Infant Male Circumcision

Routine Infant circumcision (RIC) is the most common surgical procedure performed in the U.S. It is a very common misconception that there are many health benefits to infant male circumcision. However, no national medical organization in the world recommends RIC. Infant male circumcision in the U.S. started in the late 1800s. Dr. John Harvey Kellogg (yes, the man who created cornflakes) is who is most notably known for promoting and normalizing RIC as a means to cure masturbation, and as a way to punish people for masturbating. More outrageous claims were made, like that circumcision prevented epilepsy, insanity, schizophrenia and blindness. RIC took off from there, and as time went on, more and more reasons were found to circumcise infant males at birth. The most common reasons you hear for circumcising infants at birth is a reduction in HIV, and to prevent sexually transmitted diseases, and other infections. However, medical literature shows that it is actually the opposite, and circumcision can increase the risk for certain health issues. There are also immediate complications of circumcision such as hemorrhage, infection, surgical mishap and death. In this paper, I will use my ten sources, along with my own personal knowledge to go further into detail on how RIC is not only unnecessary, but that it also causes more harm than good.
The number one reason that people chose to circumcise their newborn babies is because they are under a false assumption that circumcision greatly reduces the risks of HIV, STDs, and other infections; It’s assumed that when a male is intact, that he must be dirty. However this is just not true, infections in intact males do happen, just as females can get infections, but most of the infections such as UTI’s or yeast infections are due to medical misinformation. It is a common thought that when a male is intact, he has to pull the foreskin back to make sure everything is clean, but this is exactly what can cause infections. The penis is self-cleansing just as a vagina is; all you need to do is simply wipe it like a finger with nothing more than water, no soap needed. It is also very painful, the foreskin will naturally retract on its own; the foreskin serves as a protective barrier to the glans (head) of the penis the same as your fingernail protects your nail beds. Forcibly retracting the foreskin to clean irritates the penis, and opens it up to infections. However, it’s also good to note that UTI’s and yeast infections are very easily treated with antibiotics, and that females get more UTIs than men. We would not circumcise a female to protect against infections, so why would we circumcise a male to protect against infections? It is also a common thought that circumcision reduces the risks of STDs and HIV; however, it is actually the opposite, and being circumcised results in more cases of STDs and infections. In the USA, during the AIDS epidemic of the 1980s and 90s, about 85% of adult men were circumcised (much higher rates of circumcision than in Africa), and yet HIV still spread. There is nothing dirty about the normal genitalia of men; every part of our body serves a purpose.
Infant circumcision also does not come without complications. An infant’s foreskin has more than 240 feet of nerves, 20,000 nerve endings, and 3 feet of veins, arteries, and capillaries – circumcision removes all of them, causing the infant tremendous pain. Immediate complications following RIC include botched circumcisions, where the circumcision is performed incorrectly, or too much foreskin is taking off, leading to painful erections later in life, or in some cases amputation of all, or part of the penis. Other complications include death; infants do not have much blood in their bodies as is, if the circumcision is performed incorrectly, and the infant loses too much blood, death can be a result. It is also unknown right at birth if an infant has any type of bleeding disorder. The long-term side effects of RIC include emotion, sexual, and female sexuality effects. PTSD is something we normally associate with military members, but they are not the only ones who can get PTDS. Memory starts from birth, just because someone doesn’t remember something, does not mean that memory had no effect on them psychologically. PTSD is a normal response to an abnormal event. Neonatal genital cutting is an event in which a newborn infant experiences extreme levels of pain, terror, and helplessness, so it fulfills the criteria for PTSD. Circumcision removes more than 50 percent of the normal skin and mucosa from the penis. This skin and mucosa is provided by nature to allow for the expansion of the penis during erection. Circumcision can result in painful erections later in life due to the foreskin being removed. The foreskin also plays a huge role in sexuality; the foreskin provides a natural gliding action that helps with lubrication, when the foreskin is removed, the penis actually pulls lubrications out of the vagina, resulting in drier sex. The foreskin is the most erogenous spot on the penis, it contains up to 20,000 nerve endings; circumcision removes most, if not all of these nerve endings. For an accurate comparison, the female clitoris only has up to 7,000 nerve endings. The glans, commonly known as the “head” of the penis is meant to be an internal organ, so when an infant is circumcised, overtime the glans will become calloused, making sex less pleasurable. This is by no means saying that sexual intercourse is still not enjoyable by men, however, without their foreskins, men are missing out on more pleasure than they already do get.
The foreskin is an erogenous sexual organ that serves many functions; it is not just a “flap of skin” as some would say. It is estimated that the foreskin has upwards of twenty functions, some of the most important ones being immunological functions. Just as the eyelid protects the eye, the foreskin protects the glans, keeping its surface soft, moist, warm and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. Just like the vagina, the foreskin is a self-cleansing sexual organ. The urinary meatus (the opening of the glans through which urine and semen flow), is an entry point into the body. From infancy to adulthood, the foreskin protects the glans and urinary meatus from contaminants of all kinds. During childhood, the foreskin is also usually firmly attached to the glans to prevent contaminants from getting into the urethra. The neck of the foreskin places the vulnerable urinary meatus at a distance from the external environment and defends it against contaminants. The fusion of the foreskin and glans and the nonexpandability of the foreskin in the child’s penis are therefore necessary for the health of the child. Even after the foreskin separates from the glans and becomes retractable, which is usually around puberty, it continues throughout life to cover the glans and meatus in order to protect from dirt, contamination, abrasion, or bacterial invasion. The mucous membranes that line all body orifices are the body’s first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme. Lysozyme is also found in tears and mother’s milk. Specialized epithelial Langerhans cells are found in the foreskin’s outer surface. Plasma cells in the foreskin’s mucosal lining secrete immunoglobulin’s, antibodies that defend against infection. Rigorously controlled studies have also demonstrated that the foreskin plays a protective role in shielding the rest of the penis and thus the rest of the body from the contagion of common sexually transmitted diseases encountered during sexual activity. To help fight harmful bacteria, the foreskin has a rich flora of beneficial bacteria. Friendly bacteria exist within the body and are found on all body surfaces and throughout the gastrointestinal, genitourinary tract (the urinary system that runs from the kidneys, through the bladder, and out the penis), and the mouth. Friendly bacteria also thrive in the eyes. Without the presence of friendly bacteria, the human body would be vulnerable to attack from all kinds of bacteria.

