Sunday, August 26, 2007
Saturday, August 25, 2007
Circumcision: The private decision that's become a public debate
Posted by: "Chaz Antonelli" chazantonelli@yahoo.com chaz.antonelli
Fri Aug 24, 2007 1:40 pm (PST)
Circumcision: The private decision that's become a public debateBy Cindy Sutter (Contact)
Thursday, August 23, 2007
When Nicolett Katz's son was born 10 months ago, she and her husband decided
not to have him circumcised.
It was a natural decision � literally � for Katz who is a doula and teaches
hypnobirthing classes in Boulder.
"We just always felt that the human body is perfect as it is," she says.
"Why cut around on it? We opted to have a very natural home birth. We felt
it would be wrong to invade his little body with needles and knives."
While the decision was easy for Katz and her husband, some couples find the
decision more difficult. Open any magazine targeted at mothers, and you're
likely to see an article on the pros and cons of circumcision.
The procedure, the most commonly performed surgery in the United States,
involves the removal of the foreskin on the penis. It is most often done in
the hospital by an obstetrician or pediatrician before parents take the baby
home. Rates of circumcision in the United States, where it is relatively
routine, are much higher than in Europe, Asia and Latin countries.
But U.S. circumcision rates are declining. In the 1960s, roughly 90 percent
of newborn males were circumcised. In 2004, the last year for which figures
are available, the rate had dropped to 57 percent nationally, much of that
attributed to immigration. In Colorado, it's 63 percent. Rich Sheehan,
spokesman for Boulder Community Hospital, says the hospital has only
recently started keeping statistics on circumcision. In May of this year,
the rate was 40 percent.
The American Academy of Pediatrics has taken a neutral position on the
issue, saying that existing scientific evidence does not show enough
benefits to recommend routine circumcision. It does cite some studies that
show a reduced risk of penile cancer. That type of cancer is so rare,
however, that the reduced risk doesn't necessarily outweigh the potential
complications of circumcision, the group says.
Dr. Albert Mehl, a pediatrician at Kaiser Permanente in Lafayette, says of
the procedure, "Many of us have a Switzerland approach. I do try to make
clear that there's not a medical reason that it has to be done."
He says circumcision can prevent future problems with the foreskin being too
tight, a rare problem. And some studies show that there's a slightly lower
risk of urinary and kidney infections among circumcised boys. But those
conditions can be treated.
Why do people circumcise their sons?
For many people, it's a cultural norm. Doug Gertner, who teaches Boot Camp
for New Dads at local hospitals, says many of the fathers haven't given the
issue much thought. Since most were born when circumcision rates were
higher, they are themselves circumcised and expect the same for their sons.
Men frequently say, 'I want my son to look like me,'" Gertner says.
"I suspect in families that choose not to (circumcise, the decision is)
driven by the woman. Something I generally hear in class is, 'She reads the
books.'"
Gertner says he offers the men information to help them and their partners
make a decision.
"I never tell them what they should do other than to say, 'Never shake a
baby,'" he says.
For Jewish people, circumcision is more than a custom, it's an important
part of religious practice and identity.
Rabbi Nadya Gross and her husband, Rabbi Victor Gross, lead congregation
Pardes Levavot. They have three sons, all of whom are circumcised in the
traditional ceremony called a bris. Their first son was the family's first
grandchild. His circumcision was done in Israel with several generations
attending.
"The bris, the celebration around the circumcision was done publicly amongst
family and friends. He was another child entering the covenant," she says of
the ceremony, which was a joyous coming together of family and faith.
A small number of Jews, however, have spoken out against the procedure.
Miriam Pollack, who is a member of Pardes Levavot, regrets having her sons
circumcised in 1978 and 1982.
"I will never stop hearing those screams," she says. "They were unlike
anything I ever heard from them."
Pollack had always been bothered by her sons' circumcision and attended a
seminar on circumcision in 1991 in San Francisco. She came to see
circumcision as genital mutilation and now belongs to a group called Jews
Against Circumcision.
She cites studies that show that infants' heart rates and cortisol levels
rise sharply during the procedure.
"Witnessing my children's circumcision was extremely traumatic. I could not
reconcile their trauma with my deep maternal knowing that this could not be
right with what my (religious) tradition was telling me," says Pollack, who
spoke to her congregation about her views on circumcision.
Gross says she also found it hard to hear her babies cry.
"Even knowing it's quick and healing is quick, the baby cries, there is pain
caused," she says.
"Those who are opposed to it come at it through a rational medical
perspective. ... For me it's not a rational choice, it's tribal," Gross
says. "My brothers, my grandfather, my father, my male cousins, my sons are
all identified that way."
Pollack and members of anti-circumcision groups, some of whom call
themselves "intactivists, " also argue that the practice has long-term sexual
side effects.
A study conducted by the National Organization of Circumcision Information
Resource Centers, an anti-circumcision group; and the Michigan State
University of College of Human Medicine, published in the British Journal of
Urology, measured fine touch pressure on circumcised and uncircumcised
penises of adult volunteers. It concluded that circumcision ablates the most
sensitive parts of the penis.
Mehl says several studies have reached contradictory conclusions on the
issue.
Another recent study found that circumcised men in Africa had a 60 percent
lower rate of HIV transmission. However, Pollack points out that the U.S.,
which has much higher circumcision rates, has the highest rate of HIV
transmission in the developed world. She worries that such studies could
discourage the use of condoms.
"The HIV rate could soar," she says. "(Circumcision) is not a safe method
for HIV prevention. Safe sex and condoms must be used in any event."
Mehl says he has seen circumcision rates fall in his own practice,
especially after the American Academy of Pediatrics issued a strong
statement urging against circumcision in the 1980s. The studies on the lower
incidence of penile cancer and urinary and kidney infections, have since led
to the group's more neutral stance.
Mehl says, however, that for those without religious reasons, it's still
part of American culture.
"Some choose circumcision because the father or older brother is
circumcised, " he says. "That's part of the reason that the community's
circumcision rate doesn't change very fast."
Katz says she and her husband made the right choice for their family.
"It's not a life-preserving procedure like having a heel prick to test for
genetics," she says. "For people with religious reasons, there's a different
energy around it. They have this deep belief. For hygienic reasons, it's
outdated. Just because Daddy has it, was not a good enough reason for us."
Contact Camera Staff Writer Cindy Sutter at 303-473-1335 or
sutterc@dailycamera .com.
------------ --------- --------- --------- --------- --------- -
----
source:
http://dailycamera. com/news/ 2007/aug/ 23/circumcision- private-decision -s-beco
me-public-deba/
Sunday, August 12, 2007
circumcision rates in canada
Circumcision practices in Canada
| 1999 | 2000 | 2001 | 2002 | 2003 | |
| proportion of male infants circumcised (%) | |||||
| Canada | 16.9 | 15.8 | 15.3 | 14.6 | 13.9 |
| Newfoundland and Labrador | 0.2 | 0.3 | 0.2 | 0.2 | 0.0 |
| Prince Edward Island | 36.3 | 39.6 | 34.9 | 37.3 | 29.5 |
| Nova Scotia | 2.1 | 1.6 | 1.5 | 1.3 | 1.1 |
| New Brunswick | 17.6 | 18.7 | 17.4 | 18.5 | 14.9 |
| Quebec | 3.8 | 3.7 | 3.8 | 3.4 | 3.2 |
| Ontario | 21.2 | 18.8 | 17.7 | 16.8 | 16.0 |
| Manitoba | 26.6 | 25.6 | 26.3 | 25.5 | *25.0 |
| Saskatchewan | 28.7 | 28.3 | 26.3 | 25.2 | 16.7 |
| Alberta | 21.4 | 20.9 | 20.4 | 19.2 | 20.1 |
| British Columbia | *20.0 | *20.0 | *20.0 | *20.0 | *20.0 |
| Yukon | 12.5 | 10.2 | 9.9 | 7.4 | 9.9 |
| Northwest Territories | 16.6 | 15.5 | 13.4 | 15.1 | 8.6 |
| Nunavut | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
| For fiscal years ended March 31. | |||||
| * Estimated. | |||||
| Source: Provincial and territorial ministries of health, Statistics Canada. | |||||
Circumcision practices in Canada
| 1973 | 1974 | 1975 | 1976 | 1977 | |
| proportion of male infants circumcised (%) | |||||
| Canada | 47.4 | 46.9 | 44.3 | 41.9 | 38.8 |
| Newfoundland and Labrador | 3.2 | 5.3 | 4.5 | 3.3 | 2.4 |
| Prince Edward Island | 60.9 | 66.9 | 66.3 | 56.4 | 53.4 |
| Nova Scotia | 39.8 | 37.3 | 35.6 | 31.7 | 27.8 |
| New Brunswick | 40.6 | 40.9 | 39.5 | 35.1 | 31.8 |
| Quebec | 27.7 | 25.2 | 21.5 | 16.2 | 12.7 |
| Ontario | 59.8 | 60.0 | 57.7 | 55.7 | 54.3 |
| Manitoba | 55.6 | 56.3 | 52.0 | 52.3 | 46.7 |
| Saskatchewan | 51.2 | 53.7 | 51.0 | 53.7 | 51.2 |
| Alberta | 55.8 | 55.8 | 53.9 | 50.7 | 52.6 |
| British Columbia | 54.7 | 52.4 | 54.1 | 58.0 | 46.0 |
| Yukon | n/a* | 65.0 | 68.0 | 64.7 | 74.8 |
| Northwest Territories | n/a | n/a | n/a | n/a | n/a |
| * n/a, not available | |||||
| Source: Wirth JL. Current circumcision practices: Canada. Pediatrics 1980; 66(5): 705-708 | |||||
Ontario infant dies after circumcision
Ontario infant dies after circumcision
Mark Brennae
CanWest News Service
Thursday, June 14, 2007
OTTAWA -- A one-week-old Ontario infant died from complications after undergoing a circumcision in a provincial hospital.
Information about the case was published in the April edition of Pediatric Child Health.
The baby, whose name has been withheld by the parents, passed away after his bladder became enlarged to seven times their normal size.
The child was born at an unidentified Ontario hospital "sometime in the last three years," said Dr. Jim Cairns, Ontario's deputy chief coroner. "The family wants to keep this anonymous."
No charges were ever laid and no legal action was ever taken in the case.
According to the Pediatric Child Health article, the boy was "bottle fed and was reported to be doing well when he was circumcised."
Five hours later, the parents returned to their family doctor with the infant, who had become "irritable and had blue discoloration" below the belly button.
Doctors noticed the discoloration and slight swelling of the penis, but sent the child home.
Fourteen hours after the circumcision, according to Cairns, the child was brought to another hospital where doctors noted he was extremely irritable with marked swelling of the penis and bruising to the scrotum.
The child was then transferred to a pediatric centre, where his bladder was diagnosed, Cairns said, to "seven or eight times its normal size."
The PlastiBell ring, which is used to hold back the foreskin after circumcision, was removed and drained and the child went into shock.
"If the PlastiBell had been taken off five hours after he got there, he would be alive," said Cairns.
The child's death was attributed to septic shock - "an overwhelming infection, leading to multi-organ failure," Cairns said.
"Death is rare after circumcision," said Cairns. "But complications can happen."
The case was brought to Cairns' attention because the circumstances of every death of an Ontario child under five years of age must be reviewed by the provincial coroner's office.
Snip 'not worth cost'
August 12, 2007 12:00am
CIRCUMCISION will be banned in Victorian public hospitals unless it is for medical reasons.
The State Government has ordered the ban, which starts next month, following medical advice that circumcision of baby boys was unnecessary.
Health Minister Daniel Andrews said circumcisions would be performed only when doctors were concerned about infection or disease.
"Nationally and overseas, doctors agree there is no medical benefit to routine circumcision, and studies show the complication rate is about 5 per cent," Mr Andrews said.
The $2 million a year saved by the ban will be spent on urgent elective surgery.
"It is important to ensure hospital services are prioritised towards treating patients who have a clinical need for surgery to improve their health," Mr Andrews said.
Ministerial Advisory Committee on Elective Surgery chairman Prof Michael Grigg said it was hard to justify spending taxpayers' money on routine circumcision.
"We should be spending relatively scarce health dollars as effectively as we can to benefit the maximum number of people," he said.
Prof Grigg said circumcision had marginal health benefits for some people, but also had a risk of complication.
About 2200 circumcisions were performed by Victorian public hospitals in the 2005-06 financial year.
Parents who want to have their sons circumcised for religious reasons will have to use a private hospital.
Monday, August 6, 2007
The effect of male circumcision on the sexual enjoyment of the female partner
For complete story goto http://www.cirp.org/library/anatomy/ohara/
These results show clearly that women preferred vaginal intercourse with an anatomically complete penis over that with a circumcised penis; there may be many reasons for this. When the anatomically complete penis thrusts in the vagina, it does not slide, but rather glides on its own 'bedding' of movable skin, in much the same way that a turtle's neck glides in and out of the folder layers of skin surrounding it. The underlying corpus cavernosa and corpus spongiosum slide within the penile skin, while the skin juxtaposed agaist the vaginal wall moves very little. This sheath-within-a-sheath alignment allows penile movement, and vaginal and penile stimulation, with minimal friction or loss of secretions. When the penile shaft is withdrawn slightly from the vagina, the foreskin bunches up behind the corona in a manner that allows the tip of the foreskin which contains the highest density of fine-touch neuroreceptors in the penis [1] to contact the corona of the glans which has the highest concentration of fine-touch receptors on the glans [18]. This intense stimulation discourages the penile shaft from further withdrawal, explaining the short thrusting style that women noted in their unaltered partners. This juxtapostion of sensitive neuroreceptors is also seen in the clitoris and clitoral hood of the Rhesus monkey [19] and in the human clitoris [18].
