foreskin should stay
Dr. Mark D. Reiss, M.D.
Executive VP, Doctors Opposing Circumcision
"Circumcision is unnecessary,
traumatic, harmful, and risky, and really shouldn’t be performed at
No health benefits
All of the “health” reasons
for circumcision have been debunked. As far as urinary tract infection
prevention, we live in the age of antibiotics. Even if there’s an
infection, simply take a few antibiotics. There’s just no reason to
cut off a normal healthy piece of tissue that can be treated by more
The current disease of the
decade is HIV, which is certainly a monumental crisis but really pertains
more to the epidemic in Africa. And, unfortunately, circumcision has
been touted as a preventative method. The best way to deal with the
HIV epidemic is simply by normal hygiene, safe sex, and condoms. And
where did the HIV crisis begin? In the San Francisco bay, within the
gay male population. Probably 90 percent of them were circumcised, and
it didn’t prevent them from getting AIDS.
There are countless reasons
not to circumcise. First, it’s an extraordinarily painful operation.
People may say it’s just a cut, but let no doubt creep into your mind
-- it is surgery. Even with a local anesthetic, there’s still some
pain. And once it wears off, you have a real wound and it’s very painful.
Studies show newborns feel pain more acutely than adults. Their blood
pressure goes off the charts during circumcision, and steroid levels
get extremely high. These are definite indicators of trauma.
Lasting traumatic memory
It used to be thought that
babies didn’t feel anything during circumcision because the memory
banks didn’t exist yet. Well, there’s a good deal of evidence now
showing while they may not remember it in their conscious mind, the
emotional trauma is stored somewhere deep in the primitive part of the
brain. It’s an extraordinarily painful and traumatic experience, and
the memory will linger somatically.
Decreases penile sensitivity
There’s a belief that the
foreskin is just a vestigial organ without use, a dead piece of flesh.
Well, organs are there for a reason. The foreskin has the most erotigenically
sensitive nerve endings of the entire body. In circumcised men, the
circumcision scar is almost uniformly the most sensitive part of the
penis. The foreskin has an incredible number of very pleasurable sensations
that anyone who’s lost it will never get to experience. Men circumcised
as adults almost uniformly say that sensation fell dramatically afterward.
Risk of complications
There’s no surgical operation
that doesn’t carry risks and problems. Severe bleeding can occur,
and every year babies actually die due to the procedure. The numbers
aren’t clear because circumcision doesn’t appear as the primary
cause of death, but it does happen. There are also chronic complications
that might appear later. Approximately 50 percent of the newborn penis’
skin is removed during circumcision, and if too much is taken, there
can be erectile dysfunction and sex problems. The foreskin is made to
accommodate an erect penis, but if there isn’t enough slack tissue
left, erections can be very painful. And, if the scar isn’t symmetrical,
the penis can bend so acutely when erect -- almost at a right angle
-- that sex isn’t possible.
Human rights violation
Many people also feel circumcision
violates human rights when a parent to decide to cut off a normal healthy
body part of a minor. People argue with that by saying parents have
to make healthy decisions like immunizations. Sure. That’s not cutting
off a healthy body part. If people starting saying that to prevent breast
cancer we should cut off newborn girls’ breasts, there’d be an outcry.
Foreskin retracts naturally
In medical school, all the
penis drawings are uncircumcised. Even now, most doctors don’t know
how to deal with the foreskin. They tell the parents to pull it back,
to clean it, to look at it -- and all this is totally untrue. When a
baby is born, the foreskin is attached, and this is normal. The penis
head is sensitive and was meant to be an internal organ -- the foreskin
protects it. Over time, the foreskin will retract on its own. It’s
a misunderstanding that it’s supposed to retract by age three or four.
Research has shown that 10 is the mean age for retraction, and some
boys don’t retract fully until adolescence. I spend half of my time
dealing with parents whose baby boys had their trauma forcefully retracted,
causing pain, trauma, and scarring.
