One of the fundamental purposes of the CIRCLIST website is to guide newcomers through the circumcision decision.
Starting with the basics, in this chapter we address the key issues of “Why
circumcise?” and “When
If, having considered the evidence, you agree that circumcision is a wise choice, there’s more detail for you to explore via the Navigation Panel that appears at the foot of just about every page.
Last updated: 14 May 2014, 09:33 UTC
Reasons to circumcise - the basics
The benefits of male circumcision fall into several distinct categories:
- Personal health & hygiene issues, including male Sexual Health issues
- Sexual Health issues for the individual male’s partner
- Public Health issues
- Conformity with cultural and religious norms
- Improved sexual experience
Once the detail is added, this becomes a lengthy and formidable list. But there are counter-arguments and it would be invidious not to mention the existence of these.
Some opponents of circumcision challenge the scientific evidence. Suffice it to say in this brief introduction that both the World Health Organisation (WHO, a division of the United Nations) and the Centers for Disease Control and Prevention (CDC, the world’s clearing house for Public Health information) have accepted the scientific validity of the key parts of the pro-circumcision case.
Entirely separately, a moral and ethical debate exists in respect of the circumcision of minors, the opponents of child circumcison asserting that the procedure should not be permitted on the basis of parental initiative. The critics want the individual to decide for himself once of an age to self-consent to circumcision. This issue is explored in greater depth on our web page dedicated to rebutting the anti-circumcision arguments
At what age can circumcision take place?
The short answer is “at any age”. Let’s consider each possibility in turn:
||Infancy: Circumcision in infancy maximises the total lifetime benefits and minimises the complexity of the surgery. Later in life the individual has no memory of his pre-circumcision state and no specific recall of the procedure being done. The circumcised state is his “norm”. For a more detailed look at the benefits of circumcision in infancy, see BMC Pediatrics 2012, 12:20.
||Boyhood: Circumcision pre-puberty remains a fairly simple procedure. The majority of circumcisions done at this age are performed for cultural or religious reasons, often as part of a coming-of-age ceremony. In such a context, circumcision will normally be welcomed as a badge of maturity.
|For the United Nations / World Health Organisation / UNAIDS view of neonatal and child circumcision, please read their publication 'Neonatal and child male circumcision : a global review' published April 2010.
||Teenage: Once puberty has commenced, circumcision becomes a progressively more complex procedure. Many (maybe most) circumcisions in this age group arise as a matter of medical necessity, due to phimosis ‘discovered’ when sexual activity commences. Circumcision at this age can be embarrassing, requiring intimate disclosures in order to obtain access to healthcare that is still subject to parental consent.
||Adult: From the surgical point of view, adulthood is probably the least favourable time to circumcise. But it does happen, for example as a matter of medical need, for cultural reasons associated with a change of religious faith or simply as an individual’s lifestyle choice.
||Geriatric: In the final years of life, many require assistance with personal care such as bathing. Especially in psychogeriatric situations, circumcision may be the only practical way of maintaining genital hygiene. How much easier if the patient had been circumcised earlier in life!
Common questions answered in detail
- What are the medical benefits of circumcision to the individual?
Starting with an overview written in terms that should be understood by any adult, this page of the CIRCLIST website goes on to consider the medical evidence in academic detail.
- What are the medical benefits of circumcision to the individual’s partner?
Again, an explanation for the lay reader followed by detailed consideration of the academic evidence.
- What are the benefits in terms of Public Health?
Public Health is sometimes regarded as the “Cinderella Service” of medicine, hidden away and poorly understood. So we start by explaining what Public Health is and then move on to show how circumcision can benefit the community as well as the individual.
- Is the procedure safe?
Done in a proper medical context, male circumcision is a very low-risk procedure. A study published in 2014 shows that the incidence of AEs (Adverse Events) is lowest when circumcision is performed in infancy.
- What effect does circumcision have on sexual relations?
Here we address issues of sexual relationships, especially from the female’s point of view.
- Does circumcision inhibit masturbation?
During the 19th and early 20th centuries Western society went through a social phase best described as anti-masturbation hysteria. Tight circumcision was recommended as a preventative measure. In this section of the website we re-examine the whole masturbation issue, not just the matter of whether circumcision prevents it but also the vexed question of whether masturbation is good or bad physically and psychologically.
- Will my penis lose sensitivity?
