THE CIRCUMCISION NEWS LIBRARY
From COLUMBUS ALIVE "Homegrown news & arts delivered fresh weekly"
August 7 - August 13, 1996 Volume 13 Number 32
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"This is my covenant which you shall keep between me and you and your children after you; Every male child among you shall be circumcised and you shall circumcise the flesh of your foreskin; and it shall be a token of the covenant between me and you."
Ritual circumcision was practiced long before God made His covenant with Abraham. In fact, humans adorned their bodies in this way before the dawn of recorded history. The surgical removal of the foreskin has taken on a new significance this century, though. Some would say the act has taken on no significance at all.
Most Americans no longer circumcise their male children as an act of faith, though more than half of the boys born in this country today are circumcised. In place of religious ritual, the reduction of male genitalia is routinely conducted for purported health reasons: health care professionals claim circumcision prevents infection of the penis, venereal disease and penile and cervical cancers. But the medical benefits promulgated by modern doctors may be as mythological as the spiritual reasons practiced by our ancestors. Of course, this can be seen as a modern religion of another sort: "We follow what the doctor says and we don't question it," said Lyle Short, a Columbus resident who has written extensively about circumcision.
Added psychologist Jim Bigelow, author of the book The Joy of Uncircumcising, "All of this hysteria about what's going to happen to your child if you let him have a foreskin is just that - it's hysteria."
Bigelow and Short are part of a decades-old movement of activists who are seeking to end routine circumcision, or at least make parents think twice before consenting to a procedure that forever affects their son's sexual anatomy. Circumcision is completely unnecessary at best, activists argue, and physically and emotionally damaging - even life-threatening - at worst. And, to underscore their contentions, as the organized movement to end infant circumcision grows, more and more adult men are seeking ways to restore their circumcised penises to the way God really intended.
Circumcision in America became routine 100 years ago as part of the "masturbation frenzy" of the sexually repressed Victorian Age. Medical and social thinkers in the 1870s through 1890s were convinced that self-gratification caused a variety of physical and mental illnesses, especially insanity. "They took from that that the way to stop masturbation was to use circumcision, which we know obviously doesn't work," Short said.
"Essentially, it was a method to take away pleasure and it does" added Gary Duncan, Cincinnati field organizer for NOHARMM, the National Organization to Halt the Abuse and Routine Mutilation of Males.
Cutting off babies' foreskins really became popular after the 1940s, as the nation's population became more urban and more children were born in hospitals. This also followed on the heels of mass circumcisions in the military during World War II. In the 50 years since, the former religious rite of passage became a routine medical procedure; at its peak, more than 90 percent of American baby boys were circumcised.
Julie Ellsworth estimates that nearly 80 percent of boys born in Ohio are still circumcised, though the national figure is closer to 50 percent. Ellsworth is the northern Ohio representative of NOCIRC, the National Organization for Circumcision Information Resource Centers, an education and advocacy group that tries to inform new parents about circumcision before they sign a consent form. "No parent really understands the risks," she said. "There are so many myths around it, it's difficult sometimes to break through."
According to Ellsworth, the American Academy of Pediatrics calculates that one in 500 circumcisions will result in possibly life-threatening complications, including hemorrhaging or infection. Compare this to older men's one in 100,000 chance of contracting penile cancer, which circumcision supposedly prevents. "Logically, why would you subject your child to something that is more likely to cause harm at the beginning of his life to prevent something he will probably never get anyway," she asked.
Another myth Ellsworth tries to counteract is that a boy's uncircumcised penis is hard to care for or becomes easily infected. This is simply untrue, she said. The proper care of an intact penis is to simply leave it alone; the constant cleaning, probing and poking is more likely to cause infection than prevent it. "If you were to do that to little girls - or to any other part of our bodies - they would get infected too," Ellsworth said.
Perhaps the biggest myth anti-circumcision advocates must overcome is that of social acceptance. Many parents base the decision to circumcise their child on peer pressure or superficially "fitting in": they want the boy's penis to look like his father's, or they don't want the boy to be different or laughed at in the locker room. Critics say these are the worst justifications for a decision to permanently alter a child's sexual anatomy.
"Parents don't worry if their son has red hair and the father has black hair, or if one wears glasses and the other doesn't," Ellsworth said. "Why would you care how a penis looks? A penis is a penis."
