Contrary to popular myth, the penis or foreskin is not "dirty," and smegma is not carcinogenic. The immunological functions of the foreskin and the self-cleansing functions of the penis actually protect the body from harm. No extra care is needed for an intact infant or young boy. Hygienic care of the normal intact penis is perfectly simple. One washes it as one washes any other part of the body. The prepuce is a normal structure with a definite function. Like a shoe, or glove, it protects the underlying structure—in this case the glans—from the environment. It should never be forcibly retracted, and the first person to retract it should be the boy himself.

The myth that circumcision protects babies from urinary tract infections—which are a relatively rare and minor problem—evaporates with the realization that none of the studies showing higher urinary infection rates controlled for the all-to-common forcible retraction, which sets the scene for infection.

Another myth is that circumcision prevents premature ejaculation (which continues to be a common sexual complaint of American men—most of whom are circumcised)—it likely causes it. Preventing penile and cervical cancer are also not any more valid reasons for infant circumcision than removing infant's breastbuds to prevent breast cancer. More American men contract and die from breast cancer than penile cancer. The incidence of cancer of the penis in Europe, where circumcision is rare, is no higher than in the US. Penile cancer in the US is so rare that the government finds it unnecessary to keep statistics on it. Also, cigarette smoking contributes more to penile, prostate, and breast cancer in males, and "blame" should more aptly be placed there.

One unique argument for circumcision—now rejected in all English-speaking countries except the US—is the notion circumcision has prophylactic value, that it"prevents" certain problems from developing. As a surgery, the concept is a bizarre one, now applied solely to the genitals. No other body part is subject to"routine" removal as a"preventive" measure, especially when measured against the pain and risks of surgery. —Marilyn Milos, RN

While the intact penis may be slightly more likely to spread sexually transmitted diseases, including AIDS, the fact remains that the US has one of the world's highest AIDS rates as well as the most circumcised sexually active males. It is not the foreskin that causes these diseases, and circumcision will not prevent them.

There are no medical reasons for performing "routine" newborn circumcision and the risks and disadvantages far outweigh any possible protective benefits. Anyone who says otherwise is misinformed about relative risk. While the principles of medical ethics require that babies be protected from pain and trauma, laboratory animals are provided greater protection from painful experiences than are infants.

Any doctor who performs a circumcision is violating a major tenet of medical practice: "First, do no harm," and all seven principles of the AMA code of ethics.

Aside from medical customs, religious, cultural, and social pressures also perpetuate circumcision. Doctors performing circumcision today usually remove far more tissue from the penis than was removed during biblical times, when only the tip of the foreskin was cut. Today the foreskin is removed at the base of the glans, causing far more lasting damage.

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