Washington Daily News Publishes OBGYN Circumcision Misinformation Piece

I’d never heard of the Washington Daily News until today, when I saw this scroll up on my Facebook news feed:

 

 

 

I wanted to see if anything had changed in terms of the misinformation dispensed on American mass media. I clicked, and sure enough, it's a self-serving doctor repeating the same myths and misinformation regarding male infant genital cosmetic surgery.

 

I'm not sure exactly what kind of article this is supposed to be. Is it a news article? An opinion piece? It's not immediately obvious what this is supposed to be. It looks a lot like a paid advertisement. The user allowed to publish is one "Vidant Health." Scroll further down and it's one "Dr. Bonnie Corley of Vidant Women's Care." Presumably she's a doctor working for Vidant and she is plugging the business and attempting to justify a practice OB/GYNs hold the lion's share for; male infant circumcision.

 

 

 

One would think that a publication that calls itself "Washington Daily News" would be interested publishing factual, accurate, verifiable information they've thoroughly investigated.

You know? What most of us would call "journalism."

Instead, it seems they've given this "doctor" a carte blanche to publish self-serving lies and nonsense.

Why is an OB/GYN talking about male genital surgery?

First, it must be asked why a doctor whose purview is WOMEN’S HEALTH is pushing male infant surgery. It should strike readers as odd that a doctor who is supposed to deal in gynecology, the female reproductive system and women's health is pontificating on male anatomy and care.

This is supposed to be the territory of pediatricians and urologists. Yet here she is, spewing garbage she just doesn't know what she's talking about. Could they have not asked an actual expert in the field?

 

 

 

Pontificating in a field one has no business in has got to be against medical standards somehow. Why is this woman defending male infant genital mutilation? The answer is, as an OBGYN who attends pregnant women, they’ve got first dibs.

 

Not mentioned here is how much she makes per mutilation. Some hospitals charge up to $7,000 a pop. It is estimated that 1.4 million American baby boys are being circumcised a year. This means that, at $7,000 per circumcision, American hospitals can be making as much as $9,800,000,000 annually on circumcision alone. It's no wonder doctors and nurses gush on and on about male infant circumcision; there is money to be made, and OB/GYNs, pediatricians and urologists are in competition.

 

When Someone Says It's Not the Money... it's the money. It's always the money.

 

What Dr. Corley Omits and Why

As stated above, circumcision brings in a pretty penny, so there is financial incentive for American doctors to highlight all what's good and wonderful about circumcision to parents, while downplaying, if not omitting all the downsides. Upton Sinclair once said:

“It’s difficult to get a [wo]man to understand something when [her] salary depends on [her] not understanding it."

In other words, doctors who perform circumcision have a conflict of interest in actually conveying factual information to parents. Honest doctors worth their salt would outright say there is no medical reason for performing surgery on a healthy, non-consenting minor. They would refuse to perform surgery on healthy children. In the United States, male infant circumcision is the one exception to this rule. In all other cases, reaping profit from elective non-medical surgery on healthy, non-consenting individuals constitutes "medical fraud."

 I'm going to go down the article refuting all the lies Dr. Corley tells, and filling in all the information she omits.

First, male infant circumcision is no "small procedure." It is the removal of up to 50% of the penile skin. In babies, the foreskin may be a few square centimeters, but in adults, it can be as big as a 3x5 card. 

 

How much skin is removed is different in every circumcision as there is no real way to tell how much skin to remove. This, in and of itself is a problem; a circumcision could result in too much skin being removed, resulting in painful erections and sex. Or, a circumcision could remove too little skin, resulting in a foreskin that heals itself to the head of the penis, needing correction later on. Parents ought to be informed that male infant circumcision botch jobs are so common that there are actually doctors who specialize in circumcision corrections; children going in for circumcision revisions because the first doctor screwed it up are not unheard of.

Even in a circumcision that goes "according to plan," the head of the penis is permanently exposed, where it would have been covered and kept warm and moist by the foreskin. This results in layers upon layers of keratin, necessarily resulting in desensitization. Not talked about here is the Sorrells study that showed that circumcised men were desensitized by a factor of four. Lack of a foreskin dries out the head of the penis and surrounding mucosa, necessitating the need for artificial lubrication, like K-Y, vaseline or astroglide for masturbation and sex.

To contrast with the fact that 80% of American men are circumcised from birth, the doctor should have mentioned that 70% of men are intact globally. American parents ought to know that most men in the world are not circumcised and live their lives just fine. She doesn't talk about the fact that, according to the CDC, male infant circumcision rates in the US have dropped to about 56%, and still falling. But of course she doesn't say this; Corley is appealing to the "everybody's doing it" alibi.

This focus on “parents having circumcision performed on their children for perceived medical benefits in the US” is wrong.

 

DOCTORS push this non-medical surgery on parents for these reasons and then absolve themselves from this medical fraud by asking them to sign a consent form.

 

Male infant circumcision is the only cosmetic, non-essential surgery American doctors will perform on healthy, non-consenting minors. All other medical procedures require medical indication. Otherwise it’s medical fraud.

Let’s talk about the so-called “benefits,” shall we?

“Urinary tract infections are 90% less common in males who have been circumcised.”

How much less?

It takes around 100 circumcisions to prevent a single UTI, and UTIs can be treated easily by other less invasive ways, like antibiotics. Not to mention, it is easily prevented with basic hygiene. 

“Circumcised men have a lower risk of developing cancer of the penis, HIV and probably herpes," Corley says.

“Probably?”

First off, again, what is this difference? Is the doctor going to cite any medical literature?

 

Here is what the American Cancer Society has to say about the matter:

"In the past, circumcision (removing the foreskin on the penis) was suggested as a way to lower penile cancer risk. This was based on studies that reported much lower penile cancer rates among circumcised men than among uncircumcised men. But in some studies, the protective effect of circumcision wasn't seen after factors like smegma and phimosis were taken into account. Still, some experts have said that circumcision prevents penile cancer.

In the US, the risk of penile cancer is low even among uncircumcised men. Men who aren’t circumcised can help lower their risk of penile cancer by practicing good genital hygiene."

 

Scrutinize the medical literature; a causal link between having a foreskin and a “higher risk of HIV” simply does not exist.

Looking at world HIV data, the United States has one of the highest rates of HIV transmission in the world in spite of 80% of men being circumcised from birth. We have more HIV than Mexico.

The CDC reports the US has higher STD rates than European countries where circumcision is rare or not practiced.

Research actually shows circumcised males are at a higher risk for HPV. In case you are “probably” worried about herpes or cervical cancer.

What’s more, and here is the kicker, is that there simply isn’t a global epidemic for all of these things. 70% of men are intact globally and there simply isn’t a world epidemic of men’s penises rotting off, or women with cervical cancer in non-circumcising countries. Boys and men aren’t lining up at urologist’s office clamoring for circumcision.

She’s right about penile cancer being rare and there now being HPV vaccines. In which case, what’s the point?

She minimizes the risks as "usually not serious."

