The decision to circumcise or not to circumcise

My wife and I are at the point in our pregnancy where we need to let our OB/GYN know if we are planning to have our son circumcised. Making this decision has been very difficult for us and we have been seeking the guidance of as many resources as possible. We’re not religious and don’t have any cultural reasons to do it. We’re a lesbian couple, so there’s no need to emulate the father figure.

So far, we have consulted our What to Expect When You’re Expecting book, Medline Plus, FamilyDoctor.org, KidsHealth.org, various male friends and several other resources in both print on and on the Web. Here’s the gist of what we’ve found:

Circumcision is performed for health reasons. We’ve heard the advantages, including statements from the American Urological Association of slightly lower risk of Urinary Tract Infections (UTI) and cancer of the penis (which is very rare) in circumcised men. And we’ve also heard about the disadvantages, like the unnecessary risk of an elective surgery.

Circumcision prevents STDs. KidsHealth.org posts that “Some studies indicate that the procedure might offer an additional line of defense against sexually transmitted diseases (STDs), including HIV.” Talking to our son about sex and teaching him the importance of using protection is a top priority for us. Although circumcision is an “additional line of defense,” the condom should be the first-line.

Circumcision is the norm. As one of our male friends joked, “He has two moms, do you want him to get made fun for his penis too?” Research says, though, that our son may not be the only boy in the locker room with foreskin. According to the National Center for Health Statistics, within the Western region of the United States (where we live), “newborn circumcisions dropped from 62 percent in 1980 to 37 percent in 1999.” Similarly stated on KidsHealth.org, “Approximately 55% to 65% of all newborn boys are circumcised in the United States each year, though this rate varies by region (western states have the lowest rates and the north central region has the highest).”

With all that said, we’re leaning towards not circumcising our son. As stated on FamilyDoctor.org, “The American Academy of Pediatrics (AAP) says the benefits of circumcision are not significant enough to recommend circumcision as a routine procedure and that circumcision is not medically necessary.”

Ultimately, we’d like to leave the decision up to him. I know, I know…what man wants to get their foreskin cut off later in life? See, even though we're responsible for making decisions on our son’s behalf until he is old enough to do so, we feel that those decisions should be based on reason and supporting evidence. From what we have gathered, there isn't sufficient evidence to make a strong case for circumcism, so we feel comfortable leaving it up to our son later in life.

Comments

You might also want to check

anonymous's picture

You might also want to check out the following:

Canadian Paediatric Society
http://www.cps.ca/english/statements/fn/fn96-01.htm
"Recommendation: Circumcision of newborns should not be routinely performed."

http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
"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."

Royal Australasian College of Physicians
http://www.racp.edu.au/download.cfm?DownloadFile=A453CFA1-2A57-5487-DF36...
"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
http://www.bma.org.uk/ap.nsf/Content/malecircumcision2006?OpenDocument&H...
"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)
http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=649
"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."

Drops in male circumcision:
USA: from 90% to 57%
Canada: from 47% to 14%
UK: from 35% to about 4% (less than 1% among non-Muslims)
Australia: 90% to 12.6% ("routine" circumcision has recently been *banned* in public hospitals in all states except one, so the rate will now be a lot lower)
New Zealand: 95% to below 3% (mostly Samoans and Tongans)
South America and Europe: never above 5%

If our son wants to be circumcised when he's 18 (16 if he knows what he's doing), I'll pay for it and help him find a good surgeon. Until then, he stays intact. His body - his decision. If he wants to be circumcised later, it's easy to fix - safer, less painful, and better cosmetic results. If we'd had him circumcised, and he wanted to be intact, it's a problem.

The decision to circumcise or not to circumcise

anonymous's picture

Congratulations on your very wise decision to leave your son intact. All that you said is true, although you left out several important and valid reason to leave sons intact. Foreskin really does have a purpose and function (Check out http://www.doctorsopposingcircumcision.org for a video explanation of the prepuce). Your adult son will some day thank you for leaving him whole.

