Story transcripts

Secret boys business

Sunday, August 26, 2007
Circumcision's been around for centuries, but here in Australia it's no longer fashionable. Stand by for a new and heated round of debate, to cut or not to cut.
Reporter: Liam Bartlett

Producer: Lincoln Howes

Four Australian states have banned it in public hospitals. And, as a man, Liam Bartlett can understand why.

Now that he's actually seen a baby boy being circumcised. It really is a painful experience, even for the spectator.

Now, circumcision's been around for centuries, but, here in Australia, it's no longer fashionable.

Parents have rejected it as out-dated and unnecessary. Not to mention cruel.

Stand by, though, for a new and heated round of the age-old debate, to cut or not to cut. There's mounting evidence that circumcision has its benefits, a whole range of them. That it could just help save your son's life.

Transcript

LIAM BARTLETT: We used to say like father, like son. But in many cases these days, boys are different from their dads in one very fundamental way because of a decision made days after they were born. Jack Donaldson is just 10 weeks old, but he is about to undergo a procedure that he will live with for the rest of his life. He has got no idea what is coming up, has he?

TONI DONALDSON: No, thank God.

LIAM BARTLETT: Are you apprehensive?

TONI DONALDSON: A little bit, but I know, I know it is the best thing for him.

LIAM BARTLETT: Jack's mum, Toni, has decided to have him circumcised, to remove his foreskin.

DR TERRY RUSSELL: The pethidine is pain-killer.

LIAM BARTLETT: She has come to Dr Terry Russell, who does more circumcisions than any other physician in the country.

DR TERRY RUSSELL: First thing that we have to do is separate off that adhesion between the foreskin and the head of the penis. It is just like really peeling off a Band Aid.

LIAM BARTLETT: This is just the start and, I have got to admit, it is already pretty tough to watch. Depending on which stance you take on this highly controversial procedure, Toni is either inflicting unnecessary pain on little Jack or she could well be saving his life.

PROFESSOR BRIAN MORRIS: There is absolutely no reason to oppose circumcision. It should be promoted, it should be routine at birth, where it is cheaper, easier, simpler. Do it and it is done. Risk is reduced, massively reduced.

DR GEORGE WILLIAMS: We should call it male genital mutilation and call it by its true name, because that is what it is. You are maiming, you are injuring, and you are removing an essential body part. That's what mutilation is.

LIAM BARTLETT: It's an emotive debate, which makes it all the more difficult for parents like Toni to make a decision. But she believes she is doing the best thing for Jack's health. Some of the medical fraternity describe it as 'mutilation'. That must be confronting as a mother to hear that?

TONI DONALDSON: Yeah, that's right. I mean, it is horrible to hear it like that and any procedure that you do to your child is a concern as a parent, but I don't think they will have a memory of it and I think the benefits are much greater.

LIAM BARTLETT: This is little Jayden and this is Thomas. Not so long ago, both these boys would have already been circumcised — their foreskin surgically removed at the hospitals where they were born. In those days, it was as much a part of having a baby boy as knitting a pair of blue booties. But times have changed and circumcision, like those blue booties, has fallen out of fashion and out of favour.

ED PHILLIPS: I have actually oscillated from one side to the other — the chop or not. There are medical reasons now saying there is some value in doing it whereas, historically, they said just leave him as he was born.

LIAM BARTLETT: Ed Phillips, host of television quiz show Temptation and his wife, Jaynie, have just had a baby Hayden. Ed's of the generation of men when circumcision was routine at birth. In the '50s and '60s, 90 percent Australian boys were cut. But, since then, the figures have reversed. Now, just 10 percent of newborn sons are circumcised and Ed and Jaynie are in a quandary.

ED PHILLIPS: I would have thought I'd be happy to be the same as my dad and my brothers and all my schoolmates but, perhaps if you get the chop, you'll stand out from the crowd, so to speak. Um, I am going to have to see if it is such a big deal to be different from your mates yet, is there any pain involved? I can't remember the procedure and, of course, most kids are the same, so, I've got to make a decision in the next couple of weeks, I suppose.

LIAM BARTLETT: But if you thought routine circumcision was a thing of the past, think again. There is growing evidence to suggest that the move away from routine circumcision was a big mistake and may have disastrous consequences for coming generations of men.

PROFESSOR BRIAN MORRIS: The benefits outweigh any risks, which are minor anyway. The benefits are 100:1 in favour of circumcision, absolutely, no questions asked.

LIAM BARTLETT: Professor Brian Morris is leading the fight to see every Australian boy circumcised at birth. He has studied new international evidence showing a whole range of diseases are dramatically reduced in circumcised men. It's claimed the risk of HIV and AIDS can be cut by 60 percent. Circumcision can even protect women from the virus that causes cervical cancer.

PROFESSOR BRIAN MORRIS: We immunise children routinely to reduce all sorts of diseases. Circumcision is a surgical vaccine but it doesn't prevent just one condition, it prevents a raft of conditions through the life of the male.

LIAM BARTLETT: That's why Toni changed her mind on circumcisions for all her sons. When her eldest boy, Braden, was born, like most parents, she was happy enough to leave him uncircumcised. It wasn't even an issue. But, as a toddler, Braden suffered painful urinary tract infections and, at five, he had to be circumcised — a traumatic event that still has painful memories. Do you remember the operation?

BRADEN DONALDSON: Not too well, but some of it I do.

LIAM BARTLETT: Which parts do you remember?

BRADEN DONALDSON: The pain.

LIAM BARTLETT: It hurt, huh?

BRADEN DONALDSON: Yeah, it hurt a bit.

LIAM BARTLETT: And that would have put you off going to the doctor.

BRADEN DONALDSON: Yep. Didn't want to go back for a long time.

