By Michael Mooney (December, 2010)
Leave it to San Francisco to promote an agenda to outlaw something so controversial, it’s bound to blow our minds.
Yes, San Francisco resident Lloyd Shofield is pushing a bill to outlaw circumcision, saying that no choice is given to baby boys who are being "mutilated" for no good reason.
Some circumcision proponents say it reduces the spread of sexually transmitted diseases (STD’s), including HIV.
But eight studies say they’re wrong. Others say it’s just more hygienic. One blogger commented, “Have you been around someone who’s uncircumcised on a hot, sweaty summer day?”
Both sides are adamant, especially those who circumcise as part of their religion.
Well, Shofield doesn’t consider religion a good enough reason to "mutilate" baby boys who have no choice.
He wants a guy to be able to make his own mind up when he’s an adult.
So why does religion promote circumcision? Some religions say "God commanded it." These include Jews, Coptic Christians, Ethiopian Orthodoxy and some Muslims (although the practice seems to be contrary to what is said in the Qur’an). Notably some Jews denounce circumcision, as do many Christians.
GOD IS GOOD, REALLY?
I have a feeling that if there is a God, God is supremely logical, so somehow I can't believe that "God commanded it."
So what's the real reason? Well, one Jewish rabbi, Moses Maimonides (1135-1204), said in his work The Guide of the Perplexed, “…one of the reasons for it is… to bring about a decrease in sexual intercourse and a weakening of the organ in question, so that this activity be diminished and the organ be in as quiet a state as possible.” (Part III, Chapter 49).”
So, religions’ real reason is to keep their male flocks a bit “calmer,” meaning duller and more under control. “I’m sorry, Rabbi. Do you really think that’s OK in the 21rst Century?”
Recently, the Centers for Disease Control said that 32% of boys underwent the procedure in 2009, down from 56%, in 2006. The American Academy of Pediatrics has decided that the medical benefits are insufficient to recommend routine circumcision of baby boys. So, more parents are sparing their sons from the bloody pain.
Unfortunately, this isn’t happening fast enough. In 2005, in New York City, Rabbi Yitzhok Fischer, acting as a mohel (one who is trained to circumcise) infected three baby boys with herpes when he performed circumcision, and according to an old ultra-Orthodox (haredi) Jewish tradition called “metzitzah b'peh,” sucked blood from the boys’ bleeding penises. Newborns have weak immune systems, so one died from herpes infection and one suffered brain damage. (Metzitzah b'peh is reportedly currently performed over 2,000 times a year in New York City alone.)
In fact, death from circumsion is so well known that ancient Jewish law allows parents who have had three sons die from circumcisions to leave the fourth son intact.
Circumcision kills other baby boys because of complications, calculated at somewhere between 117 and upwards of 200 a year in the USA. But all deaths from circumcision are not reported as such. Doctors don't want to be exposed to echics probes, so deaths are frequently reported as happening from other causes. If a baby dies from a meningitis infection that was caused by circumcision, only meningitis might be reported.
THE INCREDIBLE CURE-ALL
In the late 1800’s, when circumcision became popular in the United States, American medicine laughably thought that circumcision was an effective treatment for such "diseases" as masturbation, headache, insanity, epilepsy, paralysis, rectal prolapse, clubfoot and virtually every other ailment.
Medical journals published thousands of case reports demonstrating these and other silly miraculously therapeutic benefits.
Interestingly, the notion that circumcision improves hygiene and prevents STD’s originated at the same time some were debating racial and moral hygiene and whether to force circumcision or even castration on black males to curb their “brutal and uncontrollable passion” in a campaign against venereal disease.
American doctors back then readily embraced mass, involuntary circumcision just as they had embraced involuntary sterilization and other eugenic measures--practices rejected by almost all other Western nations. Even Catholic-majority countries like Spain and Italy reject circumcision today.
Somehow, it seems American medicine hasn’t progressed that much. Critical evaluation confirms that current reasons for circumcision are no more credible than they ever were.
