Nevertheless, parents of boys with hypospadias are often led to believe “corrective” surgery is necessary and worth the risks. When they wanted to conceive, they just engaged in a private thanksgiving. He observed to me that, so far as he and his wife were concerned, they had the best of all possible worlds: he had no trouble with erections, orgasms, and intercourse-he was healthy-and yet he couldn’t accidentally get his wife pregnant. Through my work on this subject, a few years ago I met a man with “uncorrected” hypospadias who had opted for a high-quality turkey baster. In that case, a man with hypospadias was reported to have impregnated his wife by ejaculating onto a long-handled spoon and inserting it into her vagina. But there are simpler, non-surgical solutions to the problem of ejaculating somewhere other than the penis’s tip, including one reported in a late-19th-century British medical journal. I have heard some contemporary surgeons insist that hypospadias repair is done for a “medical” reason-to ensure a boy can eventually successfully impregnate a woman though intercourse. Why insurance covers it, even when there is no good evidence it is necessary or beneficial, remains a mystery. Few urologists today seem to believe that sexual orientation is caused by how one pees, but many still think boys’ psychological health absolutely depends on being able to pee standing up.
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Urology texts of the past made it pretty plain: if you don’t “fix” hypospadias, a boy might be so messed up in his gender identity that he’ll grow up gay. Most hypospadias “repairs” performed by surgeons occur because of an untested, Freudian belief that you can’t grow up a “real man” if you urinate and ejaculate from somewhere other than the very tip of your penis. ll patients participated in sexual intercourse without problems and were able to void in a standing position with a single stream.” So why label them as anything but normal? If what you care about is improving physical health, in most cases you would not go through with “hypospadias repair.”Īnd consider one of the most shocking findings of the German study: “all but 6 were not aware of any penile anomaly, all but 1 homosexual patient have fathered children.
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In fact, in most cases, the surgery increases the odds a boy is going to suffer from urological problems.
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In the vast majority of cases, initial “repair” of hypospadias is not done because a boy’s health is being actively compromised by this anatomical quirk his health is not. Make no mistake: this “crippling” isn’t caused by the hypospadias it’s caused by the complications of surgeries to “fix” hypospadias. The medical literature has a special name for boys and men like Jim: hypospadias cripples. Jim Lake, a 54-year-old counselor who works in the Chicago area, has had 17 major urological surgeries to try and undo the damage that followed the surgical “correction” performed on his penis when he was just a baby. For some boys, surgical “repairs” to their penises turn out to be downright destructive-even devastating. The risks of “hypospadias repair” surgeries include wounds opening up on the penis (fistulas), scar tissue building up inside the urethra (stenosis), chronic pain at the surgical site, and chronic infections.
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The physicians also questioned whether surgical “correction” of hypospadias was necessary, given what they admitted was the “significant complication rate” of “reparative” surgeries-and given these men seemed to have figured out how to use their penises to their own satisfaction. The team observed that “it remains unclear whether the tip of the glans is truly the normal site” for the urethral opening. Could it be that surgeons and parents have really worried that a child left to grow up with atypical genitals will be at greater risk of gender identity and sexual orientation “problems”? Of the 500, fully 225 counted as having hypospadias.
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These physicians looked at a group of 500 men and found that only 55 percent could be labeled “normal,” according to medical standards. In 1995, the Journal of Urology published a stunning-and generally ignored- study out of Germany that showed that urologists have unreasonably strict expectations for penises. In fact, hypospadias might be much more common than even that, and may have always been.