Circumcision: Why? A Physician's Perspective
Circumcision is the surgical removal of the foreskin, the skin which normally covers the head of the penis. Throughout history, people around the world have practiced circumcision. For some, as with Jews and Muslims, it has been a religious ritual, for others, as in aboriginal Australia and Africa, it has been a puberty rite.
The United States, Australia, and Canada are the only countries practicing routine circumcision for non-religious and non-medical reasons. In fact, 85% of the world’s male population are NOT circumcised.
Circumcision began in the English speaking countries during the mid 1800s supposedly to prevent masturbation, believed to cause many diseases. Since then, various rationale have perpetuated its practice, but all of these, including claims that circumcision prevents penile and cervical cancers and the spread of venereal disease, have been disproven. To remove the foreskin for hygiene is no more logical than pulling teeth instead of cleaning them.
We now recognise that the foreskin is a normal, healthy, and necessary body part. The Australian College of Paediatrics discourages routine circumcision in the newborn.
Social concerns
Parents may believe their child should be circumcised to look like his dad or older brothers, yet children can easily accept individual differences. They will understand a simple and honest explanation. As parents, we can help our children to feel good about our bodies and to respect differences in one another.
The circumcision rate (7-15%) in Australia is declining. In 1993, more than 85% of newborn boys are leaving hospitals intact.
Parents have new concerns
Now parents have begun to question the need to subject an infant to the pain and the risks of the procedure, and the complications resulting from the removal of the protective foreskin. Parents wonder if it is their right to consent to unnecessary, irreversible surgery. The risk of a “medical” circumcision later is very small.
Most parents do not realise how a circumcision is performed. The baby’s arms and legs are immobilised and the genital area is scrubbed to prepare for the operation. The foreskin is forcibly separated from the glans and slit lengthwise to allow insertion of the circumcision instrument. Then the foreskin is removed, usually without an anaesthetic.
Pain, stress and risks
Until recently it was believed babies felt no pain due to their immature nervous systems. Studies however, indicate that babies experience physical and psychological stress both during the circumcision and for hours thereafter. The procedure is undeniably painful. Some babies cease to cry or lapse into a deep sleep or coma which is how they are able to cope with the traumatic experience.
Circumcision is a surgical procedure with inherent risks including haemorrhage, infection, mutilation, and possible death. Serious complications occur with one in every 500 circumcisions.
The glans is an internal organ which the foreskin serves to cover and protect. During infancy, the foreskin is normally attached to the glans to protect it from urine, faeces, and nappy irritation. As the child grows, the foreskin provides protection from physical trauma such as zipper burns and toilet seats.
Throughout life, the foreskin protects the glans from becoming dry and hardened because of exposure and chafing. There are special nerve endings within the foreskin which enhance sexual pleasure.
Problems cause by removing the foreskin
During the healing period, the raw edges of the surgical wound can attach to the glans. The manoeuvre to separate them is painful for the infant, and like the initial wound is subject to infection. The glans is no longer protected from urine and faeces when the foreskin is removed. Consequently small ulcerations can form around the urinary opening and may require painful medical procedures to open it again.
As the foreskin represents about ONE-THIRD of the penile sensitive area, loss of sensation obviously occurs with the loss of the foreskin. Additionally, sensation decreases as the exposed glans becomes dry, thick, and hardened.
Care of the intact penis
The foreskin and glans develop as one structure. The foreskin of an infant should never be retracted because it is attached to the glans. Separation of the two structures occurs gradually during childhood and the age at which a boy will be able to retract his foreskin will be different for each child. The process should never be hurried. Forcing the retraction will cause pain, bleeding and possibly infection and adhesions.
Phimosis, an unretractable foreskin, normally exists in almost all newborn babies and in some adults, rarely causing problems. However, should painful erections occur, gentle stretching of the foreskin opening will in time, allow for retractability. Removing the important protective foreskin with circumcision is not necessary. The natural shedding of the skin cells from the foreskin lining and the glans helps in the process of separation of these structures. The cells which have been shed form a substance known as infant smegma. The baby’s body effectively discharges this harmless material which can then be wiped from the tip of the foreskin during baths. External washing with soap and water is all that is required for hygiene. During puberty, sebaceous glands begin to function, secreting an oily substance. This additional product in adult smegma protects and lubricates the glans. At this time a male simply retracts the foreskin and cleans.
In conclusion
There is no medical justification for routine circumcision. It is therefore up to parents to recognise and protect the rights of their children as every individual has an inherent right to a whole and complete body. Circumcision of unconsenting children is now a Human Rights & Legal Issue. Female genital mutilation is condemned by NOCIRC as a similar absurdity.
Dr. George Williams, National Organisation of Circumcision Information Resource Centres of Australia
P. O. Box 248, Menai Central, NSW 2234
Published in byronchild/Kindred, Issue 1
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