Circumcision

Female circumcision (often referred to as FGM or female genital mutilation, is a form of genital surgical modification). Today female circumcision is widely understood to be a dangerous and inhumane practice which has both immediate and lifelong negative consequences. There is a growing effort around the world to stop this practice, which has maimed and killed millions of females of all ages.

Male circumcision is also a form of genital mutilation and genital modification. However, in some parts of the world, notably the United States, it has become so common as to be considered a beneficial and harmless practice.

Male circumcision involves the surgical removal of part or all of the foreskin of the male penis at any time in that individual’s life. In many tribal societies circumcision is still performed as part of a rite of passage all boys are expected to go through to enter manhood. Boys may or may not be prepared psychologically to undergo this painful ritual and it is most commonly done to groups of boys the same age.

The practice of newborn male circumcision began in Victorian England and quickly spread to the English-speaking world. However, in the decade after World War II, circumcision was eliminated in most of these countries as a direct result of a scientific paper written about the value of the normal foreskin. When the British health service suddenly stopped paying for this practice it quickly went out of fashion.

Soon the United States was the only industrialized Western nation to practice routine circumcision on newborn baby boys. For decades the rate of circumcision in the U.S. hovered around 90%, with non-Jewish infant boys being circumcised within the first hours after birth.

Among the worldwide Jewish community circumcision has been a routine practice for centuries that takes place on the 8th day as part of a ceremony to welcome boy infants into Judaism and the Jewish covenant with God.

For many years U.S. parents were simply told this ‘procedure’ was being done or had already been done and they were not given enough information to make a conscious decision about whether or not it should be done. ‘We’re going to circumcise your son now.’ or ‘We’ve just circumcised you son and his penis will be a little red and sore and need special care for a while.’

Before anyone today performs this serious (potentially lethal) surgical act on any child for any reason, parents must be fully informed of the immediate and long-term consequences and potential risks to their child. In addition, every parent needs to know the purpose of the foreskin and what its functions are for lifelong physical and psychology health and sexuality.

Today any parent who considers having his or her newborn baby circumcised needs to see a circumcision. There are 2 well made and informative films on circumcision available on Birthing The Future’s website store. One focuses on circumcision done for religious reasons. The other is about circumcision in general: it’s history, implications, potential benefits and risks.

The last decades of the 20th century saw enormous efforts made by concerned parents and professionals (nurses, physicians, attorneys, therapists) to stop routine newborn male circumcision in the U.S. Today there is a large and active grass roots movement to educate parents and professionals and to require fully informed consent of the parents or guardians before this serious surgery can be performed.

Today there is also a large and growing body of scientific evidence addressing both the positive value of the intact foreskin and the long-term damage from circumcision (psychological as well as physical). The long-term damage does not just affect the male but all of his sexual partners, who suffer the effects as well.

The rate of circumcision has slowly been brought down to 60% and the movement to educate parents and professionals will continue until all children (both male and female) have genital integrity until they, as adults, can make their own decision about any permanent changes they wish to make to parts of their bodies.

© Suzanne Arms, founder of Birthing The Future®


The following information has been provided by Marilyn Milos, RN, Executive Director of the National Organization of Circumcision Information Resource Centers (see www.NOCIRC.org)

What is the male foreskin? The foreskin (prepuce) is the movable fold of skin on the distal portion of the penis that comprises half or more of the penile skin system. Every foreskin has 3 known functions:

1. Protection. The foreskin covers and protects the urinary opening (meatus), keeping the urinary tract sterile, and the glans (head) of the penis, keeping the mucous membrane soft, moist, and sensitive;

2. Sensory. The foreskin contains 20-40,000 highly specialized, erogenous nerves that allow a male to know what his penis is feeling and where he is in relation to the orgasmic trigger. These specialized nerves (Meissner’s corpuscles) are nowhere in the body more concentrated than they are in the ridged band encircling the foreskin’s opening;

3. Sexual. The foreskin provides the tissue necessary for a full erection and the gliding mechanism necessary for normal sexual function. The ridged band everts with intercourse, exposing the ridged band’s concentrated sensory nerve endings. These nerves provide pleasurable sensations as well as, when stretched, stimulate the bulbocavernosal muscle responsible for ejaculation.

Circumcision is a primal wound that interferes with maternal/infant bonding, disrupts breastfeeding, and undermines the infant’s first developmental task of establishing trust.

Circumcision is where sex and violence meet for the first time, and it imprints the connection between the brain and penis with pain instead of the pleasure that organ is meant to feel.

Scientific Facts:

  • The foreskin is a normal, protective, sexually-functioning organ
  • Circumcision is an amputative surgery with inherent risks, including hemorrhage, infection,
  • Circumcision is painful — even when analgesia is used
  • Circumcision leaves both physical and psychological scars
  • Circumcision denies a male’s right to a fully functioning penis and leaves him with decreased sensitivity, pleasure, and sexual fulfillment
  • Circumcision denies a male’s right to genital integrity and self-determination

Circumcision is always fear-based in any society that practices it. The fears have changed over the years, and some fears have persisted long after the myths have been debunked.


A Short Fascinating History of Circumcision Around the World

From the earliest oral history of genital cutting comes the first fear of the Dogon tribe, which was that people were born dual-gendered and the male part (today called the clitoris) had to be excised from the female and the female part (today called the foreskin) had to be excised from the male so that people were single gendered and could procreate.

Some people claim that Egyptians practiced circumcision, based on a bas relief found in the tomb of Ankhmahor (6th dynasty, c 2300 BC), at Saqqarah, Egypt. Others claim that the boys depicted in the relief were not being circumcised but were merely being shaved. Some people claim that circumcised Egyptian mummies have been found.

Biblically, in the old testament, Abraham’s covenant with God, among Jews, supposedly occurred around 1700 BC. However, the Genesis 17 text was actually written a thousand years after Abraham was supposed to have lived. Jews fear that, if a baby is not circumcised, he will be “cut off” from his people. However, a growing number of Jewish boys are having their bar mitzvah with foreskin intact, so the fear has not being realized.

During the mid-1800s in the English-speaking countries (starting with England), the fear of the day was masturbation, which was at that time believed to cause myriad ills, including scoliosis, hernia, gout, kidney disorders, blindness, epilepsy, and masturbatory insanity!

By the turn of the 20th century, the microscope had been developed. This resulted a new theory of disease called the ‘germ theory was put forth. So the next excuse pro-circumcision advocates was the fear of germs and the inability of boys to practice good hygiene with a foreskin.

Penile cancer was the fear of the 1930s. Cervical cancer was the fear of the 1950s. Sexually transmitted diseases was the fear of the 1960s, coinciding with the sexual revolution.

During the 1970s, as people challenged and began questioning routine medical procedures—radical mastectomy, routine tonsillectomy, routine episiotomy, and routine circumcision—the next scare tactic was that a boy would look different from his dad or peers. This was not a concern when circumcision was introduced into western medicine, but when the practice was challenged, it became paramount.

During 1980s, it was said that circumcision would prevent urinary tract infections (UTI) in baby boys in the first year of life. The studies upon which this belief was based were quickly proven to be seriously flawed. Common sense told some parents and professionals that, if antibiotics were being used for UTIs in baby girls, they could be used when necessary for boys as well.

During the ’80s, pro-circumcision advocates began the rumor that male circumcision would prevent HIV/AIDS. However, the U.S. has both the highest rate of male circumcision in the post-industrial world and also has one of the highest rates of HIV/AIDS. So common sense says this idea too is flawed. Any penis is at risk of transmitting or contracting HIV/AIDS. Clearly, education about safe sex and condom use are the best effectivemeasures against the spread of HIV/AIDS.

Newborn circumcision is, at the very least, an unkind invasion of a precious newborn baby. For many babies it is a lifelong trauma and no one can predict which male will be traumatized by circumcision. It is also unkind, at the very least, to diminish the size and sensitivity of any male’s organ of procreation and pleasure.

There is not one national or international medical association in the world that today recommends circumcision. One by one national and international organizations are coming out with clear statements against all routine newborn circumcision. In addition, in the U.S. state by state Medicaid is eliminating reimbursement to physicians for performing this unnecessary surgery.

We now must recognize the importance of loving and respecting all infants and children and protecting them from unnecessary circumcision. All children deserve the right to genital integrity and self-determination.

