Circumcision: Social, Sexual, Psychological Realities
Part 3: Should circumcision tradition trump ethics and empirical evidence?
Posted September 18, 2011 | Reviewed by Ekua Hagan
We continue examining myths about circumcision, including traditions, social and sexual relations.
Myth: You have to circumcise the baby so that he will match his dad.
Reality check: The major difference that boys notice is that dad's penis has hair, and is larger. When a boy notices the difference between his foreskin and his father's lack of one, just tell him, "When your father was born, they thought that you had to cut off the foreskin, but now we know better." Since when does parent/child bonding require a matching set of genitals? If it did, could mothers and sons bond, or fathers and daughters? The real issue at play here is protecting the father: if it is okay for his son to not be circumcised, then he did not have to be circumcised, and so he is missing something from his penis. It is not right to harm the child's body to spare the father's emotions.
Myth: My first son is circumcised, so I have to circumcise my second son.
Reality check: You can explain this to your children the same way as with the circumcised father. There are plenty of families who changed their minds after one or more sons were circumcised, and didn't circumcise any more. See here. As with the "matching dad" myth, what is really at issue here are the parents' feelings: if they don't circumcise the second son, then that means that they didn't have to circumcise the first child, and so they harmed their first child. This can be unbearably painful, but it is not right to continue to harm future children to avoid dealing with pain and regret. As they say, two wrongs do not make a right.
Myth: My husband is the one with the penis, so it is his choice.
Reality check: If your husband is circumcised, he has no idea what having a foreskin is like, and he is likely operating from a psychological position of needing to believe that what was done to him was beneficial and important. (See here for an extended discussion of pre and post circumcised adult men and much more by Marilyn Milos, director of NOCIRC.) The baby is the one who is going to have to live with the decision for the rest of his life, not your husband. The baby will be the one who has to use the penis for urination and sex — it should be his decision.
Myth: Everyone is circumcised.
Reality check: Actually, worldwide, only 30% of men are circumcised, and most of these men are Muslim (WHO 2007). Most modern, Westernized countries have rates well below 20%. In the United States about 25 years ago, around 85% of babies were circumcised. The rates have dropped substantially to 32% in 2009, according to a report by the Centers for Disease Control (El Becheraoui 2010).
Myth: Circumcision is an important tradition that has been going on forever.
Reality check: In the United States, circumcision wasn't popularized until Victorian times, when a few doctors began to recommend it to prevent children from masturbating. Dr. Kellogg (of Corn Flakes fame) advocated circumcision for pubescent boys and girls to stop masturbation: "A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anæsthetic, 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... In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement" (Kellogg 1877). Circumcision caught on among the sex-negative Victorians, but only wealthy parents could afford it. In 1932, only 31% of men were circumcised; this peaked around 85% in 1980 and has been dropping ever since (Laumann 1997, Wallerstein 1980). Far from an ancient tradition, it was only popular in post-war America; think of it as "your parent's body mod."
Myth: The other boys will make fun of him.
Reality check: What other cosmetic surgeries will we perform on our children to prevent them from being teased? Should a "flat" girl get implants? What about the boy with a small penis? What surgery would be recommended for him? Circumcised babies are the minority now, and so intact will not be mocked. Plus, as our husbands say, "You just don't look at or comment on another man's penis in the locker room."
Myth: Circumcision makes sex better for the woman.
Reality check: The function of the foreskin for women in intercourse is to seal the natural lubrication inside the vagina and provide a gentle internal massaging action. The intact penis moves in and out of its foreskin, which provides a frictionless, rolling, gliding sensation. Intact men tend to make shorter strokes that keep their bodies in contact with the clitoris more, thus aiding female orgasm (O'Hara 1999). On the other hand, the circumcised penis functions like a piston during intercourse - the head of the penis actually scrapes the lubrication out of the vagina with each stroke. As the man thrusts, his skin rubs against the vaginal entrance, causing discomfort, and sometimes pain (O'Hara 1999, Bensley 2001). Far from making sex better for women, circumcision decreases female satisfaction.
Myth: Women don't want to have sex with uncircumcised men.
Reality check: In a landmark study of US women, 85% who had experienced both circumcised and intact men preferred sex with intact men. Sex with a circumcised man was associated with pain, dryness, and difficulty reaching orgasm (O'Hara 1999). In another study, women were twice as likely to reach orgasm with an intact man (Bensley 2003). Even when a woman said she preferred a circumcised partner, she had less dryness and discomfort with intact men (O'Hara 1999).
