Saturday, October 05, 2013

A Discussion of Circumcision

Sounds like a rousing subject, no?  I thought so too.

Believe it or not, this has been a major topic of conversation at my place of employment this week due to a protest that took place a few days ago.  The hospital I work at has been doing research on the merits of different circumcision devices, and an anti-circumcision group called Intact America staged a protest outside the hospital.

OMG, right? 

In discussing this situation with various co-workers, it struck me that there are a lot of misconceptions about circumcision, its use, its purpose, and its history.  So, naturally, I decided a blog post was in order to provide a little education on the subject.

Though circumcision today is most commonly associated with Jews and Muslims, it has been practiced among humans for thousands of years.  The ancient Egyptians were practicing it, to one degree or another, as far back as 4,500 years ago.

This is a diagram of a carving in a tomb at Saqqara, Egypt, dating from around the time of the pyramids.

It's likely that the ancient Jews picked up the practice from their Egyptian cousins.  In the book of Genesis, when God establishes his "everlasting covenant" with Abraham, he establishes the practice of Jewish circumcision as a requirement for all Jewish males on the 8th day after their birth.  Circumcision, in fact, is not just "a thing" Jews are to do, but it is actually established as the very outward, physical mark of what it means to be a Jew: "it shall be a sign of the covenant between me and you" (Genesis 17:11), and "any male who is not circumcised shall be cut off from his people; he has broken my covenant" (v. 14).

In Luke 2:21, the infant son of Mary and Joseph is circumcised on the 8th day and given the name Jesus, in keeping with Jewish law and custom.

In his teaching life, Jesus is never depicted speaking or teaching about circumcision.  Like other Jews of his time, Jesus would have accepted the practice as the social and religious norm, required by God as a sign of his everlasting covenant with the Jewish people.

It was not until after Jesus's death that circumcision became an issue for his followers.  Like Jesus himself, the earliest Christians were all practicing Jews.  They followed all the Jewish rules and customs, ate only kosher foods, practiced all the sacrificial rites, and celebrated the traditional Jewish holidays, including the weekly Sabbath.  Like all Jews, they circumcised their sons.  However, when Christianity began to spread outward from Palestine into the larger Greco-Roman world, many Greeks and Romans were receptive to the message of Jesus, but not at all keen on "becoming Jewish" - that is, on following Jewish dietary laws or, especially, getting circumcised.  The Jewish leaders of Christianity at that time, namely Peter and James, insisted that new Greek and Roman converts must also get circumcised and become Jewish.

This soon became the source of a major rift among the early Christians, with the apostle Paul leading the charge against circumcision (in the book of Philippians, Paul calls Jewish Christians "dogs" and "evil workers" who "mutilate the flesh.")  According to the book of Acts, James and Peter eventually changed their minds and decided to allow new non-Jewish converts to forgo circumcision, as long as they followed certain dietary laws (Acts chapter 15).

Although conversion to Judaism, along with its required circumcision, continued to exist in small circles of Christianity for the next few hundred years, mainline Christianity after the time of Paul gave up the rite and began regarding it as part of the "old covenant" through Abraham, superseded by the "new covenant" through Christ.  Around A.D. 150 (roughly 100 years after Paul's arguments against circumcision) Justin Martyr wrote that circumcision had become a sign not of the covenant between God and the Jews, but a sign that Jews are "separate" from Christians and the rest of the world, and so that Jews, alone, would receive their "just punishments" from God, which Justin equated to the Roman destruction of Jerusalem and other Jewish towns.  These circumcised Jews, according to Justin, deserved to have their towns and cities destroyed because they crucified Jesus.

This vicious anti-Semite is one of the most beloved of the early Church fathers

A papal bull issued in the 1400's by Pope Eugene IV specifically outlawed the practice among Christians and established that it was a mortal sin which would cause "the loss of eternal salvation."
        
Like Christianity before it, Islam also has roots in Judaism, arising in Arabia in the 7th century A.D. (about 600 years after Jesus).  Islam reveres Abraham, Moses, and Jesus as prophets, but not Paul.  As a result, unlike Christianity, Islam never rejected circumcision.  Muslims, from that time to now, circumcise their sons as part of a religious rite.

With all this history in mind, why then do so many modern Americans, who are neither Jewish nor Muslim, circumcise their sons?

