The Circumcision Decision: Six Things To Know Before You Choose
This is the second of a two-part series. The first part can be read here.
The opposite of love is not hate, it’s indifference. The opposite of art is not ugliness, it’s indifference. The opposite of faith is not heresy, it’s indifference. And the opposite of life is not death, it’s indifference.
— Elie Wiesel
Despite a growing debate among many of those who’ve been introduced to this topic, the routine circumcision of newborn children in America lingers on today as both a deeply entrenched social taboo and an unyielding tradition. But what is circumcision? Why do we do it? And should we?
In this article, we’ll take a look at three more aspects of this question that should be explored by any expecting parent before facing the inevitable decision: if I have a son, do I want to destroy his foreskin?
We’re talking about sex, anatomy, and institutionalized violence against children. Therefore, it is an admittedly difficult conversation to have, but it is entirely necessary. Now, let’s begin.
1. the foreskin is not vestigial
There are a few things that should be understood about the foreskin and America’s troublesome association with it. Firstly, there is a pervasive dismissal of the foreskin and its importance among both status quo medical professionals and the general public. For example, approximately two-thirds of medical textbooks in the United States do not contain images nor substantive information about the anatomy and function of the male prepuce. Additionally, American physicians’ lack of understanding of proper care of the intact penis often leads to forced retraction, which then drives up the number of circumcisions even higher.
Then there is the popular claim that by removing the foreskin, there is no negative impact on sensitivity in the penis. This seems suspect, given the fact that an adult foreskin typically grows to the size of a standard index card, which is a whopping fifteen square inches. So, how could it be that destroying the foreskin causes no impact on sensitivity in the penis? There’s a troubling myopia to be found in the mindset which concludes that by destroying healthy, richly-innervated tissue that is capable of sensation, no impact on sensitivity occurs. In fact, the opposite is true. So, before we make the decision whether or not to remove it from another individual under duress, let’s take a look at what the foreskin is and how it functions.
The foreskin, more officially known as the or prepuce, is erogenous tissue. It’s a part of the body that is sensitive to sexual pleasure, in the form of double-sided skin. Its significance shouldn’t be underestimated, as it constitutes roughly thirty to fifty percent of the skin tissue on the penis. Therefore, the common myth that the foreskin is “just a piece of skin” and that removing it is “just a snip” should be considered a tragic misconception. In fact, the foreskin actually contains the most erogenous tissue on the penis. And, shockingly, the most sensitive part of a circumcised penis is the scar, where the nerve endings that would have ultimately found their home in the foreskin were severed.
The Ridged Band
In addition to this generalized understanding of the foreskin’s heightened sensitivity is the fact that it contains a series of specialized, anatomical phenomenon. One of these is a richly-innervated area of tissue around the end of the foreskin that is known as the ridged band. The Canadian medical researcher John R. Taylor first came up with this name after conducting his own in-depth examination of twenty-two adult foreskins. During this study, he noted that when the foreskin was retracted, there were two zones that were revealed: a ‘ridged’ zone and a ‘smooth’ zone.
Inside the ridged zone, he found erogenous tissue which is densely innervated with fine-touch receptors. When the penis is flaccid, the ridged zone lays flat against the glans, but when it is erect, the ridged band is facing the outside and becomes part of the overall shaft skin.
Now, the ridged band is the only part of the penis that is receptive to fine-touch. This is because the ridged band contains tactile corpuscles. These types of sense receptors, also known as Meissner corpuscles, are uniquely attuned to the sensations of fine-touch. They are found in the glabrous skin, which is a part of the body with little to no hair on its surface, like the fingertips, lips, toes, eyelids, foreskin, and clitoris.
If you wanted to get a feel (no pun intended) for how they function, you could touch the palm of your hand and your fingertips, and then compare that sensation to the feeling you get from grazing something like the top of your forearm. With your fingertips you could learn to read Braille, however with the top of your forearms, you’d find it impossible to get an adequate enough sense of the bumps to do the same. This is because the top of your forearm, without a rich network of tactile corpuscles, lacks the fine-touch receptivity to perform in the same way as your fingertips.
An obvious difference between the utility of one’s penis and one’s fingers is that the sensitivity to touch in one leads to sexual stimulation and pleasure, while the sensitivity in the other does not, necessarily. Common sense leaves one to understand that by destroying these touch receptors in the penis, a powerful avenue towards one particular aspect of the sexual experience becomes permanently closed off.
