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Key points
- The foreskin is half of the penis' skin — 15 square inches in an adult man.
- Only 45% of doctors who do circumcisions use any anesthesia at all.
- Circumcision has an array of risks and side effects, including meatal stenosis (the narrowing of the urethra).
When I was pregnant with my first child, I just thought that circumcision was what you did, no big deal, and that every man was circumcised. Then one day I saw a picture of a baby being circumcised, and everything changed. Just one tiny, grainy photo was enough to make me want to know more.
Myth: They just cut off a flap of skin.
Reality check: The foreskin is half of the penis's skin, not just a flap. In an adult man, the foreskin is 15 square inches of skin. In babies and children, the foreskin is adhered to the head of the penis with the same type of tissue that adheres fingernails to their nail beds. Removing it requires inserting a blunt probe between the foreskin and the head of the penis and then cutting down and around the whole penis.
Myth: It doesn't ever hurt the baby.
Reality check: In 1997, doctors in Canada (Lander 1997) did a study to see what type of anesthesia was most effective in relieving the pain of circumcision. As with any study, they needed a control group that received no anesthesia. The doctors quickly realized that the babies who were not anesthetized were in so much pain that it would be unethical to continue with the study. Even the best commonly available method of pain relief studied, the dorsal penile nerve block, did not block all the babies' pain.
Myth: My doctor uses anesthesia.
Reality check: Not necessarily. Most newborns do not receive adequate anesthesia (Stang, 1998). Only 45% of doctors who do circumcisions use any anesthesia at all. Obstetricians perform 70% of circumcisions and are least likely to use anesthesia—only 25% do. The most common reasons why they don't? They didn't think the procedure warranted it, and it takes too long (Stang 1998).
Myth: It can't cause the baby long-term harm.
Reality check: Circumcision has an array of risks and side effects. There is a 1-3% complication rate during the newborn period alone (Schwartz 1990). Here is a short list of potential complications. See Goldman (1997) for a thorough discussion.
Meatal Stenosis: This is a narrowing of the urethra which can interfere with urination and require surgery to fix.
Adhesions. Circumcised babies can suffer from adhesions, where the foreskin remnants try to heal to the head of the penis in an area they are not supposed to grow on.
Buried penis. Circumcision can lead to a trapped or buried penis—too much skin is removed, and so the penis is forced inside the body.
Infection. The circumcision wound can become infected.
But, you say, aren't there important health benefits? See this post.
Note: Primary author is Lillian Dell'Aquila Cannon
References
Anand et al., "Can Adverse Neonatal Experiences Alter Brain Development and Subsequent Behavior? Biol Neonate 77 (2000): 69-82.
Bollinger, D. "Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths," Thymos: Journal of Boyhood Studies Volume 4, Number 1 (2010).
Boyle, G.,et al., "Male Circumcision: Pain, Trauma, and Psychosexual Sequelae," Journal of Health Psychology 7 (2002): 329-343.
Goldman, R. (1997). Circumcision, The hidden trauma: How an american cultural practice affects infants and ultimately us all. New York: Vanguard
Hammond, T., "A Preliminary Poll of Men Circumcised in Infancy or Childhood," BJU 83 (1999): suppl. 1: 85-92. Goldman, R., "The Psychological Impact of Circumcision," BJU 83 (1999): suppl. 1: 93-102.
Lander, J. et al., "Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision," JAMA 278 (1997): 2157-2162.
Ramos, S., & Boyle, G. J. (2001). Ritual and medical circumcision among Filipino boys: Evidence of post-traumatic stress disorder. In G. C. Denniston, F. M. Hodges, & M. F. Milos (Eds.), Understanding circumcision: A multi-disciplinary approach to a multi-dimensional problem (pp. 253–270). New York: Kluwer/Plenum.
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York: W.W. Norton.
Schwartz, William M., MD et al., PEDIATRIC PRIMARY CARE: A Problem-solving Approach, 2nd Edition, Year Book Medical Publishers, Inc., 1990, pp. 861-862.
Stang, H. et al., "Circumcision Practice Patterns in the United States," Pediatrics Vol. 101 No. 6 (1998): e5.
Taddio A, et al., "Effect of neonatal circumcision on pain response during subsequent routine vaccination." Lancet 1997;349(9052):599-603.
Van der Kolk, B. (2014). The body keeps the score. New York: Penguin.
Van Howe, R., "Variability in Penile Appearance and Penile Findings: A Prospective Study," BJU 80 (1997): 776-782.
Van Howe, R., "A Cost-Utility Analysis of Neonatal Circumcision," Med Decis Making, December 1, 2004; 24(6): 584 - 601.
