I work as an RN in a newborn nursery. When I get the chance I try to open up conversations about circumcisions with new parents. Sometimes I'll give an opening to such a conversation when I'm doing the bath. When we get to the genitals, I say "Care of the penis is very easy, you just wash off the outside", while showing them, and see if they have any comments or questions.
Yesterday, I was helping a new dad with the bath who was over the moon about his new son, opening crying for joy, talking gently and protectively to him, very engaged. When I mentioned care of the penis, he asked "So when do they do the penis-cutting thing?"
Questions about "when do they do the circumcision?" are the most common ones I get from parents when the subject comes up. I usually will deflect it by asking them, "Oh are you thinking about having your baby circumcised?" or just skipping straight to saying, in a way that expresses mildly surprised curiosity rather than judgment, "Why do you want to do that?" Most often this leads to statements which I can then answer with information. And then I tell them that, to answer their question, first of all, it's not routinely done, because it's not considered medically necessary, and that if they are thinking about having it done, they will have to talk to their doctor first, to go over the risks and so forth (I just mention needing to know about the risks, I don't mention "Potential benefits"). Then I say, if it's going to be done, it's usually the day the baby goes home, or whenever it's convenient for the doctor, which might be an office visit after they go home. I try to work in that the foreskin is a normal body part with important sexual functions, and one that the boy may want to have a say about whether he wants to keep it or not, and also encouraging them to do more research. I don't usually get to say all this, just try to put out the idea that there's more to know about it than they think. Some conversations shut down pretty quickly, while other people are more open. It's about all I can do with the brief encounter I have with most parents, so late in the game.
When this particular dad asked about the "penis-cutting" thing, I recoiled so much at the ugliness of the wording, that all I could do at first was reflect this back to him by repeating, "Penis-cutting thing?" I sure wasn't going to make it easy on him and legitimize the whole thing by giving him the medical word for "penis-cutting".
He then thought up the word circumcision himself, and I asked why he wanted to do that. He answered, "Do I have to tell you?" It seemed to me a signal to shut down the conversation. Like I said, some people are open, and others you can just tell you don't want to tangle with them any further. So I said "Not at all" and gave my briefest version of "not routinely done because not necessary, talk to the doctor, etc." as above, and moved on to another topic. Not sure exactly why he didn't want to tell me: whether it was because he wanted him to be circumcised because he was, and didn't want to say to a stranger that he was circumcised; or because he was feeling like it was just none of my business why he wanted to circumcise his son.
There were several things about this that really bothered me afterwards, in fact I thrashed around in bed for hours later last night, just hearing that god-awful phrase "penis-cutting thing" over and over in my head.
I did think afterwards that I wish I had said something like, "No you don't have to tell me why you want to have him circumcised, but you might want to have a good answer ready, if he ever asks you about it when he's older." Makes him have to look at whether his reasons are good ones, and the fact that his son might have some feelings, maybe even objections about it later. Of course, this could bring up some defensiveness on his part, but it's better than phrasing it "Well, I hope you've got a good reason, for your son's sake."
The other side issue to this particular situation, was that the baby had a particularly smallish penis, the kind where the glans and shaft are a bit hidden in the fat pad already, with just a cone of scrunched up foreskin visible on the outside. Of course, this is a huge set up for buried penis, and excessive removal of skin (nothing left for the shaft to grow into when the fat pad goes away). I felt like I wanted to point this out to the dad, but he was already resistant, and I had already retreated, so I didn't say anything about it. Even though it was a legitimate piece of medical information to consider this as a contrindication, I felt hesitant to take on the role of pronouncing it as medically inadvisable, since that is really the doctor's job (although informed consent is not always adequately provided, as we all know). Even if I had brought it up, and he had asked the doctor about it later, I'm 99% sure, the doctor would say, oh it's no problem, you just have to know how much to take off.
I'm am beginning to try out the idea when having conversations with parents about circ, of opening the kid's diaper as we are talking (or doing it when the baby is already naked, with the bath), and saying "How much do you think they are going to take off?" or "See where the edge of the head of the penis is underneath the foreskin? That's how much they're going to cut off" or "How much do you think is going to be left?"
I wanted to ask if any of you have any other ideas about how I might have moved this conversation a little further or worked with this dad. I do not have the freedom to respond with smart remarks to parents in the hospital (although humor works sometimes, if it's not too pointed), so that might not really help me much (although I might really think such things about a dad who would say something like "penis-cutting thing".) Any thoughts would be appreciated.
