"Myth 1: They just cut off a flap of skin.
Reality check: Not true. The foreskin is half of the penis’s skin, not just a flap. In an adult man, the foreskin is 15 square inches of skin. In babies and children, the foreskin is adhered to the head of the penis with the same type of tissue that adheres fingernails to their nail beds. Removing it requires shoving a blunt probe between the foreskin and the head of the penis and then cutting down and around the whole penis. Check out these photos: http://www.drmomma.org/2011/08/intact-or-circumcised-significant.html
Myth 2: It doesn’t hurt the baby.
Reality check: Wrong. In 1997, doctors in Canada did a study to see what type of anesthesia was most effective in relieving the pain of circumcision. As with any study, they needed a control group that received no anesthesia. The doctors quickly realized that the babies who were not anesthetized were in so much pain that it would be unethical to continue with the study. Even the best commonly available method of pain relief studied, the dorsal penile nerve block, did not block all the babies’ pain. Some of the babies in the study were in such pain that they began choking and one even had a seizure (Lander 1997).
Myth 3: My doctor uses anesthesia.
Reality check: Not necessarily. Most newborns do not receive adequate anesthesia. Only 45% of doctors who do circumcisions use any anesthesia at all. Obstetricians perform 70% of circumcisions and are least likely to use anesthesia - only 25% do. The most common reasons why they don’t? They didn’t think the procedure warranted it, and it takes too long (Stang 1998). A circumcision with adequate anesthesia takes a half-hour - if they brought your baby back sooner, he was in severe pain during the surgery.
Myth 4: Even if it is painful, the baby won’t remember it.
Reality check: The body is a historical repository and remembers everything. The pain of circumcision causes a rewiring of the baby’s brain so that he is more sensitive to pain later (Taddio 1997, Anand 2000). Circumcision also can cause post-traumatic stress disorder (PTSD), depression, anger, low self-esteem and problems with intimacy (Boyle 2002, Hammond 1999, Goldman 1999). Even with a lack of explicit memory and the inability to protest - does that make it right to inflict pain? Ethical guidelines for animal research whenever possible* - do babies deserve any less?
Myth 5: My baby slept right through it.
Reality check: Not possible without total anesthesia, which is not available. Even the dorsal penile nerve block leaves the underside of the penis receptive to pain. Babies go into shock, which though it looks like a quiet state, is actually the body’s reaction to profound pain and distress. Nurses often tell the parents “He slept right through it” so as not to upset them. Who would want to hear that his or her baby was screaming in agony?
Myth 6: It doesn’t cause the baby long-term harm.
Reality check: Incorrect. Removal of healthy tissue from a non-consenting patient is, in itself, harm (more on this point later). Circumcision has an array of risks and side effects. There is a 1-3% complication rate during the newborn period alone (Schwartz 1990). Here is a short list potential complications.
Meatal Stenosis: Many circumcised boys and men suffer from meatal stenosis. This is a narrowing of the urethra which can interfere with urination and require surgery to fix.
Adhesions. Circumcised babies can suffer from adhesions, where the foreskin remnants try to heal to the head of the penis in an area they are not supposed to grow on. Doctors treat these by ripping them open with no anesthesia.
Buried penis. Circumcision can lead to trapped or buried penis - too much skin is removed, and so the penis is forced inside the body. This can lead to problems in adulthood when the man does not have enough skin to have a comfortable erection. Some men even have their skin split open when they have an erection. There are even more sexual consequences, which we will address in a future post.
Infection. The circumcision wound can become infected. This is especially dangerous now with the prevalence of hospital-acquired multi-drug resistant bacteria.
Death. Babies can even die of circumcision. Over 100 newborns die each year in the USA, mostly from loss of blood and infection (Van Howe 1997 & 2004, Bollinger 2010).
Isn’t it time to think more carefully about whether we should be circumcising our boys? “
http://www.psychologytoday.com/blog/moral-landscapes/201109/myths-about-circumcision-you-likely-believe
More Circumcision Myths You May Believe: Hygiene and STDs
Is circumcision cleaner and healthier?
