a surgical procedure, simple in technique, but extremely complex in context.
June is Men’s Health Month- a time to cherish the health of our fathers, husbands, sons, and brothers. On this day, I want to highlight an important, albeit sensitive men’s health issue, a subject so passionate to me; the circumcision of a newborn male child. As adults, we have come to accept that when children are voiceless and powerless, we have the authority to take away their basic human right– the right to decline permanent bodily change. And no, circumcision is in no way, shape or form comparable to choice of vaccination. This is an elective procedure, not a life saver, performed on perfectly healthy and normal population of newborns, to permanently change their bodies. A vaccine is none of the above. Most other parts of the world find this practice unacceptable, if not barbaric.
History The surgery we call circumcision has a fascinating history, in particular its evolution in the United States. In the late 1800’s, then famous orthopedic surgeon Dr. Lewis Sayre was asked to see a 5 year old boy who couldn’t walk. He found the boy had contractions in his legs and just as he was about to operate on him, he diagnosed a case of phimosis or unretracted foreskin. As soon as the boy underwent circumcision, he was cured and began walking again. This revelatory story gave birth to a nationwide movement of democratization of circumcision in America’s male population such that we are now the only industrialized nation in the world that routinely discusses circumcision at birth. In the 1980’s rates of circumcision peaked at 65%, and as of 2010 a staggering 40.2% of healthy, normal infants underwent this surgery within 3 days of birth. A glimmer of hope is that its popularity is declining.
Health Matters Medical professionals and laymen alike claim circumcision has many health benefits, when in truth none really exist. I learned this during my prenatal courses in UCLA. As I sat contemplating like many other moms in the room whether I should circumcise my unborn son, we learned that circumcision has unsubstantiated health claims and many real risks, including infections, poor feeding, and long term genital problems. The course instructor spoke of the 2012 policy statement by American Academy of Pediatrics which states: the benefits are not great enough to recommend universal newborn circumcision. This helped put an end to the debate, at least in my mind. Doctors who financially benefit from this act, argue reduced rate of penile cancer, and that is because there is less of it in a circumcised penis. They claim reduced rates of sexually transmitted diseases, such as HIV or HPV. We have similar rates of both compared to neighboring Mexico, where less than 20% of males are circumcised. The agony of a child undergoing a bloody, painful unnecessary surgery only two days after birth, is far more deleterious in my opinion than a cancer with an incidence rate of 0.5%. Ladies and gentlemen, we are coming short of “health benefits” to justify its continued practice among American newborns.
Purpose One of the essential purposes of the foreskin is to solidly protect the child from urinary tract infections, whereby only after the age of 4 or 5 once he is toilet trained, the foreskin naturally retracts. The sensitive skin covering the glans penis is comprised of epithelial cells different in structure than its tough outer layer, the foreskin, which imparts protection from the outside world. This in part helps maintain its ultimate sensory capabilities. In a circumcised penis, the glans skin toughens over time and continuous rubbing against clothing and touch. The transformation causes the glans to become less sensitive than an intact penis. Additionally, in its natural state, the penis fits into a woman’s body in such a way to consistently lubricate during intercourse. In a cut penis, there is constant need for artificial lubrication. The purpose of the foreskin is to prevent infections, and most importantly ensure both partners receive the highest sensory stimulation for successful mating. A definite purposeful design.
The Decision I know there are many people who are passionate about circumcising their healthy newborn sons, predominately based on cultural or religious reasons. To them I say, consider the sanctity of human choice. Delay the circumcision decision until the child reaches the age where he has maturity of decision making, a voice for himself. At least then, you have not taken the honor of bodily choice away from him.
Then, there are those parents who believe they want their sons to look like his father and peers, and to them I say, looking “different” will not matter given declining rates of circumcision in this country and worldwide. Plus, children nowadays don’t pay as much attention to their physical differences as they do their inward traits- a virtue we adults must take lesson from.
The cries of millions of newborn males in the history of circumcision deserve a moment of pause in our psyche. To pause and reflect if we are to continue to promote, practice and democratize this antediluvian act, how will it serve us?
1. Circumcision: A History of the World’s Most Controversial Surgery. David L. Gollaher, 2000. Google books
2.. Human Papillomavirus-Related Disease in Men: Not just a women’s issue. Joel Palefsky, MD
J Adolesc Health. 2010 Apr; 46(4 Suppl): S12–S19.
3. U.S. Circumcision rate drops over last 3 decades. Huffington Post, 4/2014.