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Medical Phallicies
by author Julie Cheng

Circumcision was once considered a minor, harmless procedure mainly of religious or cultural importance for some groups. Within one generation, however, the perspective on circumcision has changed as new insights on male anatomy are emerging.

Circumcision is a harsh welcome to the world. Many men wouldn’t agree. They’d say that millions of males over the millennia, themselves included, have gone through this ritual without ill effect. They’d recount how the boys in the locker room who sported foreskins were laughed at by their classmates.

There are no medical reasons for infant circumcision. Most countries do not circumcise–about 85 percent of the world’s male population have their genitals fully intact. Yet this procedure still happens to about one in six Canadian male infants. The United States is the only country to circumcise its majority of newborn males for non-religious purposes–57 percent in 1998 and a high of 85 percent in the 1970s.

During World War I, hygiene and prevention of sexually transmitted diseases were popular medical reasons to discard the foreskin. In the 1930s the foreskin was feared to cause penile cancer and in the 1950s, cervical cancer. More recent justifications for circumcision are to prevent urinary tract infections in infants and non-retractable foreskin (normal in childhood) and a lower risk of AIDS in adult males. However, research shows that parents choose to circumcise out of social concerns: perceived hygiene, because his father was circumcised, to fit in with other boys, for appearance, culture and family pressure. That’s why routine (non-therapeutic) infant circumcision is considered a cosmetic or elective procedure.

Effects of Circumcision

Circumcision involves surgically cutting off the foreskin that protects the glans (head) of the penis. Many parents believe that the procedure is minor and not very painful, but are horrified if they watch their newborn being circumcised.

• Circumcision takes off one- to two-thirds of the penile skin system. The foreskin is made up of living tissue that serves protective, sensory and sexual functions. It protects the penis and urinary tract from urine and feces when in diapers, and from infection and injury throughout life. The foreskin’s inside fold is a mucous membrane that keeps the glans moist and sensitive.


• Circumcision causes extreme pain and trauma for a baby. Some babies go into shock and don’t cry. Babies are often circumcised without anesthetic and are rarely treated for pain after the operation. The pain gets worse when the baby urinates, defecates, has his diaper changed or is held tightly during the one to two weeks of wound healing.


• Surgical complications of circumcision include scarring, inflammation, hemorrhage, gangrene, infection, mutilation and even death. Adults can endure tearing and bleeding at the scar, painful erections and impotence.


• A traumatic event like circumcision may affect mother-infant interaction and interfere with breastfeeding.


• Infant circumcision interferes with the natural development of the penis. In male babies, the foreskin is fused to the glans and normally starts to separate and push back between nine months to three years. It could take five, 10 or more years. Tight, non-retractable foreskin (phimosis) is normal and usually resolves itself by 18 years of age.
  
• Removing the foreskin can interfere with normal sexual functioning. Circumcised males lose sensitivity in their glans and the nerve endings in the foreskin that enhance sexual pleasure.

Today, to circumcise or not to circumcise is a much easier decision to make. In this generation in Canada, boys are no longer ridiculed in the locker room for being fully intact.

Foreskin Care

Caring for your son's intact penis is easy and requires no special effort during infancy.

• For infants, externally wash with soap and water the same as other parts of the body.
• Never retract the foreskin by force. Let the foreskin and glans separate naturally over time. Forcing back the foreskin can cause pain, bleeding, infection and unnatural tissue formation.
• Your child himself should retract his foreskin. Tell your son about foreskin retractability so he isn't alarmed when it happens the first time.
• Once retractable when young, an occasional cleaning is all that's needed. Teach your child to gently slip the foreskin back. Rinse the glans and inside fold of the foreskin with water. Pat dry, then slip the foreskin back over the glans.
• At puberty, boys can clean beneath the foreskin when they wash. Let your son know that keeping the genitals clean is a normal part of total body hygiene.

Source: alive #228, October 2001