"The Foreskin Dialogues"

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This conversation started on my Wordpress Blog and I'd love for it to continue here. If you posted there and would repost your comment here, that would be wonderful. If you don't feel like doing that, but don't mind if I do it, send me a note. If you haven't jumped in yet, please do!
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A Word or Two on the Penis

This is a very interesting point. Personally, I divide (and keep mutually exclusive) into two realms my perception of my penis and the image of it I like to project onto others: sociological and sexual.

I am perceptive of the role (widespread or personally infered) of the penis and the cultivated concept of masculinity in our American society. We come out of a tradition of male-dominated arenas of politics, business, and academia, where the men, some 5,000 years after civilization’s inception, still hunt for meat while the women bear the children and collect meagerly, as it were (or this mentality exists to a large extent).

The power and dominance that have come to define manhood are manifested in the penis. If it is big, one is strong; if it is small, then one is weak. This same framework effects sensativity about penis size, sexual prowess, and sexual orientation. Effectively, the male is forced to defend his own “masculinity” while repudiating homosexuality, abstinence, and, in some cases, women. While this brief outline is incomplete, it highlights some of the points tied up in our history and current social construct surrounding the penis and male-female relations.

I have chosen, whenever possible, to avert penis-derived self-agrandizement, and to debate proactively the social worth of the penis. I feel the concept of the omnipotent cock reinforces false notions of manhood and subordinates the penisless woman to something lower than a male. Such a mindset, biological disparities notwithstanding, is deeply sexist (one of the many -ists from which we must free ourselves socially).

Sexually, I approach my penis differently. In the bedroom, I relish the opportunity to be the dominant partner (and I’ve found most of my girlfriends/lovers enjoy having me dominate, as it were). I derive my feeling of dominance not merely from being physical with my partner; the possibility to feel socially powerful as a result of a sizeable cock that I reject outside of the bedroom, I take full advantage of inside.

I am significantly larger than average and I know it. This awareness coupled with my partner’s acknowledgement imbues me with a sense of power, worth, and ability. Further, I cum a lot (albeit this is a serious account, I am invariably told by lovers, “like a porn star”), and I LOVE to exploit this ability in certain acts e.g. “facials” (an act, I feel, is grossly underrepresented in bedrooms, and I’m curious to hear how others appraoch it), when I’m receiving oral sex my partner sometimes has difficulty swallowing me and I get turned on by it, etc.

Now, these acts and charecteristics are of themselves sexy, though I cannot doubt that they also fill me with a sense of power and dominance.

Of course, it could be argued that while I try to seperate the sociologicsl from the sexual, these two are intertwined at some point. Might a women, who is submissive in bed become socially submissive? Possibly. Would this be negative. Possibly. But, I approach the two arenas as I see fit, with the intention of being socially gender-egalitarian, while maintaining a sexually dominant and partly penis-powerful sex life.

(As for circumcision, I am circumsized and I’ve seen penises that are not. I feel there is an aesthetic, geometric quality in the circumsized penis. Whereas the uncircumsized cock seems to continue indefinitely, sloppily, and weakly, the circumsized one appears rigid, bold, and with purpose.)

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The Foreskin Dialogs

I am an intact American Baby Boomer because I was born in a European hospital. My American father asked that I be cut, but the European doctor who delivered me refused. During my first examination by an American pediatrician, my American grandmother kicked up a fuss about my foreskin. The pediatrician invited my European mother to have me cut, but she refused. And thus I became the only member of my family of origin to sport a whole penis. My younger brother was cut without my parents ever being asked whether they consented.

But my parents never spoke to me about this until my mother broke down one day when I was 19, and told me what’s in the previous paragraph (and more that I prefer to keep private). My father’s reticence was perhaps for the best; he had no talent for dealing with delicate human situations. My mother was often shrewd about many things, but in this tender area, she kept her own counsel until I was grown up. I suspect that she simply did not know what to say to an intact boy growing up in a circumcised culture. She very much respected American medicine but like most Europeans of her generation, found circumcision distasteful.

The boys I grew up with were almost all circumcised. The exceptions were mainly foreign born. I suspect that in much of the USA, nearly all caucasian American men born in urban hospitals between 1940 and 1985, to parents who were not seriously poor or first generation Americans, were routinely circumcised at birth. At the same time, mention of this fact was confined to medical circles and a paragraph in child care books.  

I can only recall hearing the word “circumcise” spoken by another boy only once before going to college. The boys I grew up with, who were all to quick to joke and boast about so many bawdy topics, apparently did not know that they had undergone minor genital surgery shortly after birth. They did not know what “circumcision” meant in the Bible. To this day, only two persons have spoken the word “foreskin” in my presence (one is my wife).

I was very ashamed about the way that the most personal part of my body, the tip of my penis, looked quite different from that of my father, brother, and the boys I knew in school and summer camp. At the same time, I looked like the nude men in Old Masters, and like my European cousins. I had absolutely no clue why my genitalia were deviant until at age 13, I chanced on an encyclopedia article that informed me that all boys were born looking like me, and that the men and boys around me looked different because they had been surgically altered shortly after birth.

Very soon after learning about circumcision, my doctor queried me about it while examining me. He seemed mainly concerned that I was at risk of humiliation. When he asked me whether the boys with whom I went to school were circumcised, I lied and said I didn’t know (in fact, all were but one). No other health professional has ever commented on my foreskin.

I did not learn that there was no compelling hygienic reason for me to be circumcised until I was 19. I did did not learn that American obstetric practice was mistaken in this regard until I was 31. But I was so nervous about my foreskin that I did not lose my virginity until I was nearly 37, to the woman who is now my spouse. I was quite lucky; she had had previously two intact lovers. Even though she is of my generation, for her circ is cosmetic surgery, not a medical necessity. Moreover, she discovered the foreskin at 13 years of age, while poring over diagrams in the Britannica, and looking closely at male nudes in art. For her, the foreskin is quite erotic.

I spent about 20 years of my life burning with heterosexual lust, but not daring to indulge that lust for fear that a young American woman would either have no clue that my foreskin was normal, or would break up with me because my penis disgusted her. A complicating factor was that Jewish women excited me most of all. I assumed that Jewish women simply could not be intimate with an intact man, unless they were very much on the left and the man was black. Only much later did I learn that there are secular Jewish women who are foreskin fetishists.

I now live in a nation that used to circumcise, but has given it up. That I am intact is a matter of no moment whatsoever for anybody except my wife, who very much enjoys foreplay with my foreskin. Circumcision is definitely on the wane in the English speaking world, but is more common in western Europe than intactivists realize, if reports from European locker rooms are to be believed. As many as 10% of European young men have either been circumcised for phimosis and the like, or because they like the cut look in American dominated porn. Korea and the Philippines circumcise, and getting cut is a way young Japanese men express themselves.

If circumcision reduces AIDS, why is there a lot more AIDS in circumcised USA than in any other North Atlantic nation? It is also very easy to forget that the equation is not intact = disease, but intact + trashy sex life + no condom = disease.

I predict that the foreskin will come to be seen as a nontrivial enhancer of intercourse. Whether or not that is true doesn’t matter and may be unprovable; I am only saying it will come to be thought true. And when that day comes, routine infant circumcision will vanish from the USA. The reason is that all too many women have mediocre and unsatisfying sex lives (for which men are mostly to blame). These women are ripe for a scapegoat, and a ready one at hand is “I often/sometimes don’t climax because my DH doesn’t have a foreskin.” By no means is this necessarily true; I am only commenting on the likely future course of urban myth.

