Monday, October 15, 2012

Presentation

On August 27th, 2012, the American Academy of Pediatrics (AAP) released their most recent "Policy Statement on Circumcision and Technical Report" stating that the "heath benefits of circumcision outweigh the risks". They also indicate that "male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction". Further reading of their statement indicates that "the medical benefits alone may not outweigh these other considerations for individual families", and yet they conclude that "the preventive and public health benefits associated with newborn male circumcision warrant third-party reimbursement for the procedure".

In contrast, the Royal Dutch Medical Association (KNMG) on their "Viewpoint on Non-Therapeutic Circumcision of Male Minors" states that "these days, more critical articles are being published about circumcision. These articles point to the rights of children, the absence of medical benefits and the fact that this is a mutilating intervention that regularly leads to complications and can cause medical and psychological problems, both at a young and a later age".

On their viewpoint, they later indicate that "In response to the possible medical benefits, a large number of complications resulting from circumcision are described: infections, bleeding, sepsis, necrosis, fibrosis of the skin, urinary tract infections, meningitis, herpes infections, meatisis, meatal stenosis, necrosis and necrotising complications, all of which have led to the complete amputation of the penis. Deaths have also been reported. The AAFP estimates the numberof deaths as 1 in 500,000. That would mean that in the United States, two children die each year as a result of the intervention."

 Regarding the sexual effect of circumcision, the KNMG says "Another part of this argument says that NTC does not affect male sexuality. The foreskin is regarded as a part of the body that has no function at all in male sexuality. Many sexologists contradict this idea: in their view, the foreskin is a complex, erotogenic structure that plays an important role ‘in the mechanical function of the penis during sexual acts, such as penetrative intercourse and masturbation’.49 The many attempts by men to restore their foreskins by mechanical or surgical means also contradict the idea that the foreskin is a useless part of the body."

The KNMG concludes their viewpoint with several points, including:

  • There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene. Partly in the light of the complications which can arise during or after circumcision, circumcision is not justifiable except on medical/therapeutic grounds. Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy himself can decide about the intervention, or can opt for any available alternatives.
  • Contrary to what is often thought, circumcision entails the risk of medical and psychological complications. The most common complications are bleeding, infections, meatus stenosis (narrowing of the urethra) and panic attacks. Partial or complete penis amputations as a result of complications following circumcisions have also been reported, as have psychological problems as a result of the circumcision.
  • Non-therapeutic circumcision of male minors is contrary to the rule that minors may only be exposed to medical treatments if illness or abnormalities are present, or if it can be convincingly demonstrated that the medical intervention is in the interest of the child, as in the case of vaccinations.

And with a call to restrict non-therapeutic circumcision of minors as much as possible.

A recent Global Survey of Circumcision Harm was focused on exposing the complications that frequently arise from infant circumcisions, ranging from mild cosmetic issues such as skin tags, to medium issues such as skin bridges (sometimes called "adhesions" by doctors) to more severe scarring of the glans, buried penis, denudement of the penis and even partial glans amputation.

However upsetting these complications can be, even the most successful circumcision always causes damage. There is damage inherent in removing healthy erogenous tissue and changing the functions of the penis. The human body is capable of adapting to different situations, so the body normally compensates for the lack of foreskin by changing some behaviors, which is why many people are not aware of being affected by their circumcision.

This is even reinforced by Douglas Diekema, bioethicist of the Task Force on Circumcision of the AAP who said: "Ultimately, we don't have any good data. Circumcised men may experience sex differently than uncircumcised men -- intuitively that makes sense -- but it's simply not the case that we have an epidemic of uncircumcised men that don't get pleasure or can't function sexually." It is however a fact that thousands of men are undergoing non-surgical foreskin restoration in an attempt to recreate their foreskin and improve their sexual life, as it can be seen in the Foreskin Restoration Forum http://www.foreskin-restoration.net/

Diekema also stated in an interview that circumcision "does carry some risk and does involve the loss of the foreskin, which some men are angry about. But it does have medical benefit. Not everyone would trade that foreskin for that medical benefit. Parents ought to be the decisionmakers here". Please note that if not everyone would trade the foreskin, parents making the decision are not giving the infant the option to make that choice. A current campaign of Intact America states that doctors don't just circumcise babies; they circumcise the men those babies will become.



Andrew Freedman, another member of the AAP Task Force on circumcision, stated that "[r]isks include significant bleeding, which occurs in about one in 500 boys". As for loss of sexual sensation during adulthood because of the loss of nerve endings on the foreskin, Freedman said it's a poorly studied issue. "There are lots of people who are unhappy" about a lack of sexual sensation, he said, but "millions of men are perfectly happy. From a scientific standpoint, we really don't have a good handle on it." Source

If there are lots of people who are unhappy about lack of sexual sensation, doesn't that indicate that better studies are required? That perhaps we need to re-think this cultural custom of circumcising babies?

Christopher Guest, M.D, co-founder of the Children’s Health & Human Rights Partnership (CHHRP) says: “‘Circumcision alters the structure of the penis, which inevitably alters function. Long term harm to men from infant circumcision has never been studied.’  He referred to a growing body of anecdotal evidence collected by the Canadian-based Global Survey of Circumcision Harm. Guest said that in the past 12 months over 900 men have answered the online survey to document their harm.” Read more at http://goodmenproject.com/featured-content/our-bodies-our-choices-circumcision-is-not-a-joke/#qbsdk4advxoO49fM.99

It is the objective of this page to dig deeper into understanding the damage that circumcision makes on a routinely basis, to create awareness about the need of further research and reevaluation of routine infant circumcision.

2 comments:

  1. Good article, glad that more people are waking up to this abuse of human rights. A point that doctors seem to gloss over is that the penis is pretty much the focal point of male sexuality, and when circumcision goes very badly wrong, the psychological consequences can be devastating for their whole life.

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    Replies
    1. Thank you Mike.

      You are right. Circumcision is often the first surgery performed by interns, which means that male sexuality is a disposable concept. Many lives have been destroyed by a bad circumcision (David Raimer, Brian Mathew Brandt...)

      But also every circumcision causes sexual damage, and that's my intention with this page that I'm slowly building. If you look at the top navigation, there is now a page on "Keratinization" and one on "The ridged band" -which is always destroyed by circumcision. My intention with this page is to explore that idea, that every circumcision alters the mechanics and perception of sex, so even in absence of "complications", circumcision causes damage.

      Best wishes.

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