There are more reasons than pain-avoidance to explain why intact men don't all run out and get themselves circumcised on their 18th birthday. And those are the same reasons why tens of thousands of cut men spend years using non-surgical methods to restore their own foreskin.

We should not consider circumcising our sons any more than we consider circumcising our daughters, which used to be done, and is now illegal in the U.S.

stand firm

anonymous's picture

I have two sons one with and one without a circumcision. It has never been an issue for either one of them and I was never asked why they looked different from each other. Everyone is different. Stand firm. Do not get your son circumcised.

As far as telling the medical people now about your decision, it is just another way to pressure new parents. Rest assured, it you tell them no now and change your mind the surgery will happen. The same goes if you say yes now and change your mind you can!

Good luck

great decision!

anonymous's picture

You guys are doing a great job! Keeping the baby whole is the best decision for your child and you will never regret it! ;) My husband is circ'ed and after long research we decided to keep our son intact as circumcision is not our decision to make. I also want you to congratulate you and good luck in the new parenting world! :)

Wonderful decision!

anonymous's picture

Eleven Common Misconceptions About Circumcision and the Intact Male.

MYTH 1: Circumcision protects boys from developing harmful medical problems.
TRUTH: NO medical society in the entire world, including the USA, recommends routine infant circumcision. Circumcision does NOT:
-prevent infections
-prevent or reduce the occurrence of urinary tract infections
-prevent penile cancer
-prevent transmission of the AIDs virus
-prevent the transmission of STDs
There are absolutely no medical reasons to circumcise infant boys. EVERY medical association in the entire world, including the American Academy of Pediatrics (AAP) and American Medical Association (AMA), has made statements that routine infant circumcision provides no medical benefits and is a non-therapeutic operation. Infant circumcision is purely cosmetic and has been falsely justified as having “medical benefits” thanks to a history of flawed studies performed by doctors who have tried to justify the tradition for over a century. In fact, circumcision has been fabled to protect against more illnesses than any other single surgical procedure. View the last link, a video about the “medicalization” of circumcision, for more information about this. More recent studies have now proven that foreskin actually protects against UTI and other infections.
http://www.askdrsears.com/html/1/t012000.asp
http://www.cirp.org/library/statements/
http://www.nocirc.org/statements/breastfeeding.php
http://www.youtube.com/watch?v=f4unKTMpBGA

MYTH 2: Having an intact boy means more work and extra cleaning to prevent infection.
TRUTH: It is actually easier to care for an intact boy. Only clean the exterior of an intact boy, a swish in the bath is sufficient. People are severely misinformed about the anatomy of foreskin. During the infant/childhood years the foreskin is fused to the head of the penis and the opening is only wide enough to allow for urine to pass through. This protects the developing penis from urine, feces, and other harmful pathogens. An intact boy should NEVER be retracted for cleaning or for any other reason. Premature retraction causes tearing, pain, and can result in many complications, including infection. The proper care for the intact penis is to LEAVE IT ALONE, only the exterior gets cleaned. Should poop get on the penis, all you do is wipe it like a finger. Throughout childhood the skin will slowly separate from the glands and the foreskin opening will widen. Self-cleaning excretions prevent the need for cleaning during that time. Through self-discovery a boy will learn to retract his own foreskin. After retraction is possible a boy can easily clean himself with a quick rinse in the same way that girl cleans her privates. It is a good rule of thumb to never let anyone touch your intact son’s penis. Many people, including care providers, will ignorantly try to retract the foreskin. Fact is, the US medical profession cut off so many foreskins in the past that the doctors rarely if ever saw an intact boy and have lost the base of knowledge of diagnosis and treatment. Now, they are operating in a vacuum of information or even worse, in an environment of false information. The only tool you need to care for an intact boy is a ruler to smack the hands of those curious people who attempt to retract his foreskin. Retraction happens at a different times for each boy. Some boys do not retract until puberty, this is perfectly normal.
http://www.nocirc.org/publish/pamphlet4.html
http://www.nocirc.org/publish/pamphlet6.html
http://www.cirp.org/library/normal/aap/
http://www.cirp.org/pages/parents/peron1/