© Marilyn Fayre Milos, RN, Executive Director
National Organization of Circumcision Information Resource Centers

 


Frequently Asked Questions About Circumcision

By Ryan McAllister, Ph.D., Executive Director of NotJustSkin.org
Heather Lindsay M.S.

1. Isn’t circumcision just a little snip?

Circumcision is much more than that. In a typical infant boy, the foreskin is a double-sided sleeve of skin and soft mucosal tissue that completely encloses the glans (the head of the penis). It is actually physically bonded to the infant’s glans. This skin contains thousands of blood vessels and specialized nerves. In an adult, it would grow to cover 12-15 square inches. To remove this structure, a doctor forces a metal clamp inside the foreskin, and tears the skin away from the glans. The doctor then slices the foreskin down past the glans and cuts the foreskin off. The entire procedure is excruciatingly painful. It is often done without anesthesia, since anesthetizing such a young infant can be very dangerous. Partial or complete amputation of the penis sometimes occurs. Some children even die from the trauma, hemorrhage, or other complications.

2. What problems can occur after the initial surgery?

Immediately after circumcision, a child is at risk for infection and hemorrhage. The loss of the protective foreskin places him at risk for complications including meatitis (inflammation and ulceration of the urinary meatus), meatal stenosis (constriction of the meatus, resulting in blocked urinary flow and potential infection), preputial stenosis (scarring that constricts the glans), and buried penis (entrapment of the penis by scar tissue). Together, these conditions, which are almost unheard of in non-circumcised males, affect up to 20% of circumcised males and may require additional surgery.

A circumcised male may also experience chafing and abrasion of the exposed glans against clothing, painful erections due to the tightened skin, scarring, and desensitization that can severely reduce enjoyment of sexual activity. A circumcised penis may be significantly smaller than it would otherwise have been. For more information, see the Science Library, under “Complications of circumcision.”

3. Isn’t female circumcision worse than male circumcision?

Female circumcision is typically viewed as more horrific than male circumcision because it is usually done under unhygienic conditions rather than in a hospital, and because one form of female circumcision, infibulation, is particularly severe. However, both male and female circumcisions are classed as genital mutilation by the International Coalition for Genital Integrity. Both forms of circumcision remove functional, normal tissue, cause extreme pain, permanently disfigure the genitals, and permanently damage the sexual response. When done to infants or children, both male and female circumcisions violate human rights since they are performed without the individual’s consent.

The World Health Organization recognizes three types of female circumcision. Type I removes the clitoral hood and/or the clitoral tip. Type II removes the clitoral hood, clitoris, and part of all of the labia. Type III, also known as infibulation or pharaonic circumcision, involves removal of all external female genitalia and suturing of the vaginal opening.

Male circumcision can be compared to type I or II female circumcision. Although the glans is not harmed at the time of circumcision, the loss of protective structures causes it to dry out and lose sensitivity over time. It is also important to note that many of the nerves and pleasure receptors present in the clitoris are, in the male, present in the foreskin, so removal of these nerves constitutes a loss that can be most adequately compared to a partial clitoridectomy.

4. What is the value of the foreskin?

Throughout life, the foreskin protects the sensitive glans from injury, abrasion, chafing, and infection. The foreskin keeps the glans soft and moist so that it maintains sensitivity. During sexual activity, the foreskin glides up and down over the glans, providing pleasure from thousands of specialized nerve endings. Parts of the foreskin, including the frenulum (a narrow membrane on the underside of the foreskin) and the ridged band (the edge of the foreskin, between the inner and outer skin), are particularly important in sexual function. See the Science Library, under “Foreskin sexual function.”

The foreskin secretes immunological substances that fight infection, called lysozymes, and also produces natural lubricants, reducing the need for artificial lubricants during sex. The presence of the foreskin can enhance the sexual experience for both partners. Polls of women who had experienced both circumcised and uncircumcised partners indicated a strong preference for the latter, with longer duration of coitus and higher rate of orgasm cited as the main reasons (for example, see “The effect of male circumcision on the sexual enjoyment of the female partner” from the Science Library).

5. If circumcision were really harmful, wouldn’t a lot of men be talking about it?

A lot of men are. National organizations such as NOCIRC (National Organization of Circumcision Information Resource Centers) and NORM(National Organization for Restoring Men) testify to the existence of millions of men who have lost sensitivity and function due to circumcision. Married, single, heterosexual, homosexual, and bisexual men of all ages are finding that their adult sexuality has been compromised by the loss of their foreskins in infancy.