Leave penises intact
I use the term “intact”
in place of “uncircumcised.” I don’t like “uncircumcised”
because it implies circumcision is the norm. We of the genital integrity
movement want people to think of the male penis as whole and normal,
a natural and intact organ."
Dr. Mark Reiss, M.D., is Executive Vice President of Doctors Opposing Circumcision
snip the skin
Dr. Edgar Schoen, M.D.
Former Chair, AAP Circumcision Task Force
"Circumcision is a very valuable
preventative health measure with multiple medical benefits.
Protects against UTIs
An uncircumcised male has 10
times the risk of contracting a severe urinary tract infection in the
first year of life. UTIs aren’t bladder infections; they’re potentially
fatal kidney infections accompanied by high fevers and bloodstream infections.
And they’re most dangerous
in the first year because the kidneys aren’t fully developed. And sure,
you can give them an antibiotic, but in half of severe UTI cases,
evidence of scarring remains in the kidneys. So, you don't want to
wait until the child is older to circumcise, because a lot of the
disorders it protects against occur during infancy and childhood.
Sterile urine samples
When you see a young baby that
has a very high fever, one thing you immediately think of is a UTI.
To rule it out, you need a sterile urine sample. A circumcised penis
gives sterile urine naturally, but because of bacteria under the foreskin,
an uncircumcised penis doesn’t. So, for a proper workup, you need
to tranquilize the baby and pass a tube in, and it becomes an invasive
procedure just to get a sample.
Improved hygiene & skin
Local problems are also a concern
for uncircumcised boys. Two to three percent will have an infection
of the foreskin in the first three or four years. There’s also risk
of phimosis, which is the permanent inability to retract the foreskin
and occurs in about 1/2 to 1 percent of uncircumcised boys. Local infections
and skin disorders like eczema are twice as likely when boys aren’t
circumcised. And there’s genital hygiene, of course. People say just
a little soap and water will keep an uncircumcised penis clean, but
studies show that uncircumcised boys and men generally have poorer genital
There are also sexual advantages.
Those opposed to circumcision say you need to foreskin for sex, but
this doesn’t make sense. Sex is very complex -- it starts with hormones
in the brain, and it just wouldn’t make sense if the foreskin had
anything to do with it. In studies that compare sexual satisfaction
before and after adult circumcision, there’s no difference in pleasure.
In fact, the opposite appears true. A study found that due to the hygiene
factor, circumcised men had more varied sexual activities and were more
likely to receive oral sex. Women prefer sex with circumcised men because
of the better cleanliness and smell.
Right now, what’s getting
the most attention is HIV prevention. At 60 to 70 percent effectiveness
in prevention, it’s like some vaccines. Uncircumcised men are also
about three times as likely to harbor HPV, which causes both penile
and cervical cancer. Almost 100 percent of penile cancer cases are in
uncircumcised men. And the risk of cervical cancer doubles in female
partners of uncircumcised men. Circumcision also protects against other
STDs, particularly Chlamydia (one of the most common STDs in American
teens and a cause of infertility). It’s twice as common in women who
have sex with uncircumcised men.
Benefits outweigh risks
Circumcision is an operation,
so there’s always risk of surgical complications. But if it’s performed
by an experienced operator, the risk of complication is about one in
three hundred. And even if there is
bad work performed, these complications are usually minor. In terms
of benefits versus risks, there’s just no contest.
Prevention, not abuse
There’s the argument that
circumcision violates newborn rights. But does that really make sense?
We’re talking about something that has significant benefits, just
like immunizations. You can’t ask
a baby if he wants it, and if you ask when he’s a toddler, he’d
say no. The parents make the decisions. We’re talking about a preventative
health measure here, not abuse."
Dr. Edgar Schoen, M.D., author of Ed Schoen on Circumcision, is a Clinical Professor of Pediatrics Emeritus at UC-San Francisco, spent 24 years as Chief of Pediatrics at Kaiser Permanente in Oakland and was Chairman of the American Academy of Pediatrics' 1989 Task Force on Circumcision.