After studying the affect of cutting of neo-natal, I see this as a primary issue in American culture.
Darcia Narvaez, PhD, is Professor of Psychology at the University of Notre Dame specializing in ethical development and moral education, and a fellow of the American Psychological Association. She integrates a bicultural and interdisciplinary background into her scholarship, and writes a blog for Psychology Today called “Moral Landscapes.”
Myths about Circumcision
You Likely Believe
does great harm to babies
Part 1 - Circumcision Surgery Myths
Myth 1: They just cut off a flap of skin.
Reality check: Not true. The foreskin is half of the penis's skin, not just a flap. In an adult man, the foreskin is 15 square inches of skin. In babies and children, the foreskin is adhered to the head of the penis with the same type of tissue that adheres fingernails to their nail beds. Removing it requires shoving a blunt probe between the foreskin and the head of the penis and then cutting down and around the whole penis.
Myth 2: It doesn't hurt the baby.
Reality check: Wrong. In 1997, doctors in Canada did a study to see what type of anesthesia was most effective in relieving the pain of circumcision. As with any study, they needed a control group that received no anesthesia. The doctors quickly realized that the babies who were not anesthetized were in so much pain that it would be unethical to continue with the study. Even the best commonly available method of pain relief studied, the dorsal penile nerve block, did not block all the babies' pain. Some of the babies in the study were in such pain that they began choking and one even had a seizure (Lander 1997).
Myth 3: My doctor uses anesthesia.
Reality check: Not necessarily. Most newborns do not receive adequate anesthesia. Only 45% of doctors who do circumcisions use any anesthesia at all. Obstetricians perform 70% of circumcisions and are least likely to use anesthesia - only 25% do. The most common reasons why they don't? They didn't think the procedure warranted it, and it takes too long (Stang 1998). A circumcision with adequate anesthesia takes a half-hour - if they brought your baby back sooner, he was in severe pain during the surgery.
Myth 4: Even if it is painful, the baby won't remember it.
Reality check: The body is a historical repository and remembers everything. The pain of circumcision causes a rewiring of the baby's brain so that he is more sensitive to pain later (Taddio 1997, Anand 2000). Circumcision also can cause post-traumatic stress disorder (PTSD), depression, anger, low self-esteem and problems with intimacy (Boyle 2002, Hammond 1999, Goldman 1999). Even with a lack of explicit memoryand the inability to protest - does that make it right to inflict pain? Ethical guidelines for animal research whenever possible* - do babies deserve any less?
Myth 5: My baby slept right through it.
Reality check: Not possible without total anesthesia, which is not available. Even the dorsal penile nerve block leaves the underside of the penis receptive to pain. Babies go into shock, which though it looks like a quiet state, is actually the body's reaction to profound pain and distress. Nurses often tell the parents "He slept right through it" so as not to upset them. Who would want to hear that his or her baby was screaming in agony?
Myth 6: It doesn't cause the baby long-term harm.
Reality check: Incorrect. Removal of healthy tissue from a non-consenting patient is, in itself, harm (more on this point later). Circumcision has an array of risks and side effects. There is a 1-3% complication rate during the newborn period alone (Schwartz 1990). Here is a short list potential complications.
Meatal Stenosis: Many circumcised boys and men suffer from meatal stenosis. This is a narrowing of the urethra which can interfere with urination and require surgery to fix.
Adhesions. Circumcised babies can suffer from adhesions, where the foreskin remnants try to heal to the head of the penis in an area they are not supposed to grow on. Doctors treat these by ripping them open with no anesthesia.
Buried penis. Circumcision can lead to trapped or buried penis - too much skin is removed, and so the penis is forced inside the body. This can lead to problems in adulthood when the man does not have enough skin to have a comfortable erection. Some men even have their skin split open when they have an erection. There are even more sexual consequences, which we will address in a future post.
Infection. The circumcision wound can become infected. This is especially dangerous now with the prevalence of hospital-acquired multi-drug resistant bacteria.
Death. Babies can even die of circumcision. Over 100 newborns die each year in the USA, mostly from loss of blood and infection (Van Howe 1997 & 2004, Bollinger 2010).
Circumcision: Social, Sexual, Psychological Realities, Darcia F. Narvaez Ph.D.
Should circumcision tradition trump ethics and empirical evidence?
Myth: You have to circumcise the baby so that he will match his dad.
Reality check: The major difference that boys notice is that dad's penis has hair, and is larger. When a boy notices the difference between his foreskin and his father's lack of one, just tell him, "When your father was born, they thought that you had to cut off the foreskin, but now we know better." Since when does parent/child bonding require a matching set of genitals? If it did, could mothers and sons bond, or fathers and daughters? The real issue at play here is protecting the father: if it is okay for his son to not be circumcised, then he did not have to be circumcised, and so he is missing something from his penis. It is not right to harm the child's body to spare the father's emotions.
Myth: My first son is circumcised, so I have to circumcise my second son.