From the time of Paul, up through the end of the 19th century, circumcision was virtually unheard of outside of Muslim nations, Jewish communities, and Coptic Christian communities (a form of Christianity practiced in north Africa).  Folks like George Washington, Thomas Jefferson, and Abraham Lincoln, not to mention their millions of fellow countrymen, were virtually universally uncircumcised.  The Encyclopedia Britannica of 1876 described it as a "bodily mutilation" practiced by Jews and Muslims and generally abhorred by Christian nations.

You know you're picturing it.

However, beginning in the late 19th century, doctors in mainly English-speaking nations began promoting circumcision for a variety of health reasons, claiming it could cure or prevent everything from kidney stones to joint disease.  By the first few decades of the 20th century, the practice had become widespread in places like the U.S., Canada, England, and Australia (it did not ever spread in any significant fashion to mainland Europe, Asia, or South America).

As time passed, however, and medical science progressed, it became apparent that the earlier claims for the health benefits of circumcision were not just untrue, many were patently absurd (one very prominent physician claimed the practice could cure childhood paralysis; another popular theory was that it somehow prevented masturbation).  As a result, circumcision began to decline rapidly in England after World War II, and eventually Canada and, to a lesser degree, Australia, followed suit.

In the U.S., however, circumcision has remained common.  Circumcision is practiced more widely in the U.S. than in any country on earth outside of the Middle East and northern Africa.  The practice is very rare (with rates less than 20%) across Europe, Asia, South America, southern Africa, and Central America.  The World Health Organization estimates that roughly 70% of the world's male population is uncircumcised.  Among those who are circumcised throughout the world, roughly 70% are Muslim.  Among non-Muslims and non-Jews, the U.S. has almost as many circumcised men as the entire rest of the world combined.

Even within the U.S., the practice is not geographically equal: it is far more common in the Midwest and Northeast, and less common in the South and (especially) the West (in the last decade, rates have been has high as 80% in the Midwest, and as low as 35% in the West).

Midwesterner, Rick Santorum.  Probably circumcised.

Westerner, Nancy Pelosi.  Probably not circumcised.

Advocates generally argue that circumcision prevents the spread of STD's and is a form of good hygiene.  Both of these claims are controversial.  According to various studies done in recent decades, STD infection is more likely among uncircumcised men.  However, opponents of the practice argue this is not a good enough reason to remove a portion of the penis, since simple safe sex practices can virtually eliminate the risk of STD's.

As for hygiene, though most acknowledge a need for increased care for uncircumcised people, opponents again argue that this is not a good enough reason for removing part of the penis.  The simple fact is that most human males throughout human history, up through the present day, have not been circumcised, and they've managed their personal hygiene just fine.

Despite how supporters of circumcision point to hygiene and STD prevention as reasons for circumcising boys, a WHO study in 2007 found that, in the United States, social conformity is the most commonly cited reason for parents choosing to circumcise their sons.  The same study showed a strong correlation with the father's circumcision status: 90% of circumcised fathers chose to circumcise their sons, compared with just 23% for uncircumcised fathers.

CONCLUSION

I have two daughters, so I never had to make this decision for my own children.  However, if I had had sons, I would have had them circumcised, and I would have made that choice primarily for social conformity.

Despite that, I am with the opponents of circumcision in spirit.  There simply doesn't seem to be any legitimate reason, in a First World nation, for widespread circumcision of male babies.  Safe sex practices and good personal hygiene eliminate the primary biological arguments for circumcision, and if we stopped circumcising, then the social conformity issue would quickly disappear too.

The simple fact is, the very thought of "female circumcision" is shuddered at and referred to as "ritual genital mutilation" (see this fact page from the WHO), yet the same standard is not held for mutilating the genitals of boys.  The foreskin is not an evolutionary accident; it's there for a reason.

In my opinion, there really doesn't seem to be any good argument for continuing its practice on a widespread basis, especially in developed countries where safe sex practices and good hygiene are the norm.

60 comments:

Anonymous said...

This is really ignorant. She says that if she had sons she would have had them circ'ed for social conformity, yet she agrees with those who oppose it! Social conformity? We don't walk around in public with our flys open and penis' exposed. It is a HUMAN RIGHTS issue! Everyone has the right to an intact body.
And why didn't she have a clitorectomy performed on her daughters? It is socially acceptable in parts of the world....

Scott said...

Thanks for leaving a comment, Anonymous. I'm a man by the way. A "he" not a "she."