These arguments are often framed as a human rights issue: the circumcision debate boils down to one group of people (parents) making life-altering decisions for another group of people (babies). The male foreskin is the only body part of a child that parents have the legal right to remove when it is healthy, Bigelow said.
"Do parents have the right to surgically alter their child's body when the body part in question is healthy and is functioning," he asked. "Why should you assume that a natural part of the body probably should be cut off? Shouldn't that be the right of the individual to decide?"
None of the activists accused the medical profession of being disingenuous in its traditional support for circumcision. After all, doctors once really believed that masturbation caused insanity. But medical practice has been slow to change in light of evolving knowledge on this subject. Bigelow draws parallels with another popular preventative surgery: the tonsillectomy craze of 40 years ago. Children's tonsils were thought to be unnecessary and were frequently removed for protection from sore throats, he said; but doctors now know that the tonsils are a functioning part of the immune system.
Similarly, conventional wisdom has held that the foreskin is useless, a nuisance, even troublesome if it causes infection or disease. But like the masturbation craze and the tonsillectomy craze before it, the foreskin craze seems not to be justified by anatomical facts. "As we're learning what the real structure of the foreskin is, medical researchers have started to document that this isn't just redundant skin," Bigelow said. "It's highly differentiated tissue that has more receptor (nerve) endings than the glans itself. Foreskin is a very important part of the male sexual anatomy."
The foreskin also protects the glans, or head of the penis. Without the covering of the foreskin, the glans becomes callous and loses its sensitivity. "These facts are disturbing to the medical profession because they've told parents for a hundred years that it didn't matter and surely their child wouldn't care one way or another," Bigelow added.
Of course, if the myths about foreskin becoming infected or causing diseases were true, one would look for such problems to be international epidemics. More than 85 percent of the men in the world are uncircumcised. "If you believed what you were told, you would expect to see large numbers of the world's male population having severe difficulties with their penises because they were unfortunate enough to be left with this troublesome foreskin," Bigelow said.
Many doctors in this country are rethinking the traditional policy about circumcision. A growing activist group, Doctors Opposing Circumcision, even contends that routine circumcision violates all seven principles of the American Medical Association's Code of Ethics in that it does harm to the patient by removing a functioning body part. "Routine infant male circumcision is not a valid surgical procedure. Doctors' licenses do not permit them to cut people unless they are performing surgery, nor may they harm their patents (sic)," Dr. George Denniston, president of DOC, wrote in a paper titled The End of Circumcision in America. "In order for a doctor who has been a victim himself to stop circumcising others he must take a courageous step."
In a 1990 article for OHIO Medicine, Columbus physician Dr. George Hughes reported the results of a survey he conducted to determine the sexual sensitivity and compatibility of circumcised and uncircumcised men. "Our survey suggests . . . that the uncircumcised male has a more favorable sexual compatibility in his marriage," Hughes concluded. "It would also appear that this information would outweigh all other arguments in favor of circumcision."
Activists do wonder if there is a financial incentive behind the continuation of circumcisions. With a price tag of $200 to $300 each, circumcisions can be an easy source of revenue for doctors and hospitals, critics contend. "It is a tremendous money-maker," Bigelow said, calling circumcision a $250 million a year industry. "Now that's a lot of money."
According to Duncan, when Britain instituted its national health system after World War II, the government stopped paying for circumcision; the practice ended in that country almost immediately. That same dramatic decrease has been observed in the few cases in this country where a health insurance company stopped paying for circumcision, he said.
Ellsworth, who reaches parents-to-be by distributing information through childbirth education groups, says that childbirth groups affiliated with hospitals won't have anything to do with NOCIRC. "You have to wonder if it's because they have an interest in promoting it," she said.
Riverside Methodist and Mount Carmel hospitals were contacted for comment on circumcision; neither hospital returned telephone calls by presstime.
A growing realization about the effects of circumcision is also spreading through the Jewish community - which has practiced circumcision as a religious custom for 4,000 years - though there is not an organized awareness campaign within mainstream Judaism. "Some of the more progressive branches or divisions in Judaism have always recognized that this is probably something we should not be doing," said Norm Cohen, director of NOCIRC of Michigan. "But because of the long-term tradition of doing it, these progressive movements have never officially come out against it."
Cohen has written an alternative bris ceremony for Jews to use as a way of welcoming the boy into the Jewish community without a circumcision. "This ceremony holds very closely to the traditional ceremony. It's really in spirit of the Covenant of Abraham," he said. "We're working within the Jewish faith and the concepts of Judaism to try to make it a little bit more humane."
Remaining uncircumcised should not compromise a boy's identity as a Jew, Cohen said: circumcision is not uniquely Jewish, nor was the custom invented by Jews. While Cohen says he can't argue with the faith involved in Jewish circumcision, he does object to the misconception that the practice is also healthy. "The only reason that a Jew should circumcise is for matters of faith. Unfortunately, many Jews also think they're getting some kind of medical benefit, which they're not," Cohen said. "If a rabbi or a mohel (a ritual circumciser) says that this has medical benefits, then it's our duty to challenge that."
Coinciding with the movement to end routine infant circumcision has been a movement among adult men to reclaim their lost foreskin. "There are a lot of dysfunctions that come from circumcisions," said Duncan, a psychotherapist who is writing a dissertation on men who have tried to restore their penises. Duncan said that common sexual problems in America, such as premature ejaculation, are almost unheard of in countries where circumcision is not practiced.
There are also more extreme examples of physical problems: bent or painful erections due to too-tight circumcisions and even botched circumcisions that result in horribly disfigured penises.
Men must also deal with psychological problems related to circumcision, such as sexual dysfunction or strained relationships with the parents who made the decision in the first place. "It does effect your sexually, so you're talking about a very important part of your life. When you find out that what was done to you was definitely not in your best interest, you begin to question the people who are supposed to care about you," said Short, whose articles for NOCIRC and other groups are based on his own experience. "It's a little like somebody saying I don't like your ears and I'm going to cut them off. It's not a parental choice issue."
Bigelow's ground-breaking book is considered the bible of penis restoration in the anti-circumcision movement. The Joy of Uncircumcising details the methods and techniques men can use to reclaim their foreskin. There are several complicated surgical techniques that involve a re- positioning of the skin along with a skin graft, he said. But most men can perform on themselves any of several non-surgical techniques to grow new foreskin.
These methods are based on the principle of tissue expansion, the latest practice in plastic surgery. "The skin is the one organ of the body that, if you put traction or tension on it, it will grow," Bigelow said from his home in California. "What you're really doing is fooling your penis into believing that it's growing to incredible lengths and must produce the extra skin necessary to cover the extra bulk of the shaft."
Men can attain these results by pulling the skin on the shaft of the penis forward, stretching the skin out, and taping it in place. Several ready-made products are also sold to assist in the various steps of this process. After applying this pressure consistently over a long period of time - as long as three to five years - the penis will produce the extra skin necessary to cover the glans. When the tape is removed this new skin becomes a new foreskin.
Like many in the anti-circumcision movement, Aaron Hoffer became involved because of a personal experience. Hoffer had himself circumcised when he was 25 years old in order to fit in and "become one of the guys." Now, in the unique position of knowing first-hand both sides of the circumcision debate, he is trying to restore his foreskin to its former state and reclaim the sexual sensitivity he lost when he was circumcised.
"I was ignorant of what I was getting rid of when I was 25," Hoffer said.
In the coming months, Hoffer plans to start a support group in Columbus for men who want to restore their penises; Columbus currently does not have an anti-circumcision advocacy or support group. Those interested in joining the support group can call Hoffer at 253-3144. Hoffer said he would like to focus on educating men about what was taken from them at birth, and help them understand what the foreskin does accomplish. "I want to reassure them that various methods will restore the penis to various extents and that is does make a difference," he said. "I know the difference."
An important aspect of any circumcision support group, and one that Hoffer plans to include, is activism against further infant circumcision. Trying to assist tomorrow's babies helps some deal with the psychological frustration of circumcision. Even amid the hopelessness some men feel that an unrecoverable part of their sexuality was taken from them at birth, there is optimism that the everyday practice some call "barbaric mutilation" can be stopped.
"It's a very complex issue and one that seems so strange to argue in the 1990s," Bigelow said. "We've walked on the moon and yet we're still performing an act that ancient man in caveman days discovered to go along with their other bodily decorations. We've wrapped it in a cloak of respectability and keep on doing it."