Circumcision - whose penis is it?

Cecil's Columns/Staff Reports
41

Irishman - then who decides what is a human rights issue? Suppose I claim that, for example, the act of engaging in S&M sex is a human rights issue. Does that make it one? How many people have to agree with me before it becomes a human rights issue?

I disagree that male circumcision is equivalent to FGM. In the articles I have read, the comparison made is that FGM would be the same as cutting off at least the glans (head) of the penis, not just the foreskin. Your statement that HR groups are engaging in discrimination due to cultural norms seems to me to be based on an imperfect knowledge of FGM.

42

Of course the foreskin has a purpose! It’s there to protect the sensitive tissue of the glans. The foreskin itself has little more sensitivity than any other piece of skin, which is pretty inevitable considering that it doesn’t have anything to protect it… It would quickly be desensitized by constant contact with underwear and such.

For the record, by the way, I am, in fact, completely intact, and am speaking partly from experience when I say that the foreskin isn’t particularly sensitive.

43

And chronos said:

As the song says, “You don’t know what you’ve got till it’s gone.” onigame may well integrate the pleasure his foreskin gives him into the total gestalt, and that is fine too. Taylor found the nerve endings (Meissner corpuscles) in all the foreskins he examined. The ridged band, where he found them, is normally on the inside (protected by the outer layer, which is indeed of ordinary skin). It rolls around to the outside on erection. The nerves of the glans are mainly sensitive to pressure, pain and heat, those of the ridged band to light touch.

(The physiology of itching and scratching is quite different from that of sexual pleasure.)

44

I don’t know who decides, but I don’t see why a self-appointed body like Amnesty International has the final say, and ordinary mortals like us can’t have our 2c worth. One factor is consistency, and consistency between the sexes is pretty clear. All FGM is outlawed in most of the English-speaking world now, and no excuse is allowed for religion or culture. Yet the mildest of FGM, slitting or nicking the clitoral prepuce, is milder than radical circumcision (especially the extreme forms of some tribes, slicing into the urethra and/or flaying the lower abdomen). I’m not sure, but I think you’ll find that the clitoral prepuce is much less innervated than the penile one, and the glans clitoris much more than the glans penis.

The human rights issue is one of the right to genital integrity - to decide for oneself what parts of one’s genitals get cut off, if any. Do only girls have it, and if so, why?

45

Arnold, your asking for an objective definition of what constitutes a human rights issue. I think that crosses over into the territory of GD. It requires a clear understanding of what a “right” is. I’ve carried on a long email exchange with someone else on this topic before, so I know it isn’t something easy to get agreement on.

S&M sex itself does not qualify because it is consensual. Non-consensual S&M sex is called rape and torture. The act of consenting by both parties is what prevents S&M sex from being a human rights violation.

Infantile circumcision is non-consensual - the infant doesn’t have a choice. However, we get into a gray area, because parents are entrusted with looking out for the welfare of their children precisely because the children are not able to make informed choices. Therefore, it is inherent that the parents act responsibly for the best interests of the child. But how do we define the best interests of the child? That is what the whole debate is about. Are there medical advantages to the procedure that are greater than risks associated with leaving the foreskin intact? Is there an extra sensitivity to the region that is being eliminated by the procedure? If so, what are the trade-offs between the possible health benefits vs. the sexual pleasure/function loss? Should we be slicing up genitals even if there isn’t an effect to sensitivity based purely on dubious medical advantages?

Regarding FGM, there are different amounts of cutting done. Are you arguing that a less damaging form of FGM would be acceptable? Say merely trimming part of the labia?

46

I’m still not convinced. Meissner corpuscles, as I understand it, are found in great abundance in other places, such as the fingertips. But those are rarely a source of sexual pleasure. I’ll believe that the ridged band is more sensitive to touch than most other skin; but whether those touches are a direct cause of sexual pleasure seems like an open question to me.

Admittedly, there probably is no such thing as a nerve receptor for sexual pleasure, and it may very well be a gestalt, a combination of multiple sensations simultaneously.

47

Hugh, Irishman - the debate on what exactly is a Human Rights Issue should, as Irishman said, more properly belong in Great Debates. I probably shouldn’t have brought it up. My point is that it takes more than one person saying “This is a violation of human rights” to make it so.

As far as FGM vs. male circumcision - Hugh says “the mildest form of FGM is not as damaging as the most extreme form of male circumcision”. I would oppose the most extreme form of male circumcision too, if Hugh’s description is accurate.

