex life and calculated that nearly half of respondents experienced less penile sensitivity after circumcision.
Now that we’ve laid out some of the arguments and medical research, we want to hear what you have to say. What is your thinking on the subject, and what factors have or would influence your choice to circumcise or not circumcise? Thanks for reading and contributing.
Get Free Health Tips, Recipes and Workouts Delivered to Your Inbox
Posted By: Worker Bee
Said Robin at Stone Soup Homeschool Network:
It is ridiculous to assume that a child would somehow be negatively impacted if “his” looks different from “dad’s” or the other boys in the locker room.
—————————————
Blatantly wrong. Many, many uncut boys thrown into locker rooms full of cut peers for the first time have been permanently traumatized at the discovery, and that’s IF they weren’t further traumatized by hazing or other open condemnations. I saw it more than once myself, and others’ stories abound.
“permanently traumatized”? You mean as opposed to permanently mutilated?
School kids are frequently hazed on everything from and between their shoes to their haircut.
Which trauma would be worse do you think:
Discovering many (not all) of the other kids in your school have been mutilated and lost something, unlike you
Or…
Discovering many of the other kids in your school haven’t been mutilated and lost something, unlike you?
Which kid is going to have long term “issues”? The one that discovers he is as nature intended, or the one that discovers he’s missing the most sensitive part of his penis and the gliding action – because his parents allowed someone to amputate it while he was a baby?
You’re trying to suggest the mental “trauma” of discovering some other kids have been mutilated, is as bad or worse than the very real physical and mental trauma of said amputation?
You can’t even argue ‘all’ of the other kids have been surgically disfigured like that, because even in America it is becoming a minority decision.
A.
It seems to me that all of the arguments in favor can be deflated with 1) wash “it” regularly or 2) wear a condom.
The criticisms of the social reasons can be reduced to “if everyone jumped off a bridge, would you”?
And finally, if we were talking about the social or religiously based removal of the female clitoral hood would we even be having this conversation?
From the Craig Ferguson show:
http://www.youtube.com/watch?v=xKnSWo3hkf4
Actually, this video is better:
http://www.youtube.com/watch?v=e-Lm396q8KA
Here’s a thought…
If you don’t like the isea of circumcision, don’t have your children circumcized… But, at the same time, don’t be the asshole who runs around telling people who have done it or are circumcized that they are wrong for it. The physical appearance of their penises will not affect you, and if it does, well, sleep with the light on if it helps. But basically, mind your own business and do what you want quietly.
What at asinine thought, Charlie. The same demented reasoning could be applied to all forms of child abuse (“if it does not involve you, mind your own business”).
Sorry, a great deal of people will object to and fight against child molestation and mutilation even if it does not “affect them” directly, and even if you would remain quiet and look the other way.
I’ve been with one uncircumcised man and all the rest have been circumcised. Before then, I was on the “don’t do it” end but only because I think it’s incredibly wrong to make that decision for another person.
After actually encountering one on a grown man myself, I’m still in the same camp but now can actually say I wish Americans hadn’t jumped on this bandwagon so intensely. It’s a little odd if you’ve never seen/touched one before, but that’s it. Hygiene? They shouldn’t be stinky or dirty unless the man doesn’t know how to wash. And as long as you have that covered and also know how to protect against STDs, I don’t see any valid reason for circumcision.
All I experienced were benefits =D I wouldn’t say the guy had skills other men lack, the penis just felt different- in the very best way. Everyone is different and I’m certainly not left unsatisfied by default by a circumcised partner… But the difference was something that has really stuck with me, and any time I begin dating a new man I do secretly hope his parents left his genitals alone
And I’d NEVER do it so that my son wouldn’t get made fun of- by other boys, or by women (or men if he prefers haha) he meets. Kids will be kids and nearly everyone gets teased for something they can’t help about themselves.