MYTH 3: If I don’t circumcise my son he will be ridiculed in the locker room.
FACT: 85% of the world is intact. In the US the circumcision rate is 56% and falling, so almost half his peers will have foreskin. In general boys make it a point to not look at other boys’ penises. They are not interested in whether someone is intact or not and it is safe to say that most people will never even see your son’s penis. When intact boys learn that some baby boys have their foreskins cut from them at birth and that you protected them from being circumcised, they are thankful and find it shocking that anyone would do that to a baby. Their reaction is one of pity for circumcised boys. A friend’s intact son learned about circumcision when he was about 5 years old. His response was, “OUCH, why would anyone want to do that?!?” Lastly, children will always find something to poke fun at. With positive reinforcement from his parents that his body is normal, whole, and healthy, an intact boy will be able to keep a healthy perspective should he ever encounter a problem with his peers.

MYTH 4: If a father is circumcised then he must circumcise his son to “match”.
FACT: If this were the case then all amputees would have the limbs of their children removed at birth. Children are not carbon copies of their parents. A father should teach his son to appreciate and feel good about his own body. If a boy questions his father as to why his penis looks different, parents can respond with a simple, truthful, and age-appropriate explanation. Here is a good example for a young child:
“Long ago people used to think it was good for babies to cut part off. When I was a baby Grandma had it done to me because she did not know any better. Now we know it hurts babies a whole lot, so Mommy and I decided not to ever let anyone do that to you”.

After explaining to you protected him from being cut down there, he will be thankful! Truthfully, a little boy is much more likely to question why Daddy has hair down there, it is a much more obvious difference. Besides, you already have to explain why Mommy is different, don’t you?
http://www.mothersagainstcirc.org/Like-Son.htm
http://www.circumstitions.com/Father.html

MYTH 5: The foreskin has virtually no functions so it doesn’t matter if it is cut off or not.
FACT: The foreskin is extremely functional. The skin that becomes the foreskin on men is the same skin that becomes the clitoral hood and the inner labia on women. and shares many of the same functions. Like female circumcision, male circumcision impairs the sexual function of its victims by removing erogenous tissue that is designed to enhance sexual pleasure. The foreskin includes the frenulum, the ridged band of nerves, and thousands of specialized nerve receptors that are an essential part of male genital anatomy. The foreskin itself is composed of completely different tissue than any other portion of the penis. The cells in tissue has been proven to provide both sensory an protective function. The male foreskin is designed to protect the glans of the penis throughout a man’s life, ensuring that the internal mucosal tissue remains moist and sensitive (much the same way that a woman’s clitoral hood protects the clitoris). In addition, the foreskin acts as a natural gliding mechanism to reduce chafing and dryness during intercourse. During an erection, the shaft of the penis becomes fifty percent (50%) longer. Where does the skin come from to cover that longer shaft? From the foreskin of course. And there is still some left to move loosely over the body of the penis, reducing friction during sexual intercourse, as nature intended. The total amount of tissue removed is the equivalent of 15 square inches on an adult male and contains over 20,000 nerve endings.
http://www.cirp.org/pages/parents/lostlist/
http://www.sexasnatureintendedit.com/
http://www.circumstitions.com/Functions.html
http://www.doctorsopposingcircumcision.org/video/prepuce.html (video)

