When my first son was born, I didn't even consider that I could choose to keep his #penis intact, although I remember desperately not wanting to cut him and even today, it surprises me that I didn't dig into why this procedure seemed to be a requirement. My oldest son will turn 22-years later this month. He is currently enduring the forge in basic training at Fort Jackson, and should be about half half way through the 81-hour grueling test to discover if he is soldier worthy. He hasn't one ounce of hesitation bringing up the issue of #circumcision with his friends and quite frankly anyone who will engage in the conversation as he believes it to be one of the most asinine cultural norms most just blindly follow, as his own momma did all those years ago.
Of course, neither he or I mean any disrespect to those who choose to do so for religious reasons or to those who have researched their choices and fall on the side that sees more benefit than risk for their child. In fact, I don't even mean any disrespect to those who do blindly follow through with this surgery on their newborn without giving it a second thought, but I do hope I can at help you make a more informed decision into the future.
There are a great deal of positions on this issue and a topic that can create the most heated discussions, even hostile arguments, within child-birthing circles. In fact, when I had a busy midwifery practice, I shared the same information I have here in this post with all my clients, but I also made clear that I respect their final decision. Because of that latter point, there were a number of doulas who refused to refer clients to my practice. I suppose I do prioritize a parent's right over the newborn's which is really hard for me to acknowledge honestly, but I feel if I didn't do so, this would mean that anyone could make an unanimous decision for us all. Certainly my desire for every young child to remain intact but more priority on this issue, and every other issue with my clients, is that I offer them a review of the benefits, risks, alternative options, social implications, and what others have experienced. I also hope to empower my clients to trust their intuition, to challenge the cultural norm, to think outside the box, and to encourage them to find their own convictions.
How A Broken Arm Changed His Worldview
At about the age of seven or eight, my oldest son invited a friend over to our house as each of our families educated at home and we were working together on a shared curriculum. Let me explain however, although homeschoolers in general often have a reputation of being a bit peculiar, you can emphasize that for our family significantly because I was the local homebirth midwife who breastfed all her kids through pre-school. I was also the working mother which challenged the belief system of many of the mothers, so our family was the odd duck in any circle we gathered. Of course, I was also an advocate for anyone and everyone who chose a different lifestyle than myself so that often made us an outsider.
This young child then, almost immediately upon entering our van, began sharing how his older brother had recently broken his arm and had to have surgery which caused my son to say, "Oh wow. Yeah, I had surgery once when I was little." I looked into the rear-view mirror, perplexed, wondering what he could possibly be referring to because I hadn't any recollection of him enduring surgery. He had broken his arm though so maybe this was what he considered surgery, but nope, he very confident belts out, "Yep, my mom cut half my penis off when I was a baby."
Let me remind you, he was about seven or eight. Also, let me remind you that when he was little, I was earning my undergraduate degree in lactation so he sat through many nursing mothers groups and could easily have sat for the lactation board exam had he been able to read fluently enough. This is also the point where I want to make clear that this young child was raised in a very conservative family and I was quite confident he had never heard the word penis, which was pretty much confirmed when I scanned his side of the van in horror. Yep, this was the last time this family would be visiting our home I was sure of it.
Honestly though, having already pushed the envelope so far, it occurred to me that my son and I had never had a conversation on this topic. Clearly he had picked this up via osmosis from attending all the nursing mother groups so I was curious, him having a circumcised penis, what would an innocent child think about the more common arguments so I asked, "Noah, don't you think it's important that your penis looks like your father's penis?" His response and more-so the look on his face, will be burn into my brain for eternity. "MOM! That is the dumbest thing I've ever heard. I've never even seen my Dad's penis. Why would I even care what HIS penis looks like and why would I want half mine cut off because of it!?!"
Honestly, I never heard a better argument than from the mouth of my seven-year-old son. I later had three more sons, all of which remained intact. My son turned to his friend and said, "Later my mom knew better and then she did better." Often parents tell me they circumcised the first son so feel they should all look the same. I am so grateful that my son learned that when we know better, we do better. Again, this is the perspective of my family and if your's differs that is perfectly fine. I simply want you to be empowered with knowing that for our family, of our four son's, one is circumcised and three are intact. I found they all make fun of each other's penises whether they are intact or not, but I adore that the differences in their penises for our family, means that no matter what the cultural norm is, we can change. We can be bold in our decisions and create our own path. It is perfectly appropriate to find our own conviction and it is important to not blindly follow the pack, or you could lose half your penis!
The intent of this post is not to offer a full informed consent on the issues surrounding circumcision. Speak to your clinician. If you are an active client of mine, I would be more than happy to dive into both sides of this argument with you and into the future, a much more in-depth discussion will be part of the resources offer active members of #Eden. What I share here is only to push you to think outside the box.
She Cut Half My Penis Off
This may seem an exaggeration of a seven-year old, but let me share this. When I was in graduate school, I was trained to perform circumcisions by a local obstetrician. I had assisted in the few I couldn't avoid, or the few where I felt I could somehow improve the child's experience through offering more mindful and compassionate support. The procedure certainly made me hurt to my core, but never did I lose actual vision and nearly black out as occurred each and every time I was walked through the procedure with the ultimate goal of my later performing this procedure. Nope. It just wasn't going to happen. Even if I could maybe offer a more humane experience for the little ones who would ultimately endure this procedure, I just couldn't bring myself to do it. Hearing repeatedly that "you must take off 50% of the penial skin or the parents will complain" is a large part of that horrifying memory.
