CDC rec to counsel all males about benefits of circumcision

allnurses Guide · Dec 4, 2014

Here is a link, as promised, to the research project about neonatal deaths from circumcision complications. You can download the pdf if interested. This project found numbers equal to SIDS deaths in the neonatal period.
PS I don't claim it's infallible or anything, but it's out there and it's a question that needs to be discussed.
Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths - Thymos: Journal of Boyhood Studies - Volume 4, Number 1 / Spring 2010 - Men's Studies Press
And then there are the non-fatal complications. Are these risks worth what you think you might be preventing? Complications of Circumcision

Circumcision News: Fatally flawed: Bollinger's circumcision death calculations

Commentary on the biased 1st article and the statistics used.

Complications of Circumcision

Your second article actually refutes the conclusions of your first article. The most common side effect for circumcision is bleeding according to the second article at approximately 1%, which the article goes on to state that most of those can be controlled with direct pressure.

Rate of infection overall for a sample of 5,521 circumcisions was 0.4% and when the "bell" wasn't used it was 0.07% or 4 out of 5,521. Any argument that circumcision is anything other than minimal risk procedure is a misnomer at best.

Comparison between cartilage and soft tissue ear piercing complicat... - PubMed - NCBI Complication rates for ear piercing are greater than male circumcision.

macawake, MSN · Dec 4, 2014

I find it crazy that most of this "debate" (as defined as beating each other over the head over and over) is by women. I won't make any genitalia based decisions for men. They better return the favor.

I don't understand the point you're making. This is about men and women (a.k.a. parents) making decisions about someone else's genitalia (namely minors).

Why shouldn't men AND women be able to express the opinion that CHILDREN have a right not to have a part of their body surgically removed, unless it's a medical necessity?

I'm not trying to make "genitalia decisions" for someone else, I'm simply saying that every individual should have the right to make their own decision about their own body at an age when they can make an informed decision.

canigraduate · Dec 4, 2014

While I agree that each gender can and should decide what to do with his or her own Personal Bits, as a mother, I inherited the responsibility to make just such a decision (albeit jointly, with my husband) for TWO little 'men'

I don't have kids, so I can't speak to that. If it ever came up, though, I would leave it up to my husband, 'cause he has one and I don't. I can tell you that the cultural pressure would be to cut, based on religion and common cultural practice in his family.

Red Kryptonite · Dec 4, 2014

It is the accepted practice for those in the religion I was raised. And if you try to tell them not to do it, be prepared for a Biblical debate.

If they're Christian, they should take a look at Galatians 5:2-7.

2 It is I, Paul, who am telling you that if you have yourselves circumcised, Christ will be of no benefit to you.

3 Once again I declare to every man who has himself circumcised that he is bound to observe the entire law.

4 You are separated from Christ, you who are trying to be justified by law; you have fallen from grace.

5 For through the Spirit, by faith, we await the hope of righteousness.

6 For in Christ Jesus, neither circumcision nor uncircumcision counts for anything, but only faith working through love.

RNsRWe, ASN, RN · Dec 4, 2014

I don't have kids, so I can't speak to that. If it ever came up, though, I would leave it up to my husband, 'cause he has one and I don't. I can tell you that the cultural pressure would be to cut, based on religion and common cultural practice in his family.

(a little tongue-in-cheek, but.....if he wants to bring it your way, you DO kinda have a say )

As for the parenting thing, it's hard to imagine that as a mother, you'd leave such an important thing exclusively up to your husband to decide. You would be the child's mother, after all. And while religion is a compelling reason in my family, it is not in my husband's....and HE couldn't have been more in favor of our sons having the procedures done. His reasons weren't religious, but medical. I do think, though, a major fight would have ensued if we hadn't agreed....but then, I think we'd also have known that before getting into the situation to start with!

allnurses Guide · 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?

1. We are talking about males and what research has shown to work for males not females. A labiaplasty is a totally different procedure and offers much more risk without the proven benefits of male circumcision. Male circumcision has been shown to reduce UTIs, bacterial vaginosis, trichomoniasis, and cervical cancer in women.

