The foreskin is the only part of the human body Americans routinely amputate in the absence of an immediate health threat. Since the American Academy of Pediatrics issued their 2012 statement reversing its previously neutral stance on circumcision, Intactivists have had to step up the education about the harm done by this unnecessary procedure. The AAP’s endorsement of circumcision cites medical issues which may be more prevalent by a few percentage points (sometimes fractions thereof) in the intact male: urinary tract infections, increased chances of STDs including HPV, HIV and others, as well as reduction in penile cancer. And even these are hotly debated. None are a direct threat and all are contingent on possibility, not probability.
What expectant parents must do is weigh the danger in these (mostly) adult threats against the safety of their newborn and his adult sexual health. Expectant parents must also consider the side effects of circumcision, and consider the idea that circumcision is harmful to babies.
When we think about infants, we do not like to think about the sexual beings they will become. Instead, we think of their safety, protection and innocence. But infant boys grow up to be men. All adults, men and women alike, deserve their full spectrums of sexual function and pleasure. The sleeve-like structure that is the male foreskin serves a sexual function so its removal, whether or not it is done in a safe environment, is a permanent alteration of the male sexual anatomy.
Since the penis can function (and has for centuries) without the foreskin, little thought is given to the long-term effects of its removal. Can a man experience sexual pleasure without his foreskin? Millions of men have but it is the quality of the sexual experience that serves both psychological and biological functions. (Prolonged periods of heightened sexual pleasure produce stronger orgasms in both men and women, making conception more likely.) If the plumbing works from infancy through the teen years, what problems could possibly exist? But it is often later in life that cut men start to experience problems.
Circumcision affects function
A study released in the April 2007 British Journal of Urology International (Volume 99, Issue 4, pp. 864–869, Morris L. Sorrells, et. al.) concluded that the “five locations on the uncircumcised [intact] penis that are routinely removed at circumcision had lower pressure thresholds.” In other words, the parts removed in circumcision are more sensitive than the parts which remain. The study also notes that the head [the glans] of the uncircumcised penis is more sensitive than the head of a cut male.
A Belgian study released this year reached conclusions similar to the Sorrells study; a circumcised penis is less sensitive than an intact one. (Bronselaer GA, Schober JM, Meyer-Bahlburg HF, T’sjoen G, Vlietinck R, Hoebeke PB., Department of Urology, Ghent University Hospital, Ghent, Belgium.)
The removal of the specialized mucosal tissue which protects the glans penis also causes, over time, keratinization, a process through which skin cells lose moisture, making them tougher and less sensitive.
A loss of sensitivity may not seem important – to some – but the question of how that loss affects sexual function is the subject of a Danish study published in the International Journal of Epidemiology in October 2011 (Frisch M, Lindholm M, Grønbæk M.) In that study, circumcised men reported various types of sexual dysfunction 3x more often than intact men. According to Morten Frisch, who led the study, “there were differences… the circumcised men reported orgasm difficulties much more frequently than [intact] men.” The most common problem was unnaturally delayed ejaculation and even anorgasmia (inability to achieve orgasm.) Female sexual partners of those men were 10% more likely to report incomplete sexual fulfillment.
Christopher Guest, M.D, co-founder of the Children’s Health & Human Rights Partnership (CHHRP) calls the AAP’s statement “seriously flawed.” In a press release picked up by Reuters and other online publications, Guest states: “‘Circumcision alters the structure of the penis, which inevitably alters function. Long term harm to men from infant circumcision has never been studied.’ He referred to a growing body of anecdotal evidence collected by the Canadian-based Global Survey of Circumcision Harm. Guest said that in the past 12 months over 900 men have answered the online survey to document their harm.”
I was damaged by my circumcision. I learned as an adult that I came home from the hospital with stitches in my penis. Upon examination, it is clear that a major vein was severed and the cut was too deep. Basically, too much flesh was removed from one side. The surgery left me with scarring and extreme sensitivity which causes irritation during certain sexual activities. This sensitivity has grown worse as I get older. My personal issue can be looked at as a combination of the two main arguments against circumcision: immediate danger to the infant and long-term symptoms experienced by the adult.
My complaint may seem an ungrateful one in relation to the grotesque damage on view in images of severely deformed penises resulting from botched circumcisions. Some of these are unbearable to look at it. My own sex life has been basically normal. The damage caused by my cut, because Americans are so accustomed to the circumcised penis, wouldn’t register unless you looked closely. I’ve even been asked to pose nude and appear naked onstage. I don’t know anything other than the sex life I’ve had, yet I can’t help but wonder what my sex life could be like had I been allowed to keep the body nature designed.
Circumcision leads to suicide – The story of David Reimer
In the annals of severe cases, David Reimer’s is one of the most extreme. Reimer’s horror story remained largely unknown until an expose in Rolling Stone Magazine in December of 1997. Reimer and his twin brother were scheduled for circumcision several weeks after birth due to phimosis (a
tightening of the foreskin which is often misdiagnosed in infancy and mistakenly treated through surgery). When Reimer’s surgery went horribly wrong, his brother’s surgery was aborted. The brother’s phimosis cleared up on its own without surgical intervention. But Reimer’s penis turned black and fell off.
The loss of Mr. Reimer’s penis resulted in a series of tragic decisions. First, his parents were convinced by a Johns Hopkins scientist to choose sexual reassignment for David. What followed was an orchiectomy (the complete removal of Reimer’s testicles) and an attempt to raise him as a girl via hormones and dozens of genital surgeries throughout his life. In his teen years, Reimer’s father disclosed what had happened and Reimer attempted to live his life as a man until his suicide in 2004.
