Male circumcision is a surgical procedure to remove the foreskin of the penis. This shaft of skin covers the head of the penis but retracts naturally during sex, or can be pulled back for cleaning. Circumcisions have been performed for years, for both cultural and other reasons. While most people know what it is, many people are vague on the finer details and the history of this simple procedure. So you may like more information on the ‘ins and outs’ of this tradition, particularly if you are new parents, or are perhaps considering an adult circumcision.Though circumcision is a common and simple procedure, it still carries risks like any surgery does, including haemorrhage, infection and pain. In very rare cases there can be rather nasty complications, like having to chop the poor fella off or death.
History of the no-foreskin fan-club
Circumcision was practiced in parts of Africa over 5,000 years ago, as part of ‘coming of age’ ceremonies. Today it is largely performed for cultural or religious reasons, such as in Jewish and Muslim faiths, but most medical practitioners don’t recommend it as a routine procedure, especially without anaesthetia.
Once upon a time, circumcision was thought to reduce masturbation as well as cancer and mental disorders – but this has all been thoroughly disproven. In Western medicine, it gained popularity during the turn of the 20th century, and was usually performed without anaesthesia. At this time, it was considered to be a sign of social status, as it indicated a baby was birthed by a doctor rather than a midwife, indicating a ‘well-to-do’ willy. These spurious claims and social conventions started to drop in popularity during the 20th century, then in 1971, the Australian Paediatric Association adopted an anti-circumcision policy after disproving many of the false medical beliefs. It is not covered by Medicare.
Penis familiaris? Getting to know the foreskin
The foreskin is also known as the prepuce. It is there to protect the penis, the same way eyelids protect your eyes. While it is thought to play a role in immunity, this role is still not well understood.
The foreskin is loose enough to allow for the expansion of the penis during erection. During this time, it is highly responsive to sexual stimulation. The natural moisture provided by the foreskin also acts a natural KY … bonus. While circumcision affects sexual function, it is not fully understood how.
When boys are little, the foreskin is actually still attached, so it doesn’t need any special cleaning and would hurt if retracted. By about 5 years of age, the foreskin has separated, and should be pulled back during a shower or bath to keep that area clean. Then, of course, it needs to be moved back in place to prevent irritation.
Globally, around 25% of the male population is circumcised, although it varies markedly between countries. Most men in the US are circumcised (60%), but only a small proportion of men are circumcised in many European countries (e.g. 6% in England and 2% in Scandinavia). Amongst Jews and Muslims, almost all males are circumcised.
In Australia, it is now estimated that 10–20% of the male population are circumcised in infancy. More than half (59%) of the adult men living in Australia are circumcised, as are 69% of those that were born in Australia. Circumcision is less prevalent amongst younger men (under 20 years of age), of whom 32% are circumcised.
Willy or won’t he? Why parents or men might choose to circumcise
Circumcision is no longer carried out for medical reasons, especially in Australia, largely because the benefits don’t outweigh the risks. The main health benefits of circumcision are considered to be a reduced risk of infections, such as urinary tract infections (UTIs), though it’s not recommended just to stop UTIs because we have less ‘choppy’ techniques for that now, like antibiotics.
The exception to this is the proven reduced risk of contracting HIV. Three large studies recently conducted in Africa showed that heterosexually active circumcised men were at least 50% less likely to contract HIV than their uncircumcised counterparts. This is because the foreskin of the penis contains a high concentration of cells called Langerhans’ cells. These cells help HIV enter an uninfected man’s body, and the foreskin is therefore thought to be the primary penile entry point for HIV. So in countries like Africa where HIV is a massive public health concern, circumcision is recommended. It wouldn’t be justified solely for this purpose in Australia, where there is a low prevalence of HIV.
Some other health benefits include a reduced risk of penile cancer, human papillomavirus (HPV) and other sexually transmitted infections (STIs). There is good evidence that circumcision provides some protection against genital herpes and syphilis, and reduces the risk of chancroid. However, as previously mentioned, this are either rare or can be easily treated.
Sometimes fathers will choose circumcision for a son because they themselves are circumcised, and the procedure will mean their son will look the same, or carries on a tradition. The decision to circumcise a male child is typically religious or cultural, and remains a choice for the parents of these faiths.
Adult men often choose circumcision for aesthetic reasons. There is also an argument that many women prefer the look of circumcised penises in adult men – though these studies are based on the opinions of Caucasian women, and African women, for example, seem to prefer uncircumcised penises.
Let’s get ethical
As circumcision is now considered to be optional and carries the risk of pain or disfigurement, there exists the argument that it may be in violation of a child’s human rights, as they are unable to give consent. Parents do have internationally recognised rights to make medical and religious decisions on behalf of their child, so this is a complex argument with both medical and cultural implications. In Australia, routine circumcision is opposed by professional bodies, but their guidelines still include provisions for circumcision, under anaesthesia with parental consent.
For more information on issues relating to this procedure, see Making a Decision on Circumcision.