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I was born in Australia at a

I was born in Australia at a time when all males were ‘done’, my mother once told me I was the only one not in the ward of 20 or so. I grew up knowing the difference and I would be lying to say that it did not make some sort of difference to me. Certainly I think it put me off getting involved sexually for a little longer than some of my friends. By 17 though I was involved with my first serious GF and she actually preferred a foreskin, having seen both. It certainly never stopped her from giving head, that’s for sure! At 21 I moved to the US and had several more GFs, a (white) South African, a French girl and an American. While I thought that the ’skin’ would be an issue, it never was, no matter where they were from. Actually not one cared or did/did not do something sexually because of it, though it might have taken that bit longer for it to happen.. there was always a little hesitation at first and ALL asked if I had washed first (even my first GF) even though they all knew I always showered and stayed very clean! That all said, I found sex to be less that great, no matter who I was with. I had a longish, thick foreskin that did not stay retraced like so many seem to think they do so sex, with or without, a condom was like masturbating myself! I was also finding no matter how much I washed, it always had an odour soon after especially in the warm climate of southern California. But perhaps the most interesting thing that made me decide to have it ‘done’ at some point was one night with the French girl. During intercourse, she reached down and held my foreskin back. Immediately I noticed the difference, someone turned on the light and I saw what all the fuss was about! The kicker though was right after she did it she said that ‘that feels so much better’…. After several more years, I came back to Australia and decided to have it done. It’s now been over ten years since the operation and I have to say sex has never been better and the odour has vanished. Do girls care? No, but in that vein I found the willingness to do certain things much greater or lacking hesitation. I can honestly say that I have not lost a single bit of sensation in anyway. I had a son last year and we had him done. Certainly after seeing just how little fuss it caused him (no crying and slept like a log afterwards) and how fast he recovered, I wish I had it done at birth - recovery as an adult takes a lot longer and the healed result is never as good as having it done as an infant. I make it sound like it’s all about the sex though, which it’s not. Sure, the improvement feeling wise that came with having it done is great but to me there is something that I just prefer. I lived for 25 years with a foreskin and 12 without and I much prefer the without. It is cleaner from a day to day point as well as a sexual health one and to me more aesthetically pleasing. I like the idea that I don’t always have to maintain it. Not a lazy thing, there are just instances in life where washing or ‘normal’ hygene is not possible and not not having ‘things’ grow under the skin is nice. My partner has no strong views either way and has experienced her fair share. At a pinch though she told me she thinks a circumcised penis is better for oral and the like but it’s a minor thing. To her they both feel the same and it’s what they are attached to that makes the difference, same with most women from what I have experienced. I understand where all the near hysteria comes from on the anti side. Forcing an issue on people like they did in the US and here, with little rhyme or reason, was bound to cause the backlash it has. There is also nothing better to get a guy all worked up than to tell him that he’s been ripped off because the tip of his dick has been cut off… as most, if not all, guys don’t have some sort of self doubt about what’s between their legs. But it is hysteria and makes life difficult for new parents, the one's that make this decision most of the time for their sons. There is nothing wrong or abhorent with modern circumcisions. My son’s was a simple, controlled procedure that seemed to ave cause him little or no distress - no more than trying to get used to the world he was brought into. I think there needs to be a balance and people need to be allowed to make their own choices for their sons, as there is really nothing wrong with either choice. As for being ripped off, I find though the best article of all on that topic can be found here: http://www.slate.com/id/2136062/
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infant vs. adult circumcision

 There is a big difference between the two.

 Infants are not fully grown, so even though most of the surgical incidentes have been eliminated in routine neonatal circumcision, each child matures at a different rate. I ended up not having enough shaft skin so my scrotum skin got pulled up onto my shaft and my balls got pulled up into  pockets in my groins making sex/erections painful. They also cut my frenulum nerves to make the scar look even. These nerves are the ones that give you that enhanced sexual pleasure when they are pulled, and they trigger erections as they run to the reproductive parts of the brain.  With the knowledge of the function of these nerves, a person can have control of a person's or a society's breeding ability.

 As you were fully formed, neuro/chemically, hormonally and mentally when you elected to have it done to you, your brain chemistry didn't change much, accept you are allways sexually aroused now. They probably left your frenulum intact, thats why you experience no dysfunctions. Your balls got to form in a normal scotum with no stress from a shortened shaft skin.

 FredR

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I too am an intact American

I too am an intact American Baby Boomer who long felt paranoid about having a foreskin. That paranoia lost all rational basis once I finished high school, and so became frankly comical. If Simon Baron Cohen were to learn my life story, he would have another hit movie! I've even given this kink in my personality a name: the Aardvark Complex. (Have you hugged your aardvark today?) The Aardvark Complex is not incredibly exotic. Decades ago, one turned up in Ann Landers’s newspaper column. A case I knew personally was a Chicano lad I knew in college, would approach Jewish girls saying something like "Girl, let me offer you a taste of uncir­cum­cised flesh." I can’t speak to their reactions, if any. A decade later he told me, his Anglo girl friend grinning sheep­ishly at his side, that he had had himself circumcised after college.

 The word “circumcision” was in no way alien to me, because until 1970, Roman Catholics honored the Jewish cir­cum­cision of Christ on January 1. But I did not learn what it meant until I was 13, when I chanced on an article by that name in an adult encyclopedia; that was also my first encounter with the word “fore­skin.” Only then did I learn that I was normal, that all boys were born looking like me, and that nearly all men around me looked as they did because they had been surgically altered very soon after birth. Honest, until then I had thought that American boys were born helmets, while Euro­pean boys were somehow born anteaters. This discovery brought no relief but only changed the focus of my worry, because everything I read in my teens asserted that the foreskin was unsanitary. I resolved to get myself cut as soon as I could order and pay for medical care on my own. When I was a college sopho­more, I read in a news­paper medical advice column that circumcision was medically unnecessary, and that pulling back the foreskin in the shower (which I had long done and was no big deal at all) sufficed. Only then did I finally see that one could be intact and healthy. 11 years later Wallerstein’s book taught me that RIC was unnecessary surgery. Shortly thereafter, Rose­mary Rom­berg and Marilyn Milos taught me that RIC was very painful. Hence only in my 30s did I come to understand that I was perfectly heal­thy and that American medical practice is simply dead wrong.

But understand­ing that I was normal and healthy, and had been spared serious pain, did not banish the fear of ridicule in sexual intimacy. I still believed that the foreskin had no important sexual function, wrongly believing that an erect penis was an erect penis, cut or not. I did not see the light about the pos­sible sexual im­portance of the foreskin un­til I was over 40, after years of sexual experience and after reading summaries of Taylor’s work. Incidentally, because nearly every penis I have seen in the flesh has been circumcised, the circed penises I see on the web strike me as normal and natural, and to describe them as “mutilated” strikes me as too pejorative.

One of the universals of human nature is that boys are prurient creatures. Yet I recall almost no joking about the foreskin or its amputation before college. (Exceptions: “X wears braces. He can circumcise with his teeth!” Then there’s the old saw about a father giving his intact son numbered instructions on how to pee. Soon the boy is caught masturbating, panting “3-5!, 3-5!, 3-5!” etc.) I never heard a boy say anything like “Man, the doc cuts some skin off your dick right after you’re born.” The first time I heard an adult talk about this fact was in 9th grade, when an old curmudgeon of a religious, blushing beet red, told us what cir­cum­cision meant in the Bible, adding that we had all undergone the procedure at birth. We were much too embarrassed to ask any questions. 12th grade health spoke to it for 1-2 minutes, including how only "hillbillys from the sticks" retained their foreskins. Both times, there was a lot of blushing around the room, despite no girls being present.

Circumcision was talked and joked about in college, where I began to detect a note of sadness and loss in the way some guys talked about it. The banter seemed to assume that present com­pa­ny was not circumcised. Decades later I read that some men resent having had something profoundly sexual trimmed at an age when they are unable to refuse consent or to protest. I observed that Jewish boys could make jolly fun of it, as long as no Gentile within earshot criticized the practice.

