Last time in Part 1 of this two-part series I spoke to the concerns some men have about adult circumcision. In this article, I want to address prospective parents.
Here, Maggie and her husband disagree about circumcising their infant son.
Dr Dick, my husband and I have been arguing about circumcising our son since we learned we were pregnant with a boy. It is really putting a real strain on our marriage. He is not circumcised and he wants the same for our son. But the men in my family are all circumcised; and I was taught it was a serious matter of health and hygiene. Would you mind weighing in on this? The birth of our son should be a time for celebration not conflict.
I think you’re both right; it is a matter of health and hygiene, but I side with your husband in terms of genital integrity. Our foreskins do have a purpose: a healthy prepuce is a natural deterrent to infection and it will be an aid to your son’s sexual functioning and pleasure too.
Let’s start at beginning, shall we? When us boys are born we all have a foreskin. A good portion of us will have our unit seriously altered within days of showing up on the scene. Someone, possibly a person with good intentions, will lop off 50% of our cock skin and call it a day. Those of us who escape this deed remain intact, but our foreskin is only open enough to pee through. And it only opens more if it’s stretched, and it only gets stretched if the owner of that foreskin learns to pull it back over his dickhead. No foreskin ever opens by itself; it gets gradually stretched open over time either intentionally or just through normal use.
Most little boys soon discover that pulling back their foreskin feels really good. After all, this unique piece of skin is chock full of nerve endings that register loads of delicious pleasure. But besides that, a lad’s foreskin needs to be pushed back regularly, in order to stretch it open, and to keep it from shrinking shut again, or worse, adhering to his dickhead. It is essential that the boy learn to do this himself, so that he pulls his foreskin back only as far as feels comfortable to him.
Of course, there in lies the rub, so to speak. The sex-negative pressures of the prevailing culture frown upon self-induced pleasure of any sort, even if it is associated with personal hygiene and necessary bodily upkeep. So most boys get the message that fiddlin’ around down there, even for the purpose of essential maintenance is a no-no. Simply put, without manual stretching a kid’s skin can actually shrink, closing up again. Is this good enough reason for infant cosmetic surgery? I think not. And there is plenty of research to back me up on this.
The American Academy of Pediatrics has released several statements on routine infant circumcision over the years. The first was released in 1975. The AAP said there is no medical reason for routine infant circumcision. In 1983, the American College of Obstetrics and Gynecology released a joint statement with The AAP that basically restated the 1975 position. Again in 1999, The AAP formed a task force on circumcision to study the data. They released a statement saying that there is no sufficient data to recommend routine infant circumcision to parents.
I think there is a fundamentally better way to deal with health concerns than body-altering surgery. You see, as a young fella approaches puberty there is, as we all know, a growth spurt. What most of us fail to take into account is that along with his legs, arms, torso, head and feet, his cock is also growing. His dickhead is increasing in size, and if the kid hasn’t established a healthy routine of foreskin stretching there is gonna be trouble.
Since parents are not likely to encourage self-discovery of this sort, nor are they inclined to show their young uncut sons how to properly care for this exceptional body part, the kid remains clueless till a problem arises. Wouldn’t it be so much simpler, as well as the responsible thing to do, for all parents with intact boys to pass on this priceless nugget of wisdom. It would be so easy to do while the kids are enjoying their bath. Parents could show their boys how to retract this fold of skin so that it stays supple, as well as getting things rinsed out underneath. They could encourage their boys to always pull back their lace curtains when they pee. Merely the number of times a fella will handle himself to piss will automatically keep things more lubricated and elastic.
This article was originally posted March 6, 2011
I’m a physician that routinely cares for newborns and I’ve performed many circumcisions. I have a bias. It’s a procedure that I don’t particularly relish performing, but I’m aware of my bias and just present the facts to new parents. It wouldn’t be ethical for me to skew the facts and unduly influence the decision of parents. I do appreciate the author’s post. It is a topic that should be discussed, but there are some statements in the post that are inaccurate and potentially misleading. Again, I’m not a fan of performing circumcisions, but in the interests of promoting an informed decision I’d like to clear up some points.
The facts and the AAP’s position on the subject of circumcision can be found here:
“Again in 1999, The AAP formed a task force on circumcision to study the data. They released a statement saying that there is no sufficient data to recommend routine infant circumcision to parents.”
Actually the AAP statement in 1999 and reaffirmed in 2005 stated that the evidence demonstrates potential medical benefits of circumcision, but the data is not sufficient to recommend the procedure on a routine basis. They further emphasize the importance of presenting information to parents in an unbiased manner and giving them the opportunity to ask questions and reach a decision based on this information.
“Our foreskins do have a purpose: a healthy prepuce is a natural deterrent to infection and it will be an aid to your son’s sexual functioning and pleasure too.”
Actually there is sound evidence contrary to this statement. There is a significant increase in the rate of urinary tract infections in uncircumcised versus circumcised infants and this difference is most dramatic in the first year of life.
The assertion that parental instruction about the hygiene will eliminate the problems associated with foreskin retraction (phimosis) is just not accurate. Proper hygiene can reduce the rate of problems of inflammation and difficulty retracting the foreskin, but will not eliminate them.
The crux of this article seems to be aimed at the perception that circumcision will lead to decreased sensation and therefore interfere with sexual activity. Again, this anecdotal evidence has not been borne out by studies. There appears to be no difference in the ability to sense touch on the upper and lower surfaces of the glans penis between circumcised and uncircumcised men. Also, surveys of adult males suggest that circumcised males have less sexual dysfunction and a more varied sexual practice versus their contemporaries that are uncircumcised.
I know what the author is writing here is an opinion essay and I can appreciate that opinion, but the danger is that people will read it and be swayed not by evidence, but this one opinion. Further, there is the danger that parents who previously came to the decision to circumcise their babies, will read this article and feel unnecessary guilt about that valid choice. The bottom line is that when it comes to circumcision there is no right answer. There are many valid arguments for and against the procedure. It is an individual choice.
boy, i have to take exception to what you say here, DrBrian. i never suggested that parental instruction about foreskin hygiene will eliminate anything. however, you make it sound like i do. is there anything in life or in medicine for that matter, that is foolproof? i suggest not. in fact, your own comments suggest that circumcision may decrease the incidence of urinary tract infections in infants, but circumcision doesn’t eliminate these infections. And since many circumcisions infect and many are botched, I’d suggest that this doesn’t outweigh what nature has provided.
and are you certain that “The crux of my article seems to be aimed at the perception that circumcision will lead to decreased sensation and therefore interfere with sexual activity”? i wouldn’t be so sure about that; it certainly is not what I was shooting for. and to top that off, you quote “studies” that say that “There appears to be no difference in the ability to sense touch on the upper and lower surfaces of the glans penis between circumcised and uncircumcised men.” i have some trouble with the “appears to be” part of that. doesn’t sound particularly scientific to me.
besides, i contend that a foreskin is just chock-full of nerve endings. like is said in the first part of this series; a foreskin contains about 240 feet of nerve fibers and tens of thousands of specialized nerve endings, which can feel the slightest pressure, the lightest touch, the smallest motion, the subtlest changes in temperature, and the finest gradations in texture.
in many ways, a foreskin is just like an eyelid. It covers, cleans, and protects a guy’s dickhead just like an eyelid covers, cleans, and protects your eye. a foreskin keeps the surface of a guy’s dickhead healthy, clean, shiny, warm, soft, moist, and sensitive.
in the end, a foreskin is a highly specialized, extremely sensitive functional organ of touch. no other part of the body serves the same purpose. so how do we study the sensitivity of a foreskin after it’s been removed? not the guy’s dickhead mind you, but the foreskin itself with all those nerve endings. or is that unimportant to the equation?