And if a lady thinks your equipment is “gross” and deserves ridicule, then she’s not worth your time of day in the first place. Reasonable women realize that everyone is different, and some penises are circumcised and some are not. If I’m attracted to you enough to get in bed with you, I’m also accepting the fact that there may be surprises and I need to handle them like the adult I happen to be lol… And as long as someone is clean, an unusual looking penis is not something to tease them over unless you’re a real scumbag of a person.
I’d like to smack any parents doing this because they don’t want their kid to be made fun of.
My 2 groks, ages 2.5 and 5 are uncut, and I find it mind-boggling that so many people who would be horrified at the same thing being done to girls will do it to boys without blinking an eye.
Stacy commented:
My husband… is circumcised… done when he was an infant. I asked him if it was painful and he said he was too young to remember… He has no problem, doesn’t resent it, hasn’t suffered from it. We’re both happy with that.
… our lack of knowledge on how to properly care for an uncircumcised penis is a major factor in why, if we have a boy, we’ll probably have him circumcised. I also don’t want him to have to do it later in life and remember every second of it.
——————–
I wouldn’t want to change your mind, as your reasoning makes sense and is shared by many. But do some study and see why many believe puberty to be a better age, when a boy can understand and participate in his own decision. It is not usually painful or difficult.
I’m a bit late to the party…. Nevertheless, my two cents:
My ex and I went with not circumcising our son, so he would match Dad. We weighed our options carefully before making the decision, and to be honest we couldn’t decide which would be more or less beneficial, so we just went with matching Dad. I mean this argument could be made from both sides until we’re all blue in the face because there are good things and bad things about both, as with most things. the problem that arises is how people take the decision.
For instance, I can’t begin to explain all the flack I got from people when they would change my son’s diaper and realize he is uncut. Like it’s anyone’s business. Like breastfeeding – there are obviously benefits to breastfeeding versus bottle feeding but some people are unwilling or unable to breastfeed and that’s fine too, and nobody’s business but that mother and child. So the whole debate is kind of ridiculous, tbh. Both have good and bad points and it’s a personal choice only to be made by parents and their own children, not the whole world and the next person that changes my son and gives me “that look” is going to get that “can of whoop a$$.”
“The foreskin absolutely has a function:
a) (deleted, and)
b) to act as a plunger mechanism to draw competing males semen out of the female genital tract.” –PMatt 1-13-10
– - – - – - – - – - – - – - – - – - -
I almost fell out of my chair laughing at that one. I’ve read a lot of groping for straws BS from the anti-circ foreskin freaks crowd, but this one’s a keeper.
Grok had his foreskin intact right?
My husband and I had this conversation a while back before we knew we were having a boy. I will absolutely not circumcise my baby, as I see no reason to. I looked up the care for it, and there is no increase in the infection rate to those who aren’t cut. If he wasn’t supposed to have a foreskin, then he wouldn’t be born with one. My husband kept asking me which one I preferred, cut or uncut, like it freaking mattered. I told him that if he gets to baptize our child Catholic, then I get to have him stay intact. If my boy wants it later in life, that will be up to him.
I am circumcised, and I wish I were not.
Although I have never had sex, when I masturbate, it feels painful and tight because I’m pulling on the leftover skin. Also, I cannot get any stimulation on the glans of the penis, only the area of the penis shaft below the glans. And in order to get this stimulation, I would have to do it hard which makes it hurt more. I can use lubricant, but it still hurts because the surface of my hand is not as smooth as the inner surface of a foreskin.
In terms of a “medical reason” for a circumcision, our family encountered one in our firstborn son.
We chose NOT to put him (or us) through circumcision at birth, especially after reading that the benefits are negligible and the practice is over-performed these days.
However, at 11 months old, he had his first UTI… We didn’t know it was a UTI at first – it was a persistent, HIGH fever for three days that only was relieved by infant Tylenol/Ibuprofen. After that nurse-recommended “home care” period, we took him to the pediatrician’s office. He was diagnosed with a UTI (after they took a urine sample), and he was put on antibiotics.