I was about 40 when I told my mother that her silence about my foreskin left me ashamed and confused until well after I came of age. Her reaction was little more than a verbal shrug. I then asked whether she knew that the millions of infant circumcisions in the USA had been done without local anesthesia. She muttered no, shrugging again. Here’s my best guess as to her silence. One day when I was 19, out of the blue, she broke down and cried, telling me the following story. When she immigrated to the USA with two month old infant me in her arms, her American mother-in-law met us at the dock and took us to a hotel. My grand­mother immediately undressed me and crit­icized my mother for not having had me cir­cumcised. Not only was this incident extremely embarrassing to a new­lywed young mother with imper­fect command of English, it was also because at that time, no maternity ward in con­ti­nental Europe would have agreed to circumcise me. Thus my foreskin was the cause of my mother's first humil­i­ating American experience. My mother’s tone and manner when she related this incident to me spoke volumes about the trauma and violation she had experienced.

After my father was dead, she told me that before I was born, he had asked her to have me circed at birth. My mother reluctantly raised this matter with her European OBGYN, who flatly refused. Curi­ous­ly, my father never raised the subject again. I am also confident that he never changed my diaper! A few months later, my grand­mother told my pediatri­cian (who was not the Dr. X mentioned below) that it was deplorable that I was not circumcised, but my mother declined to do anything. I am still a bit sur­prised my mother reports no further attempts to have me go under the knife. Fact: I have seen a number of posts stating that the author was intact because he was born premature. I wonder if the 1950s USA saw circ as some­thing done in the first few days of life. If that window of opportunity was missed, the medical profes­sion lost interest in the matter, unless there was a clear problem in later life. My grand­mother never raised the matter with me; in fact, I was very much her favorite grandchild. If adults ever discussed intact­ness in my presence, they did so at times when I lacked the vocabulary to understand.

My younger brother was not so lucky. My mother speaks very highly of the American OBGYN who delivered my younger siblings. But she cannot recall ever being asked whether she wanted her American-born children circumcised; I suspect that urban USA hospitals of that time (early 1950s) circumcised all baby boys unless parents took the initiative to object. My mother (like everyone else at the time) had no intellectual ammunition with which to counter this. She also inclined to defer to medical opinion, and did not want more fights with her mother-in-law. She has never told me what her women friends thought; I conjecture that they, with one exception mentioned below, probably would have endorsed prevailing medical practice.

I suspect that my mother was torn between her European distaste for circumcision (she would chide me gently when I would pull my foreskin back in the bath to look like my younger brother) and her great respect for American medicine. During the '50s and '60s, the prevailing American misconception was that the foreskin should be removed because it was unsanitary (to which my mother had no counterar­gu­ment). She also believes that routine infant circumcision (RIC) is a Jewish ritual that somehow spread to the entire American population. She didn't want me circumcised, but had no medical leg to stand on. Finally, the whole matter was tied up with her sexual feelings. I still remember her staring hypnotically at my groin when she saw me naked as a child. The upshot must have been that the whole topic had become intensely emotional, and linked to other powerful dilemmas in her life, so that she simply could not stomach trying to unravel the whole ball of wax. When a problem becomes too intense, we tend to do nothing about it.

She has told me that one of the horrors of the Holocaust was that the Gestapo would cruise the streets asking men at gunpoint to show them their penises, and arresting those who were circumcised. (This horror is confirmed in Roman Polanski's autobiography and in articles written about the Klaus Barbie trial.) Circumcision may thus be linked to her nightmarish memories of WWII.

A very secular Jewess who had the hots for me in the 70s was disappointed when I told her that circ was un­nec­essary and she guessed my condition, but it certainly not did lead her to lose interest in me. She talked freely about it, thinking that it was legally required as a public health meas­ure. I retorted "Is there a law requiring us to brush our teeth?" Ironically, she later married a European clergyman, who was almost surely intact. Otherwise, no woman  has ever expressed puzzlement or disgust at my being intact, much less ever made fun of my foreskin. However I drew little comfort from this fact, because I believed that most American women of our generation were not even aware that men were born with foreskins. Rosemary Romberg writes that she was almost totally unaware of the matter until she gave birth to her third son.

Bear with me as I practice some mental archeology. Some background. I was very embarrassed by (and very curious about) matters sexual as far back as I can remember. Ditto for feeling horny; puberty was not a “switching on” but only a “heating up.” Having unusual gen­italia only made things hotter. Reader, please understand that I experienced puberty as nothing short of an unwelcome assault on my peace of mind. And it came early; I began sprouting body hair the summer I turned 11. By 8th grade, I would experience prolonged erections from simply looking at the backs of demurely clad girls quietly doing their school work. Fortunately, none of them were aware of my lust, because teachers invariable sat me near the back of the class, as I was a well-behaved boy and could be trusted to work on my own. A bikinied beauty in an ad, even a mere hemline above an otherwise demure girl’s knee, made me feel like a pot about to boil over.

Incidents that fueled my Aardvark Complex include the following:

·        Throughout elementary school, the only boy I knew to be intact other than myself was the one with the low­est test scores. Teachers allowed him to go into the boys room by himself, after the rest of us. I believe this was done purely at his mother’s request. In grades 1 and 2, I was made fun of by the older boys at the school urinal. Not until 4th grade did I discover that I could look cir­cum­cised by retracting my foreskin. All whis­per­ing about my peculiar penis instantly ceased. In 6th and 7th grades, I was confident enough of my ability to con­ceal my foreskin that I would let other boys watch me urinate while erect. In junior high, the only class­mate whom I knew to be intact once said to me in a voice tinged with malice "I know yours is covered with skin." I was deeply afraid that he would tell the other boys. At the time, I had no idea he and I were normal.

·        The following incident is the only instance of genital play I recall from my childhood. Some­time before age 10, my regular playmate of the day showed me his penis and then asked to see mine. I screwed up my courage and complied. He shouted "Eew! It looks like a worm!" I laughed and put my tool back in my pants, but felt very much confirmed in my deviance. My impressionable young­er brother witnessed this brief episode and reported a garbled version thereof to our mother, saying that I had taken the initiative to expose myself (not true) and then let our playmate stroke my penis with a twig (if true, I had no recol­lec­tion thereof). Our mother, deeply disturbed by what my brother had told her, called me on the carpet. She referred to her version of this incident many times subse­quent­ly, main­ly to condemn the playmate involved, whose parents she considered white trash. She may have feared that I was straying into homosexuality, and later conversations revealed that she believed that homosexuality was, in some sense, “socially contagious.”—for her, homosex­uals were made as well as born. I lacked the vocabulary to explain what had really happened, and even had I known it, I would have been much too embarrassed to employ it. I denied nothing of what she alleged simply in order to avoid talking about what I later learned was my foreskin and the deep embarrassment it caused me.

·        When I was about 6, my pediatrician, Dr. X, retracted my foreskin for the first time that I can recall. It did not hurt but he did not like what he saw; I was not told what or why. He and my mother then had a discussion in my presence. The only part I understood was her emphasizing that I had been born in Europe. This incident was an excellent pretext for a frank mother-son talk that never took place. From that day until well into adolescence, my mother told me “to be sure to wash where Dr. X told you to” before every bath. Somehow, I knew what she meant, even though Dr. X in fact had spoken only to her

·        When I was 13, the same Dr. X expressed considerable curiosity, now to me alone, about how I dif­fered from his other patients. Even though he was the father of several children and I believe he was happily married, he gently manipulated my foreskin in a way that struck me as less than fully professional and innocent. He asked me if any of my schoolmates were also uncir­cumcised (recall that I had only recent­ly learned what that word meant); I ducked the humiliating truth by saying I didn't know. Dr X was the only adult who ever made me feel that my penis was a problem. Other­wise decency prevailed throughout my upbringing. Still, when I was 31, a gastroenterologist gasped loudly upon seeing my genitals for the first time. Incidentally, I agree that every boy should have the retract­a­bility of his foreskin checked starting around puberty, although we need to find ways of doing so with a minimal effect on impressionable boys.

