I thought I would get a medical doctor's take on this - out of the clinical setting, where she could voice her observations without fear of retribution. She does not know my cut/uncut status, nor my views on the subject. She has been a family practice physician for 14 years. First, my email to her (with identifying material deleted, otherwise in its entirety):
I do have a couple of questions for you. I subscribe to a message board, and one of the ongoing debates concerns circumcision. I just thought I would ask about your personal views as a physician, and what the current thinking is in the medical community, and the AMA. Medical necessity notwithstanding, how is it usually handled? Do the parents have to request it? Do doctors offer it or advise against it? Just curious.
And her reply (again, unedited except for identifiable info):
Circumcision... you have hit one of my favorite debates! I'm against genital mutilation unless there is a good reason for it, and there is no good proven reason to do this. Uncirc'd boys may have a slightly higher rate of urinary tract infection as infants, which is really minimal and easily treated. The general run of "amurican" families want circs because it looks like Dad's, and they don't want to have to "touch it," which in fact isn't really any more necessary than usual anyway! Uncirc'd infants can be washed just like any other infant with good hygiene. The foreskin should NOT be retracted until it retracts on its own, which is usually around age 5. Any normal 5-yo boy will be retracting it himself by that time! However, uncirc'd adults do have a higher rate of contraction of HIV WHEN EXPOSED. Using common sense could prevent a lot of this. Elderly men sometimes will develop balanitis, an inflammation of the foreskin, which requires an adult circumcision, which is a much bigger deal than an infant's (and yes, I've had to do both). Cons: sensitivity is GREATLY reduced by exposing the sensitive glans to more irritation... thus changing mucosal skin to "regular" skin... and hiding those nerve endings! One can never regain that lost sensitivity, and what man wants to lose any of that? As an intern, I was expected to do all the infant circs, and, as an intern, I complied, because of course you are scared to do anything else, but as a second-year resident I took a stand against it... and two other residents in my program sided with me, I gave talks on it (can you tell?) and the OB department even sided with me!! However, our standing practice (not mine, obviously) was to present the new mother with the consent form. No discussion. It was assumed everyone wanted it done, and the student or intern was expected to obtain that consent. Hopefully things are a little different now. I had one nursing student faint during a circ, and the infants are obviously traumatized. You strap 'em down and slice that sucker off. I participated in an anesthetic study (we had EMLA cream, no anesthetic, and an electric stimulation, and once or twice I tried nerve blocks also) and NOTHING seems to change the infant's distress. Circ'd nfant males show much higher sensitivity to pain and trauma than females, and they also show higher traumatic reactions to routine immunizations. No, of course chopping off the end of their penis doesn't affect them adversely! I believe there might still be a good article on the aap site, and a simple google will probably turn up a lot of stuff.
Is that what you wanted to know?
