Tales From the Crib: To Circumcise or to Not Circumcise...that is the question

Monday, May 12, 2008

To Circumcise or to Not Circumcise...that is the question

Before the baby was born, we had a few short discussions on the subject, but I was pretty much content to differ the final decision to dh since I didn't really have any strong feeling either direction. From what I had heard, most fathers choose to have their sons look like them which is why I was somewhat surprised when DH didn't really have strong leanings either.

After baby brother was born, the nurses at the small hospital informed us that the two doctors that performed circumcisions were out of town for the weekend, so if we wanted the procedure performed we would have to come back later during the week. This gave us more time to stew over the decision. When dh said that he would have probably just had it done if the doctors were available the weekend of baby brothers birth, I decided to call up a highly referred pediatric surgeon rather than going back to the doctor at the hospital we knew nothing about. The soonest available appointment was three weeks away. More time to stew.

I collected info on the web and from my pediatrician (who didn't lean either way advising that it was a completely personal decision) which cleared up some misconceptions I had about how "difficult" is it caring for an uncircumcised penis. I talked with some family members who didn't really help us make the decision but did help me realize why this has been so hard for DH and I. Our families are totally mixed in this department. Fathers: no, sons: yes, nephews: some yes, some no. At least most people have a family "trend" to go off of right?

The appointment drew nearer. I finally called dh to let him know that we had to make a final decision because I needed time to cancel the appointment. We decided that since neither of us had strong feelings either way (plus a few other factors), the default decision should be a "No" to the elective penis surgery.

Most days we feel good about the decision. But every once in a while, the reasons we have heard in support of circumcision enter our minds. Are we condemning our son to a lifetime of ridicule in the locker room? Will he end up being one of the few men who will suffer medical complications from being uncircumcised? Does it matter if son looks like father? Is it really that big of deal? Are all of our worries reason enough to make another appointment to just get it over with?

UPDATE: Thanks to everyone for your contributions to this post. After weighing both sides, we feel good about sticking with our decision not to circumcise. I highly recommend reading this article that a Dr. friend forwarded to me before making your decision. I feel it is very well rounded and highly informative without being prejudicial either way. (you have to "sign up" to have access, but it was worth it)

69 Comments:

It was a hard decision the first time, but when boy #2 came along, it was easy. Like you, we decided that our default was NO.
posted by Erin at 5/12/2008 02:11:00 PM
Circumcision rates are low enough that there will be both uncircumcised and circumcised boys wherever he goes. Either way he won't be the only one.
My personal opinion is that circumcision is not necessary. A normal foreskin is not a deformity that must be surgically corrected, and there is no longer a religious covenant associated with it, either.
posted by Anonymous at 5/12/2008 02:21:00 PM
Both of my boys are circumsized. If we have more boys, they will be, too. The only places where they are treated differently are in online forums where those who do circumsize are seen as idiots.
(Just to be clear, this is/was not one of those places.)

But on a happy note, I wouldn't worry too much, carrie. If your decision was a "gut" one, it was probably the right one. :)
posted by Cheryl at 5/12/2008 02:28:00 PM
I'm with anon. There will be both circumcised and uncircumcised boys wherever you son goes.

My family has circimcised males and my husband's does not, except a nephew who had to be circumcised because of problems around the age of 5.

My boys, if I ever have any, will not be circumcised. One to have them look like their father, two because why cause all that pain 'just in case' they may need it later and as in infant they don't remember.

I think it's funny that you can usually tell what the father is by the sons.
posted by Lacey at 5/12/2008 02:29:00 PM
And I obviously don't know how to spell circumcised...doh!
posted by Cheryl at 5/12/2008 02:29:00 PM
Mrs. M - I think that because I realize all our boys from here on out (assuming we have any more) will all be the same, we have felt the added pressure on this decision!]

Anon and Lacey - I think you are right about the rates of circumcision going down, but when I tell people this, they usually don't believe me. Do you think it depends on where you live in the US and the accompanying subculture?
posted by This is Carrie at 5/12/2008 02:43:00 PM
My husband is, and my children are, but let me tell you, I regret it. I wish I'd left them alone. My husband wanted them circumcised and I didn't really have an opinion, so I deferred to him.

I wish I'd said NO and left my boys alone. I don't care if you do or you don't, just think about it thoroughly, pray if you can, because it can't be undone.
posted by Anonymous at 5/12/2008 03:13:00 PM
Also, has anyone circ'd some of their kids and left others alone? If we have any other boys I'm wondering if I need to keep circ'ing them or if a 'mixed' family is OK.
posted by Anonymous at 5/12/2008 03:15:00 PM
Oh, boy, will this be a mega thread.

I personally don't care either way, and left the decision to DH, as you did.

My dad had to be circumcised as an adult. Ouch. (Not really evidence, just anecdotal that he is really in favor of infant circumcision)

As to the rates of circumcision, I think it is basically 50/50, but the wealthier tend to circumcise more than the poor, largely due to the fact the Medicaid no longer covers it. So it might become a "class issue" later on.

However, more and more insurances are not covering it, either, and more and more people are electing "no" so that really isn't a huge condsideration.

It does depend on where you live, I lived for a long time in a very Jewish area of LA, so the rate there was obviously much higher. But it will vary so much from location to location, it's hard to know where you'll be living when it's an issue, or what the percentage will be. You simply can't know for sure.

