Clip the Tip? Point/Counterpoint on Male Circumcision

Whether or not to circumcise your newborn son is probably the very first big decision you’ll make for him. Several decades ago, the choice would have been easy; in the 1970’s, around 90% of American-born males were circumcised. Today that number has fallen to around 60%, and the practice is markedly less popular in many other countries. The debate over whether or not to circumcise can get quite fiery, and it remains a divisive and controversial issue. Every couple should research the pros and cons of circumcision and come to the decision about what is best for their baby. To aid men in thinking through the issue and in hopes of creating civil discussion on the matter, today we present a point/counter point on circumcision.

We’ve brought together a few of our friends who have taken a side on the issue. First, we have Ryan and Amy Lee who will be arguing against circumcision. In the pro-circumcision corner, we have Jeff Trexler.

And just to give fair warning, this article does discuss sex. So if you’re easily scandalized like a Victorian housewife, please go ahead and skip this article.

Point: Circumcision does more harm than good, carries unnecessary risks, and should not be performed routinely.

Written by Ryan and Amy Lee

Considering routine neonatal circumcision is the most frequently performed surgery in the United States, it is surprisingly often misunderstood. Despite medical doctors’ vow to uphold the Hippocratic oath, primum non nocere (above all, do no harm), circumcision seems to be the exception to their rule. Typically the burden of proof would be upon a medical intervention to prove itself worthy of possible attending risks. However, because circumcision is rooted more in tradition than medicine, many doctors and parents agree to the procedure without fully examining the logic, or lack thereof, substantiating it.

As a Canadian-born intact male, I have the unique perspective of understanding the anatomical function of the foreskin firsthand, as does my wife. Based on personal experience, as well as extensive research, we have concluded that the procedure does more harm than good, carries unnecessary risks, and should not be performed routinely. Though the literature contains far more information than can be encapsulated here, we will attempt to scratch the surface of the case against circumcision and will also encourage your further consideration and research as you make choices on behalf of your children, or discuss the matter with other parents.

Because an intact penis is the default, rather than attempting to extol what is simply natural, we will approach our argument against circumcision by elaborating on the logical fallacies in the pro-circumcision arguments. We recognize the proliferation of web-based arguments on both sides of this issue, so all arguments here come from peer-reviewed articles, professional medical associations, and our own personal experience. That said, one of the most compelling pieces of web-based information on this subject is the video footage available, so if you really want to see why circumcision is a bad idea, search “routine infant circumcision” on Google video and brace yourself.

Fallacy #1: Circumcision is desirable because it promotes cleanliness and prevents disease. As an owner of an intact penis, I can confidently say that my cleaning habits are probably identical to yours and are more than sufficient to get the apparatus clean as a whistle. If our primary goal is removing people’s folds of protective, functional skin to prevent the possible accumulation of secretions, we should be going after baby girls with the scalpel. Thankfully, this idea that would horrify most everyone in the U.S., and I think the idea of approaching baby boys similarly should be equally horrifying. Regarding disease, the notion that circumcision is a legitimate preventative measure is simply unsubstantiated and, in fact, some research indicates that the foreskin may be protective against infection. The rate of circumcision is a mere 6% in the UK, and, in fact, the U.S. may be the only developed nation to practice routine infant circumcision. Check out this global distribution map provided by the World Health Organization.

