Monday, April 29, 2013

Margaret's Story-Circumcision and the Adopted Child

Shortly after we adopted our barely 4 year old son from an Eastern European country, we took him to a local pediatrician for an routine examination. He had no medical needs at that time, but we wanted to get familiar with the doctor. Our new son had already been examined by the international adoption clinic at a major hospital, so we knew his medical needs were met.

The doctor examined our son quickly and asked us if we'd thought about circumcision. Yes, I told him, and we were not interested. The doctor quickly explained the reasons for why we might want to have it done, including "increased risk of infections". "We haven't dealt with infections yet, and if they become a problem, perhaps we'll consider it", I told him. Then he told me that "it would be best done before kindergarten" and when I dismissed that as well, he quickly gave me a patronizing nod before leaving the room.

I had not even researched circumcision that that point. I knew that most of Europe no longer practices routine infant circumcision, including my child's native country, and that was enough for me. It did not seem like a fair choice for me to make for my child at 4 years old. A child I barely knew at that point. I was shocked that our doctor would advise an unneccesary cosmetic procedure on a young child, who had recently been through the trauma of international adoption. He barely spoke any English at this point, and our doctor was advocating that he go under anesthesia to be surgically altered. I will absolutely seek necessary medical care for my child, but I do not believe it is my business to make cosmetic decisions about his penis.

My son is now 6 years old. We now have 2 intact adopted sons and have never had a single infection or problem with either of their genitals. Now that I know more about circumcision, I am very glad I followed my gut and completely ignored the doctor's advice.

Monday, April 15, 2013

Dangers of circumcision

Circumcision is often lauded as no big deal.

I have strong, strong feelings about the subject of risks and side affects of circumcision surgery.

When I signed for my sons to be circumcised, a piece of paper was shoved under my nose (once weeks before delivery, when I didn't even know I was having a boy, and once while in heavy labor), and the blank where I was to sign was pointed at.  No one explained the procedure to me, or went over the risks.  No one encouraged me to read the statement. No one told me that it was not necessary (that is, until I decided not to do it).

This makes me so, so angry.  With most other procedures, and medications, we are told about all the possible risks.  A doctor should have taken the time to come in and discuss this with me.  With many other procedures that my children have had, someone has explained what was happening, the pros and cons, the risks, and made sure we were fully informed.  That was not the case for me when we circumcised our sons.

Now, let me be clear. I should have researched it. I should have read every word.  I should have considered every possible risk.  I take responsibility for the fact that I allowed a surgery, with risk, to be performed on my sons without really thinking or studying for myself because I just was going with the perceived cultural "norm", and did not even take time to consider or study the matter for myself.  However, I DO believe that medical personnel, as the ones who are performing the surgery, have an ethical duty and obligation to explain procedures and all the risks involved.  That was not done, and that grieves me.

(If you are unfamiliar with the picture to the right, this is the restraint that newborn babies are placed in while their circumcision surgery is performed, and then strapped down, awake, oftentimes with no anesthesia)

There are many possible side effects and problems that can occur as a result of this surgery.  I know many will say that there are side effects or risks of many things, and that is true.  However, the fact that circumcision is not NECESSARY means that these risks are being taken for no reason, other than a cosmetic one.  Is it really worth it? Had I known the risks that I was placing on my newborn, helpless sons, I would NOT have felt it worth it, for a cosmetic procedure.

The first, and most disturbing risk is death. In the United States, over 100 baby boys die each year from side effects of their circumcision surgery. Hospital reported deaths due to circumcision are 174, for the latest reported year.  The estimated actual number is higher than that. (2)  To put this in perspective, over the span of a decade, around 30 children died in drop side cribs, and those have been BANNED in the United States.  (1) It only takes 1 ounce of blood loss for a baby to begin to hemorrhage. ONE. OUNCE. Anytime a baby is subjected to a surgery, death is a definite risk.  (2)

Healthy Newborn Dies Post Circumcision

I will include at the end here a comprehensive, suggested informed consent form.  First, I'd like to give examples of some less extensive consent forms, and highlight some of the risks.

From a consent form from a Virginia practice:(3)
 "These risks, which can be serious, include bleeding, infection, and damage to nearby tissues, vessels, nerves, or organs. They may result in paralysis, cardiac arrest, brain damage, and/or death. Other risks for this procedure may include:bleeding, infection, possible deformity, or need for further surgery"

From a consent form from Brisbane: (4)
"I understand that circumcision for an infant is not a medical procedure. Except for extreme abnormalities, there is no medical reason for circumcision".

