Circumcision

Circumcision

Circumcision is a medical procedure that removes the foreskin from the human penis. It can be performed at any age but is usually done on neonates. People opt for this procedure for religious beliefs or medical reasons. Some just go with the flow and get it done. This is a very common procedure among Jews and Muslims.

American Academy of Pediatrics (AAP) says that there are benefits of circumcision but it is not a medical necessity. The family should make the final decision whether it is in the best interest of their child.
CDC (Center for disease control) endorses AAP.

Medical indications for circumcision:

  • Phimosis, paraphimosis
  • Frequent infections
  • Tight foreskin
  • Balanitis
  • Trauma
  • Prevention of urinary infections
  • Prevention of penile cancer
  • Prevention of sexually transmitted diseases e.g. syphilis, herpes, HIV, HPV
  • To decrease the buildup of smegma

Non-medical reasons:

  • Religious beliefs
  • To maintain the tradition
  • Prevention of masturbation
  • The belief that every child has a right to a healthy life with less risk of infections, STDs, and cancer
  • Everyone gets it
  • Circumcised people are doing well
  • It is just removal of a useless skin piece

Statistics:

  • The global rate of circumcision is roughly 33%.
  • Almost 100% in Israel
  • More than 80% in Afghanistan and more than 98% in Turkey
  • Less than 20% in Asia
  • Less than 20% in Australia
  • Less than 10% in Newzealand and Germany
  • Less than 10% in the UK and Europe
  • 75% in the U.S.A.
  • 80% in Midwest
  • Less than 10% in Nevada

Side effects and complications from circumcision:
Complications may arise from surgical procedure or anesthesia. There is a risk of-

  • Meatal stenosis
  • Meatal ulcers
  • Infection
  • Bleeding
  • Reexploration due to bleeding
  • Need of corrective surgery
  • Postoperative phimosis
  • Removal of too much foreskin
  • Scarring
  • Penile adhesions
  • Buries penis
  • Loss of penis/penile amputation
  • Death

Arguments against circumcision:

  • The risk of urinary infections is anyway very low. It is less in boys than girls. Infections can be medically treated without any surgical intervention
  • Prevention of STD-- It may reduce the transmission of sexually transmitted diseases but that percentage is very low. Also, the protection is only for vaginal sex, not for oral or anal sex. It does not prevent the transmission of STDs to the partner
  • Religious beliefs-- No one knows for sure when and where this practice originated. Why people with no religious beliefs are opting for it?
  • Men in a family should look similar. This argument has no ground to stand on. If a family member loses his arm will the other member willingly amputate his arm also? Different does not translate to less or bad.
  • If it is about hygiene, will you take out all of your nails?
  • If it is about cancer prevention, will you take out breasts, intestines, prostate, etc. before cancer detection?
  • Why it is done on males only? Why female circumcision was called genital mutilation and fell out of practice but male circumcision is still prevalent? It is a bias towards males.
  • It is a unnecessary social surgery and not a treatment for any disease.
  • It is an irreversible process. Some stretching procedures can be done afer circumcision but those do not bring the nerve endings back. Penis is the most erogenous tissue in males. It is roughly 12 to 15 square inches in area and contains approximtely 10 to 20 thousand nerve endings.
  • Nerve endings on the foreskin are permanently gone. It may lead to less sexual pleasure
  • Foreskin provides a smooth gliding action during sex. Circumcision can make insertion and ejaculation slower. It can lead to decreased chances of pregnancy
  • Foreskin has smegma which helps in lubrication
  • Foreskin protects the glans from irritation by underclothes
  • Foreskin when flaccid protects the tip of the penis, when erect, it pulls back automatically
  • God gave this to boys, why will he want it back for no reason
  • Girls do not like foreskin-- this is a myth. Different girls have different preferences. Many males and families are opting out of this procedure now so girls are going to see more males who are not circumcised. Is any girl going to mutilate her vagina if boy does not like it?
  • No solid reason for stigmatizing foreskin. It is not a birth defect. Males are not born defective. Male sexuality is not bad.
  • Globally about 2/3rd males are not circumcised and still they are doing good. This shows that it should not be mandatory and is unnecessary.
  • No one should mutilate a child. An adult male can decide for himself whether he wants this procedure or not. Adults should also not come under the pressure of society, religion, traditions, family
  • Procedure on a neonate disrupts child-parent bonding and leads to problems with breastfeeding and trust issues in the child
  • May lead to developmental and lifelong psychological issues
  • May lead to erectile dysfunction
  • How come parents have the right to decide about their child's body? SHould not it be the right of the person effected?

Cost of Circumcision:
Different, based on the insurance carrier. It is an elective procedure. Many insurance companies do not cover the cost and have a deductible or co-pay for this procedure.

Ethical issues:
Many hospitals sell the removed foreskin. The foreskin is used in body creams, for cosmetic testing, research, and to grow fibroblasts. It is used as a skin graft for burn wounds, to cover diabetic wounds, to replace eyelids, etc. Foreskin fibroblasts are used as a culture to grow skin or cells.
Some products are Invitrogen, Apligraf, and Valveta (Intercytex).
The financial gains from sold foreskins are very high. The ethical issue is that there is no consent to sell it and financial gains are not shared with the patient. Only one parent has to sign the consnet for the circumcision. Buried deep in the consent form is a sentence that the parent wants to donate the foreskin.
Often the consent for circumcision is not a well informed consent. Complications severity is trivialized, foreskin functions are understated, and it is a rushed/casual consent.

Movies:

  • American circumcision
  • Child circumcision: An elephant in the hospital
  • Sex and circumcision: An American love story
  • Circumcision: The battle for foreskin
  • Facing Circumcision: Eight Physicians Tell Their Stories - Documentary - 1998
  • The circumcision movie
  • Circumcision segment on 60 Minutes(Australia) - March 2013

Organizations working against circumcision:

  • Intact America
  • Stop infant circumcision society
  • National Organization to Halt the Abuse and Routine Mutilation of Males (NOHARMM)
  • National Organization of Circumcision Information Resources Centers (NOCIRC)

Hinduism:
There are sixteen sanskars in Hinduism, circumcision is not one of these sanskars. 16 sanskar include Karnvedhan which means ear piercing but it does not include circumcision.
Hindus are not against sex and sexual pleasure. Kamsutra was written in India. India has sculptures depicting sex.
Shiv is a Yogi and Grihsthi both.
Indian Devi Devta's are a family system.
Sex was never a taboo in India.