Honestly, I don't think it's a big deal either way, and if your little one ends up being one of the ones with multiple infections,(the only real complication I know of), then you can deal with it then. "No" IS a reversible decision in the future, "yes" is not.
posted by The Wiz at 5/12/2008 03:17:00 PM
both our boys are... but to be honest, i don't think it's really big deal, either way (even though i was giving you a hard time the other night.) if they ever got teased it would probably be in gym class in jr. high, and although, i'm not a boy. but when i was in gym class, i wasn't about to take a shower, so i don't really know when anyone would see. i think the important thing is to educate your son. let him know, that some boys are and some boys aren't. i don't think you have to get too technical, but if he's prepared & knows that not every boy will look like him, which ever way you choose, then any teasing can be quickly shot down.
posted by kelly at 5/12/2008 03:27:00 PM
both of my boys and husband are not circ'd. from what i read before son #1 was born 3.5 years ago, only about 60% of boys are circ'd these days. It really isn't that different to take care of hygenically. Son #1 did have a urinary tract infection (UTI) when he was 3 months but the pediatrician wasn't really sure if it was even realted to being not circ'd. i guess our boys can be friends in the locker room so yours won't be alone. ;)
posted by Anonymous at 5/12/2008 04:30:00 PM
I have no boys so I haven't had to face it myself, but my BFF's husband isn't. As careful/clean as they try to be, she's gotten UTI's from intercourse with him before, one landing her in the hospital with a kidney infection. She wishes he'd been, and it's kind of convinced me too.
posted by Rocketgirl at 5/12/2008 05:10:00 PM
We don't have any boys, but I voted as if we did. We discussed this before we knew we were having a girl. DH is, our boys will not be. I left it up to him, and he kinda wishes he wasn't, so we won't get our boys circumcised.
posted by Anonymous at 5/12/2008 05:22:00 PM
wiz - interesting about the possible class link. My kids will all be going to public school with the "common folk" so I guess they will fit right in :)!

Kelly - believe me, you weren't the only one who brought up the locker room issue! It was the primary reason given by almost everyone who thought I should circumcise. DH said he would just teach our son to respond with "what are you looking at my penis for". Nice.

rocketgirl - here is my question: can your girlfriend really know her UTI's were because her husband was not circumcised? I think lot of women get UTI's (especially on the honeymoon for mormon girls). But you do bring up a point I have thought about - from a woman's perspective has it mattered to you
if your husband is circumcised or not in your "personal" life? I have heard that some girls are "grossed out" by an uncir'd penis.
I for one, wouldn't have known the difference at the time.

and to the last anon - I am curious to know why your husband wishes he wasn't circ'd. Care to share?
posted by This is Carrie at 5/12/2008 05:56:00 PM
Is this a North American thing? Here in New Zealand I wasn't asked if I wanted my son circumcised or not. It only seems to happen down the line if there's a medical reason for it (religious reasons excepted). DH isn't circumcised but was taught how to clean and take care of himself, something I'll definitely get him to teach our son.
posted by Monique at 5/12/2008 06:11:00 PM
husband is, sons are not, and it has never been as issue whatsoever.

I'm not concerned about locker room or their peers at all- the statistics show it's 50-50 for this generation.
posted by cchrissyy at 5/12/2008 06:21:00 PM
I know there are lots of reasons for and against circumcision, but medically it didn't seem to matter. The main reason everyone I asked gave for having their son circumcised was that so he could look like Dad (the second was the locker room thing). But really, how often does a boy look at his father's penis? It seemed like a really strange tradition the more we thought about it. We figured we might as well stop it at some point.

Still, we were really on the fence while making the decision. We ended up doing what you did by defaulting to no. Looking back we are both glad we didn't get it done.

Besides, if my sons really want to they can have it done when they're 18 ;)
posted by Brittany at 5/12/2008 08:58:00 PM
Congratulations on leaving well enough alone! Don't ever let a doubt enter your mind (though it's tough, since so many people you encounter have a vested interest the concept that the normal penis is defective).

Circumcision is a perversion of everything that is good in medical care. I mean, what other time are you asked to remove parts of your child's body for no medical reason??? It's freakin' insane.

And can you believe, yes this is true, before around 1970 they could do it without anyone's consent whatsoever, and some time before that it was done to females too, right here in the United States?

The good news is smart people like you have figured this out and are saying NO. The problem is, the people who really need to be able to say NO (or more specifically, NOT YES) are the thousands of baby boys this happens to every day.

You've figured out what too many people can't seem to... since there's no good reason TO do it, that means implicitly there is a very good reason NOT to do it! (namely, who the hell wants penis surgery for no damn reason? Answer: Almost nobody who has a choice!)
posted by Anonymous at 5/12/2008 09:11:00 PM
We circumcised our son, and I'm still traumatized by it, although if we ever had another, we probably would again, because my husband has strong feelings about it. It's not so easy to deal with it when you have that kind of split point of view, and when some medical professionals (some I know personally and trust a lot recommend it).

Brave, I think it's important not to label other people's decisions. I'm still torn about it all, but I don't think it is as clear-cut as you make it sound. Your comment seemed to me to be unnecessarily inflammatory. Some 'smart' people labor over this decision and come up with a different answer. I think you need to make space for that.

I tend to agree with those who say that in the end, it's not a huge deal either way. I don't see this as something that will affect your eternal salvation, so do your best with your choice and move forward with confidence.
posted by Anonymous at 5/12/2008 10:24:00 PM
Brittany - My husband said something similar about "matching" his son, when he really thought about it, it seemed like a rather strange tradition to carry on - just for traditions sake.

brave - I have to agree with m&m-- your statements seem a little intense (although I figured we get some comments from people with strong opinions on the subject).

