"Foreskin is dirty!" "Foreskin increases your risk of STDs!" "Circumcision reduces the risk of penile cancer" "Foreskin makes sex more difficult!"
You probably have heard all of these before, especially if you live in the United States. You've probably assumed there's medical data to back this up, and you may even have believed (or still believe) these claims. These claims were first introduced in the Anglophone countries by a man named Johnathan Hutchinson, who promoted circumcision as a method of reducing masturbation and of preventing syphilis. His basis for these claims? A unscientific survey of some Jewish men that he conducted in the 1890s. There have been various attempts to substantiate these claims since, but there have been none that conclusively have shown any measurable benefit of circumcision.
A Cure For Paralysis?
On February 9, 1870, Dr. Lewis A. Sayre was summoned by a colleague to attempt to remedy paralysis of the legs in a five year old child. While attempting to test the boy's reflexes, the boys nurse exclaimed "Oh, doctor! be very careful - don't touch his pee-pee - it's very sore." and an examination of the penis showed that it was normal except that ""the glans was very small and pointed, tightly imprisoned in the contracted foreskin." This was determined by Dr. Sayer to be the likely cause of the child's paralysis, and rerecorded circumcision. Coincidentally the boy's condition seemed to improve after the procedure. Dr. Sayre wrote about it and carried out the procedure on other boys suffering from paralysis. When a man of Sayre's professional standing insisted that serious orthopedic diseases could be cured by means of a simple circumcision, the medical world listened. This is quite arguably the start of the hysteria surrounding circumcision in the United States.
Breakfast Cereal
Dr. John Harvey Kellogg recommended circumcision of boys caught masturbating in book Plain Facts for Young and Old:
A remedy for masturbation which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering anaesthetic, as the pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment." But he was opposed to routine circumcision of infants: "It is doubtful, however, whether as much harm as good does not result from circumcision, since it has been shown by extensive observation among the Jews that very great contraction of the meatus, or external orifice of the urethra, is exceedingly common among them, being undoubtedly the result of the prolonged irritation and subsequent cicatricial contraction resulting from circumcision in infancy.
If his name rings a bell, its probably because you have Kelloggs cereal in your pantry, and yes its the same Kellogg. He also developed cold cereal to discourage masturbation. And since medicine at the time had more in common with Humorism than modern medicine, any expulsion of bodily fluids in an unnatural way (masturbation to ejaculation included) was thought to cause all kinds of maladies. As late as 1936, circumcision of both males and females was still advocated in pediatric medical textbooks as a way to prevent masturbation. Masturbation frightened parents because doctors said it explained why so many young people were neurotic, disobedient, disrespectful of parental authority, and oversexed.
Class Divisions
In Victorian society, it became the de-facto norm to circumcise male infants, and even some female infants, although the practice of female circumcision was never as prominent as male circumcision. This began circumcision as a status symbol. The rich circumcised their boys, and the poor did not. As health insurance became more prevalent in the growing middle class, families had their sons circumcised to make them fit in with the upper class.
From Mental Illness to Cancer
As the idea that masturbation caused mental illness declined, circumcision was rationalized as a means of preventing cancer. The data used to support this argument came from a study published in 1932. Of the 830 cases of cancer of the penis that he documented in American men between 1925 and 1930, only one was in a Jewish patient, who was not circumcised. While that argument is impressive on the surface, it fails to take into account the fact that Jews represent a very small portion of the population (3% in 1930) and that penile cancer is even rarer than that. Despite its flaws, this study is still being cited today by physicians arguing on the behalf of circumcision at the American Academy of Pediatrics. There have been no further studies to make this link. What did the study determine was the carcinogen? Smegma.
Smegma
American's who have never experienced an uncircumcised penis have come to dread what they believe to be omnipresent under foreskins of all uncircumcised males: smegma. The truth is, however that smegma is relatively uncommon, especially in the developed world. As time went by, cleanliness was nonetheless added to the reasons for circumcision. No one debated a man's ability to wash the foreskin and clean off the supposedly carcinogenic smegma, but some physicians recommended universal circumcision as a way to protect certain "unclean" minorities who could not be relied on to wash their penises.
Aesthetics
By the time we get into the second half of the 20th century, circumcision was so common that many people had never seen an uncircumcised penis. Of course, the familiar becomes what is considered to look better. The argument has been made by physicians that circumcision should be done for a purely aesthetic reason. A penis without a foreskin, they said, is more pleasing to the eye, neater and less likely to produce bad odors. One physician, Willard Goodwin, wrote that "circumcision is a beautification comparable to rhinoplasty [a nose job]," and that the circumcised penis "appears in its flaccid state as an erect uncircumcised organ - a beautiful instrument of precise intent."
Popular Culture
The idea that uncircumcised penises are "gross" has been reinforced by the media, often evoked for comic effect. Unfortunately, that may be the only exposure to information about circumcision that a parent gets besides the tri-fold pamphlet at the obstetrician's office.
The Internet
While we all know the internet is full of disinformation, I believe it has been one of the larger causes of the decline in circumcision rates the United States has had over the past two decades. No longer do parents have to approach this taboo subject with a doctor who may or may not be pro-circumcision, or talk about this taboo subject with their friends to get information. A simple web search yields a wealth of information on the subject. Some of it horribly biased, of course, but there are a lot of credible sites that tell the truth that circumcision of infants is not necessary, and that it reduce sexual function in the future. While the rates are falling slowly, I anticipate the trend will snowball as a larger portion of the male population is uncircumcised in the future.
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