A Florida practice (5):
"Risks Discussed: Potential for bleeding, infection, malformation, need for re-circumcision.... The chance of failure, and the risks of unplanned injuries to organs, nerves or blood vessels, to include inadvertent puncture, laceration, a tearing of other internal organs and consequent hemorrhage and need for additional surgery to repair."

 To outline some of the other side effects in detail, I will quote below from Dr. R.S. Van Howe, M.D.  It is his belief that if circumcision is going to be offered to parents, than a full informed consent form should be offered and explained, in order that parents have full and complete understanding of what they are doing.  This should be the absolute MINIMUM of ethical care in the United States-that we have full informed consent of the procedures we are choosing for ourselves or our children.  The consent form is very long.  I will quote part, and include the link to the remainder.(6)

In closing, This simply should not be happening.  Thankfully, the worldwide circumcision rate is low-80% of men worldwide are intact.  The circumcision rate is falling in the United States as well.  Over 50% of boys born now are left intact.  That is a GOOD THING, and I am so thankful.  But it is still too many. One baby dying, or losing the function of his body, for an unnecessary surgery is too many.

From an Informed Consent for Circumcision form, by R.S. Van Howe, M.D.

"Male circumcision is a surgical procedure where 25%-50% of the skin of the penis is removed.  It is important that you understand the well-established known risks of the surgical procedure as well as the possible, but unproven benefits.

The following risks are iatrogenic (doctor caused) and result directly from neonatal circumcision surgery.  Significant complications from neonatal circumcision surgery range from 2%-10%

1. Hemorrhage (bleeding): Serious hemorrhage occurs in about 2% of infants, resulting in shock and sometimes death. While death is a rare complication of circumcision, it does occur......

2. Infections: Localized or systemic infections include bacteremia, spticemia, meningitis, osteomyelitis, lung abscess, diphtheria, tuberculosis, scalded skin syndrome, gangrene of the penis and scrotum, scrotal abscess, impetigo, necrotizing fascitis of the abdominal wall, tetanus, and necrosis of the perineum.  A realistic infection rate is as high as 10%. Serious infections can cause irreparable and lifelong harm.

3. Urinary Retnetion: ....can cause the infant to retain urine, leading, at times, to acute obstructive uropathy when the bladder distends to the point of rupture

4. Laceration of penile skin....

5. Excessive penile skin loss: ...penile bowing and pain occurs at the time of erection.  Pubic hair can be pulled forward onto the penile shaft, and bleeding during sex can occur from shaft skin tears.  Skin grafts are sometimes required.

6. Beveling deformities of the glans...: Varying amounts of the glans are shaved times the entire glans may be amputated.

7. Hypospadias: ....when the frenular area is drawn too far forward, the crushing bell may injure the urethra at the time the foreskin is removed, resulting in a urethral opening on the underside of the shaft.

8. Epispadias: When one limb of the clamp inadvertently is passed into the urethra and is closed, it may crush the upper portion of the urethra and glans, creating a urethral opening on the dorsum (top) of the glans.

9. Retention of the Plastibell ring: The Plastibell may become buried under the skin causing ulceration...Loss of the glans has been reported.

10. Chordee (permanent bowing of the penis)....

11. Keloid formation: Prominent scars can occur where the skin-mucous membrane has been incised...

12. Lymphedema: Chronic swelling of the glans due to infection or surgical trauma

13. Concealed penis: The circumcised penis becomes hidden in the fat pad of the pubic area, requiring surgery to bring the penis out again.

14. Skin bridges and penile adhesions: A common complication consisting of one or more thick areas of scar tissue. These can be quite painful during erection."

15. Phimosis of remaining foreskin: When only a segment of the foreskin is removed, the remaining tip sometimes becomes tight and non-retractable, requiring a second surgery.

16. Preputial cysts: Cysts caused by infection or mechanical distortion blocking the sebaceous glands.

17.Skin tags: Can occur at the circumcision line, representing an uneven removal of skin. 

18.Loss of part or all of the penis: This can be caused by constricting rings, such as the Plastibell, or by use of an electrocautery device. More frequently, the loss is the result of infection, with the penis becoming increasingly necrotic (dead tissue) until finally the entire organ falls off. The proposed solution in many cases is to raise the child as a girl.

