Questions about Circumcision and the Foreskin
What is circumcision?
Circumcision is the surgical removal of the foreskin, the sleeve of skin that normally covers the glans (head) of the penis. It is a good idea to look at pictures or a video of the surgery before deciding about circumcision, so that you know what it entails.
Does circumcision have any medical benefits?
Medical organizations do not recommend routine circumcision, and most physicians feel that there are not any compelling medical reasons to circumcise. Circumcision is a cultural issue, not a medical one. This becomes evident when considering the medical practices of non-circumcising nations such as Canada, Australia, and European countries. Hospitals in those areas typically do not even offer newborn circumcision. In the United States, a growing number of state Medicaid programs do not pay for newborn circumcision because it is not medically necessary.
However, over the past half-century a number of studies have attempted to demonstrate medical benefits of circumcision such as reducing the already low chance of a boy developing a urinary tract infection in the first year of life or reducing the transmission of certain sexually transmitted diseases, including HIV*. Other studies show no difference. In any case, only a small minority of boys might ever experience a medical benefit from circumcision, and these conditions can be prevented or treated in other ways without surgery.
*Practicing safe sex is always necessary whether one is circumcised or not.
What is the foreskin?
In the intact penis, the forward part of the penis's skin sheath folds over on itself and covers the glans. This double-layered fold is called the foreskin. The foreskin is an integral part of the skin system of the penis, not something extra. It contains lots of sexually sensitive nerves, blood vessels, and a thin layer of muscle. The adult foreskin is about the size of a 3x5 index card, and makes up about half of the skin the penis is naturally designed to have. With a foreskin, the skin covering the penis is very mobile, and can easily move back and forth over the glans and shaft of the penis.
What are the functions of the foreskin?
First, the foreskin covers and protects the glans from abrasion, irritation, and foreign material, keeping it soft, moist, and comfortable. The foreskin also protects the delicate urinary opening.
Second, the foreskin has immunologically active cells and substances that protect the penis and body from entry of infections.
Third, the foreskin provides sufficient skin to accommodate the increasing size of the penis as the boy grows, and to allow for comfortable erections.
Fourth, the foreskin is the most sexually pleasurable part of the penis. A specialized band of tissue encircling the tip of the foreskin contains tens of thousands of light-touch erogenous nerve endings.
Fifth, the foreskin helps retain natural sexual lubrication in the vagina, making sex more comfortable for both partners.
Sixth, the mobility of the foreskin allows for a gliding action with the motions of intercourse, reducing abrasive friction and making sex more comfortable for both partners.
Seventh, the combination of the sensory and mechanical features of the intact penis allows for a gentler dynamic with intercourse, with shorter strokes and closer contact between partners.
Circumcision alters all of these functions of the foreskin. It is important to consider that a baby boy will grow up to be an adult, with his own preferences about how his genitals work. Be sure to learn about this special part of your son's body as part of your decision-making process. Diagrams of the foreskin and how it works can be found at: www.cirp.org/pages/anatIs circumcision painful?
Yes, because of the sensitivity of the foreskin and the steps required to remove it, circumcision is very painful. Unfortunately, many infant circumcisions are still performed without any pain relief (AAP study). The impact of such a traumatic experience on a young mind is not well understood. According to the AAP, if circumcision is chosen, it is vital that pain relief be provided. However, studies show that, even when anesthesia is used, it may only reduce the pain of circumcision but it is not guaranteed to eliminate it.
What about hygiene?
Circumcision was once believed to improve male hygiene, but current medical information shows this is not true. Circumcision does not make the penis any cleaner or healthier. Contrary to myth, hygiene is simple and easy for intact men. Good hygiene through normal bathing is recommended for all males, whether they are circumcised or not.
Shouldn't a boy look like his father or brothers?
If the father is circumcised, he may be concerned that his son, if not circumcised, will feel uncomfortable being "different" from his dad. Don't worry. Many circumcised fathers are raising intact sons without any feelings of awkwardness in either father or son. The most important thing is for a father to teach his son to appreciate and feel good about his own body. Families with older circumcised sons often choose to raise later sons intact, when they learn new information they did not have a chance to consider before. If a boy ever notices why his father or brothers are different, the reason is easily explained.
Ronald Goldman, Ph.D., author of Circumcision: The Hidden Trauma wrote a letter to the spokesman of the American Academy of Pediatrics on this very subject.