·        I dreaded hernia checks in scout camp, fearing that an adult would comment on my foreskin and the other boys would ridicule me. Unlike the case in French scout camp, some boys would boast in my presence of mutual fellatio, exhibitionist masturbation, and other nighttime sex play. I was never in­vited to participate, a fact which led to deeply mixed feelings. On one hand, I was disappoint­ed that the other boys did not like or trust me enough to ask me to join in. On the other, homosexual acts did not interest me at all, my sexual curiosity being wholly for the other sex. Most of all, I was terri­fied of how other boys would react to my foreskin.

·        The prospect of having to shower before other guys in summer camp and in gym filled me with dread. On the first dozen-odd days I had gym, I kept my foreskin retracted using a rubber ban. It was hard to find the Goldilocks rubber band--tight enough to do the job, yet not so tight as to result in discom­fort. I soon discovered that I could very quickly pull my foreskin back before slipping out of my under­wear, and that it would stay back while I showered. I noted that the handful of boys (not all foreign born) who did not conceal the fact that they had foreskins also did not betray any evident embarrassment. But I simply could not bring myself to imi­tate their exam­ple. In any event, nobody in high school or college ever commented on my being un­cir­cumcised.

·        I did factory work while in college. At the end of every shift, 60-odd of us would strip and shower, and our bodies held no secrets. My coworkers were in two age groups: those hired just before WWII or the Korean War, and Baby Boomers like myself. The former were overwhelmingly intact, while the latter were the opposite. Every day, the older men would scrub their penises down with the foreskin pulled back, without any embarrassment whatsoever. Even so, while undressing I al­ways pulled my foreskin back, because I wanted to look like the other young guys. My embar­rass­ment simply made no sense because, over a period of 13 months, I recall not even the mildest good-natured ribbing of one group by the other. Mind you, most of the older men were devoted family men and churchgoers, whose own sons were almost certainly circumcised. Meanwhile, we young guys were not inclined make fun of men far more senior than we. This whole business taught me that circumcision did not become an American “universal” until the 1940s; before then it marked one as having been born in an urban hospital to middle-class native-born parents.

·        When I was about 30, I admitted to a younger man that I was intact. He was dis­gusted, telling me of his horror as a teen Candy Striper at having to clean under the foreskin of an elderly man bedrid­den in a nursing home. He did admit that a British friend he very much admired was also intact. Soon thereafter my friend and I vacationed together on a Mediter­ran­­ean island; he would go to nude beaches (yours truly the unbearably horny virgin declined to join him), indulge in one night stands with northern European women he met there, then boast to me the next day of how they were fascin­ated by his cut member.

Other incidents did not make me paranoid but marked my impressionable spirit in other ways:

·        2-3x a year, I played with the son of an American friend of my mother’s. He was kind and not over­sexed. When we would pee in the woods, he would begin with his foreskin fully extend­ed, then glance at my retracted foreskin (from age 9 to 45, I always peed with foreskin fully retract­ed), assume I was cut, blush, and try to pull his foreskin back, without complete success. We never talked about it.

·        I spent three boyhood summers in Europe. Because intact prepubescent boys typically do not retract their foreskins when urinating (I was an exception) and because the foreskin has a marked effect on the urine stream, one can determine at a glance whether a urinating boy is circumcised without act­u­­a­lly seeing his penis. A Euro­pean aunt proudly showed us color slides of her children in baby­hood, many of them revealing my cousins in their full intact glory. My aunt and cou­sins were perfectly matter-of-fact about it all; I was quiet and cool, trying to conceal my embar­rass­ment at the genital display; my prepubescent sister did a lot of nervous laughing. Thus I discovered that Euro­pean boys looked like me, but had no idea of what to make of the fact. When I was 10, I was taken to an art museum. There I made the very puzzling discovery that classical male nudes looked like me; I was far too ashamed to ask why I had a Renaissance penis!

·        One summer I took part in a 10 day scout camp in France. One of the boys had been circum­cised at age 9 because of a chronic rash. The other boys were fascinated about this fact and he talked about it happily and freely. We listened attent­ive­ly and never made fun of him. Thus I learned that circumcision after infancy was not especial­ly pain­ful, but that the recov­ery required about 10 days of down time. No boy knew the French term for circumcision, or the operation's religious signi­fi­cance until I enlightened them (my own knowledge was quite new at the time). One boy claimed that his father had told him that RIC was then the case in France; I could not make sense of that then or now. A boy interjected “Cutting it off makes no sense; I wash myself carefully down there every time I take a bath.” Much of their childish phallic humor, by the way, from the way an intact penis resembles a banana. The boys were curious about how I looked; while I evaded their questions, my habit of peeing with my foreskin retracted convinced them that I was circum­cised. I did not dis­abuse them and they made no fun me of me whatsoever. I was so uptight I could not admit to having a foreskin even to friendly intact boys.

·        In college I once joked that student nurses struck me as unusually horny. A future biology professor shot back, "That's because they see so many circumcisions." That bit of repartee has always made emotional sense to me; the act of circumcision, much more than the circumcised condition, has always struck me as laden with sadistic sexual significance. There are accounts on the web of young men taking money to be circumcised in someone’s residence with a number of adult women looking on. While these narratives could well be gratuitous sado-masochistic fantasies, they do not strike me as implausible.

·        In the 1970s, a fellow who studied in Italy once told me that Italian young men are incredulous when told that Americ­ans are all circumcised. A tall, buxom Sicilian-American engineering stu­dent, girdle showing under her jeans, told me that her saying “let’s talk about circumcision” to a tableful of fellow women stu­dents in a college cafeteria was met with stares and silence. I changed the subject.

·        The first time I read that American RIC was under a cloud was in 1979, when I read a newspaper article saying that RIC was unnecessary and had no support from the trade associations of Ameri­can pediatricians and ob­ste­tricians. (I read Wallerstein’s book in 1983.) Soon thereafter, a petite woman medical student shyly described to me how she helped out with the weekly batch of RICs at a teaching hospital. In answer to my question, she said that some mothers opted not to have it done (this was the 70s). Her Jewish fiancee waxed sarcastic when I invoked a recent newspaper article in support of my claim that the medical res­pect­a­bility of the procedure was in decline.

·        Late one summer night, I was eating in a Mexican restaurant with an Indian friend. Ten feet from us was a table full of young nurses yacking about their on-the-job experiences with circumcision. One nurse described a boy born without a foreskin as “being born circumcised,” and the doctor's trouble in explaining to the mother that no circum­cision was "necessary." Another nurse described her excitement and cur­i­ous­ity the first time she witnessed a RIC. Yet another said that she was all for RIC after having seen an adult man hospitalized for “problems down there.” I cannot recall hearing the word “foreskin” once. It is curious how many of us can talk about its removal, but not about what is removed! Overhearing this conversation made me shiver in a very embarrassing way. Some years later, my Indian friend converted to Judaism to marry an Orthodox Jew.

·        My 83 year old great-uncle told me that he was circumcised while under anesthesia for a tonsillect­omy performed shortly after he immigrated to the USA. The surgeon had recommended it because he was unable to retract completely at 26 years of age. My uncle joked about bleeding like a pig, but otherwise thorough­ly approved of circumcision for hygienic reasons. “Infections down there can be a real problem.” When I told him I was uncut, he was quite surprised then asked whether I had any difficulty with retraction. I assured him I did not. This conversation took place while both of us were drinking heavily, which made me shiver uncontrollably despite the hot weather.