Myth: "Being circumcised doesn't affect my sex life."
Reality check: Men who are circumcised are 60% more likely to have difficulty identifying and expressing their feelings, which can cause marital difficulties (Bollinger 2010). Circumcised men are 4.5 times more likely to be diagnosed with erectile dysfunction, use drugs like Viagra, and suffer from premature ejaculation (Bollinger 2010, Tang 2011). Men who were circumcised as adults experienced decreased sensation and decreased quality of erection, and both they and their partners experienced generally less satisfaction with sex (Kim 2007, Solinis 2007).
Myth: "If I were any more sensitive, it would be a problem."
Reality check: The foreskin contains several special structures that increase sexual pleasure, including the frenulum and ridged band (the end of the foreskin where it becomes internal), both of which are removed in circumcision. The LEAST sensitive parts of the foreskin are more sensitive than the MOST sensitive parts of the circumcised penis (Sorrells 2007). In other words, if you wanted to decrease a penis' sensitivity the most, circumcision would be the ideal surgery. The foreskin has nerves called fine-touch receptors which are clustered in the ridged band (Cold 1999). This type of nerve is also found in the lips and fingertips. To get an idea of the sensation these nerves provide, try this experiment: first lightly stroke your fingertip over the back of the other hand. Now stroke your fingertip over the palm of your hand. Feel the difference? That is the kind of sensation the foreskin provides, and the circumcised man is missing.
It may feel like the penis is overly sensitive to a circumcised man because there is little sensation left to indicate excitement, leading to unexpected premature ejaculation (a common problem with circumcised young men). However, as circumcised penises age they become calloused and much less sensitive. (See the interview listed below for more details.)
Should concern about family or community traditions hold priority over the short and long-term welfare of the individual? Certainly not in the case of infant circumcision.
*Note: Primary author is Lillian Dell'Aquila Cannon, with assistance from Dan Bollinger; firstname.lastname@example.org.
Male circumcision: Global trends and determinants of prevalence, safety and acceptability. (PDF). World Health Organization. 2007. http://whqlibdoc.who.int/publications/2007/9789241596169_eng.pdf. Retrieved Sept. 14, 2011.
Bensley GA, Boyle GJ. Physical, sexual, and psychological effects of male infant circumcision: an exploratory survey. In: Denniston GC, Hodges FM, Milos MF, editors. Understanding circumcision: a multi-disciplinary approach to a multi-dimensional problem. New York: Kluwer Academic/Plenum Publishers; 2001. p. 207-39.
Bensley, G. et al., Effects of male circumcision on female arousal and orgasm, NEW ZEALAND MEDICAL JOURNAL, Volume 116, Number 1181: Pages 595-596, 12 September 2003.
Bollinger, D., Van Howe, R. S. (2010). Alexithymia and Circumcision Trauma: A Preliminary Investigation (in press).
Cold CJ, Taylor JR. The prepuce. BJU International 1999; 83, Suppl. 1: 34-44.
El Becheraoui C, Greenspan J, Kretsinger K, Chen R. Rates of selected neonatal male circumcision-associated severe adverse events in the United States, 2007-2009 (CDC). Proceedings, AIDS 2010, Vienna, Austria. 5 Aug 2010.
Kellogg, J. Plain facts for old and young: embracing the natural history and hygiene of organic life, 1877.
Kim D, Pang M. The effect of male circumcision on sexuality. BJU Int 2007;99(3):619-22.
Laumann, EO, Masi CM, Zuckerman EW. Circumcision in the United States. JAMA 1997;277(13):1052-7.
O'Hara K, O'Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int 1999;83 Suppl 1:79-84.
Solinis I, Yiannaki A. Does circumcision improve couple's sex life? J Mens Health Gend 2007;4(3):361.
Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult penis. BJU Int 2007;99:864-9.
Tang WS, Khoo EM. Prevalence and correlates of premature ejaculation in a primary care setting: A preliminary cross-sectional study. J Sex Med, 14 Apr 2011, Available online at: http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2011.02280.x/abs…
Wallerstein E. Circumcision: An American health fallacy. New York: Springer Publishing Company; 1980:217.
Interview with Marilyn Milos, Director of NOCIRC (National Organization of Circumcision Information Resource Centers) on her quarter-century-long efforts to eradicate infant circumcision. Michael Mendizza of Touch the Future is the interviewer.