Irishman says - How far am I prepared to go in allowing FGM? I think this would be another unproductive argument. Am I supposed to answer with square millimeters of flesh? My answer would be - if there is a significant body of evidence saying that a certain procedure has health benefits, then I might support it. I don’t see any evidence like that in the case of FGM. Let me draw you another anology Irishman. A colleague of mine had a wife from Costa Rica, and when they had a baby girl her ears were pieced when she was still an infant (too young to walk). When I expressed my surprise, my colleague said “that’s the custom in Costa Rica”. Human Rights Violation?

I only mention the example of the ear-piercing to show that the human rights discussion vis-à-vis circumcision is IMHO subordinate to the medical justification, e.g. do the disadvantages outweight the benefits. Which was the subject of Cecil’s Column. Perhaps we should focus on that. I am guilty as anyone of leading this discussion astray, but when I hear the words “Human Rights” my ears automatically perk up.

48

It’s funny you brought up ear piercing, as I was thinking something along those lines myself.

I don’t really disagree with you that medical justification is certainly a relevant factor in whether it is a human rights violation. I merely wished to point out that just because organizations that fight for human rights don’t recognize it as a violation, that does not mean it isn’t one. But clearly the discussion of what makes a human rights violation should be discussed elsewhere. By all means, let’s focus on the balancing of the merits for and against.

49

Oh? I for one find it far more of a turn-on to stroke or be stroked by a loved one with fingertips than with, say, the heel. Doesn’t everybody? Another place rich in Meissner corpuscles is the lips…

Wouldn’t it be a bit peculiar for a part of the penis that comes into the most intimate contact with the vagina (or whatever) and is provided with tens of thousands of fine-touch nerve endings not to be wired up in such a way as to give sexual pleasure?

The discoverer of the ridged band, Dr John Taylor, has now put up a website devoted to it: http://research.cirp.org

50

Last time I checked I don’t get pleasure from what other people feel(well not directly I should say). To use your example, if my loved ones heel was as soft skinned and able to manipulate as well as the fingers, then yeah I would get as much pleasure from the heel as the fingers and fingertips. Of course, if you have a foot fetish thats all out the window :smiley:

51

I did say “…to stroke or…” Quite a few people get turned on by lip-lip contact, many by fingertip-fingertip, very few by heel-heel - in almost direct proportiion to the number of Meissner corpuscles.

52

Wow, what a wondrous waste of words on a subject of so little substance. Am I in the U.S. Congress?
Fellas, the thing is a washout and it doesn’t matter a tinker’s damn whether a foreskin is intact. Yes, the weenie is mine because it is a part of me and I control it when it isn’t controlling me.
I was raised in an orphanage, and the guys were about 50-50, so we all pointed at each other and made smart-ass wise cracks. Guess what: none of us was traumatized and we all led pretty normal lives.
The “un-cut” Joes didn’t have to be taught to work the foreskin into easy retraction for cleansing; just a natural event.
Bottom line, medically it’s neutral; religiously it’s whatever one wants to believe.
Since I’ve settled it all, Goodnight and goodbye.

53

See http://www.circumstitions.com/Non-issue.html

54

The level of comprehension and insight in this discussion was sometimes very lacking. Arnold seemed to think that the death of hundreds of infants due to circumcision was insignificant, because circumcision would supposedly help prevent penile cancer in some hundreds of mainly very old men, many of whom have smoked and/or had poor penile hygiene and/or have other predisposing factors (including genetic predisposition). I.E. Arnold was willing to believe the “facts” from a Straight Dope column which, as he had already pointed to Hugh (early in this thread), is now woefully out of date (not to mention its lack of substance and authoritative sources in the first place).

Quote:
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:

In contrast, more than 1,000 U.S. men develop penile cancer each year, 225-317 of whom die. Circumcision effectively prevents penile cancer. (WRONG see below) … Circumcision also eliminates foreskin problems such as inflammation, failure to retract, etc. (Duhhh! Cut anything off and U don’t have problems with it again. Not a good reason to chop off a body part - especially a prominent sensory item from the genitalia of infants. Sounds more like an attempt at justification.)