 

The risks include infection, a botched circumcision that may have needed correction later on, loss of part or all of his penis, hemorrhage, septic shock, a penis that was mutilated beyond what is deemed “acceptable,” , painful erections and death, not to mention the inevitability of keratinization and eventual desensitization. Hemorrhage is THE MOST common complication that sends circumcised children to the ER.

 

Injury to the penis has not only been reported, there have been very public million dollar lawsuits. Just Google them. “Appear very rare” to whom? A greedy OB/GYN with dollar signs in her eyes? Serious complications are COMMON. SO common that there are lawyers who specialize in taking circumcision cases.

 

The following is a comment taken from the comment section, written by known circumcision David Llewellyn:

 

 

"As a lawyer I have represented many boys and men who have either lost too much shaft skin or lost part of the end of the penis (and in one case all of the end) as a result of a botched circumcision or bad post circumcision care. From what I can tell I expect that 30% or so of boys and men who were circumcised at birth have had too much skin removed from their penile shafts. So, even though there are no really good studies on errors, I think the error rate is quite high. In my experience deposing doctors I have found that few docs understand the penile skin system. Also,the article is in error when it states that there are no studies showing a decrease in sensitivity. The article by Sorrells, et al. in BJU International in 2007 showed that the foreskin is the most sensitive part of the penis. This article has never been refuted. It defies common sense to think that you can remove the protective covering of the glans, tissue that is full of specialized nerve endings, and not reduce sensitivity. A study from Belgium by Bronselaer, et atl in BJU Int'l in 2013 showed a decrease in sensitivity. In fact, reduction in sensitivity was one of the initial reasons given for circumcision in this country in the late 19th Century. In summary, circumcision is risky and damaging and should not be performed unless there is a real medical necessity, which is very, very rare. Most of the world is not circumcised and gets along just fine. Uncircumcised Europe has less STDs and other penile problems than does the heavily circumcised U.S. Sadly, this article merely repeats the prejudiced views of circumcised U.S. doctors who profit from the continuation of this needless and damaging surgery."

His website is: David J Llewellyn: The Circumcision Lawyer

 

“The risk of not having a circumcision in infancy is largely related to difficulties in keeping the uncircumcised penis clean,” says Corley, but again, real world data shows that this simply isn’t a problem. Care during menstruation is more meticulous and complex. Boys and men in the world simply have no difficulty cleaning themselves.

“When bacteria and debris are trapped between the foreskin and glans, infections can result causing scarring known as phimosis, which prevents the foreskin from being retracted.” she continues.

This speaks to Corley's ignorance, willful or genuine, on the matter.

 

Phimosis is a fibrotic ring caused by lesions as a result of an infection of balanitis xerotica obliterans, or BXO for short. It is not caused by “bacteria and debris being trapped between the foreskin and the glans.”

And this can’t happen to newborns and children, where the foreskin is adhered to the glans until puberty by a bio-preputial lamina known as “synechia.” The foreskin not retracting during infancy is not “phimosis” but a normal stage in male development.

True phimosis is vanishingly rare, at less than 1%, and it occurs in adults.

“Another condition is paraphimosis, in which the foreskin retracts and cannot be returned to its normal position," Corley says.

This is usually caused by the doctor or the parents he instructs, insisting a child should have his foreskin retracted for “cleaning.”

 

Please see this post for information this doctor SHOULD have been taught and SHOULD BE telling parents. 

“These conditions may need to be eventually treated with circumcision, and the procedure is likely more painful and traumatizing to older children and adults than it is for infants,” Corley goes on.

Self-serving scare tactics.

These conditions are rare, iatrogenic and completely preventable.

Note; 70% of men are not circumcised globally. The rest are usually circumcised out of religious or cultural custom. Where is the epidemic of “problems” causing world-wide circumcise demand?

And the “more painful and traumatizing” canard is appeal to emotion; ALL surgery is traumatizing to an older child or an adult. Let’s imagine, for a moment, a reality where all surgery a child may go through as an adult is administered to him in infancy to “spare him the pain.” Ridiculous.

Very few men have conditions for which circumcision is medically indicated. In children it should NEVER be a problem; children who “need to be circumcised” are usually GIVEN their problems by American doctors and their harmful advice. As already mentioned before, there isn’t an epidemic of children or men with “problems” in non-circumcising countries.

“There is no data available on the number of males who are circumcised for medical reasons after the newborn period.”

Which is a testament to how vanishingly rare these cases are. And here, Corley is lying, because yes there is, albeit limited.

“Uncircumcised boys should be taught the importance of washing beneath the foreskin on a regular basis once the foreskin is fully retractable.” says Corley.

Just as uncircumcised women must be taught to clean out their labia and vulva. Actually, male hygiene is much simpler. This doctor is an OBGYN. She ought to know.

“One of the best arguments against circumcision is that the child is being subjected to a surgical procedure that he cannot consent to and which is often being performed as a culturally accepted cosmetic procedure.” Corley continues.

Let’s talk about FGM. That’s also a culturally accepted cosmetic procedure where it is performed. And let’s talk about a doctor’s duty to medicine, not cultural brokerage.

Lack of consent for elective, non-medical procedure is quite possibly the biggest problem for doctors like Corley; in any other case, reaping profit from non-medical surgery on healthy, non-consenting individuals constitutes medical fraud.

But this isn’t the only problem; the risks of infection, partial or full ablation, hemorrhage and even death are also important arguments against circumcision. Because male infant circumcision is elective, cosmetic surgery, any risk above zero is unconscionable.

“Some opponents of circumcision suggest that the procedure should not be performed until the child is old enough to understand the risks and give consent to the procedure. However as previously noted, at that time it will be more painful and expensive, and the recovery period needed after surgery will be longer.” - More self-serving promotion.

The pain and recovery are true of any surgery. Medically necessary circumcision is vanishingly rare. In contrast, complications are common. A child could end up with an aesthetically displeasing penis, lose it completely, or his life.

“Because there are known health benefits from male circumcision, its use has been supported by the American Academy of Pediatrics in 2012, and also by the American College of Obstetricians and Gynecologists.”

False.

In 2012, the AAP concluded that the “benefits” of circumcision were “not enough to recommend the procedure.” In the same policy statement, they said that “the true incidence of complications after newborn circumcision is unknown.”

And ACOG only support it because it’s a money maker for them. The AAP released a policy statement in 2012 after a review of all existing medical literature on the matter; ACOG did no such review and only ever cite the AAP for “support.”

“Overall it is seen as potentially beneficial and rarely harmful, but every family should weigh the risks and benefits of this procedure and decide if it is right for them,” she continues.

Absolving the doctor of any responsibility.

Isn’t “weigh the risks and benefits” of a medical procedure and determining its necessity the DOCTOR’s job?

And where does Corley get “rarely harmful” from?

Let me repeat; In 2012, the AAP concluded that the “benefits” of circumcision were “not enough to recommend the procedure.” In the same policy statement, they said that “the true incidence of complications after newborn circumcision is unknown.”

How are lay parents expected to come to a more reasonable conclusion?

