Foreskin. It’s not a common word in daily conversation or often brought up. Male circumcision, the total removal of the foreskin from the penis, shouldn’t be a weird or disturbing topic because it is a pertinent issue that needs to be openly discussed. Today, there is a widespread, contentious and controversial debate about circumcision because it has great personal impact.
Foreskin can seem mystical, maybe because males don’t advertise if they do or do not have one. Besides being mysterious, what is a foreskin really for? Is there a point to having one? Furthermore, is circumcision an appropriate and beneficial practice?
If parents decide to circumcise their child, the circumcision is usually performed shortly after birth for reasons including hygiene, spirituality and consistency between father and son. On the other hand, people against circumcision say it shouldn’t be performed on a newborn child because the child has no choice and the foreskin is a healthy, functioning body part. This issue needs to be fully examined and considered by everyone and especially by new parents.
Why is Circumcision Practiced?
Arguably, it comes down to tradition. Ranging from religious customs to keeping fathers and sons looking like each other, circumcision continues to be performed today is because it was done in the past.
Some aboriginal tribes in Australia practiced circumcision as a puberty rite starting around 10,000 BCE. Evidence of circumcision has been found in Egyptian tomb artwork from 2,000 BCE and it spread to the Semitic peoples in the Middle East. The spiritual origins of circumcision come from teachings of Abrahamic religions — Judaism, Christianity and Islam.
Rabbi Shaul Osadchey of the Beth Tzedec congregation in Calgary has presided and officiated over hundreds of Jewish circumcision ceremonies, known as brit milahs in Hebrew.
According to scripture, Abraham formed a covenant with God, which was signified by circumcision.
“God commanded Abraham not only be circumcised, but to circumcise his son,” says Osadchey. “This one action’s place in biblical tradition has led to circumcision becoming one of the most sacred and pivotal characteristics.”
With exceptions, circumcision takes place on the eighth day of a Jewish boy’s life and takes precedence over the most sacred celebrations, such as Shabbat and Yom Kippur. “It’s an obligation from God and one of the defining physical characteristics of a Jewish male,” says Osadchey.
In Genesis 17:10–11, God says to Abraham, “This is my covenant with you and your descendents after you, the covenant you are to keep: every male among you shall be circumcised. You are to undergo circumcision, and it will be the sign of the covenant between me and you.”
Christian churches are neutral on the practice, neither requiring it nor forbidding it. A Council of Jerusalem was held around 50 CE and the apostles decided that male circumcision was not required for converting to Christianity. In Acts 15:19, James says, “It is my judgment, therefore, that we should not make it difficult for the Gentiles who are turning to God.”
In Islam, circumcision is widely practiced. The practice is known a Khitan or Khatna. The World Health Organization estimates that 70 per cent of the circumcised men world-wide are Muslim. However, it is not a requirement for conversion or performing religious duties. Muhammad was said to be born without a foreskin, or “already circumcised,” which predominantly gave rise to the tradition. This is called aposthia when a child is born without a foreskin. Circumcision is not explicitly mentioned in the Qur’an, but it is mentioned in the hadith, which are anecdotes about the prophet Muhammad that offer tools for understanding the Qur’an.
Circumcision has also been used throughout history to treat physical health conditions, such as phimosis — a condition where the foreskin doesn’t retract — severe infections, diseases and penile cancer. In the 1740s, doctors practiced circumcision to prevent syphilis because the sores were commonly found on the foreskin.
Non-medical and non-religious practices of circumcision are inspired from outdated cultural beliefs. In the 1830s, circumcision was used to treat masturbation, which doctors believed led to insanity. Of course, the idea that masturbation has negative health effects has been severely rejected.
An early advocate for circumcision to cure masturbation was John Kellogg, the namesake of Kellogg’s cereals. In 1881, Kellogg wrote, “A remedy for masturbation, which is almost always successful in small boys, is circumcision. The operation should be performed by a surgeon without administering anesthetic, as the pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment.”
Professional medical associations have long weighed in on circumcision, influencing the public’s opinion. In the 1880s, the American Academy of Pediatrics called for most baby boys to be circumcised. In 1975, the Canadian Paediatric Society said that circumcision is obsolete and does not need to be routinely performed. In 1999, the AAP said circumcision should not be done routinely, but is acceptable for cultural, religious and ethnic reasons. Yet, in 2012, the AAP released a report saying that the benefits of circumcision outweigh the risks, but that parents have the final choice.
The arguments are, on the surface, pretty simple and concise. As far as upholding religious circumcision, the argument is emotional and profound.
“It would not be kind for a Jewish male to have a circumcision at age 13 or as an adult. Following the expectation of eight days should be the right way to go to best follow our tradition,” says Osadchey.
Osadchey also says that for Jewish and Islamic faith, this procedure can be central to one’s personal relationship with their respective religions and with God. To reject a procedure that has been ingrained into religious communities over thousands of years can be seen as infringing on religious freedom.
Circumcision can make hygiene and personal care easier by removing the need to retract the foreskin and remove any residue that may linger there.
Medical studies have shown that circumcision can have positive benefits. In 2012, the AAP reviewed a study that showed circumcised male babies to have fewer urinary tract infections in their first year of life than uncircumcised male babies. Other studies that the AAP looked at showed that rates of sexually transmitted diseases, such as syphilis, genital herpes and human immunodeficiency virus, are lowered with circumcision, as much as 15 per cent for members of sub-populations of American men with high infection rates. These findings also said that a women with a circumcised sexual partner can have reduced rates of infections like bacterial vaginosis, chlamydia and human papillomavirus simply because a foreskin is a good place for bacteria to thrive.
