Wednesday, November 17, 2010

Circumcision: The Most Twisted Logic in the World

By Clara Franco
This article was translated by the author and edited for DrMomma.org. It is available in Spanish here.


Let’s imagine for a moment the following series of situations at the doctor’s office.


Scenario 1:

-You: Doctor, now that my baby is crawling, his fingernails get SO filthy - full of dirt! Besides, it’s hard to cut them; it is so much trouble and takes so much time. Because of the dirt and bacteria getting under his nails, and then into his nose and mouth, he’s sick all the time and getting infections. What can I do?

-Doctor: Ma’am, the best solution would be to immediately schedule an appointment to cut your baby’s fingertips off. A solution to last a lifetime!

-You: What?! How can you even think I would cut off my son’s fingertips?

-Doctor: But this is very normal. Lots of moms do it now. It’s harmless, really! We only cut a little piece at the tip of the finger, a very small bit. Only the part where the nail begins to grow. His hands really work exactly the same; but you’ll spare yourself of the trouble of cleaning his nails and trimming them - forever! You won’t even need to teach him how to wash his nails when he grows up.

-You: But doesn’t that hurt?

-Doctor: Absolutely not. Babies this age cannot yet feel pain, and even if they did, they won’t remember it.



Scenario 2:

-Doctor: It’s a girl! Mrs. X, I must remind you that your health care plan will cover the expenses in case you want to perform a radical mastectomy on your baby. The sooner, the better.

-You: A what?

-Doctor: You know, to completely remove her mammary glands. Breast cancer is now the second cause of death in Mexico for women over 25, and it’s more common every day! If we do the procedure on your daughter, you’ll forever forget about that risk. You could save her life! It’s better now that she’s a baby and she won’t remember. No cancer for her - ever! It’s becoming routine to do it when they’re this young. Remember, if you choose not to get the surgery, there’s still a 1 in 10 chance that she will have cancer and need the procedure anyway. Her mammary glands really do nothing but put her at deadly risk.

Scenario 3:

-Doctor: It’s a boy! So ma’am, we’re going for the appendectomy, right?

-You: Well, do you recommend it, doctor?

-Doctor: Absolutely. Look, more or less, four in every fifty children will have appendicitis at some point in their lives. And then it is a problem because if they don’t have the surgery immediately, they may die from peritonitis or septic shock. Now many parents choose to have the surgery done right after birth, and do away with the problem forever! We’ll remove it now, and spare ourselves from a scare when he’s older.

-You: But you’ll use anesthesia, right?

-Doctor: Oh no, that’s dangerous in newborns! We don’t apply anesthesia because then it would be a high-risk intervention. Besides, what’s the point? He’s so small and he can’t feel pain yet. He won’t even remember when he grows up.


Scenario 4:

-Doctor: Mrs. X, this is the third time in two years that your girl has had a urinary tract infection due to bad hygiene. Seriously, she needs to have surgery. These infections are much more common in girls than boys. You’ll see how quickly it is done - just a little cut to the labia, where the smegma accumulates, and that’s it. All better.


Scenario 5:

-You: Doctor, what can I do to keep my son from fracturing his foot for the third time?

-Doctor: Well, clearly, to amputate his feet would be the most effective solution!



Scenario 6:

-Doctor: Well, because we are already performing surgery on your son due to his accident, how would you like us to complete an aesthetic rhinoplasty? With an nice aesthetic nose he will be so much luckier with the ladies later on!...



If any of the situations above, as absurd and ridiculous as sound, seem impossible to us, we are being completely hypocritical. Because - surprise! - this is the very same twisted and ill-conceived logic that we’ve been applying to a single body part, of a single sex: the male genitalia.

It’s a completely altered, ashtray logic that we only apply to a male infant, when we decide we have the freedom to amputate a part of his penis… in a “preventive” manner.

Sure enough, there are societies where, in more egalitarian fashion, the same logic is applied to both sexes. There are societies that practice both female genital mutilation and male genital mutilation. For example, some sections of Indonesia, Malaysia, Somalia, Mali, Egypt, Kenya, etc.

There are also societies where, of course, neither FGM or MGM is practiced at all. But what’s despicable is the medical double standard, in societies where every individual’s body is highly respected, and amputation is a last, extreme resort - reserved solely for truly severe cases. Somehow, male genital mutilation has slipped in as a common, acceptable amputation surgery that a baby boy’s parents “have the right to choose.”

