Considering Circumcision

Most boys in the United States today are circumcised but the procedure is less common worldwide. Many parents choose to have their sons circumcised because other men and boys in the family were circumcised or because they don't want their son to feel different. If you choose not to have your son circumcised, your son may notice as he gets older that his penis looks different than other boys if you live in a country or region that routinely circumcises males.

While many members of CIRCLIST support routine infant circumcision (RIC), others feel the decision should be left to the child when he is old enough to decide for himself. Below you will find comments from CIRCLIST members concerning RIC. For additional medical information, visit the site of the American Urological Association.

Reasons many parents choose circumcision

Research studies indicate that there are good medical reasons why your son should be circumcised. These include:

Reasons parents choose not to circumcise

As with all kinds of surgery, circumcision has some risks. Although uncommon, complications such as local infection and bleeding can occur as a result of the circumcision. On rare occasions, the foreskin may be cut too short or too long, or the circumcision may heal improperly. Since some parents see circumcision as a cosmetic procedure, they choose not to have their son exposed to these risks. Additionally, a small but very vocal minority of men (most of whom are childless) have recently begun a wide-spread campaign to halt circumcision, despite its benefits. Parents often receive erroneous or biased information from these sources and therefore choose not to elect routine infant circumcision.

Is circumcision painful?

Some parents worry about their child feeling pain. Infants who are circumcised without pain medicine (anesthesia) will feel some pain. They may have an increased heart rate and blood pressure. These symptoms usually disappear within 24 hours. They may also cry; however, they usually calm down shortly after the procedure. A local anesthetic can be injected to produce a penile nerve block and has been shown to lower pain and stress in infants. Also helpful are having the infant suck on a sugar solution and using topical anesthetic ointments. Talk to your pediatrician about the availability of pain medicine and if it is appropriate for your infant son. Problems with using pain medicine are rare and usually not serious.

With regard to pain if you choose circumcision post-infancy, I was circumcised as an adult without any medical necessity. I had a short, loose foreskin and my glans was very used to the light of day. My older son was circumcised at age 9 as a result of bad phimosis & adhesions - his glans had never been exposed before. Neither of us experienced any significant pain after the operation. We neither of us took any painkillers afterwards, although the the doctor made them available to us.

What if I choose not to have my son circumcised?

If you choose not to have your son circumcised, you need to talk to your pediatrician about the proper way to keep your son's penis clean. This is important in order to avoid infection. Additionally, when your son is old enough, you will need to teach him how to keep his penis clean and ensure he continues to clean under his foreskin until he is an adult. Finally, it will be important for you to discuss with him your decision to leave him uncircumcised as he nears adolescence and to provide him the opportunity to be circumcised before he reaches puberty. This is particularly important if his peers are circumcised.

Are there other less drastic surgical alternatives to circumcision if his foreskin is unretractable as a teen?

You may have heard that a Dorsal Slit is a surgical option. While it may be an option, the question is, is it a good option.

Dorsal slits can vary greatly in appearance. The final result also depends on how long the foreskin was to begin with. A dorsal slit is essentially a cut down the top (dorsal) side of the foreskin which, if healed properly, allows the glans to appear. It leaves all the skin on the bottom/ventral side, and most on the top side as well. A dorsal slit is usually done to release the tight band of foreskin at the tip of a boy's penis. Last year in showers at gym I saw a guy with a very obvious dorsal slit. It was very unattractive. Loose skin was hanging below the glans on ventral side, providing almost a dog-eared look. Upon speaking with the gentlemen I learned that he had also had several instances of the end of the dorsal slit (closest to his body) tearing furthing during intercourse. When done on a child though, I suspect that during puberty, the skin adjusts yielding a more normal result, looking almost like a very loose circumcision. But why do a dorsal slit then ? Besides, why submit your child to growing up with a penis that is neither circumcision, nor uncircumcised? Certainly in the locker room and with future sexual partners, your son would have to explain what happened to his penis.

In the interim, how do I care for his foreskin?

The foreskin of the uncircumcised penis must be kept clean. The foreskin usually does not fully retract for several years and should never be forced. Gently washing the genital area while bathing is sufficient. Later, when the foreskin is fully retractable, boys should be taught the importance of washing underneath the foreskin every day to remove the smegma - a white cheese-like substance that is found under the foreskin. See the American Academy of Pediatrics brochure "Newborn Care of the Uncircumcised Penis" for more detailed information on how to care for your son's uncircumcised penis if you should choose not to have him circumcised at birth. Contact your pediatrician if you notice any signs of infection such as redness, swelling, or foul-smelling drainage.

What are the social and psychological implications?

As you can see from the above, circumcision has many medical benefits. However, circumcisions are often done for religious, social, and cultural reasons. These reasons are most often the deciding factor when considering circumcision for your boys. As a parent you are required to make a number of important decisions for your children. You may be criticized for having your son circumcised, or leaving him uncircumcised. As you will see in the Personal Preferences & Experiences section of this Web Site, many men feel that they were in some way neglected because their parents failed to have them circumcised atr birth or during childhood, especially when the majority of their peers and/or relatives were circumcised. Recent studies have shown that uncircumcised boys are less satisfied with their status than their circumcised peers. Circumcision frequently becomes a topic of conversation for adolescents and is also mentioned on teen television programs. It is therefore important that your child be knowledgeable and happy about his circumcision status. As a parent, you must balance the potential medical, social and psychological benefits against the possibility that he may be unhappy with your decision. Ultimately, the psychological and social factors will likely out way any medical considerations. As you will find if you discuss this with any uncircumcised male, he will not want to be one of the few uncircumcised boys in the shower room!

Can any infant boy be circumcised?

Most healthy, full-term infant boys can be circumcised. If your child is premature or has other health problems, ask your pediatrician if circumcision is okay for your child.

What should I expect for my son after infant circumcision?

After infant circumcision, the tip of the penis may seem raw or yellowish. If there is a bandage, it should be changed with each diapering so the penis won't become infected. Petroleum jelly (Vaseline) may be used to keep the bandage from sticking. Sometimes a device called a Plastibell is used in which case your son will not have a bandage. The plastic rim of this device usually drops off 5 to 8 days after circumcision. It takes about 1 week to 10 days for the penis to fully heal with either type of covering.

Are there any problems that can happen after routine infant circumcision?

Problems after a circumcision are very rare. However, call your pediatrician right away if:

It is normal to have a little yellow discharge or coating around the tip of the penis, but this should not last longer than a week.

What does the American Urological Association say about routine infant circumcision?

The American Urological Association, Inc. (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks. Neonatal circumcision is generally a rapid and safe procedure when performed by an experienced operator. There are immediate risks to circumcision such as bleeding, infection and penile injury, as well as complications recognized later that may include buried penis, meatal stenosis, skin bridges, chordee and poor cosmetic appearance. Some of these complications may require surgical correction. Nevertheless, when performed on healthy newborn infants as an elective procedure, the incidence of serious complications is low (usually isolated case reports). Minor complications are reported to be three percent.

Properly performed neonatal circumcision prevents phimosis, paraphimosis and balanoposthitis, and may be associated with a decreased incidence of cancer of the penis among U.S. males. In addition, there appears to be a connection between the foreskin and urinary tract infections in the neonate. For the first three to six months of life, the incidence of urinary tract infections is at least ten times higher in uncircumcised than circumcised boys. Evidence associating circumcision with reduced incidence of sexually transmitted diseases is conflicting. Circumcision may be required in a small number of boys when phimosis, paraphimosis or recurrent balanoposthitis occur and may be requested for ethnic and cultural reasons after the newborn period. Circumcision in these children usually requires general anesthesia.

When circumcision is being discussed with parents and informed consent obtained, medical benefits and risks, and ethnic, cultural, religious and individual preferences should be considered. The risks and disadvantages of circumcision are encountered early whereas the advantages and benefits may be prospective.

Board of Directors, May 1989 Board of Directors, October 1996 (Revised) Board of Directors, February 1998 (Revised)

For all who are interested in the general medical benefits of circumcision (for use as arguments, perhaps) here is a summary from Dr. Wiswells "Neonatal circumcision: A current appraisal", Pediatrics 1995, Vol.1, No.2

In this video, Dr. Richard Greene demonstrates circumcision with the Gomco clamp. Dr. Greene is a pediatrician at the Palo Alto Medical Foundation in Palo Alto, California and has forty years of experience in medical practice. Because of the excellent cosmetic results he obtains with this technique, other physicians often request his services for their own family members.

It is most interesting to note that a considerable number of fathers who are uncircumcised, plan to circumcise their newborn sons. With circumcision rates continuing to be this high during infancy, the adult male circumcision rate will also continue to hold at high numbers, as many men and boys choose or require circumcision later in life. (jump to other circ survey results)

Gerald Weiss, MD an eminent physician and surgeon for 50 plus years recently released a new publication on routine infant circumcision entitled, "Circumcision: Frankly Speaking". The attached article provides a book review of the new book and let's you know how you can get a copy.

