CDC rec to counsel all males about benefits of circumcision

elkpark · Dec 4, 2014

It's completely appropriate for health care professionals to tell parents "No, I'm not going to perform an elective procedure on your newborn child that carries a high risk of hemorrhage and infection."

Yes. it is appropriate, and even ethically required. Which is why I'm pretty confident that if RIC really did carry "a high risk of hemorrhage and infection" there would be more physicians speaking out about it and refusing to perform the procedure.

macawake, MSN · Dec 4, 2014

I'm not going to get into an ugly argument because I know how anti-circumcision folks can be. I will say that female circumcision has been used to oppress female sexuality. While a circumcised member may have less nerves, it can still feel pleasure and have a relatively health sex life. Can't say the say for female circumcision.

I'd argue that male circumcision was originally intended to control sexuality too. Why should a man have to settle for a "relatively" healthy sex life when he instead could have had full sensation in his member if his body hadn't been surgically altered?

I'm Scandinavian, almost no boys or men in my country or part of the world are circumcised apart from members of some immigrant groups. I know of no men who are intact who decide to have a circumsicion performed after they've become sexually active and they've discovered the joy of having an intact foreskin. There's a reason for that.

If you have the procedure performed on you at a young age (someone else decided for you) then you don't have anything to compare to, and don't really know how sex would have been like with an intact foreskin.

I think it's dangerous and wrong to accept surgical removal of healthy parts of a child's body for cultural or religious reasons. Where do you draw the line? What other parts of the body are acceptable to remove? I'd really like someone who supports circumcision of infants/children to answer that one. Why just boys? How can someone frown at and condemn female mutilation but accept it in males?

Does it matter if you take away 20, 50 or 90 % (just arbitrary numbers) of a child's future capability to enjoy sexual touch?

To me it's a question of autonomy. Every living human being has the right to their own body. Altering that body forever and subjecting it to the risk of infection and bleeding, at an age where a person can't consent is in my opinion a violation of that individual's rights.

Every physician/pediatrician I've spoken to are against circumcision of baby boys. I believe that the fact that many American physicians don't seem to be is largely cultural.

Red Kryptonite · Dec 4, 2014

Yes. it is appropriate, and even ethically required. Which is why I'm pretty confident that if RIC really did carry "a high risk of hemorrhage and infection" there would be more physicians speaking out about it and refusing to perform the procedure.

Many adverse events and deaths are coded in such a way that it hides their connection to circumcision. There is a research project that claims that about 100 boys a year die solely due to being circumcised, but because of the coding used that's not immediately apparent. I'll see if I can find that link.

You underestimate the cultural conditioning that even doctors operate under. They ignore proper intact care even though the information is readily available, and they badger parents of intact children to try and convince them to circumcise. I've experienced this myself as a mother and have counseled many, many other parents who've faced the same problems.

You also dismiss profit motive. Doctors and hospitals sell baby foreskins to biomedical engineering firms that use them as the basis for bandages they manufacture. I won't even get into the Oprah face cream, but at one point they were used for that too. I don't know if they still are.

allnurses Guide · Dec 4, 2014

Because it's an unnecessary cosmetic procedure on a 1-day-old baby, under inadequate anesthesia (boys and men get general), with a high risk of postoperative infection (imagine that raw member sitting in a diaper, being exposed to feces and urine 24/7) and hemorrhage (newborns do not produce endogenous clotting factors until they're about a week old).
If you *choose* to do it, yourself, as a consenting adult, knock yourself out.

I am going to join this thread knowing that I am going to start a firestorm, but it is always amazes that women are the first ones to jump on these circumcision threads stating how bad it is but very few males see it as a problem.

Infant circumcision these days is usually done with small amount of local anesthesia and actually is quite different than doing it on an older child, teen, or adults. I have done anesthesia for circumcisions from toddlers on up. The main reason we do not do circumcisions under just local is that it is more time consuming, and it is usually anxiety producing operation for most men. Infant circumcision takes about 5 minutes or less for adults it is usually around 30 minutes mainly d/t to suturing time. Infants normally do not require sutures after their circumcision.

There are medical benefits to being circumcised, so it isn't just a cosmetic procedure.

