Circumcision: The decision that can tear couples apart.

Last month, The Guardian ran a story titled ‘Male circumcision: the issue that ended my marriage‘.

Mireille Thornton was living in Istanbul, Turkey with her husband who is of Muslim faith. The issues began when Thornton gave birth to their first son. She explains that she “played for time”, given that sunnet (a Turkish festival that centers are the circumcision of a boy) is usually performed around six or seven years of age.

But as her son grew older, the argument “became more polarised”. Thornton was adamant that it was unnecessary and would hurt their child. She couldn’t see how washing was not “better than cutting off part of the body”. When the debate became particularly tense, her husband finally thrust their son into her arms and said “There. Go. Take your baby.”

Their marriage eventually fell apart over the issue. And her article gave way to a heated debate that is rarely performed outside the confines of the private home.

As a 25-year-old woman who does not have children, I hadn't thought much about the subject of circumcision. Honestly, I naively assumed that no one really gets circumcised anymore, and if they do it's a fairly simple procedure performed on newborns. I had absolutely no idea how contested, deeply personal and highly political the circumcision decision really was.

Here are the facts. About 20% of men worldwide are circumcised. The majority of men in Britain, Europe and Australia are uncircumcised. In Australia, approximately 32% of men under 30 have been circumcised and the number is in steady decline.

According to a study published in the Journal of Paediatrics and Child Health, the procedure fell out of favour with Australian paediatricians in the 1960s. They discouraged circumcision, arguing that it was unnecessary and carried with it a number of dangers including bleeding, permanent damage to the glans, infection, excessive skin removal, and in extreme cases, even death.

Currently, the Royal Australasian College of Physicians, the British Medical Association and the American Academy of Paediatrics state that, "there is no medical indication for routine circumcision".

Experts maintain that newborns who are circumcised feel excruciating pain during the procedure and in the weeks that follow.

Despite the research, parents still opt to circumcise their sons for personal, social, cultural and religious reasons. Many fathers feel strongly that their son should look like them. Others believe that there are health benefits, such as reducing the risk of STIs, genital herpes, HPV, HIV, and urinary tract infections. This is yet to be confirmed by medical research. Circumcision is a religious rite as part of the Abrahamic covenant, and therefore is widely practiced by Jews, Muslims and some Christians.

But even if two parents make the decision to circumcise their son, the challenge certainly does not end there. Bupa reports that most Australian doctors refuse to conduct the procedure.

In addition, in March 2006 the NSW Department of Health changed its policy on male circumcision in the public system. As it stands, circumcision can only be performed in a public hospital if it is "medically warranted".

I spoke with a representative from the office of Paediatric Surgeon Dr. Guy Henry, who works in Sydney's Eastern Suburbs. Couples in conflict often come in for consultations, with both parties "greatly passionate" about the subject. Their job is to provide the facts, not to "judge the why". They have treated patients who require a circumcision to be redone, after they were performed by GPs rather than surgeons.

Dr Henry's spokesperson was also upfront about the very real risks involved. Many understand circumcision to be a simple, straight forward procedure, however, as with any medical intervention, there are a number of possible complications.

Of particular interest was the substantial costs associated with the procedure. Without private health insurance, Dr Henry's office tells us that a circumcision performed for non-medical reasons, will set a parent back almost $4000. That's $2000 for the four hour procedure, $760 - $880 for surgeons fees, and $600 for an anesthetist. Medicare only covers a couple of hundred dollars.

Patients have remarked that it would be cheaper for them to fly to their country of origin, have a holiday, pay for the procedure, and return home, than have it performed in Australia.

Even with private health insurance, parents may only be able to claim part of the procedure.

Dr. Guy Henry only performs circumcisions on babies over the age of six months, which allows for the use of general anesthetic.  Before that, general anesthetic cannot be used, and it is very rare that a doctor will perform a circumcision on a newborn baby.

The Motherish Confessions: Our first thoughts upon seeing our baby. 

There is, of course, an important ethical discussion that needs to be had. But for now - it's critical that parents know the risks and the costs associated with what was once a customary procedure.

As for Mireille Thornton, she did what was right for her. As it stands, male circumcision is legally the decision of the parents. It is important that couples have the discussion, as difficult as it may be. And with this parental right, comes enormous responsibility. Regardless of the choice - we must be sure to know the facts.

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