The Surgeon and The Consultant: A Circumcision Conversation

By John Trainer, M.D.
Read more from Dr. Trainer at FB.com/Jet3MD or his practice profile.


Imagine a conversation in the doctors' lounge...

Surgeon: Hey, can you do a surgical clearance for me?

Consultant: Tell me about the case.

S: Well the lawyers are all in a tizzy, because he can’t consent. They wanna make sure all the Ts are crossed and all.

C: And he can’t consent because…?

S: Well he can’t talk. Not even sure he knows English. I only admitted him yesterday. It’s okay though, he has a medical surrogate -- two in fact. They're both on board.

C: What’s his medical status like? 

S: Among other things, patients like him have trouble clotting their blood. I didn’t do any labs, but I gave him some vitamin K. Y’know to shore that up. 

C: I see… 

S: And he just had a massive body fluid exposure. And even though the source was really tested and tested, I gave him a vaccine against Hep B. Just for good measure. 

C: Okaaay… 

S: Well he’s been through a lot. Yesterday his lungs were full of fluid… 

C: (surprised) WHAT? 

S: It’s okay. His lungs were replaced by extracorporeal support. For about 40 weeks. He weaned okay after his intra-cardiac shunt was fixed.

C: (concerned) Again, WHAT!?! 

S: (moving on) So, um, the surrogates are in a hurry for me to discharge the patient. Can you get up there kinda quick? 

C: What’s the hurry? Is this some kinda urgent procedure? 

S: Umm, no. It’s mostly elective. Even considered cosmetic. But the CDC just said it can prevent problems in approximately 16 to18 years. 

C: (interrupting now) And you need to do this today because…? 

S: Well if we don’t do it today, the insurance company won’t pay for it. And that would make the surrogates mad. Then they would have to pay for it. 

C: (walking away, shaking his head)

Original post on Facebook


Related Resources: 

Medical Professionals for Genital Autonomy: www.FB.com/IntactCare

Brief comment on the proposed guidelines concerning male circumcision to be issued by the CDC: https://www.academia.edu/9603843/Brief_comment_on_the_proposed_guidelines_concerning_male_circumcision_to_be_issued_by_the_CDC

The Culture Behind the CDC's New Proposal (Dr. Carmack): http://www.adriennecarmack.com/the-culture-behind-the-cdcs-new-proposal

CDC Response Campaign: https://www.facebook.com/events/290589301151865/

CDC 'Got Ethics?' Photo Campaign: https://www.facebook.com/events/369510376550319/

Respond directly to the CDC at: http://www.regulations.gov/#!documentDetail;D=CDC-2014-0012-0001

Responses to the AAP (whose 2012 statement is overwhelmingly similar to the CDC's proposed statement) - bottom of page: http://www.drmomma.org/2012/08/aap-circumcision-policy-statement.html

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Denmark to debate male circumcision ban

Originally published at The Week


Denmark's parliament will today debate whether male circumcision should be more tightly controlled, days after a finding that 74% of Danes think the procedure should be restricted or banned altogether.

The poll, commissioned by the Danish newspaper Metroxpress, interviewed 1,000 people and found that three-fourths of respondents think there should be either a full or partial ban on infant circumcision. Only 10% thought that there should be no restrictions.

Later today the issue will be debated by politicians, with both the left-wing Red-Green alliance (Ehedslisten) and libertarian party Liberal Alliance advocating some form of ban. Last year, the Council of Europe adopted a resolution opposing all kinds of ritual circumcision, saying they cast a "moral stain" and "foster hate and racist trends in Europe." The council's resolution recommended that all 47 member states should attempt to regulate circumcision in some way.

In the UK, approximately 1/3 of men were circumcised before the introduction of the National Health Service in 1948, but rates soon began to fall as the organisation deemed that the operation was not medically necessary and therefore would not be covered. Today, approximately 9% of men in the UK are circumcised, the BBC reports. The practice of male circumcision is also falling in the US, where rates of circumcision were traditionally been much higher, hovering at approximately 1/2 of males born for the past two decades.

There is still a great deal of disagreement around the world over the medical impacts of the practice, The Guardian says. Last year the Danish medical authority, Sundhedsstyrelsen, concluded that there was not enough documentation to recommend the practice on medical grounds, but conversely, there is not enough evidence of risk to justify a total ban either.

Between 1,000 and 2,000 circumcisions are performed in Denmark each year, The Independent reports, with Muslim and Jewish boys making up the great majority of patients.

~~~~

UTI Resource Page



The following items pertain to urinary tract infection (UTI), the intact male body, and circumcision.

How the Foreskin Protects Against UTI: http://www.drmomma.org/2009/12/how-foreskin-protects-against-uti.html

Exclusive Breastfeeding Protects Against UTI: http://www.drmomma.org/2009/12/exclusive-breastfeeding-protects.html

Urinary Tract Infections Higher Among Circumcised Men in Australia: http://www.drmomma.org/2009/12/urinary-tract-infections-higher-among.html

Circumcision Increases UTIs Among Boys in Israel: http://www.drmomma.org/2009/12/circumcision-increases-urinary-tract.html

CIRP info and studies on UTIs: http://www.cirp.org/library/disease/UTI/

Circumcision Information Australia: UTIs: http://www.circinfo.org/utis.html

Circumstitions info on UTIs: http://www.circumstitions.com/Utis.html

AAP on circumcision and UTI: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477524/

A Cohort Study on Male Neonatal Circumcision and the Subsequent Risk of Urinary Tract Infection http://www.cirp.org/library/disease/UTI/to/

This Pediatrics article (Journal of the American Academy of Pediatrics) touches upon circumcision and UTI: http://pediatrics.aappublications.org/content/131/4/796.full

Forced retraction resources (retraction of the prepuce by anyone other than a boy himself increases likelihood of problems, including UTI): http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html

Urine Sampling and Catheter Insertion for the Intact Boy: http://www.drmomma.org/2011/12/urine-samples-and-catheter-insertion.html

Using a Catheter Without Retraction: My Nurse Did It and So Can Yours! http://www.savingsons.org/2013/01/using-catheter-without-retraction-my.html

The Urinary Excretory System (how the urinary tract and related system works): https://scribeschool.net/urinary-excretory-system-info-for-scribes.html


Harper, M. and Fowlis, G. (2007) Management of Urinary Tract Infections in Men. Trends in Urology, Gynecology and Sexual Health, 12, 30-35.
http://onlinelibrary.wiley.com/store/10.1002/tre.8/asset/8_ftp.pdf?v=1&t=iitxdyke&s=145b3b3c17be1ac7089565defe73d8f7ee7958e6

Thread on FOX News Report/UTIs: http://www.facebook.com/SavingOurSons/posts/340295406047477

Recurring UTIs question at SOS: https://www.facebook.com/SavingOurSons/posts/1159091854109934

Nurse's UTI question at SOS: https://www.facebook.com/SavingOurSons/posts/827398113945978

Related SOS thread: https://www.facebook.com/SavingOurSons/posts/434928126526314

Parent's question on circumcision suggested for UTI: http://www.facebook.com/SavingOurSons/posts/523220774363715

College student's question on UTI resources for professor: https://www.facebook.com/SavingOurSons/posts/886125198073269

Reflux question from parent: https://www.facebook.com/SavingOurSons/posts/959989364020185

UTIs in Dogs (analogy) - http://www.facebook.com/photo.php?fbid=465452683473858&set=a.324857987533329.82696.166998263319303

UTIs Among Women (meme) - https://www.facebook.com/photo.php?fbid=479192492099877&set=a.324857987533329.82696.166998263319303

Note that for a UTI to occur, colonization of a pathogen must first take place. Pathogens that lead to UTIs are most often from fecal matter transmitted to this area of the body during diaper wearing, and/or when a care-giver is attempting to 'clean' a baby's genitals. The best way to prevent colonization from becoming reality in intact male babies and children is to practice proper intact care: that is, leave the foreskin alone. Allow this purposeful organ of the body to do its job: protect the glans and urethral opening and keep pathogens out. Do not retract, mess with, or attempt to 'clean' a baby boy's prepuce (foreskin). Further reading on intact care: http://www.drmomma.org/2009/06/how-to-care-for-intact-penis-protect.html



~~~~

Origins of the #i2 Hashtag



With continued popularity of the #i2 hashtag to identify intact-related posts on social media sites, many have asked about its origins. The initial use of #i2 occurred in 2008 after several advocates active in responding to intact-care and circumcision related questions on Twitter and MySpace decided that a hashtag was needed to identify all responses coming from genital autonomy supporters.

There were several active pro-cutting individuals also answering questions at the time, and they would frequently hide behind symbols and usernames that would lead questioning individuals and new parents to believe they were providing evidence based responses, when in fact, they were typically circumfetish in nature.

Danelle Frisbie of Peaceful Parenting, Dr. Jennifer Coias, Enith Hernandez of As Nature Intended, and Jonathon Conte, spearheaded the collaborative effort to brainstorm hashtags and host a vote among the intactivist community to select one. Many excellent ideas were tossed out on the table, and in the end #i2 was chosen by vote among all active at the time. 

Frisbie proposed the #i2 hashtag because, "We needed something short and sweet - a hashtag that would not take up too much space in the tweet box where we had very limited characters at the time. We also needed one that represented genital autonomy for all (men and women, boys and girls, as well as intersex individuals)." She continues: 

The "I" stands for: 
  • Integrity
  • Intact awareness
  • Intactivism and Intactivists
  • Information sharing
  • Involved advocacy
  • The Intact body we are each born with and deserving of having agency over
  • The Intersex child, as well as boys and girls
  • The fact that it is up to me (or "I") to speak up and make a change within my circle of Influence

The "2" represents: 

The duality of the sexes deserving the basic human right of genital autonomy. Frisbie states, "Although there are actually more than two sexes if we dive into biological differentiation, for simplicity sake, we opted for '2' to represent the fact that our posts, and the people behind them, stand for genital autonomy for both girls and boys. In addition, a change in the rate of genital autonomy in the future, and the saving of our children from forced genital cutting is up to YOU TOO! Don't stand silent and unmoving. Speak up. Become active - in whatever fashion fits your individual style. Become involved, and be the change we are seeking to see in our world." 

Almost immediately upon the creation of the #i2 hashtag, pro-cutting people began adding it to their circumcision-supporting posts in an attempt to confuse readers. This trend resurfaced over the years by circumfetish individuals as the #i2 hashtag moved onto the pages of Facebook and Google+, but overall, it remains an effective representation of pro-intact posts, and those working toward a common goal of genital autonomy for all.

~~~~




Male Genital Mutilation: A Global Picture


A global view of male genital mutilation (MGM) rates by nation. 

Note that in some of these nations FGM and IGM (female and intersex genital mutilation) also occurs. In the United States, where MGM is most prevalent, FGM is forbidden and penalized under federal law, while IGM is ignored.




~~~~~

African Study Finds Male Circumcision Lowers Ebola Risk


New mother and her baby boy speak with clinician. 

AFRICA - Green Farm studies in South Africa, Kenya, and Uganda recently found that male circumcision lowers the risk of Ebola from females to males by 160%. The study also found that circumcision increases the risk of Ebola from males to females by 161%, but that risk was considered insignificant. A total of 5,411.5 men in the study underwent male circumcision, and 5,497 men did not. Only 6,319 of the circumcised men developed Ebola, whereas 8,927 of the intact (uncircumcised) men did not. It is theorized that Ebola enters the body through the foreskin. The Circumcision Prevents Ebola studies were funded by the Miles and Belinda Greats Foundation, the Bill and Monica Foundation, and the National Institute of Hoaxes. With researchers already available in Africa, the study relied upon those who had studied how circumcision prevents HIV. Lead authors of this Ebola study include Ima Foole, PhD; Aaron Circumstein, MD; and Mohammed Fadoul, MD.

Circumcised men were told to abstain from sex for six weeks, and were quarantined to ensure that they did. Uncircumcised men in the study were offered an all-expense paid trip to Liberia, Sierra Leone, or Guinea.

Dr. Auvert VooDoo of Germaphobe University in South Africa warned that although circumcision reduces the risk of Ebola, caution must still be practiced by men. “Circumcised men still need to wear hazmat suits during sex, and men should not think they can engage in risky behavior because they are circumcised. Men who do engage in risky sexual behavior should use a chlorine spray following sex.”

Circumcision has been known to prevent thousands of diseases throughout history. Medical experts through the years have discovered that circumcision prevents masturbation, epilepsy, convulsions, paralysis, elephantiasis, tuberculosis, eczema, bed-wetting, hip-joint disease, fecal incontinence, rectal prolapse, wet dreams, hernia, headaches, nervousness, hysteria, poor eyesight, idiocy, mental retardation, and insanity, to name just a few.

Researchers are now encouraging PEPFAR to spend billions of taxpayer dollars to circumcise as many African males as possible, in the Voluntary Ebola Eradication Program. Voluntary circumcision will be performed on newborns, children, and adults. Academic institutions, and researchers who have made studying circumcision a career, are seeking additional grant money to not only conduct future studies on how circumcision prevents Ebola, but also for perpetual studies on how circumcision prevents diseases not yet even discovered.

In light of the study’s new findings and the high death rate from Ebola, the American Association of Prevaricators is considering appointing a new Circumcision Task Force to study and recommend circumcision as a preventive against Ebola.

Contact: Ima Foole, PhD Phone: 555-CIRC-4EBOLA (555-2472-432652)

Sign outside clinic in Zambia. See additional posters, signs and advertisements for circumcision across African nations: https://www.facebook.com/media/set/?set=a.430134657005661.102599.166998263319303

End Note: The above is a spoof ("a mocking imitation of someone or something, usually light and good-humored; lampoon or parody"). The author, who wishes to remain anonymous, intends this as a satire of researchers' claim that circumcision reduces risk of HIV transmission - the same researchers who started it all with their Orange Farm studies.

Related reading:

AIDSCirc.org

HIV & Circumcision Resource Page: DrMomma.org/2014/01/hiv-aids-circumcision-resources.html

African Propaganda: https://www.facebook.com/media/set/?set=a.430134657005661.102599.166998263319303

Public Service Announcement via Intact Connecticut: Circumcision also does not cure zika virus.

Almost three-quarters of Danish people desire to ban forced infant circumcision

By Steve Anderson for The Independent
Read more from Anderson: http://www.independent.co.uk/biography/steve-anderson 


Almost three-quarters of Danish people support some form of ban on circumcision, according to survey results. The results to the poll come as the country's parliament prepares to discuss the issue next week.

In the survey of 1,000 Danes, commissioned by Danish newspaper Metroxpress, 74% of respondents agreed that there should be a full or partial ban on infant circumcision, with only 10% saying they supported the right for parents to choose whether their sons are circumcised, according the English language news site The Local.

Denmark's parliament will hold a hearing on Wenesday to discuss circumcision, with both the left-wing Red-Green alliance (Ehedslisten) and libertarian party Liberal Alliance pushing for a ban.

Last year, the Danish health and medicines authority, Sundhedsstyrelsen, came to the conclusion that there was not enough documentation of the benefits of circumcision to recommend it, but conversely, there was not enough risk to justify a complete ban. Its report came on the back of extensive media coverage debating the topic.

Figures from Sundhedsstyrelsen suggest that somewhere between 1,000 and 2,000 circumcision are performed in Denmark each year, with Jewish and Muslim boys making up the majority of patients.

~~~~

Intact or Circumcised: Teasing in the Locker Room



A new study out of the University of Iowa, in the center of a Midwest state that continues to see a high rate of newborn circumcision, demonstrates that boys who remain intact throughout high school, even with circumcised peers, do not face teasing as a result of being intact as often as parents fear, nor do they wish they had been circumcised.

Dr. Chris Cooper, the study’s senior author, points out that while only 10% of young men (ages 17 to 24) were teased about their penis in middle or high school, and 47% witnessed someone else being teased at least once, 83% of those instances were due to penis size -- not whether or not a student was intact. Across the board, 97% of respondents, both intact and circumcised, said they were happy with their own penis and did not wish for it to be different.

Abstract

Purpose

Parents of young boys seeking circumcision or circumcision revision commonly cite concern that their sons may be teased in middle or high school due to the appearance of the penis. There are no current data to substantiate or refute the likelihood of such teasing. We explored the validity of this concern by investigating the extent and frequency of teasing regarding penile appearance.

Materials and Methods

An anonymous questionnaire was administered to undergraduate men at the University of Iowa. Participants answered questions regarding middle and high school demographics, school sports and gym class participation, and any teasing experienced or witnessed due to penile appearance in locker rooms.

Results

A total of 290 men completed the questionnaire. Mean subject age was 19.2 years (range 17 to 24). Of the individuals surveyed 98% were required to participate in high school gym class and 96% participated in a school sport. Of the subjects 10% were teased about their penile appearance and 47% reported witnessing someone else being teased. The most common characteristic singled out was penile size. Having an [intact] penis or a 'strange' penile appearance accounted for 33% of the witnessed penile teasing. Only 3% of the cohort wished that they had a different penile appearance.

Conclusions

Teasing in the locker room about penile appearance occurs frequently. While our study is limited to one Midwestern university population, it appears that parental concerns regarding teasing related to penile appearance are valid, although most causes of teasing may not be alleviated by surgical therapy.

Source:

Alexander, Siobhan E. et al. "Teasing in School Locker Rooms Regarding Penile Appearance." The Journal of Urology, Volume 193, Issue 3, 983-988.

Full Text



~~~~~~~~

I Researched Circumcision! ...Did You Really?

By James Ketter © 2014



"I made an educated decision to circumcise my son."

Did you? Really? That can be easily verified.

POP QUIZ:

1-a) In what style did you choose to circumcise your son:
a) Low and Loose.
b) Low and Tight.
c) High and Loose.
d) High and Tight.
e) Radically High.
f) Radically Tight.
g) Dorsal Slit.
h) Button Hole.

1-b) What are the benefits and negatives of each style? 

2-a) What method of circumcision did you request for your child?
a) Plastibell.
b) Mogen Clamp.
c) Gomco Clamp.
d) Freehand.
e) Traditional Mohel.
f) Traditional Tribal.
g) Electro-cauterization.

2-b) What are the risks and possible complications associated with each method? 

3) What are the most common possible immediate complications of the circumcision surgery? 

4) What is the most common possible LATE term complication of circumcision? (from circumcision to 12 years.) 

5) What is the greatest risk factor for ADULT men circumcised in infancy? 

6) What is the most common cause of foreskin infection in boys that have NOT been circumcised? 

7) How do you clean and care for a circumcised boy's penis immediately after circumcision (from circumcision to healing)? List all necessary steps. 

8) How do you clean and care for a circumcised boy's penis after healing? List all necessary steps. 

9) How do you clean and care for a boy's penis who is intact (has not been circumcised)? List all necessary steps. 

10) How does an adult care for his own penis that has: 
a) been circumcised?
b) never been circumcised?

*Bonus Question* 
What are the 16 functions of the foreskin lost to circumcision?

 If you cannot answer the above questions, you did NOT research, or make an educated decision to circumcise your son.


Answer Key:

1-a) Pick one. (5 points.) If you are unable to recognize which style of circumcision was inflicted upon your son, no marks are awarded.

1-b) (5 points each.)
a) Most inner foreskin removed, minimal outer foreskin removed. A fold of outer foreskin remains. Without inner foreskin, penile sensitivity is reduced. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. Frenulum (male G-spot) commonly destroyed.
b) Most inner and outer foreskin removed, no folds remain. Without inner foreskin, penile sensitivity is reduced. Causes tight, possibly painful erections. Frenulum (male G-spot) commonly destroyed. Rolling, gliding action not possible.
c) Most outer foreskin removed, minimal inner foreskin removed. A fold of inner foreskin remains. With a fold of skin remaining, penile skin must be forcibly retracted at each cleaning. High risk of possible skin adhesions, skin bridges, and highest risk for subjecting your child to corrective surgery (second circumcision) when inner foreskin attempts to heal back onto the glans.
d) Maximum outer penile skin and outer foreskin removed, minimal inner foreskin removal. Loss of the protective layers of outer penile skin leaves penis more prone to injury from abrasion and tension. Increased chances of keritinization, leading to adult loss of sensitivity. Rolling, gliding action not possible.
e) All of the outer penile skin is removed, leaving only inner foreskin. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
f) All of the inner foreskin, and most of the outer penile skin, is removed. Painfully tight erections are assured. Most of the penis is trapped withing the pubis. Penetrative sex may not be possible.
g) All the foreskin remains, though split at the dorsal line. Foreskin must be forcibly retracted at each cleaning. Maximum possibility of skin bridges, adhesions, and secondary surgeries. Greatest possibility of foreskin healing incorrectly. Least appealing cosmetic result.
h) All of the foreskin remains, though the glans is exposed through an incomplete slit in the top of the foreskin, like a button through a button hole, where it heals in place. Cleaning is virtually impossible. Most sensitive regions of the penis is trapped and inaccessible. Penetrative sex may be impossible.

2-a) Pick one. (5 points.) If you are unable to recognize which method of circumcision was inflicted upon your son, no marks are awarded.

2-b) (5 points each.)
a) Frenulum commonly destroyed. Possible slippage of ring causing excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
b) Possible amputation of some or all of the glans. The company that manufactured this clamp went out of business settling lawsuits because of injuries of this type. Complete loss of the penis, complete degloving of the penis (loss of all outer skin,), wound dishiscence (skin coming apart), necrosis, infection, complete loss of penis, poor cosmetic result, and many others, up to and including death.
c) Frenulum commonly destroyed. Possible crushing of and loss of the penis if correct bell sizes are not used, excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
d) Riskiest method. The slightest slip of the doctor's scalpel and damage can occur anywhere on the infant penis. Excessive bleeding, damage to the glans, necrosis, infection, complete loss of penis, loss of glans, poor cosmetic result, and many others, up to and including death.
e) As risky as any of the above, with a far greater chance of infection and transference of diseases such as herpes to your infant.
f) Extraordinarily dangerous and unsanitary. By far the riskiest and most damaging circumcision method of them all.
g) Electro cauterization burns and seals shut the vascular system around the cut reducing bleeding, but excessive heat travels through the skin destroying nerve tissue far removed from the circumcision site. Heat can destroy much more of the penis, and is famously known for causing necrosis of the penis. All other above complications remain possible.

3) (5 points for each of the following. 25 points max): Pain, bleeding, infection, inability to bond with mother, lack of interest or ability to breastfeed, and infant post-traumatic stress disorder (PTSD).

4) (10 points) Meatal Stenosis. Studies differ, and place this late term complication at 5 to 30% of all circumcised children who will experience this painful and dangerous complication of missing their foreskin. Surgical correction may be the only remedy. Even at only 5%, this remains the greatest risk to all circumcised boys.

5) (10 points) Erectile Dysfunction. Adult circumcised men suffer from ED 4.5 times more frequently than their intact counterparts.

6) (10 Points) Premature Forcible Foreskin Retraction. PFFR occurs when an adult, caregiver, or doctor forcibly retracts (even “gently”) the foreskin of a child prematurely. The average age of retraction is 10.4 years. Prior to that the foreskin is fused to the glans to prevent infection from foreign materials and pathogens. Some males may not have a retractable foreskin until late puberty. (17 years old or later.) NEVER retract the foreskin of an intact child. It is self cleaning until post-puberty, at which time only clean water is required to rinse off the glans and inner foreskin.

7) (5 points) Care must be taken with the circumcised child's wound. It will be raw and sensitive. Vaseline or petroleum jelly is used to keep the raw wound from sticking to his diaper. If the foreskin appears to be healing to glans, gently pull the penile skin down, breaking the adhesions. This will be both painful and traumatic for your baby. Excessive touching or cleaning of the circumcision wound may disrupt the infant/parent bond and disrupt breastfeeding. Watch for excessive bleeding. If more than a few drops of blood are visible in the diaper, your child may be at risk of hemorrhage. It only takes 2.3 oz. of blood loss for your baby to go into shock and possibly die.

8) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin are carefully inspected and cleaned. If you notice skin bridges or adhesions, a second surgery and breaking of the adhesions may be necessary.

9) (10 points) Clean only what is seen. Wipe the outside like you would a finger. NEVER retract the foreskin or you will disrupt the natural cleaning function of the penis.

10) a) (5 points) Clean the outside like a finger... unless a fold of skin remains at the edge of the glans. If a fold remains, gently pull it down and clean around the edge of the corona, this is a fold where dirt and foreign pathogens can collect. As the natural cleaning mechanism of the penis has been destroyed, be careful that the entire penis, including any folds of skin, are carefully inspected and cleaned. If you notice skin bridges or adhesions at any point, a second surgery and breaking of the adhesions may be required.
b) (5 points) Clean the outside like a finger. Retract the foreskin briefly and rinse the glans and inner foreskin with warm water. Avoid soap inside the penis. Soaps can disrupt the natural cleaning mechanism of the penis.

BONUS QUESTION (30 points)
1. Erotic pleasure via the ridged band.
2. Rolling, gliding action during sex or intercourse. Acts as the male contribution to lubrication.
3) Prevents dyspareunia (painful intercourse).
4) Stimulates partner's genitalia, giving erotic pleasure.
5) Supplies skin to cover the shaft in erection and prevent tightness.
6) Stores pheromones and releases them on arousal.
7) Stores, releases and helps distribute natural lubricants ("smegma" and pre-ejaculatory fluid).
8) Makes the glans a visual signal of sexual arousal.
9) Provides a seal against the vaginal wall to contain semen.
10) Prevents the glans becoming keritinised, and keeps it soft and moist.
11) Protects the thin-skinned glans against injury.
12) Protects the nerves of the glans, retaining their erotic function.
13) In infancy, protects the urethra against contamination, meatal stenosis, and UTIs.
14) Provides lysosomes for bacteriostatic action around the glans.
15) Pigmented, it protects the unpigmented glans against sunburn.
16) Vascular (rich in blood vessels that bring heat to the tissues), it protects the less vascular glans against frostbite, as Sir Ranulph Fiennes found on his epic transpolar walk.


Total possible points including the Bonus Question = 200
145 or higher – Congratulations, you are likely an advocate for genital autonomy and chose to keep your child intact.
100 to 144 – You are very educated on this subject.
75 to 99 – You have a lot more to learn.
Less than 75 – You did NOT make an informed decision.



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Meatal Stenosis: Growing up with Circumcision Pain

By James Ketter © 2014

When I say I was damaged by infant circumcision, I should be specific. There wasn't anything immediately wrong with the genital cutting I was subjected to. My parents and the doctor were quite happy with the immediate result, and frankly, other than a few hurtful comments about how short my penis appeared, I didn't know any different as a child.

Puberty changed everything.

You see, it is impossible to tell how much penile skin a baby will need when he grows up. His tiny penis isn't developed yet. Doctors have to make a guess about how much of the mobile structure of the penis to destroy. They often guess wrong. One of the most common complications includes the removal of too much skin, as happened to me.

During puberty I experienced tight, painful erections. Without enough slack skin, the bulk of my penis had been trapped my whole life. It made my penis look shorter than it really was. When erections and my growth spurt started, this caused me a great amount of pain. My penis skin literally split under the tension. I was left with less than half the penile skin I should have had. No one noticed this, because frankly, some kids are just less endowed than others. And, what parent is going to try and get their child to have an erection to check and see if he has enough penile skin? No, that never happened. That would have been a whole other level of child abuse.

The growth and erections of my teen years left me with stretch marks and awful scarring. Masturbation was actually impossible for me because of the tight skin until I was 15 years old. Oh, I was as horny as all the other teens, but I just couldn't do anything about it because of the pain it caused me. I never told my parents this, because, let's face it, teenage boys DO NOT talk to their parents about their penis or masturbation habits.

With no one to talk to about it, I assumed that all my sexual problems were my fault.

I blamed myself for not being masculine enough.

I blamed myself for being defective.

Twice before I was 18 I tried to kill myself because of my perceived failings as a male.

When I finally had sex, I was disturbed to discover I just couldn't feel anything from my partner. Years of scarring and thickening of the skin left me with an insensitive member that wasn't equal to the task. The only way I could feel anything through my penis was during masturbation and with a death grip that could crush full beer cans. A vagina has some grip, sure, but no where near enough for me to feel what I ought to have felt. This led to years of depression, self blame, and a lot worse. I had to fake orgasms with women. It was devastating to my psyche. Eventually it was just too much work, so the relationships would break down because of lack of intimacy.

I came across foreskin restoration a few years ago, and it was a purely cosmetic choice for myself. I had grown up around my intact cousins, and I always felt my penis was wrong looking. The idea of hiding my horrible scars under a fold of skin sounded really appealing. Within the first few months of starting foreskin restoration I noticed a change. As I slowly developed more slack skin, my penis slowly began to heal for the first time since I'd started puberty. The more slack skin I had, the better things functioned. By the time I developed enough slack skin to again cover the glans (head) properly I was sold. When the skin covers the glans, the glans starts to heal and shed all the thickened skin that has built up over the years. My sensitivity magnified a hundred fold. Shedding the thickened skin and healing the glans also allowed the scaring around my meatus to soften. Pain I had had my entire life while urinating suddenly disappeared. That pain was so constant and expected that I thought it was normal. My mind had become accustomed to the pain so much that it no longer registered. Suddenly not feeling a pain I had had my entire life was a revelation.

Eventually I researched and discovered that I had been suffering from Meatal Stenosis all my life. At nearly 40 years of age, I was finally cured of it. Foreskin restoration has reduced the look of my scars, improved the function of my penis, and improved my overall mental, physical and sexual health. I have had enough foreskin now to know what both sides of circumcision feel like, and it is no contest. Foreskin is simply better in each and every way. There really is no excuse to remove a body part this valuable and functional.


My own parents, when I was a child, were just like all the pro-cutting parents I try and educate. They were convinced I was 'fine.' I was a happy child, and I didn't know any better. When asked, my parents were proud of their decision, and would recommend it to their friends because of how happy THEY were with the configuration of MY penis. But they didn't know the reality. They never could, and never can. Neither can you if you cut your son.

When I hear men brag about their penis, and claim, "I'm cut, and I'm fine," I laugh, because I know the truth. The more insecure you are about your penis, the more you lie and claim everything is fine. Everything is fantastic, "I am so very, very happy, happy with my cock!" It is a lie, and an evasion. I know. I used to be the King of Denial. I used to say those very same things. It takes a VERY brave man to admit his penis is less than it should be. I would have walked into burning buildings, or into a war zone without blinking, but to admit my penis was flawed was something I didn't have courage enough to admit. It took restoring my foreskin to finally make me admit out loud what had been wrong for so very long.

Now I brave insults and ridicule for spreading education about the abomination that is genital cutting. I'm sorry to say, if you cut your child, you will probably never know the damages you have done. Boys and men are not wired to talk openly and honestly with their parents about this. A man will die before he lets anyone think there is anything wrong with his penis, or his masculinity. You can claim, 'my son is fine' all you want, but you just cannot, and likely never will, know the actual truth. He may not be able to face the truth of this himself. More than to anyone else, he will lie to himself.


There is no way to know how much skin a baby boy will require for his penis when he is grown. It is NOT something that can be predicted. Doctors have to guess. They can, and do, guess wrong more than they guess right. I speak out against genital cutting because I know first hand how horrible and wrong it really is. I know what the circumcised child is missing. I know what he can suffer. I know what you've put him at risk for. I've experienced it. I've researched every aspect of it, and there really is no excuse to take this pleasure away from another person.

Make no mistake, the foreskin is erogenous tissue. It is more pleasurable to have one than to NOT have one. It IS a valuable part of the penis. It is an organ with specialized functions that make a man's life better. Its loss is not insignificant. It is NOT just skin.

If men were supposed to have foreskin, they would be born with it. Don't just research circumcision. Research the foreskin.

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Informational items available for sharing at: SavingSons.org/p/info-cards.html



Foreskin Restoration on The Tonight Show Starring Jimmy Fallon



Although couched within an aura of mockery, complete with a couple jokes about genital cutting, the fact that Jimmy Fallon highlighted Dr. Jim Bigelow's book, The Joy of Uncircumcising, may be enough to spur Tonight Show viewers into looking it up out of curiosity and stumbling into foreskin restoration options, intact information, and the many resources available today on infant circumcision.

Despite being presented in a manner that flows right along with the cutting culture in which we live, the presentation of this book for a brief two minutes on The Tonight Show last night (9.11.14) may lead to future men enjoying sex as they were meant to enjoy it... with full and complete genitals.


The Tonight Show Dialog: 

Jimmy Fallon: For all you guys out there - you guys like reading books, right? It's The Joy of Uncircumcising. And it's great. As you can see, it's a very thick book - so it must be a very joyful experience. Look who it's written by - Jim Bigelow.

Steve Higgins: Jim Big-and-Low?

Jimmy Fallon: No, no - Jim Bigelow. [camera zoom to author's name]  This book was actually a lot longer, but they cut the end off.

Steve Higgins: You used to work for a guy who did circumcisions, didn't you?

Jimmy Fallon: Ah, yeah, I didn't get paid though - I only worked for tips.


For further information on foreskin restoration, and its impact on men and their partners, visit resources on the Restoration Page.

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★ Baby Saving Folder Drive! ★


One of the seed-planting, baby-saving activities that Saving Our Sons takes on each week is to provide expecting parents, as well as families of newborn babies in the NICU and Ronald McDonald Houses, packs of information on intact care, the benefits of the foreskin, and the facts regarding circumcision. This is only possible through the donations received with the Sponsor a Son program. Still, the needs and requests far outnumber the gifts received at SOS, and one easy way all advocates can help this month is to pick up a few extra blue folders with tabs when you're out and about shopping for school supplies. Most are on significant sale at this time of the year (50-cents or less at many stores) and we need to stock for the duration of the year when the prices per folder are significantly higher.

Saving Our Sons also directly ships packets ($4 worth and free of cost to patients requesting) to any physician, hospital staff, or clinic that is involved in cases of forced retraction. Folders and funds are needed for this project as well.

Please join us in this folder drive!
Needed are:
BLUE Folders with 3 Prongs

Each will be turned into a powerful pack of information that goes out to an expecting family, a parent who is on the fence about whether or not to keep their own son intact, or a physician/clinic who needs to be reminded of current intact care protocol and encouraged to review relevant research.

Send your folders to:
Saving Our Sons
P.O. Box 1302
VA Beach, VA 23451

Not shopping for school supplies this year? If you would like to donate toward the drive fund itself, you can do so with the link below or via PayPal to SavingSons@gmail.com

Thank you for helping us prepare for the upcoming 2014-2015 educational year! Information is key to increasing the rate of genital autonomy each year, and we're seeing powerful success in these efforts, one baby at a time. ♥


Medical Organization Position Statements on Circumcision


No national medical organization recommends the routine genital cutting of infants without medically justified need for such surgery to take place. Infant circumcision is clearly spoken against in many nations, regardless of babies' sex (female, male, intersex) and is not supported for all babies in any nation, even those that otherwise stem from within a cutting culture.

What follows are current medical position statements from organizations across the globe today. Full statements are readily available via online searches. When we recognize that no national medical organization recommends routine infant circumcision, it becomes clear that such things should not be funded with tax payer dollars (Medicaid and similar programs), covered by health insurance (genital cutting of infants is not performed as a health treatment), or pushed upon unknowing parents by any medical staff who stands to financially gain from performing unnecessary genital surgery upon a non-consenting human being.


The above informational cards and more are free for download and printing,


Related Reading: 

Peer reviewed published research on circumcision and the functions of the foreskin: http://www.drmomma.org/2007/01/circumcision-studies.html


On the ethics of registered nurses assisting in forced infant circumcision: http://www.drmomma.org/2014/04/on-ethics-of-registered-nurses.html


The Medical Benefits of Infant Circumcision: http://www.drmomma.org/2013/05/the-medical-benefits-of-infant.html


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Circumcision: Never Assume Parental Knowledge

By Jen Sugarbaker
names in this story have been changed to protect identies


I have a story of circumcision regret, not for my own son, but for a baby I did not save.

My brother Jim, and his girlfriend, Carrie, gave birth to a beautiful, premature baby boy. They live in the Northeast, and I live in the Southwest, but I communicate with Carrie frequently over Facebook as our boys are about the same age. When their son, Evan, was born a month and a half premature and placed in the NICU, I never even thought to talk with Carrie about circumcision. I just assumed that because her son was so small and fragile, she would not want to do anything to hurt him. I also knew that she was aware that my own son is intact, and that she would follow my lead.

I was shocked when my mother called and told me that my new nephew had been cut, only a few weeks after birth.

I learned an important lesson that day: if you know someone who is expecting, or has recently had a baby, TALK TO THEM about the dangers of circumcision and the benefits of keeping children intact. Never underestimate the other parent's naivety on the subject, or the powerful pressure a mother may be under from her partner, her family, or her medical providers to circumcise.

I wish now that I had spoken up for my nephew, and I refuse to let another opportunity like that pass me by. Please, do the same and speak up whenever you have the chance to do so.


Hear from additional parents who are keeping future sons intact, and those who have worked through circumcision regret: http://www.drmomma.org/2010/05/i-circumcised-my-son-healing-from.html

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