The human body may have been evolving for millions of years but some cultures believe that evolution got it wrong. Take the male foreskin: chopping it off at birth is the preferred choice for many Americans and, for religious reasons, for many Jews and Muslims. The personal choice of the male involved plays no role whatsoever. The reasons for circumcision are manifold and include symbolisation of manhood, prevention of masturbation, enhanced cleanliness and religious belief. This article evaluates the arguments for and against circumcision.
Pro: Reduction in Cancer Risk
There’s evidence that male circumcision reduces the risk of developing at least three cancers — cervical cancer in women, and penile and prostate cancer in men. Cervical cancer afflicts a small number of women who started having sex at an early age and engaged with multiple partners; research shows infection with the human papilloma virus (HPV) is probably the main cause of cervical cancer, and that women are far more likely to be infected by an uncircumcised man. Penile cancer is rare and has a good survival rate, but it almost exclusively affects uncut men; in addition, about 50% of penile cancers are caused by HPV. University of Washington researchers discovered that men who are circumcised before they have sex for the first time are 15% less likely than their uncut brethren to develop prostate cancer. The reason may be because cut men are less likely to contract sexually transmitted diseases (STDs) which inflame the prostate, making it more vulnerable to abnormal cell growth that can lead to cancer.
Con: Reduction in Sexual Pleasure
Studies suggest that circumcised men may enjoy less pleasurable sex than uncut men owing to the desensitisation of the penis. In addition, there are said to be thousands of nerve endings in the foreskin, although there’s no definitive indication of just how many. The National Organization of Circumcision Information Resources Center (NOCIRC) used a ‘penile sensitivity map’ to assess differences in penile sensitivity between cut and uncut men. The NOCIRC concluded that the five most sensitive areas on an uncut penis are all absent on a cut penis as they were excised during circumcision. In Denmark, the research enterprise SSI surveyed 5,000 sexually active men and their female partners; its conclusion was that circumcised men don’t orgasm as easily as uncut men owing to the hard layer of keratinised skin on their glans. The researchers also noted that the partners of cut men were twice as likely to be sexually frustrated and eight times as likely to feel pain during intercourse.
Pro: Lower Risk of Sexually Transmitted Diseases (STDs)
Medical evidence shows that uncut men are more likely to contract a range of STDs including chancroid and genital herpes, and that they contribute to bacterial vaginosis and trichonomoniasis in women more regularly than do their circumcised counterparts. According to the British National Health Service (NHS), uncut men are 10 times more likely to get chancroid and have double the chance of contracting syphilis. The reason, as with HPV, appears to be that the moist, warm area under the foreskin is more conducive to bacteria and smegma, an oily skin secretion that affects uncut men and which more easily aids the transmission of viruses during intercourse. Another STD that preys on uncut men with more frequency is the herpes simplex virus type 2 (HSV-2) which causes genital herpes; women, meanwhile, are less likely to become infected with genital ulceration, bacterial vaginosis or trichomoniasis if their sexual partner is cut.
Con: Perils of Surgical Errors
A doctor who botches a circumcision is messing with the child’s future sex life, not to mention his immediate medical safety. Critics of circumcision point out that the risks of surgery far outstrip the dangers posed by rare cancers and curable STDs. Several horror stories can be found by doing a cursory internet search; one particularly unfortunate incident in Pittsburgh, US, in April 2013 involved a Jewish baby’s penis being severed, allegedly during a religious circumcision conducted by his rabbi. Not all mistakes make the headlines, however — the story of mother Melissa White’s decision to have her son Ben circumcised was movingly told on a blog, and summed up the dilemma that faces parents when things go wrong. After Ben’s circumcision was botched, he had to undergo a 40-minute penoplasty — plastic surgery on his penis. “When people ask me if I still believe in circumcision, knowing what I know, I’m not sure,” she writes. “Even if the supposed health benefits are real, they definitely don’t outweigh the ordeal my son went through.”
Pro: Reduction of Balanitis and Phimosis
Although they aren’t usually serious conditions, balanitis and phimosis are more common in uncircumcised men than in their cut brethren. Balanitis occurs more often in children and entails the glans becoming irritated, inflamed and swollen owing to bacterial infection, which usually also affects the foreskin. Irritation by smegma is a common cause of balanitis, according to the NHS, which recommends good penile hygiene and the avoidance of skin irritants. Phimosis, which is occasionally associated with STDs and skin conditions such as eczema, psoriasis, lichen planus and lichen sclerosus, occurs when the foreskin can’t be fully retracted over the glans. Circumcision advocates argue that circumcision in infancy makes balanitis and phimosis an unlikely problem.
Con: Freedom of Choice and Infant Trauma
In an age when an individual’s freedom of choice is seen as more important than ever, infant circumcision runs against the grain. A baby can’t give its assent or dissent to surgery that will remove a piece of his skin packed with pleasure-giving sensors. Critics of circumcision point to the fact that growing numbers of adults, circumcised as babies, are turning to foreskin restorative techniques to return their foreskin to its natural state, even though the nerve endings present in the original foreskin are unlikely to ‘regrow’. In addition, focus has been placed on the trauma suffered by babies during the operation; while a local anaesthetic is used to minimise pain, the open wound caused by the removal of the skin takes between a week and 10 days to fully heal.