I also have a close friend- a medical professional whom I respect - who also thinks we should get the circumcision done.

I think people should be smart about their choice - meaning a little thought put into the decision is not a bad idea, but I don't see the end result being an answer that is the same for everyone.
posted by This is Carrie at 5/12/2008 10:41:00 PM
And I am very interested in the results to the last question on the poll. If so many uncircumcised males were harassed in the locker room, wouldn't you think at least some would decide to have their sons circ'd to save them from the pain and humiliation of such harassment?

I know it's not a huge sampling, but it is still interesting.
posted by This is Carrie at 5/12/2008 10:43:00 PM
m&m and tftcarrie,

I don't mean to be inflammatory, I'm just expression what I sincerely believe. I would never judge someone else's decision to circumcise if they were having it done on themselves, or on a child for a real medical reason, but medical conditions in children which require circumcision are very rare.

I would be quite interested to hear what your friend in the medical profession said who thinks you should have it done. The AAP says there's no medical reason to do it.

I feel somewhat qualified to hold this view because I myself am a male who was circumcised, I don't like it, and I don't think it was the kind of decision my parents should have made for me since it was not medically necessary. I know I'm not the only one who feels this way.

I really do believe this should be an individual right, not something chosen by parents. I know some people find that idea offensive, as they feel it is their parental right. I guess that idea can come across as inflammatory, but I don't mean it that way.

The "locker room" argument holds no water. Generally, if anyone is looking around, they aren't likely to admit it. Furthermore, circumcision has fallen out of favor enough that one will not likely be the exception for being intact. Finally, people grow up and live their lives with Junior High and High School a distant memory, but they live with the consequences of a circumcision every day of their lives. Perhaps most importantly, one can always choose to get a circumcision, but it can't ever be undone.
posted by Anonymous at 5/12/2008 11:21:00 PM
(Going anon on this one, for my husband's sake)

Someone asked if there were any 50-50 families out there--yup, we're one. Dad is, second son is.

Oldest son isn't--we felt just like you, Carrie, neither of us felt strongly one way or the other. THEN we found out that an older male relative had to be circumcised at 18. Then when oldest was a year old, my husband's sister's kids had troubles and had to be done at 4, 6, & 8 years old. Possibly runs in the family, it seems.

Second son is circumcised. Oldest son--well, the pediatrician knows to watch for trouble, and so we're just hoping for the best.
posted by Anonymous at 5/13/2008 07:46:00 AM
Just to echo what others have said, these days it really is getting closer to 50/50. I have several friends who have chosen not to circumcise their sons. This wasn't something I really thought about until I met my husband. He has VERY strong feelings about it. He thinks it is unnecessary and wishes that he was not circumcised. Sure there are the rare times where it is medically necessary but if you do a little research you will find that the US is the only country where circumcision is so common. And it only became so in the 20th century. I just don't think it's worth it unless you do it for religious reasons.
posted by Katrina at 5/13/2008 08:17:00 AM
I am pro circumcision. Sounds like hardly anyone else is. Why not get it done when they're a baby and not have to worry about it when they are older. I realize the chances of it happening are slim, but why not. Besides that, I find uncircumcised penises disgusting. They look like ant eaters. We get our boys done before we even leave the hospital. The ring falls off & the cord falls off on the same day, no worries!
posted by Anonymous at 5/13/2008 08:46:00 AM
Brave,

I understand your strong feelings, but you have to realize there are men on the other side of the coin who have had to undergo circ' at an older age. Many of these men wish their parents would have taken care of it when they were babies. I don't feel parents think it is their "right" to make the decision at all. I think parents just want to do what is best for their child.

Katrina-once again I am curious to know wwhy you husband wishes he wasn't circ'd.

And to the last anon - if you look at the poll results, most people are pro circumcision, the comments are just not reflecting that. Not sure why exactly but I have some guesses.
posted by This is Carrie at 5/13/2008 09:12:00 AM
I have to say that as a woman, I am a little turned off by an uncircumcised penis. It would never be a deciding factor if I loved the man, but since Carrie asked whether women were turned off by it I'd have to say that some absolutely are. I know a lot who aren't though! And I think you'd be hardpressed to find a man who was circumcised as an infant who remembers it. There are those that subscribe to the psychoanalytic notions that feeling pain as an infant will scar you for life, but are all our fathers, brothers and husbands the worse for it? Did they ALL manage to not bond with their mothers or have some other negative consequence from it? I'd say that they at least saved themselves from having to worry about bacteria build-up and whetever (if any) consequences that can lead to in the sex department. And I am sincerely curious as to why a circumcised male would not choose it for their son. Does it affect a man negatively later on? If you are just not doing it because you want your son to make his own decision, chances are if he wants it he's gonna be pretty PO'd that he now has to get it at a time when he can and absolutely WILL remember the pain, and when he heals slower. Infants heal the quickest, much quicker and with less complications than an adult. I absolutely think that there is no right or wrong decision, this is just my 2 cents, and I am really curious about my above stated questions. I would prefer if Brave did not respond with a novel on how "it's natural" and "if there's no good reason..." etc. I heard that spiel already. :)
posted by Anonymous at 5/13/2008 09:34:00 AM
I flip flopped. When I was 13 years old and the only boy in the shower with a foreskin I wondered what my parents must have been thinking. My only solace at the time was that my father was also uncircumcised so I knew I wasn't the Lone Ranger. I think had my parents broached the issue with me and we had talked about it before day one gym class it would have helped a ton.

It seems that my situation is unlikely to be duplicated with my son's because of the changing tide of opinion on this issue. None the less I did consider my own experiences as I decided with my wife what to do with our boys. We decided not to circumcise them and are still happy with that decision.

