Note: The views expressed are solely those of the author and do not necessarily reflect the views of Pregnancy.org.
Left as nature intended, a man would never willingly part with something as normal, healthy, sensitive and functional as the foreskin.
Imagine, if you will, that you are an intact man. You have your whole body, all of it in perfect working order. You've had no problem with your penis and neither have your two brothers or your father. It is the most sensitive part of your body. It is totally normal -- not smelly, not weird. You've never had a woman complain about it. You've never heard a man complain about his own penis.
Then you are married to a wonderful woman and she is pregnant with your son. You are at what is probably one of the last doctor's appointments before she gives birth and are going over all of the hospital stuff. Suddenly the nurse asks you, "Do you want your son circumcised?" And you're searching in your head to even figure out what that entails. Once you get your mental image, you look at the nurse like, "Are you nuts?" and are speechless but your wife says, "I don't know, can we get back with you on that one?"
So on the way home, you finally get up the nerve to ask your wife why she would even entertain the idea of circumcision. She tells you that she doesn't know but everyone does it, so there must be a reason. Being that you've grown up in a place where no one is circumcised, you don't even know how it's done and what's removed, let alone why it's done. So you decide to call your best friend. He's a pediatric surgeon, surely he will know what is up with this circumcision thing. The conversation goes something like this.
You ask him to tell you about circumcision and he says, "First, the doctor will strap your naked infant onto a special table. Then he may or may not give your child an injected anesthetic. There's also a chance that the anesthetic won't be strong enough, this usually happens during the clamping part. An infant's foreskin is attached to the glans, so first the doctor will force a probe between the two and lift up on the foreskin to separate it fully from the glans. Then the doctor makes a downward incision on the underside of the penis, to open up the foreskin because the end is so narrow it won't fit the clamp. Then the doctor will apply a metal clamp like a ring around the foreskin and he will tighten it. The baby has to wear the clamp from 2 to 5 minutes until the blood supply is choked off. Then the doctor will cut the end off of the foreskin and usually remove the frenulum if it's dangling there."
Think about this --- probes, clamps and no anesthesia? Or anesthesia that isn't effective during the worst part? And to remove the frenulum (the most sensitive part of the penis) simply because it might be dangling? At this point aren't you trying hard to figure this out because surely it must seem like torture. So you ask him, where do you cut it? Because you see, you just cannot understand what is removed. It seems to you that your foreskin is such an integral part that you cannot even imagine quite how this works.
So he says to you, "Picture putting a ring over your glans, but under your foreskin. Now push it back as far as it will comfortably go. That is where we clamp it from the underside of the foreskin and there will also be a ring on the outer side. They crush together and everything forward of the ring is removed."
Now you're thinking, that's a lot of skin. All of the inner foreskin would be gone. And your frenulum, too. How on earth would you accommodate an erection? You don't even understand how that works. If all that skin is necessary for your erection, how do circumcised men do it? And why would they want to part with the most sensitive parts of their penis?
After you get over your initial shock, you call him a few days later to talk some more. You ask him why you should choose circumcision. He says, "Well, there are some studies which suggest that circumcised boys have less urinary tract infections (UTIs) than intact boys." So you ask, "How risky is this?" He says to you, "I don't know. It looks like intact boys have a rate of 1 in 100 and circumcised boys 1 in 1000, but I don't know if those are caused by anatomical problems or because parents are retracting their sons or what." So you ask him, "How big of a deal is this?" and he says, "Girls get way more UTIs and they're treated with antibiotics. That's the way we treat them in circumcised boys too. Of course, repeated UTIs can damage the urinary system, but usually only happen in kids with serious urinary or kidney problems."
But he says, "There's also a theory about penile cancer. Some researchers believe that circumcision virtually eliminates that risk. But circumcised guys get penile cancer too, plus, you'd have a better chance of having male breast cancer than getting penile cancer. The rates of men with penile cancer are so small and it usually happens to the elderly. And anyway, any part can get cancer."
He says, "There's also been some studies that suggest that circumcision could reduce the rate of transmission of several different STDs. But all of the studies are inconclusive at this point. So, it is unclear if they're valid, let alone applicable to our country. But it's a possibility. Of course, there's always abstinence and safe sex."
Then he says, "There are also several problems that can occur with the intact penis. Like phimosis. You can usually treat phimosis with a steroid cream. If necessary, you can also do a surgical procedure that keeps the foreskin or you could just do a circumcision." So you ask, "What are the chances of getting phimosis?" And he says, "About 1 in 100. But most cases are in elderly men with chronic health problems. Surely you know about this condition in your country?" You reply, "Yes, I do know one guy who got circumcised at 67 because of this. He was diabetic."
So then you ask, "How about the risks of having it done?" And he says, "There's a lot, but the chances are small. Most commonly there are adhesions, but most resolve by themselves. And then there are post-op infections but most are treated with antibiotics. Meatal stenosis is another one. This might require further surgery, but it's usually minor and can be done right in a doctor's office. And excessive bleeding is the other complication. But there are known incidences of severe complications, including death. Its really rare, but has happened. Probably around 1 in 100 have a complication."
So you say to him, "It looks like the risks just about equal the benefits." And he says, "Well, that's what the American Academy of Pediatrics says." And you say, "But how about the sexual value lost? And the pain and trauma suffered by many of these boys?" And he says, "I don't know what to tell you about that because no one really considers that part of the equation. Look most American guys don't know what you know. They've never had the parts so they don't know if they're missing something."
So, at this point you can see that the benefits and risks of the procedure are about equal. You know the details of the procedure itself and can't deny that it's not something you'd willing subject yourself to. That there's a good chance it is extremely painful. You also have first hand knowledge of the parts in question and you know that they are functional, sensitive, and you would not want to part with them. If you don't find these reasons compelling enough to allow yourself to be circumcised, then why would you allow your son?
Nutty Professor is a 37-year-old father of a six-year-old boy and husband to his American wife of 8 years. He grew up in Germany where circumcision is an oddity and moved here to America to attend university when he was 18 years old. He is now a political science professor and has taught at various colleges and universities.
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