A Note to the Reader: I have provided a number of links and references in this article. I have viewed all of these links myself. Most do not contain images of the faces of infants, or pictures that may otherwise be severely upsetting. That being said, everyone has different emotional reactions to different visuals. Please keep this in mind when you follow a link: the material may or may not elicit a strong response for you.
To circumcise or not? That is one of the most important questions that mama’s who have boys will need to answer. I have my own opinions on the matter; however, I have written this article in an effort to help you make your own decision, regardless of what I chose for my sons. I will address as many aspects of the circumcision as I can, while providing you with links to articles and studies that pertain to circumcision. I hope that this article will help you to make your own informed decision. As with everything, your decision should be informed not just by your opinions, but by your investigation of all aspects of the subject.
Circumcision (in males,) is the removal of the foreskin that covers the head of the penis. The practice of circumcision has historical and religious roots, though many parents who chose to circumcise their sons today do so because the father is circumcised, or they believe that this is routine care. This procedure is typically performed in the hospital within days of birth. The newborn is placed in this device to keep him from moving. Since general anesthesia is not recommended for neonates, they are conscious throughout the entire procedure. Many doctors will administer a DPNB or a lidocaine injection for local pain relief; however, not every doctor will utilize these forms, or any form of pain relief (though some form of analgesia is recommended by the American Academy of Pediatrics, American Medical Association, and World Health Organization. There are three common methods of circumcision today. The Plastibell, the Gomco clamp and the Mogen clamp. The Plastibell works by cutting off blood supply to the foreskin which will eventually necrotize and fall off along with the Plastibell in about 4-6 days. The Gomco clamp is applied once the foreskin has been cut and opened up. It is then inserted and remains while the foreskin is cut away. The Mogen clamp is similar to the Gomco clamp: the foreskin is stretched, the Mogen clamp is inserted and locked, and then the foreskin is cut away. More details on the specifics of each procedure can be found on the links.
There is also female circumcision; however, it can be one or a combination of any of the following:
- Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
- Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina).
- Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
- Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.” (Taken from the World Health Organization website).
A Google search on female circumcision will yield results mostly about female genital mutilation. Even though both male and female circumcision have historical and religious roots, female circumcision is more widely discouraged than that of males. The World Health Organization states that there are no health benefits to any of these procedures for females.
Why would anyone circumcise? Circumcision has a history in many cultures, for primarily religious reasons. The basic idea was to represent a sacrifice during a time of transition into adulthood. Circumcision was not historically practiced on infants until the American medical community began to view the procedure as a preventative health measure. In the Victorian era, circumcision was also viewed as a preventative measure for masturbation and deviant sexual behaviors. Currently, it is classified by the American Medical Association as an elective medical procedure aimed at preventing possible infections and diseases.
Circumcision has been purported to prevent or reduce the risk of nearly every sexually transmitted disease at one point or another. There have been numerous studies that test the validity of this hypothesis; however, very few can produce data that irrefutably supports these claims. Most of the studies cite limitations such as a sample group size and diversity. Conclusions drawn from these studies often indicate that circumcision may A recent article published discusses how HIV transmission rates were not reduced enough to recommend circumcision as a preventative measure. A Google, or Google Scholar search will yield hundreds of studies for you to look for more information on these.
Another concern is hygienic. Many doctors and medical professionals feel that the circumcised penis is less likely to trap and cultivate various pathogens and dirt. Opponents of this view (and many uncircumcised men) retort that proper hygiene and care of the uncircumcised penis is necessary as with any other part of the body (and that it is not any “extra work.”) They also contend that if the foreskin was such a dangerous appendage, millions of years of evolution should have eliminated it from all primates as well as humans. While the American Academy of Pediatrics, World Health Organization, and American Medical Association explicitly state that they do not feel that there is a medical reason to recommend routine newborn circumcision, it is still practiced as routine care and approximately 56% of newborns in America are circumcised, while only a third of the world’s male population over 15 years of age are circumcised, (68% of which are Muslim,) (Collier, 2011).