I've never really thought of it this way but I have to agree with Brave, I'm glad circumcision is a choice I can make for myself. I doubt I will ever choose such a path, ouch, but still it is a choice I can make where he can not.

For all of you who have chosen not to circumcise, at the appropriate time please talk to your sons about their foreskin. A little knowledge will go a long way in helping them understand why they are different than some. Also pass along the quote from tftcarrie's DH "what are you looking at my penis for" this one works every time.
posted by Joshua at 5/13/2008 09:46:00 AM
I asked my hubby if he thought circumcision was weird, or wrong, or if he wished he had been given the choice to make the decision himself, or if we shouldn't have circumcised our own sons, or if we shouldn't circumcise any future sons...etc., etc.

His answer: What's the big deal? Either way?

He didn't feel victimized, either.

Seriously, this subject is so controversial, and yet...what is the big deal? Obviously, doing it has postives and negatives. Not doing it has positives and negatives.

So, I would say, whatever the decision, it's probably the right one.

But holy cow! To people like Brave, it's one thing to give people and education about all the aspects of a choice --it's another to make them feel inferior for the choices they do make.
posted by Cheryl at 5/13/2008 10:27:00 AM
i really like the "what are you looking at my penis for?" comment. funny. a lot of info out there says that sex is more pleasureable for an un-circ'd male.
posted by Anonymous at 5/13/2008 10:28:00 AM
My husband is, and my son is too. Personally I think it's a lot easier to take care of when I'm changing his diaper (but this is NOT the reason we circ'd - I had never changed a boy's diaper before I had my boy so it wouldn't even be an issue), and my husband wanted his son to look like him.

I also think intact penises look like ant eaters but I would never admit to that unless someone else had first ;) Thanks anon!

My dad was not circ'd as an infant and they had to do it when he was 10 years old. Yikes! I am glad we had the surgery done - I would rather have it done when my baby is a baby and can't remember it than when he's old enough for it to really scar him for life.
posted by Anonymous at 5/13/2008 11:03:00 AM
Carrie,

I was like you when we had our first son...not caring very much either way. We ultimately decided against it. I am not sure but I don't think it is very common in the Hispanic population...maybe I'm assuming this is the reason my DH was not....so you could always tell your son you were getting back to his "hispanic roots."

I have to admit, I've been nervous that we made the right decision since then...and I feel better seeing the numbers at about 50/50 because, although I want my kids not to worry about differences...I don't exactly want to give them a reason to be tormented in the locker room. Having several little boy cousins close to their ages who are all circumcized gave me pause as well.

I really think that in the future it will be less and less common to circumsize as people realize that it is not medically necessary and as the expense to do it rises.
posted by Jen at 5/13/2008 11:33:00 AM
If doctors offer to do circumcisions based on parental preferences, parents will believe that neither choice is really right or wrong, and it's a choice they need to make.

That's why it's understandable that people here have different opinions.

But really, think about it, what other surgery can you choose for a child with no medical purpose, just a preference, when there is absolutely nothing wrong with your child?

It shouldn't be this way. It should be an individual choice.

Doctors are starting to recognize this:

Doctors back call for circumcision ban

The Australian Medical Association has backed a call for laws banning the non-essential circumcision of infant boys.

The Tasmanian Children's Commissioner, Paul Mason, says non-medical circumcision is a breach of human rights.

The AMA's Tasmanian President, Haydn Walters, says they would support a ban on the practice, except where there are medical or religious reasons.

He says there is only rarely a medical need to carry out the procedure.

"There were quite a lot of folk myths around the advantages of circumcision. They've almost all been debunked," Prof Walters said.

"There are some minimal advantages in some circumstances, particularly in some infectious diseases, but they're overwhelmingly balanced by disadvantages in other areas," he said.
posted by Anonymous at 5/13/2008 02:47:00 PM
Obviously the decision is personal. I think essentially as the parent, you just want to feel at peace with whatever decision you make. For some people the decision (either way) seems to be an easy one to make, and for others, more complicated. Maybe just try to pinpoint exactly what is making the decision complicated for you and focus on those issues.

I don't think a bunch of moms will know whether or not boys will be ridiculed in the locker room. It's all speculation. Maybe if we could get some guy feedback on that particular issue it would be helpful. But I'm not sure how many men are reading???? I think the male perspective would be interesting on this thread.

There is no way you can know whether or not he will have health issues in the future. Is the surgery and recovery particularly painful if he gets it when he's older?

And yes, I do know a lot of women who are a little "weirded out" by the uncircumcised penis. But if the percentages are rising (people on the blog seem to say 50/50) then I would think that wouldn't be quite as big an issue once your little one is old enough to be intimate.

It was an easy decision for us. I was like you, and left the decision up to dh since I had no strong feelings either way. He chose to circumcise T and that was that. I will say one of the nice things about #2 being a girl is that I don't have to deal with this particular penis issue. :)
posted by Beth at 5/13/2008 03:40:00 PM
PS - I am also interested in the few commenters who said that they had their son(s) circumcised and later wish they hadn't. Why exactly? Just curious.

Oh, and I don't know if it particularly matter if a boy looks like his dad. Even though again, the male perspective might be interesting on that point. I will say that T is VERY INTERESTED in what is different and the same about my body, dh's body, and his body right now. If his penis looked different than daddy's, I think he would definitely notice, but not necessarily care. I don't know though....
posted by Beth at 5/13/2008 03:44:00 PM
beth, you may find this interesting:

If you regret circumcising your son(s), please post here.
posted by Anonymous at 5/13/2008 05:01:00 PM
Having been asked this random question the other night by my wife, I assumed that there was a post about this on TFTC so I had to check it out...