Published on September 13, 2011 by Darcia Narvaez, Ph.D. in Moral Landscapes
There’s a lot of hype about how circumcision is better for a man’s health. But is it really?
Here is Part 2 of our series on myths about circumcision.
NOTE: Primary author is Lillian Dell’Aquila Cannon (see her blog)
Myth: You have to get the baby circumcised because it is really hard to keep a baby’s penis clean.
Reality check: In babies, the foreskin is completely fused to the head of the penis. You cannot and should not retract it to clean it, as this would cause the child pain, and is akin to trying to clean the inside of a baby girl’s vagina. The infant foreskin is perfectly designed to protect the head of the penis and keep feces out. All you have to do is wipe the outside of the penis like a finger. It is harder to keep circumcised baby’s penis clean because you have to carefully clean around the wound, make sure no feces got into the wound, and apply ointment.
Myth: Little boys won’t clean under their foreskins and will get infections.
Reality check: The foreskin separates and retracts on its own sometime between age 3 and puberty. Before it retracts on its own, you wipe the outside off like a finger. After it retracts on its own, it will get clean during the boy’s shower or bath. Once a boy discovers this cool, new feature of his penis, he will often retract the foreskin himself during his bath or shower, and you can encourage him to rinse it off. But he should not use soap as this upsets the natural balance and is very irritating. There is nothing special that the parents need to do. Most little boys have absolutely no problem playing with their penises in the shower or anywhere else! It was harder to teach my boys to wash their hair than it was to care for their penises. (Camille 2002)
Myth: Uncircumcised penises get smelly smegma.
Reality check: Actually, smegma is produced by the genitals of both women and men during the reproductive years. Smegma is made of sebum and skin cells and lubricates the foreskin and glans in men, and the clitoral hood and inner labia in women. It is rinsed off during normal bathing and does not cause cancer or any other health problems.
Myth: "My uncle wasn’t circumcised and he kept getting infections and had to be circumcised as an adult."
Reality check: Medical advice may have promoted infection in uncircumcised males. A shocking number of doctors are uneducated about the normal development of the foreskin, and they (incorrectly) tell parents that they have to retract the baby’s foreskin and wash inside it at every diaper change. Doing this tears the foreskin and the tissue (called synechia) that connects it to the head of the penis, leading to scarring and infection.
Misinformation was especially prevalent during the 1950s and 60s, when most babies were circumcised and we didn’t know as much about the care of the intact penis, which is why the story is always about someone’s uncle. Doing this to a baby boy would be like trying to clean the inside of a baby girl’s vagina with Q-tips at every diaper change. Rather than preventing problems, such practices would cause problems by introducing harmful bacteria. Remember that humans evolved from animals, so no body part that required special care would survive evolutionary pressures. The human genitals are wonderfully self-cleaning and require no special care.
Myth: My son was diagnosed with phimosis and so had to be circumcised.
Reality check: Phimosis means that the foreskin will not retract. Since children’s foreskins are naturally not retractable, it is impossible to diagnose phimosis in a child. Any such diagnoses in infants are based on misinformation, and are often made in order to secure insurance coverage of circumcision in states in which routine infant circumcision is no longer covered.
Even some adult men have foreskins that do not retract, but as long as it doesn’t interfere with sexual intercourse, it is no problem at all, as urination itself cleans the inside of the foreskin (note that urine is sterile when leaving the body.)
Phimosis can also be treated conservatively with a steroid cream and gentle stretching done by the man himself, should he so desire it, or, at worst, a slit on the foreskin, rather than total circumcision. (Ashfield 2003) These treatment decisions can and should be made by the adult man.
Myth: Uncircumcised boys get more urinary tract infections (UTIs.)