Reality check: You can explain this to your children the same way as with the circumcised father. There are plenty of families who changed their minds after one or more sons were circumcised, and didn't circumcise any more. As with the "matching dad" myth, what is really at issue here are the parents' feelings: if they don't circumcise the second son, then that means that they didn't have to circumcise the first child, and so they harmed their first child. This can be unbearably painful, but it is not right to continue to harm future children to avoid dealing with pain and regret. As they say, two wrongs do not make a right.
Myth: My husband is the one with the penis, so it is his choice.
Reality check: If your husband is circumcised, he has no idea what having a foreskin is like, and he is likely operating from a psychological position of needing to believe that what was done to him was beneficial and important. The baby is the one who is going to have to live with the decision for the rest of his life, not your husband. The baby will be the one who has to use the penis for urination and sex -- it should be his decision.
Myth: Everyone is circumcised.
Reality check: Actually, world-wide, only 30% of men are circumcised, and most of these men are Muslim (WHO 2007). Most modern, Westernized countries have rates well below 20%. In the United States about 25 years ago, around 85% of babies were circumcised. The rates have dropped substantially to 32% in 2009, according to a report by the Centers for Disease Control (El Becheraoui 2010).
Myth: Circumcision is an important tradition that has been going on forever.
Reality check: In the United States, circumcision wasn't popularized until Victorian times, when a few doctors began to recommend it to prevent children from masturbating. Dr. Kellogg (of Corn Flakes fame) advocated circumcision for pubescent boys and girls to stop masturbation: "A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anæsthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment... In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement" (Kellogg 1877). Circumcision caught on among the sex-negative Victorians, but only wealthy parents could afford it. In 1932, only 31% of men were circumcised; this peaked around 85% in 1980, and has been dropping ever since (Laumann 1997, Wallerstein 1980). Far from an ancient tradition, it was only popular in post-war America; think of it as "your parent's body mod."
Myth: The other boys will make fun of him.
Reality check: What other cosmetic surgeries will we perform on our children to prevent them from being teased? Should a "flat" girl get implants? What about the boy with a small penis? What surgery would be recommended for him? Circumcised babies are the minority now, and so intact will not be mocked. Plus, as our husbands say, "You just don't look at or comment on another man's penis in the locker room."
Myth: Circumcision makes sex better for the woman.
Reality check: The function of the foreskin for women in intercourse is to seal the natural lubrication inside the vagina and provide a gentle internal massaging action. The intact penis moves in and out of its foreskin, which provides a frictionless, rolling, gliding sensation. Intact men tend to make shorter strokes that keep their bodies in contact with the clitoris more, thus aiding female orgasm (O'Hara 1999). On the other hand, the circumcised penis functions like a piston during intercourse - the head of the penis actually scrapes the lubrication out of the vagina with each stroke. As the man thrusts, his skin rubs against the vaginal entrance, causing discomfort, and sometimes pain (O'Hara 1999, Bensley 2001). Far from making sex better for women, circumcision decreases female satisfaction.
Myth: Women don't want to have sex with uncircumcised men.
Reality check: In a landmark study of US women, 85% who had experienced both circumcised and intact men preferred sex with intact men. Sex with a circumcised man was associated with pain, dryness and difficulty reaching orgasm (O'Hara 1999). In another study, women were twice as likely to reach orgasm with an intact man (Bensley 2003). Even when a woman said she preferred a circumcised partner, she had less dryness and discomfort with intact men (O'Hara 1999).
Myth: "Being circumcised doesn't affect my sex life."
Reality check: Men who are circumcised are 60% more likely to have difficulty identifying and expressing their feelings, which can cause marital difficulties (Bollinger 2010). Circumcised men are 4.5 times more likely to be diagnosed with erectile dysfunction, use drugs like Viagra, and to suffer from premature ejaculation (Bollinger 2010, Tang 2011). Men who were circumcised as adults experienced decreased sensation and decreased quality of erection, and both they and their partners experienced generally less satisfaction with sex (Kim 2007, Solinis 2007).
Myth: "If I were any more sensitive, it would be a problem."
Reality check: The foreskin contains several special structures that increase sexual pleasure, including the frenulum and ridged band (the end of the foreskin where it becomes internal), both of which are removed in circumcision. The LEAST sensitive parts of the foreskin are more sensitive than the MOST sensitive parts of the circumcised penis (Sorrells 2007). In other words, if you wanted to decrease a penis' sensitivity the most, circumcision would be the ideal surgery. The foreskin has nerves called fine-touch receptors which are clustered in the ridged band (Cold 1999). This type of nerve is also found in the lips and fingertips. To get an idea of the sensation these nerves provide, try this experiment: first lightly stroke your fingertip over the back of the other hand. Now stroke your fingertip over the palm of your hand. Feel the difference? That is the kind of sensation the foreskin provides, and the circumcised man is missing.
It may feel like the penis is overly sensitive to a circumcised man because there is little sensation left to indicate excitement, leading to unexpected premature ejaculation (a common problem with circumcised young men). However, as circumcised penises age they become calloused and much less sensitive. (See the interview listed below for more details.)
Should concern about family or community traditions hold priority over the short and longterm welfare of the individual? Certainly not in the case of infant circumcision.