The good bacteria that live in the inside of the foreskin are similar to the bacteria found in the mouth, nose, the female genitals, and the skin in general. This good bacteria is both harmless and highly beneficial; without this friendly bacteria, the urethra would become an easy entry point for germs and harmful stains of bacteria, which could cause disease.
Circumcision is not as prevalent as one might think; 85% of the world is not circumcised. So surely, if not being circumcised can lead to so many problems, that number would be much, much lower. The United States Centers for Disease Control and Prevention (CDC) released new statistics at the International AIDS 2010 conference in Vienna, Austria. The new statistics showed a steep drop in the number of circumcisions performed in the United States. The CDC data showed that the incidence of circumcision declined from 56 percent in 2006 to 32.5 percent in 2009. According to these statistics, non-circumcision or genital integrity has become the normal condition among newborn boys in the United States. In the Muslim World, circumcision is almost universal, as well as parts of South East Asia, and parts of Africa. However, everywhere else in the world the rates are either very low, or completely non-existent unless medically necessary. In Europe, circumcision rates are so low, that it is seen as a horrible, barbaric surgery to have done, and even suggesting it to someone who is from Europe will be sure to get you a lot of strange looks. It really says a lot that besides America, no other first world country practices circumcision, and the main reason that those countries due circumcise are because of religion.
Many infants are circumcised under the guise of religion, when in reality the only two religions that believe in circumcision as a necessary custom are Judaism and Islam. For the Jewish, circumcision is a commandment from God (in the Old Testament), which is a sacrifice of flesh to honor the covenant between God and the chosen people. Jewish boys are circumcised 8 days after birth. For Muslims, circumcision is a cultural tradition that recognizes them as descendants of Abraham, and also a rite of passage from childhood to manhood. Muslim boys usually get circumcised sometime before puberty. However, Christianity, and any other religion that follows The New Testament, is forbidden to circumcise. The bible (New Testament) refers to circumcision as mutilation and clearly says that any Christian who practices circumcision has put no faith in Jesus Christ for salvation. It is also important to note, that circumcising an infant because it’s your religion, is violating that babies freedom of religion. That baby may grow up to practice another religion, or they may grow up and be an atheist, the choice to make religious decisions regarding someone’s body should be left up to the person who owns the body.
Routine Infant Circumcision is unconstitutional on the basis of the Equal Protection clause of the 14th Amendment. Female circumcision was made illegal in 1996; therefore, it is unconstitutional to not extend the same courtesy to males born from that time on. Many will say that female circumcision is not the same as male circumcision, but female circumcision is very comparable to male circumcision. There are four types of female circumcision, most people who think of female circumcision only think of the fourth type, where the entire vagina is sewn shut. However, that is the least common type, the most common type being just a prick to the clitoris, and the second most common type being just the tip of the clitoris being cut off. The reasoning for female circumcision is very similar to male circumcision. It is said to be more hygienic, and reduce disease. Also, the way female circumcision is viewed where the most common types are performed, is the same way Americans view it. They say it is just the normal thing to do, it is cleaner, everyone does it, and it is weird not to do it. RIC also goes against a doctors Hippocratic Oath, which states, “First, do no harm” circumcising a newborn male, for no medically indicated reason is harming that infant. Unnecessarily invasive procedures should not be used where alternative, less invasive techniques are equally efficient and available. It is important that doctors keep up to date and ensure that any decisions to undertake an invasive procedure are based on the best available evidence. Therefore, to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and unnecessary. Unless the circumcision is medically necessary, performing it is purely cosmetic. It is a violation of basic human rights; no one should have parts of their bodies amputated off without their consent unless medically necessary. If a male wants to be circumcised later in life, which is doubtful, then that decision should be his, and his only. Everyone, be they male or female, has the right to bodily integrity.
Routine infant circumcision is a major problem in society today. It is by definition, male genital mutilation; what are we teaching our boys when at only a few hours old, we amputate a perfectly healthy, normal sexual organ with many functions? Many reasons are given to circumcise, be they for health reasons, religion, or culture, as is seen in America. But throughout this literature review, many reasons have been provided showing the adverse effects circumcision can have, immediately, and further on in a males life. It is time that America breaks out of its bubble, and explores what the rest of the developed nations are doing. No medical organization in the world recommends circumcision, and in Europe it is heavily frowned upon and finding a doctor to even do it without medical cause would be very difficult.