LIAM BARTLETT: Not wanting her two younger sons to suffer the same fate, Toni chose to have them circumcised soon after birth. Is it fair to say that you have had your boys circumcised for health reasons rather than cosmetic reasons?

TONI DONALDSON: Yep, absolutely. Absolutely health reasons. I didn't want them to go through the pain and the infection wasn't nice either so, just to prevent that, that's the only reason we had it done.

LIAM BARTLETT: Circumcision has a brutal history and, even until recently, it was pretty barbaric. The foreskin was literally lopped off with a scalpel, all without painkillers. Now, they do use anaesthetics and I'm assured the newest procedure is virtually painless. A device called a plastibell is inserted under the foreskin and tied off with string. But I've got to say that, as a bloke watching it all happen, you can't help but feel for little Jack.

DR TERRY RUSSELL: Now, there's a better test of pain. If you can do that …

LIAM BARTLETT: You're making my eyes water just watching it!

DR TERRY RUSSELL: I'm crushing along the midline. That does three things: It's squeezes any blood out of the tissue, it also crimps off the blood vessels to minimise bleeding, and it converts what can be quite a thick foreskin down to a nice thin bit of tissue that is easy to snip.

LIAM BARTLETT: You are going to cut that?

DR TERRY RUSSELL: Yep. And he shouldn't feel a thing. There we are.

LIAM BARTLETT: I am not convinced that crying is more discomfort than pain.

DR TERRY RUSSELL: In fact, he cried probably more than that when I gave him his injection. Okay, you can see how that has cut off the circulation already so that it can't bleed. That dead tissue will all fall off some three to seven days later.

LIAM BARTLETT: Did you hear Jack having a scream?

TONI DONALDSON: Yes, I did, and that is really uncomfortable to hear that but, I mean, that was nothing compared to what my eldest one went through when he had it done. I mean, he cried for hours afterwards and even up to a week afterwards he was in pain and he had stitches, too, that had to be removed afterwards, and it was very painful.

DR GEORGE WILLIAMS: When I had to do my first circumcision, because I was training, I was horrified that you were actually cutting and crushing and removing normal tissue. To me, it didn't make sense. And, up to this day, this is now 38 years down the track, I can't see why you want to remove healthy, normal tissue.

LIAM BARTLETT: George Williams is a paediatrician totally opposed to circumcision. He claims in one percent of cases the procedure goes wrong and he simply doesn't believe that new medical research justifies what he calls 'mutilation of the penis'. There appears to be a growing body of medical practitioners who favour circumcision purely on those health grounds.

DR GEORGE WILLIAMS: Well, I haven't seen the data that convinces me that that's what you have to do. Otherwise, we have to circumcise everybody at birth, or at the time of sexual activity, and say, 'We are now protecting you against HIV, we are now protecting your partner against cervical cancer'.

LIAM BARTLETT: Because that's what some doctors want.

DR GEORGE WILLIAMS: But they are misinformed and misguided.

LIAM BARTLETT: But Australia's peak medical body isn't so sure. In light of the new medical evidence, the Royal College of Physicians is now reviewing its long-standing guidelines recommending against circumcision. But if you're expecting consensus in this divisive debate any time soon, forget it. When we brought both sides together, they came out fighting.

DR GEORGE WILLIAMS: A baby has a right to self-determination.

PROFESSOR BRIAN MORRIS: They don't.

DR GEORGE WILLIAMS: Really? So you can do anything to them and that's okay?

PROFESSOR BRIAN MORRIS: Yes. Does a baby have a right to say 'no' to vaccination? No, a baby is too young!

LIAM BARTLETT: Can I just ask a different perspective, a slightly different perspective. Are you circumcised?

PROFESSOR BRIAN MORRIS: Yes, indeed. And I know that George isn't.

DR GEORGE WILLIAMS: And I'm not, I'm 'intact'. We call it 'intact' because intact you are natural and normal, you're original.

LIAM BARTLETT: So you're both speaking from a position of strengths, so to speak.

PROFESSOR BRIAN MORRIS: One in three men will have an adverse medical condition during their lifetime that will require medical attention.

DR GEORGE WILLIAMS: I can tell you, Professor Morris, I've had no problems of my foreskin.

PROFESSOR BRIAN MORRIS: Well, you are very lucky.

DR GEORGE WILLIAMS: That is not luck. That is not luck. It is commonsense, clinical, practical. You would never know what a normal penis is because you've never had one from the first few moments of your life.

PROFESSOR BRIAN MORRIS: That's absolutely no difference in function.

LIAM BARTLETT: Hang on, the doctor's got a point.

DR GEORGE WILLIAMS: You wouldn't know, you wouldn't know.

PROFESSOR BRIAN MORRIS: It's not about what I know.

DR GEORGE WILLIAMS: The only time that you would know what a normal penis is is when you're sexually active as an adult male, and you wouldn't know the difference.

LIAM BARTLETT: For the health and safety of Australia's sons, what would be your wish-list?

PROFESSOR BRIAN MORRIS: I want to see parents fully informed about all the benefits and all the risks.

DR GEORGE WILLIAMS: Leave the penis alone.

LIAM BARTLETT: Don't touch it.

DR GEORGE WILLIAMS: Don't touch it. Parents should accept that the original penis is a normal penis, it's a natural penis, and, if it's healthy, nothing has to be done to it, absolutely nothing.

LIAM BARTLETT: Whether we turn back the clock and bring routine circumcision remains to be seen. But while the experts argue, parents are left to struggle with the dilemma and make a lifelong choice for their sons.

TONI DONALDSON: You know, mothers and fathers are having to make decisions on things that could happen later on in life. It is a difficult decision.

ED PHILLIPS: My gut feeling is to make him look like his dad and tell him that's why so, gee, but it's not a clear-cut decision. Pardon the pun!

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