Intact-friendly

Intact-friendly and foreskin-friendly are interchangable terms used in the United States, where non-therapeutic circumcision of boys has been generally practiced, to describe health-care providers who are knowledgeable regarding care of the intact natural penis with a foreskin.

The extraordinary ignorance of many American health-care providers regarding the human foreskin, a natural body part, makes these terms necessary. It is said that the only thing doctors learn in medical school about the human foreskin is that it is to be cut off!

Parents need to be especially wary at their intact son's visit to a doctor for any reason. It is very common for American medical doctors, including pediatricians who should know better, to forcibly retract a young boy's non-retractile foreskin, thereby causing great injury and pain.

Doctors Opposing Circumcision provides a page to provide assistance to parents who want to report a physician for wrongful retraction of their young son's foreskin.

Your Whole Baby provides a listing of medical doctors who have been reported to be intact-friendly.

Premature forcible foreskin retraction

Doctors Opposing Circumcision provides this detailed information for parents:

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Basic Childhood Penile Anatomy 1. At birth all boys have a natural, protective epithelial tissue layer (sometimes called a ‘synechia’), the balano-preputial lamina, which fuses the foreskin to the glans of the under-developed penis. This is normal and expected anatomy, much like the female hymen, and is not a birth defect. 2. This protective, developmental, tissue layer/membrane lasts until about age 10 years. Extensive (N=10,000+) clinical observations / research shows that only half of all boys are fully retractile at 10.4 years, and half are not yet so. There is no specific timetable for this tissue layer/synechia to ‘desquamate’ or disappear, and all boys are different. There is no need to rush the process. Physician interference in this natural progression (as in this case) is painful, injurious, unhelpful, as well as disrespectful to the rights of the child-patient who should be free of unnecessary clinical pain, and entitled to natural development — without medical interference. (As well as disrespectful to the parents, of course.) 3. Left undisturbed, (as it should be) this sterile tissue layer seals in and protects the internal organ from errant feces, abrasion, foreign substance ingress, pathogens, and other intrusions, while the organ develops. 4. The interior penis does not require unusual hygiene or internal cleaning, as sterile urine washes it out several times a day, just as outbound urine flushes the labia for females. Aggressive or intrusive hygiene will damage the tissue layer and destroy natural immune-active substances as well as disrupt the penile flora. 5. The foreskin is best thought of as similar to an eyelid — self-cleaning and self-defending. (We note that humans have no need to shampoo their eyes, as doing so would be painful, harmful, and unnecessary.)

Doctors Opposing Circumcision also discusses the possible consequences of premature forcible foreskin retraction by a foreskin-unfriendly health care provider.

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Possible consequences of PFFR 1. Immediate and enduring pain, oozing of blood, swelling, with torn and abraded tissue, leaving an open wound proximal to septic fecal matter, especially in the child who is not fully potty-trained. 2. High infection risk in the short term due to the open wound, plus long-term infection risk due to lack of natural protection of the membrane, which, once destroyed, will not re-constitute. 3. Unnatural ‘adhesions’ as the body attempts to fuse the damaged surfaces. 4. Risk of urethral ulcer causing urethral stenosis, as well as recurrent UTI, urinary tract infections. 5. Scarring from recurrent infections, leading to inelasticity of the foreskin. 6. Risk of paraphimosis (inability to replace the foreskin after retraction, a urologic emergency), due to swollen and/or inelastic tissue. 7. Risk of long-term phimosis (inability to retract the foreskin) from recurrent infections and inelastic scarring, a condition which includes adult dysfunction at sexual debut. 8. Psychological injury to the child — Parents tell us that infants whose foreskins were forcibly retracted at a prior visit resist diaper changes and bathing, sometimes needing two adults to hold them down due to the child’s thrashing and screaming. Older injured toddlers and boys cry instantly, parents tell us, when they suspect they are going to the doctor. (No one has researched what the long-term effects of this avoidable, iatrogenic, childhood injury might be, related to the loss of trust in all adults, including parents and caregivers but it could not be good.)

This information illustrates the need for parents to be certain that their intact son's healthcare provider is intact-friendly.

See also

• Development of retractable foreskin
• Foreskin Care for Boys