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Reviewed Publisher: 
New York: Warner Books. 299 pages. ISBN 0-446-67880-5
Reviewed Title: 
What Your Doctor May Not Tell You About Circumcision. (2002)
Publication Date: 
March, 2004
Starting Page: 
Page Count: 

Several decades ago, Sheila Curran, R.N., and I founded the National Organization of Circumcision Information Resource Centers (NOCIRC), of which I am currently the director. In our efforts to educate the public on the facts about circumcision, I learned early on several important lessons: first, generally speaking, no one wants to hear bad news; second, no parent wants to be told that he or she has done something wrong to their child; third, no circumcised adult male wants to be told that the size and sensitivity of his penis has been diminished by genital alteration. The overwhelming conclusion of the scientifically valid and unbiased medical literature investigating the effects of circumcision, however, clearly demonstrates that circumcision is a harmful practice that should be stopped.

Finding the best way to present information to parents without frightening them into psychological denial has always been challenging. Since the goal is to protect babies from harm, it is imperative that we discover new ways to encourage parents to become advocates for their children, even if it requires them to examine critically and to question underlying myths that induce decent people to permit indecent procedures to be performed upon their precious and helpless infants.

Renowned Los Angeles pediatrician Paul M. Fleiss and medical historian Frederick M. Hodges have teamed up to write a book that I believe achieves exactly the right tone for presenting parents with facts needed to protect babies from circumcision. Impressively organized and lavishly supported by references from the scientific literature, Fleiss and Hodges guide the reader through the historical, religious, anatomical, physiological, medical, surgical, psychological, legal, ethical, and moral dimensions of circumcision.

Of special interest to readers of this journal, Fleiss and Hodges discuss the vast scientific literature on immediate and long-term psychological effects of neonatal circumcision, which is as thorough and concise as it is persuasive. Study after study has shown that circumcision is a devastating and traumatic experience for babies. The physical and neurological shock turns out to be far more severe than we have been led to believe. In addition to interfering with maternal/infant bonding and destroying normal sleep cycles, the trauma of circumcision causes some babies to lapse into a coma. Circumcision always disrupts breastfeeding and undermines the first developmental task of establishing trust. Most disturbing of all is to learn that, while all babies appear to react differently to the trauma-some infants become frenzied and hysterical while others appear to remain relatively stunned and shocked into silence-modern and impartial monitoring techniques prove that all newly circumcised babies suffer similarly severe neurological and physiological reactions that range from dangerously elevated levels of serum cortisol to neurological rewiring that results in a permanently lowered threshold to "normal" levels of pain. Circumcised babies, for instance, at four and six months of age, scream harder, louder, and longer than intact babies during routine vaccination-a finding indicative of post traumatic stress disorder.

Circumcision cannot be considered just a minor annoyance or just one of many insignificant disturbances to which babies are routinely subjected, as its defenders would have us believe. Instead, as the authors demonstrate, "the pain that a baby experiences during circumcision is worse than anything the average person is likely to experience in a lifetime" (p. 43).

In addition to all of the other fascinating medical facts presented so ably in this book, the findings on the adverse psychological effects of circumcision on infants present a unique challenge to those of us committed to preserving, protecting, and enhancing the psychological welfare of infants and children. We must find new ways to confront and dispel the denial, willful ignorance, and (dare I say it?) deception, in some cases, about circumcision that prevails among adults, parents, psychologists, community leaders, and medical professionals so that we can better fulfill our mission to enhance the psychological wellbeing of infants and children.

With their reader-friendly presentation style and impressive array of scientific studies to support the inescapable conclusions about the harm of circumcision, Fleiss and Hodges have created an indispensable guide that everyone committed to improving the lives of children will value.