Consider this. If I think back, I believe it was my understanding that the foreskin was just extra flappy, unnecessary skin on the penis. It served no real purpose and without it, the penis looked more appropriate. I am not confident I was under the belief it even offered any health benefit or risk, but maybe socially would save him some bullying or awkwardness in his intimate relationship. What I have learned since that time is when the foreskin is retracted, there is a sort of ridged area and also a more smooth area. Well, let me be more clear. This is true if you have the recommended 20% removal of the foreskin, but if you had the more commonly 50% removal as to eliminate the wrinkling of skin at the base of the glans, then you may not notice any ridging of skin at all. However, you are likely familiar with the ridged band that runs along the dorsal side of the penis, length-wise; beside this, the skin ultimately becomes the smooth mucosa. Unretracted, this ridged band, or wrinkles around the base of the penial glands, lies flat against the glans but retracted, the ridged band is everted on the shaft of the penis. The significance of this is that this ridged band is full of complex touch-sensitive nerve endings, called Meissner's corpuscles. All of this is sensory tissue and when intact, this tissue rolls over the corona of the glans, providing significant primary sexual stimulation. If you consider that most all newborn boys undergoing circumcision are having half of their penial skin removed... the sacrifice for... assuring his penis looks more like his father's? Removed, a significant portion of this very sensitive skin is removed but any remaining sensory skin is exposed, chaffed, and scarred.
The #foreskin of a newborn boy is still attached to the glans of the penis. It is a protective covering, keeping stool and bacteria from entering the urethra as they utilize diapers and ultimately begins to mobilize and retract, as they are learning to eliminate in a more hygienic way. This milestone differs for boys, but almost all are reducible by age 17 years. Even at this point, it remains protective of the glans, helping it to remain soft and moist as nature intended.
I am not sharing traumatic stories about the circumcisions gone wrong or even that 300 baby boys die annually from this procedure, and I won't even share about the poor outcomes I've seen in the families I have cared for or the biography my oldest son read in high school about a boy who lost his penis as the result of a circumcision gone wrong and was raised as a girl, only later to commit suicide. I will share that clinicians who are unfamiliar with the intact penis have ignorantly pulled back on this skin in effort to assure that it is mobile and clean. However, in doing so, they separated physiologically adhered skin from the penial skin and created adhesions and scar tissue that later creates significant issues for the child. For this reason, I created baby t-shirts for my client to dress their littles in prior to their well-baby visits which announced, "I am intact. Please don't retract."
I will also share that in the twenty-plus years of my working with newborns, the recommendations regarding circumcisions has teetered back and forth and this wasn't based on new evidence, but rather, religious affiliations of the leaders within various professional groups and the liability associated with a procedure that could arguably be categorized as #cosmetic. The United States is the only country in the world, as I am aware, that circumcises a significant number of its newborn boys without religious reason. During my career however, I believe the incidence of this surgery has plummeted and in fact, it isn't performed on the majority of boys any longer. Last I researched the incident of circumcisions, the data was nearing two-thirds of our little boys were being kept intact, while the remaining third resided in states which continued to fund the procedure as many had started to deny coverage, claiming the procedure was cosmetic and therefore, not medically indicated.
Everyone Has An Uncle
More times than I can count, I've had a client or family member share that they had an uncle suffer removal as an adult, which was exceedingly excruciating so they were adamant it be removed as a newborn to avoid this apparently hereditarian trait. Here's the reality: the risk of needing a circumcision later in life is one in sixteen thousand, six hundred and sixty-seven. It is very rare. The risk of cancer in the penis is one in one hundred thousand. Imagine how many circumcisions would have to be performed to save one child from this fate, yet how many would sacrifice poor outcome from the procedure itself? One in one hundred boys will suffer a circumcision. Girls also suffer from urinary tract infections. We do not circumcise them. We treat them and fairly easily.
It is amazing to me as well, how many people know that their uncles did not properly clean their penises so again, because they didn't wash themselves properly they now have no confidence their own son's will either, so they then conclude it should be removed. I wonder what sort of conversations happen in the dentist's office because goodness I have a hard time getting my boys to brush their teeth, but never did it occur to me to just pull them all out!
It's Not My Penis
Ultimately, as a parent, I appreciate that it isn't my penis. If my son later decides he wants it removed, he is absolutely capable of doing so. I've had a father share very candidly in my practice that he and his brother were kept intact as children and they were picked on so bad in high school that they both elected to be circumcised as adults. Interestingly, he shared this is a group prenatal class where another client also shared that he remains #intact today and could not wrap his mind around the idea that part of his penis might have been cut off. His wife shared very candidly as well that the arguments for circumcision for cosmetic reasons were senseless. If a man lacks ability to wash himself, his foreskin isn't going to make it all that better or worse of an experience for her and once erect, visually, there is very little difference.
Not having a penis myself, and even if I did, the one attached to my child was not mine to remove. In my mind, this is a human rights issue. It is a violation of his physical integrity. He has a right to self-determine if his penis remains intact or if his foreskin is removed. I am fairly confident that those babies who suffered a poor outcome and risked disfigurement would likely have chosen to remain intact and gamble the one in sixteen thousand, six hundred and sixty-seven potential they may have to endure circumcision later.