In any case, you're right that no one walks around with their ding-dong showing. But sexual partners DO see your ding-dong, and frequently same sex friends and acquaintances (at the urinal, gym room showers, etc., etc.).

Unknown said...

Anonymous, it's clear you feel very strongly about this, but I don't think it's right to admonish Scott. I think his conclusion is very honest. And I read it as that at the time back when his kids were born, he would have circumcised, but now, he feels there isn't any strong reason to do it. I think this change of heart and objective look at the subject takes a lot of courage.

Scot, I love how you said that the foreskin isn't a birth defect and that it's there for a reason. I completely agree. A follow-up blog post that discusses the sexual functions of the foreskin would be a great compliment to this one :) (just google "functions of the foreskin" to find lots of info)

-Craig

George said...

The author says he would have a male child circumcised for "social conformity."

It needs to be pointed out that male neonatal non-therapeutic circumcision has been losing popularity for a long time and there is only a slight superiority in the number of unforeskinned boys nationwide. Now intact, foreskinned boys outnumber the unforeskinned in 13 states. So based on that argument, it would have to depend on what state in which one lived or was likely to live.

The Skin Force said...

I don't understand why you would still circumcise your child "for social conformity" when you acknowledged in your piece how low infant circumcision rates are now in the United States. Also you acknowledge there is no good reason to do it. How would you feel when your (hypothetical) son were one day protesting outside a hospital along with Intact America, angry about what was stolen from his body? How would you respond when he says, "Mother, you knowingly took a valuable part of my body and you knew there was no good reason to do it. Why did you do this to me?"

Anonymous said...

"Uncircumcised" is a somewhat strange term, if we'd really think about it. We don't refer to the healthy as "unsick," nor would we refer to a man still in possession of his head as "undecapitated."

Anonymous said...

"'Uncircumcised' is a somewhat strange term if we'd really think about it. We don't refer to the healthy as 'unsick,' nor would we refer to a man still in possession of his head as 'undecapitated.'"

May I add to that list of strange terms: A-leprechaun-ist, a-unicorn-ist, and a-the-ist. It really is strange to define people by what they aren't!

lo said...

Lots of good information, although the term "uncircumcised" is inaccurate and made me cringe every time I read it.

dreamer said...

I appreciate your thoughtful post and particularly your conclusions in the last paragraph.

Many Americans today think they circumcise for religious reasons. It's clear, following the history that you summarized, that the religious aspect among non-Jews, non-Muslims is only a justification of something that started as a misplaced medical procedure in times of an outdated medical paradigm, in other words, an obsolete medical procedure turned into a social ritual.

I sense that this was a slip: "Among non-Muslims and non-Jews, the U.S. has almost as many uncircumcised men as the entire rest of the world combined", I imagine you meant "as many circumcised men", right?

Tim Hammond in his 1999 preliminary poll of men circumcised in infancy or childhood explained the current protests in that "The magnitude of the practice in the USA renders American men the largest population of circumcised males at any one time and place in history. These men matured at a time of increased public understanding of foreskin function and greater questioning of circumcision."

Particularly, for foreigners coming to the U.S., finding out about the widespread practice of neonatal circumcision is shocking, even for those of us who were circumcised for one reason or another in our homeland.

Best wishes.

G said...

Scott used the past tense when he said he would've had sons circumcised for social conformity. I think it's fair to assume that at the time he had his daughters, he wasn't as educated on the subject as he is now. Once you know all this stuff....it's pretty much impossible to inflict it on your son in good conscience.

AnnD said...

I can see you put some thought into this piece and that is much appreciated.

Though, you did get one thing incorrect. Circumcision can, in fact, curb masturbation.

Foreskin is an organ (yes, an organ. Not just a flap of skin) that has a natural gliding mechanism that enhances sexual intercourse and prevents chafing and uncomfortable friction for both partners.

Because of this gliding mechanism, Intact men do not need external lubrication to masturbate.

Doctors during the Victorian Era sold circumcision to parents as "moral hygiene" based on this very knowledge. (This is the basis on which the myth that it is more "hygienic" came from).

KY Jelly and lotion did not exist back then so circumcision was a very adept way at keeping boys from masturbating. It worked.

It worked by destroying Mother Nature's design for sexual pleasure.

It's also worth mentioning that females have "foreskins" too, it's called the clitoral hood. Both the foreskin and clitoral hood are made from the same fetal tissue and serve the same function, to protect the clitoris and glans from the external environment.

