North Dakota mom says medical procedure needlessly harmed her uncircumcised 3-year-old
Kaylee Alvarado of Bismarck said there was "blood everywhere" when her son's foreskin was forced back during a routine medical procedure.
BISMARCK — Kaylee Alvarado and her husband made an informed, deliberate decision that their son would not be circumcised after he was born.
So it came as a shock that the one place she assumed her boy would be safe — a doctor’s office — is where he was injured in the wake of that decision.
Alvarado, 23, of Bismarck, said her 3-year-old son was left bloodied and hysterical after a nurse forcibly, and unnecessarily, retracted his foreskin during a medical procedure.
She said it happened at Sanford Medical Center in Bismarck on Jan. 5 after she brought her son to the emergency room for stomach pains.
“I just really felt like my son was violated and my rights as a mom were violated,” Alvarado said during a recent interview. The Forum is not identifying the boy by name to protect his identity, at the family’s request.
Sanford Health issued a response from Fred Fridley, vice president of operations for Sanford in the Bismarck region, which read:
“While we cannot comment on this patient’s case, Sanford Health always puts patient care at the forefront of the work we do and remains dedicated to meet each patients’ specific health care needs.”
The situation caught the attention of Intact America, a national organization that advocates for families choosing not to have their boys undergo circumcision, a surgery that removes the foreskin within a few days of birth.
Executive Director Georganne Chapin said they continue to receive reports of experiences like Alvarado’s from all over the country.
Chapin said the American Academy of Pediatrics “waffles” on circumcision itself to protect the economic interests of its physician members, but the academy does take a position on the care of intact boys, saying their foreskin should never be forcibly retracted.
“It just seems that the message doesn't get to the practitioners,” Chapin said.
The tissue connecting the foreskin to the head of the penis usually dissolves with the hormones of puberty, if not before, Chapin said, with the average age of spontaneous foreskin retraction at just over 10 years old.
She said too often, however, when a parent brings an intact boy in for an unrelated medical issue, a doctor or nurse pushes the foreskin back, claiming it’s necessary for proper hygiene.
A 2018 survey by Intact America found more than 43% of intact boys have had their foreskins forcibly retracted by an adult before age 7.
Nearly 50% of those forced retractions were done by physicians, 9% by nurses and more than 25% by the boy’s parents, the survey found.
Alvarado’s son was having bad belly pain when she brought him to a walk-in clinic that January day. There, she was advised to take him to a hospital emergency room.
At Sanford Medical Center in Bismarck, a doctor ordered blood tests, an ultrasound and an X-ray, Alvarado said, all of which came back normal.
However, the boy tested positive for respiratory syncytial virus, or RSV, a common virus that usually causes mild, cold-like symptoms.
Still, because his abdomen was so sensitive to pressure, the doctor also ordered a urine test. The boy would have to be catheterized to get a sample due to his age.
Alvarado was reluctant, wanting to spare him the pain and discomfort. She asked the doctor if the procedure was necessary and was told it was, so she agreed.
Four nurses came into the room and advised Alvarado to stay close to her son’s face while holding on to his hands.
Suddenly, her son began screaming.
“I've heard my kid yell a lot and I've heard what he sounds like in pain and it was unlike anything that I'd ever heard,” Alvarado said.
She saw that his foreskin had been pushed back and “there was blood everywhere.”
Alvarado said she told the nurse that a young boy's foreskin should never be forcibly retracted, but the nurse challenged her, saying it should be done at every diaper change.
After the catheterization was done, the nurses left the room and Alvarado called her husband, in tears.
Education gap for doctors, nurses
When the doctor came back to the room, Alvarado told her she was upset that her son’s foreskin was retracted for catheterization and had she known that would happen, she would not have consented.
Alvarado said the doctor acknowledged that wasn’t disclosed beforehand and apologized, but insisted that is the correct procedure at the hospital.
Alvarado said she can’t believe medical professionals at a large hospital were uninformed in that regard.
“It blows my mind,” Alvarado said.
Chapin cited a study that points to an education gap relating to care of intact boys.
The 2021 study in the Journal of Specialists in Pediatric Nursing found nearly 42% of pediatric nurses thought foreskin must be retracted to place a catheter, which is incorrect, she said.
Nearly 53% incorrectly believed foreskin retraction is necessary for genital hygiene until the foreskin naturally retracts. Intact boys can be bathed like any other child, Chapin said.
Alvarado said her son was in pain for days after the ER visit. At his next well-child check, he screamed and cried and tried to run away.
She’s considering therapy for her son because she doesn’t want him to be afraid of doctors.
Chapin said Intact America is launching a campaign to encourage parents who have experiences like Alvarado’s to file a complaint with state medical professional conduct associations.
Chapin would like to see hospitals and clinics adopt policies to prevent such foreskin injuries, but thinks only consumer activism will make that happen.
“They’re not going to do it without being forced to,” Chapin said.