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June 22, 2007
Men and Circumcision
This report has a very small sample size (five), but it suggests that men circumcised as adults report significant decreases in sexual pleasure.
Update: This study (via) shows a very subtle difference, and not all in one direction:
Category scores for responders with the same sexual partner before and after circumcision (30 men):
Erectile function 12.3 11.1
Penile sensitivity 10.1 9.4
Sexual activity 9.8 10.1
Satisfaction 11.2 12.3
So function and sensitivity are both slightly down, but general satisfaction and activity are both up.
Of the responders 47% reported that sex was physically more pleasurable and 47% also said that their sex lives were more satisfying after circumcision. Additional comments included improved penis cleanliness and easier voiding after circumcision. When asked generally about benefits and harms, 50% reported a perceived benefit or improvement, and 38% reported a perceived problem or difficulty as a result of the procedure. Overall, 62% of men were satisfied with having been circumcised.
Plus: "In a survey of college women 87% expressed preference for pictures of circumcised over uncircumcised penises."
Take that, Sanchez.
June 22, 2007 | Permalink
Comments
Very first sentence of the report:
Five men underwent circumcision in adulthood for reasons of infection, inflammation, or phimosis.
How many for phimosis? It doesn't say. That itself would mean that a man, before circumcision, were probably not getting much happiness from sex, especially if it was actually the reason he got circumcised. I've considered being circumcised myself because the phimosis means I can't have sex without a condom - it hurts too much when the skin is forced back and forth.
In general, the fact that these were 5 men who were all circumcised for MEDICAL REASONS means that we shouldn't compare their experiences before and after; they were not representative of most uncircumcised men if they actually had to be circumcised because of medical problems. It would have been far better to compare the experiences of men who got circumcised without having experienced any medical problem with the foreskin - like those who did it when converting to Judaism.
Posted by: George Washington | Jun 22, 2007 3:02:48 PM
Phimosis? Oooh, so that's what that condition is called! I had forgotten the name. Thanks.
Overall, let me say that I much prefer the previous post on this study.
Posted by: NotNormallyAnon | Jun 22, 2007 3:22:51 PM
The second study you link has a sample size of 123. That's not exactly impressive. Also, following up on our founding father's comment above, I notice that "Indications for circumcision included phimosis in 64% of cases, balanitis in 17%, condyloma in 10%, redundant foreskin in 9% and elective in 7%." So the vast majority of these men were getting circumcised for medical reasons; only 7% - maybe 16% if throw in the nebulous-sounding "redundant foreskin" - got circumcised for elective or cosmetic reasons. Given that the vast majority of this small sample got this procedure to improve preexisting medical conditions, it's no real surprise that they were largely pleased with the outcome. What we're talking about, however, is the wisdom of routinely circumcising male infants for cosmetic purposes, and this data doesn't begin to address that.
By the way: the "survey of college women" you mentioned was this survey, conducted in 1976, with a sample size of 55 women. There's no way that data could possibly be shoddy or out of date!
Posted by: Christmas | Jun 22, 2007 3:22:52 PM
Something not considered in these before-and-after studies of men circumcised in adulthood is that being circumcised in infancy vs. adulthood are not at all the same situations neurologically or behaviorally. The infant's brain will organize around whatever nerve endings are present after the circumcision, and through puberty and adolescence the circumcised boy will learn how to stimulate the penis he's got for successful sexual behavior. A man circumcised as an adult has neither advantage; after his entire nervous system is organized to use a penis with a foreskin, and then he suddenly doesn't have one. Small wonder that he might experience less sexual satisfaction. It's impressive that the post-operative satisfaction measures aren't much lower than reported here.
Posted by: cerebrocrat | Jun 22, 2007 3:36:37 PM
It strikes me that getting reliable data on this will be particularly daunting, since anti-circumcision advocates have an ax to grind and the medical establishment, that has been signing off on the practice for decades, has no incentive to prove themselves wrong.
Besides, isn't this a topic more suited to grade school boy's rooms and Scout camping trips?
Ezra, as long as your "significant other" is happy, who cares?
Posted by: W.B. Reeves | Jun 22, 2007 3:52:42 PM
Agreed - it always amazes me how worked up people get about a subject that, per individual case, doesn't seem to be especially consequential.
Posted by: cerebrocrat | Jun 22, 2007 4:02:57 PM
the medical establishment, that has been signing off on the practice for decades,
The American Academy of Pediatrics doesn't recommend it, even discouraging the practice.
Posted by: Stephen | Jun 22, 2007 4:44:38 PM
"Ezra, as long as your "significant other" is happy, who cares?"
It's Friday. And I don't want to think about health policy...
Posted by: Ezra | Jun 22, 2007 5:12:42 PM
But this is health policy. Sort of.