NO. IT DOES NOT STOP HIV
One African study in 2003 said that males who are circumcised are less likely to become infected with HIV. That study was later dismissed in the journal “Sexually Transmitted Infections.” It stated, “The Council on Scientific Affairs of the American Medical Association says that ‘‘circumcision cannot be responsibly viewed as ‘protecting’ against such infections.”
They further stated, “The leading international statement of medical ethics is the European Convention on Human Rights and Bioethics, where Article 20(1) prohibits non-therapeutic tissue removal from those who do not have the capacity to consent. Children have a right to the protection of the security of their person and to protection from degrading treatment. Circumcision violates those human rights. Several authorities report that circumcision degrades the erectile function of the penis. Circumcision, therefore, must be regarded as degrading treatment. Degrading treatment is an additional violation of human rights.”
While other poorly-designed African studies have stated that circumcision could reduce HIV infection for heterosexual men, a 2007 study of 1,400 homosexual men, presented at the 17th Meeting of the International Society for Sexually Transmitted Diseases Research found that circumcision had no effect on reducing HIV infection.
A meta-analysis by Millett in 2008 also found that circumcision was not associated with reduced risk of HIV for men who have sex with men.
Another study presented at the 2009 National HIV Prevention Conference also reported that being uncircumcised did not affect the risk of HIV infection for men who have unprotected sex with HIV-infected partners.
Another study in 2010 by Wei found that circumcision would have little impact on HIV transmission.
And another study in 2010 by Sanchez said that circumcision did not reduce risk of HIV.
Five other rigorously controlled studies (1-5) said that circumcised males were actually at GREATER risk for all sexually transmitted diseases because numerous immune functions generated inside the foreskin are lost with circumcision.
Indeed, moisture generated inside the foreskin contains lysozymes - enzymes that attack HIV and destroy bacteria. Circumcision destroys this natural protection against invading organisms.
But what about the human element?
FIRST DO NO HARM
A study by Sorrels in the British Journal of Urology International in 2007 found that circumcised penises were one fourth as sensitive as uncircumcised penises, and noted that five sensitive regions that protect the penis and contribute greatly to sexual satisfaction are removed during circumcision, leaving only the glans (head).
Sorrels’ study detailed the roles of these delicate nerve-filled tissues, among others the “frenulum” and the “ridged band.” During coitus, the frenulum matches up directly with the primary vaginal nerve tissue. Mutual sensations caused by these two amorous areas engaging can create deep, satisfying bonding. The ridged band of the foreskin helps to trigger orgasm and ejaculation. The frenulum, ridged band, glans, urethra and specialized skin in the penile shaft are working units in a functional whole. (6-9)
While it is known that the nervous system can make up to some extent for the loss of parts of this functional whole, and many circumcised males rate their sensitivity and sexual response as wonderful, how could they know how much more sensitivity and satisfaction they could have had if they never knew any difference?
For others, loss of these delicate sexual components can have a devastating effect, causing weakened erectile function, decreased penile sensitivity, difficulty in reaching sexual satisfaction (10-11) and a range of negative emotions and even post-traumatic stress disorder that can last a lifetime.
Because a glans with no foreskin to protect it is exposed to the elements, what would have been warm, sensitive moist internal tissue becomes dry, rough and less sensitive through a process called keratinization. Think of an eye with no eyelid.
Indeed, in a study of 255 men who were circumcised after the age of 20 and 18 men who were not circumcised, masturbatory pleasure decreased in 48% of the respondents and increased in 8%. Masturbatory difficulty increased in 63% but was easier in 37%. The authors concluded that there was a decrease in masturbatory pleasure after circumcision.
The study also found that 20% reported that their sex life was worse after circumcision and 6% reported that it had improved. They concluded that "there was a decrease ... sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men, possibly because of complications of the surgery and a loss of nerve endings."
Typically, having no foreskin causes the male to have to push greater than ten times more forcefully to penetrate and then rub more forcefully during coitus, causing some females to complain that it's too rough.
HONEY, I LOVE YOU (OUCH) ANYWAY
This effect has been evaluated thoroughly and published, for instance, in a study by O’Hara in 1999 in the British Journal of Urology International. Among other things, the study showed that women who had sex with a circumcised male were almost half as likely to experience a vaginal orgasm as women who had intercourse with an uncircumcised male.