 

“In the end most people probably make the choice based on cultural values," Corley concludes.

In any other case, reaping profit from performing elective, non-medical surgery on healthy, non-consenting individuals constitutes “medical fraud.”

Without medical or clinical indication, how is it doctors are performing surgery on healthy, non-consenting minors? Let alone giving parents any kind of choice?

This OB/GYN is nothing more than a charlatan, and this is nothing more than a paid ad.

Washington Daily News is colluding with a charlatan in perpetuating blatant misinformation. Rather than merely publish a self-serving business plug, the Washington Daily News ought to engage in journalism and publish the truth about this matter.

“It’s difficult to get a [wo]man to understand something when her salary depends on [her] not understanding it.”

Publishing circumcision information from a woman who makes her living performing them is probably not the best idea for neutral, objective, unbiased, dispassionate reporting.

Do better, Washington Daily News.

Related Posts:

The Circumcision Blame Game

 

When Someone Says It's Not the Money...

 

Circumcision Botches and the Elephant in the Room

 

CIRCUMCISION "RESEARCH": Rehashed Findings and Misleading Headlines

 

Where Circumcision Doesn't Prevent HIV II

 

PHIMOSIS: Lost Knowledge Missing In American Medicine

 

AAP: Around the Bush and Closer to Nowhere

External Links:

Washington Daily News - Health Beat: What to know about circumcision

 

American Cancer Society: Can Penile Cancer Be Prevented? 

 

US News: America's STD Rate at Record High Again: CDC 

 

Healio: Circumcised men at twice the risk for cancer-causing HPV, study shows 

 

National Post: Ontario newborn bleeds to death after family doctor persuades parents to get him circumcised 

Atlanta lawyer wins $11 million lawsuit for family in botched circumcision

David J Llewellyn: The Circumcision Lawyer

PHIMOSIS: Lost Knowledge Missing In American Medicine

Those who have been keeping their eye on circumcision, circumcision advocates and their alibis, will no doubt be aware that the diagnosis of "phimosis" is far too commonly given as a pretext to circumcise an older child. This is the reason most often cited by parents who claim that circumcision on their child "had to be done." Circumcision is also marketed as prophylaxis for "phimosis" by those who advocate or have to gain from performing the procedure.

It must be asked, how is it that after thousands of years of evolution, human males evolved to be born with a problematic sexual organ?

Is it that the human penis is inherently problematic?

Or is it that there is no real problem, and opportunistic physicians have been successful in characterizing perfectly normal, healthy stages in male genital development as "problematic," when they're actually not?


American and European Physicians Don't Learn The Same Thing
America and Europe are different in many ways. One of the biggest differences between both continents is circumcision and anatomically correct male genitals. Whereas circumcision, particularly the routine circumcision of infant males, is a common, culturally ingrained practice in the United States, it is rare or virtually not practiced in Europe, except among Jews and Muslims.

Perhaps due to Judeo-Christian roots, people in both continents share a taboo surrounding nakedness, so they are unaware of each others' practices. People in Europe often believe that circumcision is limited to religious groups, such as Judaism and Islam, and generally believe that their American counterparts hold male circumcision in the same regard; people in America believe anyone who's anyone is circumcised. It often comes to a shocking surprise to people in either country, when they find out the truth; Americans are surprised that the rest of the English-speaking world does not circumcise, and Europeans are horrified to find out that in America, male newborns are often circumcised.

It is no surprise, then, that American and European physicians hold different views when it comes to male genitals and circumcision. What they learn in medical school concerning male genital development is vastly different; while European physicians are taught to regard unaltered male genitals as nature made them as healthy and normal, American physicians are taught to look at the same genitals as aliens from another planet. While in Europe, physicians are taught to look at the foreskin as an intrinsic part of the male organ, akin to labia in female organs, in the United States, the physicians are taught to treat the presence of a foreskin as a superfluous growth and a liability. Indeed, some hospitals will list the presence of a foreskin alongside other medical problems.

This picture was taken at an American hospital. Notice that being uncircumcised

is a "problem," along side hearing loss and poor growth and weight gain.

To Europeans, penises in American textbooks may appear strange, as they are depicted as circumcised, as if this is they the human penis appears in nature. To Americans, pictures of penises may be "Ew, gross!" The foreskin, if mentioned at all in American textbooks, is often described as "that loose piece of flesh at the end of a penis, which is removed in circumcision." Whereas European textbooks present the penis as-is and moves on, American textbooks must describe various reasons why circumcision is performed, and why parents ought to make a "decision." Circumcision prevents cancer, STDs, makes it easier to clean, and, it prevents phimosis. What good parent wouldn't want to prevent all these problems in their children?

Of course, when comparing world data, it's not entirely clear that circumcision prevents much. Not a single medical organization recommends male circumcision based on any of the claimed "benefits." Circumcised males are still susceptible to cancer and any STD one can name. The latest canard used to justify male infant circumcision is that it prevents HIV transmission. No, scratch that; it's supposed to "reduce the transmission of HIV transmission by 60%," a claim that doesn't really mean much of anything, as even if it were true, even those who promote circumcision as HIV prevention must stress that circumcised males and their partners must continue to wear condoms. (In other words, male circumcision fails.)

The one valid concern is phimosis, an actual physical condition that is exclusive to males with anatomically correct genitalia.

But what precisely *is* phimosis?

Who gets it?

What causes it?

How common is it in actuality?

When and if it is necessary, what treatment options are available?

When is a situation not "phimosis" but a normal stage in development?

I'm writing this blog post to answer these questions and more.

Here, readers will learn what all physicians should be learning in medical school, but is often omitted in American medical curricula. The sources used for this blog post are cited for reference.

The Facts

What is phimosis?

The word "phimosis" originates from the Greek word phimos (φῑμός) which means "muzzle". "Phimosis" is a vague term used to describe any situation where, in intact males, the foreskin cannot be retracted to reveal the glans, or the head of the penis. The term may also refer to clitoral phimosis in women, whereby the clitoral hood cannot be retracted, limiting exposure of the glans clitoridis.

What are the normal stages of development?

At Birth 
Typically, when a baby boy is born, the prepuce is long with a narrow tip.(1)(2) Retraction is not possible in the majority of infants because the narrow tip will not pass over the glans penis. Moreover, it is normal for the inner mucosal surface of the prepuce to be fused with the underlying mucosal surface of the glans, or head of the penis,(1)(2)(4)(5) by means of a membrane called synechia, also known as the balano-preputial membrane or balano-preputial lamina,(1) further preventing retraction. This attachment forms early in fetal development and provides a protective cocoon for the delicate developing glans.(6) It is normal for the foreskin to be non-retractable in infancy and early childhood.(6)

Retraction of the Foreskin In normal development, the foreskin usually separates from the glans and becomes retractable with age.(4) As the infant matures into a boy and the boy into a man, the tip of the prepuce becomes wider, and the shaft of the penis grows, making the tip of the prepuce appear shorter. The membrane that bonds the inner surface of the prepuce with the glans penis spontaneously disintegrates and releases the prepuce to separate from the glans. The prepuce spontaneously becomes retractable.