Easier hygiene. Circumcision makes it simpler to wash the member. Washing beneath the foreskin of an uncircumcised member is generally easy, however.
Decreased risk of urinary tract infections. The overall risk of urinary tract infections in males is low, but these infections are more common in uncircumcised males. Severe infections early in life can lead to kidney problems later on.
Decreased risk of sexually transmitted infections.Circumcised men might have a lower risk of certain sexually transmitted infections, including HIV. Still, safe sexual practices remain essential.
Prevention of penile problems. Occasionally, the foreskin on an uncircumcised member can be difficult or impossible to retract (phimosis). This can lead to inflammation of the foreskin or head of the member.
Decreased risk of penile cancer. Although cancer of the member is rare, it's less common in circumcised men. In addition, cervical cancer is less common in the female sexual partners of circumcised men.

allnurses Guide · Dec 4, 2014

There's that, too. I don't think there's a high percentage of men in Europe whose memberes are falling off secondary to paraphimosis.
And females, with all their labial folds, don't seem to have a huge issue with hygiene.

Females labia do not normally cause problems, but we frequently do labiaplasties in U.S., so it even your nut and bolt comparison isn't really accurate.

All the adult men and male teens that end up having to have circumcision after infancy that I have taken care of have all stated to me that wish they would had it done as an infant.

allnurses Guide · Dec 4, 2014

I think parents should be allowed to make medical decisions for their kids without feeling vilified or shamed.

I think parents should be given all the facts on circumcision not just the polar opposite opinions from one group or another.

allnurses Guide · Dec 4, 2014

And would you feel the same if the parents wanted to do an infibulation on their infant daughter?

There is no real comparison as one has no medical benefits and the other does.

Red Kryptonite · Dec 4, 2014

Easier hygiene - females have a whole lot more moist, bacteria-trapping genital tissues. When do we start removing labia and the clitoral hood for the same reason? Plus, soap and water and a few seconds in the shower is not a huge burden. Not in this country anyway.

UTI - females still get more UTIs than any male, intact or circumcised. Why have we not found a surgical solution to this yet if that's the answer?

STIs - again, females have lots more tissue and mucosal surfaces in the genital area to trap pathogens. If removing genital tissue is a solution, then why are we not recommending the removal of labia and the clitoral hood to mitigate this problem?

Phimosis - first line noninvasive treatment for this should be steroid creams, but also, phimosis cannot be validly diagnosed until sexual maturity. And since when do we cut off healthy tissues from children because someday they might cause a problem? How can you not see the ethics problem with this?

Penile cancer - extremely rare and happens to circumcised males too. Women can get cancer in their "extraneous" genital tissues as well, so why, again, are we not cutting those off of our babies?

allnurses Guide · Dec 4, 2014

They should be able to consent to medically necessary treatments. They should not be able to have healthy, functional tissues amputated from their children to serve their own preferences.
This coming year, the federal law that protects girls from genital alterations imposed on them by adults will turn 18. That means that 18 year old men can start suing for civil rights violations because while girls were protected from genital cutting, they weren't, SOLELY because they are boys. I think those lawsuits can't come soon enough, because I think civil rights legal action will be the quickest, most effective way to finally put an end to the human rights violation perpetrated millions of times every year in this country.

Circumcision has medical benefits. To deny that is a lie. Parents should be able to obtain unbiased information on male circumcisions and make an informed decision from there. They should not be subjected to comments of how awful it is, you are just mutilating your child, or it is just a "cosmetic" procedure, which all of those comments are either opinions or false.

allnurses Guide · Dec 4, 2014

Do you know what the functions of the foreskin are? Do you know how many nerve endings are lost when it's cut off?
Anyway, reducing HIV risk by circumcising is like weeding your yard with a flamethrower. Just teach about responsible sexuality, avoiding risky behaviors, and condom use.

And how often does that work as a general public health measure? There would be almost no cases of any STIs in any country if simply educating people had a significant impact.

Red Kryptonite · Dec 4, 2014

Females labia do not normally cause problems, but we frequently do labiaplasties in U.S., so it even your nut and bolt comparison isn't really accurate.

And those are cosmetic surgeries done on fully consenting ADULT women.

All the adult men and male teens that end up having to have circumcision after infancy that I have taken care of have all stated to me that wish they would had it done as an infant.

The fact that a person who medically needs a procedure wishes he could have had it done in a way he wouldn't remember has absolutely no bearing on whether healthy, functional tissue should be removed from a newborn who cannot consent. I wonder, too, how many "medically necessary" circumcisions in this country are caused by improper intact care causing adhesions.

klone, MSN, RN · Dec 4, 2014

Yes. it is appropriate, and even ethically required. Which is why I'm pretty confident that if RIC really did carry "a high risk of hemorrhage and infection" there would be more physicians speaking out about it and refusing to perform the procedure.

Many do.

ANY risk of hemorrhage and infection from a completely optional, cosmetic procedure performed on a newborn is too high. And the fact is, infection is not uncommon at all, and hemorrhage does happen.