Researching Circumcision, Part 2: What Is Circumcision?
This article is the second in a series I am writing to help expectant parents get a jump start on their research about circumcision. Please check back next Monday for the final article in this series. Part one discussed the foreskin and its normal, necessary functions. Part two is on the circumcision procedure: what it removes, how it is performed, and what the short- and long-term consequences are. Part three will present information on many of the common concerns parents have when considering circumcision (including an examination of the research on STD’s, cancer, and other health issues).
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What is Circumcision?
Before parents choose circumcision, they should take the time to learn exactly what this procedure entails.*
What Circumcision Removes
Circumcision removes up to 80% of the penis’s skin. “Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings. The foreskin’s muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.” (1)
How Circumcision Removes the Foreskin
The following description of circumcision is extremely difficult to read (and the clickable images are hard to view), but it is easier to read and see than it is to experience. Again, before parents choose to circumcise their baby, they must know exactly what is going to happen.
[L]et’s examine how a typical medical circumcision is performed. First the child, after 9 months in the fetal position, is tied down spreadeagled and straight-backed in a circumstraint, a plastic board molded to the outline of an infant’s body, which is equipped with velcro straps. Next he is covered with a sheet which has a hole through which his penis is threaded. Then his penis is thoroughly swabbed with sterilizing solution. Naturally, this frequently provokes an erection. Some physicians deliberately provoke erections in order to judge the “cutoff line” and to aid in the surgery itself. In any case, in the infant’s brand new, wide-open, pre-verbal consciousness, this is his first sexual experience: a torturous nightmare.
Because the foreskin of an infant is attached to the head of the penis by the same tissue that bonds a fingernail to a finger, it must be skinned away before it can be cut off. So the doctor forces a metal probe between the foreskin and the head and tears apart this flesh (called synechia) which bonds them together. Next, the doctor has several options for the actual amputation. One commonly used device for this step is called a gomco clamp. This essentially functions as a thumbscrew for the foreskin. . . . Surgical scissors are used to cut a slit along the length of the foreskin in order to insert the metal “bell” which serves as one jaw of the clamp. The foreskin is pulled over the bell and the other jaw of the clamp is attached. Then, by tightening a screw, the foreskin, one of the most densely innervated tissues of the body, is audibly crushed along two lines (inner and outer foreskin) around its circumference. (Since all the nerves of the foreskin pass through this crush line, the pain perception may be similar to that of putting virtually the entire erogenous surface of the penis in a vise.) The clamp is left on for a few minutes to promote blood clotting, then the foreskin is cut off at the crush line. Afterwards, the raw, bleeding, formerly internal organ is wrapped in bandages and a diaper, and then repeatedly burned with urine and its breakdown product, ammonia, and exposed to infectious fecal matter while healing. . . .
It wasn’t until 1978 that researchers even suggested using anesthetic during circumcision, and [as late as 1999, the AMA reported that] most medical circumcisions are performed without anesthesia . . . . This is in stark contrast to what is known about infant pain perception and its profound and lasting effects on the victim, as well as the plainly obvious reaction of the infant boy, who forcefully communicates his torment to anyone who will look and listen. Choking and breathing problems arise due to the continuous screaming. Surges in adrenaline and cortisol and large increases in heart rate, all established physiological indicators of torture, have been measured. Some babies appear to go into shock. Later, problems with sleep, mother-child bonding and breastfeeding, and increased sensitivity to stress and pain are all commonly seen after [circumcision (also referred to as male genital mutilation or "MGM")]. To all appearances, the infant is left in a state of post-traumatic stress. (2)
The Short-Term Consequences of Circumcision
Circumcision is “an extremely painful, distressing, traumatic, and exhausting experience for a newborn male infant.” Because it is so emotionally and physically stressful, it has documented negative effects. These include:
1. Circumcision affects sleep: “Circumcision disrupts the baby’s normal sleep patterns.” (3) “Routine circumcision, done without anesthesia in the newborn nursery was usually followed by prolonged non-rapid eye movement (NREM) sleep. . . . We consider its increase to be consistent with a theory of conservation-withdrawal in response to stressful stimulation.” (4)
2. Circumcision can affect bonding with caregivers: “Post-operatively, the circumcised infant is in pain and is in an exhausted, weakened, and debilitated condition.” Consequently, circumcised babies may withdraw, which interferes with the normal process of bonding with his mother, father, or other caregivers.
3. Circumcision interferes with the breastfeeding relationship: Because circumcised males are in such pain for an extended period after this stressful procedure, studies have shown that some babies are simply unable to suckle at their mother’s breast. Mothers who refuse to allow this procedure have a better chance at establishing a healthy breastfeeding relationship. (5)
4. Circumcision is painful: Circumcision leaves an open, raw wound for weeks. The newborn’s surgically exposed glans is re-injured by abrasion and contaminants because it is encased in diapers (including the baby’s own feces and urine, which breaks down into ammonia). Disposable diapers themselves are also often irritants, because they are laden with chemicals, dyes, and fragrances that cause further pain.