·        I used to be very attracted to Jewish women, an attraction complicated but not dampened by my be­lief that a Jewish woman would have difficulty accepting a foreskin as part of her sex life. One of my hottest sexual fantasies was imagining a Jewish woman's reaction the first time she saw me naked. I finally met a young Jewish woman from the Middle East who, while declining to be my lover, was willing to talk frankly with me about matters sexual. She told me that she had had sever­al intact gentile lovers, and was adamant that this was not an issue with her. (She was no Jewish chau­vinist for several reasons: her family belonged to a Jewish sect many Jews do not recog­nize. Her mother tongue was Arabic, she looked very Arab and was not pretty. Worse yet, she was no intel­lect­ual and had not been a good student. Most Jewish young men did not find her attractive.) Like­­wise no woman with whom she had talked sex had ever mentioned it. After talking to me, she asked her closest woman friend what she thought about intimacy with an intact man, and her friend reportedly said that that it had never crossed her mind to think of that as a defect in a lover. In no way did any of this dent my Aardvark Complex, because I believed that it was hard for a Jewish women to appreciate the effect of universal cir­cum­cision on the expectations of American women of our generation. 25 years ago, tens of million of American women had no idea what a foreskin was. Even now, I bet most women cannot distinguish erect intact from erect cut just by sight or inter­course. The only easy way to distinguish the two is to manipulate the penis by hand or by mouth. Jews, of course, grow up knowing that there is such a thing as the foreskin, because remov­ing it is a defining Jewish ritual. I wonder if well-educated Jewish women are more likely to accept an intact lover than many American gentile women.

·        The Italian-American wife of an Indian doctor lovingly described a bris to a group of Indian friends of her husband (I was the only gringo present). That the same thing was done to most American gen­tiles was never mentioned. Someone mentioned female genital mutilation, and I took over the conversation (I have read extensively about this as well). I remember all too well the woman's disgust and indignation, so soon after she had extolled the ritual significance and beauty of slicing off an infant boy's foreskin, when I got her to understand that some cultures slice off a girl's inner labia (I did not mention a greater horror-the excision of the clitoris). Why are so many of us com­placent about removing the foreskin, yet strongly (and rightly) disgust­ed by all forms of FGM? Were women the circumcised sex, feminist outrage would be deaf­en­ing. In her book Intercourse, Andrea Dworkin says that circumcision is part of a general pattern of violence to sexual anatomy and of a wider hatred of sexuality coming under her radical feminist indictment of our culture.

·        There is a remarkable scene in the 1967 (released in 1987) Soviet film ”The Commissar”, filmed through the wheels of a moving cannon carriage, of three naked Jewish boys taking an outdoor bath in an Ukranian “shtetl” sometime in the early '20s. The two older boys were circumcised (I bet the child actors had merely pulled back their foreskins; circumcision not being an option in the Soviet Union), while the youngest one, purportedly born after the Revolution, was not. The point was to impress upon the viewer how the Revolution had suppressed Judaism. I saw this film with my sister but dared not mention this detail with her.

It was much easier to talk circumcision with my Indian friends. They are intact, proud of their sexual sophistication, and quite aware of the subject because of the large Moslem minority in their country. While somewhat surprised to learn that almost all American men born in urban hospitals between 1940 and 1980 underwent RIC, they have always discussed circ with me in a very matter-of-fact way, never giggling or smirking. My closest Indian friend had some sexual experience with American woman, and he told me that no American woman has ever com­ment­ed in any way on his being intact, including those who performed long and expert fellatio on him. He further asserted that any adult woman worth knowing should be sophisticated enough to deal with both kinds of men.

The raunchy men's magazines don't say much about circumcision. I do remember reading about a young single Swedish woman who had immigrated to the USA only to discover via foreplay, to her dismay, that her American partners were all circumcised. I read an intact American college student tell of being shown a Playgirl layout of an intact man by two women stu­dents. They then said that they could not conceive of making love to a man whose penis “looked like that” (they did not know that the fellow they were speaking to was intact).

All articles the Reader’s Guide indexes under “circumcision” strike me as superficial. To my surprise, Cosmopolitan does not appear to have written about it, even though in recent years it has gone so far as to print articles on the styling of women’s pubic hair. The discussion of RIC in books for expecting parents varies widely in quality, and is often weak. A fundamental problem is that the American main­stream media cannot bring themselves to admit that the foreskin and the frenulum may play an import­ant role in sexual intercouse for both sexes.

After decades of living in shame, I began reading about people of both sexes who would be downright envious of me! Anticircumcision activists who target their writings mainly at expecting parents, report receiving many thousands of letters from American men expressing rage and sorrow at having been deprived of a normal part of their sexual anatomy. (I suspect that RICs performed decades ago were often too radical; the skin on a flaccid cut penis should be quite loose, even wrinkled, otherwise there is not enough skin to accommodate an erection.) I am aware of the book by O’Hara and O’Hara, although I find their research methods naïve. I have even read a state­ment by a California woman, happily married to a circumcised man by whom she has had 6 children, declar­ing her passionate desire to be intimate with an intact man. I have found the following telling quote from Lara Loewenstein’s (?!?) column in the UCLA student paper:

“And while I'll be the first to admit that body image plays a large role in our society, when it comes to sex, as one girl put it, "I've never really noticed." Many did not even know how to tell the difference. I delightedly enlightened quite a few with the aid of a Goo­gle image search. Those who had noticed the physical aspects of their snake-like friends didn't express any strong preference for one or the other. The most helpful res­ponse I got was from a girl who enthusiastically told me that ‘uncircumcised penises are much more fun to play with.’ ”

There are young Ameri­can women who cruise the web looking for images of intact penises (Google makes this very easy). Nearly all web sites devoted to the intact penis cater to gay men, but I have seen two purportedly created by women for women.

This narrative is entirely archaeological. My powerful interest in the opposite sex has been little recip­ro­cated, and now that I am bald and gray, that is true with a vengeance. I live in a society that used to circumcise (but no longer does so) so that many men my age are cut, but nobody ever remarks on my foreskin. When I use a public urinal, I no longer hide my fore­skin by pulling it back At my age, the only people who see my foreskin are my im­me­­­diate family and my GP. A female urologist recently examined me for suspected prostate cancer; she did not comment on my foreskin. My spouse had ex­tensive experience with intact lovers before meet­ing me, and emphatically does not believe that “if doctors do it it must be a good thing.” We would never have a child circumcised unless absolutely necessary. Objectively considered, the foreskin is a very minor bit of male anatomy. Yet somehow no part of the human body is more burdened with historical and symbolic significance, far more so than vulva, for example. Its removal is one of the most common and most sacred rites of passage. It has torn Israeli and rabbinical politics for years. It is the reason Christianity is not simply a Jewish sect. It helps explain how even the most assimilated Jews often feel marginal. The fact that an American Jew does not stand out in this respect may help explain why the USA has a very large and well-assimilated Jewish popula­tion. For over a thousand years, circumcision has served as a rallying point for the deep animosity between Moslems on the one hand, and Christians and Hindus on the other. Closer to home, it ties into strange parts of my mother's libido and sexual shame, and her vicious 20 year battle with her mother-in-law. It explains how this a straight white male has felt marginal and deviant, and why I long felt I belonged to a sexual minority. It powerfully contributed to my having sat out the sexual revolution (no regrets in this quarter; had I taken part, it is very likely that I would be divorced or the father of a lovechild), and has colored my entire thinking about human sexuality.

 

Why are some Americans so angry about routine infant circ, to the point of losing all civility and of seeming like foreskin fetishists? Bear with me as I conjecture. Circumcision was introduced to make masturbation more difficult. When masturbation came to be tolerated, routine circumcision became cosmetic surgery fueled by a desire to have all boys with genitals that look alike. Hence over 100M adult American men were circumcised even though when it was done, there was no credible medical research supporting it. Generations of Americans were led to believe that the foreskin is disgustingly unsanitary. Routine circumcision was popular in Canada, Australia, New Zealand, and nowhere else.

