Tom Gualtieri voices his opinions on male circumcision in part two of his series, Our Bodies, Our Choices.
This is the second part in a series on circumcision. Read Part One: Circumcision is Not a Joke
“A remedy which is almost always successful [to stop masturbation] in small boys is circumcision… The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment. The soreness which continues for several weeks interrupts the practice…”
~John Harvey Kellogg, physician (1852-1943)
The abuse Kellogg suggested back in the late Victorian era is enough to turn the stomach of any 21st Century parent. While “abuse” may seem too strong a word for such a common procedure, Kellogg’s description of circumcision as a “remedy” is both a misrepresentation and a gross understatement. According to Kellogg, if you find your son touching himself, you should punish him by cutting off a part of his penis – a kind of one-slice Pavlovian training. To me, that’s psychotic.
The Victorian ideal promoted a reduction of pleasure as beneficial to the health of the soul. That influence continued into the 20th Century. Here’s another bit of anti-foreskin wisdom from the ominously-named Dr. R.W. Cockshut, published in a 1935 edition of the British Medical Journal (Br Med J 1935;2:764.1):
“I suggest that all male children should be circumcised … Nature … covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin. Thus the adolescent has his attention drawn to his penis much less often.”
Then there’s this gem:
“Another advantage of circumcision … is the lessened liability to masturbation … as a rule, pleasurable sensations are elicited from the extremely sensitive mucous membrane [the inner mucosa of the foreskin] with resultant manipulation and masturbation. The exposure of the glans penis following circumcision … lessens the sensitiveness of the organ.”
~ Ernest G. Mark, Circumcision, American Practitioner and News, vol. 31 (1901): pp. 121-126.
The ghastly motive behind the push for circumcision is clear: to interfere with male sexual pleasure. The expectation of the result was, to say the least, illogical. Boys masturbate whether they are circumcised or not – just ask one. Well, never mind asking; a teenage boy isn’t going to tell you he masturbates. But trust me on this one. My mother spent many an hour at the washing machine dealing with crunchy socks, towels and t-shirts.
Before we get to this article’s sore subject – the effect of circumcision on the adult – I should offer a caveat; I am well-aware that there are thousands of circumcised men who are perfectly happy with their penises. Noted sex advice columnist Dan Savage (whose position on circumcision has changed since the adoption of his son in 1996) put it this way:
“…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?”
This is the core of the argument against routine infant circumcision (RIC). Circumcised men cannot get back what was taken from them. My friends know that I am unhappy about my own circumcision and they often find ways of gently poking fun at my activism. Although I am vocal about my opposition to RIC, I don’t speak about the anger I carry with me and how deeply troubled I am by the fact that a part of my sex organ was removed without my consent. In preparing for this article, I interviewed men whose feelings about circumcision range from indifference to rage. Some of them are more vocal about their anger but there is one consistent thing about the expression of it: Men are supposed to put on their big-boy pants, stop whining and be glad they were circumcised because _____ (fill in the blank.)
Americans have been taught that the foreskin is a useless flap of skin: God’s mistake. There is little to no education about its function – not even within the American medical community. The foreskin, you see, is is the ONLY part of the body we routinely remove in the absence of compelling medical data. There is not one medical issue related to the foreskin in infancy which cannot first be treated through means other than surgery. The American medical community is simply ignorant of the intact penis.
The more I read about the “little flap of skin,” removed during “the snip,” the less I am able to endure the euphemisms which belittle men’s genital and sexual integrity. Why is RIC so routine in America? What is it about American culture that dictates we should remove a healthy part of the human anatomy so as to avoid talking about hygiene and (insert high pitched scream here) S-E-X? Is it really preferable to cut off a part of our sons’ genitals because it makes us uncomfortable to teach them to have confidence in their bodies as nature made them? Why are circumcising cultures like ours so desperate to believe in the dubious benefits attributed to circumcision? Why do American parents not think forward to their sons’ adult sexuality? And why, I keep wondering, is there a double standard when it comes to sexual rights?
Adam Z., a handsome 30-year-old in the computer industry, is an Intactivist, one of thousands of men (and women) nationwide who fight against RIC. Many Intactivists also fight for worldwide genital integrity and are vocal about their support for women and the intersex who also suffer choices imposed on them by others. Adam attends demonstrations and symposiums on circumcision and speaks out about it one-on-one when the opportunity seems right. He is straightforward, erudite and seemingly at ease with the most discomforting of subjects. Even when discussing his own anger at being circumcised, he remains reasonable – an impressive feat for someone who says he became “enraged” when he learned that he had lost a part of his body. In a long and compelling interview, he told me:
“…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.”
