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The "recorded" complication rate of circumcisions is extremely low due to most problems not being noticed till sexual maturity. The main initial "problem" afterward is pain and scarring at the site of the incision.

How Does Circumcision Harm?

The "medical" debate about the "potential health benefits" of circumcision rarely addresses its real effects.

Circumcision denudes: Depending on the amount of skit cut off, circumcision robs a male of as much as 80 percent or more of his penile skin. Depending on the foreskin's length, cutting it off makes the penis as much as 25 percent or more shorter. Careful anatomical investigations have shown that circumcision cuts off more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves, and more than 20,000 nerve endings.The foreskin's muscles, glands, mucous membrane, and epithelial tissue are destroyed, as well.

Circumcision desensitizes: Circumcision desensitizes the penis radically. Foreskin amputation means severing the rich nerve network and all the nerve receptors in the foreskin itself Circumcision almost always damages or destroys the frenulum. The loss of the protective foreskin desensitizes the glans. Because the membrane covering the permanently externalized glans is now subjected to constant abrasion and irritation, it keratinizes, becoming dry and tough. The nerve endings in the glans, which in the intact penis are just beneath the surface of the mucous membrane, are now buried by successive layers of keratinization. The denuded glans takes on a dull, grayish, sclerotic appearance.

Circumcision disables: The amputation of so much penile skin permanently immobilizes whatever skin remains, preventing it from gliding freely over the shaft and glans. This loss of mobility destroys the mechanism by which the glans is normally stimulated. When the circumcised penis becomes erect, the immobilized remaining skin is stretched, sometimes so tightly that not enough skin is left to cover the erect shaft. Hair-bearing skin from the groin and scrotum is often pulled onto the shaft, where hair is not normally found. The surgically externalized mucous membrane of the glans has no sebaceous glands. Without the protection and emollients of the foreskin, it dries out, making it susceptible to cracking and bleeding.

Circumcision disfigures: Circumcision alters the appearance of the penis drastically. It permanently externalizes the glans, normally an internal organ. Circumcision leaves a large circumferential surgical scar on the penile shaft. Because circumcision usually necessitates tearing the foreskin from the glans, pieces of the glans may be torn off, too, leaving it pitted and scarred. Shreds of foreskin may adhere to the raw glans, forming tags and bridges of dangling, displaced skin.

Depending on the amount of skin cut off and how the scar forms, the circumcised penis may be permanently twisted, or curve or bow during erection.[33] The contraction of the scar tissue may pull the shaft into the abdomen, in effect shortening the penis or burying it completely.[34]

Circumcision disrupts circulation: Circumcision interrupts the normal circulation of blood throughout the penile skin system and glans. The blood flowing into major penile arteries is obstructed by the line of scar tissue at the point of incision, creating backflow instead of feeding the branches and capillary networks beyond the scar. Deprived of blood, the meatus may contract and scarify, obstructing the flow of urine. This condition, known as meatal stenosis, often requires corrective surgery. Meatal stenosis is found almost exclusively among boys who have been circumcised.

Circumcision also severs the lymph vessels, interrupting the circulation of lymph and sometimes causing lymphedema, a painful, disfiguring condition in which the remaining skin of the penis swells with trapped lymph fluid.

* Circumcision harms the developing brain: Recent studies published in leading medical journals have reported that circumcision has longlasting detrimental effects on the developing brain, adversely altering the brain's perception centers. Circumcised boys have a lower pain threshold than girls or intact boys. Developmental neuropsychologist Dr. James Prescott suggests that circumcision can cause deeper and more disturbing levels of neurological damage, as well.

* Circumcision is unhygienic and unhealthy: One of the most common myths about circumcision is that it makes the penis cleaner and easier to take care of. This is not true. Eyes without eyelids would not be cleaner; neither would a penis without its foreskin. The artificially externalized glans and meatus of the circumcised penis are constantly exposed to abrasion and dirt, making the circumcised penis, in fact, more unclean. The loss of the protective foreskin leaves the urinary tract vulnerable to invasion by bacterial and viral pathogens.

The circumcision wound is larger than most people imagine. It is not just the circular point of union between the outer and inner layers of the remaining skin. Before a baby is circumcised, his foreskin must be torn from his glans, literally skinning it alive. This creates a large open area of raw, bleeding flesh, covered at best with a layer of undeveloped protomucosa. Germs can easily enter the damaged tissue and bloodstream through the raw glans and, even more easily, through the incision itself.

Even after the wound has healed, the externalized glans and meatus are still forced into constant unnatural contact with urine, feces, chemically treated diapers, and other contaminants.