In order for retraction to occur, the foreskin must have separated from the glans and the opening of the foreskin must have widened to allow it to slip back over the glans. Throughout childhood and adolescence, there is a release of hormones. As hormone levels rise, the fiber-dense tissue of the prepuce is replaced with a more elastic tissue. A boy will begin to explore his genitals as he grows, and as time passes, the elastic tissue will allow the opening of the foreskin to widen. This can happen at any age but it is not common in young boys.

The amount of time it takes for a boy's foreskin to become fully retractable varies from boy to boy; this process can take many years for some boys, and yet minutes for others. In some boys, the foreskin may not be retractable until after puberty.(7)(8)(9) This is an entirely normal stage of development and should not be diagnosed as any kind of "problem." 

When Does Retraction Happen? 
According to the experience of doctors and researchers in cultures where circumcision is uncommon, retraction happens at varying ages, and a non-retractable foreskin rarely requires treatment. Observations from doctors in Denmark, and Japan and other countries indicate that spontaneous loosening usually occurs with increasing maturity.(7)(8)(9)(10)(11)(12)

Non-retractability is considered normal for males up to and including adolescence. The process whereby the foreskin and glans gradually separate may not be complete until the age of 17.(4) A Danish survey (2005) reported that average age of first foreskin retraction is 10.4 years.(13) Marques et al (2005) reported that 99% of boys can retract their foreskins by age 14.(12)(14)(15)(16) One may expect 50% of 10-year-old boys; 90% of 16-year-old boys; and 98-99% of 18 year-old males to have a fully retractable foreskin. Treatment is seldom necessary.

A 1999 study by Cold and Taylor shows that at 6 to 7 years, approximately 60% of the boys had natural adhesions. At 10-11 years, close to 50% of the boys still had adhesions. At 14-15, approximately only 10% of the boys had adhesions. As they approach the age of 17, only a very small percentage of boys will have adhesions. That means that, left uncircumcised, most boys will be able to retract their foreskin before they are 17 years old. 

Foreskin Retraction as Observed in Children in Other Countries 

Jakob Øster, a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in Denmark, where circumcision is rare.(7) Øster (1968) found that the incidence of fusion of the foreskin with the glans penis steadily declines with increasing age and foreskin retractability increases with age.(7)

Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5, and they also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42% of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9% in boys aged 11-15.(8) Imamura (1997) reported that 77% of boys aged 11-15 had retractile foreskin.

Thorvaldsen and Meyhoff (2005) conducted a survey of 4000 young men in Denmark. They report that the mean age of first foreskin retraction is 10.4 years in Denmark.(13) Non-retractile foreskin is the more common condition until about 10-11 years of age.

Current medical literature indicates that the foreskin is non-retractable in the majority of males until they begin to approach puberty. Until a boy begins to reach sexual maturity, non-retractability of the foreskin is a normal part of growing up.

When is "phimosis" a problem?
Given the empirical facts stated above, it is already mistaken to assume that just because the foreskin cannot be retracted to reveal the head of the penis, a male has some sort of pathological condition. As evidenced by the facts given above, the great majority of male children who have anatomically correct genitals will have foreskins that cannot be retracted, and it is a mistake to assume that all children undergo this transitory "illness" where they can't retract their foreskins, akin to the mumps, measles or chicken pox. Girls do not begin to menstruate until the onset of puberty, and they are not considered to be suffering any sort of medical condition until then.

Non-retractability of the foreskin may pose a problem if it continues well past puberty. Typically the foreskin has dilated to allow retraction as a result of the release of hormones. In a small percentage of males, the production of these hormones is insufficient, and the foreskin fails to dilate, resulting in a condition known as "preputial stenosis," or, a narrow foreskin. This condition may make hygiene and sexual intercourse difficult, if not impossible, but not always. In older men that have bad hygiene habits and who smoke regularly, having a non-retractile foreskin can increase the chances of developing penile cancer.

There is another reason why the foreskin may not be retractable in a male, and that is because he has suffered an infection with balanitis xerotica obliterans, or BXO for short. In this case, the tip of the foreskin is scarred and indurated, and has the histological features of a pathological infection. The foreskin of a male who has suffered an infection with BXO will have developed a fibrotic ring, which makes retraction difficult or impossible. It is this pathologically induced non-retractability which can be correctly termed "phimosis." To differentiate normal stages of development, and even the physiological state of a foreskin which has failed to dilate as a result of lack of hormones, from pathologically-caused non-retractability, doctors have invented the term "true phimosis." It is non-retractability caused by pathological infection with BXO that can be considered an actual problem.

Can phimosis be cured?
It is estimated that 2% of males go their entire lives without their foreskins ever becoming retractable. How this condition can be treated will depend on what the actual problem is. The physiological condition where a foreskin has failed to dilate as the result of a lack of hormones, otherwise known as "preputial stenosis," tends to respond to steroid cream therapy, coupled with stretching exercises and/or stretching devices.

Non-retractability as a result of a BXO infection, however is different, as this is caused by a resulting fibrotic ring at the end of the foreskin, which is scarification that may or may not respond to steroid cream treatment or stretching exercises. It is non-retractability caused by BXO infection that can be genuinely considered a problem which may call for corrective surgery.

It should be noted that non-retractability of the foreskin as a result of BXO infection occurs in less than 1% of males. Additionally, it should be noted that even when a case of "true phimosis" may require surgical correction, it does not always entail a complete removal of the prepuce. There are procedures that can correct phimosis which can preserve the foreskin and its functions. Surgical methods range from the complete removal of the foreskin (circumcision) to more minor operations to relieve foreskin tightness, such as a "dorsal slit" (AKA "superincision") a "ventral slit" (AKA "subterincision") and "preputioplasty."

If treatment should be necessary, it should not be done until after puberty and the male can weigh the therapeutic options and give informed consent.(9)

How should a genuine case of phimosis be diagnosed?
In order to correctly determine that there is a real problem occurring in a male, a learned doctor will begin by ruling a few things out.

If, for example, a child hasn't reached puberty yet, and because non-retractability is common for this age group, the doctor should consider that the child may be experiencing normal stages of development.

If, for example, a child hasn't reached puberty yet, but he was able retract his foreskin previously, it may be probable that the child may have experienced an infection with BXO.

If, for example, an adult male who has already gone through puberty still has a non-retractile foreskin, the doctor needs to determine if this is a physiological problem caused by a lack of hormones (preputial stenosis), or if it is a pathological problem as a result of infection with BXO (AKA "true phimosis").

Because non-retractibility of the foreskin can be both a normal stage of development, and a pathological problem, it can be very easy for doctors to make an inadvertent, or even deliberate misdiagnosis. Particularly in countries like the United States, where circumcision is a perceived norm, and doctors may not be educated in the differences between normal stages of development and phimosis as a pathological condition, it can be very easy for doctors to say that a child is suffering a condition that may require surgical correction, where in fact, there is actually none. 