The glans is supposed to be an internal organ. It's not mean to be rubbed and chafed against cloth. What happens is that a circumcised penis has to protect itself since it's natural protection was removed so, over time, it keratinizes itself, further desensitizing it.

This is evident in the color differences of the glans' of Intact and Circ'ed men.

The foreskin is very, very similar to the eyelid of an eye. Foreskin makes lysozome; an antibacterial and antiviral protein that is found ONLY in tears and breastmilk and protects Intact men from infections of all sorts.

I agree with Craig...a follow up blog about the benefits of the foreskin is very much needed.

Scott said...

Thanks everyone for the comments. Yes, Dreamer, that was a typo, which I have fixed. Thanks for catching it.

As for my statements about social conformity: yes, my thoughts on this issue have changed since my children were born. However, it is important to point out that although rates appear to be declining in the U.S., they are still very high in the portion of the country where I live.

It's a simple fact that the vast majority of men in this region are circumcised, and it's what women generally expect.

For that reason, I would probably still be torn (excuse the pun) about circumcision if I had a son born today.

A good point from those of you who mentioned the incongruity of the word "uncircumcised." Again, since circumcision is the norm in my own personal experience, I tend to think in those terms when discussing this. Thanks for opening my perspective on that.

Scott said...

Great information Ann. Thank you. I must say, however, that lack of foreskin, and lack of synthetic lubricant, never was a problem for me :-)

Kim said...

I think social conformity is a pretty strange reason to permanently a child's body...particularly when social norms are changing in favor of NOT being circumcised.

My son in intact. So is my daughter. I'm not concerned about the state of other people's genitals when it came to my children's genitals. Of course my children's genitals have very little to do with me in the first place....I change diapers for a couple years and then that's it. THEY will be living with their body so who am I to change it? Ultimately they can make up their own minds...and if someone doesn't want to be intimate with them because they retained their natural genitals...well what does that say about that person? I will encourage my children to be proud and confident in themselves and not date shallow idiots. However, if they REALLY don't like having a foreskin (either of them since women have a prepuce too), they are free to have it amputated.

Devin said...

Here is an American Male’s response…
The amputation of a male child's nerve enriched prepuce is a penile reduction surgical procedure that unfortunately still infects our civilized, capitalistic, and so-called "equal rights" society. Not only is the circumcision of male infants and young boys considered a human rights violation by many, it's a men's health issue and perpetuates an irrational belief in America that all little boys are somehow born imperfect or faulty requiring surgical correction of their penises upon birth! This idea is a sick one and is absurd to not only me, but the vast majority of people on earth.

WHAT IS LOST TO CIRCUMCISION:

About 50% of the penile skin: The double layered foreskin (prepuce), along with the rest of the shaft skin, is a mobile skin system and can freely move up and down the penile shaft, even during an erection.

The Pleasurable Sensations of the “Ridged Bands”: The 1/2 inch wide bands of tissue near the tip of the foreskin is the most highly innervated and erogenous part of the penis containing thousands of nerve endings called Meissner’s Corpuscles. The loss of this tissue along with the adjacent sensitive frenulum, reduces a man’s pleasure and full range of sexual response.

The foreskin’s Gliding action: This is the hallmark mechanical feature of the natural human penis. The non-abrasive gliding of the penis in and out of its own sheath of skin facilitates smooth, comfortable, pleasurable intercourse for both partners.

The Comfort of a covered glans: The foreskin’s inner mucosal tissue provides a warm, moist, protective covering for the sensitive glans. The glans of the circumcised penis becomes dry and calloused from exposure to air and rubbing against clothing.

Choice: A man who was circumcised as an infant has lost his right to an intact, normal, and whole penis and the right to control what happens to his own body.

BOTTOM LINE: HIS PENIS, ONLY HIS CHOICE! Men (and women) who are allowed as children to keep their whole, intact, normal genitalia, DON’T choose to amputate parts as adults! Please Protect ALL children’s genitals from unnecessary amputations.

Best Regards and Many Blessings to all perfectly born Intact little boys.

EuropeanMan said...

"It's a simple fact that the vast majority of men in this region are circumcised, and it's what women generally expect."

I think that this is what you believe. It's just fear carved in American society. I doubt that women in Ohio or anywhere else in the world are that shallow. If you look for a partner that fulfills a list of physical traits, in particular concerning their genitals, you are making a mistake and you will never be in a stable relationship.