This website is really great at providing enough information for parents to make a good decision regarding circumcision. But it is not filled with numerous postings or information about anything except what a parent needs to know when considering circumcision for his/her son. I highly recommend it to new moms and dads and others that made the decision to leave their infant boy uncircumcised, but are now reconsidering. http://www.circinfo.net/

Richard M. Parker, M.D., a Board Certified Pediatrician in Seattle, Washington provides an excellent discussion of the topic for the new parent considering circumcision. It is good to see a physician speaking out on this important medical topic and provides balance to all of the anti-circ minority rhetoric found on the internet. Click here for more information from Doctor Parker.

On one of the children's health sites the resident doctor answers a FAQ from a mother about the merits of circumcising her son. He produces the usual finely balanced medical position setting out pro's and cons. Anticipating this, and to pin him down, the mother asks a supplementary; 'Did you circumcise your own sons?'

The candid reply from the doctor was 'Yes - because I wanted to share my circumcision bond with them'

Being circumcised, I can identify with this emotion and wanted to have my own boys cut when they were born. My wife was supportive of this decision, but her requests to have our sons circumcised in England, UK, were refused by the hospital and two doctors. Moreover they were unwilling to refer us to a practitioner who would do it. They also implied that if we went ahead, our doctor/patient relationship with them would be damaged.

I therefore applaud the situation which seems to prevail in the USA, where many doctors who oppose circumcision on medical or personal grounds, continue to cut boys because they recognize the deeply felt wishes of the parents in this matter. Especially as in many instances, it's simply a matter of; 'DH is, so we wanted our boys done'.

Those circumcised like me, who have seen their boys grow up intact will know the frustration of not being able to pass on the perceived benefits born from the personal experience of both their parents.

One anti-circ regular, who posts on most of the boards, is always welcoming new converts - as members of 'the society of cut dads with uncut sons', He openly rejoices that they are breaking the perpetuated generation stranglehold of circumcision in the USA. It gives me not the slightest pleasure to be a UK representative of this group along with many of my fellow countrymen.

What does intrigue me is reading of instances where the situation is the other way round; intact father, circumcised son! This can arise for a variety of different reasons.

Most common is that the parents choose not to circ, but the son develops a problem and ends up having to be cut. I must own up to a secret pleasure in reading of one active anti-circer, a mother, who told of how much joy it gave her to gaze on her son's perfectly natural penis with its lovely foreskin. She emphasised how she was careful never to retract this, and followed the collective wisdom of leaving well alone. She intended to allow it to separate from its attachment to the glans in its own good time, perhaps in puberty. Then, shock horror! Her son developed a phimosis and urination problems. These would not respond to conservative treatments and could only be cured by circumcising him at the age of three. Just the time at which most wise parents would seek to avoid inflicting such pain and trauma. The mother in this case was terribly upset that HER SON should end up being one of the tiny minority who require circumcision for a medical reason. She accepted the inevitable and the operation was carried with, it appears, a perfectly agreeable 'end result'. However, despite this experience, she is unmoved in her resolve not to circumcise her next son and expresses her disappointment that her firstborn is, in her view, now disfigured. My emotions are exactly the opposite.

It is always interesting to read of those situations where the father is uncircumcised but the son is done at birth by mutual agreement of his parents. Such fathers will often admit that they are pro circ and always wanted to have it done, but lacked the courage to proceed. Their agreement to the son's circumcision is often a reaction to their parents not having them done. I do wonder what is said when the grandparents find out.

Then there are the marriages where parents cannot agree and one of them (more often the mother) goes ahead and has the son circumcised. This must cause an almighty row but what is done is done and the aggrieved party has to accept it. Some intact men may feel particularly put out at their wife's insistence on circumcising the son. By doing this, she is implying that she would have preferred a circumcised partner herself. Conversely I find it very satisfying when a wife wants her sons done because hubby is. It's her ringing endorsement of the penis type that produced her boys.

I have a friend, Angelo, whose parents didn't have him circumcised when he was born, unlike almost all other boys. He had a circumcision at age 19, but didn't enjoy it as much as he might have.

He suffered from a tight foreskin as a boy, and was unable to draw it back to clean underneath. His father told him not to worry, that it would loosen up as he got older. His father made him a device to wash under his foreskin, a short length of garden hose that screwed on to the faucet, with a reducing adapter at the other end. The nozzle on the adapter was about ¼" in diameter, small enough to fit into the end of his foreskin. This let him force water inside the skin to rinse out stale urine and other stuff. After a couple of years his foreskin loosened enough so he was able to skin it back to wash. He still felt uncomfortable because he was different from other boys.

As he matured, he found that his cock grew, but his foreskin didn't. He was able to work it back for washing, but when he was hard, it wouldn't slide back over the big head, and this caused him problems with sex. He was never able to watch himself shoot like other guys when he jacked off, because the long tight foreskin trapped the jizz and all he saw was the white stuff dribbling out the end. I, like many cut guys, enjoy watching the big head get larger and then spurt its loads while we're cumming, but his long tight foreskin denied him this pleasure.

Then he started in with girls, and he discovered that most girls, when they saw his uncircumcised cock, would go "Ick" and not want to do anything sexual with him, especially not blow jobs. They told him that uncut dicks were dirty and smelly. He got fed up with girls and started trying to have sex with guys. Most guys he met were turned off by his uncut cock, and none would blow him. He got really tired of being called names like "anteater" and "cheesy cock." Although he was very clean, skinning it back in the shower every day, the name "cheesy" stuck.

At age 19 he told his parents he wanted to get circumcised. Their family doctor referred him to a specialist, a urologist, who after examining him carefully told him that a thorough circumcision was the only treatment for his condition, and that he would be much better off without that excess skin. He scheduled an appointment for his circumcision, which was to be an office procedure. He looked forward to watching the long ugly skin come off.The day he showed up the doctor told him he'd be unable to watch because he would be asleep. He asked if he could just have a local, but the doctor told him that, in his experience, men and especially teen-agers got very anxious during their circumcisions, and that it was better for everyone if they were unaware of the surgery while it was being performed on them. The doctor was very kind and explained everything. He said that circumcision was a minor operation that didn't justify full general anesthesia. He said that his nurse would put a mask on his face and give him just enough nitrous oxide to put him into a light sleep so that he wouldn't feel the needles injecting anesthetic into the base of his penis. This would block all the pain so that the operation could proceed without putting Angelo deeply under. It would also keep his penis numb for many hours after, so that he would have minimal post-operative pain. He'd also give him a prescription for narcotic pills in case he did feel pain later. The doctor asked him if he wanted the frenulum removed during the circumcision. He explained that his frenulum was short and thick, and that it would pull the head down during sex. Many men found this uncomfortable. Angelo agreed and the doctor told him he was ready to start.

Angelo lay down on the table and the last thing he remembered was the mask on his face and being told to breathe deeply. When he awoke his penis was wrapped in thick gauze. His father drove him home, as he was still slightly groggy from the nitrous oxide.

The scar healed very well, and was thin and very even. The doctor had circumcised him freehand, not with the Gomco that is used on babies. He found that once the foreskin was gone, the head blossomed out into the German helmet shape he has today. I've seen it, and it's very attractive, with a big flaring rim, a round nose, and a long slit. Now without the skin, his ejaculations come shooting out, and are beautiful to watch. We've stroked together many times, and I've been impressed by the way his big tip feels, warm and hard, between my fingers. I can feel the throbs in his tip when he shoots, and the best experience we had together was when we put our cocks together head to head inside a condom with the end cut off. When we came, we came together, and the feeling of his big tip throbbing against mine while I was cumming was very erotic. He regrets not having been able to watch the remodeling of his penis, but is very happy with the result. Isn't this true account enough to convince every parent to have their sons circumcised, either at birth or before they turn 10 or so?

I have been enjoying the discussion about who in the family decided upon the son's circumcision, father or mother. In my family, I made the decision and my wife had no objection. In the U.S. army, I had seen too many problems with uncircumcised men. They had tight foreskins, smelled, etc. I never had any problems being uncircumcised but I always wanted to have it done. Finally I got up the courage to have the operation done when I was 24 while at MIT. Yes, they had a small infirmary at that school. Never was sorry to this day I had the operation before marriage. We have four sons, all of whom have been circumcised and also 6 grandsons, all of whom have been done.

Recently, I asked our second son, who had been clipped by a local G.P., if he had any troubles with tightness because he had so much more skin removed than the other three. He laughed and said he never has had any problems. In fact, he had his son circumcised just after birth.

I still don't understand why all the talk about trauma on the child. If you surveyed 100 men circumcised at birth, how many will tell you that he can remember having had it done and the pain he went through? My guess is none! I don't think a newborn should be subjected to undue pain and with modern methods, it can be alleviated. Even though I grew up uncut, I strongly support Routine Infant Circumcision.

I fully agree with infant circumcision. My son was circ'd at a week old - a practice recommended in Islam and routinely performed in the USA and in all Moslem countries. Really it is hassle-free. My son did not show any sign of pain or discomfort right after the operation. Yes we still applied the painkiller cream and bathed him as per normal.

In fact to circumcise an older child, it's much more traumatic as he has to overcome the psychological fear of pain. It is even emotionally distressful to the parents. As the medical and psychological benefits are well know, I strongly support this simple procedure.