Even though Novocain and related local anesthetics have been available for about a century, and have been widely used in dentistry, doctors performed those 100M circs without pain management. The possibility that the foreskin influences the quality of one's sex life, or that of one's partner, was a question not posed before the 1990s. I submit that all in all, the American medical profession has behaved very badly here, has failed in its duty to lead, and has breached the trust we naturally place in it.

And why do Americans continue to circumcise infant boys even now? Again, forgive me as I conjecture:

1. Most fathers cannot face having their sons ask them in the bath or locker room "Daddy, how come your willy doesn't look like mine?"

2. Most American men and women of reproductive age have never seen an intact penis in the flesh. They do not want to be reminded of the foreskin every time they change a son's diaper. 3. Most American mothers do not want to talk about foreskin hygiene with their sons at bath time.

4. Many American women find the foreskin highly unsanitary, and a grave violation of the First Taboo of American Social Life: Thou shalt not emit body odor. To which I make two replies:

* Civilized men and women rinse off their genitals before undertaking sexual activity (and it is a fine thing to begin sex by showering together), and that responsible casual sex requires a condom.

* Our genitalia, and the acts lust impels us to carry out with them, all have a reproductive teleology. If a woman finds oral sex with a foreskin disgusting, I see that as Mother Nature's way of reminding her that semen belongs in the vagina and not in the stomach.

tracya's picture

medics moving away from circumcision

i have read the extensive discussion of this subject and while i may not understand what men go through, i do have 2 sons, 2 american circumcised sons.

with my older son my jewish obstetrician believed in a "modified" circ... my ex (the father) was not happy with it and insisted i take him back within the first month and question him about why it "didn't look right". that's when my OB,(whom i had major respect for and a slight crush on) explained to me that men get most of their pleasure from the sensation at the head of the penis and that leaving a bit of skin protects it and keeps it sensative...or something to that effect...i remember being 26 years old, standing in a minscule examining room, with my doctor and newborn son, talking about my sons future sex life...and leaving sexually very confused. i later had a comment from a pediatrician that he was uncirced and when i said "no he is" she said "well, i think you should ask for your money back"

the aforementioned son is now 23....should i ask him how his sex life is?

son number two was not nearly as complicated, but i was asked by the nurse why i was having my son circumcised...simple answer...because his father wants him to look like him..

i have since gone to nursing school and actually seen circumcisions, it is not a pleasant procedure and now i know why they brought me back a newborn infant screaming his head off.

i fully support the end to circumcision, health and hygiene have advanced to a level where there is little risk of infections. here is the article which brought this to my attention~~~

From next month, Victoria will be the fourth Australian state to no longer provide circumcisions at public hospitals for non-medical reasons.

From September, circumcisions will be performed in Victoria only where doctors determine there is a need because of concerns over infections or disease.

NSW, Western Australia and Tasmania have already implemented the change.

Victorian Health Minister Daniel Andrews today said there was no medical evidence to support routine circumcision of newborn males.

"In Australia and New Zealand, the circumcision rate has fallen considerably in recent years, and it is estimated that only 10 to 20 per cent of male infants are routinely circumcised," Mr Andrews said.

"Both nationally and overseas, doctors agree there is no medical benefit to routine circumcision, and studies show the complication rate is around five per cent."


Visitor's picture

Post transferred from the

Post transferred from the other blogsite:

I am an American male, son of an immigrant (and uncut) father, and I deeply resent being cut. (It was done in the 70’s without any parental notification; welcome to the USA.) To be totally frank, it is the one ‘body issue’ image that I have - and I really do suffer from it. I don’t like to see myself naked in the mirror because of it. My penis doesn’t look “right” to me - and I can accept all the other differences that I have from other folks, except that one. I’d do just about anything to change what happened - wish I could go back in time or something. I’m middle-aged now, and growing old with style - don’t mind my greying hair or slight pauch, any of that. But what I do mind - and have minded since the time I was a little boy and discovered it - is that someone took off part of my body for no reason, and without even asking.

I am in a supportive, settled relationship with a great woman who’s had lovers of both varieties, and tells me not to worry - though if we have any children, they are remaining uncut (as we both agree). I think I’d kill anyone who tried to harm my child in this way.

To all those folks, cut and otherwise, who think it’s not a “big deal,” I say fine - for you it may not be. But if there’s a small chance that your kid will have a reaction like mine, you shouldn’t play with fire. It’s just not fair to him - if he wants to be cut later, he can go ahead and do it, no big deal - I WISH I could reverse the process and heal the scar so easily. But he can’t get back what you take from him as a baby, and he may decide that he wants it back very much.

Our feelings about our genitals are such basic, private, and personal matters. Even family members will never really understand what’s at stake for any individual, and parents shouldn’t be so arrogant as to imagine otherwise. You feed your child; you don’t feel for him, certainly not once he’s grown up and out of the house. But your actions can have continuing consequences. Parents, doctors and religious leaders are merely guardians for us while we’re small; they won’t ultimately live in the bodies they are supposed to look after. It seems painfully obvious that they should do no harm while they have power over smaller people.

It’s too late for me - I realize that I will probably die unhappy about the fact of my circumcision (even though happy about many other things - my wife, job, etc.). There’s just no way I can easily get over this in my head, though believe me, I’ve tried. Don’t do that to anyone else, even if it’s only a small risk they’ll end up feeling like I do.

Visitor's picture

Foreskin + condom = little understood

Intact Yank here. The intact penis was not at all respected 30-50 years ago in the US of A. During much of the 20th century, American medical texts depicted the penis as having no foreskin. I am happy to report that the American foreskin appears to be making something of a comeback. Granted, quite a few web posts describe teenage and college girls as having attitudes that leave something to be desired. (A few articles in Cosmo and Glamour could change that in short order, LOL!) On a more positive note, about 45% of American boy babies now leave the maternity ward intact. The Wikipedia articles on circumcision, foreskin, and penis are far more objective than anything in print before 1980. YouTube is overwhelmingly foreskin friendly. An easily retractable foreskin is not a major alteration of the appearance of the penis. In fact, it takes a skilled eye to distinguish cut from uncut but rolled back. I suspect that many women do not know how to tell whether the man bonking them is equipped with a foreskin or not. The foreskin is visually and sexually blatant to a woman if she retracts it herself during foreplay. This is often unnecessary: by the time most men pull off their underpants, they are fully hard with no evident foreskin. The handjob is the only sexually act that makes the foreskin evident. I suspect that millions of American women during the 20th century never performed a handjob in their lives. I submit that the foreskin matters most when a condom is involved. Only quite recently have I read on the web instructions on how to put a condom on without first fully retracting the foreskin, and I have yet to try this myself. Otherwise, we uncuts have to be able to bare the glans fully without discomfort. Then the condom has to be rolled on from the tip of glans. This has to be done slowly and carefully to avoid painful tugging on the frenulum. When I used condoms frequently 15-20 years ago, it would take my partner at least 2 minutes of fiddling to get one on. This was not trivial, was also deadly to spontaneity. After I came and became soft, she and I both worried that the condom would slide off. I recently read that condom breakage is more common with intact men, though that has never happened to me. My better half (BH) fully agrees that a condom obliterates the sexual advantages of intactness. Cut and uncut are truly indistinguishable when both wear a condom. Also, my BH also tells me that vaginal intercourse with a foreskin and without a condom is in a category by itself. Quite a few web testimonials concur. Unfortunately, outside of a monogamous relationship, this is the riskiest sort of intercourse. Hence the following unsolved problem in biomedical engineering: to invent a device that protects like a condom, while preserving much of the pleasure derived from a movable foreskin.
Visitor's picture

When I gave birth to twin

When I gave birth to twin boys, one of them had a natural circumcison. I was unaware of this and when I took them in at two weeks of age to get them both circumcised, the doctor informed me that one of them would not require it. Years later at the age of 14 yrs. that same sone expressed his desire to be circumcised, so that he would not look different. Upon taking him to a urologist, I discovered that he was born with hypospadia, thankfully, they were able to use the foreskin to correct the defect. Thank God we had not gone ahead with circumcision. He is of completely normal now, the defect corrected and he is circumcised. I don't remember thinking we even had a choice, it was just what was expected.
Lou FCD's picture

Circumcision Is Expected

I was circumcised at birth (1967), and never thought much about it, honestly.  I think I was probably in my late teens when I first heard that the procedure was not universal in today's world.  It had always been presented to me as a historically religious practice that had become widespread for medical reasons, namely cleanliness and infection prevention.