2. Phimosis can be diagnosed at any age. Physiological phimosis can and is accurately diagnosed before sexually maturity. That you even made that statement shows that you have not seen a toddler with physiological phimosis.

Red Kryptonite · Dec 4, 2014

I have to agree with RNsRWe on this. Why in the world would any mother just give up her role as advocate for her child?

nurseprnRN, BSN, RN · Dec 4, 2014

*tiptoes in*
On that note about JW, could the parents be charged if they withheld a life saving blood transfusion from their child? Is that similar to the Parents that chose prayer over treatment and ended up letting the child die?
I've always wondered about the legality of that.

It's perfectly possible, in true life-or-death situations involving minors, to get an emergency court order for lifesaving transfusion, surgery, or other care. Happens all the time and every hospital case manager, nursing manager, ER manager, and many others know it. This is because the state has an interest in protecting the lives of its minor citizens.

Red Kryptonite · Dec 4, 2014

1. We are talking about males and what research has shown to work for males not females. A labiaplasty is a totally different procedure and offers much more risk without the proven benefits of male circumcision. Male circumcision has been shown to reduce UTIs, bacterial vaginosis, trichomoniasis, and cervical cancer in women.
2. Phimosis can be diagnosed at any age. Physiological phimosis can and is accurately diagnosed before sexually maturity. That you even made that statement shows that you have not seen a toddler with physiological phimosis.

From the National Institutes of Health:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949079/

Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management.

"Physiologic phimosis" is the normal state of affairs in a toddler! His foreskin is supposed to still be attached to the glans and the process of separation is slow and usually completes during puberty!

Referrals of patients with physiologic phimosis to urology clinics can create anxiety about the need for surgery among patients and parents, while unnecessarily expanding the waiting list for specialty assessment. Uncircumcised memberes require no special care. With normal washing, using soap and water, and gentle retraction during urination and bathing, most foreskins will become retractile over time.

canigraduate · Dec 4, 2014

I have to agree with RNsRWe on this. Why in the world would any mother just give up her role as advocate for her child?

Wow. I said I would defer it to my husband because I feel he is better equipped (literally) to make this decision and I would be giving up my role as advocate for my (nonexistent) child?

I have no words for how offensive your statement is to me at this moment.

canigraduate · Dec 4, 2014

I don't understand the point you're making. This is about men and women (a.k.a. parents) making decisions about someone else's genitalia (namely minors).
Why shouldn't men AND women be able to express the opinion that CHILDREN have a right not to have a part of their body surgically removed, unless it's a medical necessity?
I'm not trying to make "genitalia decisions" for someone else, I'm simply saying that every individual should have the right to make decisions about their own body at an age when they can make an informed decision.

I thought my point was pretty clear. As a woman, I don't feel it's my right to make a decision for a male about male genitalia. If it ever came up, I would defer it to a male, who has intimate knowledge of the part in question that I don't. Obviously, you feel that it is your right to make this decision. Difference of opinion noted.

You have expressed your opinion, so obviously you are able. I didn't say anything that indicated otherwise. I just indicated that I find it crazy that it's women who are spearheading this debate when we don't have the part in question, or at least that was my intent.

If you are male, then I think it is perfectly acceptable for you to make decisions about your son's genitalia. If you are not, then I find it a gray area. I would not make this decision. I, again, would defer it someone who has the part in question. I would also do the education, benefits vs. risks, that I would for any procedure.

allnurses Guide · Dec 4, 2014

I don't understand the point you're making. This is about men and women (a.k.a. parents) making decisions about someone else's genitalia (namely minors).
Why shouldn't men AND women be able to express the opinion that CHILDREN have a right not to have a part of their body surgically removed, unless it's a medical necessity?
I'm not trying to make "genitalia decisions" for someone else, I'm simply saying that every individual should have the right to make their own decision about their own body at an age when they can make an informed decision.

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.