I don't want to start a RIC debate as it is not welcomed here but my wife did comment shortly after my recent circumcision that it did seem a lot more complicated than our son's routine infant circumcision. He cried briefly after the procedure, but forgot about it within the hour after being cuddled and nursed by his mom. He was circed a few days after birth. You see I was the one who went against the tide in my family. My dad and my brothers were not circumcised. I decided to get done just before marriage. My girlfriend (now wife) was very supportive. There was little or no debate about having our son circumcised. We were both in agreement. With regard to my own circumcision, the feeling is both pleasant and liberating. I'm sure most men circumcised later in life would agree.

Circumcision is one of the best ways to treat a newborn penis. It prevents diseases, makes it lovelier, gives a perfectly natural feeling from the very beginning of life, and enables an instrument meant for sex to grow proud, free, and beautifully displayed for future lovers to see. It is hard to understand why anyone would like to keep a tight, baggy ring of smegma - producing flesh on such a beautiful organ, condemning poor male children to pee in their own skin until puberty, putting them and their future partners at risk because of urinary and genital infections.

I feel like I am truly "at home" on Circlist, and I think it's great that I can finally talk openly and honestly about circumcision.

Yes, my circumcision experience was a beautiful one. Not only did it bring me closer to my circumcised friends, it also brought my mother and I closer. I know that my mother shares my pride with respect to my circumcision. After I was circumcised at age 11, she made it a point to tell her friends that I had been circumcised: "he will thank me for it when he is older and so will his future girlfriends", I overheard her say on several occasions. Well, mom, thank you. You have given me the most precious gift that a mother could giver to her son: a beautifully circumcised penis, ready to give me and my partners immeasurable pleasure and joy.

As a teenager I preferred to hang out with other circumcised guys because we could joke around about ant-eaters and the like. Obviously, these (mostly good natured) remarks would sometimes cause strain if there was an uncut around. They would get visibly upset by our jokes, and I felt sorry for them. As for now...well, I'm 34 and circumcision is not something that comes up very often in everyday conversation over the water cooler. Anyways, I don't really care whether other men are cut or not, although I prefer to be with other cut guys in a gym shower. I especially envy small boys who I see are circumcised, as I do not know what it is like for them, since I had a foreskin at their age.

If you are a mom considering circumcision for her son, please remember my comments. Your son will thank you!

I know that some think that newborn circumcision is wrong. I wished my parents had circed me just after birth. I have no loss of any sensitivity after my adult circumcision. In fact, I think I got some new ones, it feel so much better now. I will definitely circumcise my future sons at birth.

Isn't more fashionable to leave your son uncircumcised these days? I hear the rich and famous aren't circumcising their boys.

These rumors are widely spread by a small but very vocal and well organized anti-circumcision group, predominantly comprised of childless men. In fact, most of the "rich and famous" continue to request circumcision for their sons, even in California where fashion is often put ahead of practicality and health benefits. Infant circumcision rates may have declined in some hospitals, but physician office and post-infancy circumcision rates have increased.

(Below you will find a few examples of recent postings to CIRCLIST with regard to celebrity circumcision. Please note that we have not sought to substantiate these postings.)

Actress Michelle Pfeiffer is a big fan of RIC. She had her son, John Henry circumcised by S California's "Doc Speedy" - Mogen-wielding Dr Fred Kogen MD in 1994. Michelle wanted ""a nice little secular" circumcision for her son. Doc Speedy is well-know among the beautiful people of Southern California; many Moms have retained him the remove Junior's foreskin. http://www.ebris.com/toc_moment.html Seems like these Moms know what they like when it comes to snipping their little men!

John Travolta left the set during a recent filming to be at son Jett's bedside as the 4-year-old boy undergoes a "minor operation". His publicist indicated "John wanted very much to be by his son's side." She described the operation as "a normal pediatric procedure". The boy had to be circumcised because of ongoing problems caused by his foreskin (recurring urethritis). Unlike John, who himself is circumcised, the boy was not circumcised at birth.

Cindy Crawford had her new son routinely circumcised on request by her husband, who is Jewish in origin. Like father, like son!

In the biography of Arnold Schwarzeneger it reports that, after coming to the US, his coach also encouraged him to be circumcised, which he did eventually have performed. He has subsequently stated that he is very pleased with the results and would have his sons circumcised.

The tabloid press recently reported that Prince William was circumcised at his request (at age 15) at a private surgical clinic in London. No doubt he felt different than his peers and wanted to be circumcised like them and the other men in his family. Unlike all of the other Royals, neither William or his younger brother Harry were circumcised at birth. (more info)

Rosie O'Donnell's recently adopted son was circumcised by a Jewish physician recommended by the Spielberg's several months after Rosie adopted the boy. Rosie had reportedly requested it be performed at the hospital prior to the adoption, but for some reason the procedure was not performed.

Film actress and model, Natastia Kinski recently reported that her ex-husband wanted to circumcise their 14 year old son, Aljosha.(Click photo at right, Aljosha is on the right side of the photo, and his teen sister is on the left) Since the boy was staying with his father for visitation and notified his mother what was about to transpire, one could surmise he wasn’t keen on the idea. The interesting thing is that Nastassja«s ex-husband, Ibrahim Moussa, isn«t the real father of Aljosha. The two met when Nasti was already pregnant in the 2nd month. The real father is unknown, so is his circ status. I wonder what his teen sister thought of him being circumcised???

River Phoenix, born to parents with strong beliefs in leading an alternative lifestyle, brought River into this world on August 23, 1970 in a log cabin. The event was totally natural and River was reportedly not circumcised because of his parents beliefs. Nude photos of River taken during shooting of the Mosquito Coast verifyy this (age 15). At some later time, River chose to be circumcised as is confirmed by his autopsy report. Rumor has it that this occurred shortly after his film with Keanu Reeves, who also chose to be circumcised during his latter teen years.

Recently Damon Wayans appeared on the David Letterman show and said he has just had his 11 year old son circumcised. He did not have him done at birth because of all of the recent information against circumcision. However he indicated his son requested to be circumcised because all of his friends at school were circumcised and he felt the odd one out! Shortly thereafter his 9 year old son was also circumcised.

One of the most watched morning talk-shows on North American TV is the live show of Regis and Kathie Lee. At the beginning of the March 11 broadcast Kathie Lee Giffford told how she had had slipped a note into her son Cody's diaper when she had taken him to have his circumcision done. The note said matter-of-factly that the doctor shouldn't trim too much (it was couched as a little verse) and she then commented how the doctor did a perfect job on Cody's penis. It's pleasant to see such a naturally sensuous female indicate without any kind of shame how she considers circumcision to be the perfectly normal way to treat a foreskin.

Catherina Zeta Jones and Michael Douglas recently had a son, Dylan. I read that she is fascinated by the Jewish religion and that her son should be raised according to the Jewish faith, particularly in that her husband, Michael, is Jewish.

With the first anniversary of the birth of the McCaughey septuplets (Iowa, USA), many of the nightly news magazines have been running specials. This week we had the opportunity to observe the babies during diaper changing and it was evident that the boys had been routinely circumcised. It obviously wasn't done the week they were born, but I suspect it was performed just before they left the hospital. All seemed happy and in good health. No doubt their routine infant circumcisions will do well for them physically and emotionally during their entire lives.

His Body, His Choice?

Most parents who choose not to circumcise, justify their decision by saying; "his body, his choice - HE can have it done if he wants". This implies they are fair minded and offering the option. In reality for most boys this is not the case. If the boy does want a circumcision he faces several formidable hurdles in front of him:

1) Just raising this subject with his parents can be a daunting thing for the average youngster. He may have already asked why he is different from his pals and been told firmly that they didn't have him done because they didn't think it was a good idea. Few, if any will add; "but if you'd like it done, we'll fix it for you" The odds are he has picked up the vibes and knows its a subject "off limits".

2) If he overcomes the problem above, most parents are going to do their best to talk him out of it. They'll tell him he's too young, doesn't know his own mind, that he'll change it later and it would be too late. That it will involve terrible pain and discomfort and cripple him for life. No matter his friends are cut, he won't like it, they're the unfortunates etc... Best wait until he's adolescent and we'll talk about it then. Having made their decision for him when he was a babe they're hardly likely to concede the argument now.

3) So he's adolescent and concerned about what the girls might think about his foreskin. They may love it but he doesn't think so. He can't explain this to his parents, Jeez! what on earth is he thinking about? Sex? Go and take a cold shower son!

4) So he's a young adult. If he still wants to be cut, he has to earn some cash to pay for it, find a doctor who'll do it and contemplate painful surgery and convalescence. What if it isn't good afterwards? Maybe his parents were right after all? If only they'd cut off his foreskin before he knew he had one he wouldn't be agonizing like this.

Yes, his parents made a lifetime choice for him just as surely as those who had their sons cut! Only the most determined youngster will cross the divide against odds like these, unless they have an unusually fair minded parent, who stick by their promise. He can have it done if HE wants!

A personal experience and advice for the parent of an uncircumcised boy.

I first learnt about circumcision when I was about 3 years old, I had recently seen another boys penis that looked different from my own and while being given a bath I ask my mother why this other boys penis looked different from my own.