I was asked when my son was born if I wanted to have him circumcised, and I found the question absurd.  "Of course I do.  What kind of question is that?"  I then hesitated.  The conversation went something like this:

"Aren't pretty much all boys circumcised?"

"Well, yes.  The vast majority are."

"Some don't?"

"Some, for religious reasons, don't."

"Is it best to have it done?"

"Yes.  It's cleaner and helps prevent UTIs.  It's best to have it done now, and he won't even remember it."

In there somewhere was also a comment about embarrassment in a locker room about not being like the other boys, and something about the psychological issues that might cause.

Thus the medical professional (I hesitate to use 'nurse' or 'doctor' because I don't know which he was) reinforced the belief I already held.  The way it was presented to me, it sounded like it was the sensible, medically important thing to do, and only people with backward religious objections declined the procedure.  It was phrased in such a way that it correlated in my mind with religious objections to vaccinations, birth control, or other modern medicine.

I can't honestly say I resent being circumcised, as I don't have any other experience with which to compare.  I'm not even terribly upset about it having been done without my consent, because in all likelihood it was presented to my parents the same way.

What I absolutely do resent is the manner in which I was misled into having the procedure done on my son.  I don't know if I'd make the same choice now that I made then, but there is absolutely no excuse for a medical professional to spin a conversation that way.  I gave consent for my son to be circumcised, but I most definitely did not give informed consent.


Baby Biologist, just trying to make the world a better place.

Visitor's picture

 I am about to have a baby in

 I am about to have a baby in Canada. I don't get the feeling that it circumcision is really being pushed on me. In fact it costs $250. I think times have changed and we are moving away from this process.

Lou FCD's picture

Published in PLoS ONE

Estimating the Resources Needed and Savings Anticipated from Roll-Out of Adult Male Circumcision in Sub-Saharan Africa

Bertran Auvert, Elliot Marseille, Eline L. Korenromp, James Lloyd-Smith, Remi Sitta, Dirk Taljaard, Carel Pretorius, Brian Williams, James G. Kahn

The abstract reads as follows:

Abstract
Background


Trials in Africa indicate that medical adult male circumcision (MAMC) reduces the risk of HIV by 60%. MAMC may avert 2 to 8 million HIV infections over 20 years in sub-Saharan Africa and cost less than treating those who would have been infected. This paper estimates the financial and human resources required to roll out MAMC and the net savings due to reduced infections.

Methods

We developed a model which included costing, demography and HIV epidemiology. We used it to investigate 14 countries in sub-Saharan Africa where the prevalence of male circumcision was lower than 80% and HIV prevalence among adults was higher than 5%, in addition to Uganda and the Nyanza province in Kenya. We assumed that the roll-out would take 5 years and lead to an MC prevalence among adult males of 85%. We also assumed that surgery would be done as it was in the trials. We calculated public program cost, number of full-time circumcisers and net costs or savings when adjusting for averted HIV treatments. Costs were in USD, discounted to 2007. 95% percentile intervals (95% PI) were estimated by Monte Carlo simulations.

Results

In the first 5 years the number of circumcisers needed was 2 282 (95% PI: 2 018 to 2 959), or 0.24 (95% PI: 0.21 to 0.31) per 10 000 adults. In years 6–10, the number of circumcisers needed fell to 513 (95% PI: 452 to 664). The estimated 5-year cost of rolling out MAMC in the public sector was $919 million (95% PI: 726 to 1 245). The cumulative net cost over the first 10 years was $672 million (95% PI: 437 to 1 021) and over 20 years there were net savings of $2.3 billion (95% PI: 1.4 to 3.4).

Conclusion

A rapid roll-out of MAMC in sub-Saharan Africa requires substantial funding and a high number of circumcisers for the first five years. These investments are justified by MAMC's substantial health benefits and the savings accrued by averting future HIV infections. Lower ongoing costs and continued care savings suggest long-term sustainability.


Baby Biologist, just trying to make the world a better place.

Lou FCD's picture

Reference Article

The article referenced by the above paper:

Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis.

Weiss HA, Quigley MA, Hayes RJ

Medical Research Council Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, UK.

OBJECTIVE: To systematically review studies of male circumcision and the risk of HIV-1 infection in men in sub-Saharan Africa, and to summarize the findings in a meta-analysis.

DESIGN: A meta-analysis of observational studies.

METHODS: A systematic literature review was carried out of studies published up to April 1999 that included circumcision as a risk factor for HIV-1 infection among men in sub-Saharan Africa. A random effects meta-analysis was used to calculate a pooled relative risk (RR) and 95% confidence interval (CI) for all studies combined, and stratified by type of study population. Further analyses were conducted among those studies that adjusted for potential confounding factors.

RESULTS: Twenty-seven studies were included. Of these, 21 showed a reduced risk of HIV among circumcised men, being approximately half that in uncircumcised men (crude RR = 0.52, CI 0.40-0.68). In 15 studies that adjusted for potential confounding factors, the association was even stronger (adjusted RR = 0.42, CI 0.34-0.54). The association was stronger among men at high risk of HIV (crude RR = 0.27; adjusted RR = 0.29, CI 0.20-0.41) than among men in general populations (crude RR = 0.93; adjusted RR = 0.56, CI 0.44-0.70).

CONCLUSION: Male circumcision is associated with a significantly reduced risk of HIV infection among men in sub-Saharan Africa, particularly those at high risk of HIV. These results suggest that consideration should be given to the acceptability and feasibility of providing safe services for male circumcision as an additional HIV prevention strategy in areas of Africa where men are not traditionally circumcised.

 

Full text as html is here and as a .pdf is here, from AIDS (Journal of the International AIDS Society)


Baby Biologist, just trying to make the world a better place.

Visitor's picture

HIV prevention is dubious, to say the least

Fascinating and sad to read the accounts of normal, whole, natural male Americans conditioned to think there was something the matter with them. The Intactivism Pages cover all aspects of circumcision from the point of view that intact is the norm (as it is: at least 75% of the world's men are intact). They include pages of intact celebrities and pages for intact boys and young men to underline this. The Intactivism Shop offers goods celebrating intactness, such as "Anteater Pride" t-shirts, and garments for babies and toddlers with messages to protect them from circumcision and forcible foreskin retraction.

The claim that circumcision prevents HIV is dubious, to put it mildly. (It's notable that the same few people write all the studies claiming its benefits.) The three trials fell far short of the gold standard for clinical trials: they were not double-blinded; not placebo-controlled; they had a significant drop-out rate - 5 times as many as were known to be infected. (And if you had endured a painful and marking operation "to protect against AIDS" and then found you had it, would you go back to the people who had done that to you?) So it's very likely that many more circumcised men had HIV than they claim. (They were encouraged to get tested elsewhere, because it was considered "unethical" to tell them they were HIV+. It was considered "ethical" to let them go home and infect their partners. These studies would never have gained ethical approval in the developed world.)

Non-sexual transmission - common in Africa - was ignored. The circumcised experimental group was given more safe sex warnings than the non-circumcised control group. One of the three trials used a method that removed significantly less tissue than the others, yet the "protection" found was the same.

In several African countries, the HIV rate is higher among circumcised men than non-circumcised, according to the National Demographic and Health Surveys.