For a correct diagnosis, a doctor who is knowledgeable about the difference between normal stages of development and non-retractability caused by BXO infection will correctly have the male analyzed for signs of lesions of BXO. Then, and only then, can a doctor properly make the diagnosis that a male child is suffering a medical problem, and that the child may need surgery to correct the problem.

Because non-retractability in adult males is rare, and "true phimosis" (pathologically induced non-retractability) even more rare, there is a high probability that a diagnosis for "phimosis" is actually false, especially in children, where non-retractability of the foreskin is a part of normal development.

Iatrogenically Induced Problems
Problems with the retraction of the foreskin may either be the result of a lack of hormones, the result of an infection with BXO, or, they could be iatrogenically induced. (E.g. actually caused by the doctor himself.)

It has been widely recognized by the medical profession for most of the 20th century that normal male infants have foreskins which are incompletely separated from the epithelium of the glans.(17) The foreskin cannot be retracted without tearing the fusion and adhesions which are commonly present between the inner foreskin and the glans penis in normal stages of development.

In English-language medicine, there is an absence of proper knowledge of the foreskin and its development in the medical curriculum. According to McGregor et al (2005), physicians often have difficulties distinguishing between this normal, natural state of the penis in neonates and pre-pubecent boys and pathological phimosis caused by BXO.(17)(18) Spilsbury et al (2003) suggest that doctors may be likely to confuse the aforementioned conditions with pathological phimosis.(19)

Unaware of the harmless nature of the normal, natural state of the penis in neonates, and the presence of adhesions in infants and pre-pubecent boys, and unaware that this can be damaging, doctors have been known to forcibly attempt to retract the foreskin in healthy, developing children, just to see if it retracts, tearing natural adhesions and/or ripping the foreskin in the process. Furthermore, they have been known to erroneously instruct parents that a child's foreskin needs to be retracted in order to "clean under it," arguing that they will develop infections otherwise.(20)

Premature, forcible retraction of the foreskin is an extremely painful, serious, and potentially permanent injury(17). It can damage the glans and mucous inner tissue of the foreskin. Forcibly retracting a child could result in iatrogenically induced phimosis, where the raw, open wounds of ripped adhesions could heal and fuse together, or where a forcibly dilated foreskin could develop scarification, resulting in a fibrotic ring similar to the one caused by BXO infection. Additionally, this can result in a complication known as "paraphimosis," where the narrow foreskin strangles the penis trapped behind an enlarged glans, thereby necessitating surgical intervention.

It must be noted here that these problems rarely present themselves in countries where circumcision is rare or not practiced. There is simply no epidemic of foreskin problems in countries where male children aren't circumcised. These problems tend to suspiciously present themselves in countries where circumcision is common, and diagnosed by doctors who happen to specialize in child circumcision. Children may have been circumcised to correct "problems" that either never existed, or whom were given their problems by ignorant doctors to begin with.

 It is harmful and misleading to tell parents that a child's foreskin must be forcibly retracted. In children whose foreskins are still adhered to the glans, or where the foreskin has not dilated to allow the glans, this can be a harrowing experience. Forcibly retracting a child's foreskin "to clean under it" is the equivalent of cleaning out a girl's vagina with a pipe cleaner. Surely, a doctor who would instruct parents to clean out their child's vagina would be dismissed as a lunatic. Medical associations advise not to forcibly retract the foreskin of an infant, as this interferes with normal penile development, and may result in scarring or injury.(21)(22).

Camille et al (2002), in their guidance for parents, state that "[t]he foreskin should never be forcibly retracted, as this can cause pain and bleeding and may result in scarring and trouble with natural retraction."(23)

Simpson & Barraclough (1998) state that "[n]o attempt should be made to retract a foreskin in a child unless significant separation of the subpreputial adhesions has occurred. Failure to observe this basic rule may result in tearing with subsequent fibrosis and consequent [iatrogenically induced] phimosis. ..."(24)

The American Academy of Pediatrics cautions parents not to retract their son's foreskin, but suggest that once he reaches puberty, he should retract and gently wash with soap and water.(25) The Royal Australasian College of Physician as well as the Canadian Paediatric Society emphasize that the infant foreskin should be left alone and requires no special care.(26)

Summary
The facts, which are well-documented in medical literature, speak for themselves.

A foreskin that is adhered to the glans and/or will not retract is a normal stage of development in all healthy male children in infancy. The belief that a foreskin that is "tight" and will not retract is a problem in male infants implies that all human male children are born with some kind of birth defect, congenital deformity or genetic anomaly akin to a 6th finger or a cleft.

In the great majority of males, the foreskin separates from the glans and becomes retractable as they approach puberty, without the aid of medical or surgical intervention.

A foreskin that will not retract in older males is rare, and may or may not be a pathological problem. In order to determine the cause of a non-retractile foreskin, a knowledgeable doctor who understands anatomically correct male genitals, the normal stages of development of healthy males, and true pathological problems of male genitalia, must run the correct analyses in order to detect the presence or absence of pathological lesions; then, and only then, can the doctor determine whether the problem can be remedied with conventional medicine or by means of surgical correction.

Even when a genuine case of phimosis that necessitates surgical intervention presents itself, circumcision, or the full excision of the foreskin is not always called for; there are surgical interventions which will correct phimosis while preserving the foreskin and its functions.

Intervention to hasten the retraction of the foreskin in otherwise healthy, prepubescent males may actually cause iatrogenically induced problems. The forced retraction of the foreskin may itself cause non-retractability. Forcibly dilating the foreskin causes scar tissue to form, which may result in a fibrotic ring at the end of the foreskin. Breaking the natural adhesions which occur between the glans and the foreskin during normal stages of development may cause new adhesions to form between the glans and the foreskin, becoming fused as the raw wounds of the broken adhesions heal together. Forcibly pulling back naturally narrow foreskin over the glans in otherwise healthy children may result in paraphimosis, where the narrow foreskin catches behind the glans, preventing the foreskin from returning to its neutral position covering the glans, ironically necessitating the need for surgical intervention.

Conclusion
It is a shame that there is a gap in medical knowledge between the United States and other English-speaking countries. The information presented here is well-documented knowledge that all doctors need to know. This is the information that a doctor needs to be giving to parents of a male child. Anything other than this is misinformation or an outright lie.

American medical curricula is either omitting information, teaching outdated information, if not outright teaching misinformation. Efforts need to be made to bring English-language curriculum on the foreskin, the natural stages of development and genital pathology up to date. Doctors need to educate themselves and stop dispensing erroneous and dangerous advice to parents. They need to learn to differentiate between the normal stages of development in human males, and actual pathological phimosis.

Doctors who diagnose "phimosis" in a perfectly healthy child are either uneducated when it comes to the foreskin and natural stages of development, or may in fact be committing medical fraud, deliberately inventing a misdiagnosis in order to justify surgery in a healthy, non-consenting minor, and/or collecting medicaid funds intended for actually medically necessary surgery.

Until American medicine undergoes this long-needed overhaul, long-term visitors to the United States ought to be warned that doctors in America are often inadvertently, or quite deliberately misinformed about anatomically correct male genital anatomy, and that taking their child to an American-trained doctor could be hazardous to their child's health.