References

Dekkers, W. (2009). Routine (non-religious) neonatal circumcision and bodily integrity: A transatlantic dialogue. Kennedy Institute of Ethics Journal, 19(2), 125-46. Retrieved from http://search.proquest.com/docview/217107843?accountid=10189

Narvaez, D PhD. (2011, Sep 11) Myths about Circumcision You Likely Believe. Retrieved from https://www.psychologytoday.com/blog/moral-landscapes/201109/myths-about-circumcision-you-likely-believe

Narvaez, D PhD. (2011, Sep, 13) More Circumcision Myths You May Believe: Hygiene and STDs. Retrieved from https://cdn.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds

R.S. Van Howe. (1999, Jan, 10) Does circumcision influence sexually transmitted diseases?: A literature review. BJU International, 52-62. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410x.1999.0830s1052.x/epdf

Frisch, M., Lindholm, M., & Gronbaek, M. (2011). Male circumcision and sexual function in men and women: A survey-based, cross-sectional study in Denmark. International Journal of Epidemiology, 1367-1381. Retrieved from http://ije.oxfordjournals.org/content/early/2011/06/13/ije.dyr104.abstract
Fox, M., & Thomson, M. (2010). HIV/AIDS and circumcision: Lost in translation. Journal of Medical Ethics, 798-801. Retrieved June 23, 2015. Retrieved From http://jme.bmj.com/content/36/12/798.abstract
Boyle, G., Goldman, R., Svoboda, J., & Fernandez, E. (2002). Male Circumcision: Pain, Trauma and Psychosexual Sequelae. Journal of Health Psychology, 329-343. Retrieved from http://hpq.sagepub.com/content/7/3/329.short

Bronselaer, G., Schober, J., Meyer-Bahlburg, H., T’sjoen, G., Vlietinck, R., & Hoebeke, P. (2013). Male circumcision decreases penile sensitivity as measured in a large cohort. BJU International BJU Int, 820-827. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23374102

Green, L., Travis, J., Mcallister, R., Peterson, K., Vardanyan, A., & Craig, A. (n.d.). Male Circumcision and HIV Prevention. American Journal of Preventive Medicine, 479-482. Retrieved from: http://www.ajpmonline.org/article/S0749-3797(10)00439-3/abstract

Fleiss, P., Hodges, F., & Howe, R. (n.d.). Immunological functions of the human prepuce. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1758142/

Complications of circumcision in male neonates, infants and children: A systematic review. (n.d.). Retrieved from http://www.biomedcentral.com/1471-2490/10/2
The Case Against Circumcision. (n.d.). Retrieved from http://www.mothersagainstcirc.org/fleiss.html