The Science of Circumcision

By: Myles Power Edited by: Hannah
.
Male circumcision is the surgical procedure for the removal of the foreskin from the human penis. It has grown in popularity over the past hundred and fifty years to such an extent that it is now considered a common medical procedure in America. For such a popular procedure, very few people actually know much about it, including its benefits, its side effects and its history. This article hopes to shed some light on those key points and make you think about what circumcision really is.
.
The first evidence of circumcision dates back to the time of the ancient Egyptians. Carvings on a tomb thought to date from between 2400-2300 BC clearly show the procedure being performed. Although no historians disagree with what is being depicted, they do disagreed about why the Egyptians would do it. Some think it was a rite of passage into adulthood, while others think it was to make a distinction between the elite and the rest of the population. Circumcision was later featured in the Hebrew Bible, which describes the circumcision of Abraham and his relatives and slaves not as a spiritual act, but as a physical sign of their covenant with God.
 cur1
Although circumcision has been around for a while, it was not as popular in America a hundred and fifty years ago as it is now. It was seen more as a religious act and not a medical procedure, unless used to alleviate specific genital problems. This was until a Dr. Lewis Sayre (one of the most prominent physicians in America at the time, who was responsible for the Bellevue Hospital Medical College and the American Medical Association) came up with some very strange theories indeed. In 1870, he was asked to look at a 5-year-old boy who was presenting with either paralysis or severe motor problems. Sayre diagnosed the boy’s condition as a result of his penis being constricted by his foreskin… I’m not kidding. The boy’s health actually improved and Sayre attributed it solely to the circumcision he performed. He then began to promote circumcision for a wide range of medical and social problems including syphilis, headaches, alcoholism, masturbation, and “lunacy”. His “interesting” theories regarding circumcision astonishingly caught on with the medical community, who – prompted by Sayre – began to investigate a whole host of genital surgeries designed to alleviate psychological problems and cure unrelated illnesses.
Believe it or not, masturbation in the Victorian times was considered a serious problem. John Harvey Kellogg (whose name you may recognise from your box of cereal in the morning) was one of the physicians investigating circumcision. He worked for the “rehabilitation of masturbators” and often employed extreme measures in his research. This would include the forced circumcision of boys and young men caught masturbating, intentionally performed without anaesthetic. In his book, ‘Plain Facts for Old and Young‘ he wrote: “The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases.” He also burnt the clitoris of young women with phenol as a way of preventing “abnormal excitement”. I want you to remember this next time you are eating your Kellogg’s cornflakes.
 cur4
The views of the medical community then changed and they began to see circumcision as more of a preventable measure than a cure. They began to promote it to the public, who then began to get their children circumcised. As time went on, circumcision became a widely accepted practice in America. However, an ever-growing body of evidence that questioned the medical justification of such a procedure convinced European doctors that it was nothing more than a fad. As a result, the levels of boys circumcised in Europe decreased from the early 20th century, whereas circumcision remains a common procedure in America to this day.
.
Although claims that circumcision can cure syphilis, headaches, alcoholism, etc, have been thoroughly disproven, there has recently been a resurgence in claims that the procedure has medical benefits. Many claim that men who are circumcised have a reduced risk of HIV infection. In case you missed it, that means the research focusses on female-to-male transmission only, which is often something overlooked by people promoting circumcision. Wikipedia gives an example of one such study, which showed that heterosexual, circumcised men in sub-Saharan Africa had a decreased risk of infection (between 38% and 66%) over two years. It then goes on to postulate the mechanism of action and says that circumcision removes large amounts of Langerhans cells which can be targeted by the HIV virus.
cur5After reading the research it’s quoting, I believe the Wikipedia article is missing out some very important information. The study in question gathered three large groups of men from South Africa, Uganda and Kenya, who I believed would be a mixture of circumcised and uncircumcised people. It turns out however, that the study performed 2,328 circumcisions on half of the men themselves and then immediately began the study. It doesn’t take a rocket scientist to know that if you have part of your penis cut off you are probably not going to have sex in the near future, thereby reducing the probability of catching the virus over a set time; the study never addresses this issue. It then says that out of the 2,328 performed circumcisions, there were 178 (7.6%) “adverse events”. These included erectile dysfunction, swelling or haematomas, excessive bleeding, infections, damage to the penis, problems with appearance, etc.