Reality check: This claim is based on one study that looked at charts of babies born in one hospital (Wiswell 1985). The study had many problems, including that it didn’t accurately count whether or not the babies were circumcised, whether they were premature and thus more susceptible to infection in general, whether they were breastfed (breastfeeding protects against UTI), and if their foreskins had been forcibly retracted (which can introduce harmful bacteria and cause UTI) (Pisacane 1990). There have been many studies since which show either no decrease in UTI with circumcision, or else an increase in UTI from circumcision. Thus circumcision is not recommended to prevent UTI (Thompson 1990). Girls have higher rates of UTI than boys, and yet when a girl gets a UTI, she is simply prescribed antibiotics. The same treatment works for boys.
Myth: Circumcision prevents HIV/AIDS.
Reality check: Three studies in Africa several years ago that claimed that circumcision prevented AIDS and that circumcision was as effective as a 60% effective vaccine (Auvert 2005, 2006). These studies had many flaws, including that they were stopped before all the results came in. There have also been several studies that show that circumcision does not prevent HIV (Connolly 2008). There are many issues at play in the spread of STDs which make it very hard to generalize results from one population to another.
In Africa, where the recent studies have been done, most HIV transmission is through male-female sex, but in the USA, it is mainly transmitted through blood exposure (like needle sharing) and male-male sex. Male circumcision does not protect women from acquiring HIV, nor does it protect men who have sex with men (Wawer 2009, Jameson 2009).
What’s worse, because of the publicity surrounding the African studies, men in Africa are now starting to believe that if they are circumcised, they do not need to wear condoms, which will increase the spread of HIV (Westercamp 2010). Even in the study with the most favorable effects of circumcision, the protective effect was only 60% - men would still have to wear condoms to protect themselves and their partners from HIV.
In the USA, during the AIDS epidemic of the 1980s and 90s, about 85% of adult men were circumcised (much higher rates of circumcision than in Africa), and yet HIV still spread.
It is important to understand, too, that the men in the African studies were adults and they volunteered for circumcision. Babies undergoing circumcision were not given the choice to decide for themselves.
Myth: Circumcision is worth it because it can save lives.
Reality check: Consider breast cancer: There is a 12% chance that a woman will get breast cancer in her lifetime. Removal of the breast buds at birth would prevent this, and yet no one would advocate doing this to a baby. It is still considered somewhat shocking when an adult woman chooses to have a prophylactic mastectomy because she has the breast cancer gene, yet this was a personal choice done based upon a higher risk of cancer. The lifetime risk of acquiring HIV is less than 2% for men, and can be lowered to near 0% through condom-wearing (Hall 2008). How, then, can we advocate prophylactic circumcision for baby boys?
Science and data do not support the practice of infant circumcision. Circumcision does not preclude the use of the condom. The adult male should have the right to make the decision for himself and not have his body permanently damaged as a baby.
http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds
Infant circumcision is an ethical issue that has lifelong effects on the child and societal costs.
NOTE: Primary author is Lillian Dell’Aquila Cannon (see her blog), with assistance from Dan Bollinger
No medical association in the world recommends routine infant circumcision. None.
The American Academy of Pediatrics Policy Statement on Circumcision says:
"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision." (AAP 1999)
The British Medical Association says:
"[P]arental preference alone is not sufficient justification for performing a surgical procedure on a child." (BMA 2006)
The Royal Australasian College of Physicians says:
"After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand." (RACP 2010)
The Canadian Paediatric Society says:
"Circumcision of newborns should not be routinely performed." (CPS 1996)
The Royal Dutch Medical Association (KNMG - Netherlands) policy statement is wonderfully clear:
"There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene… circumcision entails the risk of medical and psychological complications… Non-therapeutic circumcision of male minors conflicts with the child’s right to autonomy and physical integrity." (KNMG 2010)
Circumcision wastes money.
Medicaid spends $198 million each year on routine infant circumcision in the 33 states that still pay for it, a procedure its own guidelines consider to be medically unnecessary. Private insurance programs are reimbursing an additional $677 million, raising prices for us all (Craig 2006.) In addition to the cost of circumcision itself, correcting its complications are said to double the cost, bringing the total bill to $1.75 billion each year. Is this what we should be spending money on during a recession and at a time when healthcare costs are skyrocketing?