MYTH 6: Circumcision is a quick and relatively painless procedure with little to no risk.
FACT: Circumcision is a surgery that involves strapping a baby to a table straight limbed (this in itself is very traumatic), jamming a probe under the foreskin to tear it from the glands (remember it is fused during childhood), making a dorsal crush, cutting a slit down the foreskin, then slicing it away from the entire head of the penis, and then trimming the uneven surfaces. Male circumcision is actually longer and more involved than most forms of female circumcision. The entire head of the penis is left bloody and raw. There is a 20%-30% complication rate ranging from mild to severe. Complications of circumcision include: infection, excessive bleeding, removal of too much skin, need for corrective surgery, buried penis, adhesions, skin bridges, meatal stenosis (narrowing of urinary opening), meatal scarring or ulceration, damage or loss of other areas of penis, and even death. However, the risks of this surgery should not be confused with the guaranteed consequences. EVERY circumcision results in the loss of a healthy and functioning foreskin, causing detrimental changes to sexual function and reduced sexual sensations.
There IS pain even if the infant receives anesthetic, although, anesthetic is used LESS than 20% of the time in the US. Most infants only receive a sugary pacifier! During circumcision, an infant will experience such incredible pain that he will scream, become stiff and rigid, and then eventually go into neuro-genic shock causing him to pass into a deep sleep. This is the body’s coping mechanism to handle the intense pain he is experiencing. It is said that due to the immature nerve receptors that the pain an infant feels is actually more intense than what an adult would feel. If you have ever spoken to a victim of female circumcision they will tell you that the pain is indescribable. Nurses that work in the nursery are told to tell parents that the baby either didn’t fuss much or that the baby slept through the procedure. Nurses are not allowed to return an infant to his parents until he has calmed if he did not pass into sleep due to the shock during the procedure. New studies are now reporting that circumcision also interferes with breast feeding due to the trauma and even prevents some babies from ever establishing a breast feeding relationship.
http://www.cirp.org/library/procedure/plastibell/
http://www.circumcision.org/response.htm
http://www.cirp.org/library/pain/
http://www.circumstitions.com/Complic.html
http://www.circumstitions.com/Docs/nursing.pdf

MYTH 7: If I don’t circumcise my son, it may need to be done later in life. I’ve heard of some 5-10 year old boys having to be circumcised.
FACT: The only reasons to amputate the foreskin, or any other body part for that matter, would be in the case of frostbite, gangrene, malignancy, or serious trauma. This misconception is another that stems from an epidemic of US doctors that are not educated about the normal development of the intact penis. Doctors that do not know about the anatomy and development of the foreskin often prescribe circumcision for a multitude of incorrect “reasons”. For example if a 10 year old boy is not retractable a doctor might tell a parent that he needs to be circumcised. This is not true. In fact, only 50% of boys are retractable by age 10. Many boys do not become retractable until puberty. This is normal. In the rare event that a man is not retractable by adulthood, there is steroidal cream that can be applied which will allow the skin to stretch. Amputation is not necessary for this rare condition. Infection is another “reason” that doctors ignorantly prescribe circumcision. The foreskin is NO more likely to become infected than any other part of the body. In the rare chance that there is an infection, antibiotic ointments are sufficient. Parents that complain of repeated infection are almost always parents that are trying to retract their child’s foreskin for “cleaning”. As stated before, there is not reason to try to clean under a boy’s foreskin. Trying to “clean” under the foreskin is the equivalent to trying to wash out a girls vagina. It will ultimately cause a flora imbalance and result in infection. Only warm water should be used around a child’s genitalia; soaps and bubble baths can cause irritations. Also, doctors must do a culture by swabbing the exterior, if infection is suspected to determine whether it is yeast or bacterial. If you use an antibiotic ointment on a yeast infection you will undoubtedly make the yeast infection worse. During the diaper-wearing years or after a round of oral antibiotics yeast infections can occur in both boys and girls. Yeast infection has nothing to do with the foreskin itself and is easily treated with an OTC monistate cream.
http://www.nocirc.org/publish/pamphlet7.html
http://www.mothering.com/articles/new_baby/circumcision/protect-uncircso...
http://www.doctorsopposingcircumcision.org/pdf/2008-03retractileforeskin...
http://www.cirp.org/library/normal/

MYTH 8: The medical industry has no interest in continuing circumcision.
FACT: Circumcision is a 400 billion dollar (per-year) business. Not only do hospitals and doctors profit from the 3,000 circumcisions that are performed each day, but that precious, nerve-rich foreskin actually being sold for use in skin grafts, medical testing and cosmetics. Talk about robbing Peter to pay Paul! In light of the fact that circumcision is classified as an unnecessary (non-therapeutic) surgery, insurance companies and medicaid in some states are now refusing to pay for it. Finally, a step in the right direction!