19. Meatitis: Inflammation of the urethral opening from the loss of protective foreskin, which can lead to ulceration and meatal stenosis (narrowing). Many infants and children suffer this after their loss of protective foreskin.

20. Meatal ulceration: Caused by meatitis and/or abrasions from dry diapers and from diapers soiled with urine and feces. Meatal ulceration does not occur in the intact male and occurs in up to 50% of circumcised infants.

21. Meatal stenosis: In advanced meatal ulceration, scar tissue can constrict the urethral opening causing urinary obstruction. Meatal stenosis is usually not apparent for several years, occurring in about one-third of all circumcised infants and not at all in intact males.

22. Progressive loss of glans sensitivity: This is the most common complaint of adult circumcised men, whereby some men report stimulated needed to the point of pain to achieve orgasm. 

23.Sexual dysfunction: Includes impotence and premature ejaculation. 

24. Nonspecific urethritis: This venereal disease is more common in circumcised adults.

25. Gastric rupture: Has been reported associated with prolonged crying during circumcision.

26. Glans necrosis: The head of the penis can lose its blood supply and begin to rot from the scarring that follows circumcision.

27. Tachycardia, heart failure and myocardial injury: Have been reported associated with the procedure.

28. Death: Occurs at a rate of 1 in 5,000.
(end quote)


Thursday, April 11, 2013

Kelly's Story: I Changed My Mind

Kelly is the mom of three sons, one circumcised, and two intact.  I so appreciate her being willing to share her story here.

 Circumcision: I Changed My Mind
by Kelly McLane

When I was preparing for the birth of my first child, there was only one thing I knew I did not want - an episiotomy. I wanted to try to give birth without drugs but I was open to an epidural if needed. I wanted to try laboring in water. I wanted to try breastfeeding but wasn't sure if it would work for me. So when it came time to push and I heard my midwife say, "Let's try a couple more pushes and then we might have to CUT..." I gathered up every bit of strength I had and pushed my baby out even though I couldn't feel anything because I had an epidural. I knew I did NOT want her to cut me down there. It seems ironic now that shortly after birth, I handed my baby boy over to be circumcised.

Before I get started, I want to emphasize that I am not writing this with the intent of making any parent feel bad or guilty about their decision to circumcise a son - what's done is done. I have friends and family that chose circumcision and I do not judge their decision, we all do the best we can with the information we have at the time. I am a very proud mama of three amazing boys - my first son was circumcised but the next two boys were not. I am sharing my story with compassion and hope for all the baby boys not yet born, that maybe by sharing my story, I can save *just one* baby from the unnecessary pain and harm of this procedure. I recognize that this is a very controversial, extremely sensitive, and culturally taboo subject but I have learned that, for most people, the more a person knows about circumcision, the more they are against it and I will always wish that I had been better informed before I had my first baby boy.

I was raised Catholic in North Dakota with two sisters and no brothers. I do not remember ever seeing my father naked so I honestly do not know whether he was circumcised or not. I would guess yes because he was born in the 50s when many baby boys were circumcised, often without consent from their parents. The topic of circumcision never came up in my family. To tell you the truth, I naively assumed a circumcised penis was the way boys were born. With that assumption I can't say for certain if any of my sexual partners were circumcised or not because up until I found out I was pregnant with a baby boy I really had no clue about normal male anatomy.

In 2004 I was pregnant, and we found out our baby was a BOY! The decision to circumcise or not came up right away. I did all the research and came to the conclusion that I did not want to circumcise our son. I believe at that time I likely found out more than the average U.S. parent discovers. I learned that circumcision is painful, harmful, and medically unnecessary. I learned that no medical organization in the world recommends routine infant circumcision, not even the American Academy of Pediatrics. I learned what the procedure entails and I watched a video and had to mute the sound, no way did I want my baby to go through that. I shared what I had learned with my husband hoping he would agree with me.

Unfortunately, he did not. It wasn't even a decision for him, it was going to be done no matter what I said. We argued. I shared the information with him, I showed him the video, but his mind was already made up. It was closed actually. For him, it was a simple procedure that newborn boys went through, much like cutting the umbilical cord. Until then, he had not given much thought to being circumcised as a baby, but felt that he was just fine the way he was, so his son would be too. In the end, I foolishly gave in. I didn't protect my baby even though my maternal instinct screamed to do so. I let my husband choose circumcision for our son because he has a circumcised penis and I don't.