Fallacy #2: The foreskin is unnecessary and can be removed with no adverse effects. In my experience, the loudest proponents of this argument are circumcised men who, with all due respect, don’t have much basis for comparison. Admittedly, I have never had a circumcised penis myself, but accounts of men circumcised as adults compare the difference in sexual sensitivity after the procedure to seeing in black and white after once seeing in color. This seems understandable given the foreskin is significantly more highly innervated than the rest of the shaft. In my experience, the foreskin itself is the source of by far the most genital sensation and pleasure. In a circumcised adult male, the amount of skin missing is about the size of a 4X6 index card (depending on overall size)-over one third of the penile skin. The foreskin’s anatomical function is myriad. One important function is protecting the glans the way the eyelid protects the eye; in the absence of a foreskin, the glans becomes keratinized from rubbing against clothing and is much less sensitive. Another important function that the foreskin provides an erotogenic (good feeling!) gliding sheath over the shaft, reducing loss of lubrication and decreasing the friction that can decrease pleasure for both partners . In infants the foreskin is adhered to the glans, like a fingernail, and so before it is cut off, it must be separated. One can imagine this is extremely painful and leaves the glans exposed before it is mature enough for the foreskin to separate on its own, usually during early childhood. Additionally, I have both read about and personally known individuals with complications resulting from circumcision and, though very rarely, sometime even death can result from excessive blood loss or infection. It should be noted that these cases, though rare indeed, occur with similar or greater frequency than deaths from penile cancer, which is often cited as a reason to circumcise. Perhaps we should start removing infants toes at birth too, to prevent possible ingrown toenails in old age, or the dreaded toe cancer. Just sayin’.

Fallacy #3: If circumcision is going to be done, it is most ethical to do it during infancy, so the person won’t remember it. I’ve heard many circumcised men remark that they sure are glad the procedure was done when they were babies so that they don’t have to remember it. While I agree that having a piece of my penis cut off without anesthesia is a memory I would prefer to avoid, there is a better way to avoid it-leaving those kids alone! As I become more educated about circumcision and find myself discussing it with others it seems that for every man who, with bravado, claims his circumcised member is exactly to his liking, there is at least one humble fellow who admits, sometimes with great emotion, that he wishes such important decisions about his body had been left to him-he would have chosen to spare himself a traumatic experience during his first moments and live life with a complete, intact penis. I am glad that so many circumcised men are as satisfied with their penises as I am with mine. I am also glad that so many wives and partners are equally pleased. However, I know some men and women who grieve the loss of the foreskin from their relationship and wonder how things would be different. When a baby boy is born he, obviously, can’t consent to the procedure and by the time his opinion can be known, it is often too late. Parents must make many choices about their children without their consent, it’s true, but choosing a cosmetic genital surgery is, in my mind and many others’, taking that liberty way too far. If there is a chance your son wouldn’t want it done to his penis, why would you take the risk? At the end of the day, if you decline to circumcise your son, he always has the option to do so himself later in life. But if you consent to the procedure, everyone’s hands are tied. There is no way to fully restore what has been lost.

Fallacy #4: Intact penises are less cosmetically desirable. Whoa there! Again, I am relieved to know that so many men like the looks of their circumcised penises, and pleased that their partners share their appreciation, but this is a bold claim. Understandably, people with positive experiences with a penis, their own or their partner’s, will develop an affinity for that specific penis and may come to think that theirs is the “best.” Great. We want everyone to love their penis around here; taking good care of penises is really what we’re talking about anyway. But my wife emphatically prefers my penis just as it is: intact. And, I’m not gonna lie, so do I. People like the penises that they personally have good experiences with.

Fallacy #5: It is important for a boy to look like his father. Of all the fallacies, this one is the most confusing to me personally, probably because my dad is circumcised but I am not and neither are my three brothers-and nobody gives a rat’s. I understand that making a different choice for your son than your parents made for you may tacitly imply some level of dissatisfaction with your own experience, and heaven knows the idea that a man’s penis has been compromised is a bitter pill for him to swallow. However, in the spirit of this blog, I submit to you this question: is it manlier to protect your ego or your newborn? I know lots of circumcised guys who are proud as can be of their penises but leave their sons intact. In many other cases, the baby’s mother would prefer the baby be left alone and it is the father who insists on the surgery, without having done any real research on the subject. Be a man, do your homework and be rational. Emotions are important, but when protecting your pride comes before your duty to protect your family, something is out of whack.

For more information, please see:

http://www.cirp.org/

http://www.circumcision.org/

http://www.doctorsopposingcircumcision.org

Counterpoint: Circumcision is a legitimate choice with few disadvantages and several advantages.

