Saving Babies

We need to talk..... about Penile Cancer

2012-11-18T20:33:00.000-06:00

Cancer is a scary word. We shudder to think of it happening to ourselves or a loved one. Many of us have already experienced cancer personally or as the friend or family member of someone suffering through it.

So if you can spare your child from cancer, why wouldn't you, right?

Except that we don't understand the causes of every cancer, the risk factors, the mitigating factors, the appropriate methods of prevention, the rates of incidence and death. Did you know that if you Google "mammograms" right now that it auto-fills to "mammograms cause cancer?" Even the medical community is still figuring this one out.

But you know what nobody is saying? "Breasts cause cancer. Let's remove them all at birth." Y'know why? Because even though the rate of breast cancer in the U.S. is pretty high, we don't bet on it and we don't preemptively remove currently healthy body parts from our children.

Then there's the foreskin. Like no other part of our children's bodies, we decide to remove it at birth, and one of the reasons we are given is "it prevents penile cancer."

Want to learn a little more about penile cancer? Along with other male genital cancers, it's estimated to affect about 1500 men per year, with about 20% of those cases being fatal. That's an estimated 310 deaths per year in the U.S. due to penile cancer. The fact is "penile cancer is very uncommon in the United States, even among uncircumcised men."

Not only does breast cancer outnumber penile cancer by more than 225,000 new cases and almost 40,000 deaths per year, but MALE breast cancer occurs more commonly than penile cancer. Your SON is more likely to develop and die from breast cancer than of penile cancer. Almost 2200 men are diagnosed with breast cancer each year in the United States, and approximately 410 men will die of breast cancer each year.

The American Cancer Society does not recommend circumcision as a preventive measure for penile cancer. They do not have an official policy on circumcision (why should they, when their concern is cancer?), though when the American Academy of Pediatrics was trying to promote it as such in the mid-nineties, it did spark a response from some inside the ACS.

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What does the ACS itself have to say on the issue?

"Statements about circumcision preventing penile cancer and cervical cancer are cropping up on the Internet. A two-year-old letter being circulated on the Net discussing scientific evidence regarding penile cancer and its relationship to circumcision is personal correspondence reflecting the observations of two former ACS physician staff members. The American Cancer Society does not have a formal guideline statement on circumcision.

Penile cancer is extremely rare in the United States and accounts for less than one half a percent of cancers diagnosed among men and less than one tenth of a percent of cancer deaths among men. Circumcision is the removal of a part or all of the male foreskin either at birth or later on. This practice has been suggested as giving some protection against cancer of the penis by contributing to improved hygiene.

However, the penile cancer risk is low in some uncircumcised populations, and the practice of circumcision is strongly associated with socio-ethnic factors, which in turn are associated with lessened risk. The consensus among studies that have taken these other factors into account is circumcision is not of value in preventing cancer of the penis.

Proven penile cancer risk factors include having unprotected sexual relations with multiple partners (increasing the likelihood of human papillomavirus infection), and cigarette smoking."

American Cancer Society. Dispelling Miscommunications: Statement on Penile Cancer. ACS News Today, Atlanta (1998).

So in the same way that you respect your infant daughter's right to keep her breast buds and make her own decisions as an adult when it comes to removal of body parts for cancer prevention, respect that your son's body belongs to HIM. It is only put in your care for safekeeping for a while. Whether or not to remove currently healthy parts for whatever purported health benefits should be his decision. To sacrifice those nerve endings based on such a minuscule risk is not a decision that should be made second hand. Only he can determine how much those nerve endings are worth.

The likelihood of your son being unhappy with his circumcision is most likely much greater than the chance that you've spared him from cancer by removing his foreskin.

We need to talk... about HIV

2012-05-23T08:21:00.006-05:00

So you're having a baby boy, and you're considering circumcision because you've heard that it helps prevent HIV? We need to talk.

HIV is a scary, scary thing to think about when you're becoming a parent. It's understandable that you'd want to protect your child in every way you can. But you can't believe every rumor you hear. Not even if you hear it from your doctor. Not even if you hear it from 2 doctors or 3 doctors in your area. I'm not suggesting that Google can replace an MD, but you owe it to your son to research ANY irreversible alteration to his genitals.