In case Arnold or anyone else (including the author of the SD column) wants to try continuing to peddle falacious bulldust about penile cancer, here is what the Amercian Cancer Society has stated since at least 06/09/99:

Quote:

“The consensus among studies that have taken these other factors into account is that circumcision is not of value in preventing cancer of the penis. It is important that the issue of circumcision not distract the public’s attention from avoiding known penile cancer risk factors – having unprotected sexual relations with multiple partners (increasing the likelihood of human papillomavirus infection) and cigarette smoking.”

http://www3.cancer.org/cancerinfo/load_cont.asp?ct=35&st=pr

The fact that foreskins don’t cause cancer and that circumcision does not prevent penile cancer is simple to demonstrate. Countries with similar living conditions to the US, but where men are overwhelmingly intact (fully foreskined; such as in the Nordic region and Japan) often have lower rates of penile cancer than the US. This even holds true for countries with high rates of smoking (such as Denmark.)

Not only does such false information (as in the original SD column and repeated by Arnold) add to the trauma of infants needlessnly circumcised, it misleads adults about the true causes of penile cancer, thus hindering preventative education. Shame!

Before anyone claims health benefits from circumcision, it is their duty to check the latest statements from leading medical authorities. Arguably the medical body historically most pro-circumcision, the American Academy of Pediatrics (AAP), made it clear in 1999 that they could not find sufficient medical reason to recommend circumcision (despite the enormous efforts of circumcising doctors and their med research supporters). Instead of taking a principled stand based on sound ethics in the interests of infant patients, the AAP simply passed the buck to parents: “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.” Contrast this with: “The Australasian Association of Paediatric Surgeons does not support the routine circumcision of male neonates, infants or children in Australia. It is considered to be inappropriate and unnecessary as a routine to remove the prepuce, based on the current evidence available.”

For the full AAP statement and those of other medical organizations regarding non-therapeutic male circumcision, see http://www.cirp.org/library/statements/
and http://www.aap.org/policy/re9850.html
and http://www.circumstitions.com/AAP-ana.html
and http://www.cirp.org/library/statements/aaps/

55

WHAT trauma? You have yet to show that it is traumatic.

56

No trauma eh? You think having the foreskin sliced off is a picnic? Seen a typical North American hospital circumcision being done? The vast majority of circumcisions continue to be done without any pain relief - for the reason that anesthesia is dangerous in babies! (So is cutting off the foreskin.) For more than 100 years, doctors and others have wrongly said babies don’t feel pain. What they mean, and persist with, is that they are willing to ignore the trauma of infant patients.

Please view this video.
Go to http://www.intact.ca/video.html
The Real Player version (5 mins) might be best.
While it’s downloading carefully read the explanation:
http://www.intact.ca/vidintro.htm http://www.intact.ca/videohis.html http://www.intact.ca/vidphil.htm

Unless/until you see and hear the video, the following is “only” academic detail. But… Hopefully you can view the full-length video (13:42) or least see the tearing apart of foreskin and glans, and the crushing, clamping and cutting (5:20). Or: “The stages consisted of cleansing (cleansing and draping); separation of foreskin from glans (probing, release of foreskin from glans, incision of foreskin); application of the clamp (bell on, clamp on, foreskin excised); and clamp removal (clamp off, bell off, examination, and wiping with swab).” - to quote Janice Lander, Barbara Brady-Freyer, James Metcalfe, Shermin Nazerali, and Sarah Muttit, in their study: “Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision: A Randomized Controlled Trial” JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Volume 278 No. 24, pages 2157-2162, December 24/31, 1997.

In the above study: "A serious postsurgery incident was observed in one newborn in the placebo group [no anesthesia] … During and following circumcision, the newborn reacted much the same as others who received a placebo (continuously elevated heart rate and high-pitched cry). About 2.5 minutes after the conclusion of surgery, the newborn had an episode that included abnormal posture (lack of tone in limbs), several periods of apnea [inability to breath] (one lasting more than 25 seconds), and projectile vomiting.
“Another newborn in the placebo group had a choking episode with apnea after surgery. This began about 3.5 minutes after the circumcision and lasted less than 30 seconds. … Although our physicians were highly experienced in performing circumcision and had excellent surgical technique, every newborn in the placebo group exhibited extreme distress during and following circumcision.”
This study was terminated because several infants experienced apparently life threatening breathing difficulties. See the CNN report “Circumcision study halted due to trauma” http://www.cnn.com/HEALTH/9712/23/circumcision.anesthetic/
The shock and extremely vigorous crying caused by circumcision can also produce additional dangerous complications, including heart injury, pneumothorax and gastric rupture. (See “A complication of circumcision and dorsal nerve block of the penis” Anaesth Intensive Care 1985; 13: 79-82. “A complication associated with dorsal penile nerve block” Reg Anesth 1990; 15: 309-10. “Prospective evaluation of complications of dorsal penile nerve block for neonatal circumcision” Pediatrics 1995; 95: 705-708.)