Here is a reprint of some of the data.
|Issue (less or more)||Circumcised||Uncircumcised|
|Vaginal fluid secretions||-0.23 (less)||+0.60 (more)|
|Vaginal discomfort||2.01 (more)||0.85 (less)|
|Likelihood of vaginal orgasm (%)||34.7 percent (less)||60.6 percent (more)|
|Orgasm frequency rating||1.68 (less)||2.39 (more)|
|Multiple orgasm frequency rating||0.96 (less)||1.59 (more)|
|Duration of intercourse (minutes)||10.72 (less)||14.85 (more)|
|Positive feelings after sex||1.95 (less)||5.01 (more)|
|Overall satisfaction rating (range -10 to +10)||1.81 (less)||8.03 (more)|
The last measurement, "Overall Satisfaction Rating," is telling.
Is this what Mick Jagger was singing about?
Sex with an uncircumcised partner was rated 9.84 times (8.03 versus -1.81) more satisfying than sex with a circumcised partner.
Does it seem like this difference in satisfaction could result in more broken marriages?
Indeed, a study by George Hughes, MD, in the journal Ohio Medicine, found that being uncircumcised was associated with a higher rate of a sexual compatibility in marriage.
In the book "Bodily Integrity and the Politics of Circumcision" the authors found an association with the higher rate of US divorces and the higher rate of circumcision in the US. While many things can cause divorce, circumcision may well donate its own subtle contribution to the problems.
Though you may be pro or con on this issue, one certain thing is that public health officials and doctors should fully inform males, or the parents of a baby boy about the risk of life-long decreased sexual satisfaction before conducting circumcision.
This type of disclosure is the ethical thing to do, but, how often is it actually done and how clearly is it stated?
The American Medical Association remarked that, in one study, physicians in "nearly half" of neonatal circumcisions "did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision."
I personally wish that Shofield’s bill to ban circumcision will be passed.
It would put the rest of the country on alert. And then perhaps other progressive cities might outlaw this barbaric practice, too, and continue the movement towards a more civilized future.
1. Laumann EO, et al. Circumcision in the United States: prevalence, prophylactic effects, and sexual practice. JAMA 1997;277:1052-7.
2. Donovan E. Bassett I, Bodsworth NJ. Male circumcision and common sexually transmitted diseases in a developed nation setting. Genitourin Med 1994;70:317-320.
3. Smith GL, et al. Circumcision as a risk factor for urethritis in racial groups. Am J Public Health 1987;77:452-454.
4. Cook LS, et al. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic.Genitourin Med 1993;69:62-64.
5. Bassett I, et al. Herpes simplex virus type 2 infection of heterosexual men attending a sexual health center. Med J Aust 1994;160:697-600.
6. Taylor JR, et al. The prepuce: Specialized mucosa of the penis and its loss to circumcision. Brit J Urol Feb 1996;77:291-295.
7. Cold CJ, et al. The prepuce. Brit J Urol Jan 1999; 83 Suppl.1:34-44.
8. Winkelmann RK, et al. The erogenous zones: Their nerve supply and significance. Proceedings of the Staff Meetings of the Mayo Clinic 34(2):39-47.
9. Winkelmann RK. The cutaneous innervation of the human newborn prepuce. J Invest Dermat Jan 1956; 26(1):53-67.
10. Fink KS, et al. Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol. 2002 May;167(5):2113-6.
11. Shen Z, et al. Erectile function evaluation after adult circumcision. Zhonghua Nan Ke Xue. 2004 Jan;10(1):18-9.
http://www.youtube.com/watch?v=bk8bfpCADcA - Dr. Dean Edell on circumcision
China Not Ready For Circumcision To Stop AIDS
From a reader: " ...your article in WEHONEWS is the best I've ever read on the subject of circumcision. Talk about comprehensive, and covering all the bases. You have established the gold standard for presenting all the facts about circumcision. What a refreshing change from the self-serving disinformation usually presented by members of the American medical profession and the public health agencies which serve it instead of the American people. Every American who wants to discover the truth about circumcision should read your article."