Time to take the Cut! (Getting ready for circumcision myths and facts)

Time to take the Cut! (Getting ready for circumcision myths and facts)

By: Enrico Macaraig Claro

As the saying goes “this is what separates the men from the boys!”  Circumcision in the Philippines is more than just a clinical process or traditional custom to boys, but also a “Rite of Passage” to manhood.  The moment is usually when summer time approaches, that is the time when adolescent boys prepare themselves to be circumcised.

Circumcision or “Pagtuli” as it is known in the local language is the surgical removal of some or all of the foreskin (prepuce) from the penis. The word "circumcision" comes from Latin circum (meaning "around") and cædere (meaning "to cut").

Wikipilipinas explains Pukpok as a crude method of circumcision practised in the Philippines. It is performed mostly in barrios (rural villages) by a local surgeon called manunuli. On the Holy Saturday of the Lenten Season, groups of uncircumcised boys traditionally go to the manunuli to take the rites of passage. After bathing in a river or a lake, the boys are asked to chew guava leaves. They are then asked to sit on a lukaw, a wooden tool with pointed ends carved from a branch of guava tree. While the boy is seated, one end of the lukaw is staked on the ground while his penis is set on the other end. 

A manunulithen uses a labaha (barber's blade) to cut the foreskin off of the penis. The manunuli then instructs the boy to spit the chewed guava leaves directly on the wound to aid healing and to prevent infection. After the operation, a piece of cloth is wrapped around the wound to be changed daily. Although the traditional or pukpok type of circumcision has been chiefly replaced by the modern surgical method, some areas in the provinces still practice the old method. http://en.wikipilipinas.org

Being a parent (and a lot more pressure on the Dad), support should always be readily available at this important stage in your son’s life. Being ready to answer the why, what, when, where and how questions are of utmost importance.  Giving the real truth amidst the myths should clear our little man’s thinking of circumcision. Here are some myths that should be busted:

1.         Myth: “Having their children circumcised could make them taller or bigger”

Fact: What could a piece of skin in the penis do to stimulate growth? The truth of the matter is, no matter how long the prepuce is cut you will not be a six foot nine behemoth if your father and mother are short. This is because most circumcision is done at the age when boys grow in spurts; fast growth would be attributed to the circumcision.

2.         Myth: "Circumcision improves hygiene."

Fact: Circumcision was once believed to improve male hygiene, but latest medical information shows this is not true. Circumcision does not make the penis any cleaner or healthier. Normal bathing and healthy hygiene are advised for all men, circumcised or not. http://www.nocircmn.org

3.         Myth: "Almost all men are circumcised."

Fact: The vast majority of men are intact (not circumcised). About 85% of men in the world are not circumcised, because America is the only country in the world that routinely circumcised for non-religious reasons. In places like Canada and Europe, circumcision is very rare (approximately 5% or less). In the US, circumcision rates were very high (90%) during the 1970s, but since then, circumcision rates have been decreasing. http://www.nocircmn.org

4.         Myth: "Babies don't feel pain during circumcision."

Fact: Babies feel extreme pain during circumcision, according to studies referenced by the American Medical Association and others like this one referenced on CNN: Circumcision study halted due to trauma. In fact, some doctors have used circumcision as the definition of the most severe pain a baby can feel. Studies show that circumcision is intensely painful, and other studies show that babies are very sensitive to pain. Lastly, in 1999, the American Academy of Pediatrics (AAP) strenuously recommended that pain relief be administered during circumcision. http://www.nocircmn.org

5.         Myth: "Circumcision is a religious right."

Fact: The religious beliefs of the parents are not necessarily the same as the beliefs of the child once he becomes an adult. Parents should always keep in mind that their baby boy will one day be a grown man, with his own faith and spiritual beliefs. http://www.nocircmn.org

6.         Myth:  “Infant circumcision is ordered by a doctor.”

Fact:  Infant circumcision is a non-therapeutic, cosmetic surgery; therefore, it is not ordered by a doctor to treat a medical condition.  It is done by parental request or consent for religious or cultural reasons, not medical reasons.  http://www.nocircmn.org

7.         Myth:  The claim that the intact penis is "dirty" is highly offensive to intact men.

Fact:  It is not the penis that is dirty. It is the smegma (a pasty substance that is made up of shed skin cells, skin oils, and a relatively small amount of bacteria that accumulates at the neck of the glans penis).

Generally there are two styles of circumcision practiced here in the Philippines: the dorsal slit and the German cut. The dorsal slit is just a simple cut on the prepuce, while the German cut is a cut made around the prepuce area that will result in a longer bleeding period but a cleaner cut is produced with lesser foreskin.

You could be asking when is the best age and time to undergo circumcision? Usual practice indicates that it can be administered to boys at any age or at any time, but preferably 7 years old and above, during the summer when kids have more free time out of school. It’s also an option if the parents want it at birth.  The difference lies only in the anesthesia, for babies or infants, general anesthesia will be given. For 7-year-olds, a local anesthesia will be used. The recovery period is usually about a week.

Ultimately, here in the Philippines peer pressure and teen influence to conform to our norms are very high compared to the rest of the world.  The worldwide ratio is 80 to 20 uncut versus circumcised which is the reversed here in our local setting.  All that needs to be done as a parent is emotional preparation, information and support for our growing son to achieve a smooth transition to adulthood.