As parents of four adopted sons, one circumcised and three with intact foreskins, one of the primary reasons that we believe children's penises should be left as nature created them is that it makes for a happier, healthier child. The foreskin that is treated appropriately (that is, left undisturbed) provides comfort and protection. There is no need to clean under a baby's foreskin because there is no way for the area to become contaminated. Attempts at cleaning under it are usually what causes any problems that do exist. Even after the foreskin has become retractile, nothing needs to be done unless the boy is retracting it himself, which may introduce external bacteria to the area from dirty little hands. When cleaning is undertaken, all that is either required, or prudent, is rinsing with clean water as part of regular bathing. Soap or scrubbing can easily irritate the delicate mucosa and such irritation may be mistaken for infection. If a local infection does occur, rinsing and applying antibiotic ointment will correct the problem. Serious or recurrent infections or irritations are not normal and usually caused by inappropriate treatment, such as overzealous parents wiping under the foreskin with a contaminated washcloth, or exposing the mucosa to the perfumes and other chemicals found in commercial baby wipes. The physician who sees a child with such a problem should seek to determine the source of the problem and correct it, NOT cut off the foreskin!

None of the proposed "preventions" that are currently given justifies the practice of routine neonatal circumcision. This is essentially the position of medical groups in Australia and Canada, the only two other countries where non-religious circumcision has been practiced to a significant degree in recent years.

In comparison with other industrialized nations, the United States, which has the highest circumcision rate, has similar rates of penile cancer and HIGHER rates of cervical cancer and most sexually transmitted diseases, including Auto Immune Deficiency (AIDS).

Urinary tract infection studies suggesting that circumcision lowers the risk have been challenged at many levels. Even those most commonly used to justify neonatal circumcision show that the vast majority of infant males never experience an episode of UTI.

Lastly, Americans have been cutting off and discarding a piece of tissue which is anatomically very unique and beneficial. Recent anatomical studies have shown this.

We would like to challenge all American physicians to put down their scalpels, educate themselves about this issue, and start giving the normal genitalia of infant males the same respect that they give the normal genitalia of infant females.

Stephen E. Starr, M.D. and Darillyn Starr

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