Friday, January 23, 2009

Circumcision Decisions

If you are pregnant and having a boy, you have probably contemplated whether you should circumcise you baby. Circumcision in the United States largely became routine practice without significant scientific basis. The issue of hygiene is the only moderately viable argument, and even then it comes down to how responsible the male is in taking care of himself once he is old enough and capable. There is actually no conclusive evidence that having the foreskin removed reduces risks for STDs as might have been previously thought. There are absolutely no medical arguments for circumcision, so the decision to make it routine many years ago was made just like many other decisions in this country, on impulse, profit, and societal issues.

This is without mentioning how painful this procedure is, just because a baby cannot speak for himself it does not mean it will not hurt him. Often mothers experience a lot of trouble breastfeeding a circumcised baby boy because that trust and bond has been violated and the baby can feel it. Is it worth mutilating a body part to fit in with society? Europeans recognize that there are no medical indications for routine neonatal circumcision, why has the United States been blindly brainwashing everyone? Circumcision, or foreskin amputation, is big business. Each one costs over $100, divided between the doctor and the hospital. At its peak, there were over one million a year. This added up to well over 100 million dollars every year. Insurers need not pay for this unnecessary surgery, and they can save much needed health dollars at the same time.

Moreover, there are risks involved with circumcision just like with any other surgery. One out of every 500 circumcisions results in serious complication, the infection rate is higher than that. Four out of every 100 are considered unsatisfactory or result in other complications. Actually, a study that followed the infants beyond the post-operative period concluded that complications occurred in 55% of the boys.

For more information, read these articles:

Circumcision, If I Only Knew

George C. Denniston, MD, MPH

Paul M. Fleiss, MD, MPH

Positions of Medical Associations

Estimated U.S. Incidence of Neonatal Circumcision Complications

Circumcision Complications


2/23/09 update: great article on circumcision


  1. Male circumcision wouldn't even be an issue if it weren't for the fact that 19th century doctors thought that :
    a) masturbation caused various physical and mental problems (including epilepsy, convulsions, paralysis, tuberculosis etc), and
    b) circumcision stopped masturbation.

    Both of those sound ridiculous today I know, but if you don't believe me, then check out this link:
    A Short History of Circumcision in North America In the Physicians' Own Words

    Over a hundred years later, circumcised men keep looking for new ways to defend the practice.

    You might also want to check out the following:

    Canadian Paediatric Society
    Recommendation: Circumcision of newborns should not be routinely performed.

    Circumcision is a "non-therapeutic" procedure, which means it is not medically necessary. Parents who decide to circumcise their newborns often do so for religious, social or cultural reasons. To help make the decision about circumcision, parents should have information about risks and benefits. It is helpful to speak with your baby’s doctor.

    After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.

    RACP Policy Statement on Circumcision
    "After extensive review of the literature the Royal Australasian College of Physicians reaffirms that there is no medical indication for routine neonatal circumcision."
    (those last nine words are in bold on their website, and almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. “Routine” circumcision is now *banned* in public hospitals in Australia in all states except one.)

    British Medical Association: The law and ethics of male circumcision - guidance for doctors
    "to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate."

    National Health Service (UK)
    ”Many people have strong views about whether circumcision should be carried out or not. It is not routinely performed in the UK because there is no clear clinical evidence to suggest that it is has any medical benefit.”

    The College of Physicians & Surgeons of British Columbia
    "Circumcision is painful, and puts the patient at risk for complications ranging from minor, as in mild local infections, to more serious such as injury to the penis, meatal stenosis, urinary retention, urinary tract infection and, rarely, even haemorrhage leading to death. The benefits of infant male circumcision that have been promoted over time include the prevention of urinary tract infections and sexually transmitted diseases, and the reduction in risk of penile and cervical cancer. Current consensus of medical opinion, including that of the Canadian and American Paediatric Societies and the American Urological Society, is that there is insufficient evidence that these benefits outweigh the potential risks. That is, routine infant male circumcision, i.e. routine removal of normal tissue in a healthy infant, is not recommended."

    See also:
    Canadian Children's Rights Council
    "It is the position of the Canadian Children's Rights Council that "circumcision" of male or female children is genital mutilation of children.
    The Canadian Children's Rights Council position is that there is no medical benefit to the routine genital mutilation (circumcision) of any children (defined by U.N. as those under 18 years of age). Further, all Canadian children, both male and female, should be protected by the criminal laws of Canada with regards to this aggravated assault. Currently, the protection provided by the Criminal Code of Canada includes only genital mutilation (circumcision) of female children."

  2. How odd to see an article about the surgical removal of a normal part of the human anatomy without any reference to what that part is or does. Imagine an article about blepharectomy* (removal of the eyelids) without any reference to what eyelids do.

    *The operation appears to be extremely rare, and followed by repair.

    If circumcision were unknown until now and someone suggested it, there would be outrage, especially at the idea of doing it to newborns. It is only because it is already so common that it is allowed to continue.

    See also The Intactivism Pages.

  3. While the practice of newborn circumcision might be questionable, men either elect(for their own personal reasons), or have medical reasons to get a circumcision.

    Work in a hospital, or ask a urologist about phimosis, infection, etc.

  4. I have a very strong opinion on circumcision and I am glad you wrote this! I also wrote an entry on my blog that had some things about circumcision.

    I cringe when I see or hear women say that they are going to circumcise because it's unhygienic not to. I've also heard someone say that an uncircumcised penis was gross (yes, she was a grown woman, and pregnant). This is one of those topics that I could argue about for hours. I just wish more people would do research and become informed before making such a huge decision!


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