Thursday, February 10, 2011

Why do Parents choose Circumcision their male infants?

Most parents who circumcise their infants are loving caring people who believe that they are doing the best for their child.  We need to be very careful and respectful if we are to communicate with and persuade those Parents who will choose to circumcise their infants. We need to be very careful about using inflammatory language, because we will just alienate them, and create a defensive resistance to any of our ideas.  We need to understand the motivations behind the choice to circumcise if we are to begin to influence change.
The reasons parents circumcise are various and many.   Here are a few:
1.      Ignorance/False Beliefs = "The foreskin is of no value, it is a useless flap of skin."  "Circumcision is a harmless procedure and the baby won’t feel a thing."  "Circumcision is like a surgical vaccine, and circumcision is the only way I can achieve these health benefits for my child."  While these circumcision myths are clearly false with strong evidence that disputes these beliefs, many people still believe these strongly contested circumcision myths. The answer here, is to challenge these beliefs with facts & education.  eg. The foreskin has 20,000 pleasure nerves vs the clitoris 8,000; Circumcision is acutely painful, has many surgical complications associated with it, and circumcision provides minimal health benefits that can be gained at superior levels by more consevative means.
2.       Obedience to Medical Authority = "If my doctor says I need to do it, then it must be right."  Some people have been bought up to defer to medical authority, and that the Doctor always knows best.  Doctors are human beings and are susceptible to bias, prejudice, errors, false beliefs, greed, incompetence, medical negligence and unethical behaviour. This belief in the infallibility of the medical profession needs to be gently challenged with opinions from respected medical authorities that recommend against infant circumcision.
3.       Religious obligation = This is the most difficult one to deal with.  Ultimately it is from within the religious community that change needs to occur.  Some Jews have created an alternate ceremony that does not involve circumcision (Brit Shalom).  Respect and dignity is required here no matter how much or how strongly we disagree.
4.       Tribalism = The father who says “ I want him to look like me” is not really thinking about his son at this very moment, and just wants his son to belong to the no foreskin tribe that he belongs to, he is not thinking about any of the adverse consequences for his son, or which tribe his own son would choose to belong to.  Take a deep breath, and slowly educate and persuade.
5.       Culture = In this instance we have a cultural set of beliefs, including institutions, and high profile individuals from media to medicine, who are Saying "circumcision is good and that natural anatomy (the foreskin) is bad."  Very difficult issue to deal with but similar solutions to religious obligation basically requiring education and change from within.
6.       Investment in the procedure = Having already circumcised some parents feel very invested and defensive about the procedure, very difficult to change or persuade in this case, all of the above suggestions apply.   
7. Scientific research = "The research from Africa says if I circumcise my son it will prevent him from getting HIV." This false belief arises out of the supposed infallibility of Scientific Research.  WE need to educate that All scientific research is value laden, and not infallible.  The researcher can interpret data, & emphasise what he/she wants to find or publish, & ommisions can made of what the researcher doesnt want known about his/her research.  Again education is critical here.  Hints when discussing African Research = The research did not prove life-long protection only partial episodic protection. A significant number of circumcised men in the study became infected with HIV, even though they were given more education about healing from surgery, abstained from sex longer, and were given greater time and emphasis about wearing condoms during the period of healing from surgery.  Nearly 10 times as many participants dropped out of the study as were infected, with HIV status unknown. The studies were ended early exagerrating effects. The vast majority of participants in the study were HIV free, therefore, why was no attempt made by researchers to identify the 100% condom users and compare these to the circumcised group, Was 100% condom use more effective than circumcision = Most probably yes!! but researchers did not want to find this and report it.  In another study, Women who had sex with circumcised men were 50% more likely to become infected with HIV.  The reseach is valid only for adult circumcision volunteers, and populations with high prevalence of HIV, not babies or low prevalence nations. Demographic studies in Africa have found many circumcised populations have higher HIV infection rates than non-cirumcised populations.  The strong message here needs to be safe sex and condoms can only prevent HIV, and a false belief in the protection of circumcision places men and women at greater risk of infection.

There are many other reasons and I would invite comments and discussion on the blog.

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