Circumcision: Medically Necessary or Unnecessarily Intrusive?

by Siobhan. E. Brown

Circumcision: Medically Necessary or Unnecessarily Intrusive?

 There are few medical discussions that cause heated debate quite like Circumcision. Some parents choose the procedure because they believe it is medically necessary, decreasing their child’s chances of contracting STD’s and keeping their bodies more hygienic.  Some parents circumcise their children in order to conform or because they support social, cultural or religious norms within their community. Other parents refuse the procedure believing instead that it is medically risky, unnecessarily painful, and/or removes another human being’s ability to choose what to do with their own bodies.

 

What Exactly is Circumcision? 

During the procedure the male foreskin is surgically removed from the penis. The procedure is usually done within the first two days of a babies life. The procedure takes about ten minutes and requires approximately one week to heal.

  

The Hygiene Debate:

Some parents believe that circumcision allows the penis to be cleaned more easily and is therefore more hygenic. In babies and young boys, prior to foreskin retracting on it’s own, the foreskin is tightly fused to the head of the penis, in order to keep germs out without preventing the baby or child’s ability to urinate. Between the ages of 3 and puberty the foreskin separates on its own. For intact (males who have not been circumcised) males the foreskin should never be forcibly retracted (pulled back) in order to clean under it as this can cause physical damage. Proper cleaning of babies and boys peniscan be done relatively easily by simply washing with water and a gentle soap on the outside of the penis (only what is seen).

 

Clinical Findings:

According to Dr. Lida Farid Family Physician at Parkway Health,”Multiple studies demonstrate health benefits associated with circumcision. These include reduced risk of urinary tract infections in infants, reduced risk of penile cancer, and reduced risk of sexually transmitted diseases including HIV in heterosexual men.  Although these health benefits are widely accepted by the medical community, the American Academy of Pediatrics is still recommending against neontal circumcision as they feel that there is not enough scientific evidence to recommend it to the general population routinely.”  

When looking through medical findings and clinical websites, some reports are strongly in favor of circumcision, claiming that the procedure reduces the risk of males contracting STD’s, UTI’s and Penile Cancer. Other health care practitioners give the procedure a more lukewarm review, claiming that the supposed benefits do not warrant mandating the practice.  

“There are some potential medical benefits of circumcision in terms of a slightly lower risk of urinary tract infections (UTIs) in little boys, certain sexually transmitted infections in men, and penile cancer. However, all of these problems are uncommon (for example, only about 1% of all boys will have a UTI), so lowering the risk of an uncommon problem isn’t a huge benefit.” (WebMD)

 

Cultural Differences:

 

According to Wikipedia the practice of circumcision varies widely depending upon which country is being looked at. “An estimated one-third of males worldwide are circumcised. The procedure is most common in the Muslim world and Israel (where it is near-universal for religious reasons), the United States, and parts of Southeast Asia and Africa. It is relatively rare in Europe, Latin America, parts of Southern Africa, and most of Asia”

Dr. Yang at Renai Hospital also notes that there are cultural differences in how circumcision is viewed in the West and East. According to Dr. Yang, in China this procedure was not openly discussed in the past and there was a great deal of secrecy surrounding it. “Patients were provided very little information on this procedure, neither encouraged or discouraged by their health care practitioners to pursue this for themselves or their children. As Chinese tourists traveled abroad and/or met foreigners within Shanghai they have learned more about circumcision and the potential benefits, including reduced risk of bacterial infections.”

When speaking with Dr. Farid, she notes that within her clinical practice she has seen vast cultural differences in how the Chinese and the North American expat in particular, view circumcision. “Parents often make a decision to electively circumcise their sons based on their own religious and cultural beliefs. While in China this practice is quite common among the Muslim population, it is quite rare among the general population (around 2.7%). In contrast, the latest data in the US shows the prevalence of circumcision among adult males is around 79%. A study in 2014 studying the attitudes of adult males in China and its implications in preventing HIV found that over 80% of participants found the topic of circumcision unfamiliar and culturally sensitive and felt that being uncircumcised had not created significant health drawbacks for them or other males they knew.”

 

The Risks Associated with Circumcision: 

 

(Resource WebMD) 

                   Pain

                   Risk of bleeding, adhesion and infection at the site of the circumcision

                   Irritation of the glans

                   Increased risk of meatitis (inflammation of the opening of the penis)

                   Risk of injury to the penis

 

 

Conclusion 

Choosing to subject a newborn to a painful medical procedure, without their ability to consent, many would argue, is an ethical, if not a human right’s issue, worthy of further examination and debate. Regardless of our views, this conversation should continue, and health practitioners should encourage parents to educate themselves on the pros and cons of the procedure before making a decision on behalf of their children. Without clear cut universal support of the practice the decision is and continues to be, a family one.

  

 

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