CDC rec to counsel all males about benefits of circumcision

Red Kryptonite · Dec 5, 2014

. Traditional male circumcision by a Rabbi is hardly a sanitary procedure.

Especially if they practice metzizah b'peh. :eek:

macawake, MSN · Dec 5, 2014

I think is more important that parents have the right to an informed decision that is not tainted by some healthcare provider's personal biases.
It is an interesting phenomenon on these circumcision threads that the females are the vast majority of anti-circumcision people where the males are usually pro-circumcision or at least pro-choice circumcision group.
Informed decision is fine, but when you are considering male circumcision to be a potential public health measure then you lose part of that public protection by waiting for someone to turn an arbitrary 18 years of age when that age is often different than when the public health measure is often needed most d/t increased risk behaviors at an earlier age than 18.

I actually am in the pro-choice group, it's just that I think that it's a decision that should be made by the individuals themselves when they're adults.

I don't view children as appendages of their parents, but as autonomous individuals. Of course, some things have to and should be decided by their parents in order for the child to survive and thrive until their eighteenth birthday (which is why the baby formula example brought forward by another poster really wasn't a relevant comparison in my opinion) and in order to become a "functional member of society". (Not worded very well, but I think that you understand what I'm trying to say).

From what little research that I've seen regarding circumcision of infant boys in western countries, I'm not at all convinced that there actually are positive health effects for young men (and their sexual partners).

At what age do young men usually become sexually active on average, in the US? It can't be many years before eighteen. Are there really health repercussions if the decision to circumcise is delayed until the young man can decide for himself?

If there really were serious health effects we'd see differences in prevalence of teenage STI's and other diseases between countries in the western world where circumcision is rare like in my country and countries where it's much more common, like the US.

The last time I compared stats (a couple of years ago) I found that teenage pregnancies were more common in the US (per 100.000) than here, although a higher percentage of teenage pregnancies here end with abortion. Still I think that it was about a 3:1 ratio in teen pregnancies between our countries. STI's among teenagers are no more common here than in your country.

(And honestly, I never once saw a strangulated, gangrenous member when I worked in the ER... Judging by another person's post you'd think the place would be rife with them).

If it's sexual/reproductive health we want to promote, I really do believe in education over surgery.

I do feel that there are many cultural and some religious differences between the US and Scandinavia/Northern Europe. I think that the circumcision issue is one of those very definite differences.

I have spent a few years in the US and I actually loved it there, but I feel that the society as a whole is a bit more "prude" than I'm accustomed to.

If you want teens to practice safe sex than they need to be educated. There's no use in pretending that they won't engage in sexual activities. They likely will. Here as well as there.

I remember some slightly awkward moments when the no-nonsense sex ed teacher taught the blushing class the correct "condom application-and-use technique". Quite a good skill to have though (protecting health and preventing unplanned pregnancies), if one planned on engaging in sexual activities.

In the school nurses office/clinic there was a huge bowl with condoms of every color of the rainbow that the teenagers could help themselves to and receive education/counseling at the same time.

Another thing that young men were taught in sex ed class, since we are discussing protecting the health of young men, was to perform monthly testicular self-examinations. Testicular cancer may be rare, but it is the most common form of cancer in young men (from appr. age 15 to appr. 30) but quite curable when caught early.

I'm convinced that there is a lot to be gained by education, and I don't think that research (that I've found) supports the theory that health benefits gained by circumcising males before the age of eighteen in come close to "trumping" the important principle of the individual being allowed control over their own body.

I personally don't feel that circiumcisions in the western world are primarily motivated by medical/health reasons, I believe that it's traditionally been heavily influenced by culture/religion.

FutureRN101 · Dec 5, 2014

My husband was not circ'd as an infant. We decided together, not to circ our son as an infant because there was no medical necessity for it. However if he chooses to do so when he's an adult than so be it! The hygiene is not an issue. I always laugh when I hear that "argument" (or lack thereof) because the foreskin does NOT retract until they are older. So really, cleaning a circumcised infant is much harder and time consuming (especially in the days/weeks following the circumcision) than it is on a child that is not circ'd. And honestly think about it, it's not hard for an older boy or man to pull the skin back and then clean the member. It takes less than a second to pull the skin back so any guy that won't take the time to do so would probably have a hygiene issue regardless of being circumcised or not!

I'd also like to add that I know someone who was circumcised as an adult (purely for personal reasons, there was no medical issue making it necessary) and he does not wish his parents had done it when he was an infant. He told me he was glad he had the option for it and that it was his choice to make.

ixchel · Dec 5, 2014

I'm pro-choice on circumcision and pretty much all things parenting.

I will say, though... Uncircumcised memberes in elderly men with CHF are an absolutely horrific sight. Edematous foreskins are incapable of being retracted and when the edema does go down, in its place there are often times ulcers from the moisture that built up under the foreskin. I've seen probably a half dozen or so in my short tenure as a nurse so far, and they've all been men who had dementia or some sort of extreme self care deficit where they truly were unable to perform simple hygiene tasks reliably for themselves. It's very sad.