Let’s stop deceiving ourselves: every circumcision is an amputation, because it irreversibly removes an organ that has a name, specific functions, and the purpose of creating a normal sexual response. It is an organ that is healthy and that will no longer exist on the individual’s body after the surgery. Words such as “removal” or “extirpation” mean the exact same: am-pu-ta-tion. We cannot disguise it. Male circumcision is an amputation. And one that should only be decided upon by the owner of the body and no one else.

Rarely does a healthy human being need an amputation of anything. And, in the rest of the medical universe, amputations are rarely practiced. The need might arise because of severe, dated infections; extended, severe and uncared-for wounds; or because of gangrene (which is often the consequence of extended, severe and uncared-for wounds). Diabetes, for example, causes circulatory failures and a certain type of gangrene in the limbs, which sometimes makes an amputation necessary. But, again, those are cases of disease - uncared-for disease that has lasted a long time.


When is an amputation necessary?

• Malignant tumors
• Gangrene
• Severe frostbite (which is somewhat similar to gangrene: the organ or limb dies because the tissue is destroyed)
• Severe damage or trauma. For example, if one nearly loses an arm in an accident. If the arm remains only linked to the body by a very small part, and there is no way to recover it, amputation may be wise if the arm will only remain there as an infected limb.


No one in the medical establishment ever uses amputation as:

• A method of prevention
• Prophylaxis (as supposed “hygiene”)
• A first solution for treating infections
• A first solution for treating tight skin
• A first solution for treating anything

…Unless we are talking about the male prepuce. It is the only body part that we have not conceded the same respect to. Why are we getting carried away by such fallacy, such twisted logic? Why do we respect female genitalia, which by the way is more prone to infection and harder to clean than male genitalia, and yet we never, ever, cut away parts of it? In fact, in some nations (like the U.S.) there are federal laws in place to protect the female genitalia of minors from unnecessary cutting!

Something very similar has happened to our country’s medical establishment. We’ve ended up seeing this amputation (only this one, and exclusively this one), as something normal, desirable, "decidable by parents," aesthetic, hygienic, healthy. This is the only little loophole where no one seems to remember the Hippocratic Oath, or the need to use amputation only as a very last resort in rare and severe cases. We have conceded this amputation a sort of respect that it does not deserve. We have placed it into its own category within medical practice. (Look in many Healthcare Insurance Plans pamphlets: male circumcision really does have its own chapter).


The case becomes shamelessly lunatic when we realize that, today, many studies have been conducted concerning HIV and other sexually transmitted diseases which seek to legitimize the practice of male genital amputation on healthy individuals. These studies hold amputation as a starting point, and not the illness itself. How did we ever let this happen? What other medical study has ever started from the premise of amputation, and then tried to prove its use for something? To first push for genital mutilation, and then attempt to prove it to be good disease prevention.

Let’s imagine that an orthopedic surgeon performs a similar study:

“Medical research conducted by Doctor A. Smith, using experimental samples of individuals from Tanzania, has concluded that foot amputation definitely bears a positive effect in the prevention of various diseases and conditions; such as foot fractures, athlete’s foot and other kinds of fungi, ingrown toenails, and foot wound infections. When performed on newborns, amputation can also completely prevent accidents concerning “hair tourniquets,” a dangerous condition that happens when a hair or fine thread gets wrapped strongly around a toe, cutting blood supply. Out of 1,000 analyzed individuals, those who had feet amputations performed had a 95% lower chance of presenting ANY of these conditions, diseases and accidents!”

Doctor A. Smith is not lying. Amputating body parts does keep us from potentially having any trouble with those parts later. Because if we amputate, these organs or limbs no longer exist. Just as killing my neighbors would help me avoid any trouble with them in the future...

But that is such twisted logic that no one in their right mind would use. The body deserves respect. The body deserves treatment options. And it deserves integrity. It deserves our realization that every one of its amazing parts bears an important function - each and every one present to do something vital for normal health and funcitoning.

Would we support similar HIV studies if they were seeking to conclude that FGM is good disease prevention? No, we would probably dismiss such "research" as being unethical, and possibly a bit insane. As western women, we have been whole and healthy for centuries, knowing how to prevent and treat disease without resorting to amputation. By the way, these studies on women do exist. And yes, the results were that circumcised women had a lower chance of getting infected with HIV. Now who said there was no equality among the sexes...?

