The situation of couples at odds about whether to circumcise is becoming increasingly common. Years ago, few people in the U.S. were talking about circumcision and almost everyone was doing it. Today circumcision rates have plummeted. According to the Centers for Disease Control and Prevention, in 2010 the rate of hospital circumcision in the United States was just 55%. There is more media attention over the issue as people are becoming increasingly aware of circumcision's many harms. The 2011 film What to Expect When You’re Expecting took a humorous approach to one a couple’s disagreement over whether to circumcise. In real life, it’s never funny.
2. Try to hear what’s right about what your partner is saying. Don’t listen just to refute. You might find there are deep issues at work, such as who’s in control in the relationship, the desire for approval, and personal perceptions about what “looks better.” If you can identify and resolve underlying issues, it might be helpful.
People make a big fuss about how “awful” it would be to get circumcised as an adult. In fact, adult circumcision is considered a minor outpatient procedure. In addition to wanting the procedure and giving consent:
- An adult can provide information about pain level, so it can be adequately controlled during and after surgery. Pain relief in infants is far more complicated, dangerous, and is rarely given after surgery, if at all.
- Doctor and patient can discuss how much skin should be removed for the desired cosmetic and functional outcome. It's also easier to determine the amount of skin that should be removed on an adult, since one does not have to "guess" about penis size.
- In an adult, the post-surgical wound is not continually coming into contact with a urine and feces soaked diaper, which causes pain and increases the risk of infection.
4. Although brit milah has been practiced by Jews for thousands of years and is a very significant religious act, it’s being born to a Jewish mother that conveys lineage according to rabbinic law, not a man's circumcision status. There are also plenty of Jewish reasons not to circumcise. Jewish parents who feel circumcision is very important should think about why. If it’s about demonstrating a commitment to Judaism, this can be accomplished in many other ways, that may be much more significant. Synagogue affiliation and participation, sending the kids to Hebrew school, and celebrating Shabbat are all ways that Jewishness can be affirmed.
If you must circumcise, insist on anesthesia, be present during the operation, and comfort the baby immediately. Know who is doing the surgery beforehand and make sure they are experienced. Medical residents perform circumcisions as a right of passage, usually having only watched one. If a mohel is doing the procedure, insist on sterile conditions and make sure there is never direct oral to genital contact. You might want to think about asking for a “loose cut”—that is, make sure the circumciser leaves extra shaft skin to ensure adult erections are not tight and painful. This is a common problem with brit milah men don't often discuss. A loose cut removes the highly innervated ridged band, with its ability to close over the glans, but it’s still preferable to a tight circumcision. Some disagree with the logic of loose cuts, however.
Please note that according to Jewish law, the entire frenulum and foreskin must be obliterated and therefore a loose cut isn’t kosher. However many Jews circumcise in a hospital in the absence of religious ritual anyway, so this might not be a concern for you. With a loose cut, during healing, it is essential to retract any excess skin back behind the glans during diaper changes and apply Vaseline each time so no adhesions or skin bridges form. This should be done for several months, longer than is routinely advised, as the extra skin wants to reattach itself to the glans.