For some reason, the idea of circumcision makes people lose their critical faculties. There has been far too little criticism of the lemming-like rush to circumcise, instead of using means that are known to work.

Lou FCD's picture

Inactivism

Thank you for the link to The Inactivism Pages , Hugh.  There is quite a bit of information there.

I'm looking now for some published research on the issue, as I found the results of the papers I cited above rather surprising and perplexing.  If circumcision does in fact reduce HIV infection, I'd be very interested to know the mechanism, something I'm either not seeing or not understanding in those papers.


Baby Biologist, just trying to make the world a better place.

Visitor's picture

There is a proposed mechanism

There is a proposed mechanism for the HIV susceptibility of the intact: the inner lining of the foreskin contains cells that unusually permeable to the HIV virus. This possibly explains why intact African men are more likely to contract HIV from infected women. Circ does not influence a woman's probability of contracting HIV from an infected man. All this has nothing to do the primary way HIV gets around the North Atlantic: male-male sex. Intact Europe has a much lower HIV infection rate that the cut USA.

A hot issue now is whether the health plan that will emerge from Congress will pay for routine infant circ. The CDC is being pressured to deem the evidence from the African clinical trials as sufficient to justify routine infant circ as an anti-AIDS measure. The final decision will be left to parents, as at present. But if the CDC does rule that baby circ is part of the struggle against AIDS, that the new health plan will pay for it. Otherwise, it probably won't. As the new plan goes, so goes Medicaid, BC/BS, and private insurers.

This is not where the fate of the American foreskin lies. It lies between the ears of young unmarried women who will become the mothers of tomorrow. More and more, these women are coming to see routine circumcision as sexually weird and cruel. Nice young ladies are discovering the Pig in the Blanket in their home offices, and more and more don't mind it, and some are turned on. I conjecture that the women's conversations in college dorms had gradually turned more and more anti-circ, especially in the elite colleges. Circ cannot survive if Harvard and Stanford coeds think it uncool!

 

Visitor's picture

I just have to ask:  How

I just have to ask:  How would you conduct a double-blinded, placebo-controlled circumcision experiment?  We aren't talking about sugar pills here.

Lou FCD's picture

Circumcision Policy Statement

Following some links, beginning here, then to Elizabeth's old WordPress blog, then hither and thither, I came across this, full text at the link:

AMERICAN ACADEMY OF PEDIATRICS:
Circumcision Policy Statement

Abstract:

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.

Although the exact frequency is unknown, it is estimated that 1.2 million newborn males are circumcised in the United States annually at a cost of between $150 and $270 million. This practice has been advocated for reasons that vary from symbolic ritual to preventive health measure. Until the last half century, there has been limited scientific evidence to support or repudiate the routine practice of male circumcision.

Over the past several decades, the American Academy of Pediatrics has published several policy statements on neonatal circumcision of the male infant.1-3 Beginning in its 1971 manual, Standards and Recommendations of Hospital Care of Newborn Infants, and reiterated in the 1975 and 1983 revisions, the Academy concluded that there was no absolute medical indication for routine circumcision.

In 1989, because of new research on circumcision status and urinary tract infection (UTI) and sexually transmitted disease (STD)/acquired immunodeficiency syndrome, the Academy concluded that newborn male circumcision has potential medical benefits and advantages as well as disadvantages and risks.4 This statement also recommended that when circumcision is considered, the benefits and risks should be explained to the parents and informed consent obtained. Subsequently, a number of medical societies in the developed world have published statements that do not recommend routine circumcision of male newborns.5-7 In its position statement, the Australian College of Paediatrics emphasized that in all cases, the medical attendant should avoid exaggeration of either risks or benefits of this procedure.5

Because of the ongoing debate, as well as the publication of new research, it was appropriate to reevaluate the issue of routine neonatal circumcision. This Task Force adopted an evidence-based approach to analyzing the medical literature concerning circumcision. The studies reviewed were obtained through a search of the English language medical literature from 1960 to the present and, additionally, through a search of the bibliographies of the published studies.


Baby Biologist, just trying to make the world a better place.

Lou FCD's picture

Behavioral Factors Far More Important

Regarding specifically the efficacy of circumcision in prevention of HIV from the aforementioned statement from the American Academy of Pediatrics (emphasis mine):

"There does appear to be a plausible biologic explanation for this association in that the mucous surface of the uncircumcised penis allows for viral attachment to lymphoid cells at or near the surface of the mucous membrane, as well as an increased likelihood of minor abrasions resulting in increased HIV access to target tissues. However, behavioral factors appear to be far more important risk factors in the acquisition of HIV infection than circumcision status. "

Also note the mention of a possible mechanism, about which I inquired.

(OK, I totally give up on understanding why the blockquote function works sometimes and not others.)


Baby Biologist, just trying to make the world a better place.

TLCTugger's picture

Benefits as meant in Policy Statements

When you read a medical policy statement referring to "potential benefits" of circumcision you need to understand that the statement ignores the fact that a benefit of remaining intact is having an exquisitely delightful foreskin that feels REALLY good. 

Benefits - the way they seem to be defining them - are very nebulous.  If they were writing about head injury, one of the potential benefits of having all your teeth knocked out would be no cavities nor need to brush your teeth. 

Lou FCD's picture

Tugger

I actually read that statement as cautiously critical, with maybe a pressured nod to "benefits", to appease someone.  I didn't give the "benefits" any serious weight, given the phrasing.

Baby Biologist, just trying to make the world a better place.

Visitor's picture

There is a commentary ...

There is an interleaved commentary on the AAP's policy statement here.
Lou FCD's picture

Hugh

Thank you for that.

Baby Biologist, just trying to make the world a better place.

Visitor's picture

A lot to think about

Thank you for everyone who has posted after the original article. I have one son who is 3 and I'm about to have another, I'm undecided on circumcision but my husband is dead set on the idea. I used to be very confused about the issue because there's a big difference in the practice between the UK and America and I think I've now got some good evidence to make a decision either way.
Visitor's picture

Talking about human body,

Talking about human body, specially the naked one is usually very hard for people. There is still kind of taboo on those matters. I don't know if you are feeling and seeing it the same way but body and sex matters are private but it's worth to talk about it on public. Maybe not about the most spicy details (or maybe about it?) but about likes and dislikes, problems and happiness - everything that matters.
Visitor's picture

Circumcision vs. being left natural

Born in 1942, and not being circumcised, I was the only boy in school showers, locker rooms, and swimming pools (YMCA) who had a foreskin.  And I felt very different.  Later I certainly became aware of the benefits of being left intact, especially when masturbating.

Please see my blog http://uncutplus.blogspot.com for more details about my personal experiences in "Who your blogger is".

Today, there is so much discussion about reducing healthcare costs, so I wonder if healthcare insurance pays for infant circumcision.  I assume that it does, because I have never heard of the procedure being listed for payment on the hospital bill.  Let's start by getting US healthcare companies to refuse to pay for infant circumcision because it is a medically unnecessary procedure and thus only a cosmetic surgery. Generally, insurance will never pay for cosmetic surgery.  Then I think the number of circumcisions would be reduced.

Visitor's picture

Most intactivists have

Most intactivists have reached the same conclusion. About 15 states no longer pay for it via Medicaid, including North Carolina. ("But boys with poor parents will be laughed in high school PE for having weird dicks!") BC/BS does not pay for it in some states, including California.

When third parties decline to pay for it, so that parents are out of pocket, the circ rate goes down.

By the way David, even though Wallerstein's 1980 book converted me to intactivism in 1983, it was only about 10 years later that I began to think through the sexual advantages of being intact. And I've done more thinking on this issue in my 50s. I did not discover how to make proper use of the foreskin while masturbating until my 32nd year. Being intact does not mean that sexual sophistication is a cinch!

 

 

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