Another point to consider is the impact on a man’s sexual experiences. The foreskin contains many nerves, and intact men tend to report that they are more sensitive than men who are circumcised. This is not surprising given that intact men have more nerve endings, and thus will be picking up on more sensation. Some men who were circumcised as adults report a decreased sensitivity during sexual activity. Some of these men felt that the decreased sensitivity was preferable because they were able to engage longer in sexual activity; however, it should be noted that others were not happy about the loss of sensitivity. There were also men who report that they did not have a decrease in sensitivity. Many women who have had sex with both circumcised and uncircumcised men report that sex with a man who is intact is different, and significantly more pleasurable. This led Kristen O’Hara to write a book “Sex as Nature Intended It” with her husband Jeffrey. The website has a great deal of explicit content and is obviously opinionated, though when I asked my uncircumcised husband to reflect on the site and its claims, he completely agreed.
2.3 ounces of blood have lost a critical amount of blood-which significantly increases the risk of death.
This brings me to another point to consider; by circumcising boys at birth, are we committing an act of genital mutilation and robbing them of their right to make choices about their body? Many groups feel that this is the case and argue that claims of hygiene, disease prevention, and religious rights are simply ways of trying to avoid the truth. Men within these organizations often indicate that they feel they should have had the right to decide if they wanted to be circumcised, rather than having the decision made for them. Even some doctors contend that treating genital modification differently among the sexes is discriminatory, and that male circumcision is a violation of the rights of the newborn.
Opponents of circumcision bring up two other important issues to consider. First, newborn babies can feel pain, and a number of studies support this. There are also studies that support the idea that infants who did not receive analgesia during circumcision had a higher pain response during routine vaccinations. Historically, it was thought that babies could not feel pain, or that the pain felt as a newborn was not as significant. Ask any nurse or doctor who has performed or assisted in a circumcision what the baby’s reaction to the procedure (without analgesia) is and the response will likely include “a scream/cry that peels paint off the walls.” Studies on cortisol levels (the stress hormone) also indicate that after circumcision, a newborn is significantly stressed and much more difficult to calm.
The next big argument from opponents of circumcision contends that the procedure can be traumatic for the newborn during a critical period in his life and the potential for permanent psychological damage should be considered. This argument is harder to find evidence to support it, but there have been some investigations. Some mothers whose sons were circumcised report more difficulties with breastfeeding and bonding. The first few days and months of a baby’s life set the stage for the rest of his life. Babies communicate needs by crying, and they learn who will take care of their needs and how quickly. They do not have the cognitive capacity to understand why someone is not tending to their needs. If their needs are not met, they will eventually quiet; however, the first time they experience this can potentially signal to them that it will be difficult to get their needs met, thus resulting in a greater potential for attachment and relationship issues down the road. This informs the idea of circumcision as a traumatic experience: the experience of intense pain and the delay of comfort.
Janina Fisher discusses the idea that trauma is in the nervous system. When we experience any sort of distressing event, the biological response is imprinted on our memory and our nervous system begins to prepare for the next traumatic event by prepping the body for the biological response, (fight or flight.) Trauma doesn’t have to be reserved for victims of sexual abuse or combat veterans. Any experience that causes a biological and psychological response that is distressing can be viewed as a traumatic experience. A psychologist might thus argue that just because the circumcision procedure is quick, does not mean that the baby may not in some way remember the experience.
If you’re considering circumcision, I’d encourage you to read the links within this article. Read the studies and opinions for yourself and talk to others who support and don’t support circumcision. Talk to both circumcised and uncircumcised men. I would also encourage you to watch a video of a baby being circumcised. Here is a link to one video that is rather graphic. You can find a video through one of the links below, or probably on YouTube. I won’t post a link, because to be honest, I can’t watch it. If you truly feel that the procedure is something your baby needs to undergo, consider watching a video so that you know exactly what is involved. If you and your partner disagree on what you want to do, take some time to think about it and try to see the other’s points. Whatever you chose, make sure you go into the decision with your eyes wide open, and fully prepared to care for your son’s penis appropriately, circumcised or intact.
References and Resources (not already linked in the article):
Collier, R., (2011). Circumcision indecision: The ongoing saga of the world's most popular surgery. Canadian Medical Association, 183(17).