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The Fate of the Foreskin

"The worst foreskin problem most intact males ever have is that someone thinks they have a problem."

- John A. Erickson



As the proud "attached parent" of a natural baby, I asked a slew of questions to more doctors than I care to count before choosing my son's current pediatrician. I covered the "I'm not circumcising. That cool?". This doc passed the "We believe in extended breastfeeding. That cool?". He was the only pediatrician I found to okay the "No vaccinations. That cool?" question.
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Apparently, I forgot one. "I want a doctor that's read a relevant journal on infant anatomy written sometime after 1950. That cool?"
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The pediatrician actually instructed me to force back my son's penile foreskin once a week until it is fully retractable - and stated that it should be completely retractable by the time he is five years old. Now, I'm no expert on the human body, but I'm fairly certain there's no evidence to suggest the human genitals have evolved in such a way as to require forcible manipulation in order to develop properly. After yesterday's appointment, I did some research. Here is what I found.
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It was a journal published 24 December 1949 that stated all but 10% of boys in a particular study (that wasn't sure whether it studied 150 or 200 boys) were fully retractable by five years of age. Since then, numerous studies have been done in several different countries (notably Denmark and Japan, where circumcision is not considered "normal" or "routine") that claim the median age of full retraction is 10.4 years, and it's not abnormal for retraction to be impossible until puberty or even young adulthood. In fact, 2% of adult males are considered "non-retractable". Many of these adult males live full, healthy lives with no problem whatsoever. Those that wish to do something about it have several non-surgical options to explore. Why, then, the push to force back an infant's foreskin - which at this point is attached to the glans much like a fingernail is attached to a finger?
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The following is a quote from National Organization of Circumcision Information Resource Centers (NOCIRC), a non-governmental organization in Roster status with the Economic and Social Council of the United Nations fighting the process of routine circumcision and myths surrounding the care (abuse?) of the intact penis:

How do I care for my young son's intact penis?

The intact penis needs no special care.

The foreskin should never be retracted by force

During the first few years of a male's life, the inside fold of his foreskin is attached to his glans, very much the way the eyelids of a newborn kitten are sealed closed. The tissue that connects these two surfaces dissolves naturally over time - a process that should never be hurried.

The foreskin can be retracted when its inside fold separates from the glans and its opening widens. This usually happens by age 18. Even if the glans and foreskin separate by themselves in infancy, the foreskin may not be retractable then because the opening of a baby's foreskin may be just large enough to allow for the passage of urine.

The first person to retract a child's foreskin should be the child himself. 

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Forcible retraction of the foreskin can cause pain, swelling, and adhesions that can cause permanent disfigurement and a lifetime of problems. Also possible are acquired phimosis (The foreskin's narrow opening sometimes tears when the glans is forced through it, forming scar tissue that may prevent it from widening later on its own.), and paraphimosis (its narrow opening may "get caught" behind his glans, and, like a tourniquet, trap blood in the glans and make it swell).
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What should I do if my son's foreskin is forcibly retracted?

Regardless of your son's age, first explain that you didn't know anyone would do that to him, apologize, and tell him you will do your best to make sure no one ever does that to him again.

If your son's penis is swollen, sitz baths will help relieve the swelling and discomfort.

If it hurts your son to urinate, put him in the bath several times a day so that his urine will be diluted by the bath water, then rinse him off. Do not use soap on his penis.

Even if you have been told to retract your son's foreskin, don't. He has been hurt and traumatized and his penis needs to be left alone to heal.

Watch for infection.

Your son may develop adhesions when his foreskin and glans heal but you might not know whether these have separated by themselves or will need to be separated surgically until he has completed puberty.

No one except your son should manipulate his penis to check for adhesions or to see how far his foreskin will retract. A narrow foreskin deserves the same respect as a tight hymen. Both openings will enlarge with sexual maturity.

What legal and/or regulatory action can I take?

David J. Llewellyn, J.D., of Atlanta, Georgia, states:

"Generally the law does not permit a physician to carry out a non-emergency invasive or damaging procedure on a child without the parent's permission. If an infant's foreskin is forcibly retracted, resulting in tearing and pain, and the parents have not given their permission for the procedure, the law of most states provides that the parents may bring a suit on behalf of the child for assault and battery against the physician. Parents should be aware of these facts and should consult competent counsel if their child has been forced to suffer unnecessary pain without their permission."

Parents of boys whose foreskins have been forcibly retracted may want to consult competent, knowledgeable legal counsel about initiating litigation to recover money damages on behalf of their son.

Parents can also file a complaint against the doctor with their state medical licensing board (www.fsmb.org/members.htm). Information about reporting physicians is available at Circumcision: Legal Issues (www.cirp.org/library/legal/).

The Federation of State Medical Licensing Boards (www.fsmb.org) advises that filing complaints against errant physicians improves the quality of patient care and is a service to the public.

Please report all incidences of premature retraction to NOCIRC.

3 comments:

AutumnJade said...

Thank you for posting this. I have 2 intact sons and an intact husband. I went by instinct on this and never touched his penis. He is 4 and retracted it on his own, which scared him. I let him know it was ok and helped him get it back to normal. The only time we should touch our boys unless we are washing them before they are capable of doing it on their own. I also don't see a problem with them touching themselves in privacy. I am also a Christian woman who plans on homeschooling...wow.

Karen James said...

Refusing to vaccinate your child is most certainly not cool!

Karen James said...

Here's some info from the CDC and if that's too dry for you how about hearing the testimonial of whose 4-week-old daughter, too young to get vaccinated herself, contracted whooping cough because vaccination rates in their part of Australia are too low to provide herd immunity.

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