Thanks, Gillian
Yesterday, I was helping a new dad with the bath who was over the moon about his new son, opening crying for joy, talking gently and protectively to him, very engaged. When I mentioned care of the penis, he asked "So when do they do the penis-cutting thing?"
Questions about "when do they do the circumcision?" are the most common ones I get from parents when the subject comes up. I usually will deflect it by asking them, "Oh are you thinking about having your baby circumcised?" or just skipping straight to saying, in a way that expresses mildly surprised curiosity rather than judgment, "Why do you want to do that?" Most often this leads to statements which I can then answer with information. And then I tell them that, to answer their question, first of all, it's not routinely done, because it's not considered medically necessary, and that if they are thinking about having it done, they will have to talk to their doctor first, to go over the risks and so forth (I just mention needing to know about the risks, I don't mention "Potential benefits"). Then I say, if it's going to be done, it's usually the day the baby goes home, or whenever it's convenient for the doctor, which might be an office visit after they go home. I try to work in that the foreskin is a normal body part with important sexual functions, and one that the boy may want to have a say about whether he wants to keep it or not, and also encouraging them to do more research. I don't usually get to say all this, just try to put out the idea that there's more to know about it than they think. Some conversations shut down pretty quickly, while other people are more open. It's about all I can do with the brief encounter I have with most parents, so late in the game.
When this particular dad asked about the "penis-cutting" thing, I recoiled so much at the ugliness of the wording, that all I could do at first was reflect this back to him by repeating, "Penis-cutting thing?" I sure wasn't going to make it easy on him and legitimize the whole thing by giving him the medical word for "penis-cutting".
He then thought up the word circumcision himself, and I asked why he wanted to do that. He answered, "Do I have to tell you?" It seemed to me a signal to shut down the conversation. Like I said, some people are open, and others you can just tell you don't want to tangle with them any further. So I said "Not at all" and gave my briefest version of "not routinely done because not necessary, talk to the doctor, etc." as above, and moved on to another topic. Not sure exactly why he didn't want to tell me: whether it was because he wanted him to be circumcised because he was, and didn't want to say to a stranger that he was circumcised; or because he was feeling like it was just none of my business why he wanted to circumcise his son.
There were several things about this that really bothered me afterwards, in fact I thrashed around in bed for hours later last night, just hearing that god-awful phrase "penis-cutting thing" over and over in my head.
I did think afterwards that I wish I had said something like, "No you don't have to tell me why you want to have him circumcised, but you might want to have a good answer ready, if he ever asks you about it when he's older." Makes him have to look at whether his reasons are good ones, and the fact that his son might have some feelings, maybe even objections about it later. Of course, this could bring up some defensiveness on his part, but it's better than phrasing it "Well, I hope you've got a good reason, for your son's sake."
The other side issue to this particular situation, was that the baby had a particularly smallish penis, the kind where the glans and shaft are a bit hidden in the fat pad already, with just a cone of scrunched up foreskin visible on the outside. Of course, this is a huge set up for buried penis, and excessive removal of skin (nothing left for the shaft to grow into when the fat pad goes away). I felt like I wanted to point this out to the dad, but he was already resistant, and I had already retreated, so I didn't say anything about it. Even though it was a legitimate piece of medical information to consider this as a contrindication, I felt hesitant to take on the role of pronouncing it as medically inadvisable, since that is really the doctor's job (although informed consent is not always adequately provided, as we all know). Even if I had brought it up, and he had asked the doctor about it later, I'm 99% sure, the doctor would say, oh it's no problem, you just have to know how much to take off.
I'm am beginning to try out the idea when having conversations with parents about circ, of opening the kid's diaper as we are talking (or doing it when the baby is already naked, with the bath), and saying "How much do you think they are going to take off?" or "See where the edge of the head of the penis is underneath the foreskin? That's how much they're going to cut off" or "How much do you think is going to be left?"
I wanted to ask if any of you have any other ideas about how I might have moved this conversation a little further or worked with this dad. I do not have the freedom to respond with smart remarks to parents in the hospital (although humor works sometimes, if it's not too pointed), so that might not really help me much (although I might really think such things about a dad who would say something like "penis-cutting thing".) Any thoughts would be appreciated.
Thanks, Gillian
: To me, the cut daddies like him are no different than the mothers that hold their daughters down to be circ'd in Africa, all because their ego can't handle the thought of their sons NOT having the same inferior penis as them.
and answer questions to the best of your ability?
