Chapter 17 (Circumcision: The Painful Dilemma)

From Peaceful Beginnings

Chapter Seventeen: The Intact Penis – The Choice of “Non-Circumcision”

People from parts of the world where circumcision is not practiced would find it strange that many American parents who declined circumcision would feel that they were doing something "brave," "daring," or "radical." Often such parents worry about whether they have made the right choice, or think that their baby's penis looks "strange." Perhaps they have never before seen an intact penis.

Those giving birth in American hospitals often had to be quite insistent and militant about preserving their sons' foreskins. Sometimes they have faced criticism and lectures from doctors and nurses. Some parents who had planned to leave their sons intact have been talked into the operation.

Misinformation in medical textbooks and baby care books has led parents and physicians alike to believe that care of the intact infant is quite complicated and painstaking, and that the natural penis will be fraught with innumerable problems. Unfortunately this misinformation often results in excessive attention to the infant's foreskin and this excessive attention is what has caused most of these problems.

The movement to do away with routine infant circumcision has followed from the natural childbirth movement, the growing popularity of breastfeeding, and the awakening public interest in other natural health related issues. There are many similarities especially between mothers' struggle to "relearn" breastfeeding, and new parents' endeavor to leave their infant sons intact.

Within recent years the mother who chose to breastfeed her infant has faced curiosity, criticisms, and immense misinformation in our bottle feeding oriented society. Similarly, the parent of an intact son has encountered criticism, curious remarks and misinformation about his "natural" penis.

Opponents to routine infant circumcision, like many of those involved with other holistic health related issues, have often seemed "vehement," "fanatical," and “angry." This anger has often resulted from the outright absurdity that people should have to work so hard, and face so much misinformation, opposition, and apathy, over something so incredibly simple!

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The Care of the Intact Penis

Correct care of the intact penis, based on knowledge of the development of the foreskin and glans during fetal life, infancy, and childhood, should be a basic part of medical training, especially for doctors who will specialize in pediatrics or general practice. Unfortunately, most American doctors lack this information. They know little or nothing about the function of the foreskin, or its development or correct care. Usually they also know very little about the reasons for circumcision. When asked about the advisability of the operation they often cite non‑medical arguments such as conformity or "social" reasons. Most American doctors' only "knowledge" about foreskins is how to cut them off.

The most informative and helpful sources of information concerning the development and correct care of the infant's foreskin have come from Great Britain. In 1949, Gairdner, a British physician, conducted a detailed study. According to his findings:

"The prepuce appears in the fetus at 8 weeks as a ring of thickened epidermis which grows forwards over the base of the glans penis. It grows more rapidly on the upper surface than the lower, and so leaves the inferior aspect of the shaft of the penis and the terminal part of the urethra has yet to be constructed.... "From the inferior aspect of the glans a pair of outgrowths are pushed out and meet (the sulcus on the upper aspect of the glans marks their fusion) so enclosing a tube which becoming continuous with the existing urethra advances the meatus to its final site. These outgrowths from the glans carry with them the prepuce on each side, thus completing the prepuce inferiorly and forming the frenulum. "By 16 weeks the prepuce has grown forwards to the tip of the glans. At this stage the epidermis of the deep surface of the prepuce is continuous with the epidermis covering the glans, both consisting of squamous epithelium. By a process of desquamation the preputial space is now formed in the following manner. In places the squamous cells arrange themselves in whorls, forming epithelial cell nests. The centres of these degenerate, so forming a series of spaces; these, as they increase in size, link up until finally a continuous preputial space is formed. "The stage of development which has been reached by the time the child is born varies greatly.... "The prepuce is still in the course of developing at the time of birth, and the fact that its separation is usually still incomplete renders the normal prepuce of the newborn non‑retractable [emphasis mine]. "The age at which complete separation of the prepuce with full retractability spontaneously occurs is shown ... [in a] study of 100 newborns and 200 boys up to age 5.... Of the newborns, 4% had a fully retractable prepuce, in 54% the glans could be uncovered enough to reveal the external meatus, and in the remaining 42 % even the tip of the glans could not be uncovered.... The prepuce is non‑retractable in four out of five normal males of 6 months and in half of normal males of 1 year. By 2 years about 20% and by 3 years about 10% of boys still have a non‑retractable prepuce.... Nonretractability depends on incomplete separation of the prepuce.... �"Among 200 intact boys aged 5‑13 years, 6% had non‑retractable prepuces; and 14% could only be partially retracted. Often this involved only a few strands of tissue between the prepuce and glans so that minimal force is required to achieve retractability." 1.

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Development of the Prepuce

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Development of the prepuce. (After Spaulding, Deibert and Hunter)

From: Reichelderfer, Thomas E., M.D., & Fraga, Juan R., M.D., "Circumcision"

From Care of the Well Baby by Kenneth S. Shepard, MD., (editor), J.B. Lippencott Co., c.1968, p.296.

FIG. 25. Cross section through an infantile penis showing the adherence of the prepuce to the glans penis. The urethra is at the right.

From: Reichelderfer, Thomas E., M.D., & Fraga, Juan R., M.D., "Circumcision"

From Care of the Well Baby by Kenneth S. Shepard, MD., (editor), J.B. Lippencott Co., @1968,p.297.

FIG. 26. Cross section between the adherent glans and penis showing nests of epithelial cells that ultimately degenerate and bring about a separation of the two surfaces.

From: Reichelderfer, Thomas E., M.D., & Fraga, Juan R., M.D., "Circumcision" From Care of the Well Baby by Kenneth S. Shepard, MD., (editor), J.B. Lippencott Co., c.1968,p.298.

� ‑ Development of prepuce. (a) Eight weeks; (b) sagittal section and (c) coronal section, 12 weeks; (d) 16 weeks; (e) at about term, compare Fig. 3.

‑ Proportion of boys of varying ages from birth to 5 years, in whom the prepuce has spontaneously become retractable. Note that it is uncommon for this to occur in the first six months.

From: Gairdner, Douglas, D.M., M.R.C.P., ‑Fhe Fate of the Foreskin: A Study of Circumcision," British Medical Journal, Dec. 24, 1949, p. 1433, 1434.

‑ Incidence of preputial adhesions in various age‑groups. ‑ Total material (9200 observations); ‑‑‑ 173 boys observed through 7 years (1160 observations); ... 1086 boys observed in 1964‑65 (1052 observations).

From: Oster, Jakob, "Further Fate of the Foreskin; Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys," Archives of Disease in Childhood (British Medical Association), April 1968, p. 200.

� ‑Cross section of a penis from a 120 mm. fetus. Note the lack of cleavage between the prepuce and glans.

Kaplan, George W., "Circumcision -‑ An Overview," Current Problems in Pediatrics, Vol. 7, No. 5, March 1977 p. 6.

Reichelderfer and Fraga, in a chapter in a British‑based textbook on infant care, relate similar findings:

"Our studies have shown that less than 1% of newly born infants could retract the prepuce. We examined 495 children up to 12 years of age. 25% could retract the prepuce at less than 6 months, 61% at 6‑12 months, 63% at I year, 79% at 2 years, 86% at 3 years, 85% at 4 years, 86% at 5 years, 90% at 6‑8 years and 100% at 9‑12 years.” 2.

They include the following important information, of which parents and doctors must be aware:

"If an attempt is made to separate the prepuce from the glans at birth by running a probe around the potential preputial space, numerous raw bleeding areas are encountered where the connecting tissues have been torn. Healing then takes place by fibrosis, leaving an adherent foreskin.” 2.

This information is essential because frequently parents and doctors have believed that the infant's foreskin should be forcefully retracted, either shortly after birth or during the first few months of his life before it has separated of its own accord. Sometimes new parents of intact sons have been instructed to retract and wash under their baby's foreskin every day. In a society that is only familiar with circumcised penises, people have been led to believe that care of the intact penis is quite difficult and complicated, and therefore have proceeded to make it so.

� Forceful retraction of the infant's or young boy's foreskin before it has loosened naturally is extremely painful to the child and can create future difficulties which would not have occurred had it been left alone. While innumerable parents of circumcised infants have expressed remorse over having allowed their babies to undergo the painful operation, parents of intact sons often express just as much anger and dismay because their child had his foreskin forcefully torn back from his glans. Since the infant's foreskin is normally adherent to his glans, artificially breaking these adhesions literally involves tearing one layer of skin away from another. Some observers have believed that this step of the circumcision procedure appears to be more painful to the baby than the actual clamping and cutting. Since forceful retraction of the foreskin often is done to the baby more than once, the intact baby in our unenlightened society has frequently experienced much more pain and trauma to his penis than the circumcised baby!

Unfortunately, although British sources have clearly described the correct development and care of the foreskin, American medical sources have been replete with misinformation. For example, Taber's Medical Dictionary, which is widely used in the United States by all branches of the medical profession, advises the following:

“The foreskin is often tight after birth. It should be pulled back gently at birth to see that the meatus is clear, and then left alone for 8 days. After this, if still tight, it should be picked up in the thumb and finger and gently coaxed backwards twice a day. If it is inclined to bleed, smear it with an antiseptic ointment. Care must be taken not to strip it backwards too far or constriction of the glans (paraphimosis) may occur. If tightness still persists or there is any difficulty passing urine, a doctor should be consulted. Often the gentle (?) passage of a probe by the doctor, underneath the skin of the prepuce will obviate any need to circumcise.” 3.

Even though extensive studies have shown that only 14% of all newborns' foreskins are retractable, a leading U.S. medical text tells doctors and nurses that the tight foreskin of the newborn is abnormal and must be forcefully loosened! I have even known of parents who have wished to leave their infant sons intact, only to have the doctor advise them shortly after birth that circumcision must be done because the baby's foreskin does not retract! This is reminiscent of new mothers who have been advised by doctors or nurses that they should not breastfeed because they "obviously don't have any milk ‑‑ both parties unaware that a new mother only secretes colostrum for the first few days!

What About the Problems that the Intact Male May Encounter?

Expectant and new parents frequently express concern that their son may have "problems" if he keeps his foreskin. However, most parents would not be able to define what those "problems" might be. Sometimes people have known an intact male or parents with an intact son who did experience a problem with his foreskin, or has been circumcised during childhood or adulthood, and have understandably wondered if the easiest solution would be to have the foreskin cut off at birth.

The two major problems that intact males encounter are phimosis‑the condition in which the foreskin is either tight or adherent to the glans and cannot be easily retracted, and infection of the foreskin. A thorough analysis of both of these conditions, how and why they occur, and how they can be prevented or remedied, is necessary. Weighed against the risks of the operation itself, and the advantages of having one's foreskin, is circumcision justified as a preventive measure against either phimosis or infection? If either condition occurs, is circumcision the only, or the most advisable cure? Or can the problem be resolved by simpler, less drastic means?

Phimosis

There are three categories of phimosis. The first is the frequently misunderstood, normal developmental condition in the infant or young boy in which the foreskin is not yet ready to retract. This condition is not true phimosis because it is normal.