References:
1. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7.

2. Spence J. On Circumcision. Lancet 1964;2:902.

3. Deibert GA. The separation of the prepuce in the human penis. Anat Rec 1933;57:387-399.

4.  Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3.

5. Catzel P. The normal foreskin in the young child. (letter) S Afr Mediense Tysskrif [South Afr Med J] 1982 (13 November 1982) 62:751.

6. Wright J.E. (February 1994). "Further to 'the further fate of the foreskin'". The Medical Journal of Australia 160 (3): 134–5. PMID 8295581. http://www.cirp.org/library/normal/wright2/

7. Øster J. Further fate of the foreskin: Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child (published by the British Medical Association), April 1968. p. 200-202.

8. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. Journal of Urology, 1996 Nov, V156 N5:1813-1815.

9. Warren JP: NORM UK and the Medical Case against Circumcision. In: Sexual Mutilations: A Human Tragedy; Proceedings of the 4th Intl Symposium on Sexual Mutilations , Denniston GC and Milos MF, Eds. New York, Plenum, 1997) (ISBN 0-306-45589-7)

10. Celsus. De medicina, vol 3. Harvard University Press, Cambridge, p 422

11. Celsus. De medicina, 6.18.2. In: Spencer WG (ed and trans) (1938) Celsus. De medicina, vol 2. Harvard University Press, Cambridge, p 269

12. Hodges FM. Phimosis in antiquity. World J Urol 1999;17(3):133-6.

13. Thorvaldsen MA, Meyhoff H.. Patologisk eller fysiologisk fimose?. Ugeskr Læger. 2005;167(16):1852-62.

14. Marques TC, Sampaio FJ, Favorito LA (2005). "Treatment of phimosis with topical steroids and foreskin anatomy". Int Braz J Urol 31 (4): 370–4; discussion 374. doi:10.1590/S1677-55382005000400012. PMID 16137407. http://www.brazjurol.com.br/july_august_2005/Marques_ing_370_374.htm.

15. Denniston; Hill (October 2010). "Gairdner was wrong". Can Fam Physician 56 (10): 986–987. PMID 20944034. PMC 2954072. http://www.cfp.ca/content/56/10/986.2.long. Retrieved 2014-04-05.

16. Huntley JS, Bourne MC, Munro FD, Wilson-Storey D (September 2003). "Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons". J R Soc Med 96 (9): 449–451. doi:10.1258/jrsm.96.9.449. PMID 12949201. PMC 539600. http://www.jrsm.org/cgi/pmidlookup?view=long&pmid=12949201.

17. McGregor TB, Pike JG, Leonard MP (April 2005). "Phimosis—a diagnostic dilemma?". Can J Urol 12 (2): 2598–602. PMID 15877942.

18. Metcalfe PD, Elyas R. Foreskin management. Survey of Canadian pediatric urologists. Can Fam Physician 2010;56:e290-5.

19. Spilsbury K, Semmens JB, Wisniewski ZS, Holman CD (February 2003). "Circumcision for phimosis and other medical indications in Western Australian boys". Med. J. Aust. 178 (4): 155–8. PMID 12580740. http://www.mja.com.au/public/issues/178_04_170203/spi10278_fm.html.

20. Osborn LM, Metcalf TJ, Mariani EM. Hygienic care in uncircumcised infants. Pediatrics 1981;67:365-7.

21. "Care of the Uncircumcised Penis". Guide for parents. American Academy of Pediatrics. September 2007. http://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Care-for-an-Uncircumcised-Penis.aspx.

22. "Caring for an uncircumcised penis". Information for parents. Canadian Paediatric Society. July 2012. http://www.caringforkids.cps.ca/handouts/circumcision.

23. Camille CJ, Kuo RL, Wiener JS. Caring for the uncircumcised penis: What parents (and you) need to know. Contemp Pediatr 2002;11:61.

24. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3.

25. American Academy of Pediatrics: Care of the uncircumcised penis, 2007

26. Royal Australasian College of Physicians. (2010) Circumcision of Infant Males.


Related Posts:
Phony Phimosis: How American Doctors Get Away With Medical Fraud

What Your Dr. Doesn't Know Could Hurt Your Child

Phimosis and Circumcision in Japan

INTACTIVISTS: Why We Concern Ourselves

INTACTIVISTS: Why We Concern Ourselves

Mother speaking with intactivists at an information booth

A common dismissal to intactivists speaking out against the forced circumcision of healthy, non-consenting minors is that we should "mind our own business."

"Parents make all decisions for their children," some say.

"Whether or not a child should be circumcised should be a parent's choice." 

In this blog post, I want to address why it is intactivists concern ourselves with the well-being of children, and why some of us may go out of our way to talk to parents about what they perceive to be a so-called "personal choice."

But before I do that, I want to address a few problems with the line of thinking that "I am the parent, therefore I decide," and that "What I do with my child is none of your business."

Parental Prerogative Is Not Absolute
First, while it is true that parents make all decisions concerning a child's well-being, it is also true that being a parent is not the end-all/be-all on whether or not decisions concerning them are justified.
 
A parent will go to jail if he or she decides to tattoo their child, for example. He or she can also lose their child if they decided to inject botox into her face for a beauty pageant, for another. In some states, parents will face prison if they deny urgent medical care to a child. Female genital cutting is right out, and there is no exempt for religious or cultural practice.

There is also long-standing legal precedent that says parents are not free to do whatever it is with their child by mere virtue that they are parents.

The Prince vs. Massachusetts court decision states: 

"The family itself is not beyond regulation in the public interest, as against a claim of religious liberty. And neither the rights of religion nor the rights of parenthood are beyond limitation…The right to practice religion freely does not include the right to expose the community or the child to communicable disease or the latter to ill-health or death...

Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves. Massachusetts has determined that an absolute prohibition, though one limited to streets and public places and to the incidental uses proscribed, is necessary to accomplish its legitimate objectives. Its power to attain them is broad enough to reach these peripheral instances in which the parent's supervision may reduce but cannot eliminate entirely the ill effects of the prohibited conduct. We think that with reference to the public proclaiming of religion, upon the streets and in other similar public places, the power of the state to control the conduct of children reaches beyond the scope of its authority over adults, as is true in the case of other freedoms, and the rightful boundary of its power has not been crossed in this case."

In short, if everything we did with our children were justified by mere virtue of being a parent, we wouldn't need child protective services.

Private Matters Online Become Public
With precedents on MySpace, and even ongoing scandals on Facebook, one would think that people would have learned by now that posting their private lives publicly social media outlets for all to see carries certain risks.

Unless one takes the proper precautions of making their account private and visible only to friends on their list, anyone can see posts to their wall, and even comment on them. When you post to public pages on Facebook, such as parenting or "mommy" sites, everyone is free to see and comment.

So controversial is this issue of male infant genital cutting that a lot of mommy sites warn about bringing up this topic, or even forbid it outright.