Taking care of adult and pediatric patients who have complications associated with an uncircumcised penis more so than a circumcised penis, I recommend to all who ask for my opinion FOR circumcision. It only takes one unforgettable experience from a little one (let alone an adult) scared, crying and screaming in severe pain because his little unit is red, raw and weeping with smegma to see why I am pro-circumcision. I am not sure were the no complication data on here is coming from, but it is not accurate. The most common are UTI’s and localized infections. I would say of all boys <2 years old who I have treated for an UTI, >80% are uncircumcised. The urine gets trapped in the foreskin folds, moisture overwhelms the skin, bacteria proliferate, smegma develops and the skin becomes raw, irritated and infected. The worst infections are Balanitis (bad), Balanoposthitis (worse), Phimosis and Paraphimosis (both are big trouble). I almost lost a little who became septic from bacteremia due to delayed treatment of balanitis. And performing an emergent circumcision on a 28yo with severe phimosis because of balanitis was not a pretty sight. Almost all of these situations could have been avoided if the patient had been circumcised.

I think the 50/50 percentages are slightly skewed and biased since the procedure became elective and not covered by insurance. It is very rare to see a Caucasian uncircumcised, at least in the emergency room; it seems that most are non-Caucasian. Don’t know what that means? I can understand why pediatricians may be either or on the subject. Most don’t have to take care of the complication. I agree with most on here, that you do have to respect a parent’s right to make elective decisions for their children.

I’m not sure what Brave’s comment, “what other surgery can you choose for a child with no medical purpose,” means. I won’t comment on the fact that you are quoting an Australia Tasmanian President for your argument. Circumcision does provide a medical purpose as stated above, trust me as one who sees the complications quit often. It does significantly decrease the complication rate, and it slightly decreases the rates of STI’s (HPV and HIV) and penile cancer (very rare anyways). The reality is that it is not really even a surgery when done as an infant, unless needed as an emergent procedure to reduce a para/phimosis. The AAP parent questionnaire has some simple information at the link: http://www.aap.org/publiced/br_circumcision.htm. Be very careful what you read of the internet unless it is from a respected journal or source.

I’m not a pediatrician, pediatric surgeon, or urologist, but for the most part I am the one who has to take care of the little one with a penile complaint who is suffering from something that could have been avoided. Knowing that, It hurts to see them hurt….
posted by Darrin Privett at 5/13/2008 06:13:00 PM
Trust me when I say I know almost NOTHING about this, except what I may have seen on an Oprah show. But I do think that not circumcising is common enough these days that embarrassment won't be a problem, and it DOES to get it done (no matter what the docs claim) so in the absence of strong feelings it seems like "no" is the way to go.
posted by Kathi D at 5/13/2008 06:21:00 PM
Now that I have read what the doc just above me said, I'm not so sure. (Gee, this IS hard!)

I'm wondering if the religious insistence on circumcision was at its beginning based on real problems caused by the intact penis, in the same way that many religious dietary restrictions can be traced back to logical reasons.

On the other hand, we don't routinely remove tonsils and appendixes and gall bladders of infants just because they can cause trouble later on.
posted by Kathi D at 5/13/2008 06:38:00 PM
Darrin,

Thanks for weighing in. I wonder though, if you view on the matter is also skewed a bit being in the ER. I know that if my son was starting to have a problem with his "unit" we would go to his pediatrician first. Unless you can honestly say that problems like this come on quickly and are instantly dangerous.

Do you think more people without insurance use the ER for UTI's and other problems instead of going to the doctor? Maybe that is why you haven't seen as many uncir'd caucasians in your hospital?

I do realize there are medical complications that can come from being uncir'd (I think I stated that in my original post) but I am still not sure the "risk" outweighs the "cost".
posted by This is Carrie at 5/13/2008 07:01:00 PM
Darrin,

You're fearmongering. Circumcision is rare in many countries around the world, with no resulting epidemic of penis problems. Your (unverifiable) anecdotes don't even agree with the American Association of Pediatrics which states that the complications from circumcisions negate any potential benefits. I could link to (verifiable) horror stories from botched circumcisions, but I won't employ your tactics.

And by the way, Darrin, I didn't quote "an Australia Tasmanian President." I quoted Professor Haydn Walters, who is the Australian Medical Association President for the State of Tasmania.

The president of this state medical association says "there is only rarely a medical need to carry out the procedure [circumcision]." He also says "There were quite a lot of folk myths around the advantages of circumcision. They've almost all been debunked," and the AAP seems to agree. So does every medical association out there. They all say quite clearly that the risks outweigh the costs.

But on the other hand we have you, claiming to be a physician, telling scary anecdotes. You sure got one thing right: "Be very careful what you read of the internet unless it is from a respected journal or source." Problem for you is, it's your nonsense which that piece of good advice discredits.
posted by Anonymous at 5/13/2008 08:14:00 PM
This comment has been removed by the author.
posted by Kelly at 5/13/2008 08:31:00 PM
Keep it kind boys.
posted by This is Carrie at 5/13/2008 08:48:00 PM
Great topic...I think it is definately worth thinking about and worthy of discussion.

With my first boy I thought of it as "standard procedure" I didn't think to consider both options. My brother who is actually a Dr. made me feel a little guilty afterwards when he told me there are several nerve endings which are damaged in the process and therefore diminishes sexual pleasure - but he never did site the source. Has anyone else heard that argument?

