A normal surgery in a developed nation involves anesthetics so that the individual feels very little or nothing at all. Maybe this is why anesthesiologists are paid so well. Pain is a great motivator.
When it comes to genital cutting rituals, anesthetics are often forgone. In fact, the pain may be part of the purpose of the ritual. Dr. Kelloggs proposed having children (male AND female) feel pain in order to create a “salutary effect” on the brain so that the child remembers and avoids touching their genitalia.
There are many factors to consider when attempting to assess physical pain. Age (development of the body as well as psychological preparedness), the specific part(s) that are being touched, and the device(s) being used. There’s also post-operative pain.
Pain for Infants From “Circumcision”
OK, the heading of this section used the “Circumcision” terminology in order to rank on the search engines. As noted in the terminology section, this site aims to avoid emotional terminology. This heading is strictly used to get the attention of some readers that still prescribe to the euphemism.
Some beliefs about the idea that an infant cannot feel pain, even though studies have proven that they do, continue. Some believe that the individual will not remember, but there is evidence that there are effects. Some have reported nightmares that could only be explained by what happened to them as an infant. Check out the following for more: https://2stomps.org/risks-and-harms-of-prepuce-removal/
EMLA Cream
EMLA stands for Eutectic Mixture of Local Anesthetics. It is a topical anesthetic cream.
Have you ever cut yourself and didn’t feel the pain until later? That is because what cut you was very sharp that it bypassed nerves. You feel the pain later because bacteria have started to enter the wound. EMLA does not prevent that pain and this is why people are directed to apply protective creams such as petroleum jelly so that bacteria cannot reach the open wound. For young individuals (i.e. infants), there is another reason for the protective creams: prevent adhesions because the body expects the prepuce to be adhered to the glans and attempts to repair itself with scar tissue.
There are some issues with EMLA cream:
The prepuce is a double layer of tissue.
If the procedure is involving the cutting of both layers of the prepuce, the cream does not anesthetize the inner layer unless the prepuce can be retracted (which it cannot in younger individuals without causing pain and harm itself).
EMLA Should Not Be Used With Infants
The following image is from this link from the USA Food and Drug Administration: https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/19941s11lbl.pdf
EMLA Is Insufficient
The following image is from this link from the USA Food and Drug Administration: https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/19941s11lbl.pdf
EMLA is Dangerous for infants and Small Children
The following image is from this link from the USA Food and Drug Administration: https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/19941s11lbl.pdf
EMLA Causes Reactions on Genital Mucous Membranes
While mild and transient, genital mucous membranes (inner mucosa of the prepuce, the labia, and the glans) often react to EMLA cream.
The following image is from this link from the USA Food and Drug Administration: https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/19941s11lbl.pdf
Nerve Blocks for Genital Surgery
For infants and young individuals with a large clitorophallus (aka penis), some doctors will use dorsal penile nerve block (DPNB) which does not block the ventral nerve pain pathways so it is only partially effective. The infant still feels pain when DPNB is used. In fact, the Cochrane Review states “it can be concluded that DPNB and EMLA do not eliminate circumcision pain.” In fact, the process of injection is painful itself.
General Anesthesia for Genital Surgery
General anesthesia is considered dangerous for individuals under a certain weight (neonates and infants). For those getting any form of surgery at an older age, this definitely has the upside of avoiding pain. However, there certainly are risks and problems with general anesthesia as well.
Page last updated February 8, 2022