5. “Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500. These complications include uncontrollable bleeding and fatal infections.” (6)
The Long-Term Consequences of Circumcision
Aside from the immediate psychological and physical effects on the traumatized newborn, there are also long-term consequences.
1. Circumcision desensitizes: The foreskin’s rich nerve network of more than 20,000 nerve endings provides incredible sensitivity – even more than the glans itself. Circumcision amputates these nerve endings, which not only takes away that pleasure source, but the constantly exposed glans becomes even more desensitized with time and constant exposure to diapers and clothing. The glans actually keratinizes (much like the fibrous tissue found in hair or fingernails).
2. “Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft.” Additionally, the surgically exposed glans is left without “the protection and emollients of the foreskin,” which makes it dry and “susceptible to cracking and bleeding.”
3. “Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft” and often tears pieces of the glans itself off. “Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection. The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.”
4. “Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar.” This interruption of normal blood flow can ultimately obstruct the flow of urine.
5. “Circumcision harms the developing brain: [Scientific studies have demonstrated] that circumcision has long-lasting detrimental effects on the developing brain, adversely altering the brain’s perception centers. Circumcised boys have a lower pain threshold than girls or intact boys.” There is evidence “that circumcision can cause deeper and more disturbing levels of neurological damage, as well.”
6. “Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither [is] a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.
The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped proto-mucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.
Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.”
7. Circumcision has other health consequences: As will be discussed in part three of this series, circumcision has other health consequences, and it “does not prevent acquisition or transmission of sexually transmitted diseases (STDs).” (7)
There is no National or International Public Health Authority in the Western World Which Advocates for Routine Infant Circumcision (8)
If you or someone you know is considering circumcision for a newborn, please take time first to research. We owe it to our children to make thoughtful, ethical decisions for them. The links below lead to more information on this procedure.
10 Out of 10 Babies Agree (A “Scrubs” clip & related video; viewer discretion advised, but parents – please do not look away)
Birth as we Know it: Circumcision (Infant male circumcision video clip from the documentary film “Birth As We Know It” by Elena Tonetti-Vladimirova; viewer discretion advised)
Circumcision: A Photo Essay (this is tragic to look at, but parents who are considering this unnecessary medical procedure need to see what they would be subjecting their infants to)
Penn & Teller on Circumcision (a series of videos by Penn & Teller on circumcision – I’m not sure how they managed to get a laugh out of me while I had tears streaming down my face, but they did)
Plastibell Infant Circumcision (an alternative to the Gomco Clamp described above)
*Posts that describe circumcision may be particularly uncomfortable/painful to read if you are a parent of a circumcised boy. It is not my intention to make these parents feel judged, ostracized, or demonized. The sad fact is, circumcision has been the norm in our culture – parents have not been expected, nor do many even think about, seeking information on leaving their sons intact. If you are the parent of a circumcised boy and you regret the decision to circumcise, you can help bring about change for future generations. Speak out. Donate to organizations that spread the word about the benefits of staying intact. Forward this article on to expectant parents. Do not let ignorance result in more needless circumcisions. And thank you for reading this information with an open heart. It’s tough to have any parenting decision questioned, but reevaluating our decisions and beliefs is part of growing and maturing.
(1) Fleiss, Paul, M.D., “The Case Against Circumcision,” http://www.mothersagainstcirc.org/fleiss.html
(2) Winkel, Rich, “Male Circumcision in the USA: A Human Rights Primer,” http://www.math.missouri.edu/~rich/MGM/primer.html#fn73
(3) “Position Statement: The Effects of Circumcision on Breastfeeding,” http://www.nocirc.org/statements/breastfeeding.php
(4) “Circumcision vs Breastfeeding,” http://www.circumstitions.com/Docs/nursing.pdf
(5) Position Statement: The Effects of Circumcision on Breastfeeding
(6) The Case Against Circumcision; see also “Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 4: The Immediate Complications of Circumcision,” http://www.doctorsopposingcircumcision.org/DOC/statement04.html
(7) The Case Against Circumcision; see also Garcia, Francisco, “What Exactly is Circumcision and What is it Not?,” http://www.cirp.org/library/anatomy/garcia/; see also “Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 6: Long-Term Adverse Effects of Circumcision,” http://www.doctorsopposingcircumcision.org/DOC/statement06.html
(8) “The Medical Basis for Child Circumcision,” http://www.fathermag.com/health/circ/
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"Researching Circumcision, Part 2: What Is Circumcision?"
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