Posted by: Sanpete | Jun 22, 2007 5:15:46 PM
best circumcision joke ever....
there once was a mo'el, (rabbi who performs circumcisions)and he had the finest and most beautiful, but magical,leather briefcase...
it was a great mystery, but everytime someone rubbed the briefcase, it got bigger!!!!
(sorry, but i love to share my circumcision joke!! haha)
Posted by: jacqueline | Jun 22, 2007 5:17:12 PM
I chose to be circumcised when I was in my mid-20s purely for aesthetic reasons. I'm in my mid-40s now and there is less sensitivity, but I don't find this to be a bad thing. Prior to circumcision, the glans area was almost too sensitive, and could be uncomfortable in certain sexual situations (e.g. oral sex). The too tender feeling is gone, but the sensations of a build up to orgasm and orgasm itself haven't changed. The real upside was the loss of self-consciousness in the locker room and in the bedroom. I was the only boy I knew growing up that wasn't circumcised and that was difficult at times. I also object to Andrew Sullivan's use of the term 'genital mutilation" which conflates the practice of male circumcision with female circumcision. Women are actually mutilated when the female equivalent of the glans penis is lopped off. There is no equivalency between the two practices.
Posted by: anon | Jun 22, 2007 5:31:38 PM
i think that circumcision is a barbaric and awful practice. snipping the skin on a brand new, little baby...after the trauma they have just endured coming into the world, and then subjecting them to that.
...babies should be hidden away in warm, loving arms, near a heartbeat and milky breast...not enduring exquisite pain.
what a way to be introduced to life on earth.
it figures, though...doesnt it.
awful awful awful
Posted by: jacqueline | Jun 22, 2007 5:35:32 PM
Hey, if adult men want to get it clipped, more power to them, but I would have preferred to have the choice. Not that I'm bitter, or anything. But I really can't see any legitimate reason for taking that choice away from a man by circumcision as an infant.
Posted by: Glenn | Jun 22, 2007 5:46:05 PM
Ezra, you missed a very important study, recently released, which found significant reduction in sexual satisfaction after adult circumcision:
The Effect Of Male Circumcision On Sexuality
The entire study in pdf form can be found here.
Those interested in the effects of circumcision on males should also read Sorrells. Released three months ago, it found that circumcision removes the most sensitive areas of the male sex organ.
Circumcision is insidious because its harms are difficult to detect and admit to by many of those affected by it, who have no other basis for comparison. Very few males would ever choose this for themselves. We must stop inflicting it upon infants.
Posted by: respect | Jun 22, 2007 6:05:17 PM
I'm not an anti-circumcision "advocate" with an "ax to grind" per se, but I think it's really damn weird that in America it's considered not only perfectly normal, but the default, to surgically remove part of a male infant's penis for no medical reason. Given that this is generally done to infants incapable of consenting to a life-altering procedure with the small but very real possibility of infection and permanent mutilation, I really don't see how it can be justified. Even putting aside loss of sensitivity, there are kids whose penises are destroyed in botched circumcisions and have to undergo sexual reassignment surgery, long before they're even capable of forming coherent thoughts, much less consenting to a dangerous elective medical procedure. Would anyone think this sort of thing wasn't insane if everybody wasn't already doing it out of habit?
Posted by: Christmas | Jun 22, 2007 6:07:05 PM
Maybe this convo need to be nipped in the bud, so to speak.
I was clipped as an infant, but I'm really sensitive enough, thank you very much.
I think cerebrocrat has it right: if its going to be done, the pain as an infant seems very minor compared to the weeks/months of agony as an adult (I've known adult men who were cut, and they really suffered), with likely only minor sensitivity damage later in life.
The argument that the baby doesn't consent is bogus. He doesn't get to make any medical decisions until legally of age (vacinations, tonsilectomies, etc.)
There ARE serious health complications from not circumsizing, the most serious being HIV disease, but the condyloma's referred to above are HPV warts which are highly contagious.
That said, there's no skin off my.... so I just should let parents do what they believe is best. This is a message brought to you by "Family Values".
Posted by: JimPortlandOR | Jun 22, 2007 6:53:43 PM
if i were a man thinking of converting to judaism, and required a circumcision, i would spend some serious time rethinking the virtues of buddhism.
Posted by: jacqueline | Jun 22, 2007 7:16:29 PM
There ARE serious health complications from not circumsizing, the most serious being HIV disease, but the condyloma's referred to above are HPV warts which are highly contagious.
Good thing we have these things called condoms, which are far more effective at preventing disease transmission than circumcision.
Posted by: Christmas | Jun 22, 2007 7:31:08 PM
The argument that the baby doesn't consent is bogus. He doesn't get to make any medical decisions until legally of age (vacinations, tonsilectomies, etc.)
