So Your Son has Hypospadias

By Larissa Black, The WHOLE Network, Board Member

So your son has hypospadias. I am here with wonderful news to share with you. Are you ready? Your son does not need surgery!  I know what I’m saying flies in the face of what doctors have told you. It’s an entirely different reality from the one you’ve come to terms with as a family. I’m going to say it again, and this time, really let it sink in. Feel the relief that comes when I tell you, sincerely:

Your son does not need surgery!

Now let me explain.

I’ve been collecting stories for years from families who’ve dealt with hypospadias and there are several important things you need to know that doctors may not tell you.

The first is the most important: The vast majority of men who have unrepaired hypospadias do just fine! Meaning, they are not emotionally scarred by having hypospadias, they are able to lead normal lives, they are perfectly fertile and do go on to have children naturally, they pee standing up, and they are not bullied for the way they look. While it is natural for parents to be concerned about these issues, many research studies and personal accounts demonstrate that most boys and men are not negatively affected by having a penis with hypospadias. One study, featured in Reconstructive Urology, concluded, "Of the adults we surveyed with hypospadias, most stated that they were satisfied with the appearance of the penis, voided in the standing position, and did not have infertility associated with the abnormal position of the urethral meatus."

Now to talk about the surgery itself. Parents considering this surgery for their children need to know that hypospadias repair surgery will never, ever result in a "normal" looking phallus. The end result, no matter how “good” the surgical outcome, is going to be scarred and disfigured. I know that sounds harsh, but it cannot be emphasized enough that the resulting post-surgical aesthetic is far more unusual than if the child had not been modified. You can visit the Belgrade Center for Genital Reconstructive Surgery’s photo gallery to see images of what these men’s penises look like after having hypospadias surgery in their youth (scroll to the Photo Gallery link). Many are visiting this center for further repairs years after their initial surgery (or surgeries).

The ugly fact is, these repair surgeries are fraught with complications. The initial surgery is generally the first of many more surgeries to come; the subsequent surgeries are often needed to repair issues that the corrective surgery created. In a heartbreaking personal account that was relayed to me by a friend, one boy, after multiple surgeries to repair his hypospadias, was crying and pleading with his parents to please just give him his "normal penis back.” Of course, by the time you get to that point, there is absolutely no going back.

Dr. Tiger Devore is a psychologist who faced multiple surgeries to repair hypospadias in his youth, and now speaks out against these surgeries. It is not only children themselves who suffer from the experience of genital surgery; as many as half of the parents who have put their sons through hypospadias repair end up regretting it. View these studies from 2015 and 2014 to read more about decisional regret and hypospadias repair.

My childhood was filled with pain, surgery, skin grafts, and isolation. And I still have to sit to pee… It would have been just fine to have a penis that peed out of the bottom instead of the top, and didn’t have the feeling damaged.
— Dr. Tiger Devore

It is easy to understand why a parent of a child with hypospadias would want to fix their child’s condition, but unfortunately, when it comes to hypospadias, the "fix" often doesn’t fix anything — it only makes things worse. If the child can urinate and the condition isn't causing him physical harm, it's best to let his body grow and develop and let him decide, as an adult, how he would like to proceed. Instead of focusing on trying to change the physical features of his penis, the parent can teach their child self-acceptance.

A brief word for parents whose sons have already undergone this surgery:  
The information above is in no way intended to shame, belittle, or berate you for having made this choice for your child. I have all the love and respect for you in the world for having embarked on such a difficult emotional journey. I know that the U.S. medical community often presents surgical correction as the only option for hypospadias, and no choices were ever made without your child’s absolute best interests at heart. 

Consider joining the Your Whole Baby: Community for Learning for questions and support.