I have 3 more boys and decided to go ahead with their circ. because I didn't want them to feel so different around each other. The thing is each circ. looks different anyways.

Also, one of my pediatricians has always advised me that it is important for the boys to still push the skin back a bit for proper cleaning.

Either way I don't think it is a big deal. Had I not started with my first I may not have done it with the others. What is most important is helping them feel comfortable with and grateful for their bodies.

The good thing is we all want what we think is best for our child and in doing so we have become a generation of parents who are strong enough to stand back and question certain "traditions" or procedures. I definately belive in following "gut" feelings. And remember what is right for others may not be right for you. So stick to your gut.
posted by Mommymita at 5/13/2008 09:58:00 PM
I've noticed that several commenters have expressed the idea that "it doesn't matter either way." The problem with this sentiment is that is based on the belief that the foreskin is a body part that has no function (i.e. if there's no function, it doesn't matter whether you have the part or not). However, the foreskin does have many functions, which combine to enhance the sexual response and enjoyment of both the man and his partner.

To learn more about the functions of the foreskin, see here:

http://www.cirp.org/library/sex_function/

To learn even more, read the book "Sex as Nature Intended It" by Kristen O'Hare:

http://www.amazon.com/Sex-Nature-Intended-Important-Making/dp/0970044216/ref=sr_1_1?ie=UTF8&s=books&qid=1210740978&sr=8-1
posted by Anonymous at 5/13/2008 10:03:00 PM
I think TFTC provides a great forum for those who blog to share with each other knowledge, ideas, thoughts and opinions. And I certainly am not going to use this environment selfishly. So with that in mind, I shared my personal and professional opinion, also stating that I respect a parent’s right to choose. Like I said, it takes only one experience to see how circumcising could have avoided certain complications, which may be rare at a pediatricians office (I don’t know) or Tasmania but as an Emergency Medicine Trauma Physician I seemed to have had in my limited 4 years of clinical experience in New York City and Los Angeles, excluding medical school, more cases as what is apparently being referred to. I certainly have friends who are uncircumcised that have never had a complication. Except all there right big toes are all large, random…
posted by Darrin Privett at 5/14/2008 01:26:00 AM
Luckily for me, the decision was easy to make. My son had a defect on his penis that had to be surgically corrected, and a foreskin that DROVE ME CRAZY! It wasn't fully developed, and was very difficult to keep clean, and he had to go under full anesthesia anyway. So we circumcised for my sanity.
posted by Madame Coin at 5/14/2008 07:25:00 AM
Brave, he is not "claiming" to be a physician - he actually is.
posted by Sara at 5/14/2008 07:44:00 AM
After having 2 boys circumcised, I would like to know what you all think the problem is with having them circumcised as infants. They both came back to me and I could tell that they had been crying, but I didn't even give them tylenol afterwards & they were just fine. I guess I don't see what the big deal is.
As for the decreased sexual pleasure, don't you all want a guy who can last a little longer?? ;)
posted by Anonymous at 5/14/2008 08:34:00 AM
So, I found this little statistic interesting:

"The total cost of all hospital neonatal circumcisions in the United States was $2.1 billion in 1999"

That is a staggering number, especially for an elective procedure that is intended to avoid rare complications that *may* occur later in life. Even when such rare complication occur, they can be treated with "less-invasive techniques" that "are associated with lower morbidities and cost" than circumcision. For example, even phimosis can be treated with a steroid topical cream that "is a painless, less-complicated, and more economical alternative to circumcision for treating phimosis."

(And yes, Darrin, this is directly from the article you sent my wife).

Given the above, query whether the circumcision rates would be nearly as high as they are if insurance didn't pay for this elective procedure. Even ten years ago the cost of a circumcision was nearly $2,000 (surely that number is closer to $5,000 now given the soaring costs of medical care). Would you still elect to do the surgery if that money came out of your own pocket? There is no way I would. That cost is simply too much for the supposed benefit.

This seems to me to be the classic moral hazard that occurs with insurance - people behave differently than they would if they were to bear their own risk and this different behavior raises the costs of insurance for everyone and not in a way that provides offsetting benefits to the community.
posted by Todd at 5/14/2008 09:17:00 AM
Wow. I guess I shouldn't be surprised at the cost of a circumcision, but I am! I hadn't even thought about that aspect of it--of course, since I am fortunate to be covered by good insurance that allows me to almost ignore the costs of medical procedures.

That is a powerful argument against, to me. There are so many better ways to spend medical money, like colonoscopies, which most insurance plans don't routinely cover, but are true lifesaving tests.
posted by Kathi D at 5/14/2008 10:05:00 AM
This comment has been removed by the author.
posted by Darrin Privett at 5/14/2008 11:48:00 AM
Certainly when you look at the total cost of any hospital or medical procedure, the amount's can seem astronomical. But understand that insurance reimbursement is approximately 40-47% on the dollar, so hospital statistics and procedure fees are not a true reflection of the hard line. Little D's was $750, private pay two years ago, not $2000, which I'm sure is what is billed if covered by insurance, which reimbursed would be ~$800-900. And that is part of why healthcare is in the state that it is in today; Governed by Corporate America.