Thankfully she was happy to explain to me in a way that I could understand at that age what circumcision was and why it was done and also told me that she had in fact wanted me circumcised when I was born but that the doctors had refused do it because there was no valid medical reason.

Up to this point in time, I was unaware that it was possible to retract my foreskin but as I had brought the subject up she then suggested that I was now old enough to learn how to start to take care of myself and had me stand up in the bath in front of her and proceeded to retract my foreskin for what I thought was the first time. I was very pleased to see that my penis did in fact then look a lot like my circumcised friends and she then proceeded to instruct me on the necessity of retracting my foreskin and washing the area underneath it whenever I took a bath, something not to difficult to do when it feels nice anyway!

I think that experience was to sow the seeds of what has become a life long interest in the subject of circumcision that remains today many years later and I always remembered that day in the bath tub.

I now live in Australia and a few months ago while speaking with my mother on the phone I plucked up enough courage to ask her if she could remember that event in the bath tub all those years ago. She admitted that she could not remember that particular event I was referring but did confirm that it was true that she had wanted me circumcised like my father when I was born. She explained that when she asked the doctor to do it, he apparently explained that they no longer do that in public hospitals unless medically necessary and consented to examine my penis to see if that was the case. Following the examination she was told that circumcision would not be necessary but that if she would agree they would take me away and in her words "Stretch" my foreskin to free it up. This she consented to and a was taken away and returned to her a little while later. She was the given detailed instructions as to how she was to gently retract my foreskin at each bath time and to apply a coating of Vaseline (sp). She was to continue to do this until I was 12 months old. She also told me that when I was taken to the "baby clinics" that theory have in the UK the nurse there would also retract my foreskin to check that everything was OK.

It would appear that once it was obvious that my foreskin was developing normally and easily retractable she must have stopped doing it because as I indicated at the start I personally had no conscious knowledge at age 4 that I could retract my foreskin until that day in the bath. Now before you ask, I have what I would consider a very normal foreskin, it just covers my glans with very little overhang, is very easy to retract. My frenulum is simply a narrow line of tissue that does not in any way inhibit my foreskin from fully retracting right back until it lays totally smooth along the shaft.

Now I have read all these arguments put foreword for leaving the boys penis alone until he finds out how to retract his foreskin on his own and I have to tell you that I think that attitude is TOTALLY wrong and misguided!

When growing up like most young boys together I say the results of parents who didn't pay much attention to their sons penile health. Chris, a boy who was my age and lived across the road from me had a very tight longish foreskin that could just be retracted when he was flaccid but was impossible when hard and would cause him severe pain if attempted and at that age limited his options when it came to masturbation methods, he was circumcised at 19 or 20 at his girlfriends insistence. I also experienced as a young teenager several uncut boys whose penile hygiene left a lot to be desired!

Many years later I was seeing a divorced woman who had a 12 year old uncut son with a tight foreskin, when I asked her about it she admitted that she had not given it any thought and had never given the child any instruction on retracting or cleaning his penis and that her previous husband had been circumcised. Upon examination it was found the boy had a severe phimosis and required subsequent circumcision (See Before/after Photo.)

So my thoughts are that if you decide not to have the boy circumcised at birth then it is the parents responsibility to make sure that the boys foreskin develops normally and to make sure that the foreskin is be gently retracted as far as it will go without force at each bath until it can be easily retracted and the boy himself takes over. This is something that must be taught to your uncircumcised son, and reinforced through childhood and adolescence.

My Dad was a Navy man, and wanted my older brother and me to be circumcised at birth, but my Mom was too tender-hearted a non-US born, and she won out. However, Dad was a stickler on hygiene, and if his boys were uncut, then he was going to be sure we were clean!

From a fairly early age, and right through high school, he would subject us to surprise "short-arm" inspections, most always when our mother was not at home. We'd have to stand in front of him (on a footstool until we were tall enough not to need it) and drop our pants and shorts. With our hands at our sides, we'd experience the humiliation of Dad pulling back our foreskins to see if we were clean enough. Early on, our foreskins were rather tight and it was difficult to stand their ("stop squirming, young man") as Dad worked our foreskins back and forth and talked to us about the importance of getting these loosened up "otherwise, it's off to the circumciser for both of you."

If he sniffed even the slightest trace of male odor, it would earn us a spanking. Then he'd march us off to the bathroom for a thorough bath, sometimes an enema, and usually a lecture about the evils of foreskin and our lack of cleanliness. Yes, we tried like hell to stay clean and "fresh" down there, but he often caught us out of the blue, so we got lots of spankings for poor hygiene!

I used to wish I was circumcised like all of the other military boys, and so did my brother! It was even worse in our teens! Being horny all the time, the pre-cum we drooled always made us have a strong male smell down there! But Dad kept up his inspections! If anything, they were more frequent, and the lickings were just longer and harder. I have to admit I kind of enjoyed watching my older brother get it if I happened to "pass" Dad's inspection, but it was still humiliating to be handled and sniffed like that.

When I was 16 (my brother 17), during one of Dad's inspections and threats of circumcision, we came right out and told Dad that we had talked about it and felt we were old enough to decide for ourselves and that we wanted to be circumcised, just like he was. He still made us march into the bathroom and peel/wash, but afterwards we had a long talk about getting circumcised. Dad made it clear that only "complete" circumcisions would do, and we would come to learn that meant totally tight with the frenulum removed. When Mom came home, he told her what had transpired and that he would be making our appointments for duel circumcisions. Four weeks later, we went into to the docs office and both were done while Dad watched.

My brother and I joke about it today, but at the time it was pretty hard to take! At least we never had cheese when we were young! And we finally got the circumcisions we always wanted, and wished had been done when we were younger.

If you have an uncircumcised son, you owe it to yourself and him to check the following website. It is not a pro-circumcision website, but rather a site for parents who have chosen to leave their boy uncircumcised until he can decide for himself if he wants the procedure. The cost of this choice is potential health problems with the foreskin if not properly checked on a regular basis. Visit this site for complete information: http://www.male-initiation.net/welcome.html

We've noticed that parents who are too ignorant and/or uncaring to have their sons circumcised also neglect to teach them to keep clean, and especially to retract their foreskins for urination. Our boys tell my wife and me that they know when a boy with a foreskin has just used the urinal because there's urine splashed all over the floor. They've also noticed that uncircumcised boys have drops of urine on their clothing and shoes when they walk out of the toilet.

Surely it can't be coincidence that these boys also do poorly in classwork. Their parents don't encourage them to study. My wife and I are convinced that we made the right decision in having our sons' foreskins removed in infancy. First, my parents made the same intelligent decision for me, which is why I grew up without a foreskin, and i am glad they did.

Both our sons are old enough to know the difference between the foreskin-type penis, and the cleaner and healthier one that has had the infection-prone fleshy part removed. From what they've seen in school, they are grateful that we chose to have their foreskins removed in early life, thereby sparing them the many problems that a foreskin brings.

Where we live almost all boys have had their organs remodeled, as have their fathers. Most of their circumcisions were performed in infancy. A small number of circumcised males' parents neglected to provide this gift for their boys when they were born, and they had to be circumcised later, at ages ranging from early childhood to adult. All are happy to have been rid of their foreskins. Better late than never.

I'm writing after several years of viewing your website. I wanted you to know that my husband and I circumcised our three sons. We did not circumcise them at birth, as did most of our friends. Rather, we decided to wait until they were older and would understand what was being done so they might appreciate it more when they are adults, and considering it for their own sons. The three boys, Bobby Jr, Aaron and Jacob, were circumcised when they were 10, 8, and 7 respectively. I've always greatly admired my husband's tightly circumcised penis, and new after my first and only experience with an uncircumcised boy in college that only cleanly cut sons would do for me. I must say it was an educational experience for all of us, not really knowing that much about foreskin before the boy's were born (my husband was circumcised at birth). We did find it fascinating as they each had rather long nippled foreskins. Washing them daily was of course a necessity and teaching the boys about cleanliness and their upcoming circumcisions was routine. I also came to examine and more more finely appreciate the lovely circumcision my husband sports, and we can now proudly say each of our sons is the same. The boys were all done with a Gomco circumcision clamp by a doctor our pediatrician recommended. She did an excellent job on them, making them tight and removing the frenulums as we requested. My husband accompanied me and the boys to the doctor that day (which is rare) so he could be on hand for the big event. I know the boys were quite nervous but they behaved very well. They had only local anesthesia, but none of them made much of a fuss because they were well prepared and had seen that most every boy they knew had already been done and wanted a little dinky like their friends. They healed amazingly quick and we enjoy seeing them looking so clean and healthy now. I think we made the right decision for them and recommend all parents do the same for their sons.

Our neighbor had her baby boy delivered by a foreign born OB/GYN who was very skilled and very caring. When she asked him when he would perform the circumcision on her boy, the doctor replied that he'd never been trained to perform them in his country, and that he didn't know how. At first she was horrified, concerned that her boy would have to wear the long and wrinkled foreskin all of his life. Her husband had been circumcised at birth, and he shared her concerns.

She learned that this had happened with other women who had had their baby boys delivered by him. All were happy with his skill in delivering babies, and his excellent and caring manner, but he never circumcised any of the boys he'd delivered.

