CIRCUMCISION DECISIONS
Do the reasons for circumcision justify the potential risks and are parents depriving their sons of their basic right to choose for themselves?
Prince Charles and his brothers are said to be among the 21 percent of men in the UK who were routinely circumcised at birth. Statistics for other countries range from around two percent in Scandinavia and 12 percent in Australia, to 20 percent in Canada and 60 percent in the U.S. In South Africa circumcision is traditional in Jewish, Moslem communities, and among the Ndebele and Xhosa tribes, but isn't customary in English-speaking and Afrikaans cultures.
Judging from numerous scientific and personal reports though, these men have lost much more than what's often referred to as just a useless flap of skin. Not only have they been denied basic fundamental human rights; they're also losing out on the true meaning of complete sexual fulfilment.
| The first cut. |  |
| More than skin deep. | |
| Do the ends justify the means? | |
| A clean-cut diagnosis. | |
| A sensitive issue. | |
| Happy ever after? | |
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Circumcision is the surgical removal of the foreskin; the double layer of skin and mucosal tissue that covers the head or glans of the penis. Apart from keeping the glans soft and moist, the foreskin protects a baby against chafing during the nappy period, and from trauma and injury throughout life. The belief that babies can't feel pain is simply not true: they're probably even more sensitive to pain than children and adults, but because anaesthesia can pose risks for babies, most circumcisions are performed without.
Some medical professionals use a local anaesthetic, but many feel that the pain of the injection is as bad as the pain of the cut.
This doesn't eliminate pain though: most babies squirm and cry bitterly throughout the procedure, and suffer discomfort for up to 10 days afterwards. Like surgery, there are risks too. Apart from the risk of complications, a study published in The Lancet in 1997 suggests that the pain is remembered long after the procedure is over.
Circumcision is still an ethical and legal hot potato, though. –People have a fundamental human right not to have pain intentionally inflicted on them”, writes lawyer and ethicist Margaret Somerville in her new book, The Ethical Canary.
Legally, she explains, there may be a way to prohibit neonatal male circumcision while respecting religious reasons for the practice.
In Sweden, a law passed in October 2001, states that circumcision can only be carried out on boys under the age of two months, and local anaesthesia must be administered by a nurse or doctor. And at the Sixth International Symposium on Genital Integrity, Professor Greg Boyle of Bond University in Queensland said that the surgical removal of the foreskin could result in a range of psychological and sexual problems in adulthood, including post-traumatic stress order.
–Circumcision is a violation of a child's human rights, and should be considered an offence to be prosecuted through the courts,' said Professor Boyle. He added that it was a violation of Australia's anti-discrimination laws to ban female genital mutilation while failing to protect boys.
Do the ends justify the means?
Although there's no absolute medical indication for routine neonatal circumcision, cultural, traditional and religious reasons are key factors in the decision made by parents, or medical professionals. The U.S. is the only country in the world that circumcises most of its male babies for non-religious reasons.
A 1996 report by the Canadian Paediatric Society in the Canadian Medical Association Journal states conclusively that routine circumcision isn't recommended. Three years later, the U.S Academy of Pediatrics reversed its position on circumcision, suggesting that potential problems far outweigh risks, though there's still mention of some medical benefits.
It found that uncircumcised men and boys are at greater risk of penile infection, but that risks were extremely low and problems easily treated. Another finding was that the risk of penile cancer is up to 20 times greater among uncircumcised men, and rare in men circumcised shortly after birth.
What they don't spell out though, is that the likelihood of an uncircumcised baby contracting an infection is no more than one percent (this figure is even lower in breastfed babies) while the chances of infection or complications arising from circumcision are around two to three percent.
But circumcision is a multi-million dollar business in the U.S. and that excludes spin-off industries such as those generated by the need for jellies and lubricants.
Where the practice does seem to be justified is for medical reasons such as phimosis, when a young boy has difficulty in retracting his foreskin. This condition can cause adhesions and increase the risk of complications with secondary infection in uncircumcised males.
But a study published in the British Medical Journal argues that the condition almost always resolves itself with age, and that only 0.6 percent of boys with phimosis actually need the procedure. Dr Paul Munk, a Toronto paediatrician, has a low-tech prescription to mend a tight foreskin. –Time, patience and basic hygiene.”
The findings that have made the biggest impact though, and led hundreds of men worldwide to undergo the long and painstaking process of restoring their foreskins, are those made by Canadian pathologist Dr John Taylor.
–Whereas the foreskin is loaded with nerves, the head of the denuded penis is a blunt instrument, insensitive to light, touch, heat, cold, and, as far as the authors are aware, to pinprick” he writes in the British Journal of Urology, after discovering that the part routinely cut off contains specialised nerve endings that can be compared to similar nerve endings in the fingertips and lips.
In a study presented at the Sixth International Symposium on General Integrity, researcher Tina Kimmel also found that the penile sensitivity of intact males is 25 percent to 30 percent greater than that of circumcised males.
–Circumcision represents a true loss of sensation. It isn't a diminutive harm,” she said.
Men circumcised as adults back up these findings. Says one victim, –Sex before circumcision was like driving a powerful luxury car with automatic transmission; I used to just glide along. Now sex is like driving a tiny, powerless manual car. It takes a lot of work to get anywhere.'
One man, who was circumcised at 26 on his doctor's advice, put it more strongly: –On a scale of one to 10, the pleasure for an intact penis is 11 or 12. The circumcised penis is lucky to get to three.”
Not everyone agrees though. Research shows a less sensitive penis enables a man to –last longer” and makes orgasm much more intense. Other supposed advantages are that circumcision increases the efficiency of a small penis, and that a circumcised penis makes better contact with the vagina, increasing pleasure for both partners.
It may be difficult to think of your newborn as a sexual creature, but one day the shape and size of his penis is going to be a matter of some importance. Before you make a decision, weigh up the pros and cons carefully, for the key to your son's future self esteem and sexuality lies in your hands.
Put it this way: if your son is in the position one day to choose between a powerful automatic transmission sports car, or a reliable, but smaller and easier to maintain economy model, which do you think he'll choose?
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