This AAP report did not find evidence that penis sensitivity, sexual satisfaction or sexual function varied between circumcised and uncircumcised men. Understandably, comparing sexual satisfaction and sensitivity can be difficult.
Dr. Pierre Crouse, a circumcision and vasectomy doctor in Calgary, believes that circumcision can be beneficial. He performed his first circumcision in 1986 and often completes 15–20 procedures each week at his private clinic.
“Children do not need to be circumcised — it’s the parents’ decision — but there are all kinds of reasons to do so,” says Crouse. He says that not all newborns need to be circumcised, however, it is a fair decision parents can make.
In rare cases, circumcision is a necessity, such as when issues such as phimosis or infection arise.
The foreskin is generally a healthy, functioning body part. At the very minimum, to remove a part of the male body simply to avoid the responsibility of cleaning it and preventing infection wouldn’t make much sense for any other body part. Any part of the body is subject to infection if not taken care of properly.
Studies in the International Journal of Epidemiology in 2011 show that circumcision may permanently diminish sexual enjoyment and pleasure, due to the loss of skin coverage and skin sensitivity.
The foreskin contains tens of thousands of nerve endings, including the ridged band, which is the ring of wrinkly skin that connects the foreskin to the rest of the penis. These nerve endings are lost forever when the foreskin is removed. The glans penis, which is the head of the penis, can experience keratinization or callusing over time, where the head is no longer as soft and sensitive.
Glen Callender works with the Canadian Foreskin Awareness Project and describes himself as a “writer, performer and foreskin advocate.” Callender believes the problem with circumcision is not the practice itself, but rather society’s complicity in circumcising children against their will. Callender feels there is great value in keeping a foreskin.
“When performed on a healthy, normal penis, circumcision confers no physiological advantages whatsoever — it takes away valuable and functional genital tissue, reducing sexual sensation for the man and his partner, and replaces it with abrasive scar tissue that further diminishes sexual enjoyment,” says Callender. “The foreskin contains the most sensitive parts of the penis, including parts that are capable of orgasm independent of the rest of the penis.”
The acceptance of male circumcision contradicts with the views and opinions about female circumcision, also known as female genital mutilation. FGM is almost unanimously seen as a horrific and dangerous practice involving removing various parts of female genitalia.
Crouse stresses that FGM is far more debilitating and savage than male circumcision because the clitoris is often removed, which is analogous to the head of the penis being removed. Osadchey also says that female circumcision is “something most of us would consider mutilation.”
But Callender has a different perspective. “Both male and female circumcision are ancient methods of diminishing and controlling sexuality by permanently damaging the genitals so the child, and the adult that child will become will not be able to fully enjoy sex,” says Callender. “We shouldn’t be wasting time arguing over which mutilation is ‘worse’ — we should be protecting all children from all forms of genital mutilation, regardless of whether they are male, female or intersex.”
There are also risks of performing circumcision. A 2010 study from BioMed Central Urology reported the complication rate of circumcision is 1.5 per cent for newborns and six per cent for older children.
Crouse believes that circumcision complications need to be addressed. “Questions need to be asked when circumcisions go awry, but complications are still extremely rare,” says Crouse.
Complications can include extreme blood loss, permanent penile damage, loss of other parts of the penis, amputation and death, even in advanced heath care systems.
Risk is involved in any surgery or medical action, but is it worth it when the procedure removes an otherwise healthy and functioning body part?
The modern movement against circumcision is bringing awareness to the dangers of circumcision. The movement offers information of the effects of circumcision and advocates different degrees of change, from letting men choose to be circumcised when they are older to banning the practice outright. Opponents of circumcision believe there is no valid reason for practicing the procedure.
Pro-foreskin groups exist worldwide, from ones advocating bans, to support groups ready to give advice on foreskin restoration.
Foreskin restoration for men unhappy with their circumcised penises has become available. Callender has worked with people hoping to restore their foreskin. “I know several men who have restored their foreskin and all of them say ‘I had no idea how much more sensation I would get!’ Foreskin restoration does not restore the tens of thousands of nerve endings amputated by circumcision, but it does restore the penis’ moving skin sheath and restores its remaining mucous membranes, returning the scarred-over nerve endings to full sensitivity,” says Callender.
Surgical methods, such as skin-grafting, and non-surgical methods, such as stretching, are available. Callender says that non-surgical methods are less risky and more successful.
Circumcision has recently garnered legal and political attention worldwide, including in Germany this year, when a Cologne court ruled that circumcision is tantamount to bodily harm. A later bill qualified that circumcision could be performed on boys under six months old because Jewish and Muslim people felt the ruling was hostile towards their traditions.
In 2011, local “inactivists” in San Francisco petitioned for a ballot measure which would criminalize circumcisions on men under 18 years-old. A San Francisco superior court judge ruled that it had to be struck from the ballot because it would violate a Californian state law that makes regulation of medical procedures a state, not a city, matter.
Discussion has been growing and people have been re-examining their views on circumcision.
What's the Verdict?
People should learn about circumcision, examine their beliefs and form an opinion.
There are rare circumstances when therapeutic medical circumcision is necessary for the health of men from birth to adulthood. But, in my opinion, circumcision should not be a preferred choice for adults and should not be forced on children. If a male feels that there is a benefit to not having a foreskin, he should be able to decide that for himself once he becomes a fully-developed, conscious and sexually-active adult. Just because circumcision has been around for so long does not mean it must continue to be an option. No matter what new parents conclude, serious thought should be given as to whether a child is circumcised or not.