Reimer’s story went unreported for three decades. Other stories like it, told by horrified nurses, doctors and O.R. staff, are available to those who will listen. Read more about David’s tragic story at Slate.
One nurse, who spoke on the condition of anonymity, told me: “I had a baby who, shortly after his circ, his penis turned black and necrotic [Author’s Note: Just like David Reimer’s tragedy, above.] He was transferred to our hospital for evaluation and died within two weeks. Then several months ago, we had a partial amputation with urethral involvement. That baby had to be transferred to a tertiary care hospital for repair and will have lifetime urologic complications. The father was inconsolable.”
The damage and, in worst-case-scenarios, death are rarely attributed directly to circumcision itself but rather to complications which would not have arisen had the child been left intact. The associated complications of circumcision include infection, accidental amputation and sepsis. Death due to use of the wrong anesthesia and death from blood loss – whether or not a child is hemophiliac – are also risks.
Circumcision can lead to death
On March 9, 2013, an 11-day-old boy, whose parents posted about his surgical complications from circumcision, died as a result of blood loss due to his circumcision. He was a hemophiliac –a condition which would have been discovered with specialized testing – but had he not been circumcised, he would not have “bled out.” (The loss of a mere 2.3 ounces of blood is enough to kill an infant.)
Noted sex advice columnist Dan Savage (whose position on circumcision has changed since the adoption of his son in 1996), had no consolatory words for a young man who wrote to him in a 2004 column: (http://www.thestranger.com/seattle/SavageLove?oid=19705 ), “I am 24 years old and lost my entire glans penis, the head of my dick, in a botched circumcision. Basically I have a shaft but there’s no head at the end…” Savage used this man’s example in response to a reader’s inquiry about circumcising her infant: “…even if the odds are low–even if they’re infinitesimal,” Savage said, “I would rather teach my son to wash under his foreskin than assume even the tiniest risk of him losing the head of his penis in a botched circumcision.”
Dr. M. David Gibbons, Associate Professor, Pediatric Urology at Georgetown University School of Medicine (who has an impressive list of affiliations in his field) says: “In my practice, as a pediatric urologist, I manage the complications of neonatal circumcision… in a two-year period, I was referred greater than 275 newborns and toddlers with complications of neonatal circumcision. Forty-five percent required corrective surgery – minor as well as major, especially for amputative injury. [With] 300 pediatric urologists in this country who have practices similar to mine… one can do the math.”
A case need not be extreme to cause sexual dysfunction (which does not always mean erectile difficulties but could include pain, irritation, anorgasmia and lack of sensitivity) or emotional trauma.
Circumcision harms men at all stages in life
Adam Z., a handsome 30-year-old in the computer industry, told me he became “enraged” when he learned that he had lost a part of his body. “No one feels sympathy when you tell them you were harmed by circumcision… We vehemently oppose the cutting of female genitals but men’s genitals are sent to the chopping block in infancy… the sexist double-standard regarding genital cutting in this society is absolutely staggering.”
Thirty-one-year-old Intactivist Jonathon Conte is open about his anger but finds it a difficult subject to revisit. He channels his feelings into “the human rights movement to abolish non-therapeutic, non-consensual genital cutting. I believe that all individuals – male, female and intersex – have a fundamental right to bodily integrity.” An events coordinator for Bay Area Intactivists, Conte wants people to understand that “circumcision negatively impacts a man and those around him throughout life.” With Americans in denial that the foreskin serves a necessary function, the job of activists like Conte becomes doubly difficult, struggling with their own resurfacing feelings while trying to educate.
Another Intactivist, here referred to as “Leo” asks, “Why do you think the foreskin covers the head of the penis? Why does it exist? Why does it move the way it does? One moment of scientific thought should get you thinking.” Leo tries to get people to understand that there are no mistakes in nature’s design. “Why?” Leo says, is one of the first things a child learns to ask but they are quickly taught to stop asking because there are some things parents and society don’t want to acknowledge. “I kept asking ‘why’ about my circumcision and when I found out the answer, I was disgusted that something so delicate would be cut from a baby’s body. It was mine. What right did anyone have to take a part of my sex organ!?”
Peter C., a Filipino man residing in New Zealand after being raised in the Philippines, was circumcised in adolescence. “Getting cut,” he maintains, “didn’t really stop me from [masturbating.] It only made it less enjoyable.”
Jonathan Friedman was circumcised in a bris, the Jewish religious ceremony which is performed on the eighth day after birth. As he matured, he realized that his “shaft skin was very tight. I always injured myself and had to stop masturbating or having sex,” because of it. “I don’t feel anything when I have penetrative sex,” he says, “and I orgasm unexpectedly or not at all.”
Some men have no feelings at all about their circumcision. Others live with rage. The long-term, psychological effects of circumcision can only be examined, at present, through anecdotal evidence, since no high-profile studies have been published. But columnist Dan Savage had a remarkably erudite and direct way of addressing the question of whether or not to circumcise an infant:
“…most cut men are happy with their dicks… and most uncut men are happy with theirs. The thing about the unhappy cut men, though, is that they can’t get uncut, you know what I’m saying?”
After all, shouldn’t it be a man’s choice? A choice made for him is no choice at all.
This article is combined version of two essays originally published at www.theweeklings.com . Read more articles from Tom Gualtieri at theweeklings.com . The full text of both articles can be read here:
OUR BODIES OUR CHOICES: PART I – http://www.theweeklings.com/tgualtieri/2012/08/31/our-bodies-our-choices-part-i/
OUR BODIES OUR CHOICES: PART II – http://www.theweeklings.com/tgualtieri/2013/02/22/our-bodies-our-choices-part-ii-men-and-their-members/