The Circumcision Decision

Circumcision is not a routine, painless procedure; it is an extremely painful, completely unnecessary surgery. A newborn baby, usually less than 48 hours old, is taken from the warm arms of his parents and strapped down to a "Circumstraint". The process that ensues is akin to ripping off a fingernail. The blood vessels in the top of the foreskin are crushed by a hemostat and then the foreskin is ripped away from the glans. A device is then used to amputate the wounded foreskin. This procedure is commonly done without anesthesia, though here in Omaha, anesthesia is now being used for circumcisions. Anesthesia cannot completely prevent the pain, comes with all the inherent risks of anesthesia, and certainly doesn't help with postoperative pain.

The process of caring for an injured penis involves keeping a barrier, such as vaseline and gauze between the open wound and the diaper. The penis has to be cared for at each diaper change and it can be quite difficult cleaning the wound after a bowel movement. Healing takes several weeks. The possible complications from circumcision are infection, scarring and a bowing of the penis if too much foreskin is removed. In severely botched circumcisions, though this is admittedly rare, the surgeon may accidentally injure or cut off the glans.

So why do we routinely perform such an unnecessary and painful operation on our newborn baby boys? Well, in short, custom. Circumcision for non-religious reasons began in the early puritanical days of our country as a cure for masturbation. As with many cultural practices, circumcision continues to be done because "that's just how we do things around here". Many doctors and parents are starting to question this custom and the rates of circumcision are starting to drop. There is not a single medical body, including the American Academy of Pediatrics, which recommends routine circumcision.

Aside from the pain, what's wrong with losing a useless piece of skin? That's just it; circumcision is more than the removal of a useless piece of skin. It is the removal of part of the male genitalia. It contains millions of nerve endings, protects the glans, and provides lubrication during intercourse. Anecdotally, many women have found that a lover with an intact foreskin is preferable. Also, men who have had circumcisions done later in life report that they experience decreased sensation during intercourse after their circumcision. Ask any circumcised American male if he has decreased sensation during intercourse, and you'll probably hear a resounding, "I feel everything just fine, thank you very much." But how would a male circumcised at birth know the difference? Many with strong feelings on this subject believe that circumcision is basically sexual mutilation.

But aren't there medical reasons for circumcision? Isn't a circumcised penis cleaner and infected less often? Nope. An intact penis is not dirty and doesn't require any extra care. There is no need, and is in fact harmful, to retract the foreskin before it retracts on its own sometime between toddlerhood and pre-adolescence. A boy will figure out how to keep himself clean the same way a girl will know how to keep herself clean. Occasionally you will hear horror stories of a boy who has to be circumcised later in life because of an infection. This is very rare and the risks of a routine circumcision outstrip any risks of infection later in life. We don't perform surgeries to prevent a problem with a body part later on. If this were the case, we would routinely perform mastectomies because the breasts can become cancerous later on. Insert any other body part into this analogy.

But a boy should look like his father and his brother. Oh yeah? Do fathers and sons or two brothers ever look exactly alike? If the question ever even comes up, parents can simply explain to their son that they found out that circumcision was unnecessary and so they chose not to have it done. As a general rule, parents do not continue a practice if they find out that it is a mistake simply for the sake of sameness. Parents should not dwell on mistakes made during the past in a climate of no information or misinformation. They should simply move on and make better decisions.

And what about the locker room? First of all, young boys don't usually get naked in locker rooms any more. Secondly, the rates of circumcision are falling dramatically so chances are your son won't be the only one with an intact penis. The rate of circumcision has fallen to below 60% in this country. The rates are lowest in the Western states and still highest in the Midwest. Thirdly, we don't make decisions, especially to have surgery, to avoid teasing. Teasing will invariably happen to a child sometime in his life and it is the parents' responsibility to teach a child how to deal with teasing and it is the parents' responsibility to raise a child with a healthy self-esteem that will not be decimated by the pressures of conformity.

The circumcision decision does become more complicated when the question of religion is introduced. Around the world, only about 15% of males are circumcised and most of these males are Jewish or Muslim. Some in the Jewish community maintain that religious circumcision originally was much different than today's circumcision being that only a small portion of the foreskin was removed. Today you will find both groups of Muslims and Jews who advocate against the practice of circumcision. As the author of this article, I am neither Jewish nor Muslim, so I don't feel qualified to make a judgment about religious circumcision, so I would respectfully advise you to consult your religious leaders.

"OK", you say to me, "I'm convinced, but my spouse isn't". "OK", you say to me, "but my husband wants it done and since he has a penis, shouldn't he make the decision?" Well, there are two avenues to take. You can simply put your foot down, as is the responsibility of a parent if harm is about to be done to a child. Or, you can gently educate your spouse and ask them to read relevant literature before making the decision. Some spouses have been known to qualify the decision, saying "I'll leave it up to you honey, but you have to be present during the circumcision". Arrange for them, if possible, to watch a circumcision before you actually agree to do have it done to your own child. Or, you can find a "pro penis" doctor to explain to your spouse the reasons for allowing your boy to remain intact.

When it boils right down to it, the most convincing reason to avoid circumcision is to spare your baby boy unnecessary pain. I deluged my husband with literature (he just loves it when I do this) and tried to argue how an intact penis would benefit him sexually down the road. Truth was, he didn't care much for all the reading I gave him and he figured our son's sex life would turn out fine either way. He believed the threat of accidental penis amputation was simply a scare tactic. He just decided there was no reason for his new little baby boy to be in pain. Simple but profound.