MYTH 9: If you are Jewish then you must be circumcised.
FACT: The only requirement to being Jewish is that one’s mother must be Jewish. There is a growing community of Jewish citizens who strongly oppose infant circumcision and reject it as a practice of Judaism. These Jews offer a “Brit Shalom” naming ceremony in place of the “Brit Milah”.
http://www.jewsagainstcircumcision.org
http://www.cirp.org/library/history/peron2/
http://www.mothering.com/articles/new_baby/circumcision/my-son.html
http://www.circumstitions.com/Docs/britwm.pdf

MYTH 10: Christianity does not address circumcision.
FACT: Christianity directly protests infant circumcision. ~Phil. 3:2 "Beware of the dogs! Beware of the evil workers! Beware of the mutilation! For WE are the true circumcision, who worship in the Spirit of God, and glory in Christ Jesus, and put NO confidence in the flesh!" ~Gal. 5:3 "And I testify again to every male who receives circumcision, that he is in debt to keep the whole Law. You who do so have been severed from Christ. . . you have fallen from grace." ~Gal. 5:2 "Behold, I Paul, say to you that if you become circumcised, Christ will profit you nothing!" ~Gal. 6: 12-16 "Those who desire to make a good showing in the flesh try to compel you to be circumcised, simply that they may not be persecuted for the cross of Christ. . . They desire to have you circumcised so they may boast in your flesh. . . " ~Lev.19:28 "You shall not make any cuts in your flesh." ~Deut. 23: 1 "No one who...has his male genitalia cut off shall enter the assembly of the Lord." "I desire mercy and not sacrifice."-Jesus (Matt. 9:13)
http://www.stopcirc.com/christian.html
http://www.circumstitions.com/Xy.html
www.CatholicsAgainstCircumcision.org

MYTH 11: If I unknowingly circumcised my son so I must support circumcision.
FACT: It is never too late to save babies. When people know better, they do better. Parents who learn the truth about circumcision after already having circumcised their children can still educate their own children and others as to the harms of circumcision. As parents, we do the best we can with the knowledge we have. Sadly, many of our care providers have failed to provide us with the information necessary to make informed decisions with regards to circumcision. It is important to remember that admitting to having made a mistake does not make anyone a bad parent. Saving other babies from harm can be a source of healing for parents in this situation. In fact, these Intactivist can provide powerful testimony to expecting parents and they and are vital to the fight for genital integrity for both men and women in our country. There are also support groups to help parents who regret circumcising. It takes a strong and wise person to admit their errors, we need these people in our fight to save babies.
http://www.mothering.com/discussions/showthread.php?t=112410

SUMMARY: Do not circumcise your baby boy. If at the age of 18 he would like to be circumcised, he has that option, but it is HIGHLY unlikely that he would choose circumcision. Less than 1 in 500 intact, adult males choose to lose their precious foreskin because they KNOW what they would be missing. Bottom Line: HIS BODY, HIS CHOICE.

ADDITIONAL RESOURCES:
Circumcision Decision, a Nationally Televised Public Service Announcement: http://video.google.com/videoplay?docid=-5395565256830319025&hl=en
Circumcision Information and Recourses: www.cirp.org
National Organization for Circumcision Information and Recourses Center (NOCIRC): www.nocirc.org
Doctors Opposing Circumcision (DOC): www.doctorsopposingcircumcision.org
National Organization to Halt the Abuse and Routine Mutilation of Males: www.noharm.org
Intact America: www.intactamerica.org
Penn and Teller Video: http://video.google.com/videoplay?docid=-2577091532653693892
Top 12 Reasons to Say “No” to Circumcision: http://www.naturalfamilyonline.com/5-bc/64-no-to-circumcision.htm
Circumstitions: www.cirucmstitions.com
Information for Daddy to be (also have him see the Penn and Teller video): http://www.infocirc.org/MensHlth.htm
National List of Foreskin Wise Pediatricians: http://www.thecaseagainstcircumcision.com/index.php?topic=18.0
2008 Male Genital Mutation Bill: http://www.mgmbill.org/
Ask Your Questions Here: http://www.mothering.com/discussions/forumdisplay.php?f=44