But there are legitimate medical reasons to get vaccinations. There are no such justifications for circumcision. The American Academy of Pediatrics doesn't recommend routine neonatal circumcision and hasn't for years, specifically on the grounds that the health benefits of circumcision aren't enough to warrant such a policy. When you contrast this with the mainstream medical consensus regarding, say, measles immunizations, it becomes pretty clear that circumcision isn't considered a medical priority by doctors. And I don't think it's considered such by parents, either - parents who get their kids circumcised do so for aesthetic/cosmetic reasons, not because they want to spare their kids the hassle of bathing regularly and buying condoms.
Posted by: Christmas | Jun 22, 2007 7:39:31 PM
JimPortlandOR,
I am truly baffled that you ascribe considerable importance when adults choose a circumcision and "really suffer," yet apparently have no sympathy for the real suffering of newborns. Adults also have better anesthesia, and foreskins which need not be ripped from the glans to which they are still attached.
The "I don't remember mine" justification rings hollow, unless applied consistently. What other infant amputations are acceptable, so long as the patient doesn't consciously remember the surgery?
Your beliefs about supposed risks of being a normal male without any genital modifications are unfounded. There is no epidemic of foreskin-related disease, despite the majority of males worldwide remaining gentially intact.
Family Values include recognizing that your son's sex organ belongs to your son, not to the family. Only he has any business reducing it.
Posted by: respect | Jun 22, 2007 7:52:42 PM
Plus: "In a survey of college women 87% expressed preference for pictures of circumcised over uncircumcised penises
Those are pictures. Foreskin just doesn't photograph well.
Posted by: McG | Jun 22, 2007 9:35:26 PM
Christmas: I'm not arguing the case for compulsory circumcision, but there are now medical reasons not recognized earlier for parents making the choice to circumsize. The data on HIV transmissibility in the cut/uncut cases was only available with the last year or so, and the situation on HPV-related warts is a result of recent trends to more sexual intimacy of all kinds among younger people. So there now IS medical evidence.
Condoms should be the norm in non-exclusive sex relations. But people don't always use them, or occasionally are non-conforming in exclusivity, particularly for oral and other non-insertive sex - but the danger of transmission of disease is present in all cases, and all reasonable means to reduce transmission are a very good idea.
So the recommendations made by professional societies in earlier decades needs to be reviewed and perhaps modified. If I was a new parent, I'd sure consider recent data that make earlier recommendations questionable.
As to the question of pain: Of course I don't remember this. But thousands of years of practice of circumsizing among certain religious/ethnic groups would seem to confirm that the period/depth of pain for the baby is not prolonged or traumatic as it is in adults. In fact, many ethnic groups do this prior to puberty as a rite of passage. Whether this is medically advisable, now, or not, is not something I cannot provide - I'm not an expert.
I have said that parents should choose, based on current information - and I believe MDs have a responsibility to present balanced information that is needed for decision.
I don't believe that 'group think' in favor of the practice (especially here in the US) should be replaced by the same pressure against it.
In a choice between a questionable pleasure difference versus a non-trivial probability of disease that can be fatal or life-long, it seems obvious that disease prevention should be weighted higher.
Posted by: JimPortlandOR | Jun 22, 2007 9:59:45 PM
JimPortlandOR,
Evidence of potential benefits don't even outweigh the known risks of circumcision, much less rise to the level of justifying a sexual amputation.
The disease prevention meme that you're employing is without merit. Identical evidence would never be accepted to justify amputation of any other body part without consent.
Posted by: respect | Jun 22, 2007 10:11:31 PM
Helmet v anteater?
Wow,I haven't heard so much talk about the relative virtues of H v A since Jr. High and while in grad school, when I waitered with my old buddy, Bobby D, a former ballet dancer and self professed connoisseur of c--k. That boy could describe either variation in such florid, loving, titillating detail that it could almost make me, a rather dedicated artisan of the straight team, wonder if I was really missing out on something...big!
What I can tell you via old Bobby D. is that among your average Apple Pie lovin, American gay males, anteaters appear to be preferred. A different aesthetic and according to BD, an illusion of an additional 2 inches. Which can make all the difference in the proper circs...
Posted by: thepersianslipper | Jun 23, 2007 12:27:08 AM
So, Jim, are you suggesting that because the infant cannot remember what pain they feel when they're older...causing them pain is hunky dory? Do we have any way of measuring how much pain an infant actually feels during and after being circumsized, and for how long? Any data to back up your rather glib response to what, if it were being done to any other body part of an infant, would cause massive outrage?
I mean..why not chop off a toe? He'll heal, and he won't remember it. Or tattoo him? He won't remember that either. I mean, weeks-old infants don't remember anything later, so let's do what we want to them!
I have no sympathy...none..for the idea that an adult's having to deal with circumcision pain justifies harming him as an infant instead. Adults also have painkillers, and rational brains to understand what's happening to them. And if the surgeons giving them this procedure cause them so much pain, then perhaps the procedure should be improved.
I have an uncut son. If he, as an adult, truly wants a circumcision, he will have that option. And it will be his choice, not mine or his father's.
Posted by: emjaybee | Jun 23, 2007 12:43:21 AM
