The Circumcision Discussion

Specialties Ob/Gyn

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I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My husband says yes, it's better medically in the long run. My gpa who just turned 70 had to have a circ. due to endless complications lately.

As nurses in this area, is the medication that they use good? And what are some questions to ask my Dr. about it. I already know that my hospital i'll be at uses a med. when they perform it, I"m just wondering what you all think.

Thanks

Jen :)

I come to this thread very late in the game. Am appreciative that people are taking the time, emotional and intellectual energy to tease out this loaded subject.

Any others out there who have as L&D nurses assisted women who are victims of female genital mutilation through birth? Ever try to find a urethra to cath a woman who has been mutilated? Ever have to witness the pain of birth and endure the impossible repairs after birthing through mutilated genitalia? It is horrifying. The effects of FGM are life long. The visual of seeing a woman scarred in this way is extremely disturbing.

Any other nurses ever assist with a botched circumcision? Ever seen a baby boy have to have surgery to repair damage because of circumcision?

Possibly there will be a time when the visual of a circumcised member will strike us as all as absurd and criminal as FGM.

Cultural norms shape what is beautiful, acceptable, sexy. Let's work towards a social norm that embraces what is natural as beautiful and "right". As health care workers, we have a role in education and attitudes. But first we must work on our own notions and beliefs.

It is our duty to be evidence based.

That is quite beautifully said! Thank you so much for your thoughts!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Actually I have witnessed a circ gone bad 12 years ago. I won't go into details, but it was the beginning of my education about exactly what we are doing and why.....and learning about evidence-based literature out there discussing the subject. I touch on this subject in my childbirth classes, but am very careful not to come down "for" or "against" just giving the facts, as well as quoting the most current AAP statement regarding circumcision for my class. Most have made up their minds one way or the other, usually, but I ask them to really carefully consider their decisions, either for or against having it done for their baby boys.

Specializes in OB, HH, ADMIN, IC, ED, QI.

There is research on this....... but it is basically in regard to penile infections with/without circumcision.

I had a friend whose brother spent years in psychoanalyisis with a Freudian psychiatrist. He mentioned to his sister that he relived his circumcision during his therapy, but didn't seem disturbed about it - more like, hmmmmm.

Specializes in OB, HH, ADMIN, IC, ED, QI.
Agreed...but why is it done? Nowadays I would suspect the main answer is "tradition" which, to me at least, isn't a good enough reason to undergo surgery...especially on a member.

These days as well as in days past, circumcision is done for religious reasons, as a Commandment from G-d. In the Jewish religion, it would be unthinkable/unforgivable to decide not to circumcise males. As I wrote previously, the addition of wine on a ball of gauze (securely stitched and large enough so the baby will suck on it and not choke); and the person doing the surgery is a skilled, licensed "moille" who does only this task, on the 8th day of life for a baby boy. It is done in the home, with loving relatives exuding love on the baby, and musical prayers.

Usually the only male traumatized at these occasions, is an adult male who identifies with the baby on an emotional level, and fails to inhale.

Throughout history, it has been noted that circumcised males had fewer infections of the member that prevented urination, and their wives had less cervical cancer, so other cultures, believing that the end justified the means, have been circumcising male babies. Physicians (some of whom are Jewish) on "talk radio shows" have been negating the practice for many years, and many men call in and agree with them.

Unfortunately the time it can be done with the least trauma, is way before the age of consent. Jews would say that to argue against G-d's will is sacrilegious. I find that men who generally are comfortable with their parents' decisions rearing them, have less or no disagreement with having had the surgery. Calling it mutilation is, I believe gross overstatement; and an expression of dissatisfaction with males' acceptence of their appearance. Jewish guys usually have more distaste for the appearance (if it's long) of their noses, than an abreviated member. Now plastic surgeons can amend the former, without the prayers said at ritual circumcisions.

'Nuff said?

