German Factory Uses Infant Foreskin to Grow Human Skin

By Danelle Frisbie

An employee at the Fraunhofer Institute holds a culture plate with foreskin-grown skin samples.

We've watched before as human foreskin is harvested from infant boys in the United States and sold for use in cosmetics nationally and overseas. We've seen foreskin taken from infant babies and used in skin grafting for burn victims. Now, a laboratory dubbed the "Skin Factory" at the Fraunhofer Institute in Stuttgart, Germany is using vorhaut von kindern - children's foreskin - to grow new skin samples for testing cosmetics and other products.

Project spokesperson, Andreas Traube, says researchers hope that this use of human foreskin could replace animal testing, and eventually be used in developing treatments for cancer, pigmentation diseases, and certain skin allergies.

The process itself takes six weeks to complete, and during this time 10 million skin cells are grown from one single boy's foreskin - to make new skin up to five millimeters thick. A machine is used to heat the foreskin to 98.6 degrees Fahrenheit (the temperature of the human body), and robotic hands extract cells from the organ. Scientists then take the extracted cells, mix them with collagen and connective tissue, and incubate them inside a petri dish lined tube, where they multiply at the same regulated temperature. This tube, approximately 22 feet long, 10 feet wide and 10 feet high, fosters the growth of the foreskin's cells into an epidermis layer of skin (the outermost skin on the human body). Three layers of this new skin are finally put together to create the end sample. In regards to the month and a half long time frame, Traube says, "We can't use the machine to speed up the process; biology needs time to take its course."

While European authorities have yet to authorize the Skin Factory for official use in product testing, new skin swatches from young human foreskin is begin produced at a rate of 5,000 samples per month and authorities are examining the factory to determine if the skin can be used commercially. "It's logical that we'd want to take the operation to a bigger scale," said Traube. And at least one German organization has already expressed interest in the machine. "I think the idea is a good one. I believe cells from artificially cultivated skin are indeed comparable with real skin," says Rolf Homke, spokesman for the German Association of Research-based Pharmaceutical Companies. "I do think it might take a few years to get up and running though. There are complicated international safety standards -- these procedures can't just be changed overnight."

One ethical problem in all of this? These harvested foreskins belong to babies and toddlers who are not yet able to consent to the organ's amputation from their own bodies. The Skin Factory uses foreskin only from newborn baby boys up to four years of age, and the goal is to gather as many infant foreskins as possible. "The older the foreskin is, the worse it performs," says Traube. And this foreskin (the prepuce organ) is one that all mammals are born with, male and female alike. It is on the human body for a purpose - it serves many important developmental, immunological, and sexual functions. Just as the foreskin is valuable to researchers when amputated from babies and toddlers, it is of even more value when it remains on the body to which it belongs.

Fraunhofer Institute for Interfacial Engineering and Biotechnology


Related Reading:

Huffington Post report on the skin factory:
http://www.huffingtonpost.com/2011/12/20/german-skin-factory-uses-baby-foreskin_n_1161384.html

New York Daily News report on the skin factory:
http://www.nydailynews.com/life-style/health/german-scientists-grow-artificial-skin-cells-baby-foreskins-article-1.994464

The Foreskins in Oprah's Face Cream
http://www.drmomma.org/2009/10/foreskins-in-oprahs-facecream.html

Article Asks, "Are Infant Foreskins the New Botox?"
http://www.drmomma.org/2010/04/article-asks-are-infant-foreskins-new.html

Stealing Foreskins: The Science of Skin Grafting
http://www.drmomma.org/2009/12/stealing-foreskins-science-of-skin.html

~~~~

Urine Samples and Catheter Insertion for Intact Boys

By Danelle Frisbie © 2011


We receive two common types of forced retraction reports from parents: those that happen at well-baby checkups in the United States, often before a parent even knows what is happening, and those that happen when a parent ends up in the hospital with a baby who is catheterized (due to illness or surgery).

Before we address catheterization specifically, and the correct way to catheterize an intact male baby or child, it should be noted that frequently there is truly not a need for catheterization in the first place. With some surgeries, and post-op recovery, it is going to be necessary. However, often, in surgical cases for babies and toddlers, simply wearing a diaper and having another couple ready for change during and/or post-OR, is another option, especially if the toddler will be under general anesthesia for less than 4 hours.

Urinary Tract Infection

Besides surgery, the most common reason for catheterization is to check for the existence of a urinary tract infection (UTI). UTIs occur with much more frequency in girls than they do in boys due to the short urethra and proximity to the anus (contamination with fecal matter or bacteria from the hands of a care-taker are the two biggest causes of UTIs). UTIs are easily treated with antibiotics, but they should not be ignored or left untreated because bacteria can quickly spread up the urinary tract, through the bladder, into the kidneys, and do serious or permanent damage. UTIs are bacterial infections and once they have taken hold, merely drinking cranberry juice will not kill off bacteria, as some pop parenting reports suggest. Regularly consuming 100% cranberry extract capsules (a much higher concentration than you would get from cranberry juice) for older children and adults can reduce the likelihood of UTIs in the future by priming the health of the urinary tract, but it cannot 'cure' an already established bacterial infection. Even if symptoms disappear, the strongest bacterial strains may remain, causing future kidney problems. Therefore, if you suspect UTI, do not wait, and do not mess around with treatment if a UTI is confirmed. If antibiotics are prescribed for a UTI, be sure your baby or child takes the full does, on time, and does not miss any days or stop early (which can also lead to the most powerful bacteria lingering on when the child is asymptomatic).

There are some children (girls especially) who seem overly susceptible to contracting UTIs and may have a bout with several each year until they are older, out of diapers, without parents' hands helping them to wipe, and always wiping themselves 'front to back.' While it is not a subject regularly brought up at the physician's office, self-touching or exploration of the genitals (masturbation) with hands that have not yet been washed and have fecal particles on them is another way that UTIs can be contracted - again, especially among girls whose urethra is shorter and less protected. This does not make masturbation 'wrong' or 'dirty' -- it merely is a reality that we need to wash our hands before and after changing or wiping babies or toddlers, and encourage them to do the same before they touch their own bodies. This is also one of the reasons masturbation and circumcision became intertwined in U.S. history in the first place -- it was theorized that if we remove the prepuce (which houses the most nerves of any male body part, and a relatively equal number to the female clitoris) we would thereby diminish boy's and men's sexual desire to masturbate, and in turn, we'd also see fewer UTIs (among other illnesses previously blamed on masturbation).

In reality, when forced retraction is not part of the picture, UTIs are no more common in intact baby boys (boys who have their full, intact prepuce and penis) than in circumcised boys. The prepuce, in fact, serves to protect against UTIs. Additionally, breastfeeding reduces the rate of urinary tract infection for both male and female babies, as human milk is powerfully charged with antibodies and white blood cells, among other protective, immunological features.

Urine Sampling

Today, the two most commonly used methods of collecting a urine sample from non-toilet using babies and children in U.S. emergency rooms are the "clean catch" and "bag specimen." Neither method is done without contamination of sample, but research suggests that between the two, clean catch is the way to go. (1, 2) Note: Studies do show that there is no significant variation between clean catch versus a standard urine sample obtained through other means for older children and adults who can urinate into a sterile cup on their own. (3, 4, 5, 6, 7)

A clean catch receptacle designed by UriAid especially for use with children, women, or little ones who may be laying down during urine sample collection. 

A clean catch works by wiping down the genitals of an infant or child with sanitizing wipes (provided by the clinic), and holding a sterile specimen bottle under the stream of urine - after the baby/child has started to urinate. This is considered to be the 'gold standard' of non-invasive urine sampling, but is more difficult to time with babies. Breastfeeding may help to fill and release the bladder.

For older children who can tell you when they need to go, a clean catch can be done at home. Wipe down the outside of the genitals and the perineum (between the urethra and rectum) with a wet cloth. Have your child drink a lot of liquid or nurse, and stand by or sit on the toilet with the faucet water running (this helps to psychologically induce 'flow'). Your child may also want to stand over a cup in the bathtub if he is more comfortable with this. Write your child's name, date of birth, and the date and time the sample was taken on the outside of the cup. Take it to your local urgent care or emergency room within 2 hours of the time it was taken (if more time has passed, it is likely they will ask you to repeat the sample). If your child truly has a UTI, it may be difficult for them to push out urine even when they feel the intense urge to 'go.' This urgency and frequency, coupled with being unable to eliminate urine, is a key indicating factor that there is indeed a UTI present, and a full round of antibiotics are justified. Babies who cannot tell you that they desperately need to go, but cannot, and that it constantly hurts, and stings when they try, are those who we are especially concerned with - their cry of discomfort, fever to fight infection, and possible reduction in wet diapers, are the only indications we often have of a UTI.

Urine collection pad kit.

The National Institute for Health and Clinical Excellence (NICE) suggests that the use of urine collection pads is the next best method of urine collection in a non-toilet using baby or child. This is a special pad made specifically for collecting urine that is placed into a baby's diaper after a wipe-down with a sanitizing wipe. The pad needs to be changed every 30-40 minutes (whether the child wets or not) so as to reduce the rate of contamination. (8) One reason that we see higher rates of UTIs in the first place during the first year of life is due to the diapering of our babies - a situation that helps to move fecal bacteria from the anus to the meatus (urethral opening). The same is true for collection pads - it is merely contact with the perineal area that increases contamination of sample - so change often. (9) 

Pediatric urine collection bag. 

Another form of urine collection (which sees no less contamination of sample than the urine collection pad, and is more cumbersome, so may not be the method of choice) is the urine collection bag. The bag has a U shaped sticky area (similar to a bandaid, but with less adhesive) on the round opening that is placed over the genitals after they are wiped down. The bag lays out of the way (to the top or bottom of baby's genitals) as urine is collected. A diaper can be put on over the the collection bag. If being used at home, the urine from the collection bag can then be transferred to a sterile collection cup and submitted to your local urgent care or emergency room within 2 hours, just as it would be with a clean catch. A 2009 study published in the Journal of Pediatrics found that bag-obtained specimens produced a significantly higher number of false-positive results (parents were told their child had a UTI, when in fact, he did not). In addition, there was a higher number of false-negatives (parents were told their child did not have a UTI, when he in fact did). (10) 

 Infant with urine collection bag in place. 

Neither pads or bags may be left on a baby for more than 40 minutes or it will increase the likelihood of a bacterial infection even if your baby does not already have an infection. Leaving babies in diapers all day also increases infection potential - so give your little one some 'diaper free' time whenever you are able. Babies who are not yet crawling can do tummy time on a waterproof mat with a towel or cloth diaper laid out under him/her. Many parents today incorporate 'elimination communication' into their routine as well, which also reduces time in diapers.

Catheters

Occasionally, medical staff will suggest they need to collect an uncontaminated sample, or verify the results of a sample previously obtained through non-invasive means, with catheterization.

Adult intact male with Foley catheter in place to demonstrate how the catheter would appear inside your son. Infants and children have a shorter urethra (and shorter penis) which is one reason they have a tendency to get more UTIs. Therefore, the catheter itself will be smaller and shorter, without as far to go to reach the bladder. The balloon you see here (for the Foley) would be present if your son is catheterized for a surgery, but not present for a brief urine sample. The catheter goes directly from the urethra to the bladder - above the prostate gland that you see pictured here between the penis and bladder.

There are two types of catheters that are most commonly used with infant or young boys: the Foley catheter and the intermittent or Robinson catheter. The Foley catheter is used most often during surgery when the instrument needs to stay in place. This is done with a small balloon at the tip of the catheter that is inflated with sterile water once inside the bladder.  The intermittent/Robinson catheter is a flexible catheter that is used most often when medical staff are checking for urinary tract infection. It is designed for the brief drainage of urine - to obtain a quick sample - and cannot stay in place without being held.

When an intact male baby or child is catheterized, retraction of the prepuce (foreskin) is not necessary or indicated.

In the United States there is quite a well founded concern that forced retraction will come into play when an intact male child is catheterized. However, it is the female patient for whom catheterization is actually more diverse and confounding. Age, weight, childbirth, past surgeries, female genital cutting, and many natural variations in the female body make catheterization of a girl or woman much more complex than catheterization of a boy or man, intact or otherwise. In general (unless hypospadias is a factor) the meatus (urinary opening) is going to be somewhat centrally located directly behind the opening to the prepuce, and fairly easy to 'hit on feel.'

The prepuce will typically be tightly adhered to the glans (penis head) of a baby or young toddler with little slack or room for movement, as seen in the photograph below. Even in boys as old as 10 years, many will still not have a retractible prepuce. In Pediatrics, Rudolph and Hoffman note, "The prepuce, foreskin, is normally not retractile at birth. The ventral surface of the foreskin is naturally fused to the glans of the penis. At age 6 years, 80 percent of boys still do not have a fully retractile foreskin. By age 17 years, however, 97 to 99 percent of uncircumcised males have a fully retractile foreskin." The average age of retraction is 10 1/2 years -- some will retract naturally, on their own, sooner, and some later. Each is within the range of normal, but no one should retract a baby or child except for the boy himself when he chooses to do so.

In their bulletin, Care of the Uncircumcised Penis, the American Academy of Pediatrics stresses, "...foreskin retraction should never be forced. Until natural separation occurs, do not try to pull the foreskin back - especially an infant's. Forcing the foreskin to retract before it is ready may severely harm the penis and cause pain, bleeding and tears in the skin."

Simply put, there is never a reason to forcibly retract the prepuce. Writes Doctors Opposing Circumcision in their article, Forced Retraction of Intact Boys: An Epidemic:
Only in the instance of significant hypospadias or epispadias (congenital malposition of the urethral opening) might retraction be necessary, and even then only if it is unavoidable collateral damage for which there should be specific follow-up care.
If your son has already been the victim of forced retraction, see Forced Retraction: Now What? for more information on how to handle things from here on out.

Intact baby boy and where the catheter will go. 

If retraction of intact boys is not going to take place for catheterization, how then should it be done? By feel alone.

Nurse K. at Johns Hopkins Hospital in Baltimore, Maryland (top ranked urology hospital in the nation), writes,
I know for certain as a result of working with many intact boys that the catheter can be inserted without retracting the foreskin. There is no reason whatsoever that the foreskin would need to be retracted for a simple catheter insertion procedure. The catheter used on an infant will be tiny and should be easily slipped into the small opening at the tip of the foreskin, right into the meatus. Parents: be firm and tell others that retracting the foreskin is not acceptable! Not even 'just a little.' If you must, you be the one to hold your son's penis and slide the catheter into place. They can take it from there. Or, specifically ask for someone who has catheterized an intact baby without retraction.
Just as the skilled hand of a midwife can determine a baby's position by feel alone, without need for seeing or intervention, so can a nurse or practitioner catheterizing an intact boy without laying eyes on the meatus itself. There is simply no need to see the meatus in order to 'hit' it with a catheter. With one hand on the penis for steadying, the small tube can gently be moved into the prepuce, and pressed against the glans, so it will either hit the spongy tissue of the glans, indicating the need for ever-so-slight readjustment, or it will glide smoothly into the urethra. With a small amount of patience and practice, nurses can become skilled in catheterizing an intact boy so that it rarely takes more than the first try to get it.

Because the prepuce on an infant boy is typically quite stationary and non-mobile, there is not much prepuce slack, and there are not many places to 'go' with the catheter. If the first try does not work, a mere glance to the right or left, up or down, will. In an older, retracting child, after separation from the glans has started to occur naturally, he may wish to retract his foreskin enough on his own for a catheter to be inserted directly into the meatus (if he is awake during the procedure). But even for older children, simply holding the penis steady with one hand, while gliding the catheter into the prepuce opening, until it touches the glans where it can be pressed into the urethra, works quite well and uneventfully. If your practitioner is not willing to take the extra moment to catheterize without forced retraction, ask to see another staff member, or request a set of sterile gloves, while you take your son's penis, and his health, into your own hands.


For additional resources on raising intact boys see: How to Care for Your Intact Son


References

1) Hardy JD, Furnell PM & Brumfitt W. Comparison of sterile bag, clean catch and suprapubic aspiration in the diagnosis of urinary tract infection in early childhood. British Journal of Urology1976;48(4):279-83.

2) Alam MT, Coulter JB, Pacheco J, Correia JB, Ribeiro MG, Coelho MF & Bunn JE. Comparison of urine contamination rates using three different methods of collection: clean-catch, cotton wool pad and urine bag. Annals of Tropical Paediatrics. 25(1):29-34, 2005 Mar.

3) Lohr JA, Donowitz LG & Dudley SM. Bacterial contamination rates for non-clean-catch and clean-catch midstream urine collections in boys. Journal of Pediatrics 1986; 109:659-660.

4) Lohr JA, Donowitz LG & Dudley SM. Bacterial contamination rates in voided urine collections in girls. Journal of Pediatrics 1989;114:91-93

5) Bradbury SM. Collection of urine specimens in general practice: to clean or not to clean? J R Coll Gen Pract [Occas Pap] 1988;38:363-365.

6) Morris RW, Watts MR & Reeves DS. Perineal cleansing before midstream urine: a necessary ritual. Lancet 1979;2:158-159

7) Immergut MA, Gilbert EC, Frensilli FJ & Goble M. The myth of the clean catch urine specimen. Urology 1981; 17:339-340.

8) Rao, S. et al (2004). An improved urine collection pad method: a randomised clinical trial. Archives of Disease in Childhood. 89: 8, 773–775.

9) Rao, S. et al (2003). A new urine collection method; pad and moisture sensitive alarm. Archives of Diseases of Childhood. 88: 9, 836.

10) Welch, Thomas R. Bagging the Bag. Journal of Pediatrics 2009; 154(6):A1.

The 'Circumcision Song' Hits Airwaves Across Africa Thanks to Bill Gates' Funding

By Danelle Frisbie © 2011

Max Chiwara, Oliver Mtukudzi, Enoch Piroro and Strovers Masobwe on stage together this fall.

It is difficult for me to temper the sick feeling rising up as I listen to the lyrics of this 8 1/2 minute recording and picture the multitudes of African men (and their unknowing partners) who are being blindly hoodwinked by the new "Circumcision Song" playing everywhere that money will buy air time across southern Africa.

Production and recording of the song was funded by the Bill & Melinda Gates Foundation and is performed by three of Africa's well known musicians - legendary singer/guitarist, Oliver Mtukudzi from Zimbabwe, and pop stars, Winky Dee, also of Zimbabwe, and Vee from Botswana. Backup musicians for the song were gathered and coached by Kumbirai Chatora from PSI/Zimbabwe. PSI and the Champions for an HIV Free Generation in Botswana coordinated production and recording (including the final choice of lyrics).

The song launched live at the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) in Addis Ababa, December 4-8. [See program here.] The reception was lead by former president of Botswana, Festus Mogae, and in attendance were the many donors and stakeholders pushing the "Voluntary Medical Male Circumcision" act as a vaccine of sorts for HIV.

During the opening reception for the song's release, over 200 individuals dressed in suits got up out of their chairs and danced away to the tune, chanting with the lyrics..."If you know you are a champion...get circumcised!"

The entire ordeal is heavily reminiscent of the Tuskegee studies - only we've transported the racist 'medical' acts to another nation where they cannot be under public informed U.S. scrutiny. This time, instead of pushing black men into vaccine/disease trials through exclusive print advertisement, or telling these same men they 'must' participate, or simply lying to them face to face, or doing something to them without their knowledge or consent, we are manipulating entire nationalities into a decision that not only impedes their normal sexual functioning (and that of their partners) but also deceives them into believing they are somehow now protected against HIV and other sexually transmitted infections - a misconception that is costing more lives, not less, each year in areas where mass circumcision takes place and HIV is rampant.

It's tough to convince adult men to amputate the best part of their most cherished member... some have suggested this is the reason 32% of Americans continue to cut newborn babies instead - they cannot fight back. There is no 'convincing' them - no one who can verbally say 'NO' with anything other than torrential screams and kicks. Today, instead of following the voluntary circumcision proposal for adults, some African nations are beginning to follow suit, like the districts' hospitals in Uganda where all baby boys will now be cut at birth - no questions asked. Grown men should have every right to make informed decisions about what they do or do not do to their own bodies. Babies, male or female, are also deserving of that same basic level of autonomy over their bodies - to have the option for decisions to be made when they are adults, and not have that choice stolen from them.

But the tune is catchy.

The musicians are some of the biggest and best in Africa.

The money is flowing in.

And, besides, you're a smart man! You're a bright man! The African ladies love a circumcised man! You want to be cool, and clean, and healthy! And if you'll really be a champion...why not cut off a part of your penis?


The Circumcision Song
[Listen Below]

What are you waiting for?
It's cool. It's clean.
It protects. It saves lives.
Get Circumcised!
What are you waiting for, Zimbabwe?
What are you waiting for, Botswana?
What are you waiting for, Lesotho?
Get Circumcised!

What are you waiting for?
It's cool. It's clean.
It protects. It saves lives.
Get Circumcised!

See a brighter destination!
(Are you a bright man?)
And a smarter generation!
(Are you a smart man?)
If you know you are a champion!
(Get circumcised!)
Get Circumcised!
[Repeated several times.] 

You have to remember -
Male circumcision can be healthier,
Protect against penile cancer,
Protect against HIV.
The spreading of the virus, rise of me tempa -
So, let's go, Africa! Let's go.

Africa, let's get circumcised!
I got me emphasize:
The spreading of the virus, night and day,
Cannot be justified.
Let them know it is clean and simple.
Get Circumcised African people!

We live by example, so -
Let's go, Africa! Let's go.

See a brighter destination!
(Are you a bright man?)
And a smarter generation!
(Are you a smart man?)
If you know you are a champion!
(Get circumcised!)
Get Circumcised!
[Repeated several times.] 

What's up my brother?
Let me tell you a secret -
In Africa -
They love circumcised men.
Please do it: make 'em well.
Please - it's quick and simple.
They don't feel it...
It's quick and simple.
African men: invest in your lives!
Let's treat it well.
Invest in protection against HIV and STI by 60%.

African Men! African Men! African Men!

See a brighter destination!
(Are you a bright man?)
And a smarter generation!
(Are you a smart man?)
If you know you are a champion! 
(Get circumcised!)
Get Circumcised!
[Repeated several times.] 

If you know you are a CHAMPION! 






Related Reading:





Sub-Saharan African randomized clinical trials into male circumcision and HIV transmission: Methodology, ethical and legal concerns [pdf]

Circumcision and HIV: Harm Outweighs Benefit< ABC: Not Circumcision

South African Doctor Warns Against Using Circumcision to Fight HIV

African HIV/Circumcision Study Ends Early: Too many women becoming infected

Uganda Woman Divorces Husband for Getting Circumcised

African Healer Sees Higher HIV Rates, Lower Condom Use After Circumcision 

Two Boys, One Man Die From Circumcision in Eastern Cape

Malawi rules out circumcision as AIDS-prevention: No evidence that it works

The Nuts and Bolts of HIV in the USA and why Circumcision Won't Protect Men



Flawed Studies Used to Claim Circumcision Reduces HIV

Why is Circumcision so Prevalent in Africa?

Political determinants of variable etiology resonance: Explaining the African AIDS epidemic [abstract]

Double standards in research ethics, healthcare safety, and scientific rigour allowed Africa's HIV/AIDS epidemic disasters

Male Circumcision and HIV Prevention: Insufficient Evidence and Neglected External Validity [pdf]

Male circumcision and its relationship to HIV infection in South Africa: Results of a national survey in 2002

How the Circumcision Solution in Africa Will Increase Infections [abstract]

Male Circumcision is NOT the HIV Vaccine We've Been Waiting For

Circumcision is Not a Cure-all for AIDS


The Use of Male Circumcision to Limit HIV Infection [NOCIRC]
The Use of Male Circumcision to Limit HIV Infection [Doctors Opposing Circumcision]

The Cost to Circumcise Africa [pdf]

The Truth About Circumcision and HIV

Norm Cohen [video interview] on HIV and Circumcision

A Myth that Kills: AIDS Industry Feeds on Fear

Uganda: Mad Rush for Male Circumcision

Circumcision: Already Illegal?

Here we go again: New York Times publishes headline on HIV and Circumcision

Male Circumcision and HIV [website]


Circumcision's Profound Impact on My Family

By R.J. Bly © 2011
Mother and Son II painting by Bryce Brown of Bryce Brown Art


What follows is my personal and intimate experience with routine infant circumcision. Infant circumcision is a very emotive issue for me and it took a lot of courage for me to write this. My only hope is that others might gain something from my experience.



Once we discovered we were having our first baby boy, the topic of circumcision briefly came up. I don't have a penis, so I was intimidated by the subject and left the decision up to my husband. I trusted that he would know best because he is a kind, loving man. I did a little research - but not balanced research. I focused on the benefits of circumcision and passed over the possible complications and risks. I was too unsure of myself, as a new mommy, to question this.

When my baby boy was a couple weeks old, we took him in to have him circumcised. I was so nervous and everything in my being was telling me to hold my baby tightly and bolt out that door. I asked the doctor why we should be doing this and he told us that our son would thank us when he was older. So, I handed him over and allowed the doctor to strap him down. I insisted on being there by his side because I felt that if it had to be done then at least I could be there to hold his little hand.

It was the most horrific sight I have ever seen and it still haunts me to this day. I can tell you that circumcision was EXTREMELY painful for my newborn baby boy. He had the painkiller and the nerve block but still he cried so hard that he turned purple in the face. Pliers were used to pull his foreskin away from his glands. The clamp and a scalpel were used to cut away his foreskin and he did bleed. It was awful and I cried.

For several days after, he screamed every time he peed. My heart would break, every single time. Cleaning is/was not easy for us. For several weeks, I had to apply ointment to his red, sore penis after every diaper change to keep the urine and fecal matter from infecting his exposed glans and to keep it from chaffing. He cried every time I had to do this. Circumcision compromised our breastfeeding relationship and his sleep patterns were restless for weeks. He was a baby with difficulties (borderline colic) which I now believe was post traumatic stress due to his circumcision. He would not look me in the eyes for months. His development was disorganized and full of anxiety. He seemed very sensitive to pain and did not cope will with stress. He was emotionally upset and physically uncomfortable for much of his infancy. He has had bleeding, penile adhesions, infections, rash on his glans... He would cry every time he grabbed or pulled on his is genitals. I was full of regret over having him circumcised and it was one factor as to why I suffered postpartum depression. Three and a half years later, I still have to clean around his coronal ridge because smegma gets caught there. His glans is very sensitive and this makes him uncomfortable. Through all of this, and by doing research, I have learned that these complications are not uncommon.

Due to my son's temperament and sensitive nature, I believe he would have benefited greatly if we had left him whole. I'm not saying that circumcision caused my son's behavioral challenges, but that it amplified them, and it has had a profound, disruptive effect because of his sensitivities. I worry that the trauma he experienced due to circumcision will continue to have a negative impact on him, with long lasting physical and emotional scars. Having my first son circumcised is my deepest regret, for him.

Three years later, we discovered we were having another baby boy. I was so upset because I knew we would have to have the circumcision discussion, again. I wouldn't have been able to live with myself doing it a second time, knowing what I know now, but my husband did not agree. We did hours and hours of research and had many intense discussions. In the end, my husband admitted that the only reason he wanted it done, again, was so our new son would match his daddy and his older brother. I thought he had known best the first time around but how could he... he was circumcised as an infant and that's all he knows.

During my second pregnancy I was seeing a Jewish midwife. We had several conversations about circumcision and how my husband and I were struggling with it. She explained that she decided to have a Bris but not circumcise her son. This was instrumental in giving me strength to stand strong in my conviction to allow my son to remain whole. If my Jewish midwife could keep her son whole then I, as a Christian, could keep my son whole, too.

This time around, I fought so hard to keep my second son intact, and I was reluctantly willing to let my husband leave to protect my child. He could either accept that our next son would remain as God intended, or he could walk out that door, if he chose to. Eventually, he accepted that our son was not going to be circumcised. Praise the Lord, my second son is healthy and whole!


Caring for my intact son is very easy, and he has had no issues. We just wipe off the outside, like a finger, and we're done. He does not cry when he grabs or pulls on his genitals because his penis is whole and it isn't a sore, sensitive open wound. Our breastfeeding relationship has been very smooth, enjoyable and full of trust. The newborn stage was peaceful and I can see that his development is so much more organized than my first son's. He is calmer, much more tolerate of stimulations, and copes easier in stressful situations. He trusts me and looks at me with so much love. I believe that leaving our second son intact has been very positive emotionally and psychologically, and his character shines through, the way it was meant to. For my second son, I have no regrets to contend with and no postpartum depression because I followed my mommy instincts and protected my child by keeping him whole.

I used to think circumcision was our parental choice, until I realized it was impacting me in a big way. My husband is circumcised and after years of marriage we are realizing that his lack of foreskin is causing me pain during sex. I always thought the chaffed, burning and raw pain that I feel for several days after sex was my fault. I tried everything to make sex more comfortable, but nothing significantly helped. Now, we are realizing that circumcision is the cause. I am so angry over what circumcision has taken from our marriage! I am so upset that my husband and I cannot enjoy each other the way we are meant to! His parents made this decision for him, but I do not feel it should have been their choice. Now my husband and I have to live with the consequences of that decision for the rest of our married life.

On top of my pain, my husband has lost sensitivity over the years and he has tight, bent erections. Sometimes they can be painful for him because he does not have enough skin to grow into. My husband is slowly beginning to realize that we made the right decision when we kept our second son whole, and this intimate struggle has led us to discuss foreskin restoration because it would benefit both of us. Male circumcision impacts women, too, and I worry about my first son and his future partners. The worst part of this whole situation is that these complications were completely preventable because routine infant circumcision is an elective, unnecessary procedure.

How will we explain to my boys the reason one was circumcised and one was not?

We will explain that we did the best we could based upon what we knew at the time. Then, we learned more so we did differently. We will tell them that we love them both very much. I hope that they will have the maturity to accept one another for their differences, and love one another unconditionally. We will tell them that they are both very much loved, but a little different. We will apologize to our first son for taking his choice away, and tell him about foreskin restoration. We will support and encourage our son in any way that he needs, so he can make the choice to take back what was taken from him, if he chooses to.

As you can tell this is a very emotive issue for me and I have deep personal and intimate reasons as to why I feel so strongly. Please understand, I am not judging anyone for their own past choices; I'm simply sharing my story. I have one circumcised son and one intact son, and I love both of them fiercely. I can relate to both sides of this issue, and have learned so much from this experience.

With that said, if I could go back, I would definitely leave our first son whole because it is his penis and, therefore, I do believe it should have been his choice to make. In the end, my first son's sacrifice saved my second son. When we know better, we do better...

Mother with Two Sons by WillowTree


Hear from other parents who have walked a similar road and are raising both circumcised and intact sons at, I Circumcised My Son: Healing From Regret.

To begin a faith-based investigation of your own, see these faith considerations on circumcision (Judaism, Christianity, and Islamic resource lists).

Additional information on the prepuce (foreskin), intact care, and circumcision at: Are You Fully Informed?


R. J. Bly is a wife and stay-at-home mom to two precocious little boys, Keaton and Deckard. She says that it is a joy to be able to stay home with her boys and offer them the very best of her time and energy. Bly comes from a broken family (neglect, physical abuse, emotional abuse and sexual abuse) but she plans on doing everything in her power to provide her boys with a safe and loving home. She says her sons have taught her a great deal about patience, love and respect. Because of them, Bly is an intact advocate, a homebirthing, full term breastfeeding, natural immunization building, cloth diapering, babywearing, cosleeping momma. 

Bly graduated from Washington State University with a degree in Public Relations/Communication and hopes to apply this to a career once her boys are older. For now she says mothering is her chosen full time job. Bly volunteers her time as a La Leche League Leader to help mothers and their own babies in her community.  She has been diligently working with a few colleagues to purse a breastfeeding in public bill for Idaho and hopes to introduce it into the 2013 legislative session. Bly also serves as Director of Intact Idaho, a grassroots chapter sharing research based information on intact care and circumcision to parents and professionals across the state. 


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Thank You For Saving a Son

This Thanksgiving Day, we are especially grateful for each of you working toward a day when all forms of genital cutting will be abolished from this earth. Thank you for all you do, on behalf of the sons, and future men, you save. ❤


Even When You Lose, You are Winning

By Aubrey Taylor © 2011


For everyone who spends their precious energy spreading the word about genital integrity and the harms of genital mutilation: Don't get frustrated! Don't give up! Remember: You do not have to win! The task at hand is not to change the mind of the person who happens to choose to argue with you publicly. Those who disagree and spend their time opposing your message may never change their mind. They were already the ones most likely to respond negatively to you. Rather, you are presenting a gentle, informed perspective for the thousands of others who may never type a single word about the subject in response, but are quietly watching on, reading what you write, listening to what you say. Use the arguments of your opponent as an opportunity to address the various issues on the minds of those reading silently, but not speaking.

If that one particular person never "gets it" and goes through every argument in the book, GREAT! All this means is that you've managed to introduce and work through every point, and this person has helped you do it. Allow this to enable you to detach from the frustration of hearing the other side, or thinking you've "lost" because that one didn't change his/her mind. You're battling an idea over and over, and the way you respond is being observed by others.

Right now, some babies and children will lose. And it may be your unfortunate, heartbreaking, perspective as a freedom fighter to know about their pain, but this does not mean you are losing. As long as we are out there, as long as we are being productive, we are winning. Humanity wants to change - even when it doesn't seem like it in our little circle of the world. We want to be kind, loving and respectful to our children and we all want a society that respects human rights equally. We just need the support, and freedom, to do it. This is a long term goal, so don't worry about the ups and downs. Cruelness and lack of compassion are just symptoms of cruelness and lack of compassion, not innate traits among humans. Let this help you put up your case with a calm and righteous heart, with confidence and compassion, and without insults or belligerence, even when that is what is handed to you.

And THANK YOU for all that you do!




Aubrey Taylor is an American social activist working for human rights and equality.


Also by Taylor: Effective Intactivism

Visit Taylor's YouTube channel here.

For additional informational resources on intact care, the prepuce (foreskin), and circumcision, see Are You Fully Informed?

Erectile Dysfunction: Is Circumcision Making You Soft?

Originally Published in Men's Health Magazine, November 2011
By Madeline Haller



Could circumcision be affecting your erection? It just might, according to a new study published in the International Journal of Men’s Health.

Researchers surveyed 300 men and found that circumcised fellas had a 4.5 times greater chance of suffering from ED than noncircumcised guys.

One reason: Circumcised penises can experience up to a 75% reduction in sensitivity compared to intact members, according to a study published in the British Journal of Urology International.

A major factor that contributes to that loss of sensitivity is the severing of the perineal nerve—a nerve located on the underside of the penis that is responsible for the majority of sexual sensory input—explains Dan Bollinger, study author and director of the International Coalition for Genital Integrity.

Keep the findings in perspective, though. This was only a survey, so some of the men could be fibbing. And there are numerous other factors that contribute to ED.

“Aging, diabetes, obesity, cigarette smoking, and poor diet—these are all going to affect you and your chances of ED more than being circumcised will,” says Judd Moul, M.D., professor and Chief of the Division of Urologic Surgery at Duke University Medical Center.

Think you might have ED? Then you’re probably right. In fact, nine out of 10 men in a recent study who said they were “unsure” about their ED status actually had some level of ED. And according to a study published in BMC Urology, 70% of ED cases go undiagnosed.

Bring up your concerns at your next doctor’s visit, Dr. Moul recommends. “ED is so much more common than men realize, and it can be very easily fixed by making a few lifestyle changes or getting on a medication.”


Related Reading:

Does Circumcision Cause Erectile Dysfunction?

"Alexithymia and Circumcision Trauma: A Preliminary Investigation" in International Journal of Men's Health, Vol 10:2, 2011.

"Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark" in International Journal of Epidemiology, May 2011. [Full text pdf]

Erectile Dysfunction: Outcome of men circumcised in Kenya (Bulletin of the World Health Organization)

Erectile Function Evaluation Post Circumcision (China)

Adult Circumcision Outcomes Study (Journal of Urology, 2002) [Full text]

Circumcision to Reduce Men's Sexual Pleasure

How Male Circumcision Impacts Your Love Life

Intact or Circumcised: A Significant Difference in the Adult Penis

The Sexual Effects of Circumcision

Identifying Keratinization (NOHARMM)

The Lost List: Identifying what is lost to circumcision

Erectile Function After Anterior Urethroplasty (Journal of Urology)

"Fine Touch Pressure Thresholds in the Adult Penis" (British Journal of Urology International) [Full Text pdf]

Prevalence and Risk Factors for E.D. (PubMed)

Is Circumcision Why We Need Viagra? (Canada Free Press) 

Long-Term Adverse Effects of Circumcision (DOC)

Circumcision Sexual Dysfunction (CIRP)

Functions of the Foreskin: Purposes of the Prepuce

The Prepuce (British Journal of Urology International)

Perineal Nerve Stimulation: Role in penile erection (International Journal of Impotence Research)

Neuroanatomy of the male urethra and perineum (British Journal of Urology International)

Effects of Male Circumcision on Female Arousal

Male Circumcision: A Human Rights Primer

A Change in How Intercourse Works

Improve Marital Sex: Keep the Foreskins

Realization of Circumcision

Removing Pleasure: Male Genital Mutilation

Men Ask: Why Was I Circumcised?

RestoringForeskin.org

NORM.org (National Organization of Restoring Men)

PostSecret: His Foreskin Turned Me On

Male Circumcision and Women's Sexual Health (Resources)

Partners of Restoring Men (Women's Facebook Group): Facebook.com/Groups/Restoring

Resources on infant circumcision and intact care: Are You Fully Informed?

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Ban Male Circumcision in Britain

By Eve Fensome for The Mancunion.
Read more from Fensome and weigh in on the debate here.
Posted with permission.

Assembly line of circumcision. Residents and medical assistants circumcise baby boys born at George Washington University Hospital. 
Photo Credit: Alexandra Garcia - The Washington Post.

In Britain it is accepted wisdom that female circumcision on minors (now widely referred to as female genital mutilation) is in effect child abuse. How else could you describe carrying out an unnecessary, risky, painful surgery to remove parts of a child’s genitalia? But why do our infant males’ genitals not receive the same protection from cutting?

Despite the laws safeguarding female genitals, parents of infant males in the UK are allowed to decide on behalf of their offspring whether that child’s genitals are left intact or not. This means that male juveniles are not protected from non-therapeutic infant male circumcision. Non- therapeutic infant male circumcision is the practice of amputating healthy parts of the genitals (in this case the foreskin) of a child’s penis for non-medical reasons.

But, female genital mutilation is nothing like male circumcision, right? A circumcised male penis is cleaner and circumcision isn’t dangerous like it is for females.

Wrong. The acceptance of male infant genital cutting relies on two common beliefs: one, that the foreskin is superfluous, and two, that the practice of cutting it off is trivial. Nether is true.

The foreskin is in fact a key functioning part of the penis. It is a mucous membrane (like an eyelid) and serves the purpose of keeping the glans (penis head) moist, guarding the urethral opening, and keeping it sensitive and protected in the same way as the clitoral hood protects the clitoris. On the erect penis the foreskin serves an even more important function; namely the giving of erotic pleasure. The foreskin contains thousands of ultra-sensitive nerve endings, making it a highly erogenous zone, and its ability to move during sexual intercourse increases the pleasure for both parties by increasing moistness and reducing discomfort through a gliding action.

Indeed, scientists have mapped the regions of the intact penis with the use of “fine-touch pressure threshold tests”. Their findings show that the most sensitive regions on an intact penis are exactly those removed by circumcision. On the circumcised penis the most sensitive location is the circumcision scar – however, this is still less sensitive than five other areas on the intact adult penis. The result is significantly less pleasurable sex and masturbation for the circumcised male compared to the intact male.

The procedure itself is also very significant. Firstly, the psychological impact of the pain experienced from circumcision has been recognised as causing problems in infants and children, including post-traumatic stress disorder, maternal bonding failures after breached trust, and a lowered pain threshold recorded in babies more than 6 months after the operation.

These points, however, are trivial in comparison to the risks entailed in the procedure despite the rigorous rules on practice. Circumcised infants are not only more likely to have genital illnesses than intact children, but when complications occur they are much more likely to be serious complications such as permanent mutilation, infection or haemorrhage. Less frequent risks also include gangrene and whole or partial amputation of the penis. However, this price is still far less than that paid by some 200 babies per year in the USA, who pay with their lives.

With such a lot at stake, how can we legitimately uphold that becoming circumcised is for a parent to decide, not for the individual when he is at full consenting age and able to make an informed choice? The laws of this country rightly state that religious observance should be a personal choice. This is why I cannot accept that it is a parent’s right to force their religious beliefs on their non-consenting offspring, whereas I can accept, and in fact defend, an individual’s right to show his religious commitment in adulthood by making an informed decision to become circumcised.

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For additional resources on circumcision, the prepuce, and intact care, see: Are You Fully Informed?

Join in the conversations at Saving Our Sons on Facebook.

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Circumcision: Identity, Gender, and Power

By Miriam Pollack © 2011
Citation: Pollack, Miriam. 2011. "Circumcision: Identity, Gender, and Power." Tikkun 26(3).
Published at Saving Our Sons with author's permission.

"Isaac's Circumcision," as depicted in the Regensburg Pentateuch, Germany, c. 1300.

Circumcision is seen as the central mitzvah (or commandment) of Judaism. Even for nonreligious Jews, circumcision continues to be perceived as the sine qua non of Jewish identity. And yet, unlike any other controversial topic that we Jews address, the subject of circumcision is not to be challenged. We can calmly discuss whether there is a G-d or no G-d, if G-d is masculine, feminine, or neuter, or whether homosexual Jews should become rabbis. Yet, questioning circumcision has been out of bounds. This taboo, in and of itself, is indicative of how strong the feelings are that surround this ancient rite, and how much lies below the surface, in the dark silence, where powerful forces have coalesced for thousands of years.

In order to attempt to understand the role of circumcision in Judaism, we need to explore not simply the biblical injunction found in Genesis 17:10-12. We are also obliged to focus on the functions that male genital cutting serves — socially, politically, psychologically, and individually — in order to see what and whose invisible needs are being fulfilled. Some of this information comes to us from scholarship; some can only be derived by examining the more subtle ramifications that result from the permanent alteration of male sexual organs.

Circumcision is hardly unique to Judaism. However, two elements distinguish the Jewish version of male genital cutting. First, in Judaism circumcision is expressed as the divine mandate, which seals and perpetuates the covenant, G-d’s contractual and eternal relationship, with the Jewish people. Second, it is commanded to occur on the eighth day of the baby boy’s life. Other than these unique identifiers, circumcision in Judaism shares much with rites of circumcision in other societies.

What I intend to do here is to show that cutting out a portion of a child’s genitalia is fundamentally about gender and power. This is true whether the mandate is divine, tribal, secular, or pseudo-medical, and it pertains to little girls as well as little boys.

For those of us who have grown up with the normalcy of newborn male circumcision, this may seem like a bold, perhaps even outrageous statement. As Karen Ericksen Paige and Jeffrey M. Paige state in their book, The Politics of Reproductive Ritual, of the many theories advanced that attempt to explain the function of reproductive ritual, all agree that “the purposes of ritual are seldom if ever the object of conscious knowledge.”

In each and every circumcising society, circumcision fulfills multiple unspoken social, political-tribal, and sexual needs. Paige and Paige claim that male circumcision originally functioned as a vehicle for attempting to achieve by means of ritual what could not be accomplished by means of political arrangement: that is, the defusing of possible competitive claims by male progeny for the same limited resources. In pre-industrial societies, where clan and tribal loyalties formed the basis of economic and military security, the father’s willingness to expose, sacrifice, and risk the tender organ of his son’s procreative potential and the promise of his own male progeny to the knife was a dramatic demonstration to the elders (read that as male elders) of the father’s allegiance to his tribe, a point noted by Leonard B. Glick in Marked In Your Flesh: Circumcision from Ancient Judea to Modern America. For this reason, circumcision is rarely a private surgical event. Rather, it is most commonly a communal ceremony accompanied by feast and celebration. Circumcision is, typically, a public declaration of alignment and thus not simply a social event, but a political statement as well. Without a whisper of the true hierarchical intentions of this ceremony, the outcome was always, and continues to be, a reassertion and institutionalization of a power structure based on gender.

The timing of male circumcision furthers the political/social relationships in less obvious ways. Even though the age for circumcision ranges widely across all circumcising societies, what is most universally constant is the requirement that circumcision occur before marriage. This rule not only establishes the father’s status in the male-dominant community, but it also works to achieve another salient objective: marriageable girls are entrained to view any uncircumcised man as undesirable, thereby ensuring the ethnic stability of the tribe. Girls know from an early age that they would risk social ostracism by mating with an uncircumcised male. By enculturating all group members to the necessity, normalcy, and moral superiority of circumcision, circumcising children not only reaffirms the political and social structure of the tribe, but also deepens the identity formation of the group. In this way, circumcision functions as a primary and potent entrainment for group bonding.

In ancient Egypt, genital cutting was depicted as a rite of passage to adulthood. This drawing of a tomb painting from Ankhmahor in Saqqarah, Egypt, is the oldest known illustration of male genital cutting. Judaism took this painful rite of passage and placed it on the eighth day of an infant's life.

At a more muted level, circumcision does more than restructure identity based on contemporary and historical alliances of gender and power. On a meta-historical and biological level, circumcision acts to rename, remap, and invert our fundamental and primal relationship to the feminine. It is not coincidental that this ritual of tribal belonging necessitates the cutting, blood-letting, and altering — in a public ceremony — of the male child’s sexual organ. As Glick points out, “Female blood contaminates, male blood sanctifies.” Thus, he explains, “the shedding of male blood is an act of consecration.” By creating historical and social linkage through this sacrificial ritual, circumcision functions to supersede and transcend our most primary maternal and biological system of relationship making patrilineal and patriarchal hierarchy appear “natural and inevitable,” as Nancy Jay notes in her brilliant book, Throughout Your Generations Forever. Karen E. Fields, in the foreword to this same book, comments as follows:
In no other major religious institution is gender dichotomy more consistently important, across unrelated traditions, than it is in sacrifice. This is true not only of ancient and so-called primitive religions. Even among contemporary Christians, the more vividly the Eucharist is understood to be itself a real sacrifice, the greater the opposition to ordaining women. ... Consequently, a study of sacrifices focusing on gender leads to a new understanding: sacrifice as remedy for having been born of woman.
Similarly, in both the Hebrew Scriptures (Samuel 1:1) and the New Testament (Matthew 1:1-16 and Luke 3:23-38), by citing and repeating the lineage of male progenitors, legitimacy is established. The names of the mothers are usually unmentioned, irrelevant in a male-dominant culture.

Circumcision subverts the community’s relationship to the life-giving principle of the feminine, not only by obliterating the woman’s rightful identity in structuring the historical social network of her tribe, but also by trivializing and implicitly forbidding her to acknowledge, much less act upon, her deepest mammalian instincts to protect her newly birthed child. She knows, long before she has even conceived, that in order for her male child to be bonded to the male community — past, present and future — and to a male-imaged god, she must surrender him to the men with a knife to cut, wound and cause great pain to the very vulnerable sexual organ of this newly birthed child. Typically, a mother’s feelings are dismissed or ridiculed. Her voice is silenced, even to herself.

Can it be a coincidence that we have language for the primary disempowerment for men, but not for women? When men are wounded in their primal potency of manhood, we say they have been “emasculated.” When women are wounded in their primary potency of womanhood, we rarely notice. We have no language, no conceptual structure, no word to claim, much less attempt to heal the experience of core female disempowerment.


The wounding of circumcision irreversibly alters both mother and child: the mother is fractured at the base of her deepest womb-wisdom, which knows that she must protect her child no matter what; and the baby, shocked and traumatized, is fractured in his ability to absolutely trust the protective arms of the mother he has biologically and innately turned to as his primordial source of safety. From the beginning, masculinity is now defined as that which must be cut off from the mother and all that is female, nurturing, and essential for human survival. In this way women are made complicit in this masculine-defined model of motherhood. Nancy Jay states, “Gender is therefore unequaled as a cornerstone of domination.” Circumcision is the weapon that not only destroys a boy’s foreskin but also deftly excises maternal authority over the ultimate well-being of her child. For if a woman is forbidden to feel entitled to her instinctive need to protect her newborn child, what feelings of her own can she ever trust?

In all circumcising societies, the sacrifice endured by the child is considered incidental to the social, political, and/or religious forces that require it. Typically, the extremity of the baby’s pain is denied, ignored, or made the object of countless jokes. Because we Jews circumcise at eight days of age, when a child is easily overpowered and will not consciously recall this event, we deem those who circumcise children at later ages barbaric.

Many of us Jews are capable of witnessing a bris, that is, a ritual circumcision, looking into the eyes of the shocked, terrified, and shrieking baby, his head flailing and chin quivering, as his foreskin is severed from the delicate surface of the glans, cut, and crushed, and many of us conclude that this is no different from a routine infant protest of having a wet diaper changed.

We ignore or choose to be ignorant not only of what our hearts and wombs are telling us, but of the abundance of scientific data, replicated numerous times in the past several decades, that leave little question about the reality of the baby’s experience. Heart and respiratory rates, as well as cortisol levels of babies undergoing circumcision point to the unambiguous conclusion that circumcision is excruciatingly painful to any baby. And, as is the case in other severe trauma at the neonatal level of development, the implications of lasting sequelae in the nervous system are serious (for the data behind this, check out Male and Female Circumcision: Medical, Legal and Ethical Considerations in Pediatric Practice). Science has not yet turned its attention to identifying what these sequelae may be. Nevertheless, a modicum of psychological awareness is sufficient to suggest that issues of trust, fear, intimacy, sexuality, and gender relationships would be reasonable places for scholarly investigation. While traumatizing an infant is neither the stated nor the conscious intention of circumcision, it is an inevitable corollary of cutting a child’s genital organs with possibly unspecified but hardly neutral alterations in the nervous system.


Although the fact is vigorously denied by the proponents of circumcision, the forcible removal of the foreskin also has profound and long-lasting effects for a male’s sexual experience. Even during ancient times, when circumcision was less radical than it is today, the unique quality of the foreskin was understood. In biblical Judaism, circumcision consisted of cutting the foreskin that extended beyond the glans, leaving most of it intact. The full reaming and ablating of the entire foreskin, known as periah, was only innovated by rabbinic decree during Hellenic times in response to the practice of some Jewish men who were trying to avoid ridicule of their fellow Greek athletes by attempting to tie and stretch their foreskins so as not to look circumcised.

Both the Hellenic Jew Philo, in the first century CE, and Moses Maimonides, also known in the Jewish tradition as the Great Rambam in the twelfth century, wrote of the consequences of violently removing the most sensuous part of a man’s sexual organ before he is old enough to understand or consent to this loss. Philo wrote in Special Laws that the “excision of pleasure [caused by circumcision] . . . is most necessary to our well-being.” Many centuries later C.J. Cold and J.R. Taylor would confirm in the British Journal of Urology that the effects of circumcision on sexuality were, indeed, significant, when they discovered that there are over 20,000 specialized fine touch receptive cells in the human foreskin, which function to allow far greater nuanced sensation and control than any other penile tissue.

Additionally, the removal of the foreskin creates a secondary loss of sensitivity: not only has the most erogenous tissue of the male sexual organ been removed, but, as the man ages, the glans loses its mucosal covering, becomes dried out, and keratinizes over time. Typically by middle age the glans of the circumcised penis has lost much of its receptive potential and the man requires more abrasive stimulation to achieve orgasm. Often this is just as a woman is becoming peri-menopausal and experiencing decreasing vaginal lubrication. Typically, the problem is identified as the woman’s entry into menopause; the contribution of the circumcised partner is rarely acknowledged. In subtle but profound ways, circumcision functions to diminish a man’s pleasure potential, allowing his bond to his partner to be subordinated to his bond to his tribal male peers. Both Philo and Maimonides knew beyond a doubt that, as in all other aspects of biology, altering form alters function. Here is what Maimonides, the great philosopher, physician, and Talmudist, had to say in his famous book, The Guide of the Perplexed, written in 1160:
The fact that circumcision weakens the faculty of sexual excitement and sometimes perhaps diminishes the pleasure is indubitable. For if at birth this member has been made to bleed and has had its covering taken away from it, it must indubitably be weakened. The Sages, may their memory be blessed, have explicitly stated: It is hard for a woman with whom an uncircumcised man has had sexual intercourse to separate from him (Genesis Rabbah LXXX). In my opinion this is the strongest of reasons for circumcision.
There they are, the twin patriarchal fears: the fear of woman and the fear of pleasure. Circumcision is both the vehicle and the product, the menace and the antidote, which simultaneously assuages and perpetuates these ancient terrors. This is the achievement and true function of circumcision. Circumcision achieves this by violently breaching the maternal-infant bond shortly after birth; by amputating and marking the baby’s sexual organ before he knows what he has lost; by disempowering, “taming,” the mother at the height of her instinctual need to protect her infant; by bonding the baby to the community of men past, present, and future and to a male-imaged G-d; by restructuring the family and the society in terms of male dominance; and by psycho-sexually wounding the manhood still asleep in the unsuspecting baby boy. In all of these ways — socially, politically, religiously, ethnically, sexually, tribally, and interpersonally — the cutting of our baby boys’ sexual organs is the fulcrum around which patriarchy exerts its power. Circumcision is a rite of male domination — domination and the entitlement of domination over other men, women, and children, both institutionally and personally. It is the essence of patriarchy.

Nevertheless, it would be grossly oversimplifying to characterize Judaism as a purely patriarchal religion, nor would it be accurate to view Judaism as the source of patriarchy in Western religions. The emphatic and elaborate emphasis on this life, on the sanctity of all life as a primary organizing value throughout both biblical and talmudic texts is in complete contradiction to the practice of circumcision. Removing functional sexual tissue is harmful: it is harmful to the infant, to the pleasure potential and sexual bonding of the mature man, and to the mother who is entrained to surrender her sacred bond with her infant in order for his masculinity to be redefined in terms of his community.

The rabbis explain that, because women are closer to the divine due to our ability to give birth and sustain life, men are in need of other ways to access spirituality — circumcision being the primary one. However, the notion that trauma can be a bona fide path, much less an ethical avenue, to greater spiritual awareness would be vociferously challenged by contemporary neonatologists as well as epigeneticists. What is unethical cannot be spiritual. The dichotomy and hierarchy assumed and taught for millennia in multiple religions between sexual aliveness and spirituality is false and has led to ages of human suffering. Spiritual sexism is still sexism and needs to be discarded.

I remember when I first learned about the phenomenon of female genital cutting. I was appalled. How could they? How could anyone? It took years before I could hear their voices: “It’s who we are, who we’ve been for thousands of years.” “No one will marry us if we’re not cut.” “Intact genitalia are ugly.” “They are unhygienic.” Then, I realized... we say the same things.

Yes, there are significant differences between female and male cutting, but it is not honest to claim that one is physically and sexually insignificant and the other barbaric; that one is enlightened, the other primitive. Holding a child down and forcibly removing genitalia is sexual abuse. We would not hesitate to use that label for an individual or culture that countenanced sexual fondling of children. Why do we think slicing off genitals is acceptable? Circumcision is not holy, it does not transmit the Jewish spiritual heritage, nor does it secure Jewish continuity.

"The discarding of animal sacrifice ... did not result in an unraveling of Jewish spirituality or continuity."

For religious as well as tribal and secular reasons, many Jews believe that “circumcision ensures our survival.” Without circumcision, we tell each other, the Jewish people will disappear, a very frightening prediction to a people for whom annihilation is a perpetual possibility. Again, the transparent sexism of such a contention is only too apparent. Are males the only ones who count as Jews? Is the contribution of Jewish women irrelevant, invisible, and insignificant? More fundamentally, why is it that Jewish women can carry on our spiritual legacy and remain whole, but Jewish men cannot? How, indeed, did circumcision further our survival during the desperate epochs of Jewish purges when the enemy had only to pull down pants in order to eliminate Jewish males?

In the United States, where most men over thirty have been circumcised, or in the Middle East, where circumcision is normative for Muslims, are naked Jewish men distinguishable from their non-Jewish counterparts? And if circumcision is the quintessential protector of Jewish identity, why do we have tens of thousands of Jewish men in the United States who have had their genitalia radically and permanently altered but are ignorant of Judaism and completely unaffiliated with Jewish communities? The question of how we are to secure and sustain Jewish survival is extremely serious, but the answer is not circumcision.

An orthodox rabbi interviewed by Eliyahu Unger-Sargon in his brilliant movie Cut: Slicing through the Myths of Circumcision stated unequivocally that circumcision was tantamount to sexual abuse. Yet this thoughtful man went on to justify the practice of circumcision for religious reasons, saying that this is where “the rubber hits the road” if you are a Jew. It is a commandment. We have no choice.

Indeed, we do have a choice. What is sacred is our obligation to protect the integrity and privacy of all of our children’s genitals. They are not the province of family, community, or anyone else. Spiritualizing the wounding of circumcision does not change the damage, nor make it ethical. As Deuteronomy 30:6 teaches, what is truly required of us in order to contact the divine has to do with the architecture of the heart, not the alteration of male genitals. Creating a joyful and loving Jewish home, and providing our children with meaningful and in-depth Jewish education, are the only authentic means we have to ensure our survival. Cutting our babies’ penises will not do it.

Neither in biblical texts nor in the Talmud has brit milah been commanded for hygienic reasons. Nevertheless, in the United States routine neonatal circumcision has been normative, in spite of the fundamental standard of all U.S. medical practice that requires that surgeries be used as a last resort, not a preventive strategy, particularly when dealing with healthy tissue on non-consenting minors. For these reasons and more, the medical societies of Holland, Finland, Australia, Canada and the UK have been explicit in stating that routine neonatal circumcision is medically ill advised and not in the child’s best interest. Promoting circumcision for presumed health benefits is neither an authentically Jewish position nor medically valid.

Circumcision may be an ancient rite, but it is wrong. Over the ages Judaism has demonstrated a remarkable ability to mutate in practice and retain the integrity of its spiritual legacy. Judaism was not vanquished when the first temple was destroyed, nor when the second temple was razed. The discarding of animal sacrifice as the primary mode of worship did not result in an unraveling of Jewish spirituality or continuity. Legally, Jewish identity is defined both by halachah (Jewish law) and by the Israeli Supreme court according to the status of the child’s mother: if the mother is Jewish, the child is Jewish. Circumcision does not trump maternal lineage.

Without compromising either our children’s identity or the survival of our people, we can invite all of our Jewish children, our baby girls and our baby boys, into a brit b’lee milah, a covenant without circumcision, and school them in the wisdom, love, and beauty of the Jewish tradition. Unlike Christianity, which teaches that a child is born into original sin and must be redeemed, Judaism teaches that the soul is pure — only the penis needs “redemption.” The truth is that the whole baby is pure, body and soul, including his tender genitals, and it is both a mitzvah and our most sacred duty to protect him.

Jews for the Rights of the Child protest the continued genital cutting of infants.




For the past twenty years, Miriam Pollack, member of a Conservative Synagogue, has been advocating, locally and internationally, for intactivism. She is founder and director of the Literacy & Language Center in Boulder, Colorado.


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