Do men in Ohio also have a particular ideal about how female breasts and genitals should look like and stop dating a woman as soon as they discover her breasts or genitals are too big or too small or shaped a certain way?

Why is American society so much obsessed with sex that parents start thinking about their baby's sexual life and how they should conform to the ideals of potential sexual partners as soon as they are born?

EuropeanMan said...

Somebody please explain this to me: Ohio is the place where people go to church at least three times a day. How is it then that parent's main concern is the appearance of their newborn's sexual organs, especially when there is medically nothing wrong with them in the first place?

Unknown said...

It is strange that we would cut off part of an UN-consenting persons body for the sake of social conformity. Also it's called a penis not a ding-dong. My husband showered with classmates for years in high school and nobody ever said anything about his intact penis. Speaking of lovers intact is better, way better!

Anonymous said...

Scott: 1. STD's are actually more common in circumcised males except possibly a very slight increase in ulcerative STD's. Studies conducted in North America do not show any decrease in HPV, HIV and actually show an increase in STD's including HPV and HIV in circumcised males and this increase is about 10-30% depending on which infection is being evaluated.
2. My sons have not noted any need to 'conform' to a standard of being circumcised. Their circumcised friends wish they had been left alone. The circ rate is dropping especially on the coasts and now intact males are in the majority in young people on the West coast. Sex is better with an intact penis and sexual partners would not even be able to tell the difference in an erect penis between one circumcised or not.
3. Thank you for trying to post a balanced article on the topic.

moonjellyroll said...

Can I ask why we are attacking this guy? He is being honest and seems to have the right mindset. Everyone is in a different place on the learning path. I think it is easy for us as women to dismiss men's insecurities about this when that is the last thing they need. It IS the case that for many years this was not widely discussed and this man's feelings are normal. Just be glad this is not another typical circ'd guy slamming on the intactivist movement.

moonjellyroll said...

You may have answered your own question there. ;)

TLC Tugger said...

Jesus is depicted as being circumcised but the New Testament makes very plain in a dozen places that physical circumcision is not part of Christianity. 95% of the world's Christians don't circumcise.

Anonymous said...

Jesus was circumcised? So was Judas.

(Jesus was also cruxified, but I'd imagine most folks with a clue would rather their sons not undergo that procedure, either.)

EuropeanMan said...
This comment has been removed by the author.
EuropeanMan said...

@SeptemberWeather

We are not attacking him. We are attacking a faulty society ;) Sorry if it comes across that way. It's not meant personally.

Tora said...

http://www.youtube.com/watch?v=hi6A7wP7dKw

Anonymous said...

Scott,

Thanks for posting this. What I see in this article is an honest discussion and sharing of facts you've come up with upon researching the topic. I wish that more people would research this as thoroughly as you did because they would see that circumcision for any non-consenting minor is plain wrong.

I don't find it odd that you are still conflicted if you were to have a son if you should circumcise him. Perhaps you are fine with what I presume is your circumcised penis and you suspect your theoretical boy will be too. That's understandable, but take a step back again and remember what you described. What kind of message would you be sending to a son if you decided to circumcise him because it was "normal" (especially knowing what you do now about it!)? As parents, we teach our children to do the right thing and reject conformity in favor of doing what is right. Your sexual preferences or perceived sexual preferences of women 20 years from now should have no bearing on that. It's simply absurd.

Thanks for posting this and for reading my comment.

Unknown said...

Thank you for receiving our feedback with gentle understanding, Scott.

To further spring off of what European Man was saying:

Remember when I said that foreskin is most similar to an eyelid. You don't wash under your eyelid right? That would be awful and painful. The same is true for foreskin. It's self-cleaning but it does require some maintenance in that a male must, in general, have decent hygiene. Nothing more than what most Western societies usually expect.

From what I understand from the Intact men I have spoken with, they simply retract their foreskin and briefly run it under the water in the shower every so often. No soap should ever be used to do this. Ouch!

The whole process takes LESS time than cleaning your ear out with a Q-Tip. One of my favorite anti-circ memes is a man standing in the shower looking down and it says at the top: "I have no idea how to clean this thing" and at the bottom it reads: "Said no man ever."

It's true! And I think it's so illustrative of the ridiculous notion that we can't trust our boys to be smart enough to clean their bodies.

My circ'ed hubby and I were blessed with a son 4 years ago (next month) and we left him Intact. He's had no problems and no issues. Our biggest problem is arguing with our pediatrician who knows nothing about the normal development of foreskin which has resulted in "diaper/underwear will be left on during visits" because she can't seem to keep her hands off of my son's genitals.