Female partners of circumcised men do not report a lower rate of Cervical cancer, nor does circumcision prevent penile cancer.[41] A recent study shows that the penile cancer rate is higher in the US than in Denmark, where circumcision, except among Middle Eastern immigrant workers, is almost unheard of. Indeed, researchers should investigate the possibility that circumcision has actually increased the rate of these diseases.

Circumcision does not prevent acquisition or transmission of sexually transmitted diseases (STDs). In fact, the US has both the highest percentage of sexually active circumcised males in the Western world and the highest rates of sexually transmitted diseases, including AIDS. Rigorously controlled prospective studies show that circumcised American men are at a greater risk for bacterial and viral STDs, especially gonorrhea, nongonoccal urethritis, human papilloma virus, herpes simplex virus type 2, and chlamydia.

Circumcision is always risky: Circumcision always carries the risk of serious, even tragic, consequences. Its surgical complication rate is one in 500. These complications include uncontrollable bleeding and fatal infections.[49] There are many published case reports of gangrene following circumcision. Pathogenic bacteria such as staphylococcus, proteus, pseudomonas, other coliforms, and even tuberculosis can cause infections leading to death. These organisms enter the wound because it provides easy entry, not because the child is predisposed to infection.

Medical journals have published numerous accounts of babies who have had part or all of their glans cut off while they were being circumcised.[53 54 55] Other fully conscious, unanesthetized babies have had their entire penis burned off with an electrocautery gun. The September 1989 Journal of Urology published an account of four such cases. The article described the sex-change operation as "feminizing genitoplasty," performed on these babies in an attempt to change them into girls. The March 1997 Archives of Pediatrics and Adolescent Medicine described one young person's horror on learning that "she" had been born a normal male, but that a circumciser had burned his penis off when he was a baby. Many other similar cases have been documented Infant circumcision has a reported Death Rate of one in 500,000.

Circumcision harms mothers: Scientific studies have consistently shown that circumcision disrupts a child's behavioral development. Studies performed at the University of Colorado School of Medicine showed that circumcision is followed by prolonged, unrestful non-REM (rapid eye movement) sleep. In response to the lengthy bombardment of their neural pathways with unbearable pain, the circumcised babies withdrew into a kind of semicoma that lasted days or even weeks.

Numerous other studies have proven that circumcision disrupts the mother-infant bond during the crucial period after birth. Research has also shown that circumcision disrupts feeding patterns. In a study at the Washington University School of Medicine, most babies would not nurse right after they were circumcised, and those who did would not look into their mothers' eyes.[66]

Circumcision violates patients' and human rights: No one has the right to cut off any part of someone else's genitals without that person's competent, fully informed consent. Since it is the infant who must bear the consequences, circumcision violates his legal rights both to refuse treatment and to seek alternative treatment. In 1995, the American Academy of Pediatrics Committee on Bioethics stated that only a competent patient can give patient consent or informed consent. An infant is obviously too young to consent to anything. He must be protected from anyone who would take advantage of his defenselessness. The concept of informed parental permission allows for medical interventions in situations of clear and immediate medical necessity only, such as disease, trauma, or deformity. The human penis in its normal, uncircumcised state satisfies none of these requirements.

Physicians have a duty to refuse to perform circumcision. They also must educate parents who, out of ignorance or misguidance, request this surgery for their sons. The healthcare professional's obligation is to protect the interests of the child. It is unethical in the extreme to force upon a child an amputation he almost certainly would never have chosen for himself.

Common Sense

To be intact, as nature intended, is best. The vast majority of males who are given the choice value their wholeness and keep their foreskins, for the same reason they keep their other organs of perception. Parents in Europe and non-Muslim Asia never have forced their boys to be circumcised. It would no more occur to them to cut off part of their boys' penises than it would to cut off part of their ears. Respecting a child's right to keep his genitals intact is normal and natural. It is conservative in the best sense of the word.

A circumcised father who has mixed feelings about his intact newborn son may require gentle, compassionate psychological counseling to help him come to terms with his loss and to overcome his anxieties about normal male genitalia. In such cases, the mother should steadfastly protect her child, inviting her husband to share this protective role and helping him diffuse his negative feelings. Most parents want what is best for their baby. Wise parents listen to their hearts and trust their instinct to protect their baby from harm. The experience of the ages has shown that babies thrive best in a trusting atmosphere of love, gentleness, respect, acceptance, nurturing, and intimacy. Cutting off a baby's foreskin shatters this trust.

Circumcision wounds and harms the baby and the person the baby will become. Parents who respect their son's wholeness are bequeathing to him his birthright--his body, perfect and beautiful in its entirety.

Paul M. Fleiss, MD, MPH, is assistant clinical professor of pediatrics at the University of Southern California Medical Center. He is the author of numerous scientific articles published in leading national and international medical journals.

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