Circumcision - whose penis is it?

Cecil's Columns/Staff Reports
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Cecil is wrong that John Taylor’s discovery of the highly innervated ridged band of the foreskin has never been formally published. (Taylor, J.P., A.P. Lockwood and A.J.Taylor, The prepuce: Specialized mucosa of the penis and its loss to circumcision, Journal of Urology (1996), 77, 291-295)

“It would be foolish on the basis of such work to make any definite statements about the foreskin’s contribution to sexual sensitivity or anything else.” Well, those of us who have one KNOW that it is full of pleasure-giving nerves. (It would be sort of stupid of evolution to put it there without them.)

Cecil’s figure of ten circumcised men dying from penile cancer since 1930 has to be wrong because there are more than that many published case studies, which must be only the tip of the iceberg.

The bottom line is: whose penis is it, anyway? Nobody but its owner has any right to go having bits cut off.

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Jack? Is that you?

3

Eh, I’ll just post the (presumed) link and tiptoe quietly away…

Slice of life: the circumcision debate

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[sub]um…the “tip” of the iceberg?
[continues tiptoeing away][/sub]

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Hi, Hugh. Welcome to the SDMB.

First off, the administration here recommends that when your are commenting on a column or staff report that you include a link to it. I assume you are commenting on the column at http://www.straightdope.com/classics/a940128.html on the circumcision debate. To make a link, it can be as easy as typing (or pasting in) the url with a space on either side of it (there are fancier ways, too).

To explain Lucretia’s somewhat cryptic comment, a few months ago we had a poster with the screen name of Jack Dean Tyler who was a rabid (some would say maniacal, some would say worse) anti-circumcison advocate. Unfortunately, his feelings against circumcision overwhelmed his ability to debate rationally or with sensitivity or good judgment. He spawned lots of threads, some serious, some not, which are all linked to in a thread at http://boards.straightdope.com/sdmb/showthread.php?threadid=47631 in About This Message Board.

From your post it seems that your discussion style includes relevant citations and persuasive, supported arguments. These are highly valued here on the SDMB. I think that many here would appreciate a discussion on circumcison without Jack Dean Tyler’s type of hysteria. I hope that this thread can blossom into such a discussion.

Again, welcome.

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Welcome to the SDMB, and thank you for posting your comment.
Please include a link to Cecil’s column if it’s on the straight dope web site.
To include a link, it can be as simple as including the web page location in your post (make sure there is a space before and after the text of the URL).

Cecil’s column can be found on-line at the link provided by Duck Duck Goose.

moderator, «Comments on Cecil’s Columns»

7

The published paper you quote is from 1996. Cecil Adams’ column dates from 28 January 1994. (The date doesn’t appear on the web page, but you can tell from the URL for the article: …a940128.html ) So the statement was accurate at the time the column was written.

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I forgot to reply to this. My understanding is that if a feature comes about through a (series of) random mutation(s), and there is no evolutionary advantage to removing it, then the feature may well remain. So the mere presence of something does not necessarily mean that it currently has a purpose.

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One objection to Arnold’s statement. To my knowledge, a series of random mutations is much harder to produce a structure then a single random mutation being preserved. The only way to keep the mutation from disappearing due to genetic drift (much less be reinforced and built on) is due to it having a selective advantage.
That’s like arguing the labia are just random mutation. Seems a little unlikely.

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Posted by Hugh: “those of us who have (a foreskin) KNOW that it is full of pleasure-giving nerves. (It would be sort of stupid of evolution to put it there without them.)”
To which Arnold Winkelried offered: “My understanding is that if a feature comes about through a (series of) random mutation(s), and there is no evolutionary advantage to removing it, then the feature may well remain. So the mere presence of something does not necessarily mean that it currently has a purpose.”

Which has continued to leave me staggered. Arnold, what could possibly make you come up with this? I guess the (rather non-biological/non-evolutionary) fact that humans have so often cut off the foreskins of their infant sons may have prompted you to think/imply that this part of the penis could well be a non-functional, purposeless, redundant mutation!

