Forced Retraction: What Now?

I frequently receive questions like this in my inbox:

Help! I just took my [insert age] month-old-baby to the doctor and s/he forcibly retracted his foreskin! I took him from them right away and we are never going back there. But what do I do now?!

First: I would grab my baby from any medical 'professional' forcibly retracting my son and leave immediately as well. How sad that this happens to anyone, ever.

Let me say that no matter what happened to your son, the best thing to do now is to leave his foreskin alone. Do not try to 'clean it out' from whatever happened. Do not place any cream on it (which will only interfere with the body's natural healing process). The only exception to this is Calmoseptine (more info below). Do not place anything directly into the foreskin. Do not wash with soap (this will irritate the sensitive prepuce which likely has tears from forced retraction and will hurt your son further).

Allow the foreskin/penis to heal itself as it will quickly do in infancy (the prepuce will likely try to reattach to the glans in an effort to seal over and protect it). When you bathe your son, use only warm water (not soap). Do not ever scrub his penis. I would be the only one changing my son's diaper for a while to ensure that no one else touched or messed with his foreskin while it was healing. The best advice after forced retraction is the best advice before it ever happened: Leave it alone.

If the prepuce or penis or areas around the genitals look sore or red (even from diaper rash or heat rash or simple irritation) the best ointment to pick up is Calmoseptine. You can request a tube from your local pharmacy (for about $6), or on the shelf at most Walgreens stores. Calmoseptine does not interfere with the genitals' natural pH balance, and it is a wonderfully soothing, healing cream that is safe to use all around the genitals of babies. Calmoseptine can be placed around the base of the penis and scrotum - it will help to heal during diaper wearing time, and will get around the foreskin via rubbing. It is really the only 'diaper' cream you will need during babyhood, and is especially good for cases like this.

The following are the four most frequently posed questions I've been asked lately. Because this situation has come up so often, I am going to post some of my reply here.

1) What's the best way to file a complaint against this doctor?
2) What resources/information pages can be sent to this doctor so that other intact boys aren't put through this?
3) Is there anything else we can do to make this doctor become more informed about proper foreskin care (that is, to leave it alone)?
4) How would you go about finding a doctor who is educated about foreskin maintenance?

1) You can report this event to an attorney at Doctors Opposing Circumcision. Go to the contact section of their website and contact John Geisheker. Have your doctor's name; name/address of the practice; and the name/address/department head's name, and name of the risk manager at the hospitals where the doctor has privileges, if possible.

In addition, you can report the occurrence to ARCLAW - attorneys specifically working for the rights of babies/children in the areas of genital cutting and harmful medical practices impacting the genital integrity of human beings. They may be able to send a letter on your behalf.

2) I would re-familiarize myself with the following information and print/give what you find important to your doctor for review. When there are experts in the field of pediatrics and human sexuality publishing on the perils of forced retraction all the time, there is NO REASON for a physician to remain ignorant on the proper care and protection of an intact boy.

Forced Retraction: Ask the Experts

Doctors Opposing Circumcision (the vast majority worldwide do oppose circumcision) statement on forced retraction

AAP (American Academy of Pediatrics) statement on foreskin retraction.

Only Clean What is Seen

Protect Your Intact Son

National Organization of Circumcision Information & Resource Centers' pamphlet on Care of the Intact Penis

UTI/Medical Tests: Do Not Retract

This doctor should also review Dr. Fleiss and Dr. Hodges book and research, "What Your Doctor May Not Tell You About Circumcision." They are two pediatric and human sexuality experts in the field who have studied this topic for the past 30+ years. An excerpt of their book, "Functions of the Foreskin" can be found here. It highlights many of the reasons we want to leave boys' (and girls!) prepuce organs alone!

In the end, the best pediatric word of advice for baby boys:

INTACT = DON'T RETRACT.
Only clean what is seen.
Wash like a finger: outside only.

One of my colleagues tells his patients the only tool they need to care for their intact son(s) is a ruler - to slap the hand of anyone who comes near. I guess in a case like this, that would include the doctor.

3) If you are brave enough to engage in dialog on this topic with the doctor, I would ask questions - find out why s/he believes this is necessary, site other pediatric professionals who are publishing (articles such as those above) in this area, and maybe (hopefully) s/he will think twice about what s/he is doing and change the method of practice used so other boys are not harmed. The vast majority of problems with babies and  men's penises occur because someone forcibly retracted or 'messed with' their prepuce when they were infants. This really needs to stop. We need to educate parents so that they can protect their sons even in cases such as this when medical professionals have not been educated on this subject. It is likely that this doctor is not a 'bad guy' but rather, that he never sought out the information and is still acting out 'old school' ways of doing things...from before we understood what we do now about the functions of the foreskin and the important purposes of the prepuce organ in the U.S. (common knowledge that many in intact nations take for granted).

4) I would become very well versed in the purposes of the prepuce and proper care of an intact son myself, and then when interviewing potential care providers (you are, after all, hiring them for their services), simply ask them about their ideas on circumcision, the prepuce, and care of intact boys. You will quickly find out whether or not they are up to date and educated on the subject and will be able to stick with them, or move on. I have interviewed physicians in such a way (on this and other subjects) via phone and email. Of course, you can also set up a brief 10-minute introduction appointment with a physician. Most are willing to meet with potential new patients to see if it is a good 'fit.' If one is not willing to meet before joining their practice, do you really want them for your doctor anyway?

Best wishes to all parents out there navigating these waters. Don't be afraid to bring out the momma bear in you and protect your little cubs!

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