Dr's forcibly retract or tell parents to retract boys earlier than they need to be, which introduces an infection, which makes them go: "Look! He needs a circumcision." Truth be told, they have NO IDEA that repeated forced retractions are what did the damage to begin with.

It's crazy. I wish I could fly my son to England for his Dr's visits!

Another interesting fact is that the average woman makes more smegma than the average Intact male.

Yes, it's true.

And, on both genders, it serves a brief purpose and can easily be washed away.

Unknown said...

PS.

I'm AnnD from yesterday's comment. I apparently have 2 Google names. I can't seem to balance them apparently!

Anonymous said...

Thank you for writing this and giving it some thought most people don't even want to think about C...

EuropeanMan said...

Thanks Ann Daniel for expanding on my post. I have to say that it's ok to use soap. Water only would make it feel dry, but everybody will figure it out themselves how to do it. Don't women use soap there? It's a similar tissue.

We were also blessed with a son. Fortunately, we live in Seattle and our pediatrician agreed with us that one should not retract too early. So, you don't need to fly to England, Seattle might be closer ;)

Also, another thing to consider is that if the foreskin of your son looks red or irritated it's most likely a diaper rash. Just use bag balm, vaselin or similar. There are stories of parents who are told that a red foreskin means that there is an infection and that they need to retract it and clean underneath. That leads then to all sorts of complications. Just no panic. A red foreskin is like a red butt, just a diaper rash.

lo said...

@EuropeanMan: As a woman I don't use soap "down there". I assume a little touches down there when washing my legs, but I just rinse that area with water. It was a little weird at first, but I'm very used to it now.

The reason I stopped using soap is at the recommendation of 2 different doctors. I started having very frequent yeast infections and UTIs that never seems to go away with any medication. After much urging to stop using soap in that area (I was so grossed out thinking about not using soap)I did eventually try it and it has been almost a year with no infections, UTIs, or any irritation. I think our soaps are too harsh and in our culture perhaps we are overly hygienic.

EuropeanMan said...

@lo: Sorry to hear about your UTI and yeast infections. Have you tried cetaphil? I can't use any soap either, just a mild one. I had to experiment to find one. I totally agree with you that "our culture is overly hygienic". Humanity has been perfectly fine for thousands of years without soap.

Unknown said...

@European Man I don't use soap up in my vagina, no. I clean my vulva area with soap and that's it. I've heard from several sources that if you put soap on a glans of an Intact man it would be irritating since it's still an internal organ and doesn't have the keratinization that an circ'ed man has. But, it's good to know it isn't a huge deal if some soap happens to get on my son's when he starts bathing himself.

When his foreskin gets a little red (usually from diaper irriation, you're right or from him PULLING on it so much when he's just fiddling with it...man it looks like it hurts but he doesn't seem to mind it), I just use some organic coconut oil and an hour or so later, it's perfect again.

Anonymous said...

This is one of my favorite circumcisions post I've ever read. It's straightforward and rational and informative. I personally think nontherapeutic, infant circumcision is inane. But I do not actively oppose routine male circumcision. That's because I feel intactivists are too emotional and they scare people off. I don't want to associate with them. I would like to see the rate of circumcision decrease. But if we could just chill out and speak about it in the rational calm way that this post is presented, people would LISTEN. The average American shuts down and gets defensive when they are exposed to hyperbolic intactivist arguments.

Chill. Plant small seeds of doubt in people and then just let the truth speak for itself and circumcision will decrease. It's true that, with this approach, male circumcision won't end tomorrow and I think that's what upsets the intactivists. They don't want to wait.

EuropeanMan said...

@Ann Daniel: Yes, I had meant that women use soap to clean their vulva, certainly not put soap in their vagina. Sorry that we are getting into details. I'm intact. I started cleaning my glans with soap during or after puberty, I think but I don't remember exactly what age. Personally, I find it more irritating to keep it under water flow than to rub some gentle soap around it and then rinse it off. But everybody is different. I think that the glans of an intact male changes with age. In a toddler it's very sensitive and easy to get irritated. It's also kind of sticky and hurts when touched. As you go through puberty you realize that you can touch it without hurting. Every glans, intact or circumcised, develops some level of keratinization with time. The difference is that in a circumcised male it's thought to be thicker.

