Male circumcision is a touchy subject. People argue passionately for and against circumcising male babies, presenting evidence to back their arguments up. Not surprisingly, it’s an issue that confuses many new parents.
And the debate has flared up again with the inquest into a UK baby’s death from blood loss after being circumcised in February 2008.
Male circumcision involves surgically removing the foreskin of the penis, or the fold of skin overlapping the end of the penis head (glans penis). This procedure is usually performed within the first few weeks or months of a boy’s life.
Many people choose to circumcise their son because they want him to look like his father, so there is no confusion. The Children, Youth and Women’s Health Service puts the rate of circumcision in Australia at less than 10 per cent, so circumcising a boy would actually put in him in the minority in his peer group.
Circumcision has been performed on male babies for religious and cultural reasons for thousands of years, and is still widely practised in some cultures. However, according to MBF’s Chief Medical Officer Dr Christine Bennett, the current medical policy in Australia, “suggests that there is no medical indication for routine neonatal circumcision”.
The Pros
However, Dr Bennett added that evidence did show uncircumcised males having a higher risk of health problems such as urinary tract and kidney infections and sexually transmitted diseases (STDs).
This evidence was backed up by Dr John Schulze, one of the few Central Coast doctors who still perform circumcisions. Dr Schulze, from Absolute Medical Services at Lisarow, estimates he has performed 10,000 circumcisions. He will circumcise a child up to six months, but prefers to do it before three months of age.
“Circumcising a male child reduces the risk of kidney and bladder infection by 95 per cent, and is also reduces the risk of STDs in adults by 66 per cent,” Dr Schulze said.
“The foreskin presents a risk of infection at the end of the penis and can be treated by antibiotics, but it can be an emotional issue if it’s ongoing,” he said.
Dr Schulze explained that people with a history of bladder and kidney infections and people who work with the elderly often choose to have their children circumcised.
MBF’s fact sheet, The Pros and Cons of Male Circumcision, states that urinary tract infections affect 1-2 per cent of boys, but may be five times less frequent in circumcised boys.
Another benefit is the reduction in risk of developing some cancers. According to the fact sheet, “Compared to uncircumcised men, circumcised men appear to have a lower risk of penile cancer and their female sexual partners may have a lower risk of cervical cancer”. Penile cancer is rare, affecting one in 100,000 men.
Cons
The fact sheet also explains that 1-5 per cent of circumcisions have complications including local infection, bleeding and damage to the penis. And in rare cases, serious complications such as severe bleeding and septicaemia can result in death.
It’s an unavoidable fact that circumcision is a medical procedure that involves pain and blood. “Circumcision is a procedure that involves needles and some discomfort. I use a blocker at the end of the penis,” Dr Schulze said. “Only 50 per cent of parents give Panadol at home [after the procedure] and the majority of those cases are due to the child being unsettled [rather than in pain].”
The main ethical reason against circumcision is a baby cannot choose to have the procedure. “A baby can’t give permission [for circumcision],” Dr Schulze said.
He also said that, like many medical procedures, death was a risk. “There is a risk of dying, but there is a risk of dying if you shave your legs. You have to keep things in perspective. The risks are bleeding, infection and shortening of the foreskin, but that [shortening] has happened in one [case] that I know of and another two [cases] I suspect in 10,000 circumcisions.”
When There is No Alternative
Newborn males are born with the inner surface of the foreskin fused to the glans, and they separate during childhood. By the time uncircumcised boys are five most can retract their foreskin and can learn how to clean the area themselves.
However in some cases the foreskin is too tight and cannot be retracted – or has been retracted too far and can’t be folded back. In these rare cases, a circumcision must be performed for medical reasons.
Umina Beach mother Annalisa Holmes faced this issue with her son Oliver.
When Oliver was three, a GP and a specialist confirmed his foreskin wasn’t growing. And according to the specialist, the only way to alleviate the problem was circumcision.
“He gave us a lot of information and said it’s quite a common thing. It wasn’t something we wanted to do, but given the problems he possibly could have had we booked [Oliver] in to have the surgery,” Mrs Holmes explained.
“If it wasn’t a necessary procedure I just wouldn’t have had gone through it. It was an experience we didn’t anticipate going through. I was pretty shocked at how it looked [afterwards] because I wasn’t prepared. It was very bruised, very swollen.
“I didn’t know anyone who’d had problems who did have it [circumcision] done or anyone who had problems who didn’t. Because it was for a medical reason you tend to put faith in the medical profession. There have been no problems since and it’s been almost four years,” she said.
What About Sexual Performance?
The parentsconnect.com website also has an article on the pros and cons of circumcision, with a note at the end stating:
“Removing the foreskin is a permanent choice that your son may later regret. An intact foreskin may enhance sexual pleasure.”
This note is backed up by Dr Christine Northrup who wrote the article, How Male Circumcision may be Affecting Your Love Life. Dr Northrup has performed hundreds of circumcisions, but wrote the article stating circumcision was not only a “risky, painful and unnecessary procedure”, but also one which affected sexual pleasure.
“When a male is circumcised, some of the most erotically sensitive areas of the penis are removed: the foreskin that normally covers the head of the penis (the glans) and some or all of the frenulum,” Dr Northrup explained.
“The frenulum contains high concentrations of nerve endings that are sensitive to fine touch. The glans was designed by nature to be covered all the time except during sexual activity… Though the penis contains nerves that are sexually excited by pressure, its tip contains the greatest density of these nerves and is therefore the most sexually responsive part,” she said.
In response to these statements Dr Schulze said most people would laugh.
“Six adults have had elective circumcisions [performed by him] and said it has not affected their sex lives,” Dr Schulze said.
According to Dr Schulze, the biggest factor affecting sexual pleasure was not enough fluid - an issue for both circumcised and uncircumcised men and their partners.
“I believe people should have the right to choose. It’s been done forever,” Dr Schulze said as he showed a picture depicting a disciple performing a circumcision.
There is no doubt circumcision will remain a contentious issue. However, with more medical evidence available than ever before, parents are in a far better position to make the choice that is right for them and their son.
Contacts
www.mbf.com.au
www.parentsconnect.com
www.cyh.com
Absolute Medical Service – www.abmedical.com.au
Tags: Baby, circumcision
There is zero reason, barring a medical emergency, that the boy can not and should not, be allowed to make this choice as an informed and consenting adult. His body, his decision.
intactamerica.org
The decision to circumcise or not is a personal decision. A decision that only the owner for the foreskin can and should make.
Parents and doctors must respect the fundamental rights of the child to an intact body (and penis) and refrain from exposing their son’s to this medically unnecessary procedure.
The only valid medical reasons for circumcision are gangrene or surgically irreparable trauma.
Treatment of incomplete prepal separation, phimosis, etc can be achieved with great success using conservative treatments. Circumcision should not be employed in the treatment of these minor conditions.
It’s a human rights isuue, you can’t cut off normal and healthy tissue of any part of the body, genitals or otherwise, boys or girls, without the consent of the owner, and that does not include the parents.
He can choose when he is an adult, and isn’t it odd, he is more than 99% likely to choose to keep his foreskin.
Thank you Caroline, Wilfred and Andy for adding your thoughts to this debate.
We had our son circumsided by Dr Schulze and he is just fine. We decided to do it for the reasons Dr S pointed out, bladder infections, STDs ect. I belive it is a personal decision, one of many hard decisions we as parents will have to make for our son, and it should not be condemed.