While I commend the decision

anonymous's picture

While I commend the decision to let your son choose what kind of penis he will have to live with (as I commend parents who let their daughters choose what kind of vulva they will live with), i'm surprised that you've not even brought up the issue of sexuality.

It is well established that the foreskin contains erogenous tissue (a fact that even circumcised males can verify by observing how good their frenular remnants feel when stimulated). Ask any intact male how important his frenulum is, and you'll get a sense of what most circumcised males are missing. Why didn't you mention this fact?

Now, if your son, later in life, decides that his orgasms are a bit too intense, and that he wants to have loads of promiscuous and unprotected sex, and doesn't want to shower more than once a week, then at least you've given him the ability to make that choice.

It is fundamentally horrifying to remove sexual tissue from a nonconsenting human, female OR male, unless absolutely medically necessary.

Important Info

anonymous's picture

Now that you have decided to protect your son's genital integrity, please keep these on hand to protect him from doctors that may not understand the development of the intact boy. Print them out and keep for reference.

Protect Your Intact Son, Expert Medical Advice:
http://www.mothering.com/articles/new_baby/circumcision/protect-uncircso...

The Intact Boy:
http://www.nocirc.org/publish/pamphlet4.html

Development of Retractable Foreskin in a Child/Adolescent:
www.doctorsopposingcircumcision.org/pdf/2008-03retractileforeskinleaflet...

Avoiding Circumcision After the Neonatal Period:
www.nocirc.org/publish/pamphlet7.html

Care:
http://www.asnatureintended.info/uploads/1/5/3/9/1539174/babyboy.pdf

Most importantly: Remind all care providers and doctors before each exam not to manipulate the foreskin in any way. Simply say, "Please don't touch my son's foreskin". There is nothing a doctor needs to check in there. The foreskin should not be manipulated in any way shape or form. Also remind all babysitters not to manipulate the foreskin and to wipe like a finger if it gets anything on it.

Best of wishes!,
jen

...leave the decision up to him

anonymous's picture

You've hit the nail on the head:

"What man wants to get their foreskin cut off later in life?"

Exactly. Very, very few do. Who would elect to have the moving parts (and the most sensitive parts!) of their penis removed???

If you wouldn't consider circumcising your baby daughter, you shouldn't consider circumcising your baby son. They're simply variations of the same sick and cruel custom.

Please, do the right thing and protect your son from the ethically-challenged and money-grubbing circumcisers.

Very best wishes to your growing family :)

Brava!

anonymous's picture

"What man wants to get his foreskin cut off later in life?" EXACTLY! Why do something to him he's not going to want done later - indeed, something he may bitterly resent? And he'd have every right to, since the foreskin is the most sensitive part of the penis (and it's not just more sensitive, but better sensitive: getting circumcised in adulthood has been compared to going colour-blind). Even if it weren't, he has a basic right to such an intimate decision about his own body. If Scandinavia is anything to go by, the chances of him actually needing it done later are well under one in a thousand.

And STDs? A study from New Zealand, where circumcision was once nearly universal and is now nearly unknown, showed no difference.

So congratulations on your decision. Another resource (not unbiased, but it looks at the topic from many angles) is the Intactivism Pages, www.circumstitions.com

Thanks!

anonymous's picture

Your son will probably not thank you for this, because I just don't think a lot of guys go around thanking their moms (or dads) for their penile status.

BUT he will be grateful nonetheless! Thank you for leaving the decision up to him!!!

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