These days as well as in days past, circumcision is done for religious reasons, as a Commandment from G-d. In the Jewish religion, it would be unthinkable/unforgivable to decide not to circumcise males. As I wrote previously, the addition of wine on a ball of gauze (securely stitched and large enough so the baby will suck on it and not choke); and the person doing the surgery is a skilled, licensed "moille" who does only this task, on the 8th day of life for a baby boy. It is done in the home, with loving relatives exuding love on the baby, and musical prayers.

Usually the only male traumatized at these occasions, is an adult male who identifies with the baby on an emotional level, and fails to inhale.

Throughout history, it has been noted that circumcised males had fewer infections of the member that prevented urination, and their wives had less cervical cancer, so other cultures, believing that the end justified the means, have been circumcising male babies. Physicians (some of whom are Jewish) on "talk radio shows" have been negating the practice for many years, and many men call in and agree with them.

Unfortunately the time it can be done with the least trauma, is way before the age of consent. Jews would say that to argue against G-d's will is sacrilegious. I find that men who generally are comfortable with their parents' decisions rearing them, have less or no disagreement with having had the surgery. Calling it mutilation is, I believe gross overstatement; and an expression of dissatisfaction with males' acceptence of their appearance. Jewish guys usually have more distaste for the appearance (if it's long) of their noses, than an abreviated member. Now plastic surgeons can amend the former, without the prayers said at ritual circumcisions.

'Nuff said?

actually the lower rates of cervical ca are no longer....it is thought to have been a social rather than medical issue....the decline in faithfulness to marriage vows ......

I wanted to say that I found this conversation very encouraging. I hope that one day (hopefully in the not too distant future) circumcision will be essentially unheard of, we will have finally abandoned this leftover of 19th century medicine and bronze age ritual. To help that along, it's important that the myths about circumcision and intact boys be put to rest in the US. I think it's those myths (such as questions of hygiene) which perpetuates circumcision and hopefully you all do your part in that education. Though I can understand the difficult position some of you are in.

There are men who are bitter about their circumcision, remember some get more than the expected amount of damage. However few they are they exist and most just have to live with it. Even among those who only received the expected amount of damage, some men do feel violated but, in this atmosphere, they have heretofore not been taken seriously. That may change. An important question to ask though is how many disatified men does it take before we sit up and take notice? 10, 100, 1000, 10,000? or is it easier to think of in percentages, as long as no more than 5% are dissatisfied everything is fine. You get the picture.

To the point of comparing MGM and FGM I agree that often FGM can be worse but I think that it is the case that FGM isn't always as bad as we think (though any time we think about it we think of the worst forms first) and MGM is often worse than we think (though we always have thought of it in a 'good' light). These are two cultural ideas we have to break. I wanted to share an article that was published last year in an Australian Journal, Medical Anthropology Quarterly. Before anyone completely dismisses any comparison with FGM please carefully read: A Rose by Any Other Name? Rethinking the Similarities and Differences Between Male and Female Circumcision. I think they make some very compelling points and I hope people who completely dismiss a link might be able to see how in some cases the two procedures are closer than we would like to believe. Perhaps it will give people more to think about.

For further introspection, I also wanted to get some reactions to a blog I found. It's of an Indonesian mother praising her infant daughter for getting through her circumcision bravely. Now clearly she did this at a hospital or pedi and in fact a large majority of women in her part of the world do this. We here would have put her in jail for what she did but for some reason it was important to her.

It was important for her (whether it was culture or religion), she had it done by a doc, and since the kid is an infant she won't know what she was missing. My question to you all is: Is she a bad mother? If you say yes, she shouldn't have done that how is it materially different from what we do to boys?

Specializes in MICU/SICU.

Somewhere among the enormous amount of pages in this thread I read someone say that the foreskin cannot be retracted until puberty. As a mother of 3 boys, two of which are uncircumcised, I'd like to point out that the foreskin can, indeed, be retracted before puberty.

My two youngest boys are not circumcised. The 7 year old's foreskin is only partially retractable. The 4 year olds, however, is completely retractable. He pulls his foreskin back and washes his "weiner ball" every time he bathes.

That's his name for it, by the way. At around 3, he came out of the bathroom exclaiming (with a look of utter amazement on his face) that there was a ball in his weiner. Loads of fun when he insisted on asking everyone (and I do mean EVERYONE) he met in the next few weeks if they wanted to see it. Yeah.

Specializes in DOU.
actually the lower rates of cervical ca are no longer....it is thought to have been a social rather than medical issue....the decline in faithfulness to marriage vows ......

Really? Can you provide a link that supports this?

Somewhere among the enormous amount of pages in this thread I read someone say that the foreskin cannot be retracted until puberty. As a mother of 3 boys, two of which are uncircumcised, I'd like to point out that the foreskin can, indeed, be retracted before puberty.

My two youngest boys are not circumcised. The 7 year old's foreskin is only partially retractable. The 4 year olds, however, is completely retractable. He pulls his foreskin back and washes his "weiner ball" every time he bathes.

That's his name for it, by the way. At around 3, he came out of the bathroom exclaiming (with a look of utter amazement on his face) that there was a ball in his weiner. Loads of fun when he insisted on asking everyone (and I do mean EVERYONE) he met in the next few weeks if they wanted to see it. Yeah.

That can defiantly be an exciting thing for an intact boy. :) As far as when it can happen, it can be anytime between birth and late teens. By 10, only about 50% are fully retractable the numbers increase quickly after that.

It's explained pretty well here: http://www.cirp.org/library/normal/

Really? Can you provide a link that supports this?

Penile cancer:

http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Can_penile_cancer_be_prevented_35.asp

Cancer Generally:

http://www.cirp.org/library/disease/cancer/

Even cervical cancer is not terribly common in western countries, only about 10,000 cases per year in the US most of those in women who haven't had screenings in many years. Of those most can be treated. Further, the introduction of the cervical cancer vaccine, which has been available for nearly 4 years now, will push those numbers down much further making circumcision obsolete for this problem, even if it did have an effect (which I don't think it does). In fact, the number of cases of cervical cancer is low enough that some even make compelling arguments [from a cost/benefit perspective] against the need for the vaccination.

Specializes in DOU.

I think the problem is that different agencies make different statements about the benefits of circumcision. Here is the CDC site:

http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm

Just so you know, as the mother of a daughter, I say ANY amount of preventable cervical cancer is too much. ;)

I think the problem is that different agencies make different statements about the benefits of circumcision. Here is the CDC site:

http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm

Just so you know, as the mother of a daughter, I say ANY amount of preventable cervical cancer is too much. ;)

If the CDC is saying the reduction in penile cancer is a benefit of circumcision they'd be about the only group that says as much, though I wouldn't be surprised. The problem is that most benefits, if they exist, are trivial or can be easily realized using less invasive, more effective, and safer means. Most other western countries have recognized that, it's hard to understand why we are always behind. In fact, most of the research that tries to ferret out circumcision benefits is fund by the US. One would think that after 100 years enough would be enough.

In any case, as to the cervical cancer specifically, I understand your position and that is why I don't believe that cost of the vaccine should be much of an issue, I am just pointing out that many people have made convincing arguments with regard to its cost benefit. Indecently, Merck has made an application to the FDA to recommend the cervical vaccine for boys too. However, even if there was not a vaccine the numbers wouldn't justify circumcision the ethical bar to perform a circumcision [or any other medical/surgical procedure] via proxy consent should be very high and to perform it for the benefit of another it should be obscenely high. No current purported benefit, even if you believe the current figures, comes close. They only serve to buttress previously held cultural or religious excuses. It's a convenient way for the various agencies to avoid confronting the significant ethical issues.

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