But of course there is a quasi-evoluntionary aspect to circumcision - it is overwhelming circumcised men (and their partners) who have been driven to have foreskin cut from their offspring. Sadly, it seems once circumcision is established, it is very difficult to stop. Parents who have only ever known a de-foreskined penis, seem to have much difficulty in accepting the normal (fully/fore/skined) penis that a baby son is invariably born with - there must be some reason/s to have it cut it off!

Genitally intact communities (i.e. where circumcision is rare) are most reluctant to take sharp instruments to infant genitalia! Thus over many millenia the practice has not spread beyond about 20% of the world’s population, despite it being made almost universally obligatary for Jews, the proportionally huge Moslem religion, and recently several generations of medically-misguided USAmericans and those influenced by them. Those of us outside this ambit do not feel any need to wonder if 50% of y/our outer penis is an evoluntionary error - any more than we would wonder this about y/our ears or labia or hair or lips or thumbs.

USAmerican infant-foreskin-removal often provokes indignation and even disgust here in Europe - and no doubt it does in many other parts of the world. As Hugh indicated, intact persons know the/ir/our foreskin is full of pleasure and that a/our penis would be never be the same without it. A glans penis (dick head) without a foreskin would be as silly and frustrating as a foreskin without a glans penis! The glans and foreskin are designed to work perfectly together.

The complete penis is a wonderful fully functional item. Suggesting otherwise is a sad delusion - and seems an very selfish intellectual comfort at the expense of vulnerable infants and subsequent generations.

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My reference was specifically to the nerves whose existence Cecil disputes. It would take only a single mutation to multiply them, to the immense benefit of the owner. The foreskin has persisted since near the beginnings of mammaldom. Given the centrality of reproduction, if it had even the slighest disadvantage - let alone the extraordinary and ever-changing list its opponents claim - we would have long since lost it.

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Whoa Nellie!

All I meant was - just because a physical feature appears in an organism does not necessarily mean that it has an evolutionary benefit. It only means that it has no disadvantage.
On the other hand, something that is evolutionary harmful will obviously be selected against and disappear in the course of time.

Of course, Kyberneticist has a good point that the foreskin may be complex enough that it is the cause of a series of mutations reinforcing in each other. Which would make it more difficult to argue that it has no benefit.

And nath, I’m from Europe myself (Switzerland to be exact). While circumcision in Europe is not common practice, I disagree with your statement that it provokes “indignation and even disgust”. I have never noticed that reaction. My brother (who still lives in Switzerland) has two children and when they told me that my nephew would not be circumcised they never mentioned the fact that people found it disgusting.

I personally am neither pro- or anti- circumcision.

But to answer the question asked in the “OP” - whose penis is it anyway? I would answer that parents make many choices that govern their child’s health, appearance, etc… Absent any overwhelming evidence that circumcision is harmful and has no health benefits, I personally do not see any reason to interdict it.

Of course, female genital mutilation is another story altogether.

Hugh - I don’t know enough about biology to know if your statement that “the earliest mammals already had foreskins”. But given that fossil evidence usually only gives information about bone structure it seems to me that this would be something difficult to prove. Where did you get that information?

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Correction: my setence above should read:
Hugh - I don’t know enough about biology to know if your statement that “the earliest mammals already had foreskins” is true.

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Giddee up Nellie! And climb on Arnie, time for a long refreshing ride!

Arnold: “I personally am neither pro- or anti- circumcision.” I think you mean you are willing to consider the matter carefully and rationally. The claim to neutrality is curious. It might seem a bit like saying you’re undecided on the death penalty or recreational use of extascy - but only if you and/or members of your family have intimate experience of these things. The fact is you have a very personal stake in the issue of circumcision. (And you’re certainly not unique in this!) It is the deeply personal nature of circumcision that makes Hugh’s question (OP?) crucial and your light dismissal of it most unsatisfactory. What could be more personal - in every sense: bodily, emotionally, intellectually, pyschosexually, etc. - than having densely-sensuous (or any!) tissue sliced from your penis?