However, I had to justify this decision in some way - I couldn't just let it happen knowing what I knew. I didn't care about percentages, I've never really been one to do what everybody else was doing. And at that time the circumcision rate in the U.S. was about 50% - so half were keeping their sons intact, and half weren't. Even though some people claim a circumcised penis "looks better" that didn't make sense to me. How could I possibly think my baby's body was ugly or defective?! I am not a religious person and even though my husband is Jewish we do not practice Judaism so there was no religious reason. So I grabbed onto the one study that claimed circumcised babies have a slightly lower chance of urinary tract infections. My husband has a kidney disease that has a 50% chance of being passed down. Bingo. We circumcised our baby because IF he has this kidney disease, then we should do whatever we can to reduce the chance of a urinary tract infection which could potentially harm the kidneys. That was my reason, my excuse. I insisted that if we were going to circumcise our baby, my husband had to go with him. I did not want him to go through it alone. I was really hoping that this would change his mind, but nope, still just a simple procedure in his eyes. Going with our son actually turned out to be a blessing in disguise later on...

Our perfect and healthy little baby boy was born into this world on April 21st. For some reason, the pediatrician we had chosen wasn't called while I was in labor, so she didn't show up at the hospital until the next day as we were checking out. "What about the circumcision?" my husband asked. "Oh, we'll do it in the office next week," she said, "Call and make an appointment."  I said I was worried about the procedure and she blew me off saying it's no big deal - that I shouldn't worry about it. She also said she was "pro-circ and thinks it should be done." We scheduled the appointment for April 30th. Even though I wish so many times that during that week I had changed my mind, put my foot down, and protected his tiny perfect body, I didn't. The decision had already been made.

So we took him in. My husband went back with him. It seemed to take forever and a nurse came out at one point. She was laughing the whole thing off and mentioned that I looked "terrified." "Yes, I AM terrified!" I thought, "You people are back there forcefully separating, cutting, and removing a part of my baby's body and it is taking for-freakin-ever!"

They finally brought him out and the doctor informed me that my baby needed a couple stitches, no big deal. I wanted to throw up. My tiny little baby, his perfectly normal body, had stitches in his penis. How could I have let this happen and for what reason?! I really, honestly, don't think I will ever forgive myself for letting this happen to him. I knew better. But it did happen and I couldn't change that and so for weeks afterward at every diaper change I fought back tears and apologized to my baby as I gently pulled back and detached the remaining skin that was obviously trying to heal itself and re-cover the glans that, by nature, is designed to be covered.

In 2005 I became pregnant again and we didn't find out the sex this time. The babies would be 16 months apart. At first, my husband was very adamant that if baby #2 was a boy, he would also be circumcised. "They have to match, they have to be the same," he said. I prayed to the universe for a girl, even though I had a good feeling it was another boy. This time though, I was NOT going to give in. Two wrongs do not make a right. Maya Angelou said "When you know better, you do better," and even though I knew in my heart the first time, I wasn't going to make the same mistake twice. I wasn't going to let another baby of mine get stitches in his penis for no reason. I also learned more about the foreskin and what is lost when it is removed and how important and valuable this part of the male genitals is during infancy, childhood, and throughout a man's life. So I told my husband that if he really wanted it done, he would need to call the doctor, make the appointment, and take him in to have it done. Knowing his inability to do these sorts of things (ha!), I felt relieved inside.

Thankfully, throughout the pregnancy, and as my husband slowly processed his own experience with our first son's circumcision, he was able to see circumcision from a different perspective. I made him tell me what had happened during our son's surgery, even though I didn't want to know. I had to know. We both ended up in tears.

I continued to share facts and information, but this time, we didn't argue about it, it was kind of a non-issue because we didn't know if we were having a boy or girl. Believe it or not, what really sealed the deal for him was watching a Penn and Teller episode on circumcision. What really stood out for him was the historical reason Americans started practicing non-religious genital cutting in the first place. If you don't know, you should definitely find out before making this decision, because it really is bull. [Hint: Google Kellogg and Graham.]