There is a study by Cold & Taylor "The prepuce" where they explain that the inner membrane of the foreskin has as much keratin as the glans and both have less keratin than the outside membrane of the foreskin:

http://www.cirp.org/library/anatomy/cold-taylor/

Your son should be fine if some soap gets to the outside of the foreskin (but don't take my word, I haven't been a toddler in a long time!). It can get irritating when soap accidentally gets into the urethra though. But, in the end, keratin or not, soap or not, your son will be happy to have a foreskin. Just enjoy each one of his smiles!

Scott said...

First response: Please refrain from mentioning my place of work. I left it out of the blog post for a reason. I've had to delete a few comments because they identified my hospital. I could get in trouble for that. Like any corporation, we have rules regarding use of social media, even personal blogs like this.

Scott said...

Julie Williamson: I used the word "ding-dong" as a joke. If you can't take light-hearted humor, you've come to the wrong place.

Scott said...

Several people have commented about STD rates and circumcision. At least one person (Anonymous) stated explicitly that STD rates are lower among intact people. The numerous studies and articles I have perused on this subject seem to imply that, at the VERY LEAST, this is a very contentious subject. Numerous studies have suggested exactly the opposite - that std rates are higher among those who are intact.

I'm not saying that's a viable reason for circumcision - after all, uterine cancer rates are 0% among those who've had hysterectomies, but that's still no reason to cut out all female uteri. Still, I don't think it's reasonable to argue that STD rates are higher among circ'd men when clearly that doesn't seem to be the case.

Scott said...

Ann: Thanks again for your thoughtful and informative response.

In the end, it's sort of a moot point for me, in regards to any potential sons, because my wife and I are finished producing children. But I suppose I will have some interesting perspectives to give my daughters should they have sons in the next 20 years.

SeptemberWeather: Thanks for standing up for me :) I don't mind the responses, as long as my hospital is not named or denigrated :)

Scott said...

To the anonymous poster who said this: " I personally think nontherapeutic, infant circumcision is inane. But I do not actively oppose routine male circumcision. That's because I feel intactivists are too emotional and they scare people off."

Thank you. That's sums up my point of view exactly. And it's not just on this subject either. Activists, in general, scare people away, whether it's circumcision, environmentalism, animal rights, etc. I agree with all those groups in spirit, but think that many of the activist groups are way too out of control with their dialogue and methods.

EuropeanMan said...

The reason why many intactvists are emotional is because they are angry. I got also angry after reading the report from the American Academy of Pediatrics that the "benefits outweigh the risks". It's difficult to keep cool blood when a governmental institution issues such a flawed report putting the health of newborns at stakes. How can they come to this conclusion, in particular when they state themselves in their own report that they cannot quantify the risks? Are we, parents, supposed to trust the AAP or not?

Last March, a boy died in California after his circumcision because he had hemophilia. Parents need to be correctly informed about the risks and long term consequences of circumcision.

Scott said...

That makes sense, EuropeanMan. I guess we all have those pet things that get our blood boiling. Mine is evangelical religious goofballs and Republicans. :)

EuropeanMan said...

"Numerous studies have suggested exactly the opposite - that std rates are higher among those who are intact."

It is interesting though that the United States, where 70-80% of the male population is circumcised, has higher rates of HIV infection and other STDs than Europe, where only 10% are circumcised (except Portugal):

http://en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_adult_prevalence_rate

Either circumcision makes no difference or there are other factors at play that are much more important than the presence/absence of the foreskin. Unfortunately, there is now so much focus on circumcision in the fight against HIV in Africa that attention is taken away from finding out what other measures should be taken.

Personally, I believe that the money spent in finding a relationship between circumcision and HIV would have been better spent in finding better antiretroviral drugs and making them accessible to rural areas of Africa. Today, we are at the point where antiretroviral drugs can lower the level of the virus in the body such that the patient is no longer contagious. That should be couples with proper awareness and sexual education.

EuropeanMan said...

With "except Portugal" in my last post, I meant that Portugal is the only country in Europe with higher rates of HIV than the US.

EuropeanMan said...
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EuropeanMan said...

It seems that nobody is contributing to this blog any more. I liked this blog because the tone of the discussion was very calm. I wanted to add one last thing. I found today a very well written article on ritual male circumcision written by a Jewish man (circumcised himself) as a response to a recent statement by the European Council that circumcision violates the bodily integrity of children:

http://www.theguardian.com/society/2013/oct/15/circumcision-and-human-rights

Anonymous said...