Circumcision violates the Hippocratic Oath to “First, do no harm.”
Doctors have an ethical duty to treat the patient by the most conservative means possible, but removing healthy tissue in the absence of any medical need absolutely harms the patient. In the case of routine infant circumcision, nothing was diseased, and thus nothing justifies its removal. Medical personnel who support infant circumcision in any way should reexamine their ethical duties to the child.
Everyone has a right to bodily autonomy and self-determination.
This is a fundamental tenet of international human rights law (UNESCO 2005). As babies cannot speak for themselves, they need special protection. Balancing the potential benefits of circumcision with the definite risks can be difficult decision, but the only person qualified to make this decision is the owner of the penis, as he is the one who is going to have to live with the results, not his parents.
Parents’ aesthetic preferences are not valid reasons for circumcision.
If a mother thinks her daughter’s nose is too big, should she force her to get a nose job? If a father prefers large breasts, can he force his daughter to get breast implants? If a woman prefers circumcised men, can she force her son to be circumcised?
Even if you are fine with being circumcised, your son may not be.
If you have never had a foreskin, you cannot possibly know what having one would feel like. You only know what it feels like to not have a foreskin. You cannot know now how your son will feel in 20 or 30 years. If you have your son circumcised, he may grow up to regret the decision you made for him, but circumcision is irreversible. (Yes, men can partially restore their foreskins, but it is difficult and the sensitive nerve endings are gone forever.) Leave the decision to your son. It is his penis. He deserves to decide for himself.
Parents have a duty to educate themselves on circumcision rather than do it just because it was done to them.
As parents, we are entrusted by God or the universe or by nature with the care of our babies. They truly are a gift, but one that we do not get to keep. We have a responsibility to care for them as best as we can, because they cannot speak nor care for themselves. Though they are babies now, and we have to make decisions for them, they will be adults, with minds and feelings of their own. We need to make decisions for them that we will be proud to stand behind now and in the future. If your son asks you why you had him circumcised, how will you answer? “Because I am circumcised and I needed your penis to match mine?” “Because I didn’t trust you to be able to make your own decisions?” When making this decision for your son, be brutally honest with yourself. What does your decision serve: the child’s rights, or your ego?
For clear, easy and plain-language help making the circumcision decision, try the Circumcision Decision Maker at http://circumcisiondecisionmaker.com/.
Just because it has been a “tradition” does not make it right.
Slavery and child labor were traditions sanctioned by religions and other authorities. But we abandoned those practices because they were unjust and harmful. Infant circumcision, similarly supported by authorities, should be abandoned by the people who care for children because it is unjust and harmful.
It’s time to face our discomfort and admit that circumcision was a mistake.
Routine infant circumcision is a 90-year aberration in the more than 150,000 years that Homo sapiens has existed on this planet. It’s a remnant of times when people thought it was okay to beat your wife and children, that babies couldn’t feel pain and so could be operated on without any anesthesia, and that it was bad to enjoy your sexuality. We’ve discarded all these other ideas, and now we’re discarding circumcision, too.
It is time to face reality.
If you are a circumcised man, or a parent who circumcised his child because you thought it was good for him, you have a painful task in front of you. It’s time to face reality:
You were circumcised because your dad was circumcised because everyone else was circumcised because 140 years ago, some perverted doctors wanted to stop boys from masturbating. Being circumcised isn’t better, and it isn’t popular anymore. The 70% of the world’s men who have foreskins almost never choose to have them cut off and consider them to be the best part of the penis. You don’t have this part of your penis, and that’s really terrible, but it would be even more terrible to make the same mistake with your own child.
Circumcision is ending with the generation being born now - only 32% of babies born in 2009 in the USA were circumcised. Boys born today who keep their foreskins are not going to be mocked, because they’re in the majority, and because people now are more informed. Uncircumcised boys are not going to be scarred because their penises do not match their fathers’. The myths are dying - more and more people are realizing that leaving children’s penises intact is better.”
http://www.psychologytoday.com/blog/moral-landscapes/201109/circumcision-ethics-and-economics
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