The following intact care agreement was written by Jennifer Gardner and originally appeared at
Mothers Against Circumcision. It has been edited slightly for sharing at DrMomma.org, with updates in care (i.e. water only to clean the genitals - no soap), advising physicians and terminology. Gardner shares that she, "Wrote this after my family and I moved from Michigan to Massachusetts. In taking my son to a new pediatrician for his four month check-up, I made the mistake of trusting the doctor to know not to retract the infant foreskin. I was wrong. He did - while I was standing right next to him. I then wrote up this agreement, which has been signed - and adhered to - by our current pediatrician. (It also helps that he's already "
foreskin-friendly.") Many other parents of intact boys have since relayed their own stories, requesting a copy of the agreement."
Medical Professionals for Genital Autonomy has also assisted in the creation of a Prevention Pack for Physicians, that can be
sent to any physician directly via Etsy.
Above graphic available as stickers or informational card here.
To:_______________________
Healthcare provider/s of our son
From: ____________________
His Parents
In providing health care for the above named person, I agree to the following:
1. This boy is not circumcised. He was left intact, on purpose, by his parents at birth, who refused the operation at that time, as they feel that it is not a medically indicated procedure for infants. They intend to keep him intact, and are informed on the proper (and wary of the improper) care of the intact penis.
2. The proper care of the intact penis is to "leave it alone" (per Dr. Sears, Dr. Fleiss, Dr. Winckler, the AAP, among others). His parents do not retract his foreskin, as it is unnecessary, and likewise will not allow anyone else to do so either. Only a very small percentage of babies and young children have foreskin that is retractable. In the majority, the foreskin is firmly attached to the glans (head) of the penis in much the same way as the fingernail is attached to the finger, and DOES NOT retract.
Furthermore, any retraction of the foreskin before natural separation has occurred, as early as age three, but as late as early adulthood, can cause irreparable damage through bleeding and the formation of adhesions. The ONLY person who may retract our son's foreskin is our son himself, once natural separation has occurred.
3. There is NO reason whatsoever to touch our son's penis during an exam: Not "to see inside," not "out of curiosity," not "to break adhesions” (the attach points are synechiae, not adhesions), not "to see if the foreskin retracts," not "to clean it," etcetera.
I therefore agree that I will not touch this child’s penis for any reason. If I genuinely have a concern about whether his urethral opening is "fine" I will bring this point up to his parents and they can decide if there needs to be anything done. If they do decide that it needs to be looked at, only THEY, not I, will touch his penis.
4. The intact penis needs no special care, such as "irrigation" or "loosening of the foreskin." His parents wipe the OUTSIDE with a wipe at diaper changes, or with warm water at bath time. Any "cleaning" other than the afore-mentioned can cause irritation, infection, and problems down the road. When his foreskin has naturally separated on its own, his parents will inform him of the proper care concerning retraction, and concerning cleaning; (i.e. to retract gently when showering, rinse with warm water, and replace.)
5. As our son's parents, we have written this document as a preventative measure only, in response to a previous negative experience. It is not meant to single out any one person, but is meant to relay our wishes and concerns to all health care providers who see our son.
I have read the above information. I understand what I have read, fully, and agree to what is written herein. I will adhere to the above information, and know that if I do not, it will be seen in the eyes of his parents as purposeful abuse toward our son. If I sign, I will receive a copy of this document. If I do not agree to all that is written here, this child will not be looked after by me for his medical care.
Signed,
__________________________
