Rebuttal of the Mayo Clinic's advice

Even the prestigious Mayo Clinic is not immune from the usual prejudices about circumcision. Comments and added emphasis are in red.

[This page is at]

Baby Basics

Circumcision: Pros and cons
Adapted from Mayo Clinic Complete Book of Pregnancy and Baby's First Year

Circumcision is a [surgical] procedure in which the foreskin - the sheath of tissue [, nerve-endings, nerves and muscle...] covering the head of the penis - is removed. ... Many parents today still have their sons circumcised, for religious or other reasons. In the United States overall, the practice is somewhat less common today than it was 50 years ago [but still vastly more common than it was 150 years ago].

If you know ahead of time that you are carrying a boy, or even if you are unsure of the sex of your baby, give some thought before delivery as to whether you will have your son circumcised. If you are undecided about this option, it will help to be aware of what is currently known about the risks and benefits of this procedure, as well as some of the reasons why parents opt for or against it.

Health issues. Researchers have attempted to learn more about whether circumcision prevents infection and certain types of cancer, but more studies need to be done to answer some of these questions. [In other words, circumcision is a remedy still looking for a disease.] It is known that circumcision prevents infection and inflammation of the foreskin. [Well, D'uh! It would, wouldn't it?] And it seems to decrease the risk of cancer of the penis. [As with inflammation, it certainly totally eliminates cancer of the foreskin, but more than that is highly debatable.] This disease occurs in fewer than one of every 100,000 men in the United States [...annually, but usually late in life,and there are many co-factors, such as smoking and cleanliness].

Some studies have shown a greater risk of cervical cancer in female sexual partners of uncircumcised men who are infected with human papilloma virus. [This is a confusion. The studies that seemed to show a circumcision link were faulty - the circumcised and intact populations were from different cultures. Human Papilloma Virus (HPV) is the causal factor that needs to be treated.] Circumcision might also have a role in reducing the risk of sexually transmitted diseases. Practicing safe sex is a far more important factor in preventing these diseases than whether a man is circumcised.

Recent studies suggest that infants who are not circumcised may be more likely to develop urinary tract infections. These infections early in life may lead to kidney problems later in life. Infants who have abnormalities of the kidney or bladder are at higher risk for urinary tract infections, so circumcision may be advised for these babies. [Ignoring these abnomalities was one of the errors that gave rise to the original conclusion.]

Occasionally [at at rate of less than 1% in non-circumcising countries], problems can occur with the uncircumcised penis which require circumcision at an older age. [Problems can occur with any organ of the body - up to and including the heart, and parts of the brain - which require its removal at a later age. Circumcision is the only removal commonly done before any problems appear.] These problems include inflammation of the foreskin [which can be treated like any other inflammation] or adherence of the foreskin to the tip of the penis [...commonly caused by forcibly retracting it before it is ready, and which can also be treated without circumcision, sometimes without surgery.]. These problems occur in about 2 to 6 percent of uncircumcised males [in the US, where circumcision is still seen as a panacea - it's less than half that figure elsewhere]. Circumcision during infancy eliminates the possible need for the procedure at an older age [just as preventative removal of any organ at all can prevent future problems with that organ. This is an extraordinary "reason"].

Cleanliness. Circumcision makes it easy to keep the end of the penis clean. [The intact penis is very easy to keep clean.] However, the shedding skin cells that naturally accumulate on the glans of an uncircumcised boy are not harmful. [In other words, the "cleanliness" argument is spurious.] Do not try to force the foreskin back to clean the penis of an infant or young boy. Washing externally with [mild] soap and water is all that's necessary.

After your son's foreskin is fully retractable, then washing under the foreskin during a bath or shower is part of good hygiene habits. The risk of penile cancer appears to be linked to personal hygiene. Uncircumcised [or circumcised] males with poor hygiene have a higher risk, whereas uncircumcised [or circumcised] males with good hygiene have a lower risk.

Other factors. Many Jewish and Muslim parents throughout the world continue to have their sons circumcised for religious and cultural reasons, as they have done for many centuries. [Why is this mentioned on a medical page? What other surgery is also performed for religious reasons? Answer: Female Genital Mutilation.] One reason why some parents choose circumcision is so their son will be like his father [It is always expressed this way, as if the son will desperately want to have a penis that looks like his father's: in fact, if anything, the boy wants his father's penis to look like his, but the more anxious person about this is usually the father, so it is his penis that should be modified, if any] or his peers. [Nowadays many of his peers will be intact. It is extraordinary that otherwise-ethical doctors will even consider performing surgery for this "reason".] Some parents prefer to have their sons make this decision later in childhood or as an adult [...or not at all! Deciding whether to have part of one's penis cut off is no more obligatory than one's labia or any other part of one's body.]. All of these are issues that depend on personal preferences. [And the person whose preference should be overriding is...?]

Circumcision does not prevent masturbation [...but that is why it was introduced as a medical procedure...] or increase fertility. The belief that circumcision enhances the sexual experience for men or their sexual partners may not necessarily be true, either. [May not necessarily? It undoubtedly is not necessarily true, since many men find adult circumcision to be detrimental and many others find foreskin restoration to be beneficial. The proposition that cutting off part of the penis might actually damage sexuality - which ought to be self-evident - is not considered here.]

[The following passages are sidebars in small print.]

Risks. Like any minor surgery, circumcision poses some risk [up to and including death] to the newborn. [But unlike any other minor surgery, it is generally agreed to be medically unnecessary.] Excessive bleeding or infection occurs in fewer than one in 1,000 cases. [This unsourced figure is much lower than that given by various studies.]

Circumcision does cause [excruciating] pain for the baby. Local anesthesia is frequently used. [Actually, about half the time.] If you decide to have your son circumcised, you may want to talk with your doctor about whether local anesthesia will be used. [This recommendation is remarkably half-hearted considering that even the AAP recommended in 1999 that anaesthesia should always be used.]

Reasons to postpone circumcision. Sometimes circumcision must be delayed. In premature boys, for example, the procedure is usually delayed until the baby weighs about 6 pounds. Babies born with birth defects of the penis, such as hypospadias, usually should not have circumcision done until the time that corrective surgery is planned. Other reasons to delay circumcision include illness or bleeding problems, such as hemophilia [An absolute contraindication, surely?]. If your baby is hospitalized or requires special care after birth, your doctor will advise you as to when circumcision might be done.

[Leaving him alone. A paragraph or more about why a baby's penis might be left alone could go in here. For exmaple:

  • Well over 3/4 of the world's men are intact.
  • Very few ever have any trouble with their foreskins.
  • Many men say their foreskins enhance their sexual pleasure.
  • Giving newborn babies anaesthetics should be avoided.
  • Even with anaesthetic, circumcision subjects a newborn baby to trauma, whose effects are known to be long-lasting.
  • An intact penis requires no special care, in fact most problems are caused by meddling with it.
  • It's much easier to tell a boy he's different from the others because they've had part cut off their penis than because he has. ]

Making your decision. In deciding whether to have your son circumcised, it may help to talk to other parents of boys about what they decided and why. Health and hygiene issues, personal preferences and religious beliefs [not to mention human rights or ethics... ] all must be weighed when deciding for or against this procedure. [... and the bottom line is, whose penis is it, anyway?]

If you choose circumcision, it usually will be done within days after delivery. Your consent must be obtained, either orally or in writing, before the procedure is performed. [A man in New York is now suing the doctor who circumcised him after obtaining oral consent from his sleepy mother.]

Whatever your decision concerning circumcision of your son, it should be based on what is currently known about its risks and benefits. [Again, no mention of human rights, ethics, or whether he, as the owner might prefer to keep all of his penis for the rest of his life.] Your personal views and beliefs play an important role in making this decision. [This emphasis on the importance of your decision all has the effect of pushing you towards circumcision. Nowhere does the Mayo Clinic mention that circumcision -and hence a decision about circumcision - is not necessary, or that a human rights issue is involved.]

This policy has been summarised in a correspondingly inadequate brochure for parents.


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