Because our culture discourages men from admitting feelings of inadequacy or discussing health problems, particularly those of a sexual nature, many men have felt unable to describe their problems or have not found a receptive audience to their concerns. Many are also unaware of how much feeling they have lost; it is impossible for a circumcised man to know what degree of pleasure he might have enjoyed, had he not been circumcised. There is medical literature suggesting that circumcision causes sexual dysfunction later in life, as well as anecdotal evidence from circumcised men who experienced problems with chafing or lack of pleasure from sex (see Personal Stories).

Circumcision affects each man differently. During the healing process, some may be able to reroute the severed nerves and blood vessels and may retain feeling, while others may suffer a greater loss in their ability to feel. Some men feel numb during sexual activity and are unable to feel any pleasure. One man who was circumcised as an adult compared his sexual experiences before and after to the difference between seeing in color, and seeing in black and white.

6. If circumcision doesn’t provide any health benefits, then why do doctors still do it?

The primary reason in the United States is cosmetic. The image of the circumcised penis has become so much a part of our cultural consciousness that most people do not know what a non-circumcised penis looks like. They may feel that the natural look is ugly or may think it is unhygienic. Discomfort with the natural appearance of the penis is a learned response.

The power of tradition cannot be underestimated. Many parents cite their desire to have their son look like his father, or like his friends. As the circumcision rate in the U.S. falls (it is now around 65%), the intact penis will become the norm instead.

Some parents ask for circumcision because they believe that it will save their sons from having health problems later in life. In fact, circumcision does not provide any protection against infection, penile cancer, or sexually-transmitted diseases (including HIV/AIDS), and does not reduce the rate of cervical cancer in female partners. (See the Science Library, under “The role of the prepuce in prevention of disease and infections.”) Myths about circumcision are slow to die and are still used to justify many surgeries.

Another reason doctors continue to perform circumcisions is that they, like the general public, are unaware of the value of the foreskin. The standard medical education in the United States includes the technique of circumcision but not a description of normal penile anatomy or function. Around the turn of the century, medical textbooks began printing images of circumcised penises instead of intact ones, so most medical students do not even have the opportunity to learn what a normal adult penis looks like.

Circumcision is a quick, easy procedure that doctors can perform in just a few minutes. The cost of an infant circumcision is a few hundred dollars. Amputated foreskins can be sold later to pharmaceutical and medical research companies for use in the production of shampoos, emollients, and skin for burn therapy. The financial incentives may complicate the issue.

7. Isn’t circumcision part of Jewish religious heritage?

Circumcision occurs in both Jewish and Islamic religious traditions. In Judaism, the circumcision is performed during a naming ceremony called a Brit Milah, and is done by a mohel on the 8th day of life. In many Islamic traditions, circumcision is done near puberty, and the ceremony is called a kataan.

The vast majority of infants who are circumcised in the United States do not have Jewish or Muslim parents and are not circumcised for religious reasons. Furthermore, hospital circumcision does not fulfill religious requirements because it is not performed as part of a religious ceremony.

Within the Jewish community, there is much disagreement about circumcision. Some feel that circumcision contradicts other aspects of the Jewish religion. The Torah forbids the torture or causing of pain to any living creature, especially physically assaulting or harming another person (Exodus 21:18-27). Jewish law specifically forbids body modification, including the cutting or marking of the human body (Lev. 19:28). Jews are also required to help those who are helpless, such as newborn infants, and are exempt from performing religious duties that would cause harm to others.

There is an alternative ceremony called a Brit Shalom that incorporates the tradition of the naming ceremony without damaging the foreskin. Ronald Goldman’s article, ““Circumcision: A Source of Jewish Pain” provides an in-depth discussion of circumcision from a Jewish perspective. There is additional information under the Religious Support section of our site, including contact information for Jews Against Circumcision.

Some ethicists feel that all types of infant and child circumcision, whether done as part of a religious ceremony or not, violate human rights. Female circumcision is seen as a human rights violation even though it occurs in the context of a religious ceremony.

