Snip or Skip? The Complicated Debate Over Circumcision.

Fernando Kaskais

Jan 2

Top: A wall carving from the Tomb of Ankhmahor in Saqqara, Egypt, possibly depicting male circumcision. It's one of the world's oldest surgeries and remains one of the most common procedures today. Visual: kairoinfo4u/Flickr

The foreskin-removal procedure raises tricky questions about medicine, consent, bodily autonomy, and sexual pleasure.

BY FRIEDA KLOTZ

FOR YEARS, Ron Low took pride in his ability to give his wife multiple orgasms in a single sexual encounter. This was possible, in part, because his erections lasted up to an hour. By the age of 38, though, he found himself wishing he could climax sooner. After one particularly unsatisfying night with his wife, he turned to the internet, where he soon found information that persuaded him that his troubles had a clear explanation: His penis was circumcised.

"I was missing the capability to experience the sexual sensations to the fullness that nature has seemingly designed us for," Low recently told Undark in an email. In the early days of his research, he found material suggesting that circumcision affects penile sensitivity and sex. Then he discovered forums where circumcised men were discussing techniques for regrowing the foreskin.

Soon, Low was taking steps to reverse the surgery that had been performed on him as an infant — too young, he pointed out, to give informed consent.

Some men, meanwhile, have had a different journey. Lee Caddick was not circumcised as a child. He decided to get the procedure at age 48, after decades of suffering from a too-tight foreskin that made erections and sex both painful and embarrassing. Growing up in England, there had been few opportunities to talk earnestly about penises and sexual function. "I wish I had got it done earlier," he said. "It might have made a big difference in my life."

Male circumcision is one of the world's oldest surgeries and remains one of the most common procedures today. It involves the removal of all or part of the foreskin, known as the prepuce, and can be carried out at any age for religious, medical, or other reasons. Rates of the procedure vary widely by country: from 71 percent of males in the United States to 21 percent in the United Kingdom, from 92 percent in Israel to less than 1 percent in Ireland, according to a 2016 estimate.

Some religions practice infant circumcision, but in the U.S., religious reasons account for just a tiny percentage of all newborns who get circumcised. Most parents arrange for their child to have the procedure for medical reasons. The American Academy of Pediatrics, or AAP, currently states that families should be given access to the surgery, on the grounds that it may reduce the risk of acquiring certain infections. Complications are infrequent and generally minor, according to the AAP, particularly when the procedure is performed on newborns.

Yet the AAP did not issue a blanket recommendation, stating that the procedure's "health benefits are not great enough" to warrant one. In fact, claims that circumcision improves health are increasingly the subject of heated, and occasionally acrimonious, debate. When Andrew Freedman, a California-based pediatric urologist, agreed to contribute to the AAP's policy statement, a friend who had worked on the previous task force warned him against it. The topic was too fraught.

"He said, 'Don't do it. You'll get death threats.'"

The friend was not far off, Freedman said. After the policy statement was released, angry messages flooded his inbox: "Twenty thousand people sent me emails suggesting I get cancer and die," he recalled.

Claims that circumcision improves health are increasingly the subject of heated, and occasionally acrimonious, debate.

That anger stemmed in part from the fact that circumcision's medical benefits are not clear-cut. And for many men, being circumcised — or, for that matter, being uncircumcised — is not merely a question of medicine, but one of aesthetics, consent, bodily autonomy, and sexual pleasure.

"There's a lot of mythology around it," said Caddick, referring to circumcision's influence on sex. "You know, there are people who say their orgasms are more intense, which I think could be true. And there are other people who say you lose like 90 percent of your sensitivity." Scholarly research, it turns out, supports Caddick's impression that men's experiences with circumcision and sexual function vary widely.

"I think everybody's experience is different," he said.

RESEARCH ON circumcision is vast, spanning the fields of history, anthropology, psychology, medicine, and public health. "It's taken me 12 years to get a handle on the literature," said Brian Earp, a medical ethicist at Oxford University. "It's really, really hard to navigate because there's so much material going back so long, and it's so politicized."

The procedure may date back to the Paleolithic Age, as cave paintings from that period show possibly circumcised penises. Circumcision emerged as a medical intervention within Western medicine in 1870. An American surgeon named Lewis Sayre had been asked to evaluate a 5-year-old boy whose legs were partially paralyzed. During the evaluation, Sayre determined that the boy's penis was "imprisoned" within the foreskin. He decided to circumcise the patient under anesthesia.

Within days, the child's health improved: Color returned to his cheeks, and he "was able to walk with his limbs quite straight," according to the historian David Gollaher, whose book traces the history of circumcision. Sayre hypothesized that the procedure had somehow quieted the boy's nervous system, thus returning the child to good health...

more...

https://undark.org/2024/01/01/contested-science-circumcision/