Secondly there is "congenital phimosis." This is the condition in which a foreskin which is left alone during infancy and early childhood never does loosen or retract naturally. Some authorities, aware of the non‑retractability of the prepuce at birth and during early childhood, still label the remaining small percentage of boys with non‑retractable foreskins at age 4 or 5 as having "congenital phimosis." However, since other studies have revealed cases of foreskins first becoming retractable during late childhood or teenage years, the use of this term is highly questionable. "Congenital" implies that the condition is a birth defect, and therefore an abnormality. Some tight foreskins are actually not adherent to the glans, but simply have small openings making retraction difficult. True congenital phimosis appears to be extremely rare.

Thirdly, there is "acquired phimosis." This is the unfortunate, troublesome complication brought about by the forceful retraction of the normally adherent foreskin of the infant or young child. When two adjacent surfaces of skin are forced apart, this causes tearing, bleeding, and exposure of raw skin surfaces, the same as if a layer of skin were pulled off of any other body surface. Then, when the two fresh, raw, bleeding skin surfaces are placed back together, such as when the infant's foreskin is replaced over the glans, these two surfaces heal together creating scar tissue, leading to a troublesome, abnormal attachment of the prepuce to the glans. This is why it is extremely important that the foreskin NOT be retracted until it has loosened of its own accord.

Occasionally parents of intact sons have been frantic with worry that their son will develop acquired phimosis after one episode with forcible retraction by an unknowledgeable doctor. Consultation with medical authorities about this has indicated that if this happens, the foreskin should subsequently be left alone. A single incident of forceful retraction appears not to lead to significant build‑up of scar tissue or adhesions. A small amount of petroleum jelly applied between the glans and the prepuce may help prevent the two surfaces from healing together. Usually the unfortunate child is in considerable pain from this event and is quite resistant to having his foreskin retracted again.

Parents of intact sons may have to take the responsibility of educating their doctors about this matter. And since doctors have been known to forcefully retract babies' foreskins without any warning or discussion, parents should discuss the matter with their doctor prior to the baby's examination. Also, since some doctors retract the foreskins of newborn infants in hospitals, parents wishing to leave their sons intact should, during prenatal care, instruct the doctor not to retract the baby's foreskin if they have a boy.

Gairdner states the following in regard to phimosis:

"Since in the newborn infant the prepuce is nearly always non‑retractable, remaining so generally for much of the first year at least, and since this normal non‑retractability is not due to tightness of the prepuce relative to the glans but to incomplete separation of these two structures, it follows that phimosis (which implies a pathological constriction of the prepuce) cannot properly be applied to the infant. Further the commonly performed manipulation known as 'stretching the foreskin' by forcibly opening sinus forceps inserted in the preputial orifice cannot be justified on anatomical grounds besides being painful and traumatizing. In spite of the fact that the preputial orifice often appears minute -‑ the so‑called pinhole meatus‑its effective lumen, when tested by noting whether or not a good stream of urine is passed, is almost invariably found to be adequate." 4.

In Denmark a study was made on the eventual outcome in a population group in which intact foreskins are left alone until total retractability occurs spontaneously.

"Oster conducted 9,545 observations on the state of the prepuce in 1,968 schoolboys aged 6‑17 years. The boys were examined annually for up to 8 years between 1957 and 1965. 4% of these boys had phimosis; 2% had tight prepuces; and 5% had smegma. Incidence of phimosis decreased with age ranging from 8% among the 6‑7 age group to 1% among the 14‑17 age group. Smegma increased slightly, ranging from 1% among the 6‑9 age group to 8% among the 14‑17 age group. Preputial adhesions which did not constitute phimosis ranged from 63% among the 6‑7 age group to 3% among the 16‑17 age group.

The author concludes:

"Physiological (congenital) phimosis is a rare condition in schoolboys, and it has a tendency to regress spontaneously; operation is rarely indicated. Clumsy attempts at retraction probably cause secondary (acquired) phimosis, which then requires operation. "Preputial non‑separation ('adhesion') occurs frequently, but separation of the epithelium takes place gradually and spontaneously as a normal biological process in the course of school life and is concluded about the age of 17. "Production of smegma increases from the age of about 12‑13 years. Neither this nor the hygiene of the prepuce present any problems if the boys are regularly instructed.” 5.

Paraphimosis is another problem which is caused by forceful, premature retraction of the infant's tight foreskin. In this condition the tight foreskin has been pushed back, exposing the glans, and then constricts so that it cannot be replaced. Swelling ensues and the helpless infant is in considerable pain. Some doctors will perform an immediate circumcision to remedy the situation, although others have found that simply soaking the penis in warm bath water will ease the swelling so that the foreskin will go back over the glans.

Gairdner discusses this:

"Through ignorance of the anatomy of the prepuce in infancy, mothers and nurses are often instructed to draw the child's foreskin back regularly, on the supposition that stretching of the foreskin is what is required. I have on three occasions seen young boys with a paraphimosis caused by mothers or nurses who have obediently carried out such instruction: for although the size of the prepuce does allow the glans to be delivered, the fit is often a close one and slight swelling of the glans, such as may result from forceful efforts at retraction may make its reduction difficult." 4. � It is clear that the prepuce of the infant and young boy should be left alone. But what about the still‑tight foreskin of the older child, teenager, or adult? Some doctors, even those who know that the infant's foreskin is normally tight, still recommend circumcision for the small percentage of boys whose foreskins do not retract after ages 4 or 5. Are there other, simpler alternatives? In the United States, any parent of an intact son, and the intact male as he grows older, is likely at one time or another to encounter a doctor who recommends circumcision. As long as our society is circumcision‑oriented and regards the intact penis as an oddity, there will always be some medical authorities who think that foreskins should be cut off at the slightest indication of a problem. (This is not unlike bottle‑feeding oriented doctors who recommend weaning rather than resolution for any problem with breastfeeding.) Parents of intact sons, and intact individuals must be knowledgeable and ready to consult other physicians or sources of information when and if cutting off the foreskin is recommended.

Many intact individuals have found that gradual stretching of one's own foreskin usually can loosen it if it is tight or adherent. Most little boys handle their own penises. During early childhood this is rarely true masturbation. It is merely curiosity about one's own body parts, similar to exploring one's toes. Many little boys have unintentionally helped their own foreskins to loosen by doing this.

Jeffrey R. Wood, Founder and President of INTACT Educational Foundation (now inactive) gives the following advice:

..."Sadly, many American doctors are trained to think of circumcision as the only alternative to any problem involving the foreskin‑when, in fact, there are many other choices which may be more advantageous to the patient.

"...Anyone who doesn't want to be circumcised [or allow their son to be circumcised‑RR] doesn't have to be -‑ except in the rarest cases....

The prescribed time for the foreskin to loosen varies greatly with the individual

"...It may be before birth or after puberty! ... Normally it occurs before the age of four, [although] some men are not fully mature until around 25. In some cases [of late failure of the foreskin to separate into older childhood or teens], stretching exercise seems advisable to facilitate the loosening process. (Usually this can be done by the individual in private.) "...Difficulties with the foreskin can be among the many signs that one is not eating properly and an improved standard of nutrition provides benefits to the entire body -- not just the foreskin.... There is a theory, as yet undocumented, that continued heavy dependence on milk into early adulthood in certain individuals somehow prevents the foreskin from getting its genetic message to loosen up. Unfortunately, the average American diet is built around milk and dairy products as one of its key ingredients so that it is somewhat of a challenge for anyone in this country to maintain a nutritionally adequate diet that avoids these staples. But it is possible, and when refined carbohydrates and other 'junk foods' are eliminated as well, the results are incredible. One of the most notable benefits is a greater resistance to colds and all types of infections. Some uncircumcised men have even noticed that smegma has ceased to accumulate. As for the foreskin loosening up, this requires time and patience, and since it might have happened anyway, the significance of improved nutrition in this regard is difficult to establish. But it's certainly worth a try‑for the other benefits alone! "In the rare cases where surgery is required, there are two alternatives to ... complete circumcision.... The simplest operation is known as the dorsal slit, in which nothing is actually removed, and the effect of which is to make the foreskin more easily retractable.... [The other alternative is] partial circumcision -‑ in which only the contractile tip of the foreskin is removed‑the part which in phimosis has failed to acquire the ability to expand. What remains of the foreskin continues to protect the glans in the flaccid state....” 6.

Infection of the Foreskin

When I first made plans to write this book I intended to devote an entire chapter to the problem of infected foreskins. I had so frequently heard about infection being a common, troublesome problem among males with foreskins that I expected to uncover a great deal of information about this. Surprisingly I have found very few resources that even discuss the matter.

Nonetheless, expectant and new parents are frequently told about the "danger of infections" if their baby is not circumcised. Is this argument justified when balanced against the very common problem of meatal ulceration and other problems that are exclusive to circumcised males?

If the foreskin does become infected, is immediate circumcision the best or the only appropriate remedy for the condition?

Three medical terms refer to infections of the foreskin and/or glans. Balanitis refers to an inflammation of the glans penis and mucous membrane beneath it. Posthitis refers to the inflamed condition of the foreskin. Balanoposthitis refers to both.

As was thoroughly discussed in the chapter covering complications, the reddened, swollen prepuce of the infant still in diapers is actually protecting the more delicate glans from the much more painful, troublesome problem of meatal ulceration.

Gairdner discusses this:

"Inflammation of the glans is uncommon in childhood when the prepuce is performing its protective function. Posthitis -‑ inflammation of the prepuce -‑ is commoner, and it occurs in two forms. One form is a cellulitis of the prepuce; this responds well to chemotherapy and does not seem to have any tendency to recur; hence it is questionable whether circumcision is indicated. More often inflammation of the prepuce is part of an ammonia dermatitis affecting the napkin (diaper) area.... The urea‑splitting Bact. ammoniagenes (derived from fecal flora) acts upon the urea in the urine and liberates ammonia. This irritates the skin which becomes peculiarly thickened, while superficial desquamation produces a silvery sheen on the skin as if it were covered with a film of tissue paper. Such appearances are diagnostic of ammonia dermatitis, and inquiry will confirm that the napkins, particularly those left on through the longer night interval, smell powerfully of ammonia.... "When involved in an ammonia dermatitis the prepuce shows the characteristic thickening of the skin, and this is often labeled a 'redundant prepuce' -‑ another misnomer which may serve as a reason for circumcision. The importance of recognizing ammonia dermatitis lies in the danger that if circumcision is performed, the delicate glans, deprived of its proper protection, is particularly apt to share in the inflammation and to develop a meatal ulcer. Once formed, a meatal ulcer is often most difficult to cure." 7.

As the individual matures and his foreskin loosens, virtually all potential problems with foreskin irritation or infection can be prevented by simple, regular washing. Some problems with foreskin infection can result from the individual's not knowing how to properly clean this part of his body. Although retracting one's foreskin while bathing is extremely simple, in our society, where the intact male has been an oddity, he may grow up never knowing that his foreskin should be retracted. Another factor is that circumcision has sometimes followed social class patterns in our society, so that in past decades the upper and middle classes have been more likely to choose circumcision for their sons, while the lower classes have been more likely to leave their sons intact. This has contributed to people's prejudice against foreskins. And often people among the lower classes tend to bathe less often and pay less attention to personal health or hygiene, so that problems of infection would be more likely to occur among these people anyway.