Actually, in the 19th century, curbing masturbation was the only reason circumcision was practiced, and it was done as far back as mid-century. The idea of circumcision as a preventive measure came from a French doctor by the name Claude François Lallemand. Although what he wrote on the subject was translated and spread throughout Europe, only the English took the idea seriously - and it spread to the USA, Canada and Australia. Only later in the century did doctors start fabricating other medical justifications for circumcision - probably before they started doing it to infants, though.

Scott said...

Thanks for posting that article, EuropeanMan. An interesting take.

Anonymous: Whatever the reason, it's clear the origins of the modern tradition were ridiculous.

EuropeanMan said...

I wonder whether there are parents who do it because they think that it reduces masturbation? I wonder whether they (some parents) do it specifically for that purpose. Also, I wonder whether intact men in the US have the stigma of masturbating more. I'm just asking because I didn't grow up here and I keep learning new interesting things about American society.

Scott said...

Well, you can't put ANYTHING past some people, but circumcision for the purpose of stopping masturbation is certainly NOT a reason I've ever heard of for the practice.

And I've also never heard of anyone being stigmatized for masturbation because they are intact. I don't really sense any stigma regarding masturbation in the U.S. anyway. Doesn't everyone pretty much masturbate at some point or another, with varying degrees of frequency?

EuropeanMan said...
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EuropeanMan said...

Thanks for the reply to my question. There is also an article by Planned Parenthood on the topic:
PDF

Who reads this stuff anyway? said...

Hi Scott,

It's really quite brave of you to blog about this subject, since all parenting pages it comes up on usually end up in people insulting each other. The comments on your page reflect the intelligence and decency of your readers.

As an American who moved overseas a while back, this is a subject that I used to think was a 'non issue'. You either did or didn't and it really didn't matter.

Since then, I've learned so much more about the foreskin (both male and female) and had discussions with a pathologist I know from back home who declared "there's no reason to do it, and children have died" to answer my question as to why he didn't have his 2 boys circumcised.

It still strikes me as strange that otherwise wonderful parents such as yourself still defend the 'social conformity' of the practice. I mean, are there any other body parts you would suggest we cut off for social conformity? If one of your daughters had very small breasts, and found she had trouble finding a man willing to date her because the aesthetic of men in your part of the country require at least a 'C' cup?

I give these examples because they tend to make the point that groups like this are trying to make, which is, there is really no good reason to do this to children of either gender. As a woman, I also believe that men should be given the same rights as girls: to not be subjected to unnecessary surgery before the legal age at which they can consent themselves for any other aesthetic surgery.

You say most women would expect a circumcised penis, but I would argue that any woman not willing to date or have sex with a man because he's uncut is simply not worth dating. I'm sure you have the sense to raise your girls to be happy with their bodies, and not to want to expose themselves to surgical body modifications just to be able to feel accepted and desirable.

Scott said...

Thanks for reading and leaving a comment. You make valid points and I understand where you are coming from.

Honestly, I think writing this post, and then reading everyone's comments and engaging in discussion, has probably ultimately changed my views. I think I can pretty much consider myself opposed to circumcision at this point.

Seth said...

Scott,

I'm curious about the reaction in the hospital now, months later, is. Has there been any change? Is the study still ongoing?

Just curious. You can tweet me @sethedward.

Scott said...

I honestly don't know anything about the study. Actually, I think it's safe to say no one knew the study was even happening until you all brought attention to it.

I've never heard another word about it.

Anonymous said...

The other day I heard the term "unalived" used. Didn't even know the word existed. Why don't they call uncircumcised people homounforeskindecapitatedsapians. Or "Homos" for short. Would be the same concept. Wouldn't it? Make people scared of their kids being homos.
Let me tell you a little story...

You see back in the day, 4 score and fiveskin ago there was a feller by the name of Abraham Lincoln some folks called him honest Abe, because he never told a lie. Even after being threatened by his parents, when the cherry tree mysteriously unalived itself. They were going to cast the ultimate judgement upon him, the punishment of grounding. Abe looked them square in the eyes and said "I didn't do it though. I missed and chopped off my penis head." So Abraham and his family went around using axes to decapitate other boys penises so Abe wouldn't feel uncomfortable around them. But when they relized that the black people were to fast to catch. He said "they're free, the slaves are no longer unamancipated."

So really slavery was only abolished, due to circumcisions.