Saturday, June 2, 2012

Parents choosing to circumcise their children - your child might not forgive you

Parents choosing to circumcise their children should consider carefully the benefits and risks of the procedure. Many times the hospitals and doctors will delicately omit the information on the risks, and the consent form provides very generic information. In fact, most literature about circumcision will tell you that the risks are rare:

All surgical procedures have risks. Problems after circumcision are not common. Minor problems are short-term and may include:
  • Oozing or slight bleeding from the surgical site.
  • Infection of the circumcision site or at the opening to the urethra.
  • Irritation of the exposed tip of the penis (glans) as a result of contact with stool or urine.
Long-term minor problems can include:
  • Damage to the opening of the urethra, which leads from the bladder to the tip of the penis (meatal stenosis).
  • Scarring of the penis from infection or surgical error. For example:
    • The entire foreskin may not be removed, leaving portions of it attached to the penis (skin bridge). This may cause pain during erection.
    • Scar tissue can grow outward toward the tip of the penis from the cut edge of the foreskin. Repeat surgery on the penis may be required to improve appearance or to allow normal passage of urine if the opening from the bladder has been blocked by this scar tissue.
    • The outer skin layer (or layers) of the penis may be removed accidentally.
    • An opening that is too small for the foreskin to retract over the penis (phimosis) can happen if too little foreskin is removed.
  • Major problems are very rare but can include:
    • A complete removal of the skin covering the shaft of the penis, causing the penis to appear to have been completely surgically removed.
    • Too much bleeding. Stitches may be needed to stop the bleeding.
    • Serious, life-threatening bacterial infection.
    • Partial or full removal (amputation) of the tip of the penis. (This is extremely rare.)


While this is actually a good disclosure of problems, the list is not complete. Things that are missing, especially because they might be consequences of things already listed but unless someone tells you that you may not know them until it's too late:

  • Your child may die. One possible reason is too much bleeding. When it comes to babies, too much means 1 to 2.6 ounces of blood. It won't leak from the diaper. It will just look slightly pink every time that you change the diaper. But 1 ounce of blood is enough for your baby to go into shock, and 2.6 ounces mean that  his organs will start shutting down and he will die. It happens. Around 100 babies die every year in the U.S.
  • Another reason for dead is infection. Especially in the case of religious circumcision, in some versions of the brit milah, the Mohel sucks the blood from the open wound with his lips. This has lead to babies infected with herpes and dying from it. See:
  • Of course every surgery has risks, and 100 dead babies among 2.8 million circumcised babies per year might not look like a lot (1 in 25,000) - It's actually more than I thought- but believe me, if it's your baby this rate is not going to be consolation.
  • Your baby may lose his penis. There is such thing as necrosis of the penis, which can happen as a consequence of an infection or with the use of electrocautery devices to control bleeding. In this cases the penis or most of it has to be amputated. Sometimes it is possible to reconstruct it later. Whether it will be functional or not, depends from the treatment. Imagine as a parent explaining to your child why he doesn't have a penis or why he has to have several surgeries there.
  • Your baby may lose the glans or part of it. Accidents happen. Sometimes improper use of the devices lead to cutting the tip of the glans or all the glans. Sometimes it can be reattached. Sometimes it can't. This will definitively affect your child's sexual life as an adult.
  • Your baby's sexual life might end up being painful. A too tight circumcision will result in his penis not having enough skin for a normal erection. Erections in this case will always be painful. Everybody loves sex. Imagine your son experiencing pain during what should be one of the most beautiful moments of your life.
  • While there is debate on this (which is only the result of ignorance and failing to listen -there shouldn't be debate, the jews have known since old age that this is at the core of circumcision), all successful circumcisions will reduce the ability of your son to feel pleasure. Notice I didn't say he won't feel desire or he won't feel pleasure. He will feel pleasure... just not as much or as special as it could have been. I'm not going to go deeper into this. Another post will talk more about it. But for now believe me, there are good reasons to assert it based on testimonials from people circumcised as adults, based on testimonials of people practicing foreskin restoration, and based on the study of the anatomy of the foreskin.
  • Pain! Many circumcisions are performed without anesthesia. Those that are, don't always have enough anesthesia or enough time for it to work, after all you don't want too much anesthesia on a baby. The healing days will be very painful. Perhaps they won't remember the pain when they grow up, but you will. Sometimes doctors and mohels will tell you that the baby will just go to sleep after crying a little bit. Oh that's no sleep: that's neurogenic shock. When the mind can't handle more pain, it closes into shock.  Read:
  • Finally, something important to know as a parent: Your child might not forgive you for cutting him! It may take years before he learns the reality of what was done to him, but it is true that there are many men who wish they had not been circumcised. The treatment, once done is irreversible. Is it really important to do it when your baby cannot sit down with you and discuss the pros and cons? It's his body after all. A growing number of people are making this their slogan: HIS BODY, HIS CHOICE. Some people think it's a violation of human rights to take the decision to cut his body when he cannot consent, after all at that age there is no life threatening situation that needs to be taken care of, so why rush?
The benefits of circumcision are more debatable than the risks: 
  • Hygiene. To understand this as a benefit you have to think why it started: to prevent masturbation, so the goal was to prevent children from having to touch their penis. By associating the penis with pain and by not having to clean their penis, they had reasons not to touch it, so they would not masturbate, at least that's what the deviant mind of some doctors of the early 20th century thought (i.e. J.H. Kellogg). In reality, cleaning an intact penis is just a matter of taking it with you when you take a shower.
  • Less STDs. Well, not really. It's just that they would be less noticeable without the foreskin. In fact, now that Mr. Bill Gates and his association are promoting circumcision as a way of preventing HIV, they are doing a bad service to the world: first, circumcision MAY reduce the risk of infection from an infected female to a healthy male during unprotected sex. However, the risk remains very high. It's not a 99% safety. Condom is still necessary. What's worst, it may create a false security, when in fact it won't prevent the transmission of HIV from male to male or from an infected male to a healthy female. But the male might pressure the partners into unprotected sex thinking that the circumcision will insure safety.
  • Preventing UTIs. Well maybe. But they are usually very easy to treat. Compare to the possible risks and see if it's worth it.
  • Preventing phimosis. There are less intrusive treatments for phimosis, such as manual stretching and steroid creams. Besides, phimosis cannot be diagnosed in minors. Now it is considered normal that the foreskin won't retract until the teenage years.
  • Preventing penile cancer. First, penile cancer is very uncommon. If it happens in one in 100,000 males, then the benefit is severely out-weighted by the 1 in 12,500 rate of death after circumcision."
  • Reducing risks of cervical cancer in female partners. The studies are not conclusive, and general good hygiene and safe sex reduce the risk anyway.
My conclusion:

I chose not to circumcise my son. Even then I didn't have as much information as I do now. If I was to be in that position again I would have to wonder:

  • If my baby dies as a result of circumcision, will I be able to forgive myself?
  • If my baby ends up mutilated or with a disfigured penis because of the procedure, will I be able to explain it to him?
  • If twenty or thirty years from now my baby demands an explanation on why I chose to circumcise him, will I be able to justify myself? Will I be able to offer an apology?

What a disfigured penis looks like?

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