Monday, August 27, 2012

Not Another Circumcision Post

Right now the natural birth and parenting community is blowing up over the American Academy of Pediatrics revision of their policy on infant circumcision. In 1999:
"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."
And now this just in:
"Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it."
They repeat this about a bazillion times then sneak in:
"Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns."
Whatever. Either circumcision is a good idea for non-medical reasons or it's not. I'm not going to labor on over this because so many others are saying it. No new evidence is provided, but suddenly the AAP is making a stronger case for the benefits. It looks like the steady decline in infant circumcision (80% in 1950's, 65% in the 1990's, now 55% nationally and 30% in western states) and the loss of the hundreds of millions in revenue for both preforming the procedure and selling the foreskins for research/cosmetics AND the decline in insurance companies covering the procedure when there is no medical indication for it are all making the AAP and the American College of Obstetrics and Gynecology (who are endorsing this statement) sweat. What? Why are the vagina doctors getting involved? Most circumcisions are actually done by OB/GYN's, not pediatricians.

 However, this isn't another why you shouldn't circumcise your baby post with statistics, studies and a picture of a screaming baby. It's a post about why Eric and I have remained unconvinced by the intactivist movement and what finally tipped the scales.

 Eric and I watched the circumcision episode of Penn & Teller's Bullshit while we were dating, maybe we were engaged. At the end of the episode we had a big "would you circumcise your kid" discussion. He felt like it was an easy decision because noncircs look horrible and he always felt bad for people who weren't circumcised. I felt like it was perhaps risky and unnecessary, but not unlike when women look in the face of science and say "nope, breastfeeding is weird, pass the formula," I couldn't get passed my personal dislike. My experience was that it was like being with a shar pei. No man should have to live with that... off with their heads... or whatever.

I still hoped we would not have boy because I just didn't want to make that decision for him. We found out we were pregnant with Milo so we had the talk again. I had statistics and descriptions of the procedure, but the gross factor won and we chose circumcision, which we watched and it seemed to go smoothly, we didn't know that babies sleeping through a circumcision was a stress response, but like so many other parents we found it comforting.

Another pregnancy, another boy, and another dive into the research. It really felt like for every study that showed a few benefits like an association between fewer cases of penile cancer or STDs, there was another study showing the opposite or an article showing why the first study was flawed -- and we are talking less than a percentage point in increased or decreased incidences of some things! Then there was all the information about how circumcision can disrupt sexual function later in life because the usually protected skin on the head thickens and gets less sensitive... and because like 50% of the nerves are removed during circumcision. But... Eric and I were also thinking, how many guys need to be more sensitive? Isn't that a problem? Has anyone ever thought "this would feel so much better if I had 20,000 more nerves." Probably not. Plus, the studies about actual sensitivity differences are often small, and again for every conclusive result there is another study with the opposite or an inconclusive one. Huge headache. And... then our kids wouldn't match, would that be weird? Would that be telling Milo his penis was a mistake. Sorry son, you only get one and we fucked it up, good luck with that. So we circumcised Ash, for me, mostly based on that last issue. The evidence was not great enough to risk Milo feeling bad, and Ash and I both paid for it.

Ash's circumcision when horribly. The pediatrician would not let us be in the room, Ash was hysterical the whole time and I cried in the waiting room. This went strongly against my instincts to protect my baby and something still wasn't adding up. I began hoping circumcision would just become illegal before we had another boy.

Our third pregnancy, and the intactivist's articles are flooding my news feed and my favorite blogs following the leaks of the AAP's coming announcement. I decided to reopen the case on circumcision and Eric agreed to keep an open mind.

There are buckets of studies and facts to support my decision to birth naturally and to breastfeed, but even if they didn't exist I would still do both. Not because they are super fun or because I'm competing for some better mom award (if you are, there isn't one), but because I believe we are designed. My faith in the fact that God made no mistakes when He created our bodies and their functions prevents me from being able to believe that most women are not meant to birth normally without drugs or medical assistance, and if we have breasts that make milk that babies like that we aren't meant to feed them that way. It's important for me to reach all women, not just those who subscribe to my belief system, so I inform myself of all the facts and studies as well... but for me... I don't hold my breath and hope everything I know about birth doesn't crumble every time a new study is published. 

When I applied the same way of thinking to circumcision, my brain just about short circuited. God designed foreskins, organs with functions. He also commanded the Jews to circumcise themselves as a covenant with Him. We know that for Christians this is a non-issue with the sacrifice of Christ and New Covenant we now have. But why would God command His people to do something that could potentially lead to sexual dysfunction, hemorrhage, and infection? Eric and I believe in the inerrancy of the Word of God and that scripture in the original language and historical context is perfect, Old and New Testament. Any kind of perceived contradiction must be an error in the English translation or a misunderstanding of the context.

I checked the Hebrew word for circumcise, muwl, and it means to cut, some argue it means to cut and not remove, but my usual sources simply said to cut.