Our second baby, another boy, was born peacefully and naturally at home in the tub. No appointment was made and he was left whole just as nature intended.  I remember asking my husband, "What about circumcision?" He said after having an amazing homebirth, he saw no reason to take our healthy and perfectly normal baby to the doctor to have a part of his body cut off. I will admit, I was a little nervous about taking care of an intact baby because I had zero experience with normal male genitals. But as it turns out, it is MUCH easier than taking care of a circumcised baby. I currently have 10+ years of mothering two intact sons (baby #3 was born in 2007 - another boy!) and ZERO urinary tract infections. One time, son #2 was playing outside naked and got poked in the penis by a really nasty weed in the yard. His foreskin swelled up and it was a little scary but his foreskin did its job and protected the very sensitive glans (head) of the penis. If his foreskin had not been there, the glans most likely would have swelled up and prevented him from peeing normally. Hooray for nature and a normal body!

So, this is my story. I've experienced both sides of this parenting coin. The heartache and guilt I've felt following my son's circumcision led me to be a voice for baby boys who cannot say NO for themselves. I firmly believe ALL human beings, girls and boys, have a right to their normal, intact genitals. Should an adult man or woman choose circumcision for themselves, as an informed, consenting person - fine by me. But routine infant circumcision is not a compassionate thing to do to a little newborn baby - it hurts, it harms, and there is no good reason to do it. The foreskin is a very important part of penis! It's his body, it's his penis, and it should be his choice whether or not he wants his full penis - foreskin and all.

A shocking number of doctors in this country have very little knowledge of normal male anatomy. They do not understand the value and functions of the foreskin, they are only taught to amputate it. Our doctor did not give us accurate information, she was completely biased, and we did not give informed consent as we should have been able to do. Let's make sure our physicians receive feedback, and are encouraged to look into this subject more themselves - for the sake of their future patients.

I do not blame the doctor in our case, she only did what she knew. Nor do I blame my husband as he is a victim of circumcision himself. I can only blame myself for not listening to my mama instinct. And I blame our culture for desensitizing us to male genital cutting and allowing it to continue for so long when other English speaking nations abandoned the practice long ago, or never even started cutting babies to begin with.

The good news is we are well on our way to becoming a non-cutting country, like the majority of civilized nations around the world. The infant circumcision rate in the U.S. has dropped to under 35% in recent years, and will only go down from here as more parents learn the truth.

In the future, I will be honest with my circumcised son about what happened to him and make sure that no future grandsons of mine are cut. My husband and I are proud that we protected our 2nd and 3rd sons' autonomy and genital integrity, and once and for all ended the cycle of genital cutting in our family.

Kelly originally shared her story here:
Re-shared with edits with permission

Thursday, April 4, 2013

I don't Know Why I was Circumcised: Chad J's Story

Chad is a friend, and a father of several.  Thank you Chad for sharing your story! (*Note-the first link provides an side view anatomy drawing as seen in a text book.)

"I don't know why I was circumcised. I have never asked my parents. I was their first child and I don't know if they thought about the matter or if they made a spur of the moment decision. Since they never mentioned it to me I tend to think it was the latter.

Truthfully I never thought about it until we were going to have our first son. The thought surprised me because until then I didn't even know what a foreskin was except that it had been removed from me. I thought of it like an appendix--an unneeded, unwanted flap of skin that served no purpose. I was wrong.

I don't remember who told us to think about circumcision before we had our son. If our first child had been a boy I doubt we would have thought about it until after the doctor had routinely performed the procedure. I remember my wife saying, 'hey, I don't think we should circumcise.' I remember saying, 'Ummm why? It's not like he needs a foreskin right?...' and then thinking, 'Wait what does an uncircumcised penis even look like?' I felt embarrassed that I didn't know the answer to that question. Obviously I had never seen my own foreskin, but shouldn't I have seen a diagram or picture in some anatomy or sex education class in grade school? I remember sitting through those uncomfortable class periods with diagrams of a penis that everyone was pretending not to look at. The fact is that circumcision was and is such a ubiquitous surgery that none of the authors of our class materials felt that it was worth showing a foreskin. I can only imagine how this made the uncircumcised boys in my school feel (assuming there were any, as of course I would not know). I don't know how this has changed over the years, or how it varies in different parts of the US but I'm fairly certain that class materials outside the US all show intact men.

So I started looking into it with my wife. The more I read about it the more I realized that I kind of WANTED a foreskin. I couldn't think of a good reason to cut it off of our son so I looked for one. I mean, my parents had decided to have mine removed so there must be a good reason, right?

