To Cut or Not to Cut: The Pros and Cons of Circumcision

There has been a movement in past ten years in North America to re-examine the medical necessity of circumcision. While for many, the procedure is a religious rite, there are vast numbers of males who have been circumcised in the past thousand years or so, just because that's what was done.

Circumcision originated in ancient Egypt as a procedure to improve male hygiene, and was later adopted by various religious denominations, among them Judaism and Islam, as a religious rite. The scientific rationale for circumcision has been, at times, dubious, for example in the early part of the 20th century, when it was lauded for preventing tuberculosis and masterbation (haven't they found a cure for that yet?).

While religious and cultural traditions remain intact for the most part, medical reasons for male circumcision have recently come under fire, to the point where many health care plans will not cover the procedure, as it has come to be classified by many as a cosmetic, rather than a medical, procedure.

Ethically, much of the debate has centered on the level of trauma suffered by an infant during circumcision. While it has been suggested in the past that infants do not experience the pain or that they are too young to be traumatized by the event, who can really say what the effects of circumcision are on an infant? Some studies have shown that infants experience pain even more intensely than their older counterparts. And if it is elective, cosmetic surgery, are there reasons to take the chance that you are traumatizing your son?

Are there medical or social benefits to circumcision?
Well, the debate rages. When deciding whether or not to circumcise his new born son, a friend of mine worried that his uncircumcised son, seeing his father's circumcised penis, might feel some sort of Freudian disjunction between what a "man's" penis looks like as opposed to his own. Likewise, in the locker room, where boys are not known for their discreet sensitivity to difference, the fear was that an uncircumcised boy would be the minority and have his manhood ridiculed by his cut counterparts.

The reality is, however, that, statistically, uncut boys are no longer the vast majority (in North America and Britain, at least), at least for this new generation emerging. In the United States, where 20 years ago, 95% of infant boys were circumcised, stats place numbers for non-religious circumcisions as low as 60% in some areas. In Canada, the number is about 48%, and in Great Britain, it is down to 24%. These trends reflect a re-examination of the actual health risks associated with being uncut as opposed to the physical and potential emotional ramifications of the procedure.

In the medical benefits column of infant circumcision, uncircumcised infants and men "appear" to be at an increased risk of developing UTIs (Urinary Tract Infections), penis cancer, penile problems (such as inflammation of the glans, or head), infection (including STDs), and poor hygiene. Having said this, current literature also admits that many of these conditions (such as penis cancer and UTIs) are quite uncommon in either cut or uncut men. And poor hygiene isn't a medical condition the last time I checked. It's just inattention or lack of education.

Complications associated with circumcision can include bleeding and infection of the surgical site, which are common complications in most surgeries. Psychological trauma is thus far immeasurable.

One major argument on the part of the anti-circumcision movement is that, if a man wants to be circumcised, then that is a decision that he should be able to make for himself later in life, having personally weighed all of the pros and cons. On fact, many purport that the procedure is much more accurate if done on an adult male. One of the major reasons given for this is that an infant is born with his foreskin attached to the glans (head) of the penis. It takes up to four years for the foreskin to detach itself from the head, which means that an infant circumcision involves first detaching the foreskin from the glans before removing it, raising the possibility for damage to the glans, possibly resulting in reduced sensitivity, or worse.

Another advantage to adult circumcision is the fact that the procedure can be performed with more accuracy as it can be performed on an erect penis, to ensure that the doctor does not remove too much skin. Adult circumcision tends to scar less as well. The major detriment to having the procedure performed as an adult is the healing time (6 weeks without genital stimulation or sexual activity"”in fact, for some, amyl nitrate is used to prohibit painful erections from disrupting the wound and sutures during the healing process).

It is a misconception that most uncut men will consider circumcision, if not for a medical reason such as tearing; tightness of the foreskin, preventing retraction over the glans; painful erections during intercourse; or a painful swelling of the glans.

One of the major ethical issues for men is that there have been studies that have shown that a circumcised man may experience less sensitivity than his uncut counterpart. This can be due to several things. First, with the loss of the foreskin, comes the inevitable loss of the many nerves in the foreskin, which are thought to be even more sensitive than those found in the glans. Second is damage or loss of sensitivity to the glans due to the fact that it has lost it protective covering. An analogy can be made between the glans and the eye. The eye has no protective skin layer covering it, other than the eyelid, much like the glans and the foreskin. Without the foreskin, the surface of the glans must become heartier for its own protection (what with the chafing it endures) as it is constantly exposed. This toughens it up, making it less sensitive.

Finally (as if there needed to be more!), when the surface of the glans is covered by the foreskin, not only does it remain more sensitive, but it has a built-in self-stimulator. The glans is not being rubbed directly, but rather, it is being stimulated by both the pressure of the stimulator, and by the motion of the foreskin over its delicate surface. Without the foreskin, friction on the surface of the glans is direct (again with the chafing!).

Before I conclude this examination, a note on hygiene. If you are cut, clean it. If you are uncut, pull it back and clean it. Everybody wins with good hygiene.

This article is not meant to be a plug for either side of the debate, but is merely an introduction to a discussion you should be having with your doctor, whether you are considering the cut for yourself, or for your son. This is an issue that no longer needs to be swept under the carpet of tradition and conformity. It is time for men to take their foreskins into their own hands. So to speak.