.
Langerhans cells are present in all layers of the epidermis but are abundant in the mouth, foreskin, and vagina. There is debate in the scientific community as to whether these cells are the primary viral entry point, as they could be a vector to the lymph nodes, but they also express a protein called Langerin, which blocks the transmission of HIV. It should be mentioned that there is a lot of other research that shows a link between circumcision and a decrease of risk of HIV transmission. There is also a large amount of research that shows no link. The truth is that at this moment, we are not 100% sure one way or the other.
 cur6
If we step back here for a moment, we see the research for what it is – nothing more than an interesting tidbit; just like the fact that my being European means that I have a 1 in 10 chance of actually being immune to the HIV virus. Even if everything in the study mentioned above was true and you had the maximum 66% decrease in risk, it is still not protection against the HIV virus! The only way to prevent the transmission of HIV through sex (and most other STDs), is to wear a condom. I would not rely on my chance of having immunity and you should not rely on your circumcision to protect you.
.
Proponents of circumcision say that having a foreskin increases your chance of getting urinary tract infections. This is simply incorrect, not supported by any evidence and even if it was the truth, urinary infections are easily curable by antibiotics. You would not preventatively remove your eye in fear of contracting pink-eye, so why would you cut off your foreskin to prevent a urinary tract infection?
cir7
Some people have brought up circumcision as being a preventative measure against the risk of penile cancers. Penile cancers are very rare – about 1 case per 100,000 per year – with the number decreasing with the introduction of the HPV vaccination. If this is seen as an acceptable preventative measure against a type of cancer with rates this low, then why are we not removing the breasts from all women? Many of you would probably say that’s because breasts have a function and the foreskin doesn’t. Well, as it happens, that is not the case.
.
Among other things, the foreskin enhances sexual pleasure, protects the glans and keeps it moist. There are between 10,000 and 20,000 nerve endings compacted onto the human foreskin, which are used in the ejaculation reflex. Medics and scientists know exactly where these nerve endings are and they know exactly what they do. If those nerve endings are missing, it will decrease sexual pleasure for the participant. Since the foreskin also protects the glans and keeps it moist, without it the glans becomes thicker through a process called keratinisation. The process desensitises the glans and again, decreases sexual pleasure. There are a lot of men who can testify to this having had a circumcision later on in life, but their evidence is often dismissed as anecdotal. It should also be noted that removal of the foreskin can leave a scar and later in life, make the penis slightly smaller or even an odd, bent shape.
cur7
A lot of people say that they have had their son circumcised because it’s more hygienic. In saying this they are referring to the build up of a substance called smegma – a mixture of dead skin, oils and moisture that can accumulate under the foreskin. Many people are unaware however, that it is also produced by female genitalia. Why is not a problem for women, I hear you ask? Well, the same reason that it’s not really a problem for men – it can simply be washed away.
.
So, to sum up, there is no real scientific or medical reason for circumcision as a preventative measure. Even the most optimistic of benefits do not outweigh the negative side effects. Circumcision is like every surgical procedure – it has a risk. On average 1 out of every 100 circumcised children in America will develop complications. The majority are non-severe, but the odd few are and can even result in death. It is estimated that 1 in every 500,000 babies circumcised in America die from this unnecessary procedure. I am aware that some of you reading this will be saying you’re circumcised and you have no problem with it. That’s fine, but the decision to be circumcised should really be yours and sadly that’s not the case for most circumcised men in America.
.
We see female genital mutilation as extremely harmful and a violation of human rights – in the UK it is a criminal offence and carries a maximum sentence of 14 years in prison. We know it’s morally wrong and without merit, yet many of us see nothing wrong with the similar (albeit less severe) male circumcision. For the second time, stand back for a moment and this time imagine a world without circumcision altogether. What do you think would happen to a person found performing a circumcision on a newborn child; a procedure that will significantly decrease his sexual pleasure as an adult, by mutilating his genitalia for questionable (and as yet, unproven) benefits?
.
About Myles Power (715 Articles)
My name is Myles Power, and I run the educational YouTube channel, powerm1985. I spend what little free time I have sharing my love of SCIENCE! through home experiments, visiting sites of scientific interest, and angrily ranting at pseudoscience proponents. I am also one of the founding members of the podcast 'The League of Nerds' - which I co-host with James from 'The History of Infection'.