We need to talk about the reasons people think circumcision prevents HIV and why those reasons are both fatally flawed and also simply not justification enough for the risk you take when putting your son's future favorite body part under the knife.

I'm going to tell you what I've learned, but I'm also going to link you to where I learned it. If you see text that is a different color, it's a link, and it will open in a new window. If any of them require you to register with the website to see the full text of the medical study and for some reason you are unable or unwilling to do so, you are free to instead e-mail me for the PDF. You can find my e-mail address at the bottom of the blog or on our Facebook page. You can take my word for it, but I don't want you to HAVE to, because that's how we end up with these kinds or problems in the first place - you hear something and you don't do the independent research to verify it. I'm going to give you what tools I can to help you independently verify, because your son is worth it.

African Studies
The claims that circumcision prevents HIV are based on studies coming out of Africa. The validity of these studies is questionable, and the ethical implications are disturbing. What's more, these studies are being done with adult men in Africa. Not infants in developed nations. This article from the Journal of Public Health in Africa "explores, in detail, the data on which this recommendation [circumcision as HIV prevention] is based, the difficulty in translating results from high risk adults in a research setting to the general public... and how circumcision compares to existing alternatives. Based on our analysis it is concluded that the circumcision solution is a wasteful distraction that takes resources away from more effective, less expensive, less invasive alternatives. By diverting attention away from more effective interventions, circumcision programs will likely increase the number of HIV infections."

The December 2011 issue of the Journal of Law and Medicine cites numerous flaws in three African studies that make claims about circumcision reducing the risk of HIV transmission. You can read the full article here, but of course, I'll share some bits and pieces here:

"...the African trials suffered design and sampling problems, including problematic randomisation and selection bias, inadequate blinding, lack of placebo-control, inadequate equipoise, experimenter bias, attrition (673 drop-outs in female-to-male trials), not investigating male circumcision as a vector for HIV transmission, not investigating non-sexual HIV transmission, as well as lead-time bias, supportive bias (circumcised men received additional counselling sessions), participant expectation bias, and time-out discrepancy (restraint from sexual activity only by circumcised men).

The Ugandan trial which tested whether male circumcision could reduce male-to-female transmission of HIV was stopped early because 25 previously uninfected women became HIV-positive. It appears that male circumcision was associated with a 61% increase in HIV transmissions, leading Wawer et al to caution that "Condom use after male circumcision is essential for HIV prevention."

Wait a second, WHAT? "Condom use after male circumcision is essential for HIV protection." So it is CONDOMS, and NOT circumcisions, that are essential for HIV prevention.

Furthermore, there has been problematic reporting of the trials in the medical literature. Fox and Thomson stated: "Our concern is that such partial reporting of the trials will impact on the role that circumcision is perceived to play in HIV prevention... in perpetuating erroneous beliefs... that circumcision offers immunity to AIDS... If the contexts of the African trials can be so poorly represented in the medical literature, it is no surprise that accounts in the popular press are still more misleading."

Participants in the immediate male circumcision groups also received two years of free medical treatment plus supportive counselling and safe-sex advice, difficult to provide in any large-scale "roll out" of male circumcision in sub-Saharan Africa. WHO [World Health Organization] had specifically cautioned that the female-to-male Kenyan and Ugandan findings might not generalise to real-world settings.

It's important that we remember, also, that these studies were only conducted about adult heterosexual activity in Africa. In the U.S., according to this report, the primary mode of sexual transmission of HIV is male-to-male sexual activity. With that in mind, I'd like to bring up an article regarding a CDC study of HIV transmission in U.S. Men.

"Overall, we found no association between circumcision status and HIV infection status among black or Latino (men who have sex with men)," said Millett, who presented his findings to the CDC's National HIV Prevention Conference in Atlanta.

Experts knew circumcision would not protect a female sex partner, nor the male sex partner being penetrated.

But Millett's study found no benefit of circumcision to any of the men. "We also found no protective benefit of circumcision among those men reporting recent unprotected sex with a male partner in which they were exclusively the insertive male partner," he said.

