Circumcision

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  • The circumcision of male infants is wrong, on a number of principles.

  • And, the dangers & harms of circumcision, while sometimes real…

  • are also sometimes greatly exaggerated.

 

* A special article researched and written by Thomas Francine. *

 

Let’s explore:

Why circumcision is wrong:

 

  • 1 — On basic principles of consent and bodily autonomy…

    If any male decides he wants to get circumcised, he can decide that for himself at an age where he can think. Guess what… most males will not decide to do this when they get older. So why force it on him when he is an infant? (Yes, circumcision of infants has a lower complication rate, than if an adult does end up wishing to do it… But very few men will opt for it later on, and the vast majority of adults will be fine anyway even if they do decide to do it… so…) Let him decide for himself.

 

  • 2 — On basic principles of evolution and “Chesterton’s Fence”… if something (foreskin), evolved to be a part of you over many years, it’s usually safe to assume, that it exists because it’s ultimately more beneficial than harmful! Thus, you should first have great evidence to the contrary, before you decide to snip. (And as we will see… such great evidence, is not really there, on this issue.)

    Although to be fair, the fact that circumcision has occurred across (some) cultures, and for thousands of years, makes me wonder if circumcision has been selected for in some way, for the benefits to outweigh the cons. Maybe in previous times, it was more difficult to be hygienic, thus the pluses were stronger? — Still, in lack of strong evidence here, I go with evolution / God.
Do we still need to catch up to Dr. Blackwell's thoughts from way back in 1894?
...Or are there well-developed arguments nowadays from the pro-circumcision side?

 

  • 3 — The “first, do no harm” (primum non nocere) principle… a cornerstone of healthcare around the world… compels us consider the possible harm that any intervention might do.

    Circumcision is not medically necessary; and poses small potential benefits, alongside small potential harms. (Though, for a few select people on each side… the benefits could be big, or the harms could be big.) — That some people do get harmed by circumcision (see later section below), should give us immense pause on this practice… even if the harms are small for most who are affected.

    Check out the prevalence rates of circumcision, by country. Note, in particular, that circumcision is not common throughout Europe. Are boys having a lot of health troubles in these places, due to being uncircumcised? Are UTIs and STIs skyrocketing and/or causing lasting harm to many? No.

    Also see: 14+ medical organizations recommend against it; and some statements by some of them here:

 

  • 4 — Circumcision partly has a weird history, and we continue it partly due to tradition of various odd reasons. Check out the funny 4-minute video about some of this, below.

    But please note that while this video has some fair points, it also lacks nuance. — For example, yes, some select people like Dr. Kellogg had some insane reasons for pushing circumcision… BUT this is NOT the MAIN reason people are, or were, circumcised. People have been getting circumcised across cultures, for thousands of years, for a variety of reasons. — Today in the US, the main rationale is the small potential health benefits; various traditions; and money as an additional possible motivating factor.

 

  • 5A — Money & corruption (general wonderings)

    Circumcision rakes in a lot of money. 

    Circumcision is probably the most common elective surgery for males in the world. In the US, the procedure itself brings in somewhere around 1 billion dollars per year. — That’s a LOT of money coming in. — Now… it’s not inherently bad to make money from performing a service… BUT considering that this is an elective surgery… (which some medical associations even recommend against)… we can question if the large amount of money coming in… might slightly bias doctors, hospitals, and related scientists… to focus slightly more on the positive potentials of circumcision.

    Taking that to the next level…



  • 5B — Blatant money / corruption / ethics violations: informed consent; exploitation; transparency; and commercialization of human tissue

    Did you know… that the hospitals that circumcise your child, ADDITIONALLY make a lot of $, by SELLING your baby’s foreskin(!) to create expensive lotions for wealthy, elderly women?

    You probably don’t know that, because hospitals don’t tell you!

    This is extremely and obviously unethical, and it makes me even more skeptical to the industry as a whole. — Is their primary concern the health of newborns? Or, is their primary concern making money after all (even in unethical ways)?

    The same companies that are pushing your baby to be circumcised… are simultaneously not telling you that they will make money not just from the circumcision itself… but ALSO from selling your baby’s foreskin to cosmetic companies.

    Shouldn’t parents at least be the ones receiving the revenue from their child’s foreskin? (Even tho this would also be unethical.)

    This practice (and all the secrecy around it), reduces the human body to a source of material goods to be preyed upon, rather than respecting its intrinsic dignity. — Using parts of an infant’s body to generate revenue for cosmetic products — without the infant’s consent and even without the parents’ consent — amounts to an exploitation of the most vulnerable members of society.

