Circumcise? Or leave him intact?

The unpleasant facts about a common procedure

 

The United States is the only country in the world that performs routine circumcision on its infants. In a state like Illinois, where nearly three-quarters of infants are circumcised, it may come as a surprise to learn that, globally, only approximately 30 percent of men are. 

In the United States circumcisions have become culturally entrenched, just something you do at birth, like cutting the umbilical cord. Many parents don’t give it much thought. It wasn’t always this way. 

At the turn of the 20th century, circumcision was rare. The practice gained steam in the early 1900s for several reasons: first, it was thought to curb masturbation. Second, it became a mark of social distinction, separating “real” Americans from immigrants pouring into the United States. Third, it was heavily promoted by the U.S. military during the World Wars as an effort to curb the spread of venereal disease. 

The American Academy of Pediatrics does recognize specific benefits associated with circumcision, including prevention of urinary tract infections, penile cancer and transmission of some sexually transmitted diseases. In its policy statement the AAP declared that the benefits outweighed the risks, yet ultimately parents should decide for themselves whether or not to elect this surgery for their sons.

It is a decision to be made carefully. Opponents of circumcision have pointed out that rates of urinary tract infections, even in uncircumcised infants, is less than 1 percent. Similarly, the incidence of penile cancer in the United States is extremely low, occurring in less than one man in 100,000. As to the issue of sexually transmitted diseases, while circumcision may reduce the risks, it does not replace the need for parents to talk to their children about safe sex. 

While the prevalence of circumcision in our region and culture make it seem safe and simple, there are several unpleasant facts about this procedure:

Like any surgical procedure, circumcision carries risks. Complications associated with circumcision include infection, hemorrhage, scarring, difficulty urinating, loss of part or all of the penis, and death. One study estimates that 117 babies die each year in the United States from complications arising from circumcision.

Circumcision is not easy for the infant. During the procedure, the infant is strapped face-up onto a molded plastic board called a Circumstraint. His foreskin is forcibly separated from the glans, slit, crushed, and cut off.

Circumcision is painful. The foreskin is one of the most sensitive parts of the body. Of course children are given analgesics, but these only decrease the pain; they do not eliminate it. Not only is the actual procedure painful, but the open wound will continue to cause the infant pain for several days, until it heals.

Other factors to consider include the potential loss of sexual sensation that comes with removal of the foreskin, as well as the ethical implications of performing elective, cosmetic surgery on another person without their consent. 

Many parents who choose circumcision do so for social reasons rather than potential health benefits. Chief among them are a fear that their son will stand out or look different in the locker room, a mistaken belief that circumcised penises are more hygienic and easier to clean, and a desire for a son to look like his father. 

Yet for those who choose not to circumcise their sons, these reasons do not justify the pain and risk associated with the procedure. 

Larissa Blais of Springfield decided not to circumcise her son because she was unwilling to risk her baby’s health and safety on an unnecessary procedure. She was untroubled by the possibility that her son might one day look different from his peers, saying “the reality is there are not communal locker rooms anymore. Besides with the circumcision rate falling every year, by the time your child is in school there will be plenty of other intact boys.” 

To those concerned about sons looking like their fathers, Blais asks a rhetorical question: “What if dad lost his arm in Iraq? Or had a terrible burn to his face? Would you cut off your son’s arm to match? Burn your child’s face to match?” She went on to point out that, prior to puberty, a son’s penis will not resemble his father’s anyway, “And by the time he does they won’t be comparing.” 

Blais encourages parents considering circumcision for their infants to do their research, to watch a video of the procedure, and to carefully consider the risks.

“Finally, to any parent, doesn’t it seem crazy that five babies are injured from a crib, or stroller or bouncy chair or a monitor cord or a baby sling and we see Facebook posts and recalls and everyone is up in arms about it.....but 117 baby boys DIE, DIE every.single.year because of an elective cosmetic procedure and no one cares. Your son could be one of those 117. Consider it. Worth it?”  

 

Erika Holst of Springfield is mom to a lively 2-year-old.

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