So I checked the history of Jewish circumcision. I rarely feel like the Jews lead me astray if we are talking Old Testament. For the most part their traditions seem to be more closely aligned with scripture than Christians'. Perhaps it's because they have a better understanding of their history, which is obviously Biblical history and how scripture matches up to that, or because more of them speak Hebrew and less is lost in translation. Because I feel rabbis' have a better understanding of scripture than many pastors, it's hard for me to not trust that their bris is not how God intended it.

Turns out... it's not...

Brit milah is the cutting of the end of the foreskin, enough to draw blood necessary for the sacrifice and to look different, marking the skin of God's people. To see a drawing of what it looked like, you can go here. The foreskin still covered the head/gland and function was preserved. It would have been a minor procedure  compared to the full removal of the foreskin that is done today. It seems it should be obvious that if under medical supervision and access to antibiotics nearly 200 babies in the US die from circumcision that many more would have died in ancient times. Weren't many of God's commandments for the Jewish people to preserve their race? In case you are about to argue with me, yes... they were.

Commanding His own chosen people to take part in a ritual that could potentially kill many and cause sexual dysfunction for others does not make sense. Neither history or scripture support that this was the case. So where did the full removal of the foreskin come from?
"Many Hellenistic Jews, particularly those who participated in athletics at the gymnasium, had an operation performed to conceal the fact of their circumcision (1 Maccabees 1.15). Similar action was taken during the Hadrianic persecution, in which period a prohibition against circumcision was issued. It was probably in order to prevent the possibility of obliterating the traces of circumcision that the rabbis added to the requirement of cutting the foreskin that of peri'ah (laying bare the glans)." - The Oxford Dictionary of the Jewish Religion, ed. R.J. Zwi Werblowsky and G. Wigoder. Oxford University Press, 1997, page 161.
The medical procedure that exists today is not what God commanded Abraham to do to himself or his people, it was invented by men to support their religion. I'm forced to review my other reasons to circumcise and nothing holds up in the context of design. There is just no reasonable reason to circumcise your perfect new baby! 
When we were making the decision for our first son I thought I personally didn't like the look, but first off, God designed me to want the man He made me for. He knew Eric's parents would circumcise him (which Eric now wishes had not happened), and that's what I like. But also, a lot of my dislike had nothing to do with what an intact penis actually looked like. Have you seen one? Erect they look the same as a circumcised penis. What I did know were the joke about the intact penis. The reality looks very... normal. Because that's what it is. Either way, it's not for us to decide if it looks good or not. God made it, it has to good.
And if you do not believe in God... this all still applies. What is more important to any species that the reproductive system? Every species has a foreskin, that would be a pretty huge evolutionary mistake!
I'm not worried about our sons, even if we end up with both circ'ed and intact littles. Children are accepting of differences when they are explained in a matter of fact way. I remember one mom shared that her son just said he was "differs" from his brothers. I don't feel any guilt over circumcising Milo or Ash so they or future sons would not be able to pick up on that. They were not mistakes, just different decisions made with different information.

Update: August 27, 2013
So now a year later with a new little boy, this one kept whole, my feelings have changed some. I do feel regret over circumcising Milo and Ash. The truth is that Eric and I don't know what kinds of consequences our decisions will have for them in the future. I wish I didn't have the memory of Ash's screams, or Milo's long... honestly quite disturbing... healing time. That bothers me, but I think that's ok. As parents we will never be perfect, but we need to at least do better when we know better, and Eric and I feel good that we are at least doing that.


  1. Awesome post. I was so relieved when Carolyn came out with girl parts, because Brad and I had not agreed to circ or not. We have talked about it several times, and he feels that we need to because he is and Sam is. I let the intactivist's get into my head and tell him, "But, Brad, It is unnecessarily mutilating out baby's genitalia!" I like the whole biblical view you have taken on the procedure here. Though science can dictate many things, with "inconclusive" or "conclusive" evidence, it is still our decision to make...and with so many variables and so much research (or not enough research)...what's a mom to do? I have often just thought, "I wish it were illegal." That would be so easy! However, what it comes down to for me is sharing information that I have found with Brad, and then letting him make the decision as the leader of our household. I am going to have him read this blog post. Secretly, I will just pray that baby 4 is another girl, if only to avoid this subject forever.

  2. Aw thanks! You might be surprised if you keep bringing him solid information in a non threatening way. Eric was adamantly pro circ. We never fought over it, I just kept bringing up information and he actually brought up the "why would God injure His people" perspective. We both wanted to feel totally good about the decision and I think we've covered our bases now.

    I would avoid using "mutilating" or anything that is negative towards a circ... haha... I HATE that perspective because I really don't think there's anything wrong with a circ'ed penis, it's just the complications of the procedure and what can happen later in life.

    Does Brad have a brother? How often does he think of his penis? Or his dad's? Probably not that often. I think it seems like a big deal when they are babies because you are changing diapers and it's right there being all different all the time, and then it's not your business any more and it shouldn't be a problem for them because it's just the way it was made.