So, now that we know for sure that we are having one girl and one boy, DH (blogspeak for dear husband - barf, but it's effective I suppose) and I are starting to get serious about decisions like names, nursery themes, and....whether or not to circumcise. If you'd asked me a year ago, I would have said it was a no-brainer. Isn't that what most people do? Turns out, not so much anymore. Rates have dropped to less than 1/3 nationwide (
http://www.npr.org/templates/story/story.php?storyId=129362160), although that is somewhat misleading since it doesn't include those snipped outside of the hospital setting. But it's fair to say the practice is definitely on the decline, and that less than half of boys these days are circ'd.
In light of new information and research, the AAP no longer recommends circumcision as a routine procedure (
http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/pages/Where-We-Stand-Circumcision.aspx). So basically, they're saying it's up to you and your beliefs. DH and I are not religious, so that argument is out the window. However, DH is definitely more...traditional than I am. I can't just do things because they were done in the past (it took him 6 yrs to talk me into putting up a Christmas tree b/c I saw no purpose in it). Then again, I don't want my kid to be some badge of my progressiveness. So we find ourselves at a crossroads. I've basically just asked DH to do some reading on the subject so that we can make an educated decision. I have learned I need to pick my battles, so we'll see how it goes :)
For anyone who'd like more details, here's an excerpt from Lucie's List that I find to be informative and unbiased:
Studies that previously demonstrated medical benefits of circumcision - namely, reduced rates of HIV transmission--are now being reconsidered because they took place in sub-Saharan Africa. In that location, environmental circumstances, including poor sanitation and high rates of Chlamydia-caused open sores, invalidate the application of the results of these studies to first-world, western populations. Furthermore, any possible benefits received from the potential decreased risk of UTIs or yeast infections are essentially negated by the risk of surgical and post-surgical complications.
Background Info
Globally, circumcision is most prevalent in the Muslim world, Israel, Africa, the US, and South Korea. In contrast, it is fairly
rare in Europe, Latin America, Southern Africa, and most of Asia.
In the US, less than 60% of all baby boys are still circumcised. But there are HUGE regional differences to point out: in the West, only about 34% of baby boys are circumcised, while in the Midwest, it's nearly 80% (per the CDC's National Hospital Discharge Survey).
The Argument For Circumcision
Urologist Anne-Marie Houle, MD, FRCSC, FAAP, who is pro-circumcision, argues:
The 8 reasons for routine newborn male circumcision ~
Circumcision:
8. decreases the risk of urinary tract infections (UTIs)
7. reduces the risk of heterosexually acquired HIV infection in men.
6. lowers the risk of STDs.
5. protects against penile cancer.
4. reduces the risk of penile HPV infection and the risk of cervical cancer in female partners.
3. prevents chlamydia infections and subsequent pelvic inflammatory disease, ectopic pregnancy and infertility (in your partner).
2. decreases the risk of balanoposthitis and phimosis and the later need for postneonatal circumcision.
1. improves sexual function and creativity.
The Argument Against
Dr. Sears, a popular pediatrician, is
adamantly against circumcision.
"1. Medical benefits - THERE ARE NONE! Do not circumcise your baby because you think there are some medical benefits. A recent review by the AAP looked at all the data from the past decades to see if there truly were any medical benefits. Their conclusion: NO. Here are a few benefits that we used to think were true, and now know are not:
- Cleanliness - although it is true, a circumcised penis does not collect any white stuff underneath the foreskin like an intact penis does, THIS IS NOT A MEDICAL BENEFIT. It is really just one less area to wash in the shower.
- Decreased risk of STD's - this was a myth that we now know is not true.
- Decreased risk of penile cancer - it used to be thought that circumcised men had a much lower chance of cancer of the penis. We now know that this benefit is much smaller than previously thought. The AAP determined that this benefit is so tiny, it is not worth circumcising for this reason.
- Avoiding infections in the foreskin - it is true, occasionally intact foreskins get irritated. This is easily treated with warms soaks and washing. Rarely, the irritated foreskin becomes infected. This requires antibiotics to clear up, but is easily treatable. Even if this does happen once or twice in a person's life, it is not a reason to circumcise at birth.
- Avoiding the need to do it later on - very rarely, someone has a problem with recurrent infections in the foreskin that need antibiotic treatment. Some of these men then need to be circumcised in an operating room under general anesthesia. This is extremely rare, however, and is not a reason to circumcise everyone at birth.
- Avoiding bladder infections - it used to thought that circumcised boys and men had a much lower chance of bladder infections. The AAP now knows that this benefit is very small, and is only true for the first few years of life. After that, there is no difference in the number of bladder infections. Again, not a reason to circumcise.
2. Don't want to be teased - while this may have been true in the U.S. decades ago, the truth is that your uncircumcised kids will be in good company in the locker room when they are teenagers. Less and less people in the U.S. are now circumcising their boys.
3. Too much trouble to take care of - some people think that an intact penis is too much trouble to pull back and clean, especially during childhood. Well, the truth is, you are not even supposed to pull back the foreskin until it naturally comes back on its own between age 3 years and adolescence. So there really isn't anything to even take care of until then.
4. Want your boy to look like dad - the main difference that your child will notice between him and dad is the hair. He won't even notice any difference in the penis until he is old enough that you can then explain to him the difference.
So, what are the reasons TO circumcise? Here is the list:
Religious reasons. That is all. There really is no good reason to circumcise other that personal preference and religious reasons.
Are there any reasons NOT to circumcise? Consider these:
1. Leave nature alone - whether you believe God created men with a foreskin, or nature simply evolved this way, there must be some reason men have foreskins. Why change something that God/nature has created?
2. Sensation and sexual pleasure - the foreskin is filled with nerves, and is therefore extremely sensitive to touch. This enhances sexual pleasure.
3. Protects the glans (head) of the penis - the glans is another highly sensitive area. The foreskin protects the glans from constant rubbing and chaffing against clothing that can desensitize it over the years. This preserves sexual pleasure.
4. Ethical issues - there are groups of people worldwide, including medical societies, that oppose routine circumcision because they feel it is unethical for a parent to decide to alter the penis of their child without the child's consent. Parents who are deciding whether or not to circumcise their son may wish to consider the impact this may have in the future if the child decides they wish they were not circumcised."
-- William Sears, MD
No pun intended, but there is no clear cut answer on this one, mommy.