It is not easy to pin down the revenue per foreskin that hospitals receive. (After all, hospitals don’t tell you they do this in the first place.) However, chatgpt gets its $50 to $200 estimate this way:

At ~$125 per foreskin, and at ~2 million circumcisions per year… US hospitals have the potential to rake in ~$250,000,000 per year from selling your babies’ physical penis skin on the open market without your consent or even knowledge. (On top of the ~$1,000,000,000 per year from performing the procedures.)

The benefits of circumcision

 

We can look at succinct articles like this one from Mayo Clinic, for fair lists of circumcision benefits.

Circumcision is cited as a means to help prevent UTIs and HIV, etc… and in some cases this may be true. — But note, that simply maintaining basic hygiene, basic safe sex practices, etc… are also effective against some of these, in some cases… and don’t require cutting off any parts of one’s body. (“…the risks of not being circumcised are rare. The risks also can be lowered with proper care of the penis.” – Mayo Clinic) 

Yes, benefits to circumcision exist. But as Mayo Clinic states, they are generally minor; and similar benefits can be established via less aggressive manners.

At the same time that it has potential benefits (perhaps especially to some select individuals on the margins)… circumcision also carries potential harms (see next section).

 

 

Can the pros and cons be balanced side by side? In some limited ways, they sometimes can be:

For example… on the topic of infections:

Note this article’s conclusion, that… 111 circumcisions are needed to prevent 1 single urinary tract infection (UTI). Already, that’s a lot of surgeries to prevent 1 infection. — But on top of that, infection from the circumcision occurs at a similar rate, as the UTIs do in non-circumcised boys! – Thus, circumcisions prevent one type of infection, but cause another type!

But guess what… circumcisions cause UTIs in the end anyway !!, via increasing the number of people who develop urinary stricture disease (urethral meatal stenosis)… which then leads some people to develop UTIs.

The harms of circumcision
(and why circumcision is not that bad):

 

There are various risks of circumcision, some rarer than others; and some worse than others.

  • Circumcision can help prevent newborn UTI’s (and other diseases); however circumcision can also cause infections (at about the same rate specifically as the UTI’s they prevent). Other infections may come up later on as well, as a result of circumcision, including UTIs, from wider problems… such as…

  • urinary stricture disease (urethral meatal stenosis) – a condition which occurs in circumcised males, at approximately 3.7x the rate of what it does in intact males… causes… irritation, scarring, and swelling at the tip of the penis; incontinence; urinary bleeding; and urinary tract infections (UTIs). — Males can either live with this condition if it does not bother too much, or they can choose to get surgery if they want it to be fixed.

  • “your penile skin may be more likely to get dry, chafed, or irritated without the foreskin” (forever). A chafed penis can make it difficult or painful to even walk. 

  • Here are some other miscellaneous possible complications.

  • Keep in mind that any given harm of circumcision, even if it is not that bad on its own… can lead to additional harms as directly or indirectly. — For example, circumcision… can cause urethral meatal stenosis… which can cause occasional UTIs for life… which can cause kidney infections… which can lead to missed time at work or with family, stress, pain, and even death.

Let’s move onto the topic that most people probably wonder about, with circumcision… sex & masturbation.

Yes, this also goes under the “possible harms” category… but here, even more than elsewhere… we can see that the harms are minimal or non-existent, at least for most people who are circumcised…

SEX & MASTURBATION

The main, best way to tell the difference between being… uncircumcised vs. circumcised, is to consult men who were circumcised as adults. These men fully experienced both being uncircumcised and circumcised. Here is a study of this from South Korea. (“As circumcision in South Korea has never been predominantly neonatal, most circumcisions were of boys, adolescents and adults. Therefore, South Korea can provide unique clues about the effects of adult circumcision.”)

So, what were the results of the study?

For a large percentage of people, no difference is reported in sexual stimulation, before vs after circumcision. However, of the people who DO notice a difference, it’s more likely to be negative than positive.

  • On the topic of sex… Following adult circumcision, “20% reported a worse sex life after circumcision,” and 6% thought sex was better, and 74% thought sex was equally pleasurable. — So, on this centrally important topic, for most men, no difference!
  • On the topic of masturbation… many people felt masturbation as equally pleasurable as before. However, about the same number of individuals felt it as less pleasurable.

(For a random anecdote on this topic, one man said, “Masturbation was more fun with a foreskin, as it acts as built-in lube, but I find sex is better circumcised as the glans gets stimulated more.”)

As you can see from this study, most people don’t think there is any change, when it comes to the most-important topic of sex. And a large percentage also believe there is no change in masturbation pleasure.

