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 (723 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. Heya i’m for the primary time here. I found this board and I in finding It really useful
    & it helped me out much. I’m hoping to offer something again and aid others like you aided me.

    Like

  2. You should also keep in mind that a plant will have different branching
    structures throughout its growth. Had you always been thinking to upgrade the pavers of the patio.
    Consequently, individuals have two choices: They can bite the bullet and
    pay whatever it takes to get their front yard up to snuff, or they can see if they can do some or all of the work themselves.

    Like

  3. After turning off power to the room, unscrew the
    unit and detach the wires from it. The inertia in its government machinery will make it even more difficult to
    act on this issue. Normal cost is $500 for white and ivory, $575 for light gray and charcoal, and $600 for the other colors.

    How much can I expect to save in heating and or cooling costs.
    Adding ceiling fans to your home (or, replacing dated models) can do wonders for both comfort and aesthetics.

    Like

  4. My spouse and I stumbled over here different page and thought I
    might as well check things out. I like what I see so i am just following you.
    Look forward to exploring your web page for a second time.

    Like

  5. Thank you for your video:
    The Science of Circumcision

    The idea that the foreskin is too tight is actually ridiculous because the foreskin is tight by nature just like the fingernails are embedded in the finger by nature and are not meant to be retracted.

    Langerin in the foreskin is one more tool in the toolbox that prevents HIV infections

    Is it not ridiculous to try to prevent AIDS by cutting off healthy undiseased tissue when the tissue that is cut off contains substances that fight against viruses such as HIV? Keeping the foreskin and education is safer than circumcision. If a man is foolish enough not to use a condom, or if the condom breaks, he can be safer with the foreskin than without it. Heterosexual uncircumcised men who wait ten minutes and wipe with a dry cloth are safer than circumcised men.
    “If we were to express the efficacy of delayed washing in the same way that the results of PrEP trials were reported, that is as relative risk reductions, this would mean that not washing immediately, but waiting for at least 10 minutes after intercourse before washing can reduce the risk of infection by 83%. Compare this to the 44% efficacy of Truvada in the iPrEx trial, the 39 % efficacy of tenofovir gel in reducing the risk of infection in women in the Caprisa 004 trial, and the 38-66% efficacy reported for circumcision over 24 months.”
    http://dontgetstuck.wordpress.com/2012/05/09/have-we-ignored-a-very-simple-procedure-that-could-significantly-reduce-the-risk-of-sexual-transmission-of-hiv-to-men-from-women/

    The reason the foreskin provides protection is because it contains Langerin which is a barrier to HIV-infected Langerhan’s cells thus making the foreskin the body’s front line of defense against disease and infections such as HIV! De Witte wrote: “Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.”
    de Witte L, Nabatov A, Pion M, et al. (March 2007). “Langerin is a natural barrier to HIV-1 transmission by Langerhans cells”. Nature Medicine 13
    http://www.ncbi.nlm.nih.gov/pubmed/17334373
    http://www.nature.com/nm/journal/v13/n3/full/nm1541.html

    Condoms are safer and more effective at preventing STDs than circumcision. But Langerin in the foreskin is more effective than circumcision for those who do not use condoms.

    Intact men are more likely to use condoms than circumcised men!
    http://www.ncbi.nlm.nih.gov/pubmed/23514832

    If circumcision is supposed to protect newborns against urinary tract infections, why would the incidence of urinary tract infections increase at the time immediately following the circumcision of newborn baby boys in Israel?
    “There was a higher preponderance of UTI among male neonates. Its incidence peaked during the early post-circumcision period, as opposed to the age-related rise in females.”
    Dario Prais, Rachel Shoov-Furman and Jacob Amir (September, 2008) “Is ritual circumcision a risk factor for neonatal urinary tract infections?” Archives of Diseases of Children Online
    Schneider Children’s Medical Center of Israel, Israel
    http://adc.bmj.com/cgi/content/abstract/adc.2008.144063v1?rss=1

    Stupid researchers compare circumcised to “uncircumcised” males. The correct comparison is meddled versus unmeddled. If the intact male’s foreskin is left alone, then he will not have problems like circumcised males and intact males whose foreskin was forcefully retracted.

    Concerning UTIs in adulthood, “among Australian men, being circumcised, or not currently living as married, were associated with increased prevalence of urinary symptoms.”
    J Epidemiol Biostat 2001;6(2):211-8 (ISSN: 1359-5229) McCredie M; Staples M; Johnson W; English DR; Giles GG. Department of Preventive and Social Medicine, Dunedin Medical School, University of Otago, New Zealand.
    http://www.ncbi.nlm.nih.gov/pubmed/11434500

    Is female circumcision far worse than male circumcision? What is the weight of the female parts vs. the male parts that were cut off? Why doesn’t anyone research this? Until this research is conducted, it can just as easily be claimed that male genital mutilation is worse than female genital mutilation. Regardless of which is worse, one does not justify the other. Both are human rights violations!

    Like

  6. Sonny Vizzle // August 16, 2014 at 4:34 pm // Reply

    Thank you for your video:
    The Science of Circumcision

    The idea that the foreskin is too tight is actually ridiculous because the foreskin is tight by nature just like the fingernails are embedded in the finger by nature and are not meant to be retracted.

    Langerin in the foreskin is one more tool in the toolbox that prevents HIV infections

    Is it not ridiculous to try to prevent AIDS by cutting off healthy undiseased tissue when the tissue that is cut off contains substances that fight against viruses such as HIV? Keeping the foreskin and education is safer than circumcision. If a man is foolish enough not to use a condom, or if the condom breaks, he can be safer with the foreskin than without it. Heterosexual uncircumcised men who wait ten minutes and wipe with a dry cloth are safer than circumcised men.
    “If we were to express the efficacy of delayed washing in the same way that the results of PrEP trials were reported, that is as relative risk reductions, this would mean that not washing immediately, but waiting for at least 10 minutes after intercourse before washing can reduce the risk of infection by 83%. Compare this to the 44% efficacy of Truvada in the iPrEx trial, the 39 % efficacy of tenofovir gel in reducing the risk of infection in women in the Caprisa 004 trial, and the 38-66% efficacy reported for circumcision over 24 months.”
    http://dontgetstuck.wordpress.com/2012/05/09/have-we-ignored-a-very-simple-procedure-that-could-significantly-reduce-the-risk-of-sexual-transmission-of-hiv-to-men-from-women/

    The reason the foreskin provides protection is because it contains Langerin which is a barrier to HIV-infected Langerhan’s cells thus making the foreskin the body’s front line of defense against disease and infections such as HIV! De Witte wrote: “Langerin is a natural barrier to HIV-1 infection, and strategies to combat infection must enhance, preserve or, at the very least, not interfere with Langerin expression and function.”
    de Witte L, Nabatov A, Pion M, et al. (March 2007). “Langerin is a natural barrier to HIV-1 transmission by Langerhans cells”. Nature Medicine 13
    http://www.ncbi.nlm.nih.gov/pubmed/17334373
    http://www.nature.com/nm/journal/v13/n3/full/nm1541.html

    Condoms are safer and more effective at preventing STDs than circumcision. But Langerin in the foreskin is more effective than circumcision for those who do not use condoms.

    Intact men are more likely to use condoms than circumcised men!
    http://www.ncbi.nlm.nih.gov/pubmed/23514832

    If circumcision is supposed to protect newborns against urinary tract infections, why would the incidence of urinary tract infections increase at the time immediately following the circumcision of newborn baby boys in Israel?
    “There was a higher preponderance of UTI among male neonates. Its incidence peaked during the early post-circumcision period, as opposed to the age-related rise in females.”
    Dario Prais, Rachel Shoov-Furman and Jacob Amir (September, 2008) “Is ritual circumcision a risk factor for neonatal urinary tract infections?” Archives of Diseases of Children Online
    Schneider Children’s Medical Center of Israel, Israel
    http://adc.bmj.com/cgi/content/abstract/adc.2008.144063v1?rss=1

    Stupid researchers compare circumcised to “uncircumcised” males. The correct comparison is meddled versus unmeddled. If the intact male’s foreskin is left alone, then he will not have problems like circumcised males and intact males whose foreskin was forcefully retracted.

    Concerning UTIs in adulthood, “among Australian men, being circumcised, or not currently living as married, were associated with increased prevalence of urinary symptoms.”
    J Epidemiol Biostat 2001;6(2):211-8 (ISSN: 1359-5229) McCredie M; Staples M; Johnson W; English DR; Giles GG. Department of Preventive and Social Medicine, Dunedin Medical School, University of Otago, New Zealand.
    http://www.ncbi.nlm.nih.gov/pubmed/11434500

    Is female circumcision far worse than male circumcision? What is the weight of the female parts vs. the male parts that were cut off? Why doesn’t anyone research this? Until this research is conducted, it can just as easily be claimed that male genital mutilation is worse than female genital mutilation. Regardless of which is worse, one does not justify the other. Both are human rights violations!

    Like

  7. First off I want to say fantastic blog! I had a quick question that I’d like to ask if you do not mind.

    I was curious to know how you center yourself and clear your mind before writing.
    I have had difficulty clearing my thoughts in getting my thoughts out there.
    I do take pleasure in writing but it just seems like the first 10 to 15 minutes
    are usually lost simply just trying to figure
    out how to begin. Any recommendations or hints? Thanks!

    Like

  8. An intriguing discussion is definitely worth comment.
    I think that you need to publish more on this topic, it might not be a taboo subject but usually people do not talk about such issues.
    To the next! Kind regards!!

    Like

  9. Thanks for your marvelous posting! I genuinely enjoyed reading it, you
    happen to be a great author. I will make certain to bookmark your
    blog and definitely will come back sometime soon. I want to encourage one to continue your great posts,
    have a nice evening!

    massage table massage table massage table افضل شركة تنظيف بجدة
    massage table شركة نظافة مجالس بالرياض
    massage table افضل شركة تخرين عفش بالرياض
    افضل شركة نظافة بالرياض massage table افضل
    شركة كشف تسربات المياه بالرياض افضل شركة تنظيف بيارات بالرياض massage table massage table massage
    table massage table
    افضل شركة كشف تسربات المياه
    بالرياض massage table massage table
    massage table افضل شركة مكافحة الصراصير بالرياض massage table massage
    table massage table
    افضل شركة تنظيف بالدمام massage table
    massage table massage table افضل شركة مكافحة
    حشرات بالرياض massage table massage table افضل شركة تنظيف بالرياض
    massage table massage table massage table massage table
    massage table massage table massage
    table massage table
    massage table افضل شركة مكافحة الصراصير بالرياض massage table افضل
    شركة تنظيف بيارات بالرياض افضل شركة مكافحة حشرات بالدمام افضل شركة تنظيف بيارات بالرياض massage table massage
    table
    افضل شركة تنظيف بالرياض افضل شركة رش مبيدات بالرياض massage table افضل شركة مكافحة
    حشرات بالدمام massage table massage table massage table massage table
    افضل شركة تنظيف بالرياض massage table massage
    table افضل شركة تنظيف بيوت بالرياض massage table massage table {افضل شركة تنظيف بالدمام massage table

    Like

  10. Nice blog here! Also your web site a lot up very fast! What host
    are you using? Can I am getting your affiliate link to your
    host? I desire my website loaded up as fast as yours
    lol

    Like

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