Baby Life

Circumcision?

Articles » Family » Circumcision? Please Vote

2008-03-13 01:53:38

The decision to circumcise your son is as personal as deciding whether to breastfeed him, co-sleep with him, or give birth to him at home or in a hospital. Thirty years ago circumcision was the norm in Australia, with 90% of all children undergoing the procedure. Today, the statistics are strikingly different. Only about 15% of newborns are circumcised, and the practice of circumcision is banned in all of Australia's public hospitals. (ABC News: Circumcision, June 2002) Australia is also the home to one of the world's most vocal circumcision advocates. He has not only touted the benefits of circumcision, but has also raised the ire of many doctors who believe that he is misleading the general public in the course of his crusade. So how are you to decide what is right for you and your sons? Here are some things that you might consider:

Why Should I Consider Circumcising My Son?

Religious belief is the primary consideration for choosing circumcision. For Jewish and Muslim families, circumcision is a celebrated rite of passage central to religious faith.

Some parents may choose to circumcise their sons if the father of the family is circumcised. For them, it is important that their male children resemble their father in that respect. Likewise, in areas where circumcision is more popular, such as Queensland, parents may choose to have their boys circumcised to ensure that they look like their peers. Kristin, a mum who chose to circumcise her son, says, "my husband is circumcised, so this way when [our son] sees or talks to his dad about this subject, they are the same." She also adds that, "this way our son will, in this way at least, be like most of his classmates and teammates."

North American research has shown that, during the first year of life, uncircumcised males have a higher rate of urinary tract infection. For boys with a urinary tract problem, circumcision can prevent repeat urinary tract infections, particularly if the boy is still wearing nappies. (The Children's Hospital at Westmead: Circumcision Fact Sheet).

Phimosis, a condition in which the foreskin of the penis becomes difficult or impossible to retract, is present in about 1% of uncircumcised males. It is also a risk factor for penile cancer. (Circumcision Information and Resource Pages: Penile Cancer, Cervical Cancer, and Circumcision)

Recent clinical trials performed in sub-Saharan African showed that circumcision reduced a man's risk of contracting HIV by about 50%. As a result, many AIDS activists and public health officials recommend circumcision as part of a comprehensive plan to combat the spread of HIV and AIDS. (World Health Organization) Some researchers also believe that the mucous-lined interior of the foreskin can trap and transmit bacteria and viruses that cause sexually transmitted diseases. (CircInfo.Net: Circumcision-Why the Foreskin Increases Infection Risk) Melissa, mother of five-year-old DJ, says, "the ultimate reason I chose to have my son circumcised was the reduced likelihood of sexually transmitted diseases later in life. We all hope that our children will be responsible adults and will not be engaging in careless sexual behavior, but if circumcision would potentially decrease the chances of contracting a deadly disease, I was all for it."

Why Should I Consider Leaving My Son's Penis Intact?

Most circumcisions are completely routine. According to the Royal Australasian College of Physicians, however, 1-5% of circumcisions result in infection, bleeding, or more serious damage to the penis. Serious complications may result in death.

An intact penis cleans itself. The foreskin forms a spout that carries urine away from the body and prevents dirt from reaching the glans of the penis. In addition, recent research shows that the lubricant secreted by the foreskin has anti-bacterial and anti-fungal properties that keep the penis clean. (Circumcision Information Australia: Circumcision-A Detailed Guide for Parents)

The foreskin of the penis is responsible for increased sexual pleasure. Because it is packed with an enormous amount of nerve endings, its presence increases sensitivity during sex. (Circumcision Information Australia: Circumcision-A Detailed Guide for Parents)

For many individuals, circumcision is a human rights issue. For those people, the choice to circumcise lies with the owner of the penis rather than his parents or doctors. According to Circumcision Information Australia, "The appearance of the penis is a matter of personal preference. Only the owner of the penis has the right to decide if he would like its appearance, structure and function altered by circumcision..."

In most cases, intact penises are very easy to care for. Gina, mother of one son and another on the way says, "I was worried initially about care but soon realized in that regard I had chosen the easy route. While some of my friends were fretting over adhesions and risk of infections, I had little to worry about. I followed the simple rules of cleaning my son's penis as I would wash a finger, avoiding any forcible retraction of the foreskin and trusting in his body's ability to self-cleanse under the foreskin. Now three years of age, he's never experienced any difficulties from being intact and I can't imagine him any other way."

Circumcision is painful. Because there are risks of using anesthetics on babies, circumcisions are performed with numbing creams or local injections. It seems, however, that those are inadequate to eliminate the pain of circumcision altogether. (Circumcision Information and Resource Pages: Frequently Asked Questions About Infant Circumcision)

What is the Prevailing Wisdom Among Doctors?

It is currently the policy of the Royal Australasian College of Physicians that "there is no medical indication for routine neonatal circumcision." In answer to the claims that male circumcision may reduce incidences of urinary tract infections, HIV, and penile cancer, the RACP states that the circumcision complication rate of 1-5% proves a greater risk than the 1-2% chance of a young boy contracting a urinary tract infection. It states that, while circumcision decreases the rates of HIV in third-world countries, it is not necessary in countries with a low prevalence of HIV. Finally, the RACP states that the risk of penile cancer is so slight that it does not justify the risks inherent in circumcision.

Currently, the RACP suggests that, if elective circumcision is to be performed, it should be performed between six and twelve months of age by an experienced surgeon using a general anesthesia.

In addition, a number of other international medical organizations have issued policy statements regarding circumcision. The American Academy of Pediatrics, Canadian Pediatric Society, Finland's Central Union for Child Welfare, and The Paediatric Society of New Zealand all state, in some variation, routine infant circumcision is unnecessary. (Circumcision Information and Resource Pages: Medical Organization Official Policy Statements)

Now What Do I Do?

A thorough internet search shows that many international medical bodies advise against routine newborn circumcision. Many doctors and human rights advocacy groups also speak strongly against circumcision for newborns. However, there are a handful of very vocal advocates of the practice. Reading the enormous amount of available research can confuse the issue even more. It seems that for every study showing the benefits of circumcision, there are others that show flaws in methodology or in reporting. Likewise, research showing the benefits of leaving a penis intact is quickly answered by research showing the risks of an intact penis.

In the end it seems that there is no right or wrong answer. The only real mistake parents can make is neglecting to make an informed decision and running the risk of regretting their choice in the future. The best course of action for all parents of boys is to talk to our partners, review available research, and trust our instincts.