The fact is, when you publicly post your private life on the net, you are opening yourself to feedback from others, positive or negative, and you can't call it "people getting in your business" when the feedback you get wasn't the reassuring validation that you were looking for.

In short, if you value your privacy and you don't want people "getting in your business," publicly posting your private parenting matters on Facebook, on a parenting forum where a lot of people are likely to read about and comment on them, is probably not a very good idea.

"No one wants advice - only corroboration."
~John Steinbeck

Parents Don't Own Their Children Forever (AKA, It's Not All About You)
It is the nature of children to grow up, become individuals, and develop beliefs, attitudes and points of view separate from their parents.

Boys grow up to be men, and they have the right to be concerned about what was allowed to happen to their bodies, and they have the right to be happily content, or angrily discontent at the permanent alteration of their most private, most intimate organs which they were forced to undergo.

 These men are angry they were forcibly circumcised without their consent as children.
Should they remain silent because it makes parents uncomfortable?

Parents may view older men expressing anger at being circumcised as an encroachment on their parental prerogative, especially parents who have already made this decision for their own children, but the fact is that some men may feel angry about having been circumcised, and this is something that is beyond their control.

I posit that perhaps the reason parents react angrily to grown men protesting their circumcisions is because they do not want to have to face the prospect that one day, their children too may grow up to hate the fact that part of their private organs was cut away without their consent.

So Why Do Intactivists Concern Themselves?
There are a few answers to this question.


First, it could be personal.

People concerning themselves with stopping this practice, going as far as speaking to parents may stem from the fact that they themselves are men who are not happy, perhaps even angry with what has happened to them. They feel it was an encroachment on their rights, and by extension, that it is an encroachment on the rights of others that must be stopped.

Perhaps it's just people who see this as a violation of the most basic of human rights.

I recently saw a video with Bernie Sanders, and it spoke to me. His words are regarding other issues concerning this country, but I think it could apply here as well.

"This is what I believe. Every great religion in the world, Christianity, Judaism, Buddhism, essentially comes down to do unto others as you would like them to do unto you. And, what I have believed in my whole life, I believed it when I was a 22 year old kid getting arrested in Chicago fighting segregation.

I believed it in my whole life that we are in this together, not just not words. The truth is at some level, when you hurt, when your children hurt, I hurt. I hurt. And, when my kids hurt, you hurt. And, it's very easy to turn our backs on kids who are hungry, or veterans who are sleeping out in the street, and we can develop a psyche, a psyche that says I don't have to worry about them, all I'm going to worry about myself. I'm going to make another five billion dollars.

But, I believe what human nature is about is that everybody in this room impacts everybody else in all kinds of ways that we can't even understand. It's beyond intellect. It's a spiritual, emotional thing. So, I believe that when we do the right thing, when we try to treat people with respect and dignity, when we say that that child who is hungry is my child, I think we are more human when we do that than when we say, "Hey this world, I need more and more. I don't care about anybody else."

That's my religion, that's what I believe in. And, I think most people around the world, whatever their religion, their color, share that belief that we are in it together as human beings. And, it becomes more and more practical.

If we destroy the planet because we don't deal with climate change, trust me. We are all in it together, alright?

So, we have got to work together, and that is what my spirituality is about."
~Bernie Sanders

So I believe that this is is the true reason why any of us, if not all of us are concerned.

It all comes down to doing unto others as we would like done to ourselves.

At some level, when you hurt, when your children hurt, we hurt.

It's very easy to turn our backs on kids who aren't our own.

It's real easy to say "I don't have to worry about those other kids who aren't mine. I'm going to worry about my own kids, and that's it."

I believe we're doing the right thing, and when we try to treat others with respect and dignity, especially those people who are too young and small to speak for themselves, I think we're being more human than when we say "I don't care about other people's children."

Why do we concern ourselves?

Because of this.

Parents wouldn't know about these risks and complications unless someone showed them.

Doctors will not show them.

This will not show up in their news feed.

Unless we warn parents, they would never know.

Male infant circumcision has risks that doctors have vested interest in minimizing, if not omitting completely from information they give parents.

The risks of circumcision include infection, partial or full ablation, hemorrhage and even death.

We're just messengers.

Yes, we know that normally we shouldn't encroach on other parents, but we feel this information is that important that this protocol be breached.

Lives are at stake here, not to mention the harms children who do survive have to endure.

This is the body a child has to live with for the rest of his life.

Given that circumcision is not medically necessary, how is putting a child at these risks conscionable?

Why aren't parents being told about these risks?

Information is being withheld from parents.

This results in needless injury and death, not to mention the violation of basic human rights in "successful" surgeries.

That is why we do what we do.

No Judgement
This isn't meant to be judgemental toward anyone, so mothers, or fathers, need not take this personally.

I think most intactivists understand that parents made the best decision for their children based on the information they had at the time.

This is new information, so perhaps parents didn't know.

I know this is hard for parents to wrap their heads around, because many have made a decision, a decision they can't readily take back.

It's OK.

People make mistakes.

All any of us wants to do is give information. It is up parents to decide what they want to do with that information.

No one, at least I, am not accusing, or judging or calling names.

Your blogger is also a parent, and I can assume that as parents, all we want is the best for our children.

What Your Doctor May Not Tell You
No doubt parents are told about the "benefits" of circumcision. But how many have been properly informed about the risks?

Financial Incentive to Minimize or Hide the Truth
Doctors, at least American doctors, have incentive to paint for parents a very favorable picture of circumcision; they make a hefty stipend from this relatively simple procedure which takes about 15 to 20 minutes.

A single circumcision can cost from $100 to $400 dollars to perform out of pocket.

A single circumcision could cost as much as $2,000 in hospital fees, so hospitals want their doctors and nurses to push circumcision on you as much as possible.

Cases have been known where nurses confess that they have been told that a parent is not to leave the hospital until they sign the consent form for their child's circumcision.

Some hospitals list anatomically correct male genitals as an actual problem that needs to be fixed.

In some cases, parents have refused circumcision for their children, and were still billed for it after they left the hospital!

Still in others, parents have been given their child to them already circumcised, prompting lawsuits, including lawsuits that were lost.

$2000 may not sound like much, but consider that in America alone, 1.3 million babies are circumcised annually.

That makes male infant circumcision a 2.6 billion dollar a year industry.

And that's not even including the cost of circumcision equipment, such as circumstraints, circumcision kits, clamps, anesthetics, etc.

Because there is money to lose, in case you say "no," doctors and nurses will more than likely tell you all the good things about circumcision, minimizing all the bad, if not omitting it altogether.

What are the "benefits?"
The "benefits" often sold to parents, even if they can be called that, are "hygiene," supposed "protection" from STDs, and a better "appearance." (Better according to whom?)

Any "benefit" your doctor will tell you about in their sell can already be achieved by simpler, more effective means.

Hygiene can already easily be taken care of with soap and water, just like in girls.

The "protection" against STDs circumcision supposedly offers is speculative, and circumcised males and their partners must still be urged to wear condoms anyway, because circumcision fails.