Sylvia Topp comments:

"It seems to be true that a person who is not circumcised can develop infections of the foreskin, obviously a problem that would be unknown to a circumcised man. However, these infections are usually not serious and not one of the uncircumcised men I interviewed mentioned having such problems. A few said they had had warts which had been removed but one said he knew a circumcised man who also got warts. Now, although an infection can be annoying, is it really a good enough reason to perform an operation on every male baby? Other parts of the body get infected all the time, but this as far as I know is the only case where surgery instead of cure is preferred as treatment... "Unfortunately, few of the uncircumcised men I talked to had been trained in the care of the foreskin, since this knowledge is not easily available to this minority of American boys and men. Two of the men hadn't pulled back their foreskins until they were adults because there was no one around to explain anything to them. Another had his foreskin attached in a thin line at the back of the penis head and had assumed that everyone's was since he had no one to compare himself with. He lived with the difficulty of cleaning in the corners that this attachment formed until intercourse ripped the skin loose, and of course frightened him." 8.

Some types of irritations can occur as a result of too much attention to cleaning. One doctor relates:

“I have never seen any penile condition that could be attributed to smegma. Many irritations are due to excessive cleansing ‑- especially soap." 9.

Much of the need to inform the public about the correct care of the intact penis is similar to the need to enlighten and educate the public about breastfeeding. The doctor who advises that all infant males should be circumcised because "He might develop an infection of the foreskin" is very much like the doctor who advises that all mothers should bottle‑feed because otherwise "She might develop sore nipples or a breast infection." Some doctors, upon treating breastfeeding problems (which can be much more troublesome than foreskin problems!) conclude that "Breastfeeding is too fraught with difficulties for today's mother." Those of us who seek the benefits of more natural choices for our children prefer positive alternatives rather than such a defeatist attitude.

The Anti‑Circumcision Movement

Ever since man first decided that foreskins should be cut off, other people have been objecting to the practice. Tribes that left the penis alone often criticized or sneered at other tribes who practiced circumcision. Since circumcision has only rarely been the choice of the individual, complaints and protests have often come from the victims themselves. Their laments were usually unheard. Years later they would be circumcising their own sons.

As soon as circumcision first became a medical practice during the late 1800s, the operation had its share of critics. Yet the operation's popularity grew throughout the early decades of this century, as birth became "assembly line processed" in hospitals. Circumcision has always had its dissenters, but during recent decades when the rate of neonatal circumcision approached 98% in many parts of the United States, these individuals have been "voices crying in the wilderness."

Most circumcision critics have been men who have been victims of complications of the operation, or who have simply resented their lack of foreskin. Some were born during the earlier part of this century and now feel dismayed to find that nearly all boys today are deprived of their foreskins. Usually their efforts have ended in "burn‑out" and frustration. For they have had few listeners and rarely did their efforts reach the people that need to be educated ‑prospective parents! Out of their frustration, or due to poor methods of dealing with people their cries were often extremely vehement and bitter. Most were dismissed as angry fanatics. One of the most vitriolic of the anti‑circumcision crusaders was Joseph Lewis, a Jewish man who in the 1950’s wrote In The Name of Humanity, an angry tirade against infant circumcision, especially the Jewish ritual. Lewis was an atheist and wrote many treatises on atheistic causes. Therefore, his efforts were bound to alienate anyone with any religious beliefs. Lewis had few listeners.

Many anti‑circumcision crusaders have condemned doctors who perform the operation as evil, money‑hungry butchers, and label parents who choose circumcision as sadistic child abusers! Others rant and rave about the mutilated, sexually deficient circumcised organ. While their anger may be justified, such people fail to understand that their approach is only a detriment to the cause. Most people will not listen or learn from such epithets. Some may actually feel driven to have their sons circumcised so that they will not be like "those angry fanatics." For parents do not choose circumcision out of conscious intent to harm their child. Nor do doctors perform the operation out of sadism. People have simply been misinformed. No one wants to believe that they have done something wrong. Nor does any man want to believe that there is something wrong with his penis. Many doctors are resistant to learning from lay people. Even when the circumcision issue is presented calmly, factually, and gently some people find the subject too difficult to handle.

In order for the anti‑circumcision cause to have a significant impact on the American public, the message must reach expectant parents and the professionals who work with them. The childbirth education movement has had to emerge and develop as a powerful force before the two efforts could join.

During previous ages there was little need for organized childbirth education. Such knowledge was passed down and shared from woman to woman in a direct, informal way. Most babies were born at home with female friends and relatives in assistance. Families were large and girls grew up with knowledge about birth and infant care. During this century families have become smaller and more fragmented. Birth was transferred to the domain of male medical professionals and became centralized within hospitals. Parents were left knowing virtually nothing about birth or infant care. Usually they placed their trust in the medical profession, but the support received therein was often woefully lacking. Organized classes in childbirth education have, in part, been an effort to fill this gap.

The childbirth education movement began as an effort to develop and introduce methods of giving birth comfortably without medication, thus providing psychological and physiological benefits to mother and baby. Psychoprophylaxis and conditioned response were first studied in Russia during the late 1800s by Pavlov. These techniques were subsequently applied to women in labor for dealing with contractions. Dr. Fernand Lamaze, a French doctor, learned these methods during the 1920s and further developed them. During the 1950s an American woman, Marjorie Karmel, gave birth in France under Dr. Lamaze's direction. She subsequently introduced the "Lamaze method" in the United States. Concurrently, during the 1920s and '30s Dr. Grantly Dick‑Read developed the "Read method" which is based on relaxation, deep breathing, and spirituality. During the 1940s and '50s Dr. Robert Bradley, using Read's philosophy, plus his own observations of animals giving birth, introduced the "Bradley method." His most important contribution was the introduction of the husband as "labor‑coach" and active participant during birth.

Until the late 1960s classes in childbirth education were often difficult to find. Doctors tended to be skeptical if not adamantly opposed to childbirth classes. Many resisted the idea of allowing fathers into delivery rooms. Frequently doctors and nurses did not want their patients to be informed or knowledgeable because that made them "ask too many questions." Expectant parents often had to search far and wide simply to find doctors and hospitals willing to allow the father to be present during birth or agree to let the mother deliver without medication.

The popularity of childbirth education classes has burgeoned during the past few years due to increasing interest in natural health and consumer awareness. Consumer pressure has contributed to acceptance of childbirth education by most doctors and hospitals. Today, classes in prepared childbirth are available in virtually all communities in the United States and most developed countries.

During the latter half of the 1970s some factions within childbirth education have become increasingly critical of standard procedures within hospitals, such as episiotomies, pubic shaves, enemas, heart monitors, and separation of mothers and babies. The childbirth education movement has produced a plethora of books and publications. The first books centered on basic issues such as father participation during birth or the advantages of giving birth without medication. Many books published more recently have been more openly critical of dehumanizing hospital procedures and doctor control of birth. Within childbirth education the home‑birth movement has emerged, as many parents, desperate for a humane and meaningful birth experience have chosen to stay home to give birth. As an alternative to both hospital and home birth, alternative birthing centers have provided a comfortable choice for many.

Throughout all this, infant circumcision has received very little attention. There have simply been too many other important issues to bring light and question. The anti‑circumcision cause is still just beginning to emerge as a worthy issue to be covered in childbirth education classes.

Dr. Frederick Leboyer's book and philosophy about Birth Without Violence became popular during the�mid‑1970s. Being French, it never occurred to Dr. Leboyer to mention circumcision. However, he introduced the concept that newborn babies have feelings! Never before had we thought about the baby's perception of birth. Some new parents began trying the "Leboyer method" when giving birth. But we were typical Americans who had never thought to question the cutting off of baby boys' foreskins. Those of us who gave birth to sons found ourselves shocked with the painful reality!

During this time, in 1976, Jeffrey R. Wood established INTACT Educational Foundation in Wilbraham, Massachusetts. He promoted the adjective "intact" to define the state of the penis that has its foreskin. Whenever possible we use this term as a more positive sounding alternative to "uncircumcised."

Some of Mr. Wood's letters to his followers relate this organization's history and purpose:

"As we begin to understand something of the complex psychosexual processes that underlie this barbaric assault against masculine integrity, there is a link being established between the violence inflicted upon helpless infants, and the unrest which they may in turn manifest when older. We are discovering that emotionally as well as physically, the results of circumcision are unpredictable and often disastrous. Only in a religious context does there seem to be any less potential for lifelong psychological consequences, yet even progressive elements within the Jewish culture are calling for reform on this vital issue. What has been taken for centuries to symbolize a covenant of faith now increasingly appears to be symbolic of the same contempt for nature that has brought mankind to the very brink of self‑destruction. Today's trend toward more natural living is not merely another fad; it is an expression of humanity's deepening concern for its ultimate survival." "Inspired by the work of Roger and Peggy Saquet, whose Non‑Circumcision Information Center offered free material to readers of Boston's alternative newspapers, I established INTACT in the fall of 1976 to serve Western Massachusetts in much the same capacity. Both N‑CIC* and INTACT work harmoniously together, each sharing its ideas and reprints with the other, and in recent months, each has received some degree of national publicity. The name INTACT came about in the following manner. The alternative newspaper here in the Pioneer Valley, the Valley Advocate was my initial advertising medium, and it charges by the word for classified ads. "NonCircumcision Information Center of Western Massachusetts" would come to seven words, running up the advertising bill considerably. Not wanting to use a mysterious, unpronouncable bunch of initials, I hit upon INTACT as a good code word. The name stuck; actually, it's our entire message condensed into just one word! Incidentally I've always thought that the letters in our name should all stand for something, as in 'Immediate need to Abolish Circumcision Totally' -‑ but that particular choice sounds too extreme for good public relations. 9. [He later came upon "Infants Need to Avoid Circumcision Trauma.]"

At One time I served as vice president and west coast representative for INTACT Educational Foundation. In 1985 Mr. Wood and I mutually decided to separate our forces, primarily over philosophical differences. My efforts were then named “Peaceful Beginnings.” Wood is no longer active in this arena, but his writings still give inspiration to many others. My own activism in this dwindled by the mid-90’s, chiefly due to personal exhaustion over the subject. Meanwhile the growing efforts of Marilyn Milos who founded NOCIRC, Tim Hammond who founded NOHARMM, and countless others have continued to grow and reach others continually.

Most books and publications about childbirth education or infant care say nothing or only give vague advice about circumcision. However, within the latter half of the 1970s and early 1980s a few books and publications have given more attention to the circumcision question. The Home Birth Book by Charlotte and Fred Ward includes a chapter on Primal Therapy by Patricia Nicholas which mentions circumcision trauma. (Inscape, c.1976.) Labor and Delivery, An Observer's Diary by Constance A. Bean (Doubleday c.1977) includes a poignant, eye‑opening chapter entitled "The Circ Room" which describes infant circumcision in detail. (Her chapter is one of the reprints that I have widely distributed over the years.) Magical Child by Joseph Chilton Pearce (Dutton c.1977) strongly denounces circumcision. Mothering magazine has included a number of articles, including some written by me, opposing circumcision. In the winter of 1980, ICEA News (the newsletter of the International Childbirth Education Association) published a brief article opposing infant circumcision. Paul Zimmer, another opponent of routine circumcision who resides in Pennsylvania, was listed as a resource and was deluged with requests for information. Right From the Start (Rodale Press c.1981) by Gail Sforza Brewer and Janice Presser Greene includes a highly informative chapter about circumcision. The December 1981 issue of The Saturday Evening Post included two informative articles and an eye‑opening picture display of a baby being circumcised. These photographs are displayed throughout this book and constitute the slides series that I have widely sold. (In recent years they have also been displayed in several other books, publications and websites.)

My concern about infant circumcision dawned in 1977 following my son Ryan's birth and circumcision. In 1979 1 began selling copies of my circumcision slides and information sheets to childbirth instructors. In 1980 Jeffrey Wood appointed me as Vice President of INTACT Educational Foundation. Shortly thereafter I wrote out INTACT's Philosophy and Policy and made several of our information sheets available singly and in bulk to the public. Numerous ads and references in various childbirth education‑related newsletters and magazines have kept the public informed of our cause.

In 1979 Nicholas Carter's book Routine Circumcision: The Tragic Myth was published by Noontide Press. His book was well researched, but is somewhat dated as he wrote it during the 1960s and searched 10 years for a publisher. The tone is quite angry and vehement and it has not been well received.

In 1980 Edward Wallerstein, a Jewish man, published Circumcision: An American Health Fallacy through Springer Publications. It is well‑documented and factual, with a calmer, much less threatening tone than many other works on the subject. It has gained considerable respect among medical professionals.

In October of 1981 NBC Magazine did a feature on infant circumcision showing several infants actually undergoing the operation. I was on that program as was Edward Wallerstein and several doctors including Dr. Paul Fleiss whose interview appears in this book. � What type of people are involved in this cause? Many, like myself, are parents of circumcised sons who regret our decision and have seen a desperate need for more information to be made available about circumcision. Others are parents of intact sons who have been uncertain or put on the defensive about their less conventional decision. Some activists are circumcised men who resent the fact that they lack their foreskins. Others are intact men, resentful about the absurdity of being "unusual" for having a natural penis. Many concerned individuals come from Jewish backgrounds. Some are childbirth instructors wanting to share this information with their students. Some are doctors and nurses who seem to be as frustrated with the medical establishment as the rest of us.

Like all causes, this movement has its critics. Some find our information, no matter how gently or factually it is presented, simply too "new" or upsetting to take. Some publications have been approached with articles about the growing concern against infant circumcision and have flatly turned it down. It is an absurdity that something as simple as not cutting off part of the body should be considered “radical."

�

One of our major goals is that this information become an accepted, vital concern within all programs of childbirth education. We urge that our materials and information be included in childbirth preparation classes, classes in infant care, and as information included with prenatal care.

We have experienced immense concern and participation from childbirth educators and groups throughout the country. We have also experienced some dissention and apathy. Like most major endeavors, the field of childbirth education has many factions and conflicts. Some classes are offered through specific hospitals and merely prepare the expectant parents to accept and cooperate with all of the hospital's routines. Some instructors merely teach exercises and breathing techniques for labor and birth, and consider even such basic issues as nutrition or breastfeeding inappropriate to cover in class. Independent instructors are more likely to be true parent advocates, raising challenging questions and issues and urging parents to actively make choices and seek changes that will better their birth experiences.

Not all childbirth educators agree with us. Some advise in favor of circumcision. Most do not cover it at all. Others basically agree with us but are afraid to cover it in their class for fear of getting someone upset if they present this vital information. Some feel that it is not right for the childbirth educator to influence people's thinking on such a "personal" decision. This is just a cop‑out, for virtually all parents have had so little information about circumcision that their "decision" scarcely deserves to be called such. And while the childbirth educator may not have thought the issue through, a neutral stance on infant circumcision is taking the position that only the needs and feelings of the parents are important, and that the babies' rights and well‑being have no significance. This approach may be easier and "safer" from the childbirth instructor's perspective. However, growing awareness and true concern for the best interests of the helpless infants involved should hopefully inspire more and more childbirth educators to come out opposing the painful and unnecessary operation.

Making changes in society and inspiring people to think about something that they have never before considered is immensely challenging, frustrating, and rewarding. Fortunately, within childbirth education changes do take place relatively fast. Many issues that have been considered "radical" and "controversial" have become widely accepted and commonplace within a few years. During the early 1970s delivering without medication and husbands in the delivery room were "hot" issues -‑"causes" that we had to fight for. Most childbirth educators considered other issues such as immediate contact with the baby, total rooming in, and home birth too "radical" to discuss in their classes. Alternative birth centers, "birth rooms" in hospitals, or Leboyer births were unheard of. Today these practices have become commonplace in most parts of the country. Similarly, in the future information about infant circumcision will reach more expectant parents and increasing numbers of expectant parents will leave their baby boys intact.

The intact choice does have one major advantage. It is a much simpler decision than most other concerns and issues. Similar causes such as alternative education for one's children, specific diets, or even natural childbirth and breastfeeding require their followers to learn and do many things. Some choices require considerable expense and sacrifice. In contrast, leaving one's son intact usually requires relatively little commitment or action. (i.e. American parents who leave their sons intact sometimes have to have strong convictions about their choice in order to counter criticisms and misinformation from others. But unlike breastfeeding or other childrearing choices, there is virtually nothing for parents to do with their baby’s foreskin except leave it alone. The intact choice is as simple as not cutting off the baby’s fingers or toes. In most parts of the world babies’ foreskins are left in place and left alone with no conscious thought otherwise – circumcision being a foreign or totally unknown concept.)

References:

1. Gairdner, Douglas, D.M. "The Fate of the Foreskin" British Medical Journal, Dec. 24, 1949, p. 1433‑1434.

2. Reichelderfer, Thomas, M.D. and Fraga, Juan R., M.D. "Circumcision" Reprinted from Care of the Well Baby, 2nd Ed., c.1968, J.B. Lippincott Co., by Kenneth S. Shepard, M.D., p. 297‑298.

3. Thomas, Clayton L., M.D. ‑ editor Taber's Cyclopedic Medical Dictionary F.A. Davis Company, Philadelphia, c.1977, p. C‑75.

4. Gairdner, p. 1435.

5. Oster, Jakob "Further Fate of the Foreskin" Archives of Diseases of Children, Vol. 43, 1968, p. 200‑203.

6. Wood, Jeffrey R. "Alternatives to Circumcision in the Treatment of Phimosis" INTACT Educational Foundation ‑ Informational Material

7. Gairdner, p. 1435‑1436.

8. Topp, Sylvia "Why Not to Circumcise Your Baby Boy" Mothering, Vol. 6, January 1978, p. 73.

9. Wood, Jeffrey R. General Letter ‑ INTACT Educational Foundation

10. Wood, Jeffrey R. "Notes from Jeff Wood" ‑ INTACT Educational Foundation

Dr. Paul M. Fleiss, M.D., Los Angeles, CA. (Pediatrician)

Dr. Fleiss: The basis of circumcision is not in preventive medicine, but as a ritual. But it has become common practice in the United States for about 80% of all males. We are now learning that babies ... they have eyes and they see, they have ears and they hear ... they have feelings. The findings about how important early bonding is makes you realize that an infant is more than just a lump of clay. You should treat a baby the same way that you expect to be treated yourself. I wouldn't want to be strapped down to a board, taken away from all the security and love that I have known, and then have part of my body cut off without an anesthetic. I'm Jewish and I've been circumcised. I have one boy that was circumcised when he was born in 1968. 1 yielded to what I thought were cultural reasons for doing it. My younger boy was born in 1977. 1 didn't have him circumcised and I feel much better about it. He was born at home. He stayed next to his mother after birth. Circumcision would have been completely contradictory to all the other things we've done for the baby.

R: If anybody past infancy is circumcised it is done under anesthesia. Yet with a baby it is done without anesthesia. Why?

F: It's easy to strap him down. The newborn baby is not considered a human being. They're considered without feelings. Obviously it hurts. Once we put them back with the mother they appear to forget it.

R: You used to do circumcisions?

F. Yes. I'm not sure I ever believed in it. I did them because people asked to have them done. But I stopped when I just didn't want to do that to babies any more.

R: If you are studying to be a pediatrician, obstetrician, or general practitioner, are you automatically trained to do circumcisions in medical school?

F: It's a simple procedure to learn. Most doctors who work with newborn infants can learn 'the procedure if they want to. Some don't choose to learn it. It's not automatic. You just somehow learn it in your training.

R: Have you, being Jewish, found any family pressures with having your youngest son remain intact?

F: There might be. There comes a time when your own sense and rationality takes the place of every dogma that you might have lived by. What may have been a good ritual for centuries doesn't mean that it's still good.

R: If a little boy is not circumcised, what is the nature of the infection that can develop? Is that a major concern? I've heard that they can get terrible infections under the foreskin.

F: No. It's a normal piece of tissue. My practice is not to do anything until they're a year old or more, and then push back and gently retract the foreskin and wash underneath when you bathe them. When he gets older he can do this himself. When you're older, if you don't retract the foreskin it's possible to get bacteria or infection underneath it. Sometimes the foreskin can get swollen. An infection does not mean that the individual has to be circumcised to correct it.

R: If parents felt that they had to have their baby circumcised, what if they waited until the baby was older and had him anesthetized for the operation?

F: Think of the cost! You're talking about several hundred dollars for an elective procedure!

R: How old or large would a baby have to be for that?

F: When I used to do circumcisions, we would do them in the office until 4 or 5 months of age. When they got too big to be strapped down, then we stopped.

R: Which doesn't mean it hurts any less when they're littler.

F: No.

R: In the Jewish ceremony they sometimes give the baby wine or alcohol of some kind to sedate him. Does that really make it easier for the baby?

F: I think it's mostly part of the ritual. Alcohol is a depressant and can't be used like an anesthetic. But why would you want to give a baby alcohol? Alcohol is a poison.

R: If circumcision is to be done, is there any one way that's better or less traumatic than the others?

F No, I don't think there's any advantage to any of them. I feel very strongly that it simply should not be done.

R: Do you believe that the trauma of circumcision results in any long term psychological ill effects?

F: It seems to be a very brief moment in the baby's life. I don't think it's something to have guilt feelings about if a parent has already had a child circumcised. It was done to me. I did it to my boy. I've done thousands of them. We always thought that we were doing the right thing. But now we have a new awareness. Our whole opinion of what babies are has changed. All procedures like this are going to stop because babies begin to learn as soon as they're born. They need special treatment, not the treatment that we've been giving our children. That's a disaster! Whether circumcision has any serious psychological consequences, I don't know. It wouldn't matter to me. Even if you found that there were absolutely no harmful psychological effects, it still would not justify doing an unnecessary procedure. You just should not be cruel to babies.

Tonya Brooks, Los Angeles, CA.

Tonya: When my first son was born I was considering having him circumcised because my husband Bob was circumcised. I thought if our son wasn't circumcised he'd feel strange about it. I had also read Dr. Bradley's book Husband‑Coached Childbirth. In it he recommends that all baby boys be circumcised. He also says all women should have episiotomies, so I wanted an episiotomy. Now I disagree and cannot recommend that book. Bob was circumcised when he was five and remembers how it felt. He said "No, absolutely not!" So our boys have not been circumcised. Now I'm really glad. There is so much wrong information about intact babies. With my first son Gabriel, the doctor convinced me that his foreskin was too tight. I watched my child be traumatized as she took tweezers and forced it open. He was just a newborn when that happened. I felt that some of the good effect of not having our child circumcised was negated by that. With my second son I resolved that nobody was going to mess with his foreskin! When he was four months old I took him to a pediatrician who said, "Look at all this smegma," and forced it open. Some smegma did come out, but he'd never had an infection. I didn't have time to stop the doctor. From what I know now, the foreskin doesn't collect smegma as long as you leave it alone. I had been working with it to get the foreskin to retract. Now I know that it builds up because people bother it. I've had no problems with my kids getting infections or getting it dirty. I find them sometimes in the bathtub pushing their foreskins back and there's no trauma. One time when Cyrus was four he woke up and the end of his penis under his foreskin was swollen and red. I thought "Oh dear, he's got an infection!" So I put him in the bathtub and had him soak in warm water and the foreskin retracted easily. By the end of the day the swelling was gone. He had slept in his underwear that night and it may have bound him. Maybe some mothers would have gone running to the doctor to have their kid circumcised over something like that.

R: Parents are often led to believe that circumcising the baby prevents "problems" when he gets older.

T: My oldest boy has never had the slightest problem. And Cyrus had only that one time. My kids are responsible for their own baths. I don't enforce baths. They have certainly been grimy sometimes and have gone a few days without baths, but there's never been a problem. When you clean a baby girl you'll find smegma in the labia. You just wipe it out. It's very simple. I have never forced back my baby girls' clitorises to clean out smegma from under the hood. It never occurred to me to do so, nor on myself. It's so ridiculous because we never worry about it. I suppose they could offer similar arguments for female circumcision, that it would prevent vaginal infections or problems later.

R: Now that your sons are in school, have they had any problems with feeling different from their peers?

T: No. They also haven't worried about being different from their father. They simply have been told that they were not circumcised. My older son tells his friends, "I'm not circumcised," and then the other kids are fascinated. Today increasing numbers of parents are choosing not to circumcise their sons anyway.

(Since this interview took place, Tonya has given birth to two more sons, Aaron and Ethan. They have both been left intact like their older brothers. Tonya also has two daughters, Shannon and Aleisha.)

Diane Cook

(Diane is the mother of five children, four of whom are boys. Her husband and oldest three boys have all been circumcised. Her youngest son, Joshua, is intact, Diane is also a La Leche League leader. She lived in Pt. Hueneme, Calif. at the time of this interview.)

Rosemary: You had your first three children in hospitals. What were the births like? Why did you choose circumcision?

Diane: We had the first two in the same hospital, but with different doctors. The births were natural, as best as I could do back then with no classes or doctors supporting natural childbirth at that time. I had Demerol with the first baby. The second time I had hypnosis. With the third, there were still no classes, but I got a lot of information from a friend who had had all of her children naturally. We didn't think we had a choice about circumcision. My husband had been circumcised. I guess we thought "We'll just carry on this family 'tradition'." I happened to be walking by the nursery window when they were circumcising my first son. I could see him screaming and throwing up and strapped down on his back. I was horrified, kind of paralyzed when I realized it was my own baby there. But then I walked back to my room and stopped thinking about it. Soon they brought the baby to me and he was fine. You would think that would have "cured" me. But no, we went ahead and had our second son circumcised, and then the third son. I thought they had to match. Now I think that's a ridiculous reason, but then I thought it was a valid reason. After that we had Julie and then Joshua at home. I did more thinking about it and decided it was unnecessary. So we didn't have it done with Joshua.

R: Does it seem like he is "different" from the rest of the family?

D: No.

R: Are you concerned about problems later when he goes to school?

D: No. I think more parents are choosing non‑circumcision. We also have not had any adhesion problems.

R: How did you care for his foreskin when he was a baby?

D: I didn't do anything for the first three months. Then a friend who had two boys who were not circumcised got me all worried. She said if you don't pull it back every day it will get problems with infections. I tried to pull it back and it was completely stuck. So I worked on it for a few minutes every day. After several months it started to get unstuck. It wasn't like those horrible moves that doctors sometimes do to forcefully yank it back. Now I don't do that anymore because he's very sensitive. He's not old enough yet to do it himself, so we just leave it alone. Since then I've read that it normally takes about three years for the adhesions to naturally disappear. But in our case, what I did worked.

R: How did you make the decision not to have Joshua circumcised? Did your husband have strong feelings about it?

D: No. Anything that means saving money, he's for. We didn't even consider it. He doesn't really care one way or the other. I'm sorry now that I did all the rest of them, but what can you do?

R: Just make sure that they know that it's not necessary, so that when they have kids of their own they won't feel that their own sons have to be circumcised just because they are.

Our son, Thomas Jonah, was born November 8, 1976. I had never considered having an uncircumcised child and when pregnant began talking to friends about circumcision and how it was done. We planned a home birth. Our doctor and nurse practitioner did not do circumcisions. After hearing descriptions of tying the child down or holding him forcibly and how most of them scream as no anesthetic is used, I began to question the practice. I read both pros and cons in several birthing books. Finally my husband Tom expressed his desire not to have it done. He is circumcised and does not feel that it has caused him any psychological damage. But he did feel that since we were searching for a positive birth experience with a loving atmosphere and caring attendants, a circumcision would be a less than positive event and certainly not peaceful. We decided against it.

The birthing was the most affirming and fulfilling moment of my life. My labor was peaceful and short. The support and assistance with relaxation that I got helped the birth to be peaceful. The child I held in my arms, touched, nursed, talked to, and massaged was also peaceful. He was alert, attentive, curious, and beautiful. I am so glad we decided against circumcision. Jonah means "peace" and that is what we call him.

Following our doctor's instructions I gently tried to retract the foreskin. Once it would retract easily I did it only once a week. After a few months we discontinued this and will resume it when he is old enough to continue it as part of his hygiene routine. We haven't experienced and don't anticipate any problems. If we have another son we will leave his foreskin alone until he is 4 or 5 years old and can care for his hygiene himself.

Jan, Tom, & Jonah Easterly, Petersburg, N.Y.

(Jan & Tom have since had a second son, Teddy, born in 1980, He is also intact.)

� I am the mother of two sons, one circumcised and one not. Jeremiah, my 61/2 year old was circumcised because no one ever offered me the choice. My obstetrician’s fee had an extra $25 tacked on "if the baby is a boy" for circumcision. His circumcision is only a part of what I feel now was an early traumatic experience for him. Other than slight bleeding though, he suffered no noticeable ill effects. He did get a meatal ulcer at about one year of age concurrently with a fungal diaper rash.

The doctor who was to deliver Elisha, my second‑born, at home, was very much against circumcision. By that time, I was too. I had read more about it, that it is painful and done without anesthesia to a newborn baby who is then left to scream in his plastic crib. Also I had become convinced that there is no medical justification for the operation. My husband, who is circumcised, decided he was also not in favor of it being done. Therefore Elisha was not circumcised.

He has never had any problems with his penis. When he was two months old we moved and took him to a new doctor for a check‑up. This doctor, while professionally reassuring us "he didn't believe in circumcision either" and that "this wouldn't hurt," he'd "just break a few adhesions so we could clean beneath the foreskin to prevent infection" ‑- forcibly yanked back Elisha's foreskin, causing it to bleed! It did seem to hurt a great deal and he screamed whenever he urinated for a day. We still can't retract his foreskin, are no longer concerned with doing so, and he has had no infections.

I would advise any concerned parent of an intact son not to succumb to the "line" that this doctor handed us. The treatment is unnecessary and quite painful. If he gets an infection, it could hardly be worse than the "prevention." Cure it then, when (and if) it happens.

We know two adult men who are not circumcised and who have had no problems with their foreskins. Both say they took no special care of their foreskins till school age, when they learned to clean beneath the foreskin.

Vicki Meyer, Sandstone, West Virginia

(*Repeated forcible retraction of an infant's foreskin is more likely to cause an infection. An intact baby is less likely to develop a penile infection if his foreskin is left alone. – R.R.)

My son was born at home. My naturopathic chiropractor who attended our birth was against circumcision. I felt that if boys were born with coverings for their penises, there must be a good reason. It seemed a cruel, painful thing to do to a little one. I felt I would be able to teach my son cleanliness and to feel at ease with his body. When he got to be 11/2 years old he was getting real squirmy about it. He'd get ornery and wrestle with me and giggle. So I gave him the cloth to clean it and he started getting involved in it and mellowed out. I pull his skin down, he squeezes warm water on his penis, then I wash it and quickly check it and then pull his skin up. We do this after a bath along with cleaning toenails, fingernails, etc. It only takes a few minutes. Gradually he'll grow into caring for his cleanliness and his foreskin will be part of that.

We lived in the woods for a year and Ansel ran naked except in cold weather. I think the foreskin is handy when you're cruising through the bushes!

When Ansel was five months old he was in for a check‑up and the doctor felt I should have circumcised Ansel. I explained my feelings. He said, "Well okay, if that's how you can do it." But he felt that I should let him separate the membranes that were keeping the foreskin attached to the penis. He said if I didn't do this now, I'd run into problems later with infections. Under pressure, misinformed, and wanting to do best, I agreed. My God, what an agonizing few minutes we spent!! Ansel was tense, red, and screaming with pain!! I felt helpless and "Oh no! What did I do?!" As soon as it was done, Ansel collapsed in my arms exhausted and frightened.

Now I know that that was an unnecessary, cruel thing to do. Now I know the membranes naturally separate by the time the boy is 3 or 4 and that he cannot get infected underneath the skin that has not separated yet.

I think that people have often been inhibited about natural occurrences. There is an idea of not touching one's body intimately. "This is bad, sick, might lead to who knows what! Mother has to touch her son's penis!!" if that boy has a foreskin. Well it's not a big deal. You brush your teeth, wash your ears .... so you clean the foreskin. Simple.

My husband is circumcised and he supported my decision. They don't feel concerned that they're "different." I think that's a heavy ego trip and no reason to do it.

Ansel's penis rarely has any white stuff on it. He is a clean, robust, healthy, strong boy. This is probably because of the way we eat and live. We are vegetarians, love our mother earth, fresh air, and good exercise. We work hard to help our planet earth and its creatures and peoples. We're low income so we don't have control over much, but we do what we can. You can always do more than you think.

Willow, James & Ansel Harvey, Missoula, MT.

My husband Stephen and I went through our first pregnancy and birth in 1970 in the midst of a great wave of "back to nature" enthusiasm. We were strong‑willed and had great faith in the natural order of God's creation. Thus if God made penises with foreskins, who were we to say they shouldn't be there? So our firstborn son, Noah, remained intact without our being even slightly tempted to do otherwise. It seemed like common sense to us.

We have never had any physical problems resulting from Noah having his foreskin. I did not try to retract it for any reason such as cleaning, but did try very gently once or twice out of curiosity and found it very adherent. I wondered at this and looked for information but found none. It has only been in the past few years that I've read of the normalcy of this adherence and that I was right not to force it back.

Our second son, River, was born in 1972. Again we did not consider having him circumcised. He, like Noah, was born at home and both of them were untouched by medical hands until school physicals were required at around 5 years of age. Circumcision seems like a real nightmare of medical intervention! Unthinkable cruelty! River did have some occasional redness and swelling of his foreskin with general diaper rash, but leaving his diaper off always seemed to clear it up. His foreskin was also non‑retractable. Now that they are older both of them can pull back their foreskins with no difficulty. I'm not sure when the change came‑maybe at 4 years of age.

Socially we had no great pressure. My family wouldn't think of talking about something like circumcision. Stephen's family lived far away. Our peer group was generally in agreement with us. Occasionally we heard comments such as:

1.) "They won't 'look like' their dad. Won't that cause problems?" It hasn't so far. They've accepted easily the rational and loving reasons for not having something cut off.

2.) "The other boys will make fun of them." No problems so far.

A couple that we know with two intact sons who did foreskin retraction for cleaning -‑ their sons had bad smegma buildup. The doctor had advised them to practice daily retraction and cleaning. I wonder ... perhaps if you start doing it you have to do it continuously after that? But if the foreskin is left adherent, no smegma problem? Or is smegma buildup related to a general state of lowered resistance? I never saw smegma on our boys' penises.

I never paid any more attention to our sons' penises than I did to their ears, noses, or toes. They got baths once a week or so with hardly any soap used, just plain water, the best food we knew how to feed them and lots of exercise and fresh air. Their health has been very good.

I'm glad there's so much more information around today and that more babies are being spared that pain and insult.

Diane Brandon, W. Burke, VT.

My husband and I decided while I was pregnant that if the baby was a boy he would not be circumcised. My husband is not circumcised and is perfectly healthy. He has never experienced any problems or criticism from schoolmates. His older two brothers were circumcised, but the doctor that delivered my husband said it wasn't necessary to circumcise him and my mother‑in‑law agreed.

The woman who taught our natural childbirth classes said she didn't have her six year‑old son circumcised and he's just fine. Also our pediatrician said it is not necessary. The doctor who delivered our son was in favor of circumcision "for medical and social reasons." This amazed me since he is strictly a natural childbirth doctor. He uses the Leboyer method with dim lights, warm bath, etc. He then has the babies come back one week later to be circumcised. There was no way I was going to take our son back for such a cruel procedure.

We have been criticized by my family for not having it done. My three brothers and nephews have all been circumcised. My mother and sisters‑in‑law never even questioned it.

Steven Finch (Photograph contributed by Frances Finch.)

At the local hospital, the standard admitting form for all patients says in the fine print that by signing to be admitted you are also authorizing circumcision if you have a baby boy. However, our son was born at the doctor's office. He has two rooms set up for births that are furnished with double beds, picture on the walls, printed sheets, etc.

I have been breastfeeding our son. I have been criticized by my mother for not putting him on the bottle and for waiting so long to start solids. She didn't nurse any of her children. I have had support from my mother‑in‑law and other friends who have nursed their babies.

One friend had a baby boy one week after ours was born and he wasn't circumcised either. Maybe one day it will no longer be "the thing to do."

Frances Finch, Fullerton, CA.

My husband is not circumcised. He's never had any kind of problem because of it. He's also a very good lover and does not have the premature ejaculation problem that so many circumcised men experience. I think there may be a connection.

As a nurse's aide at a hospital several years ago I witnessed a circumcision. It was the first and only time I have ever fainted. The poor infant screamed in pain. The whole procedure seemed incredibly sadistic. I decided right then that no son of mine would be subjected to that senseless torture and our son was not circumcised.

Some parents worry about junior looking different from papa if they don't circumcise their son. Fortunately we don't have that concern.

Debra Bottomly, Poughkeepsie, N.Y.

Photograph contributed by John C. Glaspey, MD.

My wife and I are both doctors. She trained in Pediatrics and then Child Psychiatry. We were initially confused about circumcision when confronted with the task in medical school. I chose to ignore the absurdity of the procedure and the baby's screaming and learn to do circumcisions. My wife absolutely refused to have anything to do with it.

When she went into Pediatrics, she was considered a bit odd, being unwilling to perform a simple procedure which is economically beneficial to the doctor. I went into Internal Medicine and had no further confrontation with the issue until my wife became pregnant. I was hoping to have a female baby so that I could avoid the issue. I had been circumcised. My major conflict was not whether I thought circumcision was beneficial, for I had long since decided that it was no more than a pagan ritual, but rather whether I wanted the baby to be like me or not.

In order to make a final decision I went to the newborn nursery at the hospital where I worked. I watched a circumcision being performed and immediately, without any question, knew that there was no way that I could have my newborn son tortured in such a manner. It seemed like the first time I had ever really watched the procedure even though I had done several dozen in medical school. The baby was absolutely panicked and exhibited the most shrill and desperate behavior one could imagine! The pediatrician performing the procedure continued his mutilation as if nothing were happening. I almost vomited.

We had a son and of course we did not circumcise him. We have had absolutely no problems and I am certain there will be none. I consider circumcision a vestige of savage ritualism. I am certain that it scars the psychological and sexual development of the human being.

Gregory E. Skipper, M.D., Newberg, OR.

My husband Philip and I decided not to have our son circumcised. Circumcision decreases sexual sensitivity and dries out the glans, whereas if he weren't circumcised there would be a natural lubricant which can aid in intercourse.

My midwife, (an elderly lady) told us that the baby had adhesions between the head of the penis and the foreskin and that some of these adhesions should be broken with a probe inserted into the opening. We were also told that this opening was too small for the head to be forced through and that we would probably need to have his penis circumcised.

Since then we've learned that the head should not be fully exposed by force. We got the opinions of three doctors, read two articles (which were hard to come by) and talked to some intact friends with intact babies before we decided that our son is a perfectly normal, healthy little boy with no reason to have this unnecessary operation performed on his sensitive little body.

We now know that the foreskin should be gently pulled back when bathing and that the head of the penis usually will not be completely exposed until approximately three years of age. The father can then teach his son how to clean it.

The only problem now will be what to say when Nicholas asks why he is "different" from Daddy.

Viki and Philip Morgan, Canyon Country, CA.

We decided not to have our son circumcised. Since he was born I've allowed myself to be unsure of my decision. Since the article about circumcision in Mothering ("Why Not to Circumcise Your Baby Boy" by Sylvia Topp, Jan. 1978, Vol. 6), I'm reassured now that we did the right thing.

I used to think that circumcision was right and normal. I never questioned it. But while I was pregnant I thought about it. We were having the baby at home, partly to protect him from insults and unkindnesses that would happen to him at the hospital. It would be a paradox to put him through such a trauma after he had such a peaceful, calm birth.

The doctor I saw for prenatal care is Orthodox Jewish. When his son was born seven years before, he researched circumcision and found no evidence in favor of it, so he did not have his son circumcised. He will circumcise babies if the parents want it done, but the midwife that he works with told me that he doesn't perform the operation often. She told us that none of the younger pediatricians in town will do circumcisions. They consider it "cosmetic surgery." The obstetricians do them, though.

I am an R.N. and I should have known, but I honestly did not know the difference in appearance between circumcised and intact penises. All the men I've paid attention to looked the same and I didn't realize how very common circumcision was. I had thought they all must be uncircumcised. I realized what an intact penis looked like from our son Ethan. For a while I was sorry we hadn't had him circumcised because I thought that circumcised penises were more attractive.

But I really feel that God knew what He was doing when He designed people. He must have put foreskins there for a purpose. I think people should respect that. Also, I really believe babies shouldn't have to go through that!

I recently visited some old friends, including a doctor who is a very good friend. He made me feel really bad about not having Ethan circumcised. He said a lot about older men needing to be circumcised, peer acceptance, etc.

But now after reading the article in Mothering, I'm feeling a lot more confident in my decision. My husband left it up to me.

Even this article didn't describe how to clean under the foreskin. I've never read an article that did. You'd think I might have had the opportunity to learn in nursing school or working or just in life. It seems strange to me how uninformed I am and I consider myself a fairly bright, sophisticated person.

Susan Scott,Santa Fe, N.M.

I am the mother of two children, a three‑year‑old girl and a five‑month‑old boy, both of whom were born at home.

When I was pregnant for the first time we discussed circumcision. I didn't want it, but my husband, who is circumcised, felt it was a good idea. I knew that he would be the one to make the final decision. Sighs of relief when Sarah arrived -‑ no decision to make!

During my first pregnancy I read The Hygienic Care of Children by Herbert M. Shelton, which has a strongly anti‑circumcision chapter entitled "Mutilation of Boy Babies." This, in conjunction with my European upbringing and sexual experiences with intact men convinced me that routine infant circumcision is unnecessary and undesirable.

In the interim between Sarah's birth and my second pregnancy my husband became more receptive to the idea of non‑circumcision. This was a relief to me, since we both felt very strongly that I was carrying a boy. The chiropractor who assisted at Daniel's birth put no pressure on us one way or the other. We decided not to subject our beautiful, whole, newborn baby to mutilation and unnecessary pain.

I was unable to find any information on care of the intact baby. I was not sure if I should try to retract the foreskin forcibly or not. Asking other mothers produced the information that all their boys had been circumcised. I was beginning to feel like an "oddball!" Fortunately, Mothering magazine had an article that bolstered my instinct to "leave well enough alone" by telling me that the foreskin is not usually retractable until 11/2 to 2 years.

This is an area of parenting that is still not considered deeply by many couples. I asked a close friend why their son had been circumcised. She said, 1 thought you needed to! You mean you don't have to?" Too many parents say "yes" simply because they really don't know that they can say "no."

Lynne Knox Cross City, FL.

My son has not been circumcised because I felt that a foreskin is a personal and private part of a man's body and I could not make the decision on having him circumcised. That decision is for him to make when he grows old enough to know whether or not he wants it done. It is a barbaric thing to do to a tiny baby. I have been in a clinic where it was done and have seen the trays that babies are strapped to. I shuddered when I saw them. Besides, what if the doctor should slip?

My son was born five weeks early and in breech position. I delivered at home as planned. The waters were clear so I anticipated no problems. However, my baby was born with Infant Respiratory Distress Syndrome. He was trying so hard to breathe that he couldn't take the breast. We took him to the hospital which had a Newborn Intensive Care Unit. I was glad I had him at home even with the problems we had because I couldn't have endured it in a hospital. This way, at least he was mine for a little while.

The doctors did not even bother to mention circumcision, since the babies in the NB‑ICU were already traumatized enough.

One of my grandmothers told me that we should circumcise because uncircumcised boys would "play" with themselves. (So what!)

I have had no problems with my son's foreskin. I have left it alone as I have heard it is not a good idea to mess with it. I don't anticipate any trouble with his peers.

I saw the circumcision trays in the hospital after my son was born. It only reinforced my feelings. It seems quite barbaric to me. I could never do that to a little boy. It makes my mother's heart pain when I hear parents talking about having their sons circumcised.

(My correspondence with this mother continued for several months. I received the following, very sad letter):

Unfortunately my son has died as a result of the heart and lung problems he was born with. It is a very hard thing to lose a child when you have worked as hard as we did just to keep him alive. [Her son lived for about 5 months.]

(A couple of months later she wrote again:)

It wasn't too hard to let my son go because I knew that it was going to happen. Eric was born prematurely and had congenital heart disease. When he first looked into my eyes right after birth, I knew he would never grow up. It's better this way because he had a very painful life. It was amazing that he lived as long as he did. But we sure had love while it lasted.

We do plan to have more children. I may already be pregnant as it has been over a month and still no period. I hope I am. I'd like to have another chance as soon as possible.

Deborah & John Hollenbeck Albuquerque, N.M.

(Deborah and John gave birth to their second son, Jacob, in November of 1978. He too has remained intact, and is thriving and healthy.)

My son was born at home in Fairfax, California. The doctors that I saw for prenatal care were very open concerning the issue of circumcision. They saw no medical need for the operation. This concurred with my intuitive feeling on the subject. I feel that "nature" created us perfectly and it seemed bizarre to me that such a radical alteration was necessary. It made sense to me that the foreskin served in a protective capacity. That this should be removed because a small percentage of males had trouble with uncleanliness was analogous to dentists pushing tooth extraction and plates so that the maintenance problem be handled.

My main objection to circumcision, however, is that it is such a painful experience. I've come to recognize that much of the fabric out of which we operate consists of "forgotten" imprints. A trauma occurs and from this painful experience the child gets feedback from his/her environment... "I am not safe here! Life is painful!" The child has no framework to modify the imprint such as "This procedure is for your future well‑being." He receives a painful experience for which he has no means to assimilate except in the direct experience of hurt. People continually reconstruct reality as "unsafe," "detrimental" and with the feeling that other people can have power over their lives because of long forgotten (to the conscious mind) events.

My son is now 15 months old. I recently took him to a local doctor for an examination. The doctor was looking at him and explaining some things to me when he suddenly reached down and yanked my son's foreskin back! It was horrible! After months of dealing with conscious doctors in California who developed a warm and respectful relationship with my son, I was filled with sorrow not only because of the pain he felt but because of the imprint that doctors and their environments aren't safe. He said my son definitely needed a circumcision and I set up a date which I later cancelled.

I still did not feel that circumcision was necessary even after another doctor examined him and said it was. This doctor's response to my questions and wanting to be with my son up to the time the anesthesia would be given and immediately afterwards while awakening, was "What's your hang‑up?!" He figured that when the child cried out enough that signaled that he would be awake enough to be carried out to his parents.... I found the "professionals" to be totally insensitive to the human factors involved. They had no awareness of a child's needs or of the psychological implications of their actions.

I called my doctor in California. I related to him the whole situation and he told me that he recommends that nothing be done to the penis until the child reaches two years of age. At that time he said to begin gently retracting the foreskin. By the time the child is three the foreskin will be completely loosened and the child will be able to learn how to clean himself.

Around here it seems that most people consider not being circumcised “unheard of.”

The Mothering issue with Sylvia Topp's article arrived three days after my experience with the doctor. I learned of acquired phimosis and was really crushed until I was reassured by the California doctor that one instance would not create scar tissue.

(The following is this mother's letter to the doctor who forcefully retracted her son's foreskin:)

I am writing to express my concern over the recent experience my son Aleph and I had in your office.

You gave no indication to my child or to me that you were going to proceed so abruptly in your examination of his penis. With the knowledge that his foreskin was tight you yanked it back aggressively. You never acknowledged the child as a person, said anything to him, or touched him in a kindly way before doing something which you knew would be intensely painful for him.

A child is extremely impressionable. Until his experience with you, every visit he had ever made to a doctor's office was one in which he was treated with care and respect. He enjoyed going to the doctor's office and had no fear of examination.

You were appraising his condition and expressed the need for circumcision based on the fact that his skin tone had become leathery and tight, when you suddenly retracted it! I don't feel that you had to make your point by further illustration, especially when your action aggravated an existing condition, causing bleeding and severe pain which still persists. Last night he awakened repeatedly, crying, and now gives indication that he feels discomfort in this area.

I feel strongly that a requisite to the healing that a physician performs is an attitude of respect and compassion toward the people who are his patients. Human beings are more than their bodies and when this is overlooked the harm done to a person's psyche can be equal to or greater than the physical repair. This is even more important when dealing with children who have not yet evolved a framework in which to understand the "whys" of certain actions and interchanges.

Please cancel all the arrangements we made for circumcision. I will take my son to a physician whose qualifications include sensitivity and compassion as well as adeptness in surgical procedure.

Esther Frances Schrank, Bridgeton, N.J.

My first son was born when I was 18. I was naive about pregnancy and birth and had never read anything that was informative about circumcision. I had Solomon in a hospital and didn't have him circumcised because I felt it wasn't natural. When my dad noticed he wasn't, he expressed his disapproval saying it wasn't clean and that he should have it done right away.

I lived with my mother after the baby was born. (My boyfriend whom I had been living with shortly before Solomon's birth was out of the country and we planned on getting back together when he returned.) My mother and I had a talk about the baby's not being circumcised. She disapproved also, saying it wasn't clean. Not having any support, I gave in and had it done at a doctor's office. It was a very traumatic experience. We were separated and it took us a long time to get over it. I very much regret having had Solomon circumcised.

I knew I wasn't going to have my second son circumcised. At the time I had Silver, the first edition of Spiritual Midwifery was out. They recommended retraction of the foreskin for keeping it clean. I couldn't pull Silver's skin back so I took him to a woman doctor who did it. She wasn't nice and sent me out of the room while she did it. It was very painful also and I regret having let her send me out.

When I was pregnant for the third time I went to the Wisconsin Farm. (Sister Farm of the one in Tennessee where Spiritual Midwifery by Ina May Gaskin is published.) I read the revised edition of Spiritual Midwifery and it said retraction of the foreskin is not necessary. The Farm midwives neither encourage nor discourage circumcision. They circumcise boys if the parents wish and they do it in a religious manner, showing the baby and mother utmost respect and keeping the vibes holy.

The midwife who delivered my third son, Brook, circumcised her own baby and said she held him a lot afterwards. She, and also another woman there who had her son circumcised by Ina May, said if they had another boy they wouldn't have it done. Their reasons for circumcision were cleanliness but they felt the natural way was cool too. I didn't have Brook circumcised, but if I had wanted him to be I feel it would have been okay.

I don't think it matters about boys being embarrassed because they "look different." Lots of boys aren't being circumcised these days. I think children are growing up with a healthy attitude about their bodies and it probably doesn't matter to them. I had thought Solomon should look like his dad who was circumcised. My husband doesn't think it's an important factor for someone making this decision. The father can explain in an informative way why his penis is different. It's no big deal. I explained it to Solomon who is five now. He understood it and that was it. My other two are too young for explanations but I'm sure there won't be any problems just because they look different from daddy.

Most of the ladies I've met with boys have had their first boy circumcised and not their second son or any boys after that. This is because they weren't informed while pregnant with their first sons.

Linda Kehoe, Ball Club, MN.

We chose not to circumcise our son, but it was not an easy decision. I did not want it done because I believe it to be a trauma. We had our son at home to provide the most pleasant birth experience for all of us.

My husband, who is of Jewish heritage, though not a practicing Jew, was more inclined toward having it done. He was less skeptical of the medical reasons. He also felt our son would wonder why he was different from the other boys and his father.

We anguished for months and he finally decided that I was correct or at least could have my way. He came to the conclusion that it was unnecessary surgery.

Aaron, our son, is 18 months old now and we are both glad we did not have him circumcised. We have never pushed his foreskin back. I'm sure it would not go back easily as it is very tight. He has had an infection once‑after a doctor's visit during which the doctor pushed it back. It was red for a day and we put a cornstarch solution on it. Now we always state that we don't want his foreskin pushed back to any physician before we remove his diaper.

Maxine and Armand Altman, Kennebunkport, Maine

I split with Seagan's father when I was six months pregnant. We had never discussed circumcision. A few years before Seagan's conception I lived with a couple who had an intact child. Until recently we lived in Venice (Calif.). Many of the boys there are intact. Before Seagan was born I always thought intact penises were very 11 odd" looking until I would occasionally see a "naked" penis (one bare of foreskin). It always had a raw, "uncovered" look to it. Adult penises always seemed like "adult penises" to me, but though looking a bit mutilated, don't seem as odd as a young child circumcised.

It also seemed, though we lived in a community where naked children are accepted as natural, that circumcised males chose to remain covered more often than intact ones. This could go in hand with parental hang‑ups over "private" areas and cleanliness to these parts.

Seagan was born at a hospital with my mother at my side. I told my mother often (as I knew my belly was full of boy child) I would not have my son circumcised. After Seagan's birth I lay on this bed in the hallway with my still‑nursing son an hour out of my womb. People were singing "Happy Birthday" and sipping orange juice. The pediatrician was asking if I wanted Seagan circumcised. I was saying "No," and my mom, seemingly shocked, was saying "Yes." Then she asks for the doctor's advice and that of his wife. They say they're biased to a mother's choice about her own child. My mother was frantically talking about cleanliness and what not....

And Seagan, so young and sweet, nursing ... lying warm and naked next to my body ... trusting me to do the best I can for him ... with this argument/discussion about his penis ... such a small, tiny penis ... as new as he was.

In my mind I see picket lines of tormented males with signs saying "Save the Foreskin!" How odd, and what a fantasy!!

I am not often around relatives other than my immediate family, so I haven't had any pressure from my Jewish background other than my mother who to this day remarks how "funny" Seagan's penis looks.

For a short while I had an intact, very Italian, stepfather who couldn't relate to circumcision at all. He often said American men must have little penises because they were "half chopped off as a baby!"

Male friends with any sensitivity would react towards the idea of circumcision similarly to the way a nursing mother reacts to the thought of a cracked nipple. They reach for their penis or cross their legs and look very wounded.

In the past I have had three intact "intimate" friends. Two were more into "hiding" their penises and cleaning up after intercourse, making love in the dark or under the covers. The third was a wonderful man who felt most fortunate for having his foreskin intact. It is, amongst other things, an added attraction.

Laurie Levites , Los Angeles, CA.

I chose not to have my sons circumcised so they would remain whole and unmaimed. The foreskin acts as a shield that protects the end of the penis from desensitization from contact with underclothing and also functions as a flexible folding‑unfolding sleeve during sexual intercourse for the increased pleasure of both partners.

Our first son was born in 1964. Prior to his birth we discussed circumcision with our family physician who recommended it for general hygiene. Other friends gave varying reasons -‑ reduces masturbation, would be more painful later, or other boys in the locker room would tease. Since these ideas seemed vague at best, I made some cursory research and learned that circumcision was rarely necessary. The only substantial reason that I have found favoring it is for religious grounds.

When we were expecting our second child, my wife told our doctor that I did not want a male child circumcised and asked that I visit him to discuss it. His penile and cervical cancer scare did little good because I knew more about circumcision than he did.

In 1974 we found ourselves expecting another baby. By this time I was a virtual anti‑circumcision fanatic. I suspect that circumcision can be related to homosexuality and high divorce rates. When my anti‑circumcision stand was mentioned to the doctor he suggested that we make an appointment with him to discuss it. This physician said "Circumcision was so common that the hospital might as well do all male babies as routine." He did admit that many doctors did not find circumcision necessary. After I sent our doctor and the hospital a certified letter refusing permission for circumcision, our doctor threatened to drop my wife as a patient, but did not and never mentioned circumcision again. After our son was born his bassinet was marked with 4 inch letters "NO CIR."

(Name Withheld by Request)

My husband, Larry, has a very good friend. This man had always been an analytical type‑if you couldn't explain it mathematically, it couldn't be true. Several years ago he started to change and see things more "spiritually."

One afternoon he was working in his garden and suddenly felt very bad -‑ so terrible that he didn't want to stay out there. He went inside to work out his problem. He had been practicing yoga, so he went into a meditative state. He began feeling extreme anger, humiliation, and frustration and realized that these feelings "reminded" him of his circumcision as an infant. A subconscious realization is very hard to describe to someone else, but Larry's impression was that his friend had no doubt that he had, indeed, recalled the operation and was feeling the same sensations and emotions he felt as a newborn.

�CIRCUMCISION: THE PAINFUL DILEMMA

Over the last few years I began to doubt the practice, but figured it must be very difficult to deal with an intact foreskin and perhaps it was best to remove it. However, I've come to realize how brainwashed I've been. If new mothers can be taught to clean their newborn daughters' genitals, then why not their sons'? If little girls can be taught to clean the myriad folds that we're blessed with, why not little boys?

My feelings toward circumcision are the same as my feelings about the entire birth experience. Everything that happens, from the onset of labor, if not before, is "remembered" by the subconscious. Everything changes us toward higher or lower potential as adults. Any intervention with the natural birth and mothering process, must be detrimental to the physical and emotional well‑being of the newborn. Believing this, I must agree with my husband who says, "What kind of a way is that to start your life, getting the end of your penis cut off ?"

Debi Miller, Camarillo, CA.

(Debi was pregnant when she wrote this. Their son, Bartholomew, was born at home, June 1978.)

When I was pregnant with my first son, Terence, we found a wonderful doctor who would assist us with a home delivery. I asked him, "When do people have their babies circumcised?" thinking most people did this. I had never seen an intact penis. I am Jewish and my husband is Catholic. He had been circumcised and so had all the other males I had known.

The doctor said "Did you know circumcision is not necessary?" With all my knowledge about birth and pregnancy, I had to answer "No." No book that I had read was informative on the subject. We discussed the matter. He gave us some literature to read and said that if we chose to have it done he would do it three weeks after the birth. He felt that birth was traumatic enough and one should wait to circumcise.

We then researched the subject so we would make a responsible decision. We talked with male friends, some circumcised, others not. I wondered whether uncircumcised men had any difficulties. One friend had chosen to be circumcised when he found intercourse painful. It was an individual situation though. When he and the woman he lives with gave birth to their son, they chose not to circumcise even though the father had experienced a problem. What was most influential to my own decision not to have Terry circumcised was my husband's saying, "When I found out my foreskin had been cut off without my permission, I felt angry and cheated!" We decided we wanted it to be Terry's decision.

My mother was terribly upset and had one of my stepfather's colleagues write me a detailed letter about Terry's future as an uncircumcised male. My stepfather is a doctor. For a month my mother and I didn't speak. This was mostly my choice, for each conversation would come around to the horrors of non‑circumcision. She would cut out clippings from medical journals that described phimosis and other such things. My dear grandfather said "We should have him circumcised because God wanted it that way." I couldn't get too angry at him because he's Orthodox Jewish. But I did reassure him that God really didn't make a mistake when he put the foreskin on.

When Terry was a little older I took him to a different doctor. The doctor saw that Terry's penis was not retractable (which I now know, was totally okay!). So he pulled it back, Terry cried, and he said to pull it back regularly so that the foreskin doesn't adhere to the head of the penis and the smegma is removed frequently. He was gentle about it. I did this. As Terry got older occasionally I did find a little smegma. Later he learned to clean himself. I explained to him how it is important to keep his penis clean along with all the other parts of his body. I talked to him about being uncircumcised and showed him pictures. We talked about his friends since occasionally it was noticed that he was "different." He has said he would like one like Peter (his Daddy). Peter and Terry talked together. Now Terry says, "Daddy wishes he had a cover on his penis like me."

Our second son, Kian, was born at home also. There was no question as to whether or not we'd circumcise him. When Kian was about four months old he became quite ill with a cold. My doctor was on vacation, so I saw the doctor who was on call. He examined him, removed his diaper, and exclaimed in a loud, disapproving voice, "You should have had this baby circumcised! His foreskin doesn't retract!" He then proceeded to pull it back and make it bleed.... Here was this very sick baby and the doctor was worrying about his foreskin not retracting!! My regular doctor had seen the same penis many times and nothing was said or done. On Sunday Kian was worse but I didn't want to see that doctor again. By Monday, Kian was in bad shape. I waited at my doctor's doorstep, was his first patient, and told him of my experience. He said "I'm sorry this happened, Julie. You're going to have to put Kian in the hospital. He's got pneumonia pretty bad. He's full of mucus and dehydrated." I asked, “What else can I do?” He knows I am an intelligent, responsible person and gave me an option to take Kian home, get four humidifiers, a breast pump, and push fluids. I was to call him every hour to let him know Kian's progress. Kian had become too weak to nurse so I was feeding him with an eyedropper, pumping my breasts, and suctioning out tons of mucus. If he hadn't looked better the following day the doctor would have admitted him to the hospital.

Thank God he progressed. I saw the doctor every day for two weeks. It was a horrible experience for our whole family. It took Kian three months to fully recover.

Then began my attempts to educate others, by giving articles to childbirth educators, doctors, ministers, etc., and by sharing my experience of having two healthy, happy boys who are intact and are having no problems.

I am not attempting to retract Kian's foreskin. I have friends in France and in Denmark. They have said that it is practically unheard of [in Europe] to mess about things like that. Everyone there seems to know that by age three or so the foreskin loosens naturally.

Julie Freitas, North Hollywood, CA.

I have two boys, one born in 1966 and one in 1976. We also had three girls in between. My oldest son's birth was a typical uninformed first birth -‑ induced labor, drugs, forceps. I didn't question any of that, and did not question the routine circumcision.

My birth experiences with each of the three girls got a little better. The oldest girl's birth was somewhat "prepared" with only a little medication, but my husband wasn't there. The next girl's birth was my husband's first time present at a birth. He got to stand in the delivery room doorway -‑ a big concession for that hospital in 1970. The last girl's birth was a good hospital experience and we went home the next day.

With my fifth baby we planned a home birth. During this pregnancy we talked to other home birth couples about the unnecessary things done in hospitals. Nobody had any good reason why a boy child should be circumcised. I didn't want to subject my baby to it at all, but my husband felt strongly that if the baby was a boy he should be circumcised so that all the males in the family would "match!" Reluctantly I agreed.

When our second son was born in 1976, (a beautiful home birth!), my husband immediately started trying to arrange the circumcision. We are members of a group health plan, so he called the hospital and got started on the "merry‑go‑round!" Pediatrics wouldn't perform an outpatient circumcision because they didn't have the “equipment." Urology wouldn't perform a circumcision on a child under a year of age. The Health Plan office wouldn't pay for a circumcision performed by an “outside" doctor. He called a local synagogue (we are not Jewish) to see if they could recommend someone, but they couldn't. He called the Social Services Office at the hospital. The social worker called back the next day to report that Urology had told them that they didn't have to do it because the child wasn't born there! Finally my husband called the Chief of Staff obstetrician. The Chief of Staff said he'd do the circumcision himself.

I had to take Trent to the doctor myself as Paul couldn't get off work. I dreaded it and took a friend with me for support! When we arrived a nurse took the baby to get him ready while I signed a form stating that "I understood there is no medical reason for this procedure, but I wanted it done...." My mothering instincts and common sense were fighting the whole thing, but I knew it meant a lot to my husband. So, against my better judgment, I went ahead.

I started into the examining room where they had taken Trent. I could hear him crying. It was the first time he had ever been away from me! The nurse tried to stop me, (my friend said it looked like she was going to slam the door in my face!) but I pushed on through. I found my poor little boy naked, strapped to a horrible contoured board with room for his legs, arms, head, etc. each in a compartment! He was painted with an orange antiseptic from the waist down. As soon as the nurse left I crawled up on the table next to Trent and by half‑lying, half‑standing I nursed him and tried to get across to him that I loved him and hated what I had to do to him. I think he got the message. He stopped crying and was peacefully nursing (as much as possible in that contraption!) when the doctor came in. He told me to leave. (I think he didn't want me to see such a personal "male" procedure!) I refused. He said that either I left or he would. Again, common sense was overcome by what I felt was "duty" to my husband, so I left and stood right outside the door.

A couple of minutes later the door opened. We had an "eleventh hour reprieve!!" Trent had a rash and he didn't feel he should do surgery without having someone look at it. The Chief of Pediatrics was called. I unstrapped Trent and held him. The pediatrician concurred that it was inadvisable to do a circumcision at that time because with the rash there was a good chance that the open wound would get infected.

Thankfully I took my uncircumcised baby home, determined not to put him through THAT again! When I described the procedure to my husband and said, "If you want him circumcised, YOU get him circumcised!" he agreed that he didn't want his son to go through all that, even if it did mean they didn't "match!"

Paul isn't a cruel or unreasonable man. I'm sure if he had known what was involved he wouldn't have been so insistent on the procedure. Needless to say, if we ever have another son, we will also not have him circumcised.

My friend who accompanied me to the doctor's office had had a similar experience with her baby who was born six weeks before Trent, also at home. Her husband was in the military and she called four large military hospitals before she could find someone to do it. She also said, "Never again!" and tried to help me talk Paul out of it.

The pediatrician who examined Trent said that if we did decide to have it done after the rash had cleared, he would recommend using a general anesthetic!

Trent is seventeen months old now. We have never had any problems with the care of his penis. The foreskin retracts quite easily and although we aren't fanatical about cleaning it, he's never had any infections.

(Dee is also a La Leche League leader.)

Dee Le Clair, Vallejo, CA.