On the 8th day....

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I was asked in a comments box about the topic discussed here. My reply was too big for Haloscan, so I am also going to post it here.
Cicumcision has caused controversy since the Acts of the Apostles! For Christians, there is no theological reason to circumcise, as that visible mark of the covenant has been supplanted by Baptism (and that, BTW, is our best argument for infant Baptism). As prophylactic circumcision is a form of bodily mutilation, medical ethics would require that there be a greater good to be gained that outweighs the risks of the procedure. (Obviously, this does not apply to cicumcisions done for medical indications, such as phimosis or paraphimosis, or as part of the repair procedure for hypospadias.) OK, so what are the risks of circumcision, and what are the potential benefits (and these are theoretical when performing this prophylactically)?
Well, the risks are small and very infrequent, especially in the hands of a competent mohel or otherwise well trained cutter. They include bleeding, infection, surgical error, stress to the patient, and, if anesthesia is used, the risks of the anesthesia. In extremely rare cases, circumcision can lead to penile amputation or death from hemorrhage or infection. The pain felt by the infant is real - and the reaction to that pain may interfere with breastfeeding. There was an interesting study that looked at the reaction of children to the pain of injection for immunizations at ~~ 2 months of age - the boys who had been circumcised had what the observers rated as an exaggerated pain response. (The observers did not know who had or had not been circ'ed, and they were also rating girls). I am sorry that I can not remember the exact citation for this study but I will look it up if anyone is interested.
OK, well how about the benefits? A circumcised penis is easier to keep clean, especially in situations where water is rare and soap non-existant (like desert nomads?) Cleanliness is important to prevention of infection. Of course, the same applies to just about any skin-fold area, male or female. Material gathers in skinfolds, and it can get pretty rancid and grow bacteria, fungus, or shelter viruses. Cleanliness in important overall for health.
There have been studies that the partners of circumcised men have lower rates of cervical cancer and sexually transmitted disease, but later studies that factored out sexual behaviours such as multiple partners disproved this thesis. (makes sense, since 99% of cervical cancer is probably due to infection of the cervix with a strain of the human papillomavirus that is sexually transmitted). So marrying (both) virgin and remaining monogamous is actually a better protection against cervical cancer and other STDs than circumcision.
Circumcision does make applying condoms easier.
The only disease against which circumcision seems to be universally effective (prevention, that is) is primary cancer of the penis, a disease so rare that there has not been any study to see if it too may be related to a sexually transmitted virus.
The other advantages of cicumcision are psychosocial (matching one's peers) and psychosexual (meeting the expectations of one's parter(s) in bed). In a culture of modesty and monogamy, I don't think these would be real issues, but in our current culture I just don't know how much weight to put on them.
Having said that, I will say that our 2 sons were both circumcised, despite the fact that we paid cash for the procedure. At the time of their births, the weight of the medical evidence seemed to be in favor of circumcision. After their births, we had 3 more girls, so the issue did not arise. I honestly do not know what we would decide if faced with the decision today.
My advice to women who ask me is to carefully and prayerfully weigh the evidence (along with your husband), and submit to your husband's authority in this area. I do, however, recommend that those who choose cicumcision have it done no earlier than the 8th day of life, and that the cut be done by an expert (mohels are my first choice, if you can find one). Sugar and wine are traditionally given to the baby ahead of time, and help with the pain, and nursing immediately afterwards is a great comfort to the baby.

5 Comments

I just KNEW you'd be the perfect lady to ask. I hope the person asking the question over at Mark's blog reads what you wrote. You're a pro in every way!

That was extremely informative and helpful. Thanks. We'll continue to circumcise. It's a family tradition. :-)

Impressive and fulsome study of the issues involved. A tip o' the cap! You do know your stuff.

I thought I was born that way. The things your parents don't tell you..

LOL @ William! Me too!

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This page contains a single entry by alicia published on August 17, 2003 10:03 PM.

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