Won't a boy be teased if he isn't circumcised?
Circumcision is becoming less common in America, so intact boys will soon no longer be in the minority. With positive messages from his parents that his body is normal, whole, and good, an intact boy will be able to keep a healthy perspective if he ever encounters a problem with his peers.
What about religion?
It's important to consider that the religious beliefs of the boy, as an adult, will not necessarily be the same as the beliefs of his parents. Your baby boy will one day be a grown man, with his own faith and spiritual beliefs.
Circumcision is not required by Christianity. The following passages in the New Testament state that circumcision has no spiritual value and should no longer be practiced: Acts 15:1-31, I Corinthians 7:18-20, Galatians 5:6, Galatians 6:15, and Colossians 3:11. More information is available at: www.Acts15.net and www.CatholicsAgainstCircumcision.org
Circumcision has long been practiced by Jews and Muslims. However, there are small but growing movements in these religions to end the practice. More information is available at: www.JewishCircumcision.org and www.quranicpath.com/misconceptions/circumcision.html.
How did circumcision get started?
While circumcision is thought to have been practiced thousands of years ago in the Middle East or Africa, it was not introduced in the U.S. until the Victorian Era, in the late 1800s. At that time, the causes of disease were not well understood, and some doctors believed that it would curb masturbation, which was thought to cause insanity and many physical ailments.
How common is circumcision?
In the U.S., circumcision rates were as high as 80-90% during the 1970s, but since then the rates have been decreasing. Currently, about 55% of American baby boys are circumcised, though it varies by region, being very low on the West Coast and higher in the Midwest.
Non-religious circumcision has never been practiced in most of the world, including Europe, Asia, and South America. All males are born with a foreskin, and the great majority of men in the world are not circumcised (>70%). Many famous men throughout history were intact, including William Shakespeare, Beethoven, Frank Sinatra, Elvis Presley, Dr. Martin Luther King Jr., and every American president until the mid-20th Century.
Can there be complications from circumcision?
Yes. While the procedure is generally considered "safe," if performed by an experienced medical professional, as with any surgical procedure, complications can and do occur. Most complications are minor, but some can be serious. The true rate of complications is not known, because there is no national system for collecting this data. However, the following problems have been well documented: pain, infection, excessive bleeding, removing too much skin, need for repeat surgery (1%), interference with the start of breastfeeding, buried penis, adhesions between the glans and remaining foreskin (15-30%), meatal stenosis (scarring of the urinary opening, 7-10%), damage to other parts of the penis, and in rare cases, loss of part or all of the penis, and even death.
However, the risks of the procedure should not be confused with the guaranteed consequences. Every circumcision results in the loss of a healthy and functioning foreskin, causing detrimental changes to sexual sensation and function.
How do I care for my son's intact penis?
A boy's intact penis needs very little care. The best advice is to simply leave it alone. At birth, the foreskin is normally fused to the glans, like a fingernail is to the finger. During childhood, the foreskin slowly separates from the glans, and its opening becomes looser, as part of normal development. This process is very variable and may take many years, even into adolescence for some boys. The foreskin should never be forcibly retracted before it has naturally separated. Premature retraction of the foreskin can cause pain, bleeding, infection, adhesions, and scarring. The first person to retract a boy's foreskin should be the boy himself and no one else.
All children should be taught to wash their genitals, whether they are circumcised or not. Before the foreskin is retractable, cleaning under it is not needed. Simply wash the outside of the penis during normal bathing. Once the foreskin is retractable, teaching the intact boy to clean his penis is easy, using the "Three Rs" as a guide: While in the tub or shower, have him occasionally Retract the foreskin, Rinse with warm water, and Replace the foreskin back over the glans. If you have medical questions, seek out a pediatrician who has a good understanding of foreskin development and care, and knows not to try to force the foreskin back during examinations.
How can I learn more?
The following web sites contain further helpful information about circumcision, including medical facts and studies, anatomical diagrams, ethical considerations, sexual implications, descriptions of the procedure, and care of both intact and circumcised anatomy.
www.circumcision.orgwww.cirp.org
www.circumstitions.com
www.IntactAmerica.org
www.NoCirc.org
www.DoctorsOpposingCircumcision.org
www.MothersAgainstCirc.org