And for good measure, here is a study that shows similar results, a different way:

“Comparison of circumcised (N = 98) and not-circumcised (N = 261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7–44.1 minutes) in circumcised compared with 6.0 minutes (0.5–37.4 minutes) in not-circumcised men (not significant).”

^ this is saying that during sex, circumcised men take about 40 seconds longer to ejaculate on average… a number that is not statistically significant (meaning there is no difference, in the time it takes for these two types of men to reach orgasm).

This helps to validate the South Korea study, that there really isn’t any difference in the experience of sex, at least for the majority of men. (We might imagine that if one type of men was losing something vital here, it might take either a lot longer, or a lot shorter, for him to ejaculate.)

WHAT DO WOMEN THINK?

Some women prefer circumcised men; others prefer uncircumcised. When it comes down to sex, the vast majority of women find it equally pleasurable. (Note that ~100% of women’s sex toys… dildos, etc… do not have a faux foreskin.)

If you want to please a woman, there are many, many other things to worry about before considering foreskin vs no foreskin. (In fact, worlds that are not even of the physical… the mental world, and the spiritual world… are also quite important.)

(Likewise, if you want to be pleased yourself, there are many, many other things to prioritize — mental, spiritual, physical — besides a… possible but unlikely… slight loss of sensitivity in your penis that is out of your control even if it is the case, since it happened when you were only a couple days old.)

STILL, ITS PROBABLY PREFERABLE TO NOT CIRCUMCISE

…That all said, we definitely need to note that.. it seems like it would be better to NOT circumcise.

  • on various principles including bodily autonomy it should be generally advised against;
  • many developed countries don’t do it much at all and they’re fine;
  • a number of mainstream medical organizations advise against it;
  • while there are potential benefits (usually small), there are also potential harms (usually small);
  • (there’s also both normal, and extremely odd, financial incentives behind circumcision that I really wonder about even though that’s way above my pay grade of $0 here to figure out how much of an impact they have on the discussion and practice).

Conclusion

The South Korea study above presents by far the most accurate assessment on this topic that I know of. It reaches a fairly moderate conclusion… circumcision is not a good idea because it affects some people poorly, at least in some domains; on the other hand… for most people, it is not bad across all domains… and in fact for many/most people it presents no significant difference at all, across any domain!

A fair and moderate conclusion, based on a good methodology.

…But many people, on this topic, jump to extreme, doom-and-gloom ideas. Why?

Well, it’s normal for humans to focus on the worst (negativity bias). And… the worst stories usually get the most press. — For example, this man offed himself after a circumcision gone wrong. It’s a tragic story. — At the same time, the BBC isn’t going to report about any of thousands of boys and men that got circumcised the very same day but had no bad consequences. So we end up focusing more on the negative possibilities.

On top of that, some studies out there, have horrible methodologies. For example:

  • this study claims that uncircumcised people with foreskins enjoy sex more… but it turns out they’re asking people totally subjective questions without any standardized reference point for what a “3” vs “4” is etc; and without any ability to directly compare one vs another (like what the men can actually do directly in the South Korea study above). And even with their horrendous methodology… the actual reports came out to be very similar anyway. Off by only 0.2 to 0.4. Not even statistically significant anyway? I’m not sure. In any case, there are 0 conclusions to be reached from this.

Other times, I will see people reference a study, but falsely interpret or exaggerate what is said. For example:

  • @thetinmen, who I love in general, is way off on this particular point… He says “Circumsized men have more difficulty during sex.” What is his citation? A study I mentioned above… which said that circumcised men last, on average, 40 seconds longer in bed! 40 seconds! 😂 And the study said that these 40 seconds were “not significant” statistically, anyway. (Meaning, if you ran the same study again, it could just as easily go the other way, that the uncircumcised men lasted 40 seconds longer… because 40 seconds is too close to 0 for it to mean anything, even with a large sample size.)
  • I’ve seen it said that the foreskin is the most sensitive part of the penis… but some of this convo seems based around unusual, and non-sexual, experimental settings, like how slightly better your penis can be at detecting heat from far away, with a foreskin. (– here is a proper rebuttal to this idea.)

I’ll leave the final thought to Brian D. Earp, in his article: “Infant circumcision and adult penile sensitivity: implications for sexual experience” :

Other miscellaneous info:

+ Other various background info, on the two sides of the “debate”
+ Can circumcision and female genital mutilation (FGM) ever be compared?
+ Nice piece that shows some of the many variables one needs to take into account… when looking into circumcision studies and methodologies. I don’t know if I agree with them totally, but it just shows the complication in figuring this stuff out. It’s almost like a Rorschach test where your confirmation biases can find plenty of supporting data no matter what you believe 🙂