10 Comments on The Science of Circumcision

  1. As an uncircumcised male, I have no problems with my penis, and the friends I have that have been circumcised either hate that it’s been done and wish it wasn’t, or it was done poorly and they still wish it wasn’t done.
    The people that I hear have had it done and are happy with it just use the same fault excuses as listed above which just show that they are either brainwashed (more like bleached), or they are just bitter and hide behind their sadness.
    Regardless, this practice needs to stop.

    Like

  2. For the most part an informative and mostly accurate thesis on male circumcision. The only part I would change though is would be referring to the United States as North America. The USA is the only North American country where the majority of men are cut.

    Like

  3. Drunken Hobo // March 31, 2013 at 8:46 pm // Reply

    Did you write this article to help prove to the truthers that you’re really actually not Jewish?

    I wonder if the lower incidence of HIV in circumcised males is partly due to them being more cautious? If you’re willing to have part of your penis cut off in order to prevent infection, then you’re likely to take the issue more seriously and perhaps take other precautions. Those that don’t bother might be more careless with contraception or choice of sexual partner.
    (I’m sure there’s a name for that type of statistical bias but it eludes me).

    Of course it could also work the other way; some people who are circumcised might see it as a mark of invincibility and be even more careless!

    Like

  4. Hey! Read through this and i agree with alot of stuff you wrote. As a cut male by religious(i guess?) means i dont hate it i just accept that its done since i can’t change it. I have asked my father why he did it and he replied to me “because everybodyw as asking when i was gonna get your circumsized”. Now i dont really care neither am i angry at him for doing it, but its a little stupid that he did it because people asked him or on religios grounds since we are not even muslim, we just lived in a muslim “country”, we dont pray or excercize any of the holidays except for Bajram ” I get money and tons of food, win!!”

    Either way i know i am not experiencing sex the way nature intended me too but there is little to do about that. Am i angry. no. Am i going to circumsize my son when he gets older? Not a chance. This is like religion(im an atheist), if you grow up in a house where you go to churc every sunday or where you are forced into another religion, then ofcourse you are going to be “bound” to it when you grow up. Circumsizion is stupid, religions is stupid, people are stupid.

    PS: I have been with quite a few girls in my time, and many of them have said that they prefer cut men, since most people here in Europe are uncut, i dont know if its bullshit but thats the way it is. Being cut is definetly cleaner and more hygenic, but it really isnt that hard to clean that area if you are uncut so yeah, i too am against circumsizion.

    Like

  5. you said that 1/500,000 dies. However, there are about 1 million circumcisions done every year in the united states, and between 100-500 children die from it per year

    Like

    • How many of those are Hemophiliacs? There are a lot of things that can complicate the procedure, not necessarily just a fuck up. I don’t like the way he criticized surgeons, like it was because they fuck up the operation.

      Like

  6. Except that promoting circumcision in Africa has nothing to do with the prevention of HIV. Sales are down in the US so those who profit from surgical circumcision kits, pharmaceuticals and circumcision devices are simply setting up shop in Africa. It is very easy to sponsor research in areas where a desired outcome is likely in order to flog your wares, based on the suggestion that there is a link between foreskin and HIV. Simply germ theory marketing to dazzle them with the “science”. Even better if you have connections in organisations and then use them to bully African countries, eager to get their hands on donor money, by making it the most prominent HIV program these organisations will sponsor. People in Africa cannot pay for it, so you get other gullible sponsors on board to pay for it.

    Read some of the original research and then the roll-out strategy documents – it is glaringly obvious that HIV prevention is not the focus, rather it is the testing and sale of circumcision devices. Then create the demand with marketing campaigns in the media that suggest “foreskin is the mark of HIV in every village” (this is an actual line from a marketing tactic described in one of these documents). Another is “bend the reed while it is young” that targets parents to circumcise their kids, even if their is no proof it protects infants in any way from HIV transmission later in life. They know men circumcised at birth are more likely to circumcise their sons. This will produce repeat customers for many generations. Consider also that neonatal foreskins are very valuable and used to make foreskin fibroblasts and extract other products like insulin, elastin, collagen etc – motivated by a multi-billion dollar industry that trades in the human body parts of those who cannot consent. Another factor to consider is that it is mostly circumcised men who promote this to others, maybe to normalize their own condition.

    This is about installing a belief system in Africa about the benefits of circumcision. Remember “Weapons of Mass Destruction”? Same style of marketing… You don’t need proof or valid scientific evidence… you just need the suggestion. This is experimentation and exploitation of people in Africa for purely for profit. They state that circumcision will protect men from female to male transmission by 60%. This is projected value for the WHOLE population based on a computer simulation, ONLY if they reach the target of 20 million men in Africa. Condom are cheaper and provide 95% protection. Condoms together with circumcision still only offers 95% protection, which makes circumcision useless as a preventative measure during safe sex. A protection factor of anything between 0 and 60% during UNSAFE sex does not sound like it will be a very effective strategy.

    If it works it will be the additional training about condom use men receive when getting circumcised that will impact HIV transmission rates. If it does not work they will simply blame poor condom use. Either way they will make a lot of money.

    Religion, culture, beliefs, preferences, hygiene and health all play a roll, but at the core it is greed, ignorance and apathy that drives the circumcision industry.

    Like

  7. May I imply jujst say what a relief to find someone who ggenuinely knows what they are talking about over the internet.
    You definitely know how to brinbg an issue to light and make it
    important. A lot more people need to read this
    and undedstand this side of your story. I was surprissd you’re not more popular since you
    definitely possess the gift.

    Like

  8. Wonderful, whhat a weblog it is! This webpage gives valuable information to us,
    keep it up.

    Like

  9. I don’t even know how I endfed up right here, however I believed
    this put up was once great. I don’t know who you are however
    definitely you are going to a well-known blogger if you
    happen to aren’t already. Cheers!

    Like

1 Trackback / Pingback

  1. The Circumcision Decision: A Tale of Two Boys | unnecessarywisdom

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s