Research has shown that the frenulum is among the most sensitive parts of the intact penis. However, every time a child is circumcised, his frenulum is either partially or completely destroyed. This should be a cause for alarm for any concerned parent. Now, the frenulum is a band of tissue that connects the inner foreskin to the glans penis. It helps to hold the foreskin over the glans when the man is not aroused, and its form is not unlike the frenulum beneath one’s tongue. Many circumcised men consider what is left of their frenulum to be their most sensitive erogenous zone, i.e. their “G-Spot”. However, this is likely because, for the circumcised male, the ridged band on his inner foreskin has long ago been removed.
The frenulum functions in a way that, much like the frenulum beneath the tongue, may cause a painful feedback sensation if the foreskin becomes extended too far backward. This means, that if the man pulls away from the woman too far during his cyclical motions inwards and outwards, it will cause him pain and he will be compelled to remain closer to the woman. This, as was shared on a public forum, typically leads the man to pleasure the woman’s clitoris more consistently, which aids her in achieving orgasm during intercourse.
As the intact penis is capable of transforming between two states, this is made possible by the frenulum. Eversion is the process through which the flaccid penis becomes erect, and the glans penis extends outwards. During this, the foreskin rolls back and the ridged band rolls over the surface of the glans. During inversion, the opposite takes place, and the foreskin rolls up to cover the glans once again. Both of these processes are made possible by the frenulum, which, through its elasticity, creates a spring-like action.
Another unique aspect of the human foreskin, contained within its inner fold, is a subset of cells called androgen receptors. This positions the foreskin, in yet another way, as specialized tissue present nowhere else on the body. And this is due to the fact that it exercises the ability to receive hormones from an external source. Research has shown that there are hundreds of different types of hormonal signals which these cells are able to tune into. The purpose of these hormone receptors are nut fully understood. But, we do know that vaginal fluids contain hormones. If we were to speculate, perhaps these receptors play some role in an exchange of sex hormones during intercourse.
2. the ethics
First, to do no harm.
If there were one, fundamental aspect of the circumcision question into which all others find their ultimate culmination, it would have the be the realm of ethics. It may be considered through the lens of bioethics, medical ethics, legality, the rights-based perspective; whichever way serves best for your own understanding.
At the core of this issue, is the reality that secular circumcision in America is a medically unnecessary, controversial, culturally-driven, cosmetic procedure that is permanent, irreversible, painful, traumatic, and forced upon an individual who is too young to provide their own informed consent. It is the forceful destruction of a body part in a person too small to defend themselves. It will happen to a person based only upon their sex and into which culture they are born. It results in the loss of healthy tissue and permanently and fundamentally alters the form and function of the individual’s primary organ of physical intimacy.
History has placed the responsibility of this decision, in an arbitrary and problematic way, into the hands of the parents. Yet the rationale behind this tradition — the argument that the child is too young to choose for himself — is weak at best, if we consider the child as someone who is born with the right to security of person, i.e. the protection of his full, complete, and intact body. Without medical necessity, it is at best inappropriate and at worst woefully immoral to destroy erogenous tissue in a child.
The central argument driving the status quo tradition of neonatal circumcision is the logic of beneficence, which states that because the benefits outweigh the risks of the procedure, it is acceptable to do it. However, this simply is not sufficient, because it is not uniformly imposed. In other words, where does one draw the line? If it simply is a matter of benefits outweighing the risks in order to justify non-therapeutic, prophylactic amputations, then it would become accepted as well to remove other tissue from the body which may run the risk of infection or becoming cancerous later in life. Yet, any reasonable person would consider it woefully inappropriate to, for example, perform mastectomies on children in order to prevent the risk of future breast cancers.
The medical researcher Dr. Janet Menage, through her extensive research into the effects of medical genital surgeries, has concluded that procedures such as hysterectomies or circumcision that are performed under duress, very often result in the patient’s experiencing conditions such as PTSD. She writes that the loss of a body part, without offering consent, is a form of trauma and is often perceived by the patient as an assault. Through the lens of common sense, this is a more than reasonable assertion.
The Child’s Right To An Open Future
The individual’s right to autonomy is explored in great depth by Australian researcher Dr. Robert J L Darby in a paper he published in the Journal of Medical Ethics titled The child’s right to an open future: is the principle applicable to non-therapeutic circumcision?. In it, he draws upon the principle of a child’s right to an open future, as developed by legal philosopher Joel Feinberg. Much time has been spent by social and educational thinkers, considering this right as it applies to the mental conditioning of children. This is particularly relevant to religion and educational systems. However, Dr. Darby points out that very few in the realm of bioethics have applied the concept of this right to both the mind and the body. Therefore, in his paper, he explores the ways in which this principle is relevant to the circumcision of infants.