This doctor was next door to a pediatrician, and as all of the mothers sought out a pediatrician for their children for routine well-baby care, the solution was to have the pediatrician perform the circumcisions. This pediatrician had performed many and was now performing even more to take up the slack in the OB/GYN's practice. Our neighbor was very happy with this arrangement, as the pediatrician used the Gomco Clamp, the favorite among both doctors and parents in our area. She had her boy done about a week after his birth. She showed us the baby's penis the morning that she was to take him for his circumcision. It looked like a little worm, tapering to a tight pucker of skin at the end. There was no bulge to show the outline of his glans, due to the tightness of the constricting foreskin. We assured her that the boy would benefit from having it removed, as it was obviously bound tightly to his glans, and might possibly impede urination. She'd told us that she'd noticed that the boy seemed to strain during urination, and that the foreskin swelled up like a balloon. After he'd urinated, no matter how much she wiped his penis, there would always be a few drops leaking to wet the diaper afterward, as urine had become trapped inside his foreskin.

When she brought her newly circumcised baby home, she invited us over to see the results. She removed his diaper, which had to be changed because it was wet, and she also removed the gauze pad that had been over the operative area. We saw that the result was perfect, the red glans standing free of its foreskin, with only a red cut line behind it, and no wrinkled skin bunched up behind the rim as happens when other methods of circumcision are employed. When he urinated, it was with a neat strong stream, and there was no foreskin to retain any residue to stain his diaper. He also seemed to be more relaxed while urinating, as he didn't have to strain.

We later found out that the first woman in our area who had a boy delivered by the foreign born OB/GYN had simply accepted that he could not perform a circumcision on their boy, and she left it at that. She had not thought to have a pediatrician perform the circumcision. From the start, she had nothing but trouble with his penis. The foreskin was abnormally long, extending beyond the boy's glans an amount equal to the length of his penis. It was so long and tight that she didn't think retraction for cleaning was possible, and she was probably right.

The boy suffered from the same problems that our neighbor's boy did while he still had his foreskin. He had difficulty urinating, always crying because of the effort required. The foreskin swelled with trapped fluid during each urination and afterward would be seeping urine into the new diaper. Because the foreskin was so long, it retained enough urine to form a three inch wet spot after ten minutes, and the mother had to change the diaper twice each time. If she forgot the urine would irritate the boy's penis.

When the boy was five he started school, and the school nurse noted that he wasn't circumcised, and had a talk with his mother. She mentioned that an especially long foreskin, such as the one on her boy, would inevitably lead to serious problems. She advised circumcision, but Mother didn't want to put the boy through surgery at that age.

Shortly thereafter the boy developed an infection, and his penis swelled. The emergency room doctor prescribed an antibiotic but told the mother that she had to have the boy circumcised as soon as the swelling went down. Several days later she brought the boy back to the hospital, and the emergency room physician called in a pediatric urologist who put the boy under heavy sedation for the surgery. With the boy barely conscious, he was unaware of the multiple injections into his penis for full local anesthesia, and the urologist performed a circumcision while the mother watched. He used the Gomco Clamp, and the result was perfect, although five years too late. The lesson is that parents should never take "no" for an answer and insist on having their boys circumcised right after birth. If one doctor won't do it, or doesn't want to, they can easily find another who will. As many OB/GYNs and pediatricians perform infant and childhood circumcisions today, they will have no problem locating one qualified to do this.

Uncircumcised guys are less happy about it, than their circumcised counterparts

My recent survey indicates that 17% would rather not have been circumcised. But 60% described themselves as very happy to be circumcised, and another 16% were glad to be. That's 76% who liked being circumcised. Only a measly 7% didn't care either way.

Only 51% of uncircumcised men were happy they had a foreskin. But they had a much higher proportion who didn't care either way.

It seems that circumcision is the 'love it or hate it' option - but the vast majority love it.

When is the best time to circumcise?

Infant circumcision is quick, easy, relatively painless and inexpensive. The results may not be perfect cosmetically and the boy might grow up feeling that he had been robbed of a desirable bit of skin. Conversely, he will never feel 'different' from his circumcised father, brothers and classmates.

Childhood circumcision (i.e., after infancy, but before 11 years old) is probably best avoided unless there are clear medical indications or the boy specifically requests it. General anesthetic, with attendant extra risks and higher cost is almost always needed because the boy is too young to lie still.

Early teenage (11 to 13) is a good time to circumcise the boy who missed out at birth due to prematurity, one parent being opposed, being born in a non-circumcising country, etc. It will make the boy feel 'regular' and removes the foreskin before the boy starts to gain sexual stimulation from it at puberty. It is also about the earliest that one can say that the penis is no longer a tiny organ which is hard to work on accurately. The boy can be actively involved in the decision, although he is still young enough for a parent to mandate it without too much adverse reaction. Local or general anesthetic can be used dependent upon the boy's ability to cooperate and the surgeon's requirements. General should be used if the boy is of nervous disposition or is not really wanting the operation.

Puberty is the time for corrective surgery as a result of puberty phimosis, and a good time to see if the boy himself wants to be done before he leaves school for the wide world of work and sex. The penis is of a size which allows for very accurate surgery to place the scar line exactly where wanted with the exact degree of tightness that is desired. The discomfort is considerably greater and, because the operation takes somewhat longer, the costs are higher. Local or general anesthetic can be used, although a local is to be preferred.

If a boy is circumcised anytime after infancy and before adulthood, a complete explanation and simple drawings should be used to help him understand the procedure he is about to undergo.

Explain the two basic types of penises.

looseskin male drawing.jpg (38629 bytes)

Teach some basic anatomy and try to reassure that only the foreskin (1) and frenulum (4) will be removed.

Show your son what he can expect to look like after the procedure.

And let him know the many benefits of circumcision.

Choices	%
Routine infant circumcision (RIC) is best.	37.21%
Between ages 1-6	1.16%
Between ages 7-12 (pre-pubescent)	12.79%
Between ages 13-15 (during puberty)	1.16%
Between ages 15-18 (adolescent)	8.14%
Between ages 18-25 (young adult)	18.60%
Anytime Before Adulthood/Marriage	8.14%
After age 30 to be sure this is what he wants	4.65%
Should NEVER be performed at ANY age	1.16%
At any age but only for medical necessity	6.98%

Website Survey of CIRCLIST members Fall, 1999 with approximately 1/3 of the CIRCLIST membership responding.

I have used only the basic medical pointers so far in discussing age. Of course, for Jews the 8th day is a MUST. For Moslems the age will depend on their local customs and may be birth, 10 years old or 13 years old (as well as many ages in between) depending upon which sect,etc they belong to.

Teenage (puberty) circumcision can be used as part of a rite of passage from childhood to adult status (at least within the family) and the boy can be trained to look forward to the day when he will become A MAN.He may also be expected to endure the operation with minimal pain killer to show the fortitude of a man, BUT this MUST be within a large family or community circle where ALL males are treated this same way. If fortitude is to be expected then the boys should be circumcised in pairs or larger groups, never alone. The benefits of their newly, and painfully acquired 'adult' status must be real and tangible.

Infant. If circumcision must be done for any reasons then 7-10 days after birth is the ideal time. At this age there is no anesthetic risk, no separation from parents, no psychological trauma, no stitches, no memory of the event and the wounds heal in a few days without causing any discomfort. Circumcision with a 'Plastibell' is probably the best method and the baby can be bathed normally.

Child. In the child circumcision may be an unpleasant experience causing psychological trouble which persists for some time afterwards. Separation from parents, the anesthetic, having his 'tail' made sore etc. may all be upsetting. The anesthetic agent 'Ketahr' and the 'Plastibell' circumcision device have made the operation simpler and safer in young children. Lads in the 2-6 age group are aware of the differences between boys and girls and being unable to appreciate the nature of the operation may fear that their masculinity has been taken away.

Adolescent and adult. Circumcision at this age can readily be done under local or general anesthesia without psychological harm because the patient can understand the reason for the operation. It can be done on an out-patient basis because the wound is not particularly painful and the patient remains up and about. The wound heals in a week and sexual intercourse can be resumed in 3 weeks. To secure maximum benefit the surgeon should be requested to remove all the foreskin. The main problem is embarrassment in having the genitals handled, explaining absence from school or work, and having to face remarks when news of the operation leaks out. The fear that an erection after the operation will tear the stitches is of course quite unwarranted. For more information visit the American Family Physicians article on Adult Circumcision.

I've often considered what is the ideal age to circumcise. My starting point is that adult males with foreskins just don't look right. Something should have been done about it before the owner reached adulthood. It seems to me that one can distinguish four age ranges during which the procedure can be carried out, each of which has different advantages and drawbacks.

Working backwards from adulthood, the first age range you come to is puberty. Some cultures perform circumcision at puberty as part of coming-of-age ceremonies. This is a good time, as it leads to bonding, kinship and cultural identity. I think Nelson Mandela has something to say about that. Also, the anti's really can't complain about that because the individual is able to decide for himself at that age that he wants to partake. The downside of circumcision at this age is the pain and the fact that healing takes longer than it would if the subject were younger.

