Forward I

After reading Rosemary Romberg’s carefully researched book, Circumcision, The Painful Dilemma, one wonders why there still exists such a diversity of opinion on the subject. Routine neonatal circumcision obviously is unnecessary and serves no sensible purpose. But in arriving at this seemingly logical conclusion, one discounts the all pervasive sexual opinions and emotions that reside in each one of us.

Males in particular, because of their convex genital makeup, visually confront, and probably assess, their penises many times. Each day the male awakens with an erection. The penis must be touched when washing, dressing, and directing the urinary stream. A man usually regards his penis as an extremely valued possession, and in its frequent perusal, cannot fail to associate with it emotions, reminiscences, and possible fantasies. These factors then enter into any evaluation of neonatal circumcision by physicians and laymen alike. To different people the act of circumcising carries varying weight and significance. To some it is a removal of a piece of skin of no relevance. To others it represents a covenant with God, or a rite of passage. To still others it is an irrational, cruel, desensitizing mutilation.

Coldly appraised, circumcision is clearly a surgical procedure involving a subtraction. The sensitive foreskin is lost. The delicate glans is forever exposed to toughening abrasive trauma. The mobility of the loose penile skin sheath, a function that greatly facilitates sexual dalliance, is destroyed. Logically, how does one legitimize a “routine” operation upon a normal structure? Normalcy in itself interdicts any interference. Consider the paradox of absurdities associated with neonatal circumcision. The patient does not give his consent. Anesthesia is rarely used. There are no legitimate surgical indications for the procedure. And the operation entails many risks and possible complications: death, psychic trauma, hemorrhage, infection, urethral damage, excessive skin removal, etc.

A poet-philosopher once wrote: “One sees what one knows.” This aptly applies to today’s prevailing sexual milieu in the United States regarding the prepuce. Most American women have never seen a foreskin, least of all a foreskin on an erect adult penis. They have no concept of its function or merit. Most American physicians are circumcised males, and of necessity expound their views on the merits of circumcision from a base of incomplete penile sensitivity.

How does one find fault with the beauty and perfection of the normal infant’s body? What quirk in our psyche causes us to focus upon the male prepuce as a mistake of creation, to be removed by our flawed judgment, believing that now the penis is improved and more acceptable?

Rosemary Romberg’s book is exceedingly timely. Each year in the United States, 1.3 million male infants are circumcised. Since the 1940s, when hospital deliveries became commonplace and circumcision became almost routine, well over fifty million males have been subjected to this worthless operative procedure.

Ms. Romberg is a dedicated childbirth educator who has been mesmerized by the beauty of birth. The infant is to be brought into this life with gentleness, and accepted with love. But into Ms. Romberg’s rational humane perusal of birth, a most serious incongruous event has appeared that offends her sensibilities- circumcision of the male infant, an act that brings pain. In her humanity and concern, Ms. Romberg has set about studying why this painful procedure is inflicted upon male infants. She has delved thoroughly and extensively into this subject of infant circumcision and has moved from a position of neutrality to one of dogged condemnation.

The author presents her material in a mildly judgmental way and arrives at an obvious conclusion: circumcision of infants is unnecessary. It is difficult to refute Ms. Romberg’s reasoned presentation. Any unbiased reader must agree with her.

This book should be read by all prospective parents, but especially by all physicians. Ms. Romberg’s advice and counsel would bring greater love and gentleness to all mothers and infants.

Clear heads, gentle hearts, and common sense eventually shall prevail. Rosemary Romberg’s scholarly treatise hopefully shall lead to the discontinuance of circumcision of newborn males.

 

THOMAS J. RITTER, M.D., F.A.C.S