Newman 1 Samm Newman Professor Misty Ewry English 1510 6 November 2013 Saving Our Sons All around

the world, expectant parents are faced with many decisions when it comes to the birth of their unborn baby. The interest parents take in researching these decisions has exploded in the last few years with alternative medicinal practices like midwives, home births and natural births on the rise. Many new parents attribute the outcome of their choices to the research they do online. The United States in particular is faced with a new issue taking hold of the internet, one only parents expecting a baby boy must consider, and that issue is routine infant circumcision. Routine infant circumcision has been a normalcy within the United States since the 1950s, following the end of World War II. Most parents expecting baby boys in the United States do not think twice about the issue of circumcision, especially when most generations of men in their family are circumcised as well. However, there is a rapidly growing number of parents, men, and organizations on the internet and on the streets challenging expectant parents to reconsider routine infant circumcision and bring their baby boys home intact. This movement, rightly called the intactivist movement, has been said to have broken the internet with its powerful message about the dangerous and medically unnecessary procedure, and the misleading nature of doctors and healthcare providers to promote the procedure as a minor, preventative surgery.

Newman 2 The risks of routine infant circumcision are not worth the minimal benefits of the procedure, especially in comparison to the benefits of protection and pleasure that the intact foreskin provides. To understand why the issue of routine infant circumcision is important, there must first be an understanding of circumcision rates worldwide and the concept of what is considered to be normal in other first world nations. Secondly, there must be light shed on why many Americans circumcise their sons, the largest reason being aesthetic or cosmetic concerns. In addition, one must examine the important role circumcision plays in the sex life of a man and his partner. Finally, one must take into account the arguments proponents of routine infant circumcision use to explain the necessity behind circumcision, such as cleanliness and infection/disease prevention, parental rights, and the ideology that circumcision is a minor, safe procedure. While circumcision may be prevalent in the United States with many Americans believing that circumcision is a normal practice, it was estimated in 2006 that only 30% of men worldwide were circumcised. That means that 70% of the worlds men are intact. With most industrialized nations ending routine infant circumcision, these rates are now expected to be somewhere near 80%. In comparison to other first world nations, such as England, New Zealand, and most of Europe, the United States is much higher than average in the percentage of men who are circumcised. Australia and Canada have higher circumcision rates than that of Europes countries, however, these rates are still much lower than the United States. Central and South America and most of Asia also have a dramatically low percentage of men who are circumcised. Africa and Central Asia are the regions where male circumcision is nearly universal, however many of these circumcisions are performed for religious or cultural reasons. While there is evidence that circumcision isnt as common as once thought, its even more important to

Newman 3 question routine infant circumcision practices worldwide (The Global Prevalence of Male Circumcision). In the United States, 54.7% of newborn males are routinely circumcised ("Trends in InHospital Newborn Male Circumcision). This number is much higher than that of Great Britain where only 1% of newborn males are circumcised and still much higher than that of New Zealand and Australia, where only 10% of newborn males are circumcised. In Canada, it is estimated that newborn circumcision rates are in the upper 30 percentiles, and still, the United States reins (Wallerstein). In most countries in Europe, routine infant circumcision is nonexistent. It is rarely performed in Australia and must be done by appointment and paid for out of pocket by the parents, as it is not covered by medical insurance. Taking these statistics into consideration, its blaringly obvious to see that circumcision, especially routine infant circumcision, is not normal in comparison to other first world nations like the United States and is only heavily practiced in nations where religious or cultural beliefs still dictate many ways of life. To understand a large reason why Americans still insist on circumcising their newborn sons, there must be an examination of the culture within America. The culture within the United States can often be thought of as one that values tradition and in modern America, one that deeply values aesthetic beauty. Both of these values can help explain why Americans are still circumcising newborn males. The value of tradition lies in the history of circumcision and ties to family values. Circumcision rates began to skyrocket in the United States in the 1950s, following World War II. Most men entering the war were circumcised as it was thought to prevent venereal diseases, even though there was no proof that it prevented anything. For centuries, circumcision had been used as a deterrent from sexual activity and masturbation, as created by the church to cleanse the spirit. It is reasonable to assume that