I trust you won’t mind me refering to your own experience (as you have raised this):
Posted by Arnold Winkelried 10-27-2000 08:17 PM :-

" posted by Jack Dean Tyler (quote) “You’re not a freak because in the society in which you live almost all of the men are circumcised. Your son probably won’t be living in such a society.” Here’s my anecdotal evidence - I was circumcised at birth (born in the USA) but grew up during my formative years (grade school, high school, college) in a country where most people aren’t circumcised (Switzerland). My first day in the gym shower I was a little surprised, my parents explained to me the difference, and that was that. I never felt like a freak and I don’t hate my parents. "

A neat story, but it’s clear you have not forgotten the experience. And you continue to engage with the issue. That is to your credit. What you don’t say is how the local boys reacted (or perhaps more importantly, how you perceive/d them as reacting). This takes us to your reply to me:

" And nath, I’m from Europe myself (Switzerland to be exact). While circumcision in Europe is not common practice, I disagree with your statement that it provokes “indignation and even disgust”. I have never noticed that reaction. My brother (who still lives in Switzerland) has two children and when they told me that my nephew would not be circumcised they never mentioned the fact that people found it disgusting. "

I am happy to qualify my statement by saying that the most common initial reaction here is probably something between surprise and astonishment. But the more considered response (in the face of details about how circumcision is practiced in the USA) is far from the casual indifference you suggest. I have followed this issue with interest in Sweden over the past 2-to-3 years. Since (male) genital health and medical care generally are extremely good here (certainly better than in the USA) it naturally staggers both observers and medical professionals that USAmericans persist with supposed medical justifications for slicing foreskins from their sons. But the real concern over here is with ritual circumcision - a much more difficult issue. Cultural sensitivity is strong in Sweden, and yet the rights of children are taken seriously:

http://www.sr.se/rs/english/news/20000221.htm
Radio Sweden 12:30 hrs UTC February 21, 2000
Circumcision Ban Proposed
A new report here condemns the circumcision of boys for ritual or religious purposes as violating the United Nations Convention on the Child. The report - based on studies at Swedish children’s hospitals - proposes that the private, unprofessional circumcision of boys should be outlawed now, and ultimately a complete ban should be considered. It’s estimated that 3,000 young boys are circumcised in Sweden each year - only one-third at hospitals. According to the report, infections after irregular operations have in some cases led to serious injuries and even death.

Most other reports here are of course in Swedish. You might be interested to see the news report of a 3-y-o boy who died very shortly after being circumcised by a registered doctor in Stockholm. He is now before the courts for manslaughter. Covering up death due to circumcision is not so easy here (even if punishments are much less severe).

How many boys do you think die as a result of the million or so circumcisions each year in the USA? According to one informed source the figure tops 200. See Baker RL “Newborn male circumcision: needless and dangerous” Sexual Medicine Today 1979;3(11):35-36. “If we assume there to be about 1,325,000 newborn male circumcisions in the U.S., the annual cost to the consumers is around $54 million. And at least 229 of these newborns will die as a result of the operation.” http://www.cirp.org/library/general/baker1/

Obviously circumcision-related deaths rarely reach the media in the USA. But sometimes the truth gets out:
http://www.noharmm.org/evansdeath.htm
Circumcision That Didn’t Heal Kills Boy (NewsNet5 - Cleveland, OH) October 20, 1998
http://www.cirp.org/news/1993.06.21%3Adeath/
MIAMI HERALD, June 26, 1993. BABY BLEEDS TO DEATH AFTER CIRCUMCISION
http://www.cirp.org/news/1995.07.28:HoustonChronicle/
BOY’S DEATH TO BE PROBED …Texas Department of Health Officials sought permission Friday to investigate the death of a 5-year-old boy after a circumcision.

I’ll spare you the details from clinical reports of massive injuries, many from disasterous infection and gangrene. There seems to be more than 200 case reports referenced at http://www.cirp.org/library/complications/
One in/famous case was well known in the literature since the 1970s, but only recently gained attention (and only because the victim was supposedly “turned in a girl” - the cause of the original injury being treated as insignifcant). See “As Nature Made Him” by John Colapinto; and http://www.cirp.org/library/psych/diamond/ http://www.cirp.org/library/complications/bradley/ “Ablatio Penis at 2 Months, Sex Reassignment at 7 Months”

Why, Arnold, are you waiting for “overwhelming evidence that circumcision is harmful”? Clearly you are erring on the side of circumcisers, rather than their objects/victims. Is this really just another matter of a “child’s health, appearance etc…” such that parents should be free to opt for it on behalf on their sons, and doctors free to do it their patients if the parents of a patient give consent? The civilized world says no!

You will feel I am exaggerating the case. But consider some of subtleties of our semantics:

I say: “circumcision is rare (here in Europe)”
U say: “circumcision in Europe is not common practice”

U say: “the mere presence of something does not necessarily mean that it currently has a purpose”
I say: “(we have) no need to wonder if 50% of the outer penis is an evoluntionary error”
U insist: “just because a physical feature appears in an organism does not necessarily mean that it has an evolutionary benefit”

U say: “My brother (in Switzerland) told me that my nephew would not be circumcised”
I say: “Your nephew has a normal penis; he is and will be genitally intact - of course!”

I say: “circumcision provokes indignation and even disgust (in Europe)”
U say: “they never mentioned the fact that people found it disgusting.”
– Why would they? Your brother apparently is not the sort of the person who would attract such forthright comments - he seems to have the good sense not to inflict on his son an intremely intrusive, potentially dangerous, sexually reductive, and entirely unnecessary penile slicing. OK uncle, now get with the good guys man, join the civilized world!

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nath said:

Funny you should include hair in that list, given that the vast majority of people do some sort of styling to their hair, often involving trimming and cutting to greater or lesser extents. What about fingernails - are they an “evolutionary error”? We certainly have no qualms about trimming them.

The appendix seems “designed” to do nothing but occasionally get infected and rupture. Do they qualify as “evolutionary errors”?

And 50%?

Designed? And given the vast number of circumsized men who are sexually satisfied and able to reproduce, that claim is hyperbole at best.

Arnold Winkelried said:

A couple of comparisons to give perspective. Consider body piercing - not just the current fad, but the various and sundry forms practiced by indigenous cultures. There’s a tribe of indigenous people in the Amazon that the males insert a stump of wood into their lower lip, cutting a hole through the skin. How do you feel about those practices?

Would you advocate, protest vehemently against, or remain tolerant of a custom of cutting off the ear lobes? How about the little toe?

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OK nath, let me respond to your main points.

nath: <<What you don’t say is how the local boys reacted (or perhaps more importantly, how you perceive/d them as reacting). (to my circumcision)>>
I don’t remember them reacting in any particular way. If they did, I have forgotten. I wasn’t emotionally scarred by the experience.

nath: <<http://www.sr.se/rs/english/news/20000221.htm
Radio Sweden 12:30 hrs UTC February 21, 2000
Circumcision Ban Proposed
A new report here condemns the circumcision of boys for ritual or religious purposes as violating the United Nations Convention on the Child.>>
I would be interested in reading that report. As a matter of a fact, human rights is a particular interest of mine. Has the report caused a change of legislation governing circumcision in Sweden?

You mention several deaths due to circumcision, 229 out of 1,325,000 in your post. Let me contrast that with what I read in the Straight Dope column:

If one accepts your numbers, and the numbers in the Straight Dope column, the number of deaths caused by circumcision seems to be roughly equal the number of deaths prevented by circumcision. Also circumcision has additional health benefits.

nath: <<The civilized world says no (to circumcision)>>
How many countries have made male circumcision illegal?

nath: <<U say: “they never mentioned the fact that people found it disgusting.” – Why would they?>>
My brother discussed circumcision with several parents in Switzerland, and so have I. I have never hear anyone say “circumcision is disgusting.” As for myself, if/when I have male children, I will review the latest studies on circumcision and attempt to make an informed decision.

Irishman says:
<<A couple of comparisons to give perspective. Consider body piercing - not just the current fad, but the various and sundry forms practiced by indigenous cultures. There’s a tribe of indigenous people in the Amazon that the males insert a stump of wood into their lower lip, cutting a hole through the skin. How do you feel about those practices? Would you advocate, protest vehemently against, or remain tolerant of a custom of cutting off the ear lobes? How about the little toe?>>
You will notice that in my post I spoke of practices “with no health benefits”. As mentioned in the Straight Dope column (see my quote a few paragraphs above) there is some evidence that circumcision does have health benefits. Do the practices that you mention above have health benefits that exceed the health and/or psychological disadvantages? Then I would not legislate against them. For a practice with no health benefits, I suggest considering the severity of the body modification (e.g. piercing your ears seems minor as opposed to chopping off part of your nose). Part of those considerations would of course include the general feeling in society. e.g. if I lived in a society where tattoos were considered unsightly, and if it were shown that tattoos had significant health risks, then I would favour preventing parents from tattooing their children. On the other hand, if I lived in a society where tattoos had great symbolic significance, and everyone was tattooed, and tattoos had little or no health risk, then I would not favour preventing parents from tattooing their children. Is that clearer? Your examples, by the way, seem (in my uninformed medical opinion) to clearly have no health benefits but significant health risks.

