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.

11 comments:

  1. If I'd had a boy I wouldn't have done it. I'm not a religious person and in Europe it's not popular. It seems to be an outdated tradition, something that a lot of people do just because their parents did it. And I agree, teaching your kids about safe sex and proper hygiene negates any positives.

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  2. I also chose not to circumcise my son, and I feel very strongly about it. As you noted, many of the studies pointing to reduced rates of UTIs/HPV/HIV are somewhat flawed, and the difference is so small even in those studies.

    But honestly, my main reason for not circumcising my son is that I don't believe I have the right to make such an important and irreversible decision for him, especially in light of what is inconclusive evidence at best. If he chooses to get circumcised later in life, more power to him--but that is 100% his decision. We are not religious, but I don't think religion alone is a valid reason to circumcise, either. You are making a permanent medical decision in favor of YOUR religion. It may not wind up being your son's.

    I often hear that most men are happy they were circumcised as infants, and instead of taking this as a good reason to circumcise my infant son, I take it as a good reason not to. Circumcision is painful and traumatic--of course adult men are happy they don't remember the procedure! I simply feel that there are better ways to encourage safe sex and proper hygiene that cutting off an integral part of the male genitals. I agree with you that it's there for a reason...I think my little boy was born perfect and whole, and I have no reason to interfere with that.

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    1. "Perfect and whole" was my husband's reason not to want to circumcise.

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  3. This is something I'm seeing more and more of these days, which has made me question whether we'd circumcise any future male children. As a Christian who does not believe in evolution, I know that circumcision is something that, as you mentioned, Jews and Muslims believe in. However, just like you, I am neither. In the New Testament of the Bible, circumcision is mentioned, but in an "it doesn't matter whether you circumcise or not" kind of way. Biblically, there is no command for or against it, so I am free to choose.

    Thanks for sharing this post, as it shows that you've done your research on the health risks of both sides of the story. It was an unbiased and informed presentation. ;)

    P.S. And, thanks for stopping by my blog... ;)

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  4. This is something I haven't really thought about until you mentioned it. I think most people circumcise because everyone else is doing it - and that's not a good reason to do much of anything. It's interesting to hear about the studios and your experience with the hygiene and keeling your son with you and not going through a procedure in the hospital. It's definitely food for thought once we get closer to actually possibly having a son.

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  5. This is something I haven't really thought about until you mentioned it. I think most people circumcise because everyone else is doing it - and that's not a good reason to do much of anything. It's interesting to hear about the studios and your experience with the hygiene and keeling your son with you and not going through a procedure in the hospital. It's definitely food for thought once we get closer to actually possibly having a son.

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  6. I honestly have no idea, and I could potentially have a son in less than 5 months! (We will hopefully find out the baby's sex in a week!!!) Like you, it's just something that I don't feel especially strongly about, so if it turns out we're having a little boy, I think I'll probably defer to my husband on this matter. After all, he's the one who actually has a penis, so he's in a better position to say whether he feels circumcision is worth it or not, so even if I felt strongly about it, I feel like his opinion *should* carry more weight on this particular subject.

    Also, ultimately I think it's probably a decision we'd keep to ourselves (well, and I guess anyone who would be in a position to change our son's diaper!), regardless of what we choose. I can think of a couple of people who would probably criticize us pretty heavily if we did, but I also feel like if we opted not to circumcise, the anti-circ crowd would expect us to start advocating that point of view, and as I've said, I just don't feel that strongly about it because it seems like both the risks and benefits associated with either decision are quite low.

    Oh, and in response to one of your comments on my blog: that is EXACTLY my plan with cardigans! I've wanted to stock up for awhile, and they seem like the perfect option since I will be able to wear them after pregnancy as well. And I've actually never worn leggings but since I've heard that they are a pregnant lady's best friend (and since some of the sweaters I got are a longer, tunic style), I'm going to get a few pairs of those as well. :-)

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  7. I vote yes on circumcision of my own kids, but it's just my own and it really isn't a burning issue for me. Dad makes the decision; since there isn't really any clear evidence that either way is better, I'll trust him since he's the one who has a penis. Haha.

    But I don't really think people who don't do it are doing anything wrong. In fact, I'm willing to bet in 10 years the doctors will be endorsing forgoing the operation. It's been going back and forth for ages.

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  8. Great post. I agree that if, someday, your son wants to be circumcised, he can make that decision on his own. Luckily we had a girl first but, if our next one is a boy, I will be referring to your post for talking points with my husband!

    When I was in nursing school, during my OB rotation, one of my instructors told us that, unless there is a religious aspect to the circumcision, most parents do what the dad has... either cut or uncut! But I think, the times... they are a changin'! ; )

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  9. Even though my husband is the one with the penis, this was a decision we made together because we wanted to consider all the pros and cons of either decision, not just my husband's personal experience. Whatever your circumcision choice is, I think moms need to be involved in the decision making process too. After all, it is your son too so you have an intrinsic interest in his body and you'll be involved with changing and bathing him, so you have a practical interest as well.

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  10. We did not circumcise. At first it just seemed unnecessary and not worth the risk (complications of the surgery can include infection, mutilation, and death--it's not *unusually* risky, but it *is* surgery!) but then my partner did some more reading and began to feel very strongly against it.

    The idea that the parent with the penis gets to make this decision seems silly to us. Nearly all men have experience only with being cut or being uncut; they have no way of knowing what the other option is like. A woman's opinion of what she prefers to find on a man is at least as valid, even more so if she's been with a variety of men. In my case, I've never been with an intact man, but because I've seen some variety of circumcised penises I'm aware of some of the complications that are possible, and I can imagine how that extra skin would be useful if you had it. The problem, of course, with discussing any of this is that it can raise the implication that the father's penis is not perfectly satisfactory to the mother...so it's important to be tactful!!

    Thanks for writing about this and presenting a balanced view.

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