Unfortunately, too many of us allow ourselves to be sold nonsense justifications for amputation, for the most hollow and false reasons. Those of us sold on the surgery have an easier time if we also buy into the lies - "babies feel no pain" and "it won't hurt." If circumcision actually were helpful in reducing HIV, or sexually transmitted infections, or the latest "disease of the decade" then all our clinical trials would work the other way around. We would analyze the illness, and then conclude that it is solely and exclusively caused by this one body organ, and that amputation is truly the only way. But because this has never been, and likely never will be the case, we continue on in our desperate attempts to keep up with the myths and reinvent the latest "need" for prepuce amputation.


Clara Franco is the director of the National Organization of Circumcision Information Resource Centers Mexico chapter. Read more from Franco (in Spanish) at Mexico Intacto, follow at Mexico Intacto on Facebook, or find Franco's work in English also at:

Is the Pain of Circumcision Truly "Brief"?

Intactivists: Those Uncommon Activists

Related items: 


Routine Toe Removal Has Health Benefits


For further resources on the prepuce, circumcision, and intact care, see: Are You Fully Informed?


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16 comments:

  1. great article, posting to Sunday Surf.
    I had an article along these lines a litle while back.
    http://www.authenticparenting.info/2010/10/routine-nose-removal.html

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  2. I'm so confused & conflicted on this matter. My first son was circumcised because I was told it was cleaner and promoted better hygiene, resulted in a lower risk of STD's, etc. It was performed with anesthesia, so I didn't really think anything of it. Now I'm expecting my second child, a boy, and the nurse-midwife I go to told me that there is no medical reason for circumcision. Why are there differing reports? Is there or isn't there a medical reason for circumcision? In the event there truly is no medical reason for circumcision, I feel horrible for my first son, even though he was numbed during the procedure. I don't want to put my second son through it if there's no reason to.

    I really wish this issue would be something that doctors would get their act together on. I've been told circumcision is healthy and unhealthy - it can't be both, so which is it? I feel as if I was lied to back when my first son was born, and I want to know the truth.

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  3. Taylor,
    I circ'd my first son and regret it so badly. We WERE lied to. It's not recommended by any medical association in the world (routine). It's risky and harmful. It can actually introduce infection because you're cutting the skin open. Not only that, but I've read stories from circ'd men that they're actually upset with their parents for cutting them. I think you should say no. You can't undo it, and if he chooses to when he's older, so be it. But, please, don't make that choice for him. I left my second son intact. He's the only intact member of our household, and it's not weird for us that he's different. He's whole and perfect, just the way I gave birth to him.

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  4. Taylor, there is no medical reason. Nobody in my husband's family is circumcised. None of their friends is circumcised. And none of them have ever heard of anyone having a medical problem due to possessing their foreskins.

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  5. Taylor-

    Sadly, doctors don't know everything, and it's often up to parents to do research and make informed, compassionate decisions. While no medical organization in the world promotes circumcision, many doctors still do it as a matter of routine. As an interesting historical note, female circumcision (including cliterodectomy) was performed in the United States (and even covered by insurance) as late as the 1970's. Our culture has since evolved to understand that female minors have a right to genital integrity; my hope is that we'll continue that growth and likewise recognize the right of boys to genital integrity.

    As the mother of two intact boys, I can tell you a few things:

    1) Taking care of an intact penis is easy---you just clean it like a finger. Only clean what's seen; eventually, the foreskin will retract. At birth, it's attached to the glans of the penis the same way a fingernail is attached to the nail bed. Don't try to forcibly retract it, and don't allow anyone else to. Your son will eventually discover that his foreskin retracts, and at that point you can teach him to care for himself: In the bath or shower, just retract, rinse, and replace. Simple.

    2) Don't worry about the discussion your sons will have about why their genitals look different. All genitals will look different; if your older son asks about it, you can explain what happened, and that later you learned it wasn't necessary so his brother didn't have that operation done.

    Here's a great link about talking to your intact son about why his penis might look different from his dad's:

    http://www.restoringtally.com/blog/2010/03/fathers-talk-his-son-about-infant-circumcision


    3) Don't beat yourself up about the choice you made for your first son. When you know better, you do better.

    Thank you for being a concerned, thoughtful, caring parent!

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  6. Taylor, the fact of the matter is that there is NO scientific evidence that there is a medical benefit to foreskin amputation.
    But let's just pretend there was potential for avoiding disease by cutting off part of the body preemptively. We need to remove several other areas of the body that are much more prone to disease of one kind or another. Imagine the idea of removing your daughter's breast tissue because breast cancer is possible, or her labia because vagina's are cheesy and unhygienic.
    The point is, that the arguments for circumcision are generally unfounded, but even if they were founded, they are still lacking in logic. We don't remove any other body part in a preventative manner as a standard of practice, even when there is clearly a high potential for disease to attack that body part.
    The "science" for the STD argument is weak at best. There is some simple logic that can balk at that argument, though, just think about how high our AIDS rate is here in the US where most men of a sexually active age are circumcised.