And of course this is only immediate outcomes. For several weeks (and particularly during the following days) the baby has a very tender (oozing raw) denuded penis in his nappy. His penile wound is rubbed when he moves, and gets regularly soaked in urine and sometimes faeces (his baby poo). And then, what of the long/er term outcomes: THE LANCET, Volume 349 Number 9052: Pages 599-603, March 1, 1997. EFFECT OF NEONATAL CIRCUMCISION ON PAIN RESPONSE DURING SUBSEQUENT ROUTINE VACCINATION Anna Taddio, Joel Katz, A Lane Ilersich, Gideon Koren http://www.cirp.org/library/pain/taddio2/ “This study showed that neonatal circumcision in male infants is associated with increased pain response in vaccination 4-6 months after surgery. The results support our previous finding of a higher pain response in circumcised than uncircumcised male infants during routine vaccination. We postulate that circumcision may induce long-lasting changes in infant pain behaviour because of alterations in the infant’s central neural processing of painful stimuli. Transmission of noxious afferent input from the periphery (eg, brought about by skin incision) to the spinal cord induces a sustained state of central neural sensitisation or hyperexcitability that amplifies subsequent input from the wound and leads to increased postoperative pain.”

  How might circumcision affect the body and its psychobiological mechanisms? One thing that certainly happens at the time of the cutting is a dramatic rise in cortisol (an adrenal hormone), similar to what occurs in persons being tortured. PSYCHONEUROENDOCRINOLOGY, Vol 6 No 3, pages 269-275, 1981 "THE EFFECTS OF CIRCUMCISION ON SERUM CORTISOL AND BEHAVIOR"

See http://www.cirp.org/library/pain/gunnar/ “Circumcision produced striking increases in serum cortisol concentrations … 30-40 minutes after the beginning of circumcision, concentrations of serum cortisol were 3-4 times greater than concentrations of serum cortisol immediately before circumcision.” Similarly: American Journal of Diseases of the Child, Volume 134 Number 7: Pages 676-678, July 1980. “Circumcision in neonates has been shown to affect adrenal cortical functions, immediate postoperative behavior and possibly long-term behavior. The present study demonstrates that circumcision also affects the heart rate, respiratory rate, and tcPo2 both during and immediately after the procedure.” See http://www.cirp.org/library/pain/rawlings1/

The warnings about adverse effects are not new. Go back 25 years to: DEVELOPMENTAL PSYCHOBIOLOGY, Volume 9, Number 1: Pages 89-95, January 1976. EARLY BEHAVIORAL DIFFERENCES: GENDER or CIRCUMCISION? “In view of all the evidence showing long-term behavioral, physiological, anatomical and even neuropharmacological effects of “minor” events in early animal development, . . . we would be unwise to assume without empirical demonstration that the circumcision effects are short-lived.” See http://www.cirp.org/library/psych/brackbill/

And finally, apart from gaining trauma, what does the baby loose at circumcision? See discussion of this at Health Insider on WebMD Health: http://my.webmd.com/content/article/1700.51248 “The foreskin is not just skin, but is a five-layered organ or part of an organ. It is an integral part of the penis. It has epidermis and dermis on the outside, but underneath that is a layer of muscle known as the “dartos muscle” or “dartos fascia.” In addition, below is the muscle “lamina propria” followed by inner mucosa. Where the outer and inner layers of the foreskin meet, there is a ridged band of inner mucosa, which is filled with most of the fine touch nerve receptors in the penis. In an adult, when the foreskin is retractable, the foreskin is retracted during sexual intercourse, and this ridged band rubs against the vaginal wall creating pleasure and it has been hypothesized, mediating what is known as the afferent limb of the ejaculatory reflex. Thus, the ridged band is necessary for optimal sexual feeling.”

**For more details of the sexual physiology of the foreskin see http://research.cirp.org/   Loss of specialized sensory tissue is traumatic! When it results from the arbitrary, unnecessary circumcision of infants, it involves both trauma and serious sexual/genital assault. Recognizing one's individual loss and the harm done to millions of victims is not easy. But all the evidence is there, if we are willing to look carefully, and think again...**
57

In my judgment this thread is far enough removed from a commentary on the original Straight Dope column that the discussion should be continued in our Great Debates forum if anyone feels the need to pursue this train of thought.

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