Recently, there has been intense lobbying in the United States by persons who adamantly oppose male infant circumscision.
Several concerns that have been voiced about infant male circumcision
1. Circumcision results in less sexual pleasure
1a. General statement circumcision results in less sexual pleasure.
(not true according to a systematic study in the journal of sexual medicine).
1b. Circumcision results in less sexual pleasure because the foreksin contains nerve endings
It does not affect penile sexual function. (further information on theory pending)
1c. It is inherently wrong to remove the foreskin, as it can give and receive pleasure, eg. during intercourse.
If it has no noticeable effect on sexual function, then I think that many may not agree.
1d. Men that have not been circumcised feel that they have better sex and do not want to have their foreskin removed.
No one intends to impose circumcision on them, but some may perform it on others.
1e. "I was circumcised as an infant and because of that I lost valuable sexual function."
a. How can one know if they lost valuable sexual function if they have never experienced having sex with a foreskin.
b. Studies show that such is not the case, other information may not be accurate.
1f. Monofilament study showed that there was decreased monofilament sensation on the glans of the circumcised as compared to the uncircumcised penis.
Reply: Most people do not use a monofilament during sex, and according to a 2013 metanalysis, there was no difference in response to sexual stimuli between circumcised and non-circumcised penises.
Histology of Penis, the letter F represents the Prepuce, it is different that tissue in the middle.
2. Female circumcision is not always more traumatic and destructive than male circumcision
2a. Women who have part of their labia excised probably do not enjoy it.
2b. Female Circumcision is the same as male
2c. Clitoridectomy is comparable to male circumcision.
a. Such is not the case, the male foreskin is not composed of "spongy," erectile tissue.
2d. The male prepuce is not just skin.
Reply: It is a dual layer of epithelium and connective tissue similar to two layers of skin, similar to taking a section through the lower part of the ear. There are only trace whisps (relatively thin strands) of smooth mucle.
This is the histology of the male foreskin.
4a. A newspaper article that informs readers that the rate of genital wart transmission is increased to the circumcised.
4b. Lower rates of penile carcinoma in Denmark where the rate of penile carcinoma is lower
perhaps men in Denmark use condoms more often. Regardless, when comparing people of the same group, with similar exposures, there is less acquisition of Human Papilloma Virus in those that are circumcised.) Pending review of rates between circumcised & uncircumcised males in Denmark;
5. Infants are below the age of consent and circumcision should be a choice made by the individual and not their parents.
-Topic that may be prudent to discuss further.
6. Kellog introduced circumcision into America becuase he believed it would instruct boys to masturbate less frequently.
- Regardless of why circumncision was introduced into America, there are health benefits and it is given a recommendation of Grade 2C by UpToDate.
7. Doctors that support circumcision do so becuase they have been circumcised and want to believe that there is nothing wrong with their own penis.
-This topic is not about physicians and their personal experience, but a review of the scientific and medical literature
In summary, there are reasons that people do not want circumcision of male infants, and one of their more vocal arguments is the claim that the loss of of nerve endings in the excised (removed) foreksin is inherently bad. The 2013 Systematic review found no significant difference in penile response to sexual stimuli, and thus the loss of sexual function is only supported by hypothesis, and not by real-world data.
2012 American Academy of Pediatrics Position Statement on Male Infant Circumcision
Evaluation of current evidence suggests that the health benefits of infant male circumcision outweigh the danger; furthermore, the benefits of newborn male circumcision make a case for this to be routinely offered to all families in addition to the procedure being covered by health insurance.1
Distinct advantages of male circumcision were shown that it prevents: acquiring urinary system infections, acquiring Human immunodeficiency virus, transmission of several sexually transmitted diseases, as well as cancer of the penis. Male circumcision doesn't appear to negatively alter penile sexual function, sensitivity, or sexual joy. It certainly is crucial that those providing circumcision should be properly trained understanding that both sterile methods along with effective pain management are employed. Noteworthy injury is rare. Overall, inexperienced providers who provide circumcisions generate more adverse outcomes as compared to experienced doctors and this occurs irrespective of whether the former are clinical doctors, nursing staff, or spiritual practitioners. Everyone must therefore be trained until expertise is achieved in the surgical art of circumcision.
Some from Europe have claimed that the 2012 American Academy of Pediatrics (AAP) Circumcision Guidelines were culturally biased.2
However, the AAP has issued a prudent reply to the European criticism:
For example, the authors dismiss the data related to urinary tract infection on the grounds that no randomized controlled trial has been performed, despite the fact that there is good evidence from other studies that suggest a preventive benefit of circumcision. At the same time, they readily dismiss 3 randomized controlled trials and 11 other studies that provide good to fair evidence of a reduction in HIV acquisition associated with circumcision. They claim that these data are “contradicted by other studies, which show no relationship between HIV infection rates and circumcision status,” yet support that claim with only a single reference to a review article authored by the vice president of an organization opposed to circumcision.3
1. American Academy of Pediatrics Task Force on C. Male circumcision. Pediatrics. Sep 2012;130(3):e756-785.
2. Frisch M, Aigrain Y, Barauskas V, et al. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision. Pediatrics. Apr 2013;131(4):796-800.
3. Task Force on C. Cultural bias and circumcision: the AAP Task Force on circumcision responds. Pediatrics. Apr 2013;131(4):801-804.