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  7. Taylor - congrats on your pregnancy!
    I understand where you are coming from. I was not fully informed when I had my first son and I thought circumcision was just normal and of course, it had to have benefits! Why else would doctors do it! Since then I have learned so much. First, the foreskin is missing from medical school curriculum in most cases, so doctors are no more informed than anybody else and are walking around under the same shroud of ignorance as the rest of us, thinking it's just a useless flap of skin. Sadly for circumcised boys, this is not true :( and in fact it is the most sensitive part of the penis! That is actually why doctors recommended routine circumcision to begin with - to prevent masturbation, which, at the time (Victorian era) was thought to be the cause of various ailments, and immoral. As time went by, and as it became clear that these claims were incorrect, new claims came along to replace the old ones and the practice was perpetuated and a vicious cycle began, until it became so normal in our culture that you didn't really need much of a reason at all to do it. (look like dad, or the other boys in the locker room, to not have to rinse underneath the foreskin in the shower, etc.) You may be surprised to learn that women actually make more smegma than men! And get way more infections. Yet no American doctor would ever suggest "snipping" a baby girl! They just tell you to bathe her, or treat any ailment that comes along! Doctors are just so accustomed to the idea of male circumcision, some of them do not see it for what it is. The logic is really twisted, as this witty writer has pointed out. I actually had my 2nd son in Europe, where it is simply not done. And there are no epidemics of any foreskin-related issues here lol. Our German pediatrician thinks it's pure insanity that any doctor would recommend doing such a thing to a baby. I suggest you check out the site www.doctorsopposingcircumcision.org as a starting point to learn more. Best wishes for a healthy pregnancy and birth!!

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  8. Taylor, I can understand your frustruation. I an a childbirth educator and hear the same things from couples in my classes. Curcumcision is an irreversable action, and if you have any doubt in your mind then you should NOT make an irreversable decision. (A general rule that's just good sence!) I have a friend that ends up in tears when we talk about circumcision because she is in the same scenario you describe; she circ'd her first because she thought that's "what you did", then found out that it wasn't necessary at all and was heartbroken. She didn't cut her other boys, and is so thankfull. I believe that if you continue to educate yourself, you will see that the rsks far outweigh any "possible" benifit. It is an elective procedure and the choice should be left up to the owner of the penis. Good luck. Jennifer

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  9. Taylor~ I agree with the other moms who say it is not needed. I left my son intact because I just couldnt stomach the idea of cutting my perfect little boy. BUT.. I grew up with thinking it was normal... and didnt know it was a choice to be made.. I just thought it was something done to boys no matter what. After having my gut feeling, I did a lot of research, and the saying.. The more you know, the more your against it? SO TRUE!!! Leave this little boy intact, and do some research... And also.. Dont be hard on yourself for your first boy.. Moms do what they feel is right with the information given to them. I was lucky to have a pediatrician who is all for keeping boys intact... and Good for you for having a Midwife who spoke up.

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  10. @Taylor:

    n the 1930s and 40s, many American maternity wards began circumcising every baby boy born in them without asking the mother. Circumcision was cancelled if the mother raised the subject and said No.

    A result is that most middle class Americans have never seen a foreskin in the flesh. If they know what an intact penis, it is only thanks to graphic imagery on the internet. The foreskin became a sort of Loch Ness monster of American masculinity. The foreskin was seen as trapping stale urine and precome and turning a boy and man into a walking petri dish. If he wasn't chronically infected, he was permanently gross. I've been told to my face several times that intact men never receive oral sex. The unstated assumption is that oral sex is every male's birthright.

    Your typical medical school prof, older doctor, and RN is not competent to judge the natural penis, because it is so alien to their parenting and sexual experience. So the intact penis become the butt of a host of urban myths. A major source of these urban myths is that the uncircumcised minority had darker skins, were recent arrivals in the USA, had illiterate parents, were rural rednecks, functional illiterates, etc etc. The pointed penis was seen as a sign of inferior origins.

    Over the past 20 years, the ground has shifted to being more favorable to leaving baby boys intact. It is not uncommon at all for a mother to have been told 1990-2005 that circ was better (cleaner and all that) and then to be told after 2005, that intact is fine if not better.