A female acquaintance of mine has said, regarding the pro-choice movement, “Men have no rights when it comes to women’s bodies.” She also indicated that religious motivation should have no bearing on reproductive choices but she hesitated when asked if the same applied to men in regard to circumcision, which is part of her own religious heritage.
Men have feelings too – about a whole bunch of stuff (shocker!) and their regard for their genitals is almost universal. Men protect their manhood, metaphorically and physically. Freud’s “castration anxiety” follows us around, even unconsciously. But when it comes to circumcision there seem to be two camps: the “man up” camp and those who refer to their circumcisions as a betrayal, robbery, mutilation and even rape.
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.
Genetic anomalies and deformities notwithstanding, why do Americans consider the foreskin an evolutionary mishap? Like every part of the human body, it is functional. The foreskin, or prepuce, protects the glans, which is meant to be an internal organ (look at the penis of any mammal). It also provides a natural “gliding mechanism” which eliminates the need for extra lubricant during penetrative sex. It is this gliding mechanism which makes sex more pleasurable for men and women. It is also loaded with nerves (some 10,000-20,000 of them in 12-15 inches of tissue) which provide additional stimulation and then there are the blood vessels needed for proper flow to and from the penis during erections.
“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!?”
Visually at least, the glans penis and the clitoris seem correlative, but a 2007 study led by Morris L. Sorrells determined that the foreskin itself, not the head of the penis (the glans), is the most sensitive part, making the foreskin more analogous to the clitoris in terms of its nerve function. The study also concluded that the head of the penis is more sensitive in the intact male. The clitoris, which is protected by a prepuce embryonically analogous to the foreskin, remains hyper-sensitive because it remains covered.
“The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce [the muco-cutaneous junction] is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates [the muco-cutaneous junction], the most sensitive parts of the penis.”
The removal of the specialized mucosal tissue which protects the glans also causes, over time, keratinization, a process through which skin cells lose moisture, making them tougher and less sensitive. Keratinization is the process referred to by Dr. Cockshut. The more leathery surface of the glans makes it less sensitive.
A Belgian study released just this year concluded the same thing as the earlier 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.) 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 the [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.
Frisch is careful to point out that his study does not indicate all circumcised men have problems. Anecdotally, anyway, we know this just isn’t true but cut men are more likely to report dysfunction. Even in the absence of sexual dysfunction, circumcised men report changes in sensation after surgery. Dragging a scalpel through the flesh is bound to cause damage. You’ve surely heard of it happening in face lifts, caesarian sections, and hair transplants. The difference with circumcision is that once the tissue is amputated – along with its connecting nerves – it is discarded. The nerves are permanently severed and cannot be regained.
Peter C., a Filipino man residing in New Zealand after being raised in the Philippines, was circumcised in adolescence. He says there was a notable change after his circumcision. Before, he says, the tip of his penis was so sensitive it made him pleasurably “…weak at the knees.” That changed after he was cut. Then, he says, he ceased to produce any noticeable pre-seminal fluid and lost much of the pleasure in masturbation. “Getting cut,” he maintains, “didn’t really stop me from [masturbating.] It only made it less enjoyable.”
Immediate complications from infant circumcision also occur though there is no adequate study data to tell us the numbers. (An Intactivist might argue that a denuded penis IS a serious complication.) Some of these require direct medical attention and follow-ups for years.
In a Savage Love column from 2004, a young man wrote to Dan Savage to say, “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…” (As a man, I can think of nothing more horrible happening to my body than damage to my genitals as a result of someone else’s flawed decision.) Savage used this young 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… 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.”
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.”
Loss of sensation, lack of sensation, flesh on the penis too tight – none of this is normal. The knowledge that parts of the sex organ have been removed without their consent and, possibly, that the highest quality of sensation has been lost is partly what fuels the frustration of the Intactivist movement and a connected offshoot: foreskin “restoration.”
Foreskin “restoration” is the process of applying tension to the skin of the penile shaft in order to induce mitosis – a subdivision of cells which produces more skin. Mitosis is used in post-mastectomy reconstruction and to create skin grafts for burn victims. Men looking to “regrow” their foreskins apply manual, non-surgical stretching techniques periodically throughout the day or wear a specialized device for many hours which accomplishes the same thing. A cottage industry has sprung up around the movement, with private manufacturers making devices just for this purpose. The process takes years and is only partially successful in that there is no way to regain the specialized parts of the intact penis. At the very least, it can restore some of the lost sensation in the glans penis by bringing it back to its previous state of suppleness.
