Circumcision: A Medical or a Human Rights Issue?
Feinberg, J. () The child's right to an open future. In: A. Aiken, & H. Circumcision and its relationship to attachment impairment. Paper presented at the. However, often longitudinal datasets fail to analyze its relationships to child outcomes Other impairments, like ADHD and schizophrenia, are comorbidities . We justify male infant circumcision by pretending that the babies don't Laibow, R. Circumcision and its relationship to attachment impairment.
Humanities and Social Science Papers. Van Howe R, Bollinger, D. Alexithymia and circumcision trauma: Int J Mens Health. Frisch M, Simonsen J. Ritual circumcision and risk of autism spectrum disorder in 0- to 9-year-old boys: J R Soc Med. Oxford University Press; Prevalence of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, A preliminary poll of men circumcised in infancy or childhood.
Gemmell T, Boyle GJ. CreateSpace Independent Publishing Platform; The compulsion to repeat the trauma: Psychiatr Clin North Am. Relationship of maternal and perinatal conditions to eventual adolescent suicide. Perinatal origin of adult self-destructive behavior.
Jacobson B, Bygdeman M. Obstetric care and proneness of offspring to suicide. The newly recognized, shattering effects of child abuse. Anchor Books Doubleday ; Say no to circumcision: The psychological impact of circumcision. Rediger C, Muller AJ. To cut or not to cut? Am J Mens Health. The Intactivism Pages website. Last updated Nov 5. His book was last printed inthe same year that one physician, writing in Medical Aspects of Human Sexuality, called the book "pertinent and carefully thought out" 7.:: (Be) Foreskin: The Truth About Circumcision ::
As scientific advancements found legitimate pathologic etiologies for diseases previously believed to be prevented or cured by circumcision, new excuses were adopted to substantiate this elective genital surgery. Since the turn of the century, one excuse after another has been used to perpetuate a practice most of the world has never considered. Hygiene and prevention of venereal diseases became popular excuses for circumcision during World War I 8, 9.
The erroneous fear during the s of foreskins causing penile cancer 10, 11 and during the s of foreskins causing cervical cancer helped champion the practice of prophylactic circumcision. The most recent justifications for routine neonatal circumcision of boys include protecting infants from urinary tract infections UTIs during the first year of life 15, 16 and decreasing the risk of AIDS in the sexually active male While the American medical community was presenting one pathology after another to support amputation of the foreskin, its European counterpart began to research the normal structure and function of the external male genitalia.
Anatomy and physiology offer new insight Medical enlightenment began in with publication in the British Medical Journal of Dr. Douglas Gairdner's classic article, "The Fate of the Foreskin" Gairdner declared that the foreskin is normal, healthy tissue, and its adherence to the glans head of the penis by a common epithelium synechia serves the important function of protecting the glans penis from urine and feces in infancy and early childhood.
Subsequently, the British National Health Service discontinued payment for the surgery and the practice ceased. Following this study, Dr. Jacob Ostera Danish medical officer who conducted a longitudinal study with nearly 10, observations, reported that the continuous, shared epithelium of the foreskin and glans penis separates spontaneously during childhood.
He stressed that this natural process, should never be interfered with, and is usually complete by the age of 18 In his published study, he quoted Sir James Spence: What looks like a pinpoint opening at 7 months becomes a wide channel of communication at By the end of the s, the American College of Obstetricians and Gynecologists had concurred The section on the function of the foreskin read: The foreskin shields the glans; with circumcision, this protection is lost.
In such cases, the glans and especially the urinary opening meatus may become irritated or infected, causing ulcers, meatitis inflammation of the meatusand meatal stenosis a narrowing of the urinary opening. Such problems virtually never occur in uncircumcised penises. The foreskin protects the glans throughout life. But, rather than respond to the apparent need to cease performing a surgery that was responsible for identifiable iatrogenic disorders, in the AAP revised its publication, excluding this litigiously provocative paragraph.
Information important for helping parents make informed choices had been deleted. From informed consent to human rights issues Informed consent and self-determination for childbearing- childrearing health care were an essential component of the cataclysmic changes brought about by the Women's Movement. American women who had struggled to achieve these rights for themselves were now beginning to consider rights for their babies as well.
The need to defend the baby's right to a peaceful beginning was brought to light by Dr. Frederick Leboyer in his landmark work, Birth Without Violence This French obstetrician acknowledged the importance of a nonviolent birth coupled with a gentle newborn experience because he recognized the long-term impact that these early experiences have on emotional and psychological development. Many healthcare providers, including certified nurse-midwives CNMsresponded to this need by performing gentle births.
The obvious contradiction of a gentle birth versus a painful newborn circumcision placed health care providers in a precarious position. With informed consent an issue, words that were once used euphemistically to describe circumcision now left parents feeling betrayed 24, Parents who watched their newborns being circumcised were horrified and considered themselves deceived by the dishonest portrayal of a surgery they had been led to believe was minor, necessary, and minimally painful Health care providers themselves were often uninformed and unaware of the findings or proclamations of their own professional organizations.
Those who questioned the ethics of circumcision and wanted to provide adequate information for an informed choice were often intimidated by employers who endorsed the practice. This organization serves as a clearinghouse for information on all aspects of male and female circumcision.
International experts from the diverse fields of cultural anthropology, theology, psychology, medicine, midwifery, law, and ethics gathered to discuss male and female genital mutilations and their human rights implications. We recognize the inherent right of all human beings to an intact body.
Without religious or racial prejudice, we affirm this basic human right. We recognize the foreskin, clitoris and labia are normal, functional body parts. Physicians and other health-care providers have a responsibility to refuse to remove or mutilate normal body parts.
The only persons who may consent to medically unnecessary procedures upon themselves are the individuals who have reached the age of consent adulthoodand then only after being fully informed about the risks and benefits of the procedure.
We categorically state that circumcision has unrecognized victims. The last tenet states: Benjamin Spock, one of America's best-known pediatricians, was honored with and accepted the first Human Rights Award of the ISC for reversing his position on this issue: The practice of genital mutilation of females in Africa was addressed by Dr.
Asha Mohamud, an African pediatrician. Today, million females, including young girls and infants, suffer the effects of this debilitating surgery. And now, with increased African immigration, American health care providers are faced with clinically caring for infibulated women 29 and requests to infibulate their daughters.
The ISC is an international forum, networking with Women's International Network News WIN News and the Inter-African Committee to abolish the myths of genital mutilation of both males and females in defense of body ownership rights of all the world's children. The greatest tool of the ISC and related international groups is truth because of the many myths which still prevail.
Biases influence interpretation of scientific data base Circumcision has a strong irrational bias that seeks validation, and many parents and health care providers continue to believe the old myths or to conjure up new ones. After reviewing current studies, which admittedly were "retrospective," "may have methodologic flaws," and often contain "conflicting evidence," the AAP broadened its policy.
What are Men Saying about Infant Circumcision?
Their new position statement, ironically released just three days after the adoption of the Declaration of the First ISC, states "Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks" And, it went on to say, " Left with this meager AAP guideline, health care providers must take it upon themselves to become educated in order to provide legally correct and accurate information.
To teach the parameters of normal genitalia adequately and effectively, health care professionals must first recognize and overcome personal bias regarding intact genitalia and the myths of circumcision. James DeMeo's broad cultural perspective gives insight: Simply put, all forms of male genital mutilation to include infant circumcision, are ancient blood rituals associated with primitive religion and absolution of the male The ritual has absolutely nothing whatsoever to do with medicine, health, or science in practically all cases.
The fact that so many circumcised American men, and mothers, nurses, and obstetricians are ready to defend the practice in the face of contrary epidemiological evidence is a certain give-away to hidden, unconscious motives and disturbed emotional feelings about the penis and sexual matters in general. This is not a small point, as before such painful and traumatic mutilations can be perceived as "good" and be championed by both high caste priests and average people alike, certain other antisexual and antichild social factors must already be present and thriving.
Circumcision, Breastfeeding, and Maternal Bonding
These, then, are the most prevalent myths of the day. A circumcised penis is cleaner. Cleansing the intact penis is similar to cleansing intact labia and is simply a matter of common sense. During infancy, when the foreskin and glans are attached to one another, external washing with only warm water is all that is required.
Once the foreskin and glans separate, retraction of the foreskin and washing with warm water are all that are necessary. After the age of reason, one hopes that a boy who has already learned to tie his shoes can be cajoled into washing behind his ears and directed to clean his penis.
It is painless, takes only a few seconds, and when it takes any longer is probably associated with a smile. Circumcision is minor surgery. Circumcision, like all surgery, has inherent risks, which include hemorrhage, infection, mutilation, and death.
And, although neonatal circumcision is the most commonly performed routine surgical procedure in America today, we have no accurate statistics on the resultant complications or deaths. Intwo Atlanta boys lost their penises and, adding insult to injury, doctors subjected one boy to a sex reassignment.
He will live the remainder of his life as a female That same year, two other boys were victims of staphylococcal infections, the port of entry was the circumcision wound. One boy died seven days after his birth from "scalded skin syndrome," the other is a blind, spastic quadriplegic Circumcision is not a minor procedure and there are many unrecognized victims. Robin recommends, "If it ain't broke, don't fix it!
Circumcision prevents penile cancer. Penile cancer, which has been documented in both circumcised and intact men, is a rare disease of elderly men and one of the least common malignancies. James Snyder, past President of the Virginia Urological Society, notes that the low incidence of penile cancer in the United States is not due to circumcision because " Research indicates that good hygiene prevents penile cancer and, according to Dr.
Sydney Gellis, "It is an incontestable fact Women with circumcised partners have a lower incidence of cervical cancer. Inaccurate studies of the s are to blame for the erroneous idea that cervical cancer occurs in women because their sexual partners are intact According to Wallerstein, "Jewish women have a relatively low rate of cervical cancer, but Moslem women, whose husbands are circumcised in infancy, have a much higher rate.
Parsis of India, who do not circumcise, have a lower cervical cancer rate than their Moslem neighbors, who do circumcise" According to the most recent AAP report, " The strongest predisposing factors in cervical cancer are a history of intercourse at an early age and multiple sexual partners" Circumcision will decrease the risk of sexually transmitted diseases, including AIDS.
There is an epidemic of sexually transmitted diseases, including AIDS, in the United States, where the majority of sexually active men are circumcised. It is not the foreskin that causes these diseases, and circumcision will not prevent them.
Circumcision prevents urinary tract infection. The AAP reported that studies reflecting an increase in UTIs among intact boys are "retrospective," may have "methodologic flaws," and "may have been influenced by selection bias" The more recent research of statistician and pediatrician, Dr.
Martin Altschul, refutes the earlier UTI studies New York pediatrician, Dr. Marino, agrees with Altschul: Since one fourth of my male infant patients are not circumcised, and if the frequency of UTI in the uncircumcised is as high as it is said to be, I should be seeing many UTIs in male infants.
If I'm missing the diagnosis, they somehow are getting better without treatment. My experience reinforces the practice of discouraging routine circumcision, a cause of more morbidity than benefit Phimosis when the opening of the foreskin is so small that the foreskin cannot be retracted over the head of the penis is normal in infancy 18, 19 and is not an appropriate diagnosis before the age of 18 Furthermore, some men live their entire lives without being able to retract their foreskin, and " The normal accumulation of sloughed epithelial cells smegma are lysed by these secretions.
It is a normal, natural body product no more harmful than ear wax.
Circumcision vs. Child Health, Breastfeeding and Maternal Bonding
It is definitely not a carcinogen Adult smegma serves as a protective, lubricating function for the glans, just as adult smegma in women protects the clitoris" Some men with phimosis, who prefer to have a retractile foreskin, employ nonsurgical measures, i. My parents let my foreskin loosen at its own slow rate. I was about 12 before my urethral meatus was visible and 16 before I saw the corona of my glans.
Even with this slow loosening of the foreskin, I never experienced irritation or inflammation.
Before becoming sexually active, I spent a few minutes each day over a period of several months gradually stretching the foreskin by hand until it would easily retract. When scar tissue has formed at the preputial opening secondary to premature retraction or ammoniacal burns, there are surgical techniques Y-V-plasties and Z-plasty 43, 44which can be employed to make the foreskin retractable without amputating it.
And if phimosis has been caused by a rare pathologic condition such as balanitis serotica obliterans, only the afflicted area need be removed. Using the surgical treatment of circumcision to prevent phimosis is a little like preventing headaches by decapitation.
It works but it is hardly a prudent form of treatment. Intact boys will be teased in the locker room. Although this may have been an issue for a few boys when the circumcision rate in America was at its peak, the incidence of circumcision in the United States is steadily decreasing. Circumcised boys have already begun to ask "Why am I different? A boy should look like his dad. Ironically, this argument was never used when medical circumcision was initiated just a hundred years ago.
Nor has it been used by Western feminists working to stop female circumcision in Africa. A simple explanation is all that is needed for children to understand that there are individual differences, and to help them feel good about themselves. A response something like this usually suffices: Your body is perfect just the way it is. You did not need to be circumcised.
More to the point, a father may be worried about being different from his son. What was so difficult in leaving my son intact was not that my son would feel different in a locker room, but that I would feel different from him. I would then have to accept that I'm an amputee from the wars of a past generation An intact penis looks funny.
Circumcision: A Medical or a Human Rights Issue?
To whom does an intact penis look funny? Certainly not to the baby, nor to most of an intact world. While circumcised African women consider intact female genitalia unacceptable, American health care professionals would find this inappropriate, if not repugnant, justification for performing female circumcision.
Considering the potential physical and psychological harm of neonatal circumcision, as well as the infant's right to his own body, we must take responsibility for educating ourselves and overcoming our cultural bias with regard to the appearance of the intact penis.
A review of classical art at a local library will illustrate what is normal. Circumcision prevents foreskin infections. Yes, it does, in both males and females, and removing all the teeth would prevent cavities. Where does this argument end?
Infections are caused by invading organisms and can be treated effectively with antibiotics. Fear of infection is no reason to routinely amputate a tonsil, an appendix, or a foreskin.