I'm not going to go over the reasons that people use to rationalize this amputation because it has been done before. As I continued researching I found myself really trying to find a way that I could get my foreskin back! But no, I cannot. Perhaps there are uncircumcised adults who wish they could remove their foreskin (I cannot fathom this). Guess what? They can, and under general anesthesia if desired! When it is desired, circumcision is available for adults just like any other cosmetic surgery.

For me the main thing I needed to know was that my son didn't NEED a circumcision. True, he may not NEED a foreskin either (although circumcisions can have major problems!) but who was I to decide that he shouldn't have one? Is there any other part of his body that I could legally remove? Removing the entire foreskin is a dramatic surgery, not a simple nick of the scalpel. It irrevocably changes the size and shape of your penis.

I wish I could say these things to all parents before their children are born. I wish it would be enough to make them take the time to research the issue and make the right decision. I wish that doctors would read this, think critically, and realize that largely they are the ones with the power over this issue. After all they hold the knives! It would be enough to reverse the trend if doctors would offer to perform circumcisions only when requested, instead of assuming that parents will want it."

Tuesday, April 2, 2013

Assumed Medical Benefits of Circumcision

As I stated I would, I have taken some time to gather some information for you regarding the supposed "health benefits" of routine infant circumcision.  

One thing to consider, is that there can be some benefits to something, but an important factor to consider is this: do the reported or hoped for benefits justify the risks. In another post, I will outline the risks.  First and foremost to consider is death.  Over 100 baby boys die each year from complications of their unnecessary circumcision surgery.  This is more baby boys in the initial 6 week newborn period than die from SIDS.  

The  American Academy of Pediatrics admits that “Existing scientific evidence demonstrates potential benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision”

One helpful informational source that outlines a number of these issues is a presentation by Ryan McCallister, PhD, a research professor in the areas of oncology and Physics at Georgetown University.  

The entire presentation is available for viewing here: 

As a warning, there are some slides on this educational presentation (given in a college seminar class) that include medical pictures of the male genitalia. A video of an infant circumcision is also shown. The professor gives warning before any of these slides, so that viewers may choose to turn their heads if desired.

The following are the most used "medical reasons" that parents believe are prevented by circumcision.

1. Urinary Tract Infection

This is from the American Academy of Family Physicians regarding Urinary Tract Infections in Children (2011): (1)

"Acute UTIs are relatively common in children. By seven years of age, 8 percent of girls and 2 percent of boys will have at least one episode."

"Routine circumcision in boys does not reduce the risk of UTI enough to justify the risk of surgical complications"

"Boys are at increased risk of UTI if younger than six months, or if younger than 12 months and uncircumcised. Girls are generally at an increased risk of UTI, particularly if younger than one year." 

The above quote is of note, as it shows that  

A boy being left intact is only at increased risk of UTI (over the circumcised boy) from the ages of 6 months to 1 year. Otherwise, the risks of developing a UTI are the same for a circumcised or intact boy.

Yes, UTI's do happen in children. However, for girls, the treatment is antibiotics, not the removal of body parts. The removal of the female labia could actually reduce the number of UTI's in women and girls.  UTI's occur because of bacteria being introduced to the genitals.  Typically, the bacteria is from the rectal area.  Removal of the labia would reduce the risks of UTI's, as the labia can catch and hold bacteria.  Obviously, this would be an over the top (and illegal) way to prevent a relatively minor health concern.

For males, a UTI, in an intact boy, or a circumcised boy, antibiotics are completely appropriate treatment.  Surgery for a UTI, or for the prevention of a UTI is not necessary. 

A study done in the UK in 2005, states the following: (2) 

"Singh-Grewal et al concluded that 111 circumcisions would be required to prevent one UTI,... It is doubtful that a cost–benefit analysis could ever justify routine circumcision under those circumstances."