It may seem desperate, or crazy or just kinda weird to think of men trying to re-grow their foreskins. But re-empowerment is part of the allure. Some restoring men, who gather in internet groups online and in support groups such as NORM (the Nationwide Organization of Restoring Men), report physical as well as psychological recovery through restoration. Jim K. from Arizona insists that he has experienced new sensations since his restoration. Circumcised at 5 years old, Jim believes his restoration has been successful. “It was like having the lights turned on…I had no idea of the vast increase in sexual sensation that a foreskin provides.” Jim also reports, “…it is highly empowering changing something that was done without my consent.”
“Ian” has been restoring as well. Having been cut at birth, restoring is “as much a psychological healing process as a physical one… The closer I get to calling myself restored,” he says, “the more whole I feel.”
Ian, like most of these men, has battled the negative feelings that come along with the recognition of loss. “I’ve had to work past the feelings of betrayal and the acknowledgment that I have suffered…” Betrayal is a theme repeated by men who feel they have been awakened to their body’s true functions. Ian emphasizes “It was mind boggling to me how it could never occur to someone how cruel, barbaric, and tortuous a procedure it is… that parents still believe this is beneficial and swallow the medical establishment’s party line without question especially in this age of readily available information.”
The movement toward gentle beginnings to life drives Ryan McAllister, a biophysicist, Assistant Professor of Physics and Oncology at Georgetown University, and the Executive Director of www.notjustskin.org, a non-profit organization which supports childbirth education, female and male genital integrity and intersex rights.
Over the last 10 years, McAllister has been studying the medicalization of childbirth in U.S. hospitals. His site provides a vast array of data on all aspects of parenthood, and the organization provides local talks and an extensive lending library. He is soft-spoken and patient, choosing his words carefully. (At various points in our conversation he was careful to check in and see if I understood his points.) He has lectured about the foreskin in an attempt to curb RIC. Understanding some people will be squeamish, McAllister maintains an easy tone, despite his passion on the subject. His excerpted lecture, “An Elephant in the Hospital,” available at YouTube, is an example of his ability to put people at ease with an uncomfortable subject. (The full version is also available for viewing here.)
McAllister came to his work through an interest in interpersonal relationships which led to studies of power and attachments dynamics in situations like childbirth which, of course, involves relationships not only between the new mother and her child but also between patient and physician. “You can dissect obstetrics into set of attitudes and procedures. For example, I have compiled a list of 20 odd procedures which are unnecessary, often even harmful. And one of them obviously – to me a very major one – is circumcision.”
I asked McAllister what he thinks happens to the mother/child bond if one of the child’s first events after birth is for the mother to turn the child over to someone else, allowing this very painful thing to happen. Circumcision, I proposed, disrupts the attachment cycle.
“I have certainly talked with a lot of moms who say that when they receive their child back that it then hit them what they had allowed to happen, because their child was upset. The child is bandaged, bleeding and crying.”
McAllister then went on to make a point I had not considered:
“…[the mother] hadn’t been prepared for that. I think it’s subjecting a parent to something to even approach them with the idea of doing this. There’s a broken informed consent process.”
In his lecture, one of McAllister’s slides quotes Michelle Storms, an MD who stopped performing circumcisions in 1988: “Any person who wants to subject a child to this should be required to witness one first.”
The long-term, psychological effects of circumcision can only be examined, at present, through anecdotal evidence, since no high-profile studies have been published. In my own interviews, I was amazed to have other men articulate for me things I have been feeling for almost 3 decades: that a part of my body was taken without my consent. In the past I’d thought, “Maybe I’m making too much of it. Is it possible that these feelings are misdirected from somewhere else?” But Jonathon Conte was able to point out, “when victims such as myself do speak out we are often ridiculed or our pain is minimized.”
The combination of dismissal and misinformation affirming the foreskin as “just a little bit of a skin” instead of the sexually functional part that it is, leads many men to silence. They simply don’t know there is something missing. But those who have conducted their own research believe infant circumcision is wrong.
Adam Z., in his erudite way, brought the humanity of it home;
“It took a long time to come to grips with the fact that someone had taken something so obviously valuable from me in the name of cultural aesthetics. My feelings have never changed. I will always resent that this was done to me. I will always be upset that I can’t experience sex the way that it was meant to be experienced. I will always feel ripped off by society. I will always feel inferior to women whose genitals are adamantly protected throughout the world. I can’t walk around angry all of the time … I have come to peace with it and don’t walk around angry (as much as I used to).”
Adam is, like most of us, unable to completely let it go. Every time we look down, we see that part of our genitals was removed.
“My wheels can spin for hours trying to make myself feel better about it — but in the end the only escape is to accept that it was done and try to keep it from happening to the boys that are being born today.”
Originally appeared at The Weeklings
Read Part One of Our Bodies, Our Choices: Circumcision is Not a Joke
Lead photo: Flickr/fontplaydotcom
Other photos are courtesy of original publisher, The Weeklings