“It quickly became apparent that what had just happened was a catastrophe… I died in 2015, not now.”
Lesley Roberts was stunned as she read the devastating final email from her beloved son Alex Hardy.
The email had been timed to arrive on 25 November 2017, 12 hours after he killed himself. Less than an hour before the email arrived, Lesley had opened her front door to find a police officer standing there, explaining her son was dead.
Alex was an intelligent and popular 23-year-old with no history of mental illness. Lesley could not understand why he would have wanted to take his own life.
His email explained how the foreskin of his penis had been surgically removed two years before. This is commonly known as circumcision, but Alex had come to believe it should be regarded as “male genital mutilation”.
He never mentioned this to his family or friends when he was alive. Lesley did not even know her son had been circumcised.
In the following months, she tried to find out more about circumcision. Why had it affected Alex so badly, and why did he feel killing himself was his only option?
Alex was the eldest of Lesley’s three sons and had been very much longed for, having been conceived after fertility treatment.
Lesley says her “dreams came true” when she became a mother in July 1994.
“He was everything I could have wished for,” she says. “Gorgeous, easygoing, and adoring of his younger brother Thomas who arrived following more treatment almost three years later.”
He also adored his baby brother James, who was born when Alex was 13. The walls and windowsills of Lesley’s home in Cheshire are covered in photos of all of them.
Alex sailed through his education and was particularly gifted at English, so much so that his old school established the Alex Hardy Creative Writing Award in his memory.
“Alex was passionate about history but as his English teacher I saw in him a true talent for writing,” says Jason Lowe, who is now head teacher at Tarporley High School.
It was while on a school skiing trip to Canada, aged 14, that Alex fell in love with the country. He had enjoyed skiing as a child and the trip reignited his passion. So, when Alex reached 18, he decided to defer university and live in Canada for a year.
“He fell in love completely with Canada and made so many friends and got a promotion at work,” says Lesley.
“After one year he rang me and said ‘Mum, I’m deferring my place for university’. The same thing happened after year two.”
Two years turned into three, then four, and by the time of his death Alex had been living in Canada for five years and had obtained residency.
“He was known as the ‘super-smart Brit’ with impeccable manners,” says his mother. “The super-intelligent guy from the UK who helped people with their Canadian residency applications.”
Lesley visited her son several times, both alone and with his brothers and stepfather. They were a close family, but Alex did not tell any of them he was secretly suffering with a problem with his penis.
“I had issues with a tight foreskin,” he eventually wrote in his final email, “but from my late teens it created issues in the bedroom as it meant my foreskin would not retract over the glans as intended which caused some awkward moments.”
In 2015, still silently suffering, Alex consulted a doctor in Canada. He was given steroid cream to stretch his foreskin, but went back to the doctor after just a few weeks because he did not think the treatment was working.
The medical name for Alex’s problem is phimosis. It simply means his foreskin was too tight to pull back from the head of his penis, or the “glans” as Alex referred to it in his email. This is perfectly normal for boys in the early years of their life. As boys get older, their foreskin usually starts to separate from the head of the penis.
Phimosis does not always cause problems, but if it does, problems can include difficulty urinating and pain during sex. In England, the NHS advises topical steroids and stretching techniques – and circumcision as a last resort.
Over in Canada, where circumcision is more common, Alex was referred to a urologist.
“He immediately suggested circumcision,” Alex wrote. “I asked about stretching and he completely lied to my face and said it would not work for me.
“I was mostly trusting as I felt he was the expert who knew best in this regard so with a pinch of salt I accepted it.”
Lesley has since read online reviews of this urologist which have made her question his competence. One patient said she had been unable to work since having surgery for kidney problems, and he had “destroyed” her quality of life.
“I’m a mother of three young children who are scared every day I will die as they see me suffering in so much pain,” she wrote.
“I can see how he misdiagnosed others, botched surgeries, and ruined lives,” said another review. “He’s dangerously incompetent.”
Another review of Alex’s urologist read: “They left a surgical instrument in my bladder but I only got notified three months later. Run away before you get hurt!”
Lesley, who was “horrified” by these reviews, has asked for the urologist to be investigated. She has been told an inquiry is ongoing.
The College of Physicians and Surgeons of British Columbia told the BBC it “cannot disclose the existence of a complaint against a physician, and only may do so if the complaint leads to formal discipline”.
“I will wish with my last breath and with all of heart that my darling son had run away,” says Lesley.
Much to his regret, Alex was not able to research the urologist – or circumcision – properly at the time because his laptop was broken.
He had tried researching the topic in a public computer space but felt uncomfortable, and also felt it was “too much of a taboo” to discuss with friends.
So Alex booked what he believed was a minor procedure and had the surgery in 2015, at the age of 21.
In the email to his mother, Alex explained, in great detail, the physical problems he had suffered afterwards.
He described experiencing constant stimulation from the head of his penis, which was no longer protected by his foreskin.
“These ever-present stimulated sensations from clothing friction are torture within themselves; they have not subsided/normalised from years of exposure,” he wrote.
“Imagine what would happen to an eyeball if the eyelid was amputated?”
“He was in so much pain that it hurt to do normal physical activity,” says Lesley. “He was a keen skier and snowboarder so you can imagine the pain he was in.”
Consultant urological surgeon Trevor Dorkin, who is a member of the British Association of Urological Surgeons, advises his patients that the head of their penis will be more sensitive after circumcision.
However, this sensitivity usually reduces.
“I always say to guys ‘it’s going to feel more sensitive to start with’ because all of a sudden you haven’t got this protection over the head of the penis and it will feel different,” says Mr Dorkin, who has carried out more than 1,000 circumcisions.
“But in the vast majority of the cases the man adjusts to that, the brain adjusts to that, it adjusts to the signals that are coming back through the nerves from the head of the penis.”
Alex also wrote about experiencing erectile dysfunction, and burning and itching sensations, particularly from a scar which sat where his frenulum was removed. This is analogous to removing the clitoris in women.
“It’s one of the more erogenous zones so it’s thought to be important in sexual function,” says Mr Dorkin.
In fact, the foreskin tugs the frenulum with each stroke back and also forth. No frenulum, no stimulation during sex. Most men can barely orgasm from regular sex.
“The foreskin, the head of the penis and the frenulum is a very, very sensitive area.
But not after circumcision, it’s all gone then and it can end badly.