Written by: Jeff Trexler

I’d like to start off by saying that I’m not really pro-circumcision per se. I wouldn’t try to convince someone who wasn’t going to circumcise that they were making the wrong choice. It’s no skin off my, um, back. What I would like to argue is that circumcising is in fact a perfectly legitimate choice. This is a stance that many anti-circumcision advocates will simply not allow. Take for example the following reader’s comment made in reference to a recent article in Men’s Health on the subject (an article I highly recommend everyone read):

“Subjecting non-consenting individuals to any amputation of any of their normal, healthy, living body parts grossly violates their unalienable human rights. It constitutes crimes against humanity; torture, mutilation, human vivisection. Nazi doctors were convicted at Nuremberg after World War II of committing these crimes against humanity during the war.”

The idea that circumcision constitutes a human rights violation is positively ridiculous. I take the same stance that the American Academy of Pediatricians does: there are benefits and there are disadvantages to circumcision and everyone should do their research and come to the decision they feel is best for their child. As for me, if I have a son, I plan on circumcising him. And I don’t think I should be put on trial at Nuremberg. Here’s why.

First let me address three of the points opponents make and then I will add my positive reasons:

Traumatic for the baby? Circumcision is undoubtedly no picnic in the sun. But I don’t think it’s abject torture for the kid either. Yes there are videos that string together shots of screaming babies as they undergo the procedure, but those are cherry picked and misleading. Who knows when these pictures were taken? The videos often show the baby with its arms restrained crucifixion style-which is rarely done anymore. And babies today are also routinely anesthetized before the procedure and given a sugar covered pacifier which helps mitigate the pain. This doesn’t mean that the procedure is painless, but it’s not cruel and unusual punishment either. My sister-in-law works as a neonatal nurse and has seen tons of circumcisions done; she says that some babies sleep right through it. Yes, some babies do scream and cry, but babies scream and cry even when they’re not being touched at all.

Furthermore, there’s no evidence to show that it permanently damages kids’ psyches or causes any kind of psychological trauma when they grow up. If that were true, you would think that babies who had true medical emergencies as newborns, the ones that were being stuck with needles, incubated, and cut open, would grow up to be insane. The baby doesn’t know why you’re cutting him after all. But alas, this simply isn’t the case. So a little snip is not going to leave them emotionally scarred; either way they don’t remember it.

The baby doesn’t have a choice! So true! And the baby sadly doesn’t have a choice in who its parents are, where it’s going to live, what it’s going to be fed, what religion it will be raised in, where it will go to school, and on and on and on. Parents make hundreds of choices for their children, many of which will have far greater effects on their life than circumcision will. That’s a parents job-to make decisions for their kids that they feel are in their best interest. I understand that men can choose to be circumcised later in life, but it would be more traumatic then, a fully remembered event. Best to snip it in the bud right away.

The sensitivity issue. Perhaps the most fear-inducing argument the anti-circumcision people employ is the idea that a circumcised penis is not as sexually sensitive as its circumcised counterpart. Yet no study has conclusively proven that to be true. The American Academy of Pediatricians reports that in a self-reporting study, circumcised men enjoyed “more varied sexual practice and less sexual dysfunction” than their uncircumcised brothers. And the APA calls reports of loss of sensitivity in circumcised men merely “anecdotal.”

Meanwhile a real study has shown the idea to be a myth. The LA Times reports:

“A recent controlled study published in the January issue of BJU International, the British Journal of Urology, looked at nearly 4,500 Ugandan men, ages 15 to 49, who were all sexually experienced. Researchers randomly selected half to undergo circumcision, and half to have a circumcision in 24 months. They compared the two groups at six, 12 and 24 months to measure sexual satisfaction and performance.

The circumcised group’s rate of sexual satisfaction remained constant, with 98.5% reporting sexual satisfaction before circumcision, and 98.4% reporting so two years after the procedure.”