What is "good appearance" is based on the eye of the beholder. In cultures where women are circumcised, labia and the presence of a clitoris are seen as "unsightly." (Since when was "better appearance" a "medical benefit?")

The bottom line is that not a single respected medical organization recommends male infant circumcision based on the current body of medical literature concerning the matter. Not a single one, not even the AAP in their latest statement, found the "benefits" so compelling that they committed to a recommendation.

In fact, other medical organizations have come out *against* it.

Only the AAP tries to remain "neutral," leaving the "choice" to be "up to the parents," presumably because coming out and saying that circumcision is not beneficial would disenfranchise members of the AAP who do reap profit from male infant circumcision, and leave them open to lawsuits. (The AAP is a trade organization whose main interest is the welfare of their members, your child actually comes second or third.)

In the real world
The fact of the matter is that 70% of the world's men aren't circumcised, and there simply isn't an epidemic of "problems" in those countries where circumcision is rare or not practiced.

In Europe, East Asia, not to mention Australia, circumcision is rare or not practiced, and it is actually being circumcised that has a "strange appearance."

With 80% of American men circumcised from birth, one would expect to observe a lower rate of STDs; higher rates are actually observed in the US, with lower rates being observed in countries where circumcision is rare or not practiced.

According to the CIA World Factbook, the US has a higher HIV prevalence than 53 countries where circumcision is rare or not practiced.

We have more HIV than Mexico.

So what are the risks?
The risks include infection, partial or full ablation, hemorrhaging, and even death.

The risks change depending on the method the doctor uses.

Galloping gangrene and complications of necrosis are more common with the Plastibell technique, and higher pain levels are observed using the Gomco clamp.

The Mogen clamp is notorious for glans amputations, so notorious that, in fact, the Mogen manufacturing company has been put out of business by the numerous lawsuits brought against it involving children whose glans was partially or fully amputated by the device.

Parents, do you know what method your doctor will be using? Has your doctor fully disclosed the risks to you? This is information the doctor should be making clear to you, and/or you need to question him or her if she isn't, as a responsible parent.

Deliberate Misinformation
Still, other doctors or nurses may give misinformation outright. Misinformation, such as "advice" to forcibly retract a child for cleaning. Or that if the child hasn't retracted by 3 years there's a problem. (The AAP actually says that the foreskin should never be forcibly retracted, and rightfully advises that this happens on its own.)

This misinformation often results in the necessity for surgery becoming a self-fulfilling prophecy.

It is a parent's responsibility to make *informed* decisions for their children
This is your child we're talking about, and he will undergo life-altering surgery.

As responsible parents being asked to make a decision, you need to know these things.

Parents, you may not hear about the complications that have resulted from circumcision, because they rarely make the news, and I'm almost certain you are not involved in intactivism, where we keep an eye out on the news outlets and social media.

Circumcision complications are more common than American doctors and their trade organizations would like you to believe.

On Facebook alone, it is not uncommon to see posts by parents who are asking for prayers for their children, because there were complications and their child is in grave danger.

Typically the child won't stop bleeding (hemorrhage) or the doctor cut off the head of the penis, and they don't know if reattaching it will work.

In other cases, sadly, babies and older children have died.

Sadly, oftentimes parents are still not receptive to information we give after this, and still believe circumcision is "necessary" and it would have all worked out "if only the doctor hadn't screwed it up."

You have to remember, circumcision is not a necessary procedure.

Your child is not sick, and will not suffer from having the parts god gave him.

Is putting your child through these risks worth it?

For non-medical surgery?

Your healthy child with whom nothing is wrong?

I'm not sure about everyone else, but for me, just knowing that death is one of the risks was enough for me to say, HELL, NO.

Not my kids.

I look into my son's eyes, and it breaks my heart to imagine his lifeless body in my arms.

Ask Yourself, "Why?"
Boys and men in the rest of the world aren't circumcised.

Why is America the only English-speaking country where boys are circumcised routinely?

If infant circumcision is "so effective" at preventing disease, why can't a single respected medical organization commit to a recommendation?

What are other respected medical organizations around the world saying about the matter?

Why aren't reductions in STDs and other diseases circumcision is supposed to "prevent," observed in real-world data?

If circumcision is supposed to prevent STDs, why isn't this observable in our own country, where 80% of all men are circumcised from birth?

These are questions that, I think, parents ought to be asking themselves.

I can't say who is a good or bad parent, but what I can say is that a good parent researches everything.

A good parent tries to find everything there is to know about something before making a decision.

This is permanent cosmetic surgery on your child we are talking about here.

This is an irrevocable decision that will affect your child for the rest of his life as a man on earth.

Do you want to ruin it for him?

What if he doesn't like it?

You will have taken away his choice.

And there is nothing you can do to give it back.

This is why some men are angry about this and protest. A good parent makes decisions for their children.

It is the responsibility of parents to make decisions for their children.

Hopefully, as parents, we want to make informed decisions, especially with permanent ones like this, with which the child has to learn to live with for the rest of his life.

You may be his parent now, but you are not going to be there in the room when he masturbates or has sex with his partner.

This is his body we are talking about, the body he will have for the duration of his life on earth, and one of the biggest reasons I oppose this is because circumcising a healthy, non-consenting child violates his most basic of human rights; the right to his own body, the violation of his most private, most intimate organs.

Circumcision is a personal choice.

A private and intimate, if not *the* most private and intimate choice.

A choice that rightfully belongs to the person whose body is in question.

Human rights are everyone's business.

Closing
I close with this:
The foreskin is not a birth defect. Neither is it a congenital deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair or fingernails.

The foreskin is not "extra skin." The foreskin is normal, natural, healthy functioning tissue, present in all males at birth; it is as intrinsic to male genitalia as labia are to female genitalia.

Unless there is a medical or clinical indication, the circumcision of a health, non-consenting individual is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

Without medical or clinical indication, doctors have absolutely no business performing surgery on healthy, non-consenting individuals, much less be eliciting any kind of "decision" from parents.

Under any other circumstance, reaping profit from performing non-medical surgery on healthy, non-consenting individuals constitutes medical fraud. In children, it is clear abuse.

Doctors who engage in this practice are engaging in charlatanism and abuse. Abuse of parental trust, and ultimately, abuse of the child himself.

The day is coming when male infant circumcision will be seen for what it is, and doctors will be held accountable for their actions.

Peace to all.

Related Posts:

The "Mommy Page" Wars

The Circumcision Blame Game

"I Did My Research" - The Quest for Scientific Vindication

Phony Phimosis: How American Doctors Get Away With Medical Fraud

What Your Dr. Doesn't Know Could Hurt Your Child

OUT OF LINE: AAP Circumcision Policy Statement Formally Rejected

"Religious freedom?" "Parental choice?" or "Child Abuse?"

Mogen Circumcision Clamp Manufacturers Face Civil Lawsuit

CIRCUMCISION DEATH: Child Dies After Doctor Convinces Ontario Couple to Circumcise

GRANOLA BABIES: BIG MISTAKE

"Religious Freedom" and "Parental Choice" Not Absolute: Yet Another Example

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