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I just wanna know who Arny is calling a “Nellie.”

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Hi, nath, and welcome to the SDMB.

Again it is good to have another poster here on the SDMB to discuss this issue with reasoned argument. (As you have searched out and found an old Jack Dean Tyler thread, you can no doubt see the, um, gaps in his arguments).

On the use of citations in arguments here, I should point out that we are familiar (from the Jack Dean Tyler incident and prior circumcision discussions) with the CIRP and NOHARMM sites and recognize that they are strong anti-circumcision advocacy websites. Although there is nothing wrong with citations to an advocacy website, skepticism about those particular sites (skepticism that I believe to be justified) means that arguments supported by those websites will not be as well received at those supported by direct citations to scientific (like Sexual Medicine Today) or neutral (like Radio Sweden) sources.

Again, welcome, and I look forward to hearing more reasoned discussion from you on this and other topics.

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… for your charming welcome. Your advice as an ‘old/er hand’ here is also appreciated.

Certainly you are correct that the CIRP and NOHARMM sites are firmly dedicated to the cause of advocacy for the rights of children to genital integrity (i.e. letting boys (and girls) remain genitally intact - not cutting off foreskins (or anything) unless really necessary). BUT the sites are much more than ethical opinion and reasoned argument. They are in fact invaluable libraries with precisely the sort of scientific and neutral/journalism documents you ask for: (Quote) "arguments supported by those websites will not be as well received at those supported by direct citations to scientific (like Sexual Medicine Today) or neutral (like Radio Sweden) sources."

My 'Sexual Medicine Today' reference and quote were taken from the CIRP site (as shown by my url ref). It seems rather pointless to quote medical journals that we cannot easily access. Similarly with all my other references accessible on the websites: 3 to US news reports - each with the original reference clearly stated; 2 to medical case reports - ditto, 1 to a list of over 200 medical articles - ditto. My one non-web-accessible reference was the John Colapinto book, available via http://www.amazon.com or your local bookstore.

If you check http://www.cirp.org/library/ (and your scepticism as you enter!) you will see that it allows you to read (hundreds of) original articles. Often, as in the case of the ‘Sex. Med. Today’ ref, with scanned material from the original hard document - least we get too suspicious!

Quote: “Although there is nothing wrong with citations to an advocacy website” - I disagree, if you simply mean quotes from what some advocate has written on a website. That would be mostly worthless; I wouldn’t and didn’t bother.

Quote: “Skepticism about those particular sites (skepticism that I believe to be justified) means that arguments supported by those websites will not be as well received at those supported by direct citations to scientific…” Has your scepticism stopped you looking at what is actually on these sites? You might want to contrast them with the leading “pro-circ” (or anti-genital-integrity!) website - it is extensively devoted to sexual fantasies about cutting infant and adult, male and female, genitalia (sic, indeed!).

Anyone willing to think outside the dominant US paradigm, will not find it at all difficult to question any attachment they may have to foreskin removal (what a tragic turn of phrase!). The Finnish, Japanese, Swedish, Chinese, Norwegian, Dutch, German, Italian, Thai, Argentinian, Spanish, Danish, Indian, New Zealand, Brazilian, Swiss, French, Chilean, Austrian, Australian, British, Icelandic - and even the Canadian and US - medical authorities are not wrong. Routine male circumcision is NOT medically justified - check the latest policy statements from the medical associations! The only question is whether it is right for parents and doctors to impose their penile peference on infants who cannot protect themselves and demand their right to having their healthy genitalia left alone.

Since every other part of the infant body (including the genitalia of girls) is protected from the elective removal of normal healthy tissue - why should the male foreskin be a unique exception?

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Smells like Great Debates to me.