Men who are circumcised later in life do sometimes say that it takes more friction to get things going, but find their orgasms equally or sometimes even more intense. And if you can keep the great orgasms while also lasting longer and pleasing your woman, isn’t that a good thing? I doubt a lot of women are wishing their men were more sensitive than they already are.

Anti-circumcision advocates also say that sex is less pleasurable for the women because the foreskin provides natural lubrication. But again, such a theory is based on anecdotal evidence. For every story you can find online of women preferring sex with an uncircumcised penis, you can find ones which favor the alternative. (Warning! This link contains graphic language and pictures). Many women prefer the feeling of an circumcised penis; women have said that having sex with a uncircumcised man feels as though he is having sex inside his own foreskin instead of inside of her.

And now for the pros:

Like Father, Like Son. I’m circumcised, and my son will be circumcised too. My son should look like me in that way. Some people, especially women it seems to me, dismiss this reason as baloney. While it’s true that my son will not see my member very often, if he does, I want them to look alike. I can’t even explain why; I just do.

Hygienic. The inner layer of the foreskin has glands that create a substance called smegma, which the dictionary describes as a “cheese-like substance.” Uncircumcised men must regularly lift and cleanse under their foreskin to prevent this build-up. Sure, doing that is no big deal for adult men (although knowing the cleanliness habits of my male friends, I’m not sure it would always get done). But for little boys and old men who don’t realize the importance of hygiene or can no longer clean themselves respectively, the foreskin can be problematic. It’s not just a myth; my grandfather, who lives in a nursing home, developed an infection in his nether regions because he did not clean under his kangaroo pocket. And his is not an isolated case. In fact, the reason that circumcision became the norm in this country can be traced to the experiences of our GI’s during World War II. 145,000 soldiers who took part in the North African campaign were beset with foreskin related ailments, including “balanoposthitis (inflammation of the foreskin and glans), phimosis (a foreskin that’s too tight to retract over the glans), and paraphimosis (a foreskin stuck in the retracted position).” (MH) Whether or not you’ll ever find yourself in the trenches, circumcision keeps a man’s member nice and clean. Which brings me to my next point:

The Ladies Love It. I’ve known a handful of women who have been with both uncircumcised and circumcised men, and they all preferred the latter, especially when it came the act of oral sex. There’s nothing erotic about anything that can be described as “cheese-like.” Women like how a circumcised penis looks and they perceive it as cleaner. My evidence for this claim is of course anecdotal, but scientific studies back it up as well.

Circumcision helps reduce disease. Anti-circumcision advocates would have you believe that there are no bonafide medical reasons for being circumcised. But such is not the case. Lise Johnson M.D. the director of healthy-newborn nurseries at Boston’s Brigham Women’s Hospital said recently, “The weight of scientific evidence might be shifting in favor or circumcision.” Here are the reasons backing up such a statement:

• A study carried up by the National Institute of Health reports that circumcision can prevent a man’s acquiring of HIV by up to 64%. (NIH)

• Circumcised men have a reduced risk of contracting syphilis. (APA)

• Uncircumcised male infants have as much as a 10 times greater risk of getting a urinary tract infection than their snipped brethren do. (APA)

• Uncircumcised men have a 3 times greater risk of developing penile cancer. (APA)

• Circumcised penises reduce the rate of cervical cancer in women. (BMC)

In conclusion, I truly believe that circumcision is a perfectly legitimate choice. But I encourage you to do your own research and make the choice you feel is best. As you do so, be careful when simply googling the subject. Many of the sites that come up such as circumcision.org and cirp.org look to be straightforward information sites but are in fact heavily biased on the anti-side. It’s best to stick with looking at scientific studies and sources which do not have a preset agenda and bias.

Thanks Lee family and Jeff! Alright, now it’s time for you all to weigh in. Vote in our poll. Afterwards, drop a line in the comment box and voice your opinion, but please keep it civil.

I’ve closed the comments on this post. The discussion isn’t going anywhere and people were starting to thread jack.