Newman 4 the men who were circumcised before being deployed were deterred from sexual activity while overseas completely due to painful intercourse. Therefore, not protected by the circumcision, but by a lack of activity altogether. When these veterans returned home, they opted to have their sons circumcised under the impression that it was cleaner and it would prevent them from experiencing the pain that they had undergone before entering the war ("History of Circumcision). At this point, circumcision rates in the United States were at an all-time high and those rates have only slowly fallen since, meaning that most living American men are circumcised. This created tradition in many families and many parents of circumcised infant males list looking like the men in their family as a reason for circumcising their son. The idea that so many men in their family before their son were circumcised puts most parents under the impression that routine infant circumcision is both a safe and normal procedure. Aesthetic beauty is more valued in the United States than any nation in the world. Americans are the number one consumer of cosmetic plastic surgery worldwide, coming in at a whopping 21.1% of Americans having had some type of plastic surgery or alteration in the year 2011. All other countries come in at under 10% and countries like Great Britain, the United Kingdom, Australia, Canada, Italy, and Germany come in at under 5% ("ISAPS International Survey on Aesthetic/Cosmetic Procedures). Americans are also the most invested in diet pills and beauty products, proving that when it comes to beauty, health risks are worth taking. In America, where the intact penis is seen as ugly and unattractive, many people opt for circumcision as a way to provide normalcy for their son. Most parents who decide to circumcise their son fear that if left intact, their son will one day be made fun of in the locker room or rejected by women simply for the way his penis looks. This is a fear deeply rooted in the value Americans place on aesthetic beauty that puts the importance of the appearance of the penis

Newman 5 above the function of the penis, risks included. This fear could be completely eradicated if parents knew that an erect intact penis and an erect circumcised penis look nearly identical. With the fear of their sons penis looking abnormal resolved, they can begin to look at the importance of the foreskin and the role that circumcision will play in active parts of their sons, and even his future partners life. There might be questions as to how circumcision can affect a womans life, but the role of the foreskin is vital to both men and women when it comes to sexual pleasure. The foreskin protects the head of the penis from many things, including dryness, injury, friction, and contamination (Goldman). Without it, the head of the penis is forced to adapt and function as an external organ rather than an internal organ. This leads to changes in pH balances, temperature changes, and most importantly, moisture and lubrication level changes. A significant drop in moisture and lubrication levels can lead to dryness, desensitization of the penis, and callusing of the head of the penis to build extra layers of protection that the foreskin once offered (Frisbie). Without the foreskin to move up and down the penile shaft throughout intercourse, it causes more vaginal friction and significantly reduces vaginal secretions, making sex uncomfortable for women (Goldman). A medical journal survey showed that of women who were with both intact and circumcised men comparatively, they overwhelmingly preferred the intact men. When all other things were equal, these women rated circumcised men a 1.81 intact men an 8.03, both on a scale of one to ten. Women were also less likely to have multiple or even one vaginal orgasm when having intercourse with the circumcised men and they were likely to experience vaginal discomfort. The circumcised men were also more likely to have a premature ejaculation, causing

Newman 6 shorter periods of intercourse. But women are clearly not the only ones who suffer loss of sexual pleasure because of circumcision (Goldman). Men who have been circumcised from birth have nothing to compare their sexual pleasure to, but men who were circumcised as adults offer a lot of insight into the amount of sexual pleasure lost to circumcision. A questionnaire done to study this loss of pleasure was given to men circumcised in adulthood and the results reflect exactly what you would expect given that the foreskin is the most sensitive portion of the penis, with ten to twenty thousand specialized nerve endings stretched up to 240 feet (Cruz et al). The study found that masturbatory pleasure decreased by 48% and that masturbatory difficulties increased by 63%, which correlates with one of the reasons the practice of circumcision began in the first place: to hinder masturbation (History of Circumcision). 20% of men surveyed said their sex lives got worse after circumcision while only 6% said that it increased after circumcision. The remaining men identified no change (Kim). The conclusion taken away from this study was that masturbatory and sexual pleasure decreased after circumcision, showing that circumcision adversely affects the sex lives of men. Although decreased sexual pleasure is a result of circumcision, there are still proponents of circumcision who say that this unfortunate side effect is worth the alleged benefits that circumcision offers. Proponents of circumcision claim that a circumcised penis is easier to take care of and therefore, cleaner. They also claim that circumcision helps prevent urinary tract infections, phimosis sexually transmitted diseases, HIV and even penile cancer. However, very few studies have shown any higher tendency for intact males to develop urinary tract infections and the ones that have can only attribute a 1% higher risk for intact males than circumcised men to develop UTIs, which are easily treatable with antibiotics. Even then, many of these studies are lacking

Newman 7 proper methodology, as acknowledged by the American Academy of Pediatrics in 1999. There are also studies to suggest that circumcised males have a higher risk of UTIs than intact males and that circumcision may hide the symptoms of serious urinary tract abnormalities (Cruz et al). Phimosis is a condition where the foreskin opening is too narrow that occurs in less than 1% of males and is often misdiagnosed by doctors who are unaware of the true function and progression of the foreskin. The foreskin naturally separates from the penis and widens as an intact male grows older. 90% of cases of true phimosis can be treated with steroids and the other 10% can be fixed via plastic surgery that would leave the foreskin intact (Cruz et al). Studies were performed in Africa that suggested that intact males were more likely to contract HIV, but these studies were flawed too, as they did not take into account the cultural, economic, and religious differences between those in the studies. Many of the men circumcised in these studies were prevented from having sex for two to twelve months following the procedure, depending on the speed of their healing and pain having intercourse. Therefore, their risk of contracting HIV during the time of these studies were dramatically decreased because they simply were not having sex. The United States has one of the highest circumcision rates worldwide and yet also has one of the most rapidly increasing HIV rates. Countries such as Denmark, Finland, Japan, and Norway do not routinely circumcise and a very small portion of their male population is circumcised. Yet they have lower HIV infection rates than the United States, suggesting that, as the American Medical Association and American Academy of Pediatrics state: Behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, and circumcision cannot be responsibly viewed as protecting against such infections (Cruz et al).

Newman 8 The prevention of penile cancer is used to justify routine infant circumcision frequently, but penile cancer is extremely rare, occurring in only 1 in 100,000 men in the United States. Studies suggest that there are more important factors in regards to the risks of penile cancer than circumcision. The rate of men who partake in cancer related activities or come into contact with the human papilloma virus getting penile cancer is three times higher than that of intact men in countries that do not routinely circumcise. According to the American Cancer Society, men are more likely to contract and die of breast cancer than they are to contract and die of penile cancer. Penile cancer can be successfully treated without circumcision if caught early and the American Cancer Society states: Circumcision is not of value in preventing cancer of the penis (Cruz et al). Although there is an astounding lack of evidence to support the alleged health benefits of routine infant circumcision, proponents of the procedure still claim that it is worth the risks because it is a simple surgery that will prevent a male pain from circumcision later in his life. However, circumcision is extremely dangerous and puts a newborn baby at an immediate risk of infections and complications. Routine infant circumcision usually takes place within the first few days of a newborns life, before even leaving the hospital. The newborn male is restrained by his arms and legs to a plastic board called a circumstraint. Most newborn males are not given any form of anesthetic. Instead, they are given a binky dipped in sugar water and Tylenol after the procedure is over. The other 45% of infant males who are lucky enough to receive anesthetic are given a Novocain shot near their genital region, but often not given enough time for it to even take effect ("Male Infant Circumcision Facts and Information).Being that the foreskin is the most sensitive part of the penis, this ten to twenty minute long surgery is excruciatingly painful and has been known to

Newman 9 put newborn males into psychological distress/shock, a state of being where they grow limp, stop crying, and their eyes gloss over. The foreskin of a newborn male is very narrow to prevent the entrance of foreign substances in infancy, such as fecal matter. It is attached to the foreskin and the membrane attaching it must be torn so that the foreskin can be pulled away from the head of the penis. The doctor then crushes the foreskin with clamps to sever blood vessels and prevent excessive bleeding. The foreskin is then held with forceps and a slit is made down the side of the foreskin. A device called a Plastibell or a Gomco clamp is then inserted in between the foreskin and the head of the penis, and the foreskin is pulled over each device. The doctor performing the circumcision will then estimate how much foreskin needs to be removed and either clamp down or tie string around the foreskin to cut off blood supply and allow for clotting. Then, foreskin above the clamp or string is cut away. Circumcision is always based on the estimation of the doctor as to how much should be removed, which could explain why routine infant circumcision results in so many complications. The rate of incidences of complications of routine infant circumcision vary greatly when published, but it is suggested that the realistic rate is between 2% and 10% at any given time. These complications include (but are not limited to) hemorrhage, which occurs in 2% of newborn males, infections ranging from septicemia to meningitis to tetanus, which occurs in 8% of newborn males, urinary retention, excessive penile skin loss, beveling deformities of the glans, keloid (severe scar) formation, skin bridges and penile adhesions that reconnect the foreskin to the head by way of scar tissue, and in very serious cases, loss of part or all of the penis (Cruz et al). Men who are circumcised are also 5 times more likely to experience erectile dysfunction than men who are left intact. Without the foreskin, the penis is left exposed and with no choice but to adapt, becomes desensitized to the constant sensation of clothing rubbing