The next age range is about age five to puberty, when the subject will retain conscious memory of the procedure, even though his choice in the matter might be limited. The is the Turkish/Albanian/Bosnian Muslim age range. At this age technically it is probably easier and safer than infant circumcision. Sociologically it is excellent as the child will be rewarded by gaining entry to his society along with his circumcised peers. I think the society also gains coherence by the shared experience of its members of going through the ordeal of being circumcised.

The third age range is from say 3 months to five years old. This is probably the least good time to circumcise a child, as he will be frightened and will be unable to understand the reason for his circumcision.

This leaves infancy/the neonatal period. This is probably a good age, and in societies with no tradition of circumcision later on, it has to be done then. The operation might be slightly riskier in infancy as a small mistake has greater consequences than later on when there is "more to get hold of".

Overall, it seems to me that in an ideal world the age range from five to puberty is the best time for circumcision.

I am often torn between the benefits of neonatal and teenage circumcision. Since neonatal circumcision is quick, simple, virtually painless and has benefits in UTI reduction there seem to be good reasons to-do it then.

On the other hand there is the possibility of soiling of the wound from fecal matter in the diaper and the fact that the boy has no possible say in whether or not he is to keep or lose the foreskin.

Teenage circumcision makes most sense when it is seen as a puberty ritual by the whole tribe/neighborhood. Boys could then have some say in whether or not they got clipped but those who chose not to would be known to everyone and would find getting a partner or a good job more difficult as they would be perceived as 'rebels'.

Circumcision in early teens should give the best results since the penis is large enough to position the cut for best effect and the growth spurt of puberty can then tighten fully what the surgeon got to the best of his ability.

Indications For Circumcision

CIRCUMCISION IS ESSENTIAL

Tight Foreskin. After infancy the foreskin should be loose enough to be drawn back so as to completely expose the whole penis head and to be pulled forward again without pain or difficulty. In the mature youth this action should be possible with the penis erect. If it cannot be retracted at all (phimosis), washing is not possible and smegma accumulates. Phimosis in adults also makes sexual intercourse unsatisfactory and low deposition of semen in the vagina due to poor penetration may cause infertility. Occasionally the opening becomes so small that even urinating becomes difficult. If a tight prepuce is forcibly drawn back (e.g. during intercourse) it may become jammed and incapable of being pulled forward again (paraphimosis). In this painful condition the foreskin strangulates the glans and emergency treatment is necessary. Phimosis may follow injury inflammation (see below), or it may be a developmental abnormality. Parents are often surprised to learn that their teenager needs a circumcision, having been assured he was perfectly normal earlier in life. The explanation is that before puberty the opening in the prepuce was large enough to allow the glans to pass through but during the rapid growth of the penis after puberty only that part of the foreskin which covers the glans enlarges. In consequence, the tip of the prepuce which lies beyond the glans does not grow, the opening stays the same size and the much enlarged glans will no longer pass through. A tight prepuce (foreksin) CANNOT BE CURED BY stretching because little splits or tears which heal with scarring making the condition worse than before.

Inflammation. In spite of adequate hygiene one may suffer from persistent to recurrent soreness, itching or redness of the inner aspect of the foreskin and penis head (glans)-a condition called balanitis. Occasionally there may be an acute attack with a discharge of pus which resembles gonorrhea. Balanitis may also occur before the prepuce has fully separated from the glans in childhood when washing is not possible. A long prepuce tends to retain moisture predisposing to this condition which is often precipitated by warm weather (summer balanitis). Balanitis occurs especially in sportsmen and others who sweat a lot. One or more acute attacks or recurrent mild attacks heal with scarring of the foreskin and phimosis develops. Similarly, inflammation affecting the glans may heal with scarring and narrowing of the water pipe opening (meatal stenosis). If passing water becomes difficult an operation (meatotomy) to enlarge the opening may be necessary. A variety of germs will flourish under a damp prepuce and they are difficult to permanently eradicate until the area is rendered permanently dry by circumcision. Thrush or Monilia, a fungus infection, is quite common in the vagina of women on 'the pill' and their male consorts are liable to get 'thrush balanitis'. Due to the presence of sugar in their water diabetics are also prone to balanitis. Similarly warts under the prepuce, which are caused by a virus infection, are difficult to cure until circumcision is performed. If you suffer from balanitis seek medical advice and DO NOT TREAT YOURSELF WlTH A STRONG Antiseptic which may make the condition worse. A similar malady found only in uncircumcised men is posthitis. This is an inflammation of the foreskin, as opposed to the inflammation of the glans.

Torn or tight frenulum. The frenulum, also called frenum is a band of skin containing a blood vessel and some sensory nerves which joins the inner aspect of the prepuce to the glans on the under surface of the penis. Drawing back the prepuce pulls upon the frenulum and in full penetration during sexual intercourse the frenulum is quite taut. If the frenulum is short or tight, full penetration may cause discomfort which may last for several days; or the structure may tear causing a painful wound for a longer period. Occasionally bleeding occurs which requires emergency treatment. Surgical division of the frenulum usually cures the trouble and this can easily be done under local anesthesia. Sometimes circumcision has to be done as well to relieve the tension in the frenular area. A boy should be instructed to check that his frenulum is satisfactory before he leaves school. He should be able to completely retract his prepuce so that it lies flat along the shaft of his erect penis without causing pain or markedly bending the glans downwards.

Religion. The operation is obligatory for infant Jewish males and pre-adolescent Moslem males as a religious rite and should be performed in accordance with religious custom and tradition so that the boy feels part of, and is accepted into, the society.

Parental request. Routine circumcision at birth other than for religious reasons is a custom in several countries. Most males are circumcised soon after birth in the U.S.A, Canada, Australia and New Zealand but until recently this was rare in Continental Europe. In Britain, routine infant circumcision is much more common among the well-to-do or upper classes; and it is commonly known that Prince Charles was done by a Mohel, or Jewish circumciser, and that his two brothers and now his sons, are also circumcised. Every parent wants to do what he thinks best for his child and this may include a sincere belief in the benefits of circumcision. Common reasons given by parents requesting the operation are "His father was done"; "It's more hygienic" and "It will prevent trouble later in life". One can sympathize with the man who has unpleasant memories of having the operation done later in life and thus seeks to avoid the same situation in his sons by requesting circumcision at birth. Likewise, one can understand the request when an older son, or child of a relative, is distressed by circumcision later in childhood.

Desire to be circumcised. It is not uncommon for a man to be dissatisfied with the size or appearance of his penis. Quite a number of men have an intense desire to be circumcised which usually arises after seeing the circumcised organs of brothers or school fellows. In time, this initially simple wish to have the appearance of his penis improved becomes an obsession in which he feels that the continuing presence of his foreskin is affecting his sex life. If he is brave enough to confide in his doctor he will be told that his penis is quite normal, operation is not necessary, and he should see a psychiatrist and not a surgeon. Most surgeons are unsympathetic and would refuse to operate on these unfortunate individuals even as private patients. Whilst it is true that the patient's mental attitude is the cause of his sexual disability, it is equally true that circumcision cures the condition. The stand taken by doctors on this issue is quite inconsistent when one considers that a woman who thinks her breasts or nose are not quite the right shape is sent to see a plastic surgeon without any investigation of her psyche.

SUMMARY AND COMMENTS Phimosis and persistent balanitis are the most common medical reasons for circumcision in this country. Have yourself circumcised if you suffer from these troubles because they will get worse with time and may lead to more serious complications in later life. A vicious circle develops in which balanitis produces phimosis which prevents washing the penis and leads to further attacks of balanitis, due to lack of hygiene, with more scarring. If phimosis is the primary condition then balanitis will sooner or later be a complication and the same cycle of events results. Men who get cancer of the penis usually give a history of 20-40 years of phimosis and/or chronic balanitis so these troubles have more than just a nuisance value. It is not generally known that the tendency to penis troubles is inherited so if a man has trouble with his prepuce or frenulum he should seriously consider having his sons circumcised at birth as a preventative measure.

CIRCUMCISION IS ADVISABLE

Climate or occupation. Balanitis and its complications may occur in this country but are even more likely to occur in individuals who are going to live in a warm climate. In hot and humid countries the inhabitants are aware of the problem and practice routine circumcision in childhood as a preventative measure. Merchant seamen, particularly engine-room staff, are also at risk and although circumcision is not a condition of employment it is a sensible precaution and advised by some firms. Whilst one cannot predict that anyone will have trouble abroad or at sea, it is probably better to lose a normal prepuce at a suitable time under optimum conditions in the UK than find that the operation has become necessary when conditions are primitive, the time is inconvenient, the foreskin is inflamed and medical aid is not readily available. The normal penis heals rapidly after circumcision but healing may be delayed and the wound become infected in tropical conditions, particularly in the presence of balanitis. To be unable to work because of an attack of tropical balanitis is embarrassing enough-but no one will believe that it is not really a dose of VD!

