Monday, September 10, 2012
Why My Son Is Not Circumcised
Recently, the American Academy of Pediatrics changed their neutral position and made a weak endorsement of circumcision. I realize that most people have really strong opinions about circumcision. I am not one of those people. Because much of my Master's thesis focused on public health in Sub-Saharan Africa, I'm very well read on the issue of circumcision. The conclusion I came to was there are pros and cons to having the procedure and not having the procedure. Deciding whether or not to have my son circumcised was difficult for me. (I'm speaking in the first person because it was not as difficult for my husband to form his opinion. Rest assured though, it was very much a joint decision.)
The main arguments in favor of infant circumcision are that it reduces the risk of contracting a sexually transmitted disease, decreases the likelihood of urinary tract infection, and it fits with cultural norms. The main arguments against circumcision is that healthy tissue is being removed without consent and that it reduces sexual pleasure.
Studies have shown that circumcision reduces the transmission of STDs, including HIV and HPV. It is because of this that the World Health Organization recommends male circumcision in countries with high rates of HIV infection.
Studies have also shown that circumcised boys have fewer cases of UTIs than their uncircumcised counterparts. However, the difference in risk is small and the studies I've read on the subject don't seem to be very rigorous (i.e small sample size and not controlling for variables.) Even according to the AAP, "There is little evidence to affirm the association between circumcision status and optimal penile hygiene."
In terms of cultural norms, historically, circumcision has been standard in the United States, however as rates of circumcision continue to fall in the US, I think this argument has less validity. Furthermore, it seems a little silly to think that boys are going to feel ostracized for having a penis that looks different than their peers. My son, a blond, has a non-dominant hair color, yet no one expects him to feel abnormal for looking different from the majority of his peers in that (much more evident) way.
The cultural argument makes much more sense to me from the religious standpoint. Jews and Muslims both typically follow a tradition of circumcision, but since we are neither Jewish or Muslim, it wasn't an aspect I took into consideration when making my decision. It was simply not applicable.
As for the arguments against circumcision, I was most concerned about the claim that circumcision reduces sexual pleasure. (While it's a little icky to think about my baby having sex, if I think about it in the abstract, I can acknowledge that I want my son to have a happy, full life and sex tends to be a part of that.) However, as I dug into that claim, I could only find anecdotal evidence from opponents of circumcision and not an unbiased, scientific studies to support that argument.
Ultimately, my decision not to circumcise boiled down to one simple reason that I never explicitly saw mentioned in any of the literature I had read on the topic--evolution. I believe we have evolved in a way that is optimal for our survival. Even if you believe in intelligent design, the same argument applies. There must be some reason the penis exists naturally with a foreskin.
I felt like with education, we could overcome the some of the arguments in favor of circumcision (teach our son proper hygiene, safer sex practices, and positive self-esteem) but that we couldn't really get around the arguments against circumcision. Finally, I realized that if my son was unhappy with our decision not to have him circumcised, he could always have one later in life, whereas it would be more difficult to reverse the choice if he was circumcised.
Now that he's here and these are no longer discussions in the abstract, I can report that I'm happy we didn't circumcise our baby. It meant he could spend more time with us in the hospital rather than being away having a medical procedure. It's also been lower maintenance for us since we didn't have to care for the wound while it was healing. I've found no difference in diaper changes or baths between our uncircumcised son and circumcised boys I've babysat in the past.
Did you circumcise your son? Would you?
Let's keep the comments respectful. You can disagree, but I'll delete personal attacks or insults.