Just the tip, please.
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Aside from vasectomies, there’s another kind of intimate snipping that’s been a topic of much debate over the years: circumcision. For religious and cultural reasons, the decision on whether or not to remove the foreskin of a baby within eight days of his birth is trickier than it might appear at first glance. And what about medical reasons for doing so? Or is circumcision just something we’ve gotten used to?
Circumcision in one form or another has been around since before recorded history—certainly before it was even mentioned in the Bible (Genesis 17). Historians differ on where and how precisely it came about, but the best guess is that it originated somewhere in eastern Africa, possibly as a way to “purify” the people who underwent it.
The foreskin, or prepuce, is a big deal when it comes to experiencing sexual pleasure. In societies and timeframes when sexuality was thought of as “dirty” or “impure,” circumcision developed as a way of reducing that sensation—a sort of sacrifice believed to prepare someone for a better afterlife.
Jewish culture has used circumcision as a religious ritual for generations, harkening back to Biblical stories of Abraham, Moses, and Joshua to explain the tradition. Their method of circumcision began as something less intensive than what many boys experience today: only the tip extending beyond the glans penis was removed. Circumcision became a way for Jewish men to differentiate themselves from Greeks and Romans. A variety of circumcision methods were practiced over the years, including some pretty invasive cuts that removed the entire foreskin from the glans, where it fuses during infancy. This kind of circumcision, called synechotomy, is often practiced today.
Other religious cultures, such as Christianity and the Reform movement within Judaism, rejected circumcision and advised against it.
It wasn’t until 1865 (England) and 1870 (United States) that circumcision became a medical practice and discussion. There wasn’t a lot of science behind it at first; it mostly served as a way to discourage masturbation.
By the late 1940s, however, doctors and medical associations began arguing that circumcision is not medically necessary. Official American writing on the subject didn’t become well known until an article was published by Dr. E. Noel Preston in The Journal of the American Medical Association in 1970. Dr. Preston concluded that there is no therapeutic benefit to circumcision and that it can lead to “undesirable psychologic, sexual, and medico-legal difficulties.”
It gets trickier here, though, because later research did show some medical benefits to circumcision, including reducing the rates of urinary tract infections, and penis cancer. Men with circumcisions have been shown to have lower rates of contracting and transmitting HPV (genital warts) and herpes. Female partners have lower rates of cervical cancer which is caused by HPV. Additionally, men with circumcisions have lower rates of contracting and transmitting HIV since the foreskin in uncircumcised men is thinner and more prone to small tears which can allow the virus to cross into or from the blood of the uncircumcised man.
A variety of medical issues related to the foreskin can still cause problems today, including:
- Phimosis (the foreskin narrows and cannot be retracted. This may obstruct the flow of urine in extreme cases and can also be a source of pain during erections as well as during attempts at hygiene)
- Paraphimosis (the foreskin gets trapped when retracted, restricting blood flow resulting in acute painful swelling of the head of the penis)
- Balanitis (inflammation of the tip of the foreskin and tip of the penis or infection of the foreskin or tip of the penis by bacteria or fungus)
These diseases and disorders can be particularly problematic for older men with diabetes or other causes of poor circulation.
The key for prevention and treatment in these cases is personal hygiene, which can be made easier with circumcision. Since the circumcision process becomes more difficult as the patient gets older, it’s generally best to do it as young as possible.
Today there are still more circumcised than uncircumcised boys in the United States, but the amount is definitely in decline. In 2001, the ratio was 55% circumcised to 45% uncircumcised.
Though the medical side of circumcision is inconclusive, there is still a significant cultural and religious history behind it. That can make parents’ decision about whether or not to circumcise their sons more complicated.
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