I don't necessarily add this to the debate to say go circ all the babies, but more to mention that this part of life is often left out in these conversations. These babies will be old men one day.

allnurses Guide · Dec 5, 2014

American Teens' Sexual and Reproductive Health 15-24 years account for over 9 million of the new STIs every year. The majority of teens have had intercourse before turning 18. Young adults are also the ones most likely not to be insured, so if you are looking at this from solely a public health perspective then it doesn't make sense to wait unti a male turns 18+ to be circumcised because they will more than likely already have started having sex and will be unlikely to be able to afford circumcision for several years after turning 18.

allnurses Guide · Dec 5, 2014

It is important to note that the CDC is not recommending circumcision, but only recommending that uncircumcised males be informed of the risks and benefits of circumcision.

"Those health benefits prompted the Centers for Disease Control and Prevention's proposed recommendation that doctors counsel parents of baby boys and teenagers, as well as men, on the benefits and risks of circumcision."

"I want to emphasize that it's a voluntary procedure, and really requires conversation between the doctor and the patient," says Dr. Eugene McCray, director of the division of AIDS prevention at the CDC. "Our role is to insure that physicians have the information that they can then use to counsel or inform patients about the risk and benefits."

http://www.npr.org/blogs/health/2014/12/03/368008742/cdc-considers-counseling-males-of-all-ages-on-circumcision

RNsRWe, ASN, RN · Dec 5, 2014

A) A circ done by a mohel is usually not as extreme as that done in the hospital (i.e. they generally take off less prepuce)
B) The procedure is done at 8 days of life. At that point, gut is colonized with E. coli and the infant is making its own endogenous Vitamin K, thus less risk of hemorrhage

Most modern Jews I know have their sons circumcised in the hospital, not a living room, and by a pediatrician, not a moyel. Although some have a party afterwards :)

So, therefore, I would expect the risks for the newborn Jewish male to be the same as the newborn NON-Jewish male.....and we're not losing our kiddies to infection OR blood loss :)

morte, LPN, LVN · Dec 5, 2014

if i had had children, none of the boys would have been circ., that would have been my present to their wives. what hasn't been discussed here, is the difference for women in have sex with circ.ed or uncirc.ed men. the lubrication provided is what nature indented.

edmia, BSN, RN · Dec 5, 2014

What you don't seem to understand is that a growing number of Americans regard RIC as exactly the same thing, a serious crime and a human rights violation.

And that is ridiculous and offensive to my religion where circumcision has been performed for thousands of years.

Sent from my iPhone -- blame all errors on spellcheck

phuretrotr · Dec 5, 2014

Of course, some things have to and should be decided by their parents in order for the child to survive and thrive until their eighteenth birthday (which is why the baby formula example brought forward by another poster really wasn't a relevant comparison in my opinion) and in order to become a "functional member of society". (Not worded very well, but I think that you understand what I'm trying to say).

Actually, my point was not whether we SHOULD feed our children, it was WHAT we should feed our children, which is very relevant. An infant is able to thrive purely on formula, but there are plenty of people who believe that mothers should solely breastfeed if they can. Parents are able to decide if their infant is breast or formula fed, just as they are to decide if their child is circumcised or not.

There is evidence that formula fed infants do not receive the amount of nutrients that breastmilk provides, nonetheless, formula is safe to feed to infants and is good enough for the infant to thrive. Thus, formula is a viable source of nutrients if breastmilk is unavailable. However, by the logic of some posters in this thread, parents should omit to decide to breast or formula feed (default being breast feed), because infants, being human beings, should have a choice in whether they receive the added nutrients that breastmilk produces, rather than being formula fed because it could provide benefits to their health later in life (i.e. less chance of developing anemia, etc.).

Both options in both situations are merely a matter of preference and neither have evidence to support that a child's health WILL suffer if one or the other is chosen. If they did have evidence, and a lot of it, that an option or the other were to 100% harm the child's ability to thrive, it wouldn't be a choice, it would be mandatory/outlawed.

phuretrotr · Dec 5, 2014

Why should the default position be FOR cutting something off? Why shouldn't the default be that we do NOT cut parts off of our children, and that in order to cut parts off, you should have to prove significant, unequivocal benefits that cannot be achieved in any other way?

The default isn't FOR circumcision, the default is for NOT circumcising. To omit to decide whether to circumcise is defaulting to NOT circumcising.

Furthermore, to make a decision, benefits are not the only factors. What are the cons to circumcision? What makes it unsafe? What are long term consequences to the procedure? What makes having a foreskin safer for males?

You cannot simply look at a topic and only point out biased opinions and certain facts to prove your point. Doing so only makes you look silly and lose credibility.

edmia, BSN, RN · Dec 5, 2014

what hasn't been discussed here, is the difference for women in have sex with circ.ed or uncirc.ed men. the lubrication provided is what nature indented.

Well I've had both and noted no difference at all. Personally, I prefer a circumcised member. To me, they look (and often smell) better. :)

But that's not scientific, just some case studies I can attest to ...

Sent from my iPhone -- blame all errors on spellcheck