After he finished his antibiotics, ONE WEEK later, the fever returned. We were perplexed and upset how this could’ve occurred again in such a short time. This time he was put on stronger antibiotics and sent for follow-up tests to look for any kidney issues (since it’s unusual for infants to have recurring UTIs, though the percentage is slightly higher for uncircumcised boys).
In the HORRIBLE test – after a HORRIBLE experience with two nurses, and finally a doctor each trying to insert a catheter into my son’s penis (they had to push back further on the foreskin than it was ready to be pushed) – they filled his bladder with X-ray-able liquid of some sort, then kept him on an ultrasound table for at least 30 minutes, until he eliminated the liquid for their observation.
What they discovered was that when he pushed out the liquid/urine, one of the tubes leading down from the kidney pouched out from the bladder, then filled with liquid (in the wrong direction), then propelling that liquid up towards the kidney. (BAD.)
We had a few visits with a pediatric urologist after this, and she recommended we either: (1) use a steroid multiple times per day to push down on his foreskin to make it retract earlier than normal, so skin cells (and bacteria) couldn’t collect there… but until it retracted, keep him on a low-dose antibiotic (potentially for many many months)… or, (2) if we weren’t opposed to it, have him circumcised. (She said circumcision would eliminate the possibility of infection happening at all because the whole penis would be cleaned more thoroughly, so the bacteria wouldn’t be able to build up in the urine.)
It was a excrutiating decision for us as first-time parents, but we chose circumcising our son at that time. It required anesthesia, since he was older, so that was especially worrying.
Thankfully, everything went smoothly with the operation, and while after-care was difficult with a stronger-than-infant child in pain, it healed wonderfully. (The urologist said that because it was a larger penis than a newborn’s, it would be “beautiful.” Yeah, he never needs to know that.)
He hasn’t had another kidney infection since (he’s now almost 2 years old).
Anyway, I think we’d do this again with a future baby boy… the circumcision, that is, only from infancy next time. The urologist said there was a good chance we’d never have known of his bladder-valve issue if he’d been circumcised at birth… (It supposedly heals itself when they’re 3-5 years old, and if he doesn’t have any future UTIs, there’s not much of a need to check if it has.)
My daughter had chronic UTIs from ureter reflux, same as your son. Thank God no one ever tried to remove any part of her anatomy to prevent it, although the urologist did want that horribly invasive exam repeated yearly from age 5 to 12, and did want to correct it with surgery and DAILY prophylactic antibiotics and antispasmotics for years. (After the second catherization, exam, & xray, I put my foot down.)
I figured out it was a hygiene problem (although not the ones typically insisted upon with UTIs), ended the UTIs & kidney infections quickly each time one sprang up with vitamin C megadosing, and then permanently ended them once I figured out and corrected the hygiene problem.
When I was younger, I had chronic eye infections from very slightly poor makeup hygiene. It took me years to figure out the root cause and solve the problem on my own without drugs from the optometrist, but thank God that in the meantime, no one ever tried to cut off my eyelid to prevent it in the future (that would indeed, have prevented it, while causing many other problems – the eyelid has a function very similar to the foreskin).
@MamaGrok – Thanks for sharing your experiences. It is terribly scary and difficult for any parent to deal with physical ailments with their child, and I’m sorry you had to go through that with your daughter.
I think the point you were trying to make is that our pediatric urologist mis-recommended a circumcision as an option for our son’s issue. However, both examples you gave are anatomically dissimilar of how our son’s physiology was more precarious for future infections.
I’m not sure what your experience is with uncircumcised infant penises, but there is no way to fully “clean” them before the foreskin completely retracts on its own – not until they are well into toddlerhood or sometimes later. Consequently, dead skin cells (and bacteria, if it manages to get in there) are trapped between the head of the penis and the outer opening with very little ability to be “cleaned” by external methods.
For most uncircumcised children, this is not an issue – as long as the whole penis + foreskin are being well-groomed on a daily basis. However, for a child with internal reflux (as your daughter was also found to have), this is a big issue. This means that any bit of bacteria that becomes trapped in that area could travel through the urinary tract into the kidney.