Newman 10 against the glans. This makes it increasingly difficult for a man to become aroused or feel sensations when having intercourse, resulting in erectile dysfunction, a complication of circumcision that is not always seen immediately following the procedure ("Male Infant Circumcision Facts and Information). Proponents of routine infant circumcision claim that the alleged prevention is the most important factor of the procedure, and for 117 newborn males each year, they are right. These newborn males will never experience a UTI, penile cancer, or contract HIV. They will also never take their first steps, see their first day of school, or have their first kiss. Each year, at least 117 newborn males die as a result of complications from their circumcision (Frisbie). It is estimated that the actual number of deaths is more like 230 newborn males every year (Cruz et al). A lot of deaths as a result of circumcision are classified as hemorrhages, SIDS, and infection and in no way linked to the circumcision on the record (Frisbie). While circumcision has little to no health benefits and a large number of risks, proponents continue to say that this issue should be left up to the parent of the child to decide. Most parents feel that it is their child and therefore, they can exercise their right to alter his body however they please. The problem with this argument is that female circumcision, otherwise known as female genital mutilation, was banned in the United States in 1997. The law now states that you cannot cut a female child without legitimate medical or health concern for the child (U.S. FGM Law). Female circumcision can be defended in many of the same ways Americans today defend routine infant male circumcision. However, American culture recognizes that female circumcision yields no benefits and many risks, along with life long side effects in a womans sex life.

Newman 11 Routine infant male circumcision yields no benefit great enough to justify the procedure, and the risks and life long side effects of the procedure are harmful to both men and women. This violates the fifth, fourteenth, and nineteenth Amendments to the United States Constitution which are supposed to protect all child under the law, regardless of gender. If a parent is to request the amputation or cosmetic change to any portion of a childs body, the physician must examine each case and determine whether an irreversible procedure, such as circumcision, has any medical justification (Cruz et al). There are cases in which therapeutic circumcision may be necessary, but to routinely circumcise a perfectly healthy newborn male and take from him healthy genital tissue is a human rights violation on a massive scale. Therapeutic circumcisions can be performed at any point in life if necessary, but an unnecessary circumcision cannot be undone and the invaluable protection and sensation of the foreskin can never be fully restored. Routine infant circumcision is a dangerous, medically unnecessary procedure performed on non-consenting infants with perfectly healthy genital tissue. The idea of parents waiting in anticipation for nine months on the arrival of their perfect son is ironic when more than half of American parents believe their son is only perfect when given cosmetic surgery. With no real health benefits, routine infant circumcision serves no purpose other than changing the outward appearance of the penis and if that is to be done, it should be a decision left up to the newborn male himself, when he has grown into the man he will one day become. He is a person outside of his parents cosmetic preferences and he deserves equal protection of his rights under the law.

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Works Cited Cruz, Rio, George Denniston, Gary L. Harryman, George Hill, J. Stephen Svoboda, John W. Travis, Robert Van Howe, and Eileen M. Wayne. "Full Disclosure: Circumcision Information for Health Professionals and Parents." International Coalition for Genital Integrity. Icgi.org, 2001. Web. 4 Nov. 2013. PDF file. Frisbie, Danelle. "Death From Circumcision." Peaceful Parenting. Drmomma.org, 8 May 2010. Web. 20 Nov. 2013. Frisbie, Danelle. "Intact or Circumcised: A Significant Difference in the Adult Penis." Peaceful Parenting. Drmomma.org, 22 Aug. 2011. Web. 20 Nov. 2013. "The Global Prevalence of Male Circumcision." World Health Organization. Who.int, n.d. Web. 20 Nov. 2013. Goldman, Ronald. "How Male Circumcision Harms Women." Circumcision Resource Center. Circumcisionresourcecenter.org, n.d. Web. 20 Nov. 2013. "History of Circumcision." History of Circumcision. Historyofcircumcision.net, n.d. Web. 20 Nov. 2013. "ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2011." International Society of Aesthetic Plastic Surgery. Isaps.org, n.d. Web. 20 Nov. 2013. Kim, D. and Pang, M.-G. (2007), The Effect of Male Circumcision on Sexuality. BJU International, 99: 619622. doi: 10.1111/j.1464-410X.2006.06646.x

Newman 13 "Male Infant Circumcision Facts and Information." Male Infant Circumcision Facts and Information. Circumcision Decision Maker, n.d. Web. 20 Nov. 2013. "Trends in In-Hospital Newborn Male Circumcision." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 Sept. 2011. Web. 18 Nov. 2013. "U.S. FGM Law." Mgmbill.org. A Bill to End Male Genital Mutilation in the US, n.d. Web. 20 Nov. 2013. Wallerstein, Edward. "Circumcision: The Uniquely American Medical Enigma." The Circumcision Reference Library. Cirp.org, Feb. 1985. Web. 20 Nov. 2013.