Redundant foreskin. As we have already seen in over half the male population the prepuce shortens during development leaving the glans partially or completely exposed but in the remainder the long infantile form persists. The persistence of a long foreskin must be regarded as a failure of normal development because of the greater incidence of troubles associated with this state. Foreskin length is an inherited characteristic; thus if a man finds his long prepuce is a nuisance then his sons are likely to grow up also wishing they had been circumcised when they were small. A long foreskin retains moisture so that the inner aspect of the prepuce and the glans become white, sodden and malodorous. Balanitis develops in the devitalized tissues and even if the inflammation is mild, phimosis may follow in a few years. A long prepuce may be an anatomical cause of premature or early ejaculation, a condition in which a man 'comes' too quickly during sexual intercourse and sometimes even before he has entered the vagina. It seems that the glans is too sensitive due to a combination of over-protection from an excess of foreskin and some degree of balanitis. A long foreskin may also be a nuisance during intercourse due to its sheer bulk. An excess of prepuce may cause social embarrassment or to quote one youth "I 'm fed up with the comments about my elephant's trunk in the school showers". The trouble may be associated with a rather long foreskin suggest that it is a redundant or unwanted piece of skin and it would be better to complete the development process by shortening it surgically. It is interesting to record that a man with a long prepuce living in the UK runs a much greater risk of foreskin troubles than he would of developing say tetanus, TB, polio or other diseases against which he is probably protected.

Very loose foreskin. Having shown that a tight prepuce is a definite indication for circumcision one would expect that a rather loose one would be an advantage. A loose, short foreskin usually causes no trouble during sexual intercourse but it may ride to-and-fro during everyday activities trapping pubic hairs. A long, loose foreskin may be a nuisance if it will not remain retracted as a collar behind the glans during sexual intercourse but tends to slip forward re-covering the glans. The man virtually masturbates inside his foreskin during intercourse and his partner complains of lack of stimulation.

Physical or mental handicap. Severely physically handicapped males may be unable to wash their own genital area, while the mentally handicapped may be incapable of learning and appreciating the need to do so daily. It is therefore desirable to relieve them of this problem, and the resulting risk of serious infection, by performing a complete circumcision. Where the degree of handicap is obvious in infancy then this is naturally the best time to perform the operation, otherwise in the early teens. If the severely handicapped boy is to live in a residential institution (even on a weekday only basis) he should be circumcised before starting there so as to avoid unnecessary embarrassment.

Prevention of cancer of the penis. Cancer of the penis affects men in the 40-70 age group and being fairly rare only causes 80-100 deaths every year in the UK It is treated by partial or complete amputation of the penis and about half of the victims survive hr 3 years. Men who develop this cancer give a history of phimosis and/or balanitis over a period of years. Smegma seems to be the cancer producing agent which accumulates before the foreskin becomes retractable in the child, or later in life when hygiene is not practiced due to phimosis or ignorance. Complete circumcision in the first three years of life completely prevents this disease and a lesser degree of protection is afforded if circumcision is incomplete or done later in life. Whether it would be justifiable to circumcise all new born boys to protect the small number who will later in life get penile cancer is a matter for debate. It has been suggested that it is better to lose a little bit than risk losing the lot!

Prevention of cancer of the neck of the womb. The low incidence of cancer of the neck of the womb or cervix in Jews has been known for a long time and investigation has shown that it is associated with circumcision of their men and is not a racial immunity. Statistics in Moslems and other groups practicing circumcision in various parts of the world have produced conflicting results and overall the operation seems to be less effective in preventing cancer in non-Jewish people. Jewish and the other circumcised groups may not be strictly comparable because whilst all Jews are thoroughly circumcised soon after birth the others may have been incompletely circumcised at various times after birth, or into their teens. Also unreliable answers about circumcision status may be given by men (and for their wives) when they are not Jewish or Moslem. It is now known that a number of factors are involved in cancer of the cervix and circumcision is of secondary importance compared with the other variables - personal hygiene, age at first intercourse, and number of partners. Good personal hygiene may well be the relevant factor and this is ensured by circumcision; but herpes virus infection has recently been implicated in the causation of cervical cancer.

Prevention of cancer of the prostate gland. The prostate gland lies at the base of the bladder and supplies part of the liquid which forms the semen ('cum'). Cancer of the gland may occur in later life and it causes about 3,000 deaths a year in the UK Circumcision may be a preventative measure since the disease is less common in Jews than Gentiles and herpes virus has now also been implicated in the causation of this disease.

Hygiene. Those who argue that soap and water are all that is required for penile hygiene and that circumcision is quite unjustified are ignoring the evidence that many males forget or ignore this part of their toilet. Parents must show the boy how to retract his prepuce at bath time until he is old enough to do this for himself. Due to fear, ignorance or embarrassment in dealing with his 'privates' they often fail to give this instruction; and subsequently to ensure that he keeps this part clean. Circumcision renders the penis permanently clean and avoids the washing and inspection which may draw unnecessary attention to his penis at an early age. As we have already seen, where the hygiene problem is the result of physical or mental handicap then circumcision becomes not just optional but highly desirable.

Aesthetic considerations. Many women think that their baby sons look neater and tidier after circumcision. In their husbands some think the circumcised penis is more handsome and do not regard the operation as a mutilation. They may well be 'turned on' by the sight of the naked glans but the absence of smell and smegma may be contributory factors. Women are more willing to participate in fellatio (oral sex) if their partner is circumcised. The glans without its masking foreskin tends to produce a more prominent bulge in tight clothing which some females find sexually stimulating.

Delays orgasm. A male reaches his climax or orgasm in about half the time it takes a female to achieve orgasm. The ideal is for the female to have one or more orgasms before the male reaches his climax. It is not uncommon, particularly for inexperienced men, to have difficulty in delaying orgasm to meet the needs of their partner. Various measures, including circumcision, may be used to delay orgasm. After circumcision the glans becomes dry, tougher and less sensitive. Most men find that after the operation orgasm is delayed but much more intense and their partners notice that they last longer'.

Improved stimulation during intercourse. After circumcision the glans increases in girth, since it is no longer constricted by the prepuce, and the margins of the base of the glans become more prominent. In the uncircumcised man the rolled back foreskin masks the margins of the glans hence circumcision makes these parts more prominent during intercourse. The circumcised penis thus makes better contact with the vagina increasing stimulation and pleasure for both partners.

Increases the efficiency of a small penis. While there is no exact relationship between stature and the size of the penis there is a general tendency for the shorter man to have a smaller penis. In Britain growth of the penis is complete by about the seventeenth birthday and the average man then has an organ which when erect is 6" ( 15 cm) long and 5" ( 12.5 cm) in circumference at the base. The importance of penis size as a factor in sexual adequacy has been exaggerated but it must be apparent that to give the same amount of stimulation the man with a short penis must insert a greater proportion of his organ than his better endowed neighbor. A limiting factor in penetration is how far a prepuce can be drawn back without causing discomfort. The size of the penis cannot be increased but circumcising a small organ may be a useful measure in enabling a man to give greater satisfaction to his partner.

Reduces the risk of Sexually Transmitted Diseases Circumcision does not prevent VD but men who are circumcised, or have naturally short foreskins, are less likely to become infected than those with long foreskins. The protection afforded is due to the toughening of the glans and the dry conditions which are unfavorable for the growth of germs. Circumcision does not affect the incidence of gonorrhea and syphilis, but of the other sexually transmitted diseases genital herpes, genital warts and thrush balanitis are much more common in uncircumcised males. Circumcision may be necessary as part of the treatment of thrush balanitis and genital warts. There is no effective treatment for herpes simplex virus and if it is confirmed that it plays a part in the causation of cancer of the cervix then, in the face of increasing promiscuity, circumcision at birth may be advocated as a preventative measure. Recent research has indicated that circumcised males are less likely to contract AlDS than their uncircumcised brethren in similar circumstances (this is due to the drying and toughening of the circumcised glans and the reduced risk of tearing of the frenulum). It has also been shown that circumcised infants are less likely to suffer from non-specific urethritis (inflammation of the urethra, or water pipe).

Circumcised brothers. A number of boys show signs of distress if they are different from their brothers in respect of their circumcision status. This is particularly true at the time when a young uncircumcised boy starts to notice the difference between himself and his older circumcised brother or brothers. The resulting psychological disturbance can lead to various problems including enuresis (bed-wetting). Parents may therefore wish to consider the advisability of having younger sons circumcised at birth if their older brothers have already been circumcised. Similarly if one son needs a circumcision for medical reasons then his parents may want to consider having all his brothers, both younger and older, circumcised at the same time to keep them alike and avoid possible future problems.

Unsatisfactory circumcision. Between 10% and 16% of males in the United Kingdom (Great Britain) are circumcised and most of them are satisfied that the operation has produced a trouble-free penis of acceptable appearance which functions well during intercourse. In circumcision for medical reasons (usually phimosis) there may be incomplete removal of the prepuce and the penis looks the same as in the 20% or so of men who have naturally short foreskins. The patient is usually quite satisfied because the operation has cured his trouble and the preputial remnant does not cause any bother. A minority are dissatisfied with their circumcision because the penis looks untidy due to the remnant of prepuce, or an ugly wound scar, and occasionally because the operation has failed to cure the balanitis for which it was performed. If an individual finds his circumcision functionally or aesthetically unsatisfactory he can be re-circumcised to give a better 'end' result. If the problem is physical rather than aesthetic then revision surgery should be available under the National Health System.

This vestige of early man that evolution forgot is more useless than your tonsils and more problematic than your appendix. Usually, your foreskin behaves itself and you hardly know it's there, but it can create a few problems--and a few of those problems are potentially dangerous.

Because bacteria and germs thrive in the warm, moist fold of skin that envelops the head of the penis, males with intact foreskins are ten times more likely to develop kidney and bladder infections and sexually transmitted diseases than their circumcised peers, according to Lt. Col. Thomas E. Wiswell, M.D., chief of the Neonatology Department at Walter Reed Army Medical Center in Washington, D.C.

When it comes to foreskins, cleanliness is next to nothingness in keeping bacteria at bay. No matter how meticulously and diligently you clean that fold of flesh, it still makes you much more susceptible to urological inconveniences, says Dr. Wiswell, who was once a staunch opponent of circumcision. He has since changed his mind. "I'm obviously a proponent of good hygiene," he says. "But there's no good data saying hygiene will minimize the risk for these complications as much as or more than circumcision."

The recurrent infections cause tissue scarring that makes the foreskin lose its elasticity, a condition called balanitis, says Irwin Goldstein, M.D., a professor of urology at Boston University School of Medicine. Men with diabetes are particularly vulnerable.

The foreskin can close off around the head of the penis, impeding urine flow, which is known as phimosis. And if the too-tight sheath is retracted over and behind the head of the penis, the head begins to swell and the foreskin cannot be returned to its normal position. That phenomenon, called paraphimosis, is a surgical emergency and "can be dangerous," Dr. Goldstein says. "I've seen the head of the penis amputated because of this."

With hygiene almost ineffective against infections and their complications, what recourse exists to keep your foreskin healthy and problem-free? Here's what doctors recommend.

Do keep it clean. Whether it reduces the chance of infection or not, you should keep the foreskin as clean as possible. "Wash the penis as you would any other area of the body," Dr. Wiswell says. "Then gently retract it and wash in and around it with soap and warm water. Then dry it carefully." For the infections that inevitably crop up, physicians prescribe antibiotics, he says.

Don't force the tissue. In cleaning or making love, never attempt to forcefully open the foreskin or pull it back over and behind the head of the penis, doctors say. In men, the foreskin should retract naturally as they get an erection, according to Dr. Goldstein. In children, the foreskin cannot always be retracted to expose the head of the penis until the age of two or three, Dr. Wiswell says.

If you can't return the foreskin to its original position, see a doctor immediately. An incision called a dorsal slit will be made in the foreskin to allow it to move more easily over the head of the penis, Dr. Wiswell says.

Consider a circumcision. Not all doctors will recommend that circumcisions be performed, but many recognize that the benefits outweigh the risks, Dr. Wiswell says. It is, after all, the only real way to virtually guarantee prevention of the relatively rare cancer of the penis. (Interestingly, of some 60,000 reported cases of penile cancer since 1930, only 10 of the men have been circumcised.)

More and more uncircumcised males are having the procedure done later in life. "It's not entirely risk-free," Dr. Wiswell says. "The risks are there, but they're low." Possibilities to discuss with your doctor if you consider a circumcision include infection from the surgery, trauma to the head of the penis, bleeding and, although it's extremely rare, abnormal healing.

Bed Wetting

I've met a lot of discussion about whether circumcision affects bed wetting or not, and I agree that for me at any rate there is no real connection, and I know it all ways. As a kid, I grew up uncircumcised in an area where all the other kids were circumcised, and quite naturally I got the idea (the other kids did too) that I wet the bed because I had a different sort of penis than them, and it was one of the things that made me aware of circumcision and started my interest in it. My foreskin was tight at the time, but I realized I had a knob underneath it, so I worked at loosening my foreskin, and succeeded, and I remember being disappointed when I found that when I was able to skin back, it made no difference to my bedwetting or to having to piss more than the other kids. I have always been a natural bedwetter, probably hereditary, since I have aunts and cousins who are the same, and when I was much older and got circumcised, I wondered if it would have an effect, but it did not. If anything, it made me want to piss a bit more in the daytime, but that was only while I was getting used to being circumcised. The only thing I'd add is that if you are a pisser or a bedwetter (and there's one in a hundred people who wet their beds all their lives), it's better to be circumcised, because with me, I had a lot of trouble from my foreskin getting sore and this was probably because it was wet so much.

There is discussion of whether a child’s foreskin can be retracted and questions about at what age. Some of my earliest memories (definitely age 4 years or earlier), are of problems of infections under the foreskin and going to the doctor to be treated. He would retract the foreskin to clean it and put medicine on it. For some reason, they never had me circumcised.

I remember too, at age 4 or earlier, my little playmate Lilah, from up the street, used to pester me to see my bare glans (my “strawberry” as she called it). I don’t remember if she did any more than look at it. Us kids used to stand on the creek bank and see who could pee the farthest. My tight foreskin kept me from being able to urinate with the skin retracted, so I always lost the contest.

I had been taught to pull back the skin and wash under it when bathing but, I had also been taught not to play with myself. So, I would just give it a quick swish and forget about it. But, when I was about 13 and starting to grow up, I would get erections when I cleaned it and noticed the foreskin had started to grow on to the glans (adhesions). I asked my parents what to do about it and they said, just pull on the skin and you can probably pull it apart. I did, and was only partly successful. In the Navy, I was always embarrassed in the “shortarm inspections” because there was always a stink when the foreskin was pulled back, even though it was washed at least daily.

I took some teasing from teenage friends, who liked to point out that my penis was “adjustable for gardening”.

When I got married, I realized my penis was very uncomfortable with the foreskin retracted. However, sex required it. Fortunately, you might say, sexual activity could distract me enough that it did’t seem like a big problem. I was always concerned that I could not continue sex very long without ejaculating. When we were young, my wife couldn’t continue very long either, so it didn’t matter much. Later, she needed nore stimulation and I became more concerned about it and began wondering if circumcision was what I needed. Also, the discomfort of the retracted foreskin bothered me more and more, as it somewhat spoiled prolonged sex play. I wasn’t sure whether that discomfort when retracted was normal or not. I guess I was pretty naive.

When I went to the urologist and was asked to do a “free catch” urine sample, I couldn’t follow the instructions to pull back the foreskin before urinating, because I couldn’t pee with it pulled back. I discussed circumcision with two different urologists and both strongly discouraged it, more or less saying, “unless you have a big problem with infections, I won’t do it”.

Eventually, I located CIRCLIST and some other circumcision sites, most of which were ANTI-circumcision. However, some of the women at these other sites were very sympathetic and one, at “nocirc” suggested I had a tight frenulum. That was news to me but it made sense. She told of some acquaintances who corrected a similar problem by having their frenulum “shaved” away from the underside of the glans.

My frenulum had spontaneously developed a small split during sexual activity but it didn’t split enough to relieve the tightnesssignificatly. I was aware a lot of my sensitivity was in the area of the frenulum, so I tried to investigate whether it would impair my sexual functioning if the frenulum was removed. Surprisingly, I never was able to get enough evidence to feel sure.

I was getting more interested i the idea of being circumcised. It had always been clear to me that females liked to see the bare glans, ever since my days playing with Lilah. Female nurses always seemed to sneak a look at it. Surveys showed women liked circumcised penises by a large margin. My urologist’s pretty little blond nurse, when asked, told me that, “by all means, yes, you should get circumcised”. That urologist, however, did not want to do it.

My wife was having recurrent vaginal infections, partly because of medication she was taking. But, we began to wonder if I could be passing germs to her from my stinky foreskin. I got her to read some of the pro-circ information and she began to agree with me that I should be circumcised.I had to have some work done on my prostate (a new procedure called “Trans-urethral Vaporization, or TUVP”, which worked great with no side effects). This urologist agreed to do a circumcision while he was at it. He did a “freehand” circumcision, and used self dissolvingstitches. I had no bleeding or significant discomfort. After 14 days my wife said my penis looked “like a bulldog with one of those spiked collars” because of the stitches sticking out. On day 15 she pulled out a dozenof them. On day 16 we tried it out. Despits some tenderness, it worked fine. People discuss whether the glans seems to enlarge after circumcision. I think it has, somewhat.

I was very pleased at the wonderful feeling of freedom and comfort when erect which my new, circumcised, penis gave. That discomfort from the pulling frenulum was gone. My wife liked it. It stays wonderfully clean and I realized that, before circumcision, I had to spend too much time trying to keep it clean. That was no longer necessary.

I’m very happy to be circumcised. It’s a good conversation piece with women. They are very interested. I do have to be careful and not discuss it with other women when my wife is around. I can do a “free catch” urine sample with no problem. I could make a respectable showing in the contests to see who can pee the farthest.

Sexually transmitted disease (not HIV)	1 in 4
HIV	1 in 300
Penile cancer	1 in 400-600
Urinary tract infections	1 in 25-100
Balanoposthitis*	1 in 6
True phimosis (obstruction to urine flow)	1 in 10-50


Just Prior	9 Hours After	15 Days After	1 Month After

Parents who would circumcise their infant sons	72%
Parents who would not circumcise their infant sons	27%
Undecided	1%
Of These...
Father IS circumcised	51%
Father IS NOT circumcised	48%

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