    All the problems that routine circ is alleged to cure can also be addressed by condoms and conservative sexual behavior.

    Finally, circumcision ablates the most sexually sensitive bits in the entire male body. The consequences for sexual pleasure and functionality are not always major, especially before age 40 or so, but they can be.

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  11. Thank you for all of your kind responses and information. I've been in tears throughout the afternoon as I've started researching. I'm now following this blog. Thank you for pointing me in the direction of some resources and for being so helpful.

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  12. I left a comment when I first read this article, but it still hasn't shown up, so I'll try again. I am very passionately opposed to both abortion and non-medical circumcision of minor children and babies of either sex, I do not know how someone could be for one and not the other. I see many similarities in the two. Both involve huge industries who make vast sums of money off of both the "procedures" and the "products." It is because of this vested interest in continuing the practices that parents are purposely withheld crucial information, lied to, and encouraged to follow through. Both are horrific, excruciatingly painful assaults against helpless babies. I can not understand how someone could be grieved by one assault and not the other, so I think they must not be fully informed on the one they support.

    Taylor, you are in the right place to research girl!!! I recommend Dr.Momma's site constantly as the place to begin research on this issue. Look on the left hand sidebar, and click on the foreskin/prepuce resources with the picture of the figure with the circle over the genital area, if you haven't already done so. This takes you to many articles on every aspect of circumcision and intact genitals, along with links to numerous other educational sites, and recommended books. There is a Doctors Against Circumcision website, and their link is listed there as well.

    I am confident as you learn more, you will see that all the "benefits" you have been taught are untrue. Intact penises are much easier to clean because only the outside is cleaned. NEVER retract! The child will retract on his own, over time, and often not until after puberty. Just leave his little penis alone, and he will be fine. Forced retraction causes injury. Once he does retract, he just takes an extra few seconds to retract and wash. No big deal at all.

    And, amputating part of a baby's healthy penis for some supposed benefit of a lowered STD risk (read all about the flawed studies on this site), is an extremely poor reason. Using that logic, we must consider amputating all the other healthy body parts that could potentially get infected as the article above goes into. If anyone is relying on a circumcision as an excuse to engage in risky sex thinking he is protected, he will learn the hard way that he was wrong.

    Please fully research and keep your precious baby genitally intact. Circumcision removes most of the feeling from the penis as most of the nerves and sensitivity are in the foreskin. Do the supposed benefits you were told seem worth taking so much away from your son? Please don't blame yourself for your firstborn's circumcision. We do the best we can with the information we have at the time.

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  13. Hugs to you, Taylor. Be gentle with yourself. <3

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  14. Taylor- Big hugs to you mama... you last paragraph just breaks my heart... the way you pin the blame squarely where it belongs- you were misled, you had faith, you trusted them to guide you and they let you down, they never gave you a straight answer and they took your money and cut your baby. Shame on them, shame on this disgusting game they play with their medical tools which act with no reason or responsibility. Any reason will do..."shh shh don't even tell me... it doesn't matter to me one bit... your reason is TMI, just say the word, sign right here, you are the boss... (the parents insist- tee-hee)" where else do doctors EVER act that way!?! I'm so sorry for you Taylor!! Shame on them! I hurt so for your mother's heart.

    One of the most profound pieces of writing on circumcision came as a letter from a Canadian medical society- The College of Physicians and Surgeons of Saskatchewan. It says very clearly what you needed to hear.
    http://www.infocirc.org/saskmemo.htm

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  15. You forgot a scenario
    You: Doctor, my child seems to be perfectly healthy.
    Doctor: Yes, but we should still cut a bit of his penis off, otherwise I can't make any money out of him.

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  16. I just asked my intact 8-year old son how he would feel if we sliced the end of his penis off. His reply? A most emphatic "NO!!" So there you have it.
    My 6 year old (& also intact :) ) daughter also gave me an idea for another scenario...

    Doctor: Well, it looks like you're most ready to take your new baby home. [Big smile] We just have one little procedure to perform.
    Parent: Of course, Dr. What do you need to do?
    Doctor: Oh, we just need to cut your baby's tongue off.
    Parent: His tongue??? Why?
    Doctor: Well, all the parents are doing it now. It prevents that annoying backtalking which can often lead to worse things like crime & jail time. It'll make his mouth cleaner because his tongue won't be rubbing up against his teeth. We do lots of these surgeries every day, so he'll be just like all the other kids in his class. And besides, we just cut the end off. Wouldn't you want your child to avoid all this unpleasantness? All you need to do is sign right here...

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