Foreskin Decisions

If you want to piss off some of your readers, write about politics or sex. Well, I’ve never worried too much about rejection on this blog, so here I go with another controversial subject: circumcision.
Do me a favor, BEFORE reading this post take the poll to the right.  Then, after reading this post, take the other two polls at the end — no peaking, wait until you read the post.

This is the first post of a series.  Your comments and these polls’ results will assist in the coming content.  Thank you for participating.

I have worked in medicine for a few decades. For the last three years I have worked in Urology where I have seen more foreskin problems then I knew existed — some are even life threatening. Circumcision avoids these problems.

I believe circumcision evolved as a life-saving technique, not as a mere rite-of-passage ritual.  Instead, it was probably used preventatively and then evolved into a ritual.   But I am only making a wild guess.  I have not studied the issue of circumcision deeply and am instead, just sharing my biased opinions, experiences and choices.

Letting a child decide about circumcision when they get older seems a good option. But without working as a Urologist, and hearing of all the problems, I can’t imagine a person ever wanting to electively remove their foreskin. Why?  Because men don’t share their penis-problem stories with other men.  Even if a person would desire a circumcision as an adult, they would be very hesitant because of the anticipated pain, necessary healing time and the worry of explaining the change to others. So even leaving the choice to adults has its drawbacks.

Mind you, I see a disproportionate number of foreskin problems because (1) I work in urology and (2) because I work with a large number of elderly ex-coal miners whose families were poor and their births took place at home where circumcisions were not performed.

Here are some of the conditions we have treated with circumcision in adult men:

• chronically infected (balanoposthitis) (often due to poor hygiene)
• painful on erections due to short frenulum (frenulum breve)
• narrowed down tip which restricts or stops urine (phimosis)(medscape)
• swollen from not being reduced (paraphimosis)
• foreskin cancer
• prophylaxis for balanitis xerotica obliterans (medscape)
• cosmetic concerns due to culture pressures

Since I do not work with pediatric patients, I have not seen horribly botched-up circumcisions which would probably alter my opinion. But I knew of botching dangers when my son was born and that is why I assisted in my own son’s circumcision 12 years ago.   Prior to that, when our ultrasound confirmed our first child to be a male, my wife asked me, “What do you feel about circumcision?” (as she was leaning away from it) and I said, “My son will be circumcised.” To which she replied, “It doesn’t sound like you’ll be compromising on that opinion.” And I said, “No.”  And she let me have my way on that issue.

I’ve discussed my son’s circumcision with him several times since. Part of our discussion surrounds stories from my clinic of  horrible foreskin problems. I hope in this way, when he is an adult and thinks how horrible I was to rob him of a foreskin at least he may think, “I resent my Dad’s barbaric decision, but in his own stupid ways he thought he was doing good.”

Questions for Readers:

There are many good arguments for not doing circumcisions, but there are bad ones too. Being “unnatural” is one of the bad arguments — medicine has taught me that nature does not care for our happiness or comfort.

• Given the above potential problems with foreskins, what do you think are the best anti-circumcision arguments aside from botched circumcisions?
• How will / did you decide about circumcision for your male child?

Closing polls:

After reading this post has your opinion changed toward: