A baby is circumcised.

Durban - Many cultures have elaborate initiation rituals, either at birth or when a child attains adulthood.

One physical ritual that has prevailed over time is male circumcision – the surgical removal of foreskin from the penis. The book of Genesis speaks of it as a religious rite.

Jewish boys have been circumcised on the eighth day of life with a celebration. It is also a religious practice among Muslims.

Parents of male babies in these religious groups thus have the circumcision issue settled for them by custom.

In the latter part of the nineteenth century people from other religions also started this practice as a hygienic measure. By the mid-20th century, American physicians were circumcising male babies routinely because they believed that an uncircumcised boy was more susceptible to infection, and that newborns did not feel pain from the procedure.

More recent findings have shown that the assumption about the pain was incorrect.

The Canadian Paediatric Society notes that prolonged severe pain may affect newborns into later years.

In one study, circumcised 4- and 6-month-olds had stronger reactions to the pain of vaccination than uncircumcised infants.

The reaction was muted among infants who had been treated with a painkilling cream before being circumcised.

What are the benefits of circumcision?

Commonly cited benefits of circumcision include:

* A decreased risk of urinary tract infections, such as a bladder infection.

* Possibly, a reduced risk of getting some types of sexually transmitted infections, such as HIV and genital herpes.

* Possible protection against penile cancer and a reduced risk of cervical cancer in female sex partners.

* Circumcision also makes it easier to keep the end of the penis clean.

Those opposed to circumcision claim that there are more effective, and less invasive ways of preventing these conditions... for example, by practising good hygiene to prevent urinary tract infections, or using a condom to prevent sexually transmitted infections.

It is argued that, when the time comes, men will leave this world with all the bits and pieces they came with.

What are the risks of circumcision?

Commonly cited disadvantages of circumcision include:

* Pain.

* The risk of bleeding and infection at the site of the circumcision.

* Potential complications of circumcision – these include excessive bleeding, post-operative infection and, in rare cases, injury to the urethra.

* Risk of injury to the penis.

* Reduced sensitivity – Some claim that an uncircumcised penis is more sensitive than a circumcised one, suggesting that circumcised men may experience less pleasure during sex.

After a comprehensive review of scientific evidence, the American Academy of Paediatrics found that the health benefits of newborn male circumcision outweigh the risks. However, the academy stopped short of recommending universal newborn circumcision, because it found that the benefits are not great enough to do so.

The academy also recommends that whoever performs the procedure should use a local anaesthetic to ensure that it is as safe and painless as possible.

Also, the final decision about circumcision should be left to parents to make in the context of their religious, ethical and cultural beliefs.

Seen in this light, parents who do not fall within the ambit of religious expectations, have to make their own decision about circumcision. This can place them in a dilemma, especially where one parent prefers circumcision but the other parent sees it as unacceptable.

It would be advisable for parents in this category to discuss the benefits and risks of the procedure with their paediatrician before making a decision.

These parents will also have to keep in mind that their son will reach puberty in the not-too-distant future. While they may not openly admit it, this is the time when boys surreptitiously try to “measure up” to others.

The penis, though it is just a body part, is a source of great pride and, in some cases, a source of great stress, even humiliation. How would a son later view the decision his parents took on his behalf? Interesting.

 

* Ramphal is an educational psychologist with special interests in career counselling and the learning and behaviour problems of children and adolescents. Visit www.ramphaledupsych.co.za.

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