As you discovered, a girl’s urinary tract-to-opening is much shorter than a boy’s, and this is why – if hygiene isn’t maintained – it is easier for girls to get UTIs than boys. (Bacteria doesn’t have to travel far to get into the bladder.) However, you have the opening on a girl completely “available” for external cleaning at all times – not the case with an uncircumcised boy.
An eyelid is also not a comparable example, since you have the ability to flush out the eye and thoroughly soak/clean the eyelid of the infecting factors.
Anyway, thanks again for your input to this topic.
I also wanted to add that I’m sorry your pediatrician recommended that same invasive test every year. Our pediatric urologist said that procedure USED to be performed at regular intervals to see if the valve-reflux issue had healed yet, but she said it’s no longer necessary unless any further infections occur.
Hopefully your daughter has been doing much better with her issues, too.
I know how very difficult it is to deal with these medical issues with our children, and especially when we’re not sure the course of action being recommended is best. I can never second-guess someone else’s decision when I don’t know all the factors in a given case.
My main intention in reading is to let other parents know, who may encounter a similar situation, that chronic UTIs, whether caused by reflux or not, can be solved without any surgical intervention at all. UTIs are nearly always a case of something getting in there that doesn’t belong. For women, it’s usually lube, applicators, toys, fill-in-the-blank. For children, it’s usually poop. And diapers usually contribute to the problem for babies, especially if they have diarrhea. There is always a root cause – as we found in our case, even with the reflux, if you stop the UTIs, you stop the problem. And you can stop the UTIs without drugs or surgery in nearly every case. I cannot say with full confidence *every* case, but I have helped many people with many types of UTIs and have been able to stop all of them by finding the root source of the contaminants that shouldn’t be there.
A foreskin protects a penis from infection like an eyelid protects the eye (and provides moisture, prevents callous, etc.). Identically, a foreskin can trap infection like an eyelid can, *IF* something gets where nothing, biologically, should be able to get. My main point is that if a little boy is getting UTIs, something is happening that should not be, *on the outside*, that should be the doctor’s primary focus before worrying about how, physiologically, to cut up the body to try to fix the problem.
Neither my doctor nor my child’s went outside of standard Redbook magazine hygiene tricks to address the root cause of our chronic UTIs. Going outside their box and using our brains, we stopped them. I don’t go through all this to blame you, or to blame me, or to blame our doctors for our children’s problems, but to give information for parents in the future who may encounter this same problem. Dig, dig, dig to get to the root cause before taking a permanent, irreversible course. Don’t use an elephant gun to kill a roach.
I was circumcised when I was 25, about 10 years ago now. I had a cyst on the end of the foreskin that needed removing and had the choice of just having the cyst removed or the full circumcision.
Having been sexually active both ways I can say with certainty there is no reduction in feeling whatsoever – it is different yes but no less enjoyable and there has been no negative impact on sensitivity.
It is definitely cleaner, I showered and cleaned myself regularly pre circumcision but it is still much cleaner now than it was before.
The final point I’d make is addressing the comment earlier comparing it to female “circumcision” – the term is a misnomer, and female genital mutilation is the preferred term since the clitoris is often removed not the hood – this is a direct and concious act to remove sensitivity from females, it is nothing like removing the foreskin and would have more in common with you having your glans removed.
Forgot to mention, I have quite a few males in my house, some circumcised, some not, so I am very familiar with benefits and risks of both situations, with regard to UTIs, cleanliness, and otherwise. In our home, we do not find the uncircumcised penis any more difficult to clean and care for than an eye.
It’s pretty obvious to anyone with a logical mind and an IQ over 50, that Christopher Dollis has wiped the floor with the pro-circumcision camp; and Alan provided the necessary information on the value of the foreskin and hopefully educated some of the ignorant people frequenting here.
There is no logical reason for circumcision. I was circumcised and it has destroyed my life – loss of sensitivity, anxiety and depression.
As far as I’m concerned, the people who keep peddling this circumcision nonsense are no less evil than child rapists.
Sick in the head, the lot of you.