A few days ago it had been mentioned that searching for “intactivist” on Google was displaying, before any results, a suggested 2012 text from an odious article by pro-circumcision and misandryst author Charlotte Allen.
Bad as that is, today something far worse and way more dangerous has been reported. Searching for “care of uncircumcised newborn” displays a snippet from a webmed article explaining how to retract the foreskin to clean “under” it. It is problematic, because it is missing a sentence from the beginning of the paragraph, that limits this advice to “[w]hen the foreskin is easy to retract”, and also omits the most important, initial warning: “Do not force the foreskin back over the tip of the penis. At first, a baby’s foreskin can’t be pulled back (retracted) over the head of the penis. After the first few years of life (though it may take somewhat longer), the foreskin will gradually retract more easily“.
Naive parents may take the snippet as advice without reading the full article, resulting in pain, bleeding, possible infection and possible scarring which may require surgical care in the future.
Even then, the webmed article isn’t that great. It states that “[b]y the time a boy is 5 years old, his foreskin is usually fully retractable“, and also that “[a] boy as young as 3 can be taught to clean under his foreskin“. Both statements are wrong. It’s long been known that there is wide variation to the age of retraction, with close to 50% of the boys becoming retractable by age 10, and approximately 95% being retractable by age 17. Trying to retract the foreskin of a 3 year old boy or a 5 year old boy (when less than 30% of the boys are capable of retracting) is likely to create trauma and injuries to the child.
McGregor et al (2007, Can Fam Phys) wrote: “if one is patient and does not rush Mother Nature, most foreskins will become retractile by adulthood“. Likewise, Wright (1994, Med J. Aust) wrote “nature will not permit the assignment of a strict timetable to this process.”
Denniston and Hill (2010, Can Fam Phys) explain: “Gairdner’s bar graph [1949!] shows a steep increase in retractility from birth to age 3 years. This does not occur in nature; it is possible that these values were obtained by the use of the probe. In any event, they have been disproved by later research. In actuality, development of retractility tends to be much slower. [...] Gairdner’s values for the development of foreskin retractility stood alone and unchallenged for decades, during which they were quoted by the authors of numerous textbooks. Unfortunately, thousands of physicians the world over have been trained with these false values.”
In fact, the advice from the webmed article seems to be using the retraction values of Gairdner (1949) and the erroneous advice of Allan F. Guttmacher (1941) who came with the idea that a baby’s foreskin needed to be retracted and cleaned daily. Both pieces of really dangerous advice.
We call on Google to become more responsible with the snippets presented when they can lead to harming babies.
For a far better article on care of the uncircumcised newborn, read this page of the Paediatric Society of New Zealand
Update: I searched some more keywords on Google. The word “uncircumcised” also brings a biased article, this one from Cosmopolitan: “Although circumcision rates are declining in America, foreskin is still a hotly debated issue“. No Cosmo, foreskin is a part of the body. Circumcision is a debated issue.
And afterwards, a downward arrow offers more related topics: the definition of cicumcision and the definition of mohel.
In the United States, the foreskin is the only part of the body that when named, is followed by the description of the procedure to remove it. Sad and ridiculous.