You can also read more here about a study by the U.S. Navy that found circumcision does NOT prevent the transmission of HIV or other sexually transmitted infections.

In the following video, Dr. Dean Edell outlines the many flaws in the studies coming out of Africa, as well as his sound opinion on the naivety and desperation of anyone who thinks we can walk into such an enormous continent and, instead of giving food, water, or medicine, we can give them all genital surgery. He makes some excellent points and I highly recommend you watch the video. It is well worth your time.

So here's what we've learned so far:

Circumcision can actually INCREASE a woman's risk of contracting HIV from her partner,
Supplying fresh water and soap to men will bring down AIDS infection as much as these studies claim circumcision will,
The U.S. has the highest rate of circumcision and the highest rate of HIV,
The studies that claim circumcision reduces HIV transmission are completely irrelevant to those most at risk in the U.S., and
You still have to wear a condom.

Not only is circumcision clearly not a viable means of HIV prevention, it may actually impede your son's ability to fight off invading HIV. There are specialized cells produced in the mucosal lining of the human genitals - that lining is largely removed by circumcision and what is left dries up. These cells are called Langerhans cells, and their function is outlined in an Washington Post article:

Researchers have discovered that cells in the mucosal lining of human genitalia produce a protein that "eats up" invading HIV -- possibly keeping the spread of the AIDS more contained than it might otherwise be.

Even more important, enhancing the activity of this protein, called Langerin, could be a potent new way to curtail the transmission of the virus that causes AIDS, the Dutch scientists added.

Langerin is produced by Langerhans cells, which form a web-like network in skin and mucosa. This network is one of the first structures HIV confronts as it attempts to infect its host.

However, "we observed that Langerin is able to scavenge viruses from the surrounding environment, thereby preventing infection," said lead researcher Teunis Geijtenbeek, an immunologist researcher at Vrije University Medical Center in Amsterdam.

So it stands to reason that if you want to protect your son from HIV, you'll leave his natural body as it is so that it can fight off infection properly, and you'll teach him the importance of using condoms. And remember, infants do not engage in risky sexual practices. This is not the time to be making decisions about your son's future sex life. It could be argued that there is never a time for you to make your son's sexual decisions. And let's face it, the best prevention of HIV is education and condom use.

Even those promoting circumcision propaganda are aware of this fact. The following is a poster from the Uganda Ministry of Health. An advisory at the bottom, in incredibly small print, reads "Even with circumcision, having sex without condoms puts you at great risk of contracting HIV/AIDS."

So there you have it. HIV prevention is in no way a legitimate justification for infant circumcision. I'm glad we had this talk.

Dollars & Sense: the Business of Circumcision

2011-08-09T19:56:00.122-05:00

You might be surprised to learn how lucrative infant circumcision in America is for the doctors, hospitals, clinics, and vendors who take part. Believe it or not, there is big money to be made in the business of circumcision. When money is involved, it becomes more important to question the motives of the one who stands to profit. “It is difficult to get a man to understand something when his salary depends on his not understanding it.” [Upton Sinclair]

I know better than to think a used car salesman is looking out for MY best interests instead of his own commission. Like a used car salesman, doctors will gloss over or completely ignore the facts that would turn you away from what they're selling. That's business.

Circumcision is a cash cow for doctors and hospitals. An OB might make a couple thousand dollars for every pregnant woman under their care, and that’s over the course of nine months. Circumcision takes about five minutes and you can charge over a grand each! I’ve searched high and low and found quite a range of prices for the surgery itself. The cost to have your son circumcised comes out to $704.83 on average. If a doctor circumcised just five boys each week at that rate, they can pull in $176,208.20 annually, and that is if they take two weeks vacation!

To put that in perspective, that is about 25 minutes of work per week (as opposed to the 2400 minutes per week the rest of us work), for which the doctor and/or hospital are paid over 4 times the national average wage index for 2009.

If you take that five minutes of work at $705 and extrapolate that into an hourly charge (5 goes into 60 twelve times), that’s $8,458 per hour. Per HOUR. Granted, this assumes 5 minutes per circumcision. We could expand it to 30 minutes per circumcision, which gives time for set up and clean up. That would turn this into a $1409.67 per hour charge.

Of course, we should take into account the fact that doctors and hospitals and clinics have expenses associated with performing circumcisions. The circumstraint immobilizer (essentially the board they strap your baby to) costs anywhere from $200 - $400 each. I’ve found one for quite a bargain. This one is $298.70, marked down from $343.50.

The seller brags, “In less than 30 seconds, a nurse can immobilize the struggling infant securely in the correct position with Circumstraint. The immobilizer works on a proven principle of positive 4-point restraint. Soft wide Velcro straps encircle the infant's elbows and knees, depriving him/her of leverage. The child is held safely and securely without danger of escape. Circumstraint's comfortable contoured shape positions the infant, hips elevated, perfectly presenting the genitalia. The platform between the infant's legs provides support for a circumcision clamp. Without pins, towels, plastic shells or the threat of strangulation, Circumstraint snugly and securely immobilizes the infant with their entire torso visible.”

Sounds great, right? And when the straps wear out from having restrained hundreds of thrashing newborns, eBay has replacements on sale for $23.95 plus shipping.

There are plenty of other tools these clinics and hospitals have to pay for. The Gomco clamp, a popular tool for circumcision, runs about $150 plus shipping (marked down from $210). Of course, you have to buy two different sized clamps if you intend to circumcise both newborns and older children.

The Mogen clamp is a little more high-end, coming in around $400 apiece. I can’t tell the difference between the Moore Medical Mogen Clamp and the Skylar Mogen Clamp except that the Skylar Mogen Circumcision Clamp is more expensive: $543.44. Thank goodness both of these clamps can be used multiples times - otherwise it might really cut into profits!

The PlastiBell circumcision device is single use, so doctors and hospitals buy these in packs of 25 for around $150 or in bulk (125 devices) for about $650 If you’re planning on performing at least 125 circumcisions with this device, you’ll save $100 by buying in bulk. It’s a deal you just can’t pass up!

But really, doctors recoup their costs pretty easily. One father complained that the triple antibiotic ointment the hospital used on his child, the same ointment you can get at any drugstore for $4.95, was listed on the itemized bill at $166. That’s a 3354% mark-up.

And if the mark-ups on supplies and services don’t satisfy, there’s always money to be made from the discarded foreskins. Wait, what’s that? They can SELL foreskin? You betcha.

There are actually two different markets (that I know of) for human foreskin. One is the cosmetics industry. You may have heard that Oprah Winfrey uses a face cream made with human foreskin. It’s a pretty lucrative business when you consider that a bottle of this face cream will sell for a hundred bucks.

The other market for foreskins is in the medical field. Did you know that you can buy a milliliter of frozen foreskin for $399.00 to $559.00? These fibroblasts have many applications. The website of ATCC (the biological resource center selling these fibroblasts) says they can be used in response to pathogens, skin aging, wound healing, gene delivery and skin diseases. One single foreskin can actually pull in $100,000 in total. Bet the owner of that foreskin won’t see a dime, poor kid. He could go to college a few times on that amount of money!

So the doctors, hospitals, clinics, and vendors are pulling in a pretty penny. And American parents? They’re paying someone anywhere from $300 to $3,000 to cut away a healthy body part from their newborn sons. They might pay hundreds or thousands more on follow-up “circumcision revision” surgeries. One way or another, the math isn’t adding up on their side.

How about instead, you take the $705 and put it in the stock market for your son. That way, if in 18 years he decides that his natural body is "icky," he can use that money to get circumcised. Or to buy a car. I bet he'll choose the car.

It’s a Boy!

2011-06-24T16:08:00.011-05:00

Are you expecting a baby boy? Congratulations!

There are a few things you’ll probably want to consider while waiting for the little gentleman to arrive. Breast milk vs. formula, cloth diapers vs. disposable diapers. There are a lot of choices you have to make for your son. One choice you may be thinking about is whether or not to circumcise your baby. You’ve probably heard a lot about circumcision, but can you trust everything you’ve heard?

The fact of the matter is that the U.S. has a lot of untruths circulating about circumcision.

What You’ve Heard

Hygiene:

It’s cleaner. It prevents the build-up of smegma and unpleasant odors.

Appearance:

If you don’t circumcise, his penis will look like an anteater and he will be teased in the locker room by all the other boys. A boy should look like his father, so if dad is circumcised, baby should be as well. Otherwise, he’ll notice that he and dad are different, and it’ll make him think there is something wrong with him.

Health:

Studies have shown that circumcised men have a lesser chance of becoming infected by HIV. Circumcision prevents penile cancer. My baby will get a UTI if he isn't circumcised.

Function:

The foreskin is just a flap of skin. I and/or my partner are circumcised and just fine.

It is inevitable:

My uncle’s cousin’s daughter’s husband’s hair dresser’s baby wasn’t circumcised at birth, and he kept getting infections and/or his foreskin was too tight and they had to cut it off.

The REAL reason we circumcise:

The sad fact of the matter is that circumcision became popular in the United States for NONE of the reasons you’ve heard. The practice of infant circumcision outside of the Jewish faith started gaining popularity in the U.S. as a means to curb masturbation. Masturbation, they claimed, caused blindness, seizures, and all manner of maladies.

Dr. John Harvey Kellogg, co-inventor of the cornflake (and quite a fruit loop, if you know what I mean), had a hand in starting the trend in the U.S. In his book “Plain Facts for Old and Young: Embracing the Natural History and Hygiene of Organic Life,” he says of circumcision, “the operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment.” In brief, make it hurt so they won’t ever want to touch it. To curb masturbation, he claimed that “A remedy which is almost always successful in small boys is circumcision.”

Dr. Kellogg also found that the “application of pure carbolic acid to the clitoris” is “an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice.” Yep… let’s burn their genitals with acid so they won’t get aroused.

The Truth

Hygiene:

There is nothing unclean about a foreskin, especially in infancy. The foreskin is actually fused to the head (glans) of the penis in infancy and through much of childhood. For all intents and purposes, they are one in the same. “[The foreskin] protects the developing penis from feces, bacteria and other harmful pathogens. This is especially important during the diaper-wearing years when a baby is continually exposed to his/her own feces (e-coli and other harmful bacteria/viruses).”

As far as smegma is concerned, “During or after the separation process, there may be some shedding of dead skin cells in the form of smegma (please note that women and girls also have smegma). This shedding of dead cells aids in separation since it helps the foreskin differentiate itself from the glans. There is no need to try to clean smegma from underneath a child's foreskin. It will slowly work itself out via the narrow opening.”

Smegma is not unique to men and boys – women and girls also have smegma, but no one suggests genital surgery to prevent such a thing. Instead, we simply bathe regularly. There is no need to wash the inside of a girl’s vagina, just as there is no need to wash the inside of a boy’s foreskin. If intact, don't retract - only clean what is seen. When the foreskin is differentiated and retractable, the boy (who will likely be in his teens by the time this happens) can simply retract the foreskin in the shower and gently rinse the glans with warm water.

We teach our children to brush their teeth twice daily. If we’re lucky, they won’t skimp on flossing. Teaching healthy bathing habits is so much easier than teaching proper oral hygiene.

Appearance:

The circumcised penis and the natural penis only look different when flaccid. One has a protective covering over the glans (head) and the other does not. Having the foreskin there to protect and cover the glans allows the glans to remain soft, smooth, and sensitive. Without the foreskin, the mucosa of the glans thickens and causes a decrease in sensation. This, sadly, often leads to sexual dysfunction in later life when the desensitization makes it difficult to become erect and/or achieve orgasm. The United States of America, the country with the highest rate of circumcision (70% of the current male population, compared to 10-15% worldwide), also seems to have the highest prevalence of erectile dysfunction. This is not a cause-and-effect comparison, simply a correlation, but it does make you wonder...

These days, the circumcision rate for American baby boys is on the decline. Almost one in three American boys were circumcised in 2009, and it is suspected that the rates have fallen more since that time. Locker room comparisons (which I suspect are much less common than we’ve been led to believe) will not make the intact boy look strange – most of his classmates will be intact as well.

But honestly, do boys compare penises with one another? Or with their dads? There may be the occasional pissing contest, but it’s not the same as a dick comparison.

If your son DOES ask why he and daddy don’t look the same, the easy answer is either or both of the following: “Everybody is different” and/or “Daddy had a surgery when he was little, but we didn’t have to do that to you.” Neither of these will make your son feel somehow inadequate. Honestly, he's more likely to point out his dad's pubic hair, not his lack of foreskin.

Health:

There are three main issues that circumcision claims to fix. Hot in the news lately has been the claim that HIV can be prevented through circumcision. To this I would like to state the following: this particular "benefit" seems to be confined to very few countries in Africa. It is not the case in North America. Greg Millett of the U.S. Centers for Disease Control and Prevention said the following: "overall, we found no association between circumcision status and HIV infection status" when he presented his findings to the CDC's National HIV Prevention Conference.

Experts knew circumcision would not protect a female sex partner, nor the male sex partner being penetrated. But Millett's study found no benefit of circumcision to any of the men. "We also found no protective benefit of circumcision among those men reporting recent unprotected sex ... in which they were exclusively the insertive male partner," he said.

Penile cancer is among the diseases circumcision claims to prevent. What I have to say on that is this: penile cancer is incredibly rare. The chance of dying from penile cancer is so low that it is not even presented separately by http://www.cancer.gov/ - it is lumped in with all male genital cancers (including testicular cancer and the much more common prostate cancer) at a total of 310 estimated deaths in 2010. Compare this to the annual circumcision death rate of approximately 117 neonates (first month of life). That's more than SIDS (115 annually) and more than suffocation (44) and auto accidents (8) combined.

It is important to point out that penile cancer, like cervical cancer, is tied to HPV. Not circumcision. I have heard many personal accounts of women who contracted HPV from circumcised partners. Circumcision does not make you immune to HPV. The use of a condom is not only required to effectively prevent HPV, but is effective enough that circumcising is completely unnecessary for this purpose.

Urinary Tract Infections are very rare in boys. They do not hit both sexes equally. The prevalence of UTI in girls up to 2 years is more than twice the prevalence in boys of the same age. The rate in girls up to one year of age is 6.5%, while it is 3.3% in boys. From age one to two, it is 8.1% in girls and only 1.9% in boys. The rate for circumcised boys IS lower than intact boys. It is the difference of 0.2-0.4% for circumcised boys and 1.0 - 4.0% in intact boys.

With our girls at a much greater risk of UTI, we still do not suggest surgical removal of genital tissue to prevent them. We treat with antibiotics if and when the infection occurs. On the very rare occasion that a boy gets a UTI, we treat it with antibiotics. Surgical removal of genital tissue to prevent an infection when the risks of that infection are so low seems ludicrous to me, as well as to Dr. Benjamin Spock, renowned pediatrician, who said this: "You don't want to do something to 100% of boys just because of a very slight difference in infection. My own preference, if I had the good fortune to have another son, would be to leave his little penis alone."

Function:

The foreskin is NOT a flap of skin. In infancy and much of a boy’s early years, it is adhered to the glans of the penis to protect it. In teens and adult years, it has important sexual functions for both your son and his future partner(s). Women who have experienced intercourse with both intact and circumcised men overwhelmingly prefer the intact partner. Please learn more about the sexual function of the foreskin at www.sexasnatureintendedit.com [ADULT CONTENT]. Men who were circumcised at birth may tell you they are “just fine,” but they will never experience sex the way nature intended it. They have forever lost tens of thousands of fine-touch nerve endings that cannot be replaced. They can choose foreskin restoration in order to regain SOME of the function lost, but those nerve endings are gone forever. And please remember there seems to be a link between circumcision and erectile dysfunction.

Inevitability:

There are many boys who suffered through infections or were not able to retract. That is because the foreskin is not supposed to retract in childhood. Some parents who choose to keep their sons intact are told by misinformed doctors or friends or relatives that you must pull back the baby’s foreskin to clean his penis every time you change his diaper. This is both wrong and incredibly harmful. The foreskin in an infant should never be forcefully retracted – to do so is to rip the skin away from the glans and it causes injury, bleeding, and possible infection. It is akin to ripping a fingernail out of its nail bed.

There is a very clever rhyme that can help you remember how to properly care for your intact infant: if intact, don’t retract: only clean what is seen.

As far as the “too tight” foreskin, this is referring to what is called “phimosis” – a condition where the foreskin does not allow retraction. American doctors are not familiar with intact care and they misdiagnose many infants and young boys with phimosis. TRUE phimosis can only be diagnosed in an adult man. In childhood, the foreskin should not be retractable. The hormones a boy produces during puberty cause a gradual change in the tissues of the foreskin and allow a gradual widening of the opening of the foreskin. It is only if a boy reaches adulthood without retracting that he can truly be diagnosed with phimosis. Even if this diagnosis were correctly applied, a much simpler treatment is to apply a steroid cream and use gentle stretching exercises. It is very rare for circumcision to be medically necessary. A study in Finland found that the rate of medically necessary circumcision is just under 0.006%.

Simply put, the foreskin does not and should not retract until puberty or later. If your son can urinate, he is doing just fine.

It IS Surgery

There will always be risks associated with any surgery. The risk of serious complications (the type that require additional surgeries) is very low (I believe <1%) when performed by a medical professional in a clinical setting. That said, all boys suffer a great deal of pain from this procedure that can be shown by raised cortisol (stress hormone) levels prior to, during, and after circumcision. In 1998 reportedly only 26% of circumcisions in the United States used anesthesia. This is because for YEARS we labored under the insane idea that infants do not feel pain. The number is believed to be closer to 60% these days, but it's difficult to find a concrete answer since circumcision takes place in hospitals, clinics, homes, synagogues, etc. If you would like to watch a circumcision that was performed recently WITH anesthesia, I recommend this video. I will warn you it is graphic and shows a child's genitals, but this video was created by and for medical professionals.

Please also remember that death is a risk associated with this surgery, even if it is rare. The statistic of 117 per year may not seem earth shattering to you, but it was earth shattering to the families that lost those babies. Each and every one is a person, a life that was lost needlessly, a family that was broken. They are not just statistics - they are children.

Regret

There are scores of men who learned what was lost to them, and they deeply regret their parents' choice to circumcise them as infants. Please remember that your infant son will become your school aged son, your teenage son, and your adult son. He will eventually be able to make his own decisions, and he may wish you'd left this one up to him. If you don't believe me, please check out the National Organization for Restoring Men, or TLC Tugger or RestoringForeskin.org or ForeskinRestore.com or Restoring Tally. These are not every man's story, but these men give a voice to the many who did not consent to this surgery.

In Conclusion

The simple truth is that circumcision is neither necessary nor required. There is no special care required of you when you leave your baby whole (no Vaseline and bloody bandages in diapers). There is no compelling reason to perform surgery on the genitals of a healthy infant. There is no condition in childhood that would be cured by removal of the foreskin. After six years of research, I have never come across a single sound reason to circumcise an infant. You should not need to be convinced NOT to have genital surgery on your bouncing baby boy. It should be the other way around. Why WOULD you circumcise?

The Absence of No does NOT mean Yes.

2011-06-05T20:31:00.022-05:00

If there is one thing I've learned about newborns, it's that they communicate their feelings quite clearly. Unfortunately (for us and for them), we don't speak the same language.

A baby's cry means that something is wrong. I'm too hot, I'm too cold, I'm hungry, I'm sleepy, I'm bored out of my incomplete skull... We get pretty good at interpreting these cries and figuring out what baby needs, but it takes time - time that baby boys can't afford.

Imagine you are warm, safe, happy, maybe a little cramped, but generally content. The next thing you know, after a great deal of pressure, some harsh lighting and cold air on wet skin, you are removed from the woman who has been your home, your safe place, for every previous moment of your existence. This already sounds like a bad day, doesn't it? Like waking up to someone yanking your blankets off in a cold room, perhaps while sitting on your head.

If you're a girl, the story ends with a meal and a nap and some time for bonding with mom and dad. If you're a boy, you're not so lucky. Even though mom and dad love you just as much as they love your sisters, there is a part of your body that is unfamiliar to them. They've been fed inaccurate information that tells them that you weren't put together right in the womb, and you now need to be "fixed" even though all your parts work exactly as they're supposed to.

Of course, you don't understand this. You're a newborn. This is all a bit beyond your grasp right now. All you know is that you were swaddled in mom's arms a minute ago, but now you're stripped and strapped down to what we call a circumstraint. It looks a little something like this:

That's right - there is a special medical restraint made just for infant circumcisions. Kind of looks like what they'd use to strap down a death-row inmate in order to execute him or her, doesn't it?

These run around $300 to $450 each, and it's about $25 to replace the straps after they've been worn out by hundreds of thrashing infants.

But what do you care if a company is turning a profit on the backs of innocent children? You're a baby. You've never heard of commerce. All you care about is that you can't move your arms or legs.

You can't curl up like you're used to, you can't sooth yourself by sucking on your hand, you can't get your mom to come to your rescue no matter how much you scream. Nobody understands that your screaming means "I AM NOT OKAY WITH THIS!" And you don't even know what's coming next, you poor little thing.

First is the betadine swab. They smear it around your penis and scrotum, which is cold and uncomfortable. If you're lucky, the next thing that happens is someone putting a needle inside the base of the most nerve-rich part of your body to inject a local anesthetic into your penis. This itself is painful enough, and it doesn't do enough to block the pain of the next part of the procedure. Next the medical professionals take two metal clamps and put them on the end of your foreskin and pull on it to stretch it out. You're still screaming, and they're not stopping. An instrument is stuck inside your foreskin and used to forcibly separate the fused foreskin from the delicate internal organ inside - the head of your penis. You would probably give anything to go back to a time when the most painful thing in your life was a needle in your penis. You're screaming so much that you're actually choking on your saliva.

This is probably where you go into shock. The pain is beyond your comprehension. It is excruciatingly painful. The pain causes a permanent change in your brain (this is scientifically proven). While your body is still reeling from the shock and pain of having your tender little penis ripped apart, the skin that was there to protect you is cut away and cast aside. You have no idea how much you just lost, but you know something is very wrong.

The pain is so distracting that after being placed back in mom's arms, you're really not all that interested in your next meal. Your sleep patterns and breastfeeding are disrupted because of the pain. In fact, you're in too much pain to really respond to your parents' attempts to bond with you. You might even flinch when touched, and studies show that you'll probably have a higher pain response to painful stimuli in the future. There are a lot of physical and behavioral issues you and your parents are unaware of just yet. You aren't thinking about sex right now, though you will have to suffer through painful erections while you heal from this surgery, and when you're older you're more likely to have erectile dysfunction. You've lost all the fine touch nerve receptors in your penis, and after time and constant contact with your clothing causes your glans to keratinize, you'll only be able to sense temperature and pressure. Not pleasure.

But you're lucky - you survived. Not all babies do. It doesn't take much blood loss to kill an infant. You could have met a much worse fate.

The fact still stands that if anyone had been listening to you, this wouldn't have happened. Your foreskin was not a ruptured appendix. It wasn't an impacted wisdom tooth. It wasn't a vestigial tail. It was a healthy, normal part of your body, there to serve several functions. Your memory may not include this moment when you're older, but your body will always remember this. You will wear a scar on your body for the rest of your life, and you will never experience the joy of sex as nature intended it.

You said no.
You said it over and over again.
You said it with your body.

You said it with your voice.

Nobody listened.

Let it end here. A language barrier is not an excuse not to listen. Our baby boys are saying no. They are shouting it, they are screaming it, they are begging you to stop the pain. They are losing their lives. There is no excuse for this. There is no reason to keep this tradition alive when so many boys no longer are. There is not a single major medical organization on the planet that recommends non-therapeutic, routine infant circumcision. Not one. It is a cure looking for a disease.

Your son will not always be an infant. He will be a grown man one day. Respect your son and the man he will become by protecting him until he can give informed consent for elective, cosmetic procedures. The absence of the word "no" does NOT mean "yes." If we believed that it did, we'd be no better than someone who rapes an unconscious woman. We would not sit back and condone that violation of someone else's body without consent, but we do it to the most vulnerable of us - a newborn baby. He is saying "no" every way he knows how, and it's our job to listen.

Be your child's voice. Say no to circumcision.