furthermore, i’m not interested in making parents feel guilty for the choices they’ve made, as you suggest that I do. i do, however, want future parents to consider carefully what they plan to do, before they do it. so many people resort to circumcision without really thinking it through. i mean, can you think of any other surgical procedure that is as routine? i can’t. so many parents tell me that they were never given all the information they needed to make an informed decision about circumcision. often people tell me that they just followed the advice of their doctor.
now, if my column, does nothing more than get prospective parents to begin to ask more questions, to get more involved in this important decision, than i think i’ve done my part. considering the preponderance of the cultural pressures to circumcise, i don’t think my comments are a particular threat to, or are going to undercut, the medical industry on this issue.
“Our foreskins do have a purpose: a healthy prepuce is a natural deterrent to infection and it will be an aid to your son’s sexual functioning and pleasure too.” –Richard Wagner, PhD.
Yeah I guess it was a real stretch to say that “The crux of your article was the perception that circumcision will lead to decreased sensation and therefore interfere with sexual activity. I’m not sure where I got that impression.
The fact of the matter is that quotes like the following:
“…your own comments suggest that circumcision may decrease the incidence of urinary tract infections in infants, but circumcision doesn’t eliminate these infections. And since many circumcisions infect and many are botched, I’d suggest that this doesn’t outweigh what nature has provided.”
Are exactly the type of non-factual hyperbole that I was speaking about in my response to your post. If you want to argue against circumcision and open a dialogue, then please do it based on the facts. The facts are that the infection and complication rate for circumcisions are very low. The increased rate of UTI in uncircumcised newborns is as much as 12-20 x greater than circumcised infants in some studies. That’s not small and is much more likely than a complication from a circumcision.
As for the argument that the foreskin is an amazing sensory organ, it’s just redundant skin. I think you’d find the density of nerve endings and special receptors is the same in this region as it is in the rest of of the skin of the penis. The redundant skin that surrounds the glans penis, or as you call it the “dickhead”, does serve to keep the glans moist much the same way that an eyelid keeps the cornea moist. The nerve endings embedded on the eyelid, don’t somehow make the eyeball more sensitive though.
You’ve seen boy dogs get excited? You know the lipstick that comes out when the boy dog gets excited? That’s the glans penis. The boy dog doesn’t fuck the girl dog with his oh so sensitive foreskin. So, when Masters and Johnson investigated the relative sensitivities of the glans penis in circumcised and uncircumcised men in their landmark 1966 work and found no difference, I believe them. I also believe this was a scientific study and not something I conjured to try to sway a readership. I would argue that the foreskin is irrelevant in this situation unless you’re going to fuck sideways.
I would again reiterate my opinion that a case can be made for and against circumcision. This is based on the consensus opinion reached by the AAP position paper. If parents want to leave their infant uncircumcised that is as valid a choice as circumcision. That is the AAP’s position, that is my opinion and that is the opinion of the vast “medical industry”, whatever that means. It’s no skin off my ass if a parent chooses not to circumcise their infant. It means I get to finish rounding early and get coffee. It’s a shame when a large percentage change their minds later on and the child has to go under general anesthesia and see a Urologist to have it done. Go ahead and “undercut”, just please do it based on facts otherwise what happens is we reduce this site to an outlet of misinformation that is no better than Jenny McCarthy telling people to not immunize their infants because they cause autism. Then you know what happens? There’s a whooping cough epidemic amongst uncircumcised infants in California.
you’ve completely won me over with your modest proposal, drBrian.
now i’m completely indifferent to physicians freeing us up, as infants, from all and sundry redundant skin anywhere on our body that might at some point in our lives possibly, maybe lead to some medical issues of one kind or another. who needs all those pesky extra nerve endings anyhow.
i just hope all this extra work will still allow you to finish your rounds early and get you to your coffee without incident.
Essential Viewing! The Circumcision Debate — http://wp.me/pb1xi-2fy
watch the whole program. watch it in segments if you must, but watch it all.