In the US, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Urological Association recommends that physicians discuss circumcision on the basis of these protective benefits.
This is NOT JUST A COSMETIC PROCEDURE.
When circumcision is done as a routine procedure on infants, it is a cosmetic procedure. When done on a case-by-case basis it can offer benefits. I don't think anyone would argue that point. However, many circumcisions are performed later unnecessarily because our society is not accustomed to caring for an intact penis. Often, good hygeine and safe sexual practices greatly reduce if not altogether prevent many of these complications. Resources are available and the solution is usually much more simple than a surgical procedure.
Here's the AAP's stand on circumcision... "benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised." Members of the AAP Task Force on Circumcision reviewed nearly 40 years of medical research on circumcision before issuing the new recommendations.
It's not resonable to justify a routine surgery on a non-consenting infant because of what MIGHT go wrong. That's like becoming anorexic because you don't want to be obese. Yes, you might not develop some problems associated with obesity (diabetes, high blood pressure, etc.) but you are going to have an entirely different list of health complications/side effects. Where's the balance? Routine circumcision is overkill.
I read the statement from the AAP on the relationship between circumcison and squamous cell carcinoma of the penis and they said this " there have been few rigorous hypothesis-testing investigations", "This uncertainty makes analyzing the literature difficult","This study did not analyze in situ and invasive SCCP separately. This study also used self-report to determine circumcision status. Self-report may not be an accurate method of determining circumcision status.103"The relationship among hygiene, phimosis, and penile cancer is uncertain, although many hypothesize that good hygiene prevents phimosis and penile cancer.92 ","it is difficult to estimate accurately the magnitude of this risk based on existing studies."
It sounds like some more accurate studies need to be done.
http://aappolicy.aappublications.org/cgi/cont ent/full/pediatrics%3b103/3/686
Ultimately it's a decision you have to make and be prepared to stand by. I'm just not one to fix something unless there's something actually wrong. There is no disease on a perfectly healthy baby's foreskin. So there is no reason to cut it off.
It's unjustified if done solely as a preventative and the AAP does not support it as such. |
Original Post by neveraim:
my response to post #13 to simwaves1
from http://nocirc.org/articles/fleiss1.php
Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea,43 nongonoccal urethritis,44 human papilloma virus,45 herpes simplex virus type 2,46 and chlamydia.47
43. B. Donovan et al., "Male Circumcision and Common Sexually Transmissible Diseases in a Developed Nation Setting," Genitourinary Medicine 70 (1994): 317-320.
44. G. L. Smith et al., "Circumcision as a Risk Factor for Urethritis in Racial Groups," American Journal of Public Health 77 (1987): 452-454.
45. L. S. Cook et al., "Clinical Presentation of Genital Warts among Circumcised and Uncircumcised Heterosexual Men Attending an Urban STD Clinic," Genitourinary Medicine 69 (1993): 262-264.
46. I. Bassett et al., "Herpes Simplex Virus Type 2 Infection of Heterosexual Men Attending a Sexual Health Centre," Medical Journal of Australia 160 (1994): 697-700.
47. E. O. Laumann et al., "Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice," Journal of the American Medical Association 277 (1997): 1052-1057.
Again.......circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea,43 nongonoccal urethritis,44 human papilloma virus,45 herpes simplex virus type 2,46 and chlamydia.47
I guess if you choose to circumcise DESPITE all the medical reasons not to, you can rest assured that he won't develop squamous cell carcinoma of the penis. It makes sense...If I cut my liver out, I guess I won't get liver cancer either, but there are a lot more reasons NOT to do it than to do it.
(If my first child, now 11, had been a boy, she would have been circumcised...however, I've done a lot of research since then and a child of mine would only be circumcised over my dead body now. It's genital mutilation.
If someone decided to clip their baby's ears off because they like the way it looked, they'd be in prison or a mental institution. Why is it ok to slice a baby's genitals because 'it looks better'???
~A |
| this is from http://nocirc.org/articles/fleiss1.php
What Are the Foreskin's Functions?
The foreskin has numerous protective, sensory, and sexual functions.
- Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands-glands that produce the sebum, or oil, that moisturizes our skin.11 The foreskin produces the sebum that maintains proper health of the surface of the glans.
- Immunological Defense: The mucous membranes that line all body orifices are the body's first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme.12 Lysozyme is also found in tears and mother's milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin's outer surface.13 Plasma cells in the foreskin's mucosal lining secrete immunoglobulins, antibodies that defend against infection.14
- Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis.15 These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.16, 17, 18, 19, 20, 21, 22, 23
- Coverage During Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.
- Self-Stimulating Sexual Functions: The foreskin's double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.
- Sexual Functions in Intercourse: One of the foreskin's functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male's foreskin is missing.
- The foreskin fosters intimacy between the two partners by enveloping the glans and maintaining it as an internal organ. The sexual experience is enhanced when the foreskin slips back to allow the male's internal organ, the glans, to meet the female's internal organ, the cervix-a moment of supreme intimacy and beauty.
The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells.24 Researchers at the University of Manchester found that the human foreskin has apocrine glands.25 These specialized glands produce pheromones, nature's chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.
How Does Circumcision Harm?
The "medical" debate about the "potential health benefits" of circumcision rarely addresses its real effects.
- Circumcision denudes: Depending on the amount of skin cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.31 The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.
- Circumcision desensitizes: Circumcision desensitizes the penis radically. Foreskin amputation means severing the rich nerve network and all the nerve receptors in the foreskin itself. Circumcision almost always damages or destroys the frenulum. The loss of the protective foreskin desensitizes the glans. Because the membrane covering the permanently externalized glans is now subjected to constant abrasion and irritation, it keratinizes, becoming dry and tough. The nerve endings in the glans, which in the intact penis are just beneath the surface of the mucous membrane, are now buried by successive layers of keratinization. The denuded glans takes on a dull, grayish, sclerotic appearance.
- Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft. Hair-bearing skin from the groin and scrotum is often pulled onto the shaft, where hair is not normally found. The surgically externalized mucous membrane of the glans has no sebaceous glands. Without the protection and emollients of the foreskin, it dries out, making it susceptible to cracking and bleeding.
- Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin.32
Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection.33 The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.34
- Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine.35 This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.
Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid.
- Circumcision harms the developing brain: Recent studies published in leading medical journals have reported that circumcision has long-lasting detrimental effects on the developing brain,36 adversely altering the brain's perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.37 Developmental neuropsychologist Dr. James Prescott suggests that circumcision can cause deeper and more disturbing levels of neurological damage, as well. 38, 39
- Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither would a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.
The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped proto-mucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.
Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.
Female partners of circumcised men do not report a lower rate of cervical cancer,40 nor does circumcision prevent penile cancer.41 A recent study shows that the penile cancer rate is higher in the US than in Denmark, where circumcision, except among Middle-Eastern immigrant workers, is almost unheard of.42 Indeed, researchers should investigate the possibility that circumcision has actually increased the rate of these diseases.
Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea,43 nongonoccal urethritis,44 human papilloma virus,45 herpes simplex virus type 2,46 and chlamydia.47
- Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500.48 These complications include uncontrollable bleeding and fatal infections.49 There are many published case reports of gangrene following circumcision.50 Pathogenic bacteria such as staphylococcus, Proteus, Pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death.51, 52 These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.
Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.53,54,55 Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun.56,57, 58 The September 1989 Journal of Urology published an account of four such cases.59 The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicine described one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby.60 Many other similar cases have been documented.61,62 Infant circumcision has a reported death rate of one in 500,000.63,64
- Circumcision harms mothers: Scientific studies have consistently shown that circumcision disrupts a child's behavioral development. Studies performed at the University of Colorado School of Medicine showed that circumcision is followed by prolonged, unrestful non-REM (rapid-eye-movement) sleep.65 In response to the lengthy bombardment of their neural pathways with unbearable pain, the circumcised babies withdrew into a kind of semicoma that lasted days or even weeks.
Numerous other studies have proven that circumcision disrupts the mother-infant bond during the crucial period after birth. Research has also shown that circumcision disrupts feeding patterns. In a study at the Washington University School of Medicine, most babies would not nurse right after they were circumcised, and those who did would not look into their mothers' eyes.66
- Circumcision violates patients' and human rights: No one has the right to cut off any part of someone else's genitals without that person's competent, fully informed consent. Since it is the infant who must bear the consequences, circumcision violates his legal rights both to refuse treatment and to seek alternative treatment. In 1995, the American Academy of Pediatrics Committee on Bioethics stated that only a competent patient can give patient consent or informed consent.67 An infant is obviously too young to consent to anything. He must be protected from anyone who would take advantage of his defenselessness. The concept of informed parental permission allows for medical interventions in situations of clear and immediate medical necessity only, such as disease, trauma, or deformity. The human penis in its normal, uncircumcised state satisfies none of these requirements.
Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.
Organizations
Doctors Opposing Circumcision (DOC), 2442 N.W. Market Street, Suite 42 Seattle, WA 98107 206-368-8358 weber.u.washington.edu/~gcd/DOC/
The National Organization of Circumcision Information Resource Centers (NOCIRC), PO Box 2512 San Anselmo, CA 94979-2512 415-488-9883 www.nocirc.org
The National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM), PO Box 460795 San Francisco, CA 94146-0795 415-826-9351 www.noharmm.org
Nurses for the Rights of the Child, 369 Montezuma, Suite 354 Santa Fe, NM 87501 505-989-7377 http://nurses.cirp.org/
Books
Available from bookstores, from the publishers, or from NOCIRC.
Bigelow, Jim, PhD. The Joy of Uncircumcising! Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure and Human Rights. 2nd ed. Aptos, CA: Hourglass, 1995. [Out of Print]
Denniston, George C., MD, MPH, and Marilyn Fayre Milos, RN, eds. Sexual Mutilations: A Human Tragedy. (Proceedings of the Fourth International Symposium on Sexual Mutilations, Lausanne, Switzerland, 1996). New York: Plenum Press, 1997.
Goldman, Ronald, PhD. Circumcision: The Hidden Trauma: How an American Cultural Practice Affects Infants and Ultimately Us All. Boston: Vanguard Publications, 1997.
Goldman, Ronald, PhD. Questioning Circumcision: A Jewish Perspective. 2nd ed. Boston: Vanguard Publications, 1997.
O'Mara, Peggy, ed. Circumcision: The Rest of the Story-A Selection of Articles, Letters, and Resources 1979- 1993. Santa Fe, NM: Mothering,1993.
Ritter, Thomas J., MD, and George C. Denniston, MD. Say No to Circumcision! 40 Compelling Reasons Why You Should Respect His Birthright and Keep Your Son Whole, 2nd ed. Aptos, CA: Hourglass, 1996.
Video
Whose Body, Whose Rights? Examining the Ethics and the Human Rights Issue of Infant Male Circumcision. Award-winning documentary. 56 min. VHS. Personal use: VideoFinders, 1-800-343-4727
Educational facilities
UC Center for Media and Independent Learning 2000 Center Street, 4th Floor Berkeley, CA 94704 510-642-0460.
For World Wide Web ordering and preview: www.cirp.org/pages/reviews/whosebody/
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