The local tradition, with baby boys, is to have them circumcised. I don’t have strong feelings about this one way or the other: I know what the research says about HIV and STI rates, and I think this research is very flawed, and is being conducted by people who have a political agenda. I know about the people who want their foreskins back and equate it to female genital mutilation, and I think these people are missing something other than a small piece of skin.

There are likely a few reasons for the local preference:

Local penile hygeine is possibly suspect (here we have a group of people who have casual and dress-up sweatpants, and for whom underwear is optional), so women may have had a few bad experiences with unkempt foreskins.

Families are often split, so mothers don’t necessarily know how to care for a foreskin.

The father is often circumcised and “I just want him to look like his dad.”

And obviously there is the odd horror story about infected foreskins, but I think may of these are urban legends.

At any rate, it’s commonly done. When asked about it, I provide all the information and a referral to someone who performs this procedure. I explain both sides and I try to give a balanced view.

Mothers for some reason like to ask me: will it hurt?

At which point I say, Of course it will hurt.

Here’s what happens:

A baby boy is strapped into a little harness on his back. His diaper is opened and his penis is cleaned. He is given a pacifier soaked in sucrose (table sugar- which has been shown to somehow provide pain relief in infants).

The attachment of the foreskin to the tip of the glans is broken and a small metal bell is placed to protect the glans. The foreskin is rolled forward over the bell and is sliced through using a scalpel.

Usually the baby is screaming by now, regardless of the sucrose.

Usually there is not much bleeding.

A non-stick dressing is placed on the penis. It will take about a week of vaseline in the diaper (to prevent the penis from sticking to the diaper) to heal.

Complications are unusual, though there is the occasional infection.

I do not describe this procedure to parents, because usually they do not want to know. I also don’t offer my opinion on what they should do.

Personally, I think if it was my baby, I would let it grow in and he could make his own decision.