Is Circumcision Medically Necessary?

by Cay L. Crow

Man cutting a cucumber off of a vine with a small red swiss army knife

Does Circumcision Cause Lack Of Sensitivity?

Q: Dear Cay, why in the world are men circumcised? Mr. Turtleneck

What is Circumcision ?

A: Dear Mr. Turtleneck,

Good question! Circumcision involves surgical removal of the foreskin, which normally covers the glans, or head of the penis. Circumcising a male is comparable to surgical removal of the clitoral hood in the female, which is one form of Female Genital Mutilation. According to Dr. Terry Hamilton in Skin Flutes and Velvet Gloves, circumcision removes more than 3 feet of veins, arteries, and capillaries, 240 feet of nerves; and more than 20,000 nerve endings. The average size of a removed foreskin is about 15 square inches or roughly the size of a 3 x 5-index card. All of this is done without the boy's permission; usually he is too young to protest.

Over time, however, a medical purpose has evolved for this 'unnecessary' tissue. Foreskins are the primary source of skin grafts for burn victims and the tissue plays a role in the generation of insulin. Could it be possible that the practice of circumcision continues partially because infant foreskin has become a medical commodity?

History Of Circumcision

The origins of circumcision are decidedly cultural or religious. Artistic depictions of circumcision date back to the Egyptians in 2400 BC. In Circumcision: A History of the World's Most Controversial Surgery, David L. Gollaher says that the ritual "must have presented an opportunity for a youth, on the threshold of manhood, to demonstrate his mastery over bodily pain." Still other historians claim that removal of the foreskin was at one time a fertility rite, offering part of the body to the earth in exchange for abundant crops.

In Judaism, removal of the foreskin represents a covenant with God and is an important ritual for males taking place in the presence of family and friends.

Circumcision did not become routine among American doctors until the late 19th century. Around that time, a prominent orthopedic surgeon, Lewis A. Sayre, began promoting male circumcision as a way to heal muscular ailments. He claimed that relieving the "imprisoned glans penis" restored the patient to health. Although the surgery failed to improve the muscular ailments of many patients, other doctors adapted the practice because they believed it would be more sanitary and might curb masturbation. This focus on cleanliness and suppressed sexuality appealed to many Victorians thus perpetuating the procedure.

In 1971, the American Academy of Pediatrics (AAP) Committee on the Fetus and Newborn declared that "there was no valid medical indication for circumcision in the neonatal period." From that declaration arose a movement against circumcision. In the mid-1970's, 4 of every 5 males in the U.S. were circumcised. Today, the circumcision rate has fallen to 61%. In 1999, the AAP stated that the procedure should not be routinely done on all boys and proposed for the first time, that anesthesia should be used for the procedure. This position statement was reaffirmed in 2005.

There is little research exploring the impact that circumcision has on a male's sexual satisfaction. However, men who were circumcised as adults consistently report a reduction in sexual satisfaction following the surgery. A 1999 study of women indicated more sexual satisfaction with intact rather than cut partners.

The only benefits of circumcision mentioned on Medline are a lower risk of HIV, a slightly lower risk of STIs and a slightly slower risk of UTIs. By the time a male is old enough to be sexually active, he could make the decision to remove or keep his own foreskin.

CAY L. CROW, LPC, AASECT-CERTIFIED SEX THERAPIST

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