This is most men’s greatest fear as regards circumcision.
- Is there any way to “Try before you buy”?
Yes! Uncircumcised adults considering circumcision can use the information here to experiment with the feeling of having a permanently bare glans.
- Where do I find a physician to perform a circumcision?
As noted throughout this site, selecting a physician or other medical practitioner to perform your circumcision (or that of your son) is very important. You must choose someone you are comfortable talking with, so that you can openly and frankly communicate your desire for the particular circumcision style you want. It is equally important that you find a person with training and experience at performing this simple but important procedure, agreeing with them the method or device to be used.
Maintaining a worldwide list of competent circumcisers is beyond the scope of this website. An excellent resource for locating a physician within North America is the website of the American Urological Association. At this site, you will find a search tool that will allow you to select trained urologists in the area in which you live.
An alternative search appropriate to the USA and Canada involves going to your preferred search engine and entering the word PHALLOPLASTY. This will produce a fair number of home pages for doctors that do penile enhancements, many of whom will list circumcision amongst their services. They are all board certified urologists and most seem to have training in cosmetic/plastic surgery. Some even list their credentials on their web sites. Most have an e-mail preliminary consultation facility, so at the very least you can get some issues out of the way without cost. None should promise to use any particular technique until they have seen your penis and nobody should promise you a true “high and tight” cut if you have a short foreskin. This is why they won’t commit to a given result or technique until they can see what they have to work with.
- What’s involved in terms of post-circumcision care?
The information linked here is intended to help you decide whether or not to be circumcised (or have your son circumcised) and to make preparations for the procedure. It is not intended to replace the advice of your physician once circumcision has taken place. If you think that something isn’t right, such that you need post-circumcision care for issues such as wound infection, urine retention or inadequate wound healing, go see the person who circumcised you.
It used to be the case that the argument between the pro-circumcision and anti-circumcision lobby groups was an argument of opinion versus opinion. That is no longer the case. The pro-circ groups (CIRCLIST included) now have proven scientific fact on their side, whereas the anti-circ groups continue to rely on a less tangible line of reasoning based primarily on the morality of genital integrity - especially as regards child circumcisions. Of necessity they have, in the main, quietly dropped their assertions that the science is bunk.
What has developed in consequence is reminiscent of the Chinese proverb about the irresistible force meeting the immovable object. The scientific case for circumcision is now proved; be in no doubt about that. Not just in respect of HIV/AIDS but also other sexually transmitted diseases too. The resulting Public Health implication that circumcision is beneficial to society at large becomes the irresistible force in the analogy, not far removed from the reasoning behind mass vaccination campaigns against smallpox, polio and suchlike.
But the scientific proof does nothing to overturn the morality argument about circumcisions performed on children. Even if the anti-circumcision camp were to accept every aspect of the science, they would probably still maintain their view that an assumed right to genital integrity is paramount. They become the immovable object in the analogy, stubborn and unyielding.
Any newcomer to the scene faces a trade-off situation. Which should they accept - the proven facts about medical benefits or the contentious opinion about morality? Ultimately it is their choice. Our task in the pro-circ lobby is to ensure that our side of the case is adequately presented and not drowned out as the opposition would wish (and, indeed, attempt to do).
My own view is that the surgical removal of an infant or child’s foreskin, properly done, is so trivial a matter that it is entirely reasonable for a parent or guardian to decide that their son should be circumcised. I go on from that point to express opinions about style, technique and so on but those issues only come into the frame once the fundamental decision to circumcise has been taken.
If one makes circumcision the norm, nobody frets about being different and everyone benefits from both the personal and public health advantages.
Undoubtedly there is angst amongst those who resent having been circumcised as children. Such resentment I consider to be amplified (maybe even caused) by the anti-circumcision lobby and it is something that I condemn unreservedly. The engendering of worry seems to have become a deliberate campaign technique of lobby groups in all walks of life. That’s always unfortunate, if only because worry leads to irrational thinking and bad judgement. But retrospective criticism of an individual’s circumcision can lead to feelings of sexual inadequacy and consequent depressive illness. That in my view cannot be excused. Lobby groups are entitled to their opinion whether you or I agree with them or not, but they should not build their position at the expense of the mental health of those who cannot turn the clock back and thereby attain the circumstances being promoted.
[Adapted from text that originally appeared in the Circlist Google Group on Tuesday 27.October.2009]
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