Within this concept, the rights of children are uniquely defined as rights of trust. These can be defined as rights that cannot yet be exercised, but can and will be once the children have reached the state of capable adulthood. The crux of this definition can be found in the widespread agreement and legal protection of the rights of autonomy for adults. If it were to be, that a non-therapeutic procedure is carried out on an adult without their consent, then their right to bodily autonomy would be violated. Why not extend this to the child?
Feinberg argues that non-therapeutic procedures which are irreversible, should not be performed upon children because the right of autonomy that belongs to the future adult in question is then violated preemptively. In other words, there would be little difference, ethically, in circumcising a child without consent than circumcising the adult version of that child, years later, without consent. Destroying the foreskin of a child creates the future adult who then can say, “Why did they do that? Nobody asked me.”
According to this theoretical framework, if a child’s body is altered without his or her consent before she is able to exercise his or her right to bodily integrity, then these rights of trust are violated. Therefore, Darby argues, circumcision should not be allowed to be performed upon a healthy child, and it should be the role of the state as parens patriae to enforce that protection. Circumcision should only be carried out of medical necessity or on individuals old enough to provide their consent. To do otherwise is simply unethical.
Furthermore, let us consider this right to an open future through the lens of a simple diagram to illustrate the possibility of a desirable or undesirable outcome, with regards to rights in trust, as it applies to the circumcision question.
In the top-left quadrant, we can see that if an intact male grows into an adult and reasons for himself that he is happy that he was circumcised, it may be possible to conclude that this is a desirable outcome. However, having never fully experienced physical intimacy with himself or with a partner with fully intact genitalia, he will necessarily have based that decision upon incomplete information.
In the bottom-left quadrant, we can see that if an intact male grows into an adult and reasons for himself that although he was not circumcised, he wishes to be, then this is indeed a desirable outcome. Because he is able to choose for himself as an adult to have the circumcision procedure done, he is able to achieve for himself the outcome which he desires for himself. His rights in trust have been protected.
In the top-right quadrant, we can see that if a circumcised male grows into an adult and, through his own independent reasoning, concludes that he wishes he had not been circumcised, his rights in trust have been violated and this has produced an ethically untenable outcome. A recent poll has indicated that roughly one-third of all men in America fall into this category[i]. The undesirable nature of this outcome is rooted in the fact that he is unable to reverse his condition of having been circumcised. With contemporary technology, it is not yet possible to regenerate a foreskin that has been destroyed.
In the bottom-right quadrant, we can see that if an intact male grows into an adult who has reasoned for himself that he is content with his status of not having been circumcised, a desirable outcome has been achieved. It can be reasoned that this is because his rights in trust have not been violated and that he may choose at any stage in his life to remain intact or to have himself circumcised.
If we take this basic logical framework into account, we can see that the only possibility of generating an undesirable outcome, from the point of view of the individual, while considering the individual’s right to autonomy, bodily integrity, and an open future, would be to forcefully perform a circumcision upon him before he reaches a level of maturity from which he may make this decision for himself. To whom does the penis belong? Who’s life-long sexual experience does this affect? Certainly not the parents, and certainly not the medical staff. Nobody owns the child’s body, other than him. So to remove healthy tissue without his consent is a serious violation of human rights.
Rights in trust depend upon the understanding that every child is more than what she or he appears to be at the present moment. She or he is, instead, a future adult, as she or he carries the seeds of that potentiality within themselves. If one were to limit that potential, through a circumcision, for example, one would force a condition upon the child that is irreversible and will be imprinted onto them for the rest of their lives. Every healthy male child carries within him the potential to experience the full robustness of physical intimacy. Yet by destroying key aspects of his anatomy in childhood, he is then condemned to an irreversibly limited sexual experience for the rest of his life. The man who was circumcised as a child loses his capacity, to a degree, for acute erogenous sensations.
3. we can do better
Circumcision is kind of like warfare; it’s a lesson humanity should have learned decades ago, yet stubbornly refuse to do so. After two World Wars and the invention of the use of nuclear weapons, we should by now have figured out how to get over our addiction to finding ever more advanced ways of killing one another and instead use our resources more wisely and peacefully. Similarly, after decades of doctors and nurses cutting the genitalia of infants behind closed doors, and without really understanding why, we must reconsider this whole situation and do what’s right for the child.
Those among us who seek to protect future generations from this practice are doing so out of a deep and sincere love for rightness and a genuine desire to protect the most vulnerable members of our society — newborn children — against the enduring merging of sexuality and industrialized violence, a point at which they are forced to have a fundamental part of their physical self-hood carelessly destroyed. The more children from the next generations that we can spare from this particularly nascent barbarism, the better for all of us.
We can do better.