Wednesday, 18 October 2017

To cut or not

By Emily Prucha | Prague Daily Monitor |
26 June 2009

When I learned our second baby would be a boy, I never gave much thought to the circumcision debate. I assumed that since he would be born in the Czech Republic, where the practice is uncommon, it was a no-brainer. I asked my husband, Radek, how he felt and his quick but passionate response – "What? No one is going to cut my son." – sealed the issue.

Radek's veto was a relief. But, since I grew up thinking circumcision was necessary and routine, I anticipated questions from family and friends in the US, although I knew that even there the trend has slowed since the rate peaked at 85% in the mid-60s, according to the Circumcision Reference Library. Even though parts of the nation and certain ethnic groups have long favoured genital integrity, the practice remains prevalent, with the lowest recorded rate being 56% in 2006.

I knew my mother felt a little uncomfortable when I told her we didn't plan to circumcise the baby, although, apart from suggesting I read a Time article on the Top 10 Medical Breakthroughs of 2007 that claimed the practice can prevent HIV, she didn't try to persuade us. Knowing that the "locker room" mentality is among the most common reasons for nonreligious circumcisions in the US, my mom may have figured our son, Oliver, would fare better looking like his father and other guys here.

I had my doubts when two married but childless American girlfriends of mine engaged me in debate with arguments based on historical, religious, cultural and health reasons – but giving the most credence to hygiene and studies on sexually transmitted diseases – and tore into my unresearched go-with-my-gut argument.

I quoted from the 2004 edition of Dr. Spock's Baby and Child Care, in which he writes that "most doctors now agree that there is no medical justification for routine circumcision". Although the book mentions a slightly higher incidence of bladder and kidney infections in uncircumcised boys, it concludes the data are not medically significant. It seemed that with proper hygiene (and, down the road, safe sex), most health concerns could be avoided. Plus, I couldn't argue with the part of me that believed it unnecessary to subject our newborn to nonessential surgery.

When I talked with other non-Czechs in Prague, I realized again how cultural norms factor in the decision. A Swede remembers children mercilessly teasing the one circumcised boy in her school. Other American expats who'd circumcised their newborns here expressed anxiety over doing it in a country where the procedure isn't common, although it always went smoothly. I found a website for cosmetic surgery with a list of physicians who circumcise here. Interestingly, most of the doctors bill themselves as offering "beauty" services.

In 2007, a few weeks after Oliver's birth, we travelled to the US for my brother's wedding. One afternoon in the midst of the wedding-related chaos, I handed the baby to my aunt for a diaper change. "Oh my goodness," she exclaimed as she opened his diaper, "I've never seen one of these!" I'd expected my aunt, as the mother of four, to have had the full range of experience with children's bodies, so I had to laugh when she tried to avoid explaining to Oliver's wide-eyed 3-year-old male cousin why the baby's penis looked different.

When I thought about it later, I guessed it would have been complicated to address the subject on the spot in child-friendly terms, but I probably would have tried. As the boys grow up, I'm certain we'll have the discussion more than once. As part of a multicultural family, Oliver will have circumcised and uncircumcised friends, and I hope his penis will never be seen as unnatural, just as I hope he'll never tease circumcised friends.

This spring the debate again gained press when a study in the New England Journal of Medicine called for more circumcisions to promote sexual health after a two-year look at Ugandan men concluded circumcision reduces the prevalence of herpes by one-fourth and human papillomavirus by one-third. Although American scientists advocated the procedure, UK doctors cautioned against using the procedure as a solution for sexually transmitted infections or applying research from another part of the world to the British population.

Each family makes its own circumcision decision. Historical, cultural, religious, aesthetic and health implications contribute to the decision. I'm thankful, for Oliver's sake, that his father and I decided, with minimal stress, together.

Emily Prucha is a Life Section columnist for the Monitor. She likes writing about bilingual and multicultural families.
You can reach her at emily@praguemonitor.com. You can read more of her stories here.