8. Some babies don’t even cry when they’re circumcised, so it must not hurt them. Even if it is painful for them, if they can’t remember the pain later, why does it matter?

It’s impossible for us to know what kinds of long-term consequences a procedure as traumatic as circumcision might have on the developing mind and senses of a newborn baby. Babies who don’t cry during circumcision are so severely traumatized by the pain that they lapse into a state of shock. For all infants, the experience of circumcision is an injury that betrays their early desire to bond with their caregivers. Babies who have been circumcised are significantly more likely to avoid eye contact, to be unresponsive to adults, and to have problems breast-feeding.

Babies may feel pain more intensely than adults. Because the neural pathways that allow ‘pain-killer’ endorphins to be released in response to severe injury are not yet fully developed, babies may experience more intense and unrelenting pain than they would if they were subjected to the same trauma later in life. There is also evidence that the memory of circumcision pain is retained far longer than previously thought. In one study, circumcised male babies reacted more severely to the pain of vaccination months later, than non-circumcised male babies did. See the Science Library, under “Pain of circumcision and pain control.”

9. If parents decide not to have their son circumcised, won’t he be teased?

The body of a non-circumcised boy is normal, healthy, and whole. A proper understanding of his own anatomy and the reasons he was allowed to remain intact, will enable a boy to feel self-confident about his body. Furthermore, circumcision is already uncommon internationally and is becoming less common in the U.S.

10. Isn’t it more complicated to care for an uncircumcised penis?

An infant’s foreskin is non-retractable and should not be forcibly retracted for cleaning. It does not require any particular care. By the age of 18, most men’s foreskins will have become retractable, and can be cleaned by sliding the foreskin back, rinsing with warm water, and letting the foreskin slide forward again. It is not necessary to use soap or any harsh cleansers. The intact penis is a self-cleaning organ that produces smegma (a creamy substance also produced by females, containing dead cells and immunological substances) to combat infection. See the Science Library, under “Proper penile hygiene for intact men.”

Following circumcision, the penis requires careful attention and monitoring. In the absence of complications, the wound takes as long as ten days to heal. During this time, the child may have difficulty sleeping and breastfeeding. In addition, there is a risk of infection, adherence of the bandages to the wound, and abnormal healing.

11. What if an uncircumcised man has problems with his foreskin later?

The most commonly cited indication for circumcision after infancy is a condition called phimosis, in which the foreskin becomes inflamed and tight around the glans. This can result from premature, forcible retraction of the foreskin, which causes tearing of the skin and creates a raw wound susceptible to infection. Circumcision is an excessive treatment for phimosis, which can be resolved by steroid creams, preputioplasty, and gentle manual loosening and stretching of the foreskin. See the Science Library, under “Conservative treatment of penile problems.”

Like every part of the body, the foreskin has the potential to develop malignancies. Malignancy of the foreskin is extremely rare (approximately 1 in 100,000) and occurs mostly in older men. The only other medical reasons to circumcise are frostbite and gangrene of the foreskin, also extremely rare.

12. How late can parents wait to make the decision about circumcision?

Parents may wait as long as they like to make this life-changing decision; circumcision does not need to be performed at any particular point. Parents are typically asked during pregnancy whether they want a circumcision if the child is a boy. In more rushed scenarios, mothers may be presented with a circumcision consent form while they are in labor or under anesthesia. Doctors usually do not provide comprehensive information about the procedure or its effects, so parents need to take the time to educate themselves about it.

If they decide not to circumcise, they must be prepared to enforce their decision and to not allow the infant to be removed from their sight while they are in the hospital. There are numerous cases of circumcisions being performed on infants whose parents had not given consent, or who had directly indicated that they did not want a circumcision done.

13. What is foreskin restoration?

Partial, non-surgical restoration of the foreskin is possible. Circumcised men who wish to restore their foreskins can attempt the slow process of non-surgical restoration, which involves gradually stretching the shaft skin over the glans until it grows enough to cover the glans. There are various techniques, including daily manual tugging, taping, or extension devices like weights. The process typically requires several years. Many men who have restored report benefits including reduced chafing, enhanced lubrication and softness, and enhanced pleasure during sex. For more information, visit the National Organization of Restoring Men (NORM).

 

© 2003 NotJustSkin.org. Reprinted by National Coalition of Free Men, with the permission of the authors.