Think about it; everyone who we do business with charges us or bills us for 100 percent of the service rendered; we are expected to pay 100 percent of the bill. Mortgage is paid at 100 percent, or we default/foreclose; the grocery store is paid at 100 percent, or we go hungry, etc...; all other insurances/services billed to the doctor are at 100 percent, and all expect 100% payment for coverage (malpractice, car, home, life, disability, health, family). It doesn't take a mental giant to realize if everyone in our lives who charges us a fee at 100 percent and we only collect 40-47 percent for every dollar billed, that it is a recipe for sure failure. Anyway, that’s another blog, but keeps things in perspective when looking at the statistics…
posted by Darrin Privett at 5/14/2008 11:51:00 AM
Lots of interesting points made here.

Carrie, to answer your question. My husband just doesn't feel that circumcision is necessary, that it is based in tradition, not sound medical fact, and he would rather have been left intact. Not that he's bitter or anything. It doesn't effect his life much either way. It's more the principle of it.

I think it's great that you and others are taking time to actually think about this. I think that for the past couple generations it was just done without much thought.

As for those who have said that uncircumcised penises look weird... well that equates the procedure with cosmetic surgery. I don't think many people would give their babies elective cosmetic surgery, and yet the "looking like his dad, etc" argument does seem to come up a lot. All penises look different anyway. I don't think a little extra skin is that weird.
posted by Katrina at 5/14/2008 12:13:00 PM
"I don't think many people would give their babies elective cosmetic surgery . . ."

Actually, that may not be true - if my son had an extra finger sticking out of the top of his head, I would have it taken off even if doctors said he would live a perfectly normal life without the surgery and he wouldn't have any medical complications resulting from the finger itself. It would be elective cosmetic surgery, but I wouldn't think twice about it.

So, it seems "cosmetics" can have some bearing on whether we elect a surgery. The relevant question for me is whether having a foreskin is really that big of a deal "cosmetically". If it were, I might think about having the circumcision performed. But I'm just not convinced.

And Darrin - doesn't the fact that you can have a circumcision performed for $750 privately, but the doctors charge your insurance $2,000 show that the doctors are charging too much to the insurance companies? If the insurance companies were really paying too little, then you would expect doctors to charge private parties MORE, not less, than they charge the insurance companies in order to make up for the actual costs of the procedure. I hate insurance companies more than most, but I'm just trying to think through the logic here. We might have to take this discussion off-line! : )
posted by Todd at 5/14/2008 03:59:00 PM
Hey Carrie- I just skipped ahead, and only read a few of the comments- it does tend to get heated. We opted out, for many of the same reasons you did- and if my boys want to have it done later, they can.

Just fyi- we have never, ever had any issues with infection or cleanliness. DH showed the boys how to clean themselves in the shower, (DH is circ'd) explained that when he was a boy doctors used to think it was necessary to cut off the foreskin, and the boys yeeshed and oooghed about that, and that was the end of it. All is well with all the penis (peni?) in our house. :)
posted by Anonymous at 5/14/2008 05:43:00 PM
Breast cancer is actually FAR more common than penile problems that require circumcision later in life. Shall we start removing little girls' breasts at birth in order to prevent breast cancer?
Sounds pretty rediculous, doesn't it? And yet, that is precisely the argument made for infant circ: "Gotta chop it off just in case something goes wrong later!"
Truthfully, something can go wrong with ANY part of the human body, at any time. That's part of life. Good hygiene, good nutrition, and prompt medical care when problems come are a much more appropriate course of action than routine surgery on the most sensitive part of a baby boy's body!
I'm pretty amazed at the numbers of people here who seem to believe a foreskin is a mistake that must be surgically corrected at birth - Especially those who fall into the to avoid "grossing out" women later category. How shallow is that?
Heavenly Father did NOT create all little boys faulty and in need of surgery later. We mere mortals (and yes, even physicans are mere mortals) should not be trying to improve on God's design for humans.
posted by Anonymous at 5/14/2008 07:35:00 PM
"We mere mortals (and yes, even physicans are mere mortals) should not be trying to improve on God's design for humans."

Interesting logic, since God Himself told Abraham to start circumcision.

I know it's not part of Church Doctrine now, but saying people are playing "God" when it comes to something like this is kind of arrogant. Especially since it all started with God's commandment.
posted by Anonymous at 5/15/2008 10:01:00 AM
I really liked the post, but got a little annoyed reading the comments. Circumcision is a completely personal decision, and it is not our place to judge what other people choose.

I am expecting a baby boy in a few weeks. I was on the fence about this one, and didn't really care either way. But my husband is a pediatric surgeon, and told me a few stories of recent surgeries he has performed because of bad infection, or too much fore-skin. I'm sure that is incredibly rare, but I guess when you see a few bad things, it sways your opinion.

Apparently there is also evidence that men have a higher risk of getting HIV and HPV if they aren't circumcised. While I certainly hope that my son will never be at risk for an STD, I guess it is a good idea from a public health standpoint.

At the end of the day, it doesn't matter what you choose. My son will be circumcised-- to make his dad happy. He will also never ride a motorcycle, snowmobile, or jet ski, and he won't jump on a trampoline either. That's what happens when your dad sees the bad things that can happen to kids.
posted by Anonymous at 5/15/2008 12:34:00 PM
My husband and 2 boys are circumcised. DH wanted #1 circ'd and didn't want #2 circ'd since it wasn't covered by insurance in our new state.

#1's was a spa circumcision--done in a great hospital by a great doctor with anesthetic. He didn't cry, didn't flinch.

I'm still traumatized by #2's. Our pedi insisted anesthetic wasn't necessary (since #1's was so easy, I foolishly thought he might be right). I still look at his penis when I change his diaper and wonder if it was worth it.

I think the Wiz is right--it could easily become a class issue. I think there's also a significant cultural component; we live in a state with a large Hispanic population. I guess circumcision is quite rare outside of the US. Someone said that the circ rate here was 80% don't, 20% do (I've never been able to verify that, though).
posted by EmilyCC at 5/15/2008 01:14:00 PM
We decided against circumcising our baby until an older friend of mine told me about his uncircumcised father's humiliation at having an aid pull back the foreskin to clean thoroughly during his bath now that he can't take care of himself. That changed our minds pretty quickly. We circumcised our son the day after he was born.
posted by Daisy Paige at 5/15/2008 02:21:00 PM
Annie, it's ironic that you recognize circumcision is "a completely personal decision" but then express willingness to take that decision away from the individual who will live with the consequences every day of his life.

Circumcision should indeed be a completely personal decision, but newborns are different people from their parents. Parents have the responsibility to care for their newborns, including medical care, but surgery to make a child look more like his father is not legitimate medical care. Surgery based on speculation that some rare condition could require it later is not legitimate medical care, either.

It only has the appearance of legitimate medical care because doctors are still willing to do it, strangely, even when it doesn't need to be done at all. What is legitimate for an adult to choose for himself or herself is not necessarily ethical to do to a child who cannot consent.

EmilyCC, it's terrible that your son's pediatrician lied to you about the need for anesthesia. But it's hardly surprising, since he or she was already failing to provide competent medical care for his patient by being willing to perform non-therapeutic surgery. That is irresponsible professional behavior. You are right that there is a cultural component (newborn circumcision is rare outside the United States), and that most men in the world are intact. Perhaps you'll be more informed and have a different perspective in case you have a DS #3!

Daisy Paige, of all the indignities that can come with being unable to care for yourself in old age, none of them rise to the level of justifying removing body parts from a newborn. I wonder how many adult men would get themselves circumcised to spare themselves from such a fate. Probably very close to none, and yet they have that option if they want it. Surgery should never be forced on a person to potentially spare them some embarrassment nearly a century later! No doctor should ever perform surgery on a newborn for that reason.
posted by Anonymous at 5/15/2008 03:18:00 PM
And still, Brave, you have been unable to convince me that circumcising my sons was wrong. Or that I shouldn't do it again in the future.

I find it horrifying that some parents get their baby girls ears peirced. I mean, where is the choice factor? How painful! And what if there's infection?

Yeah, I know. Lame comparison. Holes in the earlobes can grow back together.

But claiming that parents aren't being kind or wise in their cirucumcision choices is like a slap in the face. I'm not an uneducated idiot, and I'm well aware of the statistics, and facts, and medical journals, and physician opinions, and blogging people's opinions. We knew what we were doing when we did it. We love our boys --the fact that we willingly got them circumcised doesn't change that. We did what we believed was best for them. If they are legitmately upset with us because we took away that choice for them, then so be it. I have a feeling that my children are going to hate me for a heck of a lot more than a piece of foreskin. I am their mother, you know, and just the other day they called me "the meanest mom in the whole world!" So, I'll deal.

Brave, I'm sorry you feel cheated out of life because your parents removed your foreskin. But I really don't think every man feels that way. I know my husband does not. I also know your comments were meant to show your point of view and give others some education on the subject. That's fine. But yours is not the only opinion. Nor does it necessarily make it the "right" one.

Mine probably isn't "Right", either. Thus my previous comment on "What's the big deal?"
posted by Cheryl at 5/16/2008 02:24:00 PM
Cheryl, I am sure you love your boys and were doing what you thought was right. The move away from non-therapeutic circumcision is difficult partly because we are all invested in our previous actions, which means that changing our minds can mean facing the possibility that we hurt someone we love. Circumcised men have their self-image invested in their bodies as they are, so they face a similar hurdle which they must overcome. The right to genital integrity may be one that men earn in a generational time frame, where your boys are the ones who see this differently than their parents did.

I do not claim to know with certainty how any particular boy will view this issue when he grows up. I do know that every boy deserves the right to choose for himself whether to have this surgery, but I also understand that American culture has not yet fully appreciated this right.

Intact men very rarely choose circumcision for themselves or their children. The newborn circumcision rate in the United States has come down substantially and is poised to fall below 50%. The next generation will be in a better position to understand why non-therapeutic circumcision is too personal a decision to be made by parents.
posted by Anonymous at 5/16/2008 08:14:00 PM
I am obviously late on this one - but I just read an article in parenting magazine about this. It said that un-circed boys are 50% more likely to aquire an STD than are circed boys. Also the incidence of bladder infections is 1 in 100 for non-circed and 1 in 10,000 (i think) for circed boys.

My grandfather had to be circumcised when he was in his 70's! Ouch! We dont have a boy, but I think there would be no question with us - it would be a definate "yes".
posted by Ellen at 5/21/2008 09:11:00 AM
Brave, why are you trying so hard to create controversy? I'm sorry that you are obviously so scarred by circumcision, but please let other people have their opinions. At this point, I will be making many decisions for my son that he can't make for himself-- it is part of life.
posted by Anonymous at 5/21/2008 12:31:00 PM
Annie, I am not trying to create controversy. I'm just promoting the individual right of normal sexual development. Males deserve this right the same as females. It isn't broke, so it shouldn't be "fixed" with surgery. Parents make many decisions for their sons, but the removal of normal and healthy body parts for non-medical reasons is not properly one of them. Our culture has already started to realize this, which is why the rate has fallen dramatically and is near 50/50.
posted by Anonymous at 5/21/2008 03:05:00 PM
This comment has been removed by the author.
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Monday, May 12, 2008

To Circumcise or to Not Circumcise...that is the question

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