Circumcision: Just A Little Off The Top, Please [Mature Content]

circumcision

I want to talk a bit about circumcision. To be fair, I should warn the reader that I personally have strong feelings about the ethics of the procedure, specifically regarding cases where the procedure is performed on infants, with the main consideration being adherence to societal norms, or in cases where other, non-religious, non-medical reasons are used.

Let me begin by saying that I’ve come to be actually amazed at how ignorant of the penis American society seemed to be during my upbringing. I don’t have a male child to instigate the type of interaction with the medical community that could provide me with an idea of what it’s like in the clinical setting today, but my own experiences occurred within a fog of poor understanding of all aspects. My father was circumcised, and to his credit, his moral questioning of the ethics involved superseded his desire to validate his own circumcision by inflicting another on his son (please excuse the biased language, though I did disclaim my position). His lack of a shared experience left my parents in a situation of not knowing much about what to expect with a foreskin.

So, just to cover it in case there really was a general lack of education on the subject, and it wasn’t just the case that I slipped through some sort of crack (can we pretend that that was a clever?), let’s talk about dicks.

From the period of 8-16 weeks, the developing male fetus will begin to grow a foreskin, which is attached to the glans (what the Bloodhound Gang referred to as “purple bulldog cheeks”) via sharing a mucous membrane. Essentially, the intact male will begin life with a sort of pseudo-phimosis, which can generally be expected to resolve itself at some point in the adolescent years. Now, this is another baffling thing to me, that studies talking about the age range to expect this range from saying “most males will achieve foreskin retraction by the age of three,” to “The median age of retraction is 10.4 years old.” I believe it’s fair to say that having such a wide disparity reported in medical literature is an indication of a topic that hasn’t had nearly enough study.

For myself personally, my foreskin retracted for the first time when I was either 8 or 9 years old. I was taking a bath, and had at least been warned about keeping it clean. For the sake of treating the subject with an uncomfortable degree of honesty, and so as to introduce another facet for later discussion, the cleaning process was borderline masturbatory. I wasn’t really old enough for it to make sense, or to know that it was the forerunner of sexual development, but it felt nice, until the foreskin retracted and I completely panicked that I had broken my penis. I don’t really remember if I told anyone about it, I think I felt pretty ashamed and may have tried to “hide” it.

What I feel I was left painfully uneducated about was the existence of the shared mucous membrane, and I sort of resented being caught completely by surprise when it separated. To this day, I worry that the whole process is nearly apocryphal in the United States. Ironic, being as we’re a country that often applauds itself on being first-world and open-minded. I also believe that this vital experience is the crux of disparities in study data regarding the safety and potential benefits of circumcision. I believe that the ultimate findings regarding the statistical outcome of circumcision will need to incorporate information that considers the level of education in regard to genital hygiene in intact males.

I’d like to go on to say that the foreskin isn’t simply a piece of skin. We have already covered that it also has a certain amount of mucous membrane, however it also contains a plethora of nerve endings, blood vessels, and smooth muscle tissue. While it’s not fair to compare male circumcision entirely to female circumcision, largely because female circumcision most often involves removal of the externally visible portion of the clitoral glans, it is unconscionable to me how entirely disparate the American attitude towards either is. Female circumcision is widely described as “female genital mutilation,” which I very much support and agree with, however male circumcision, for as trivial a reason as the parents’ aesthetic preference, is regarded as normal. I’d also like to make it clear that it is not my intention to discuss gender equity at this time, nor is the treatment of babies’ genitals an appropriate topic to segue into such a discussion.

The cultural phenomenon of standardized circumcision for males began in the early part of the 19th century as a gambit to inhibit masturbatory behavior, in light of the Victorian-era belief that masturbation led to a host of maladies of the mind and body. Until the middle of the 18th century, masturbation had largely been regarded as natural. A hallmark moment in the changing of that acceptance was the printing of an anonymous pamphlet which denounced the practice of masturbation in religious and moral terms, while also recommending a tincture or powder remedy from a local apothecary. The pamphlet was a popular success that invited numerous re-printings in London, and spread to other parts of Europe and the American colonies. The idea took root so firmly that by the end of the 1700’s, famed philosopher Immanuel Kant opined that masturbation was a dereliction of duty to ones’ self worse than suicide.

That view is contrary to more modern theories, which generally regard masturbation as normal and harmless, and take into consideration the likelihood of repressed guilt resulting from the demonization of sexual self-gratification. Perhaps the primary non-religious reason that the prevalent attitude towards circumcision has been slower to change is that medical studies sometimes show a reduced risk of sexually transmitted infections in circumcised men. However, an ample body of contradictory medical literature also exists, which has lead to a general decline of the practice throughout Europe, Australia, Canada, Latin America, and the areas of Asia where Islam (which recommends the practice) is less prevalent. While the World Health Organization has recommended circumcision to combat the AIDS epidemic in parts Africa, many medical professionals believe that the studies upon which they based the decision were flawed.

Another major complication with the understanding of circumcision is that doctors are also human, and therefore it is unrealistic to expect them to completely detach themselves from a pervasive bias that can exert itself in the form of compelling them to subconsciously prefer the outcomes of studies which present conclusions that confirm their existing beliefs. I also suffer bias on the subject, though I believe that mine comes primarily from concern over the ethics of removing healthy tissue from the body of human beings who are not mature enough to have a say in the matter. It seems to me that ethics would dictate that in such a situation, the removal of the tissue would only be justified by medical urgency and necessity. Also I believe that when it comes to the religious practice of circumcision, if a person wanted to display faith and loyalty to their conception of God, that it would make a more sincere gesture to offer their own foreskin, rather than that of an un-consenting child.

In an article such as this, the common practice would be to produce a list of citations to essentially prove the claims made, via appeal to authority. However, I don’t want my readers to take this as constituting medical claims. I encourage readers to conduct their own research, rather than blindly agreeing with mine. If there is a single point that I would like to have understood, it would be that the biggest problem in regards to circumcision is our poor understanding and lack of consensus on the subject. I’m personally opposed to the practice because I have come to believe that the medical aspects are inconclusive, and the ethics are against it. However, neither do I believe that it would be ethical of me to attempt to persuade anyone to do anything other than inform themselves.

And I’m not just being lazy, there are articles I would love for people to read. I just don’t think it would be right for me to back up my view with citations, because that gets too close to giving medical advice.

Enjoy yourselves,

-Brian Whittemore, Intact Penis Aficionado of my Own Penis

Photo Courtesy of The Magnes Museum on FlickrCreative Commons

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