It happens much more often than it should: a parent feels extremely bothered or angered by an experience at a pediatrician’s office in which a nurse or doctor forcibly retracts the foreskin of an intact child. This can result in pain, crying, redness, bleeding, small tears, swelling and obvious discomfort for the boy. Sometimes this is done even when the parent asks the care provider to stop, but is often done so fast that the parent barely has time to process what is happening and react before the damage is done. Often, the parent feels hurt, angered, violated, disrespected, confused or even betrayed by their provider for going against their wishes and for causing unnecessary harm to their child.
So what can be done to prevent this?
The most important thing that parents of intact boys can do is to be very proactive from the start. The simple truth is that many care providers in the US are misinformed about normal healthy intact male anatomy, the function of the foreskin and proper intact care.
When taking your child to a doctor visit, always keep within touch or very easy reach of baby and do not allow anyone to touch your children’s genitals unnecessarily. I personally do not remove the diaper or underpants from my child in preparation for a provider to come in. Unless you have a concern about the genital area, there should not be a reason for a provider to touch it. If they want to, then it’s a good time to have a discussion about why they feels it’s necessary, what they are looking for, and how they plan to do it. This is also the time to express in clear terms that you do not consent to any retraction or manipulation of the foreskin for any reason. Not even “just a little bit”.
The only person who should ever retract a child’s foreskin is the child to whom that foreskin is attached!
Parents should be proactive and preemptive when it comes to genital touching by anyone, even care providers, and you should not feel embarrassed or reluctant to speak up. This is YOUR child and it is your responsibility and obligation to act in his best interest. Do not fear insulting or offending anyone: you can be firm in a kind and calm manner. I’m not at all suggesting you have to be aggressive or confrontational, rather only that you set the stage with your expectations for conduct that is in line with respect for genital integrity. Yes, this is something you still actually have to do in this country.
One thing you may do is consider using a temporary ankle bracelet such as the one below (available free here!) as this will catch the attention of any provider – especially if your child needs to be hospitalized for any reason – or even as a reminder to family, friends or any child care provider who may need to change your child’s diaper. For many years, people who chose not to circumcise their infants were instructed to retract the foreskin regularly, in the bath or during diaper changes, but now that we know better, we must work proactively to change the thinking of anyone who may come into contact with our child’s genitals. They may even be well-intentioned, but we cannot risk assuming that they know what we know. Be proactive and make your wishes known explicitly in advance.
If your child has had problems urinating or appears to have pain during diaper changes or you have any other concerns that warrant a care provider examining your child’s penis, then again, have the conversation about your expectations BEFORE exposing his genitals. If your child needs surgery or some sort of procedure that requires catheterization, know that forced retraction should absolutely NOT be part of that procedure and there IS a way to safely and properly catheterize an intact penis. I would suggest printing that out and bringing it with you to discuss with your care providers – they may be aware of this, but it’s best to be over-prepared. No retraction is necessary, not even “just a little”.
Another way to be proactive is to get out your Sharpies and write directly on the diapers and wipes package that anyone who may change your son’s diapers will be using. They will have to see it AS they are changing the diaper so they can’t forget.
Here’s an example of what one woman did when she dropped her child off at the YMCA:
Is this really an issue? Are care providers really going around retracting the foreskins of young boys against parent wishes and without understanding normal male anatomy? The answer is yes. Here are just a few examples of posts I’ve seen on local parenting groups regarding this topic, which make me realize just how often this happens and how important it is that you feel EMPOWERED to be proactive about protecting your boys:
At my pediatrician appointment for my 1 week old baby boy who is intact, I asked her to not forcibly retract my son. She goes, “What? You mean like this?” and begins manually going up and down on his foreskin for several seconds and he begins crying!!! She continues…”Oh, this is what you should do every day to his penis to prevent adhesions from forming.” It all happened so fast, it was over before I could stop her. Anyway, in preparation for our upcoming 4 week visit, I want to type up some formal statement that I will present to them for inclusion in his medical records. I was thinking something like: “I do not give consent for any nurse or physician at XYZ Pediatric Office to retract the foreskin of my son in any way. I do not consent to having his penis touched or examined at any office visits. The American Academy of Pediatrics says that no special care or routine retraction is necessary for intact boys.” I am shocked how uneducated pediatricians are on intact boys!!
Today at my son’s 2 week check-up, I had to get very firm with the nurse practitioner who was doing the check-up to NOT forcibly retract his foreskin. I about jumped out of my seat and grabbed the baby! He’s my third boy but first uncircumcised one… I know many of you have links to why forced retraction is bad and I’ve read them but I was so shocked at what was going on all I could say is “we are not forcibly retracting him” (OK, I was so flustered I said manually instead of forcibly at first) but I looked like a fool! I need a simple statement I can say AHEAD of time at his next check-up to educate them or at least state my reasons for not doing so.
A friend of mine has a 6 month old who is uncircumcised. Her pediatrician advised her to start to retract it during diaper changes and now it appears to be infected. Any experience with this? What can she do?
My first son was circumcised. My second not. We recently went in for the 4 month check up. The doctor looks at the genitals. She pushes the extra skin back. The tip of the penis almost looks completely sealed. I don’t know if this is normal. She didn’t think so. She kept trying to push the skin off the tip which caused irritation. She gave me a referral for a urologist. The diagnosis says this: “Distal partial urethral obstruction.” He pees fine and in a stream from what I can tell when he has his bath.
My cousin just messaged me upset because her Dr retracted her baby boy! He is only a few months old. What the heck is going on? I feel so bad that he is doing this to moms who have no clue about proper intact care! He said to do it at every change until the skin moves freely.
You do not want to be one of these parents. Better to be safe than sorry, right? Speak up for your child from the moment you walk in the door. You won’t regret it! And if you hear bad advice, please take the opportunity to educate that person on the very simple proper way to care for the intact penis. If you are not comfortable doing that yourself, head on over to The Whole Network and have an info package sent to that person or office. They also have lots of free educational materials you can print and distribute or mail. You may save not only your own child from an unfortunate or painful experience, but you can help prevent it from happening to another child as well!