2. Cervical Cancer:
A position statement by the National Organizations of Circumcision Information and Resource Centers, and Doctors Opposing Circumcision clearly and thoroughly outlines the history, studies, flaws with studies, new findings, updated information regarding HPV and cervical cancer, and health measures to treat and prevent cervical cancer. The statement is highly referenced, and cross referenced. (3)

To quote the study, Male Circumcision and Cervical Cancer (2010):

"Male circumcision does not insure protection from HPV infection. The possible reduction in risk is slight at best. Along with education, and the introduction of HPV testing, the best hope of bringing cervical cancer under control may be introduction of a vaccine.  HPV vaccine is now in stage 3 trials" *note, the vaccine is now available and part of the CDC recommended vaccines for all children*

Cervical Cancer is most often caused by HPV, which is a sexually transmitted disease. The Center for Disease Control provides information about HPV, cervical cancer, and the vaccine (4)

From that information, it is notable that more than half of sexually active men and women are infected with HPV at some time in their life.  This is with the fact that currently, the majority of adult American men are circumcised.  Circumcision is NOT preventing HPV or cervical cancer. The CDC materials promoting the Gardasil vaccine do NOT mention circumcision as a preventative for HPV or cervical cancer.

Also noted, is that  "Condoms may lower the risk of HPV infection....But HPV can infect areas that are not covered by a condom-so condoms may not fully protect against HPV. People can also lower the risk of HPV by being in a faithful relationship with one partner; limiting their number of sex partners and being with a partner who has no or few prior sex partners".  If HPV can be caught from areas not covered by a condom, this eliminates the foreskin as the biggest problem, as it would be covered by a condom.
 The best prevention for sexually transmitted disease is to minimize sexual partners, and to use protection with sexual partners.  Even a circumcised man can and does spread sexually transmitted disease, and the United States, while having one of the highest circumcision rates also has one of the highest Sexually Transmitted Disease rates in the first world.  Circumcision as a means to reduce STD's is clearly not working. Abstinence, monogamy and condom use outside of monogamy are the best ways to reduce the spread of STD's.

On the medical front, however, there is now a vaccine (Gardasil) that prevents HPV in both males and females.  If you are interested in promoting the avoidance of STD's, I would suggest that monogamy, limited sexual partners, and condom use outside of monogamy would, as always, be good choices.  Researching and considering the Gardasil vaccine also is an option. 

If your son was circumcised, would you tell him to have unprotected sex with partners who are known to have HPV or HIV? Or who might have HPV or HIV? Of course not.  Everyone knows that being circumcised does not make one safe from sexually transmitted disease.

Circumcision is NOT STD prevention.  Circumcised men are spreading STD's at an alarming rate in the United States.  

3.Penile Cancer: 

Penile Cancer affects less than 1% of men in the United States. 

The American Cancer Society has this to say about preventing penile cancer (last revised 1/17/2013): (5)

"In the past, circumcision has been suggested as a way to prevent penile cancer.  This was based on studies that reported lower penile cancer rates among circumcised men than among uncircumcised men.  But in many of those studies, the protective effect of circumcision was no longer seen after factors like smegma and phimosis were taken into account.  Most public health researchers believe that the risk of penile cancer is low among uncircumcised men without risk factors living in the United States.  Men who wish to lower their risk of penile cancer can do so by avoiding HPV infection and not smoking. Those who aren't circumcised can also lower their risk by practicing good hygiene.  Most experts agree that circumcision should not be recommended solely as a way to prevent penile cancer.  The most important factor in preventing penile cancer is good genital hygiene. "
Seems simple enough.  Wash the body. 

As a thought, I encourage you to consider, would you recommend that all baby girls have their breast buds removed at birth? Breast Cancer affects and kills many more women in the United States than penile cancer affects men, yet we do not remove healthy tissue from baby girls in order to prevent the possibility of Breast Cancer.

4. Bacteria: The foreskin is fused to the glans of an infant, and it helps to prevent foreign bodies from entering the body through the urethra, which is an entry point to the body.   As the child ages, and naturally retracts, the child can be taught to wash his penis, including under his foreskin.  All body parts can become infected, or grow bad bacteria.  Ears, throats, skin, female genitalia, male genitalia, rectums, eyes, mouths, teeth, breasts, etc. etc.  Some of these parts are necessary for survival, some are not.  However, none of them (including the male genitalia, or parts thereof) are recommended to be routinely removed from infants due to the fact that they could one day contain bacteria.  Teaching boys proper hygiene is preferable to removing a healthy and functional part of their body.

 I do want to mention, again, that washing under the foreskin is not necessary and SHOULD NOT be attempted until the boy retracts on his own, which typically happens during puberty if not before.  The premature retraction of the foreskin causes pain as well as medical problems.
Studies Referenced: