Myths about Circumcision You Likely Believe
CIrcumcision does great harm to babies
*First author is Lillian Dell'Aquila Cannon
I was pregnant with my first child, I just thought that circumcision
was what you did, no big deal, and that every man was circumcised.
Then one day I saw a picture of a baby being circumcised, and
everything changed. Just one tiny, grainy photo was enough to make me
want to know more, and the more I knew, the worse it got. It turns
out, circumcision really is a big deal.
Part 1 - Circumcision Surgery Myths
Myth 1: They just cut off a flap of skin.
Not true. The foreskin is half of the penis's skin, not just a flap.
In an adult man, the foreskin is 15 square inches of skin. In babies
and children, the foreskin is adhered to the head of the penis with the
same type of tissue that adheres fingernails to their nail beds.
Removing it requires shoving a blunt probe between the foreskin and the
head of the penis and then cutting down and around the whole penis. Check out these photos: http://www.drmomma.org/2011/08/intact-or-circumcised-significant.html
Myth 2: It doesn't hurt the baby.
Wrong. In 1997, doctors in Canada did a study to see what type of
anesthesia was most effective in relieving the pain of circumcision.
As with any study, they needed a control group that received no
anesthesia. The doctors quickly realized that the babies who were not
anesthetized were in so much pain that it would be unethical to
continue with the study. Even the best commonly available method of
pain relief studied, the dorsal penile nerve block, did not block all
the babies' pain. Some of the babies in the study were in such pain
that they began choking and one even had a seizure (Lander 1997).
Myth 3: My doctor uses anesthesia.
Not necessarily. Most newborns do not receive adequate anesthesia.
Only 45% of doctors who do circumcisions use any anesthesia at all.
Obstetricians perform 70% of circumcisions and are least likely to use
anesthesia - only 25% do. The most common reasons why they don't?
They didn't think the procedure warranted it, and it takes too long
(Stang 1998). A circumcision with adequate anesthesia takes a
half-hour - if they brought your baby back sooner, he was in severe
pain during the surgery.
Myth 4: Even if it is painful, the baby won't remember it.
Reality check: The body is a historical repository and remembers everything. The pain of circumcision causes a rewiring of the baby's brain so that he is more sensitive to pain later (Taddio 1997, Anand 2000). Circumcision also can cause post-traumatic stress disorder (PTSD), depression, anger, low self-esteem and problems with intimacy (Boyle 2002, Hammond 1999, Goldman 1999). Even with a lack of explicit memory
and the inability to protest - does that make it right to inflict
pain? Law requires anesthesia for animal experimentation - do babies
deserve any less?
He slept right through it.
Reality check: Not
possible without total anesthesia, which is not available. Even the
dorsal penile nerve block leaves the underside of the penis receptive to
pain. Babies go into shock, which though it looks like a quiet state,
is actually the body's reaction to profound pain and distress. Nurses
often tell the parents "He slept right through it" so as not to upset them. Who would want to hear that his or her baby was screaming in agony?
Myth 6: It doesn't cause the baby long-term harm.
Incorrect. Removal of healthy tissue from a non-consenting patient is,
in itself, harm (more on this point later). Circumcision has an array
of risks and side effects. There is a 1-3% complication rate during
the newborn period alone (Schwartz 1990). Here is a short list
Meatal Stenosis: Many
circumcised boys and men suffer from meatal stenosis. This is a
narrowing of the urethra which can interfere with urination and require
surgery to fix.
Adhesions. Circumcised babies can
suffer from adhesions, where the foreskin remnants try to heal to the
head of the penis in an area they are not supposed to grow on. Doctors
treat these by ripping them open with no anesthesia.
Circumcision can lead to trapped or buried penis - too much skin is
removed, and so the penis is forced inside the body. This can lead to
problems in adulthood when the man does not have enough skin to have a
comfortable erection. Some men even have their skin split open when
they have an erection. There are even more sexual consequences, which
we will address in a future post.
circumcision wound can become infected. This is especially dangerous
now with the prevalence of hospital-acquired multi-drug resistant
Death. Babies can even die of circumcision.
Over 100 newborns die each year in the USA, mostly from loss of blood
and infection (Van Howe 1997 & 2004, Bollinger 2010).
Isn't it time to think more carefully about whether we should be circumcising our boys?
But, you say, aren't there important health benefits? See the next post.
POSTS IN THIS SERIES
Part 1: Surgery Myths
Part 2: STD/Hygiene myths
Part 3: Social and sexual myths
Part 4: The ethics and economics of circumcision
Part 5: Greatest danger for uncircumcised boys
Part 6: Harming boys through ignorance of male anatomy
References for Part 1
Anand et al., "Can Adverse Neonatal Experiences Alter Brain Development and Subsequent Behavior? Biol Neonate 77 (2000): 69-82.
D. "Lost Boys: An Estimate of U.S. Circumcision-Related Infant
Deaths," Thymos: Journal of Boyhood Studies Volume 4, Number 1 (2010).
Boyle, G.,et al., "Male Circumcision: Pain, Trauma, and Psychosexual Sequelae," Journal of Health Psychology 7 (2002): 329-343.
Hammond, T., "A Preliminary Poll of Men Circumcised in Infancy or Childhood," BJU 83 (1999): suppl. 1: 85-92.
Goldman, R., "The Psychological Impact of Circumcision," BJU 83 (1999): suppl. 1: 93-102.
J. et al., "Comparison of Ring Block, Dorsal Penile Nerve Block, and
Topical Anesthesia for Neonatal Circumcision," JAMA 278 (1997):
Schwartz, William M., MD et al., PEDIATRIC PRIMARY
CARE: A Problem-solving Approach, 2nd Edition, Year Book Medical
Publishers, Inc., 1990, pp. 861-862.
Stang, H. et al., "Circumcision Practice Patterns in the United States," Pediatrics Vol. 101 No. 6 (1998): e5.
A, et al., "Effect of neonatal circumcision on pain response during
subsequent routine vaccination." Lancet 1997;349(9052):599-603.
Van Howe, R., "Variability in Penile Appearance and Penile Findings: A Prospective Study," BJU 80 (1997): 776-782.
Van Howe, R., "A Cost-Utility Analysis of Neonatal Circumcision," Med Decis Making, December 1, 2004; 24(6): 584 - 601.