Circumcision: a Medical Necessity?

Day 27 28 +3

This question would have never risen if we didn’t attend the Triangle Homebirth Meetup. We thought this is a “default” procedure so never really thought there’s a reason to look into whether to get the boys circumcised or not.

At the meetup, a lady asked us to check out the Intact America. So that’s what we did, and after watching the procedure, which I couldn’t really watch, I wonder if any parent was present at the circumcision and if that’s the case, anyone would agree to have such procedure done.

The questions we had were:

• Is foreskin really a useless body part?
• Can babies feel the pain?
• What medical problem would arise if the foreskin is kept?
• What is the percentage of the circumcision rate in the US?

The reasons to circumcise the boys:

• Religious reason, especially Jewish. Circumcision originally started as a treatment and cure for masturbation.
• Parents don’t want the boys to look different or they want them to look alike, or look like dad. Kids may get laughed at if their penises look different from those of friends.
• May reduce the infection caused by insufficient hygiene and proper care.
• Babies don’t remember the pain or it’s not that painful.

The reasons NOT to circumcise the boys:

• Babies can feel the excruciating pain even if anesthesia is applied and there may be deep psychosocial effects and cause mistrust of the mother – babies turn their heads away from moms after the surgery.
• There’s no proof of cutting off foreskin prevents AIDS and other STDs.
• It should be the right of the child to determine if he wants to have circumcision done or not.
• Complications after the surgery that could cause serious infection even death.
• Improper care after the circumcision causing deformation of the penis.
• Foreskin contains nerve endings that are extremely sensitive which enhance the sexual experiences.

Of course neither I or someone who had the circumcision done  would know whether the last point is true or false, unless if we ask someone who wasn’t circumcised as an infant but chose to get circumcised as an adult. To us, we are not convinced that it’s medically necessary, we could care less about all the other religious and cultural reasons, just like if we are going to circumcise our baby girls if we have any, probably we will be considered evil parents. We also found out that circumcision fees (about $400 per boy) is not included in the delivery costs.

We will just have to teach our boys to do a job cleaning themselves. I wasn’t sure about the circumcision ratio in the US so I looked it up, it’s 56%, much less than I would have guessed.

Source: http://www.cirp.org

We also did some searched on Australia (2004 infant circumcision rate 12.7%), UK(3.8% by age of 15), and Canada (9.2% by 2005), none of these countries recommend circumcision be a routine procedure performed on infants, same with the US. Here are the recommendation from AAP, AMA, AAFP, and AUA.

The American Academy of Pediatrics (1999) stated: “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child’s current well-being, parents should determine what is in the best interest of the child.” The AAP recommends that if parents choose to circumcise, analgesia should be used to reduce pain associated with circumcision. It states that circumcision should only be performed on newborns who are stable and healthy.

The American Medical Association supports the AAP’s 1999 circumcision policy statement with regard to non-therapeutic circumcision, which they define as the non-religious, non-ritualistic, not medically necessary, elective circumcision of male newborns. They state that “policy statements issued by professional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns.”

The American Academy of Family Physicians (2007) recognizes the controversy surrounding circumcision and recommends that physicians “discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son.”

The American Urological Association (2007) stated that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks.