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The headline is a direct quote of a question we have been asked many times.
We have been asked whether we are seeking a ‘ban’ on medical circumcision – Short answer no, for a more in-depth answer read on.
Our mission is clear.
We are serious about getting the message out there regarding the harm that circumcision can cause, we firmly believe once people start to recognise the harm, logically society will naturally become averted to using circumcision in all but the strictly necessary circumstances.
We openly acknowledge that some situations call for a definite surgical intervention. Advanced BXO/Lichen Sclerosis can be a definite indicator, and delaying this can cause significant distress also.
That being said, it is rare that harm is discussed and there has never been a long term followup on patient satisfaction or complications. Some doctors have started to recognise the problems of circumcision.
Read here: “Bad Medicine” – The British Journal of Medicine.
Doctors Opposing Circumcision have been instrumental in promoting quality health information, and steer people away from unnecessary surgeries.
WHAT ABOUT A BAN ON INFANT CIRCUMCISION?
In Denmark, parliament is about to decide this year on a legal minimum age of 18 years old for genital operations that are not medically necessary. Danish society for anaesthesiology and intensive care medicine (DASAIM) recommends a legal minimum age of 18 Years for non-therapeutic genital surgeries. This is not a “ban”, rather a recognition of the importance of informed adult consent of the individual.
The official explanation of the DASAIM: Translated into English.
“Like the Danish medical association, we recommend delaying non medically indicated surgeries till 18 years of age, so that the patient is able to consent himself.
Circumcision is a surgery with the risk of complications from the surgery and the anaesthesia. Life-threatening complications have been observed in Denmark. These include circulatory collapse, seizures, severe hypoxia, and cardiac arrest.
Two children died in other Scandinavian countries from the consequences of circumcision. We don’t understand, how it can be acceptable, that this surgery can be performed by people without medical education and pediatric neurological/surgical knowledge.
The Danish society for anaesthesiology and intensive care medicine will not take any legal, moral or ethical responsibility for a guideline, which does not adequately correspond to our professional advice.”
Once we recognise the harm, if the correct medical practice was in place then there wouldn’t even need to be a ban. We would still prevent up to 86%* of circumcisions for phimosis. Avoiding harm, and trying less invasive alternatives should be the standard path of medical practice. Only specific situations call for circumcision.
This is how – Every. Other. Medical. Issue. Is. Treated.
We have records of men who have:
- lost their penis’s
- had irreversible tissue loss
- sensitivity loss
- gratuitous scarring
- disfigurement
- constant pain or irritation
- nerve damage, etc.
In addition, the lack of any form of consent causes serious trauma in some men. Some of these men take their own lives.
Here is what we wrote in correspondence when asked about a medical circumcision ban:
‘In the ideal scenario you should have had the following information given to you by the doctor:
–The risks and complications of the procedure. (sensitivity changes etc)
A lot can be explained here, but the bare minimum would be to acknowledge the sensitivity changes and the more extreme complications. Circumcision can significantly affect your sex life. Some men adjust. Some find it much harder to.
-Primary (less invasive) alternatives that can be used as a first resort.
This is in line with medical ethics legislation. The General Medical Council, for instance, claims that it is considered unethical to perform surgeries with complications if alternatives exist that are shown to be less invasive but effective.
–Accurate information on these alternatives.
You should have been told that you need to perform regular stretching techniques with the steroid creams provided. Many doctors recommend creams but do not tell patients they need to stretch the foreskin manually and frequently.
They do not warn them of “physiological phimosis” and that the foreskin is naturally fused to the glans (head of the penis) early in childhood until adolescence in some cases.
Damaging these adhesions by stretching or forcibly/painfully tearing them can actually make phimosis worse. This should absolutely be taught to all boys to prevent causing phimosis in the first place.
-If these do not work, then all the surgical options should be given.
For instance, there are other surgeries such as a preputioplasty which can occasionally help whilst still allowing the sensitivity, protection, and “piston mechanic” that is provided during intercourse by the foreskin. Other examples are the dorsal slit procedure to remove the tightness without any tissue loss.
The patient can then make an informed decision. In your situation, we absolutely support informed consent. If you decided that you wanted a circumcision as the phimosis was already causing you pain and discomfort then that is absolutely understandable.
Certainly, after a couple of years of trying alternatives, it would make sense to step up to a different solution other than stretching techniques and steroid creams. Every case is different though, so it also depends on whether the doctor noticed pathological phimosis or physiological.
Sometimes circumcision can be the correct course of treatment.
15 Square’s philosophy is that personal autonomy and informed decision making should not be ignored, and where complications arise, support should be provided to help with these medical issues.’
Interestingly, the BMA circumcision toolkit has the following quote:
“As with other therapeutic procedures, unnecessarily invasive procedures should not be used where alternative, less invasive techniques are equally effective and available. It is important that doctors keep up to date, and ensure that any decisions to undertake an invasive procedure are based on the best available evidence.
Therefore, to circumcise solely for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive (and there are no relevant social and cultural interests to take into account for that particular child*) would be unethical and inappropriate.”
*an interesting justification for ignoring the practice of good health.
To emphasise our thought process: if the issue is medical, (rather than aesthetic, which is a separate topic), then the same principle that is applied to any medical condition should be followed.
That is that there should be a process of trying less invasive methods first rather than the more drastic surgical option. This is true for adults as well as children. There is no need for 15 Square to seek a “ban”, as this is the process that all medical practice should follow.
Unfortunately, this is rarely the case. When it comes to true medical “consent”, the rule is that if the individual can comprehend and appreciate the nuances, then they can give consent. If they cannot, then a guardian must take that responsibility. They too should understand the procedure completely.
In short: We do not feel we even need to introduce a “ban”, only that there should be consistency in treating medical circumcision in the same way that any other medical issues are dealt with. The permanent nature of the procedure encourages caution when it comes to making final decisions.
That’s just good health practice.
Hi 15 Square,
a Saturday afternoon about 12.30 pm 10 years ago I was in an internet café in Ilford, east London when I happened to run into a Turkish woman speaking fluent English who was aged about 20 or 21 and very well dressed for what I assumed was some special occasion like an engagement, wedding, birthday or anniversary. She happened to mention that she was about to travel to north London to attend a “circumcision party” for her 8 year old nephew who was being circumcised that afternoon, an event that she described as a “wonderful celebration” involving her extended family and umpteen guests who were all looking forward to the “festivities” surrounding this “joyous traditional Turkish family occasion”. She also stated that the circumcision was essential for “turning [her] nephew into a Muslim”. I vividly recall being so transfixed with horror and disgust at what she was saying that I felt completely unable to speak or answer her.The feeling of horrified revulsion at that moment has never left me. All I remember thinking was how can I stop this happening to this boy while realizing that to stop such a time-honoured, deeply entrenched “family celebration” was absolutely impossible. I have since learned of the existence of a “Circumcision Palace” and a “Sultan of Circumcision” in Istanbul where this practice has occasioned regular merrymaking and festivities down through the centuries, although such “festivities” are also an important feature of the global Turkish diaspora as I found out. I also notice from YouTube videos of these very special “festivities” (none of which show the actual severing of the foreskin) that some Turkish parents are nevertheless favouring “hospital-based” circumcisions. However, the practice itself is clearly and incomprehensibly considered to be above criticism.