Having a Foreskin

The Unspoken Aspects of having a Foreskin
(the tale of how a pair of lungs and a foreskin changed my life)

From Post on: http://barreloforanges.com/2012/07/17/the-unspoken-aspects-of-having-a-foreskin-a-guest-post-by-life-intact/

Maria Bangs “I asked a fellow intactivist to write a guest post on his experiences growing up in the U.S. with an attached foreskin.  He has asked to remain anonymous, but you can follow his tumblr account here: life-intact.  This is a very moving story and I invite you to read the post in its entirety; these are the sort of stories that help change our perceptions about circumcision.”

My mother gave birth to me in June–two whole months before anybody expected her to. I was the last of her children, and the only male. As a result of my early birth and undersized lungs, I clung to life in an oxygen-enriched incubator for an extended period.

Like the vast majority of other males on this planet, I came into this world with a foreskin firmly attached to my penis. In spite of my parents’ wishes to see me circumcised and part from my foreskin, the doctors determined that it would be too dangerous for me to undergo surgery in such a delicate state, given my condition. I got to keep my foreskin. In a very odd way, I was lucky.

As my life progressed, my lung capacity improved gradually throughout puberty, finally resulting in my lung capacity being within normal parameters around age 17, fortunately enough. However, even with my lung capacity at normal, I never did end up parting with my foreskin, and it wasn’t for want of my parents’ trying.

And looking back at it all, I can say that life has been interesting, growing up as a man with intact genitals in a cut culture.

I now invite you to take a categorical journey with me, starting at the beginning of my life, and progressing forward and outward.

This tale touches many interconnected aspects and parts of my life, much like the threads of a spider web. If I were to tell all of these anecdotes chronologically, it would make little organizational sense. It is too complicated to capture accurately in a sequential manner, because of the intricacies of this web.

At the center of the web is the start of my life, and while growing up I spiraled outward in time, touching each of those straight cross-threads as time moved forward. For the sake of clarity and organization, I shall start from the center, the start of my life, and raconteur outward in a straight line, covering each of these threads (aspects) in a sequential manner.

Spiritual Aspect

My parents are devout Fundamental Baptists. They both believe in God, Jesus, salvation, Heaven, Hell, and they both believe in the Old Testament covenant of circumcision. My parents initially wanted to circumcise me for a few reasons, but their religious reasons have been a recurrent reason that they repeatedly remind me of throughout my life.

I remember being taught that my foreskin was an “icky” part of my body that God commanded my mother and father to cut off, and that the only reason that they could not was because surgery was too dangerous for me. For a time I had the same attitude, however briefly, as they did.

From observation, I find that Baptists are very much for the right to religious self-determination. For this group of Christians, baptism is something that is chosen at age 18. It is something sacred that a person only ought to ever choose for oneself as a covenant with God. Religion for Baptists is something that is freely chosen, and something that should not be forced on anybody, lest it become a hollow, bitter, and outward obligation.

Under this same attitude, it is a wonder that my parents didn’t also wish for me to get circumcised by my own accord at age 18 to meet some bizarre spiritual expectation, but as I have been told repeatedly throughout my life, “the Bible says 8 days is the age to do it,” and that is what they firmly believed.

During my early teenage years, I began searching for my own answers in the Bible itself, and found comfort in the writings of the apostle Paul. It was he that pointed out that the law of Old Covenant need not be followed anymore, and that the Old Covenant had been replaced by the New Covenant. It was for this reason that modern Christians are not disallowed from things like the consumption of bacon, use of synthetic or mixed fabrics, or eating leavened bread. He also directly discounted the covenant of circumcision, stating that circumcision really made no difference in regards to the fate of the immortal soul. I, like Paul, believed that religion had more to do with what was in one’s own heart, not what was in one’s pants. I lament not being able to convince my own parents otherwise

I pointed this biblical observation out to my parents. They were unimpressed, and unphased. They saw it as a symbol of a covenant worth remembering, and were unchanged and insistent on this issue. To me, the idea of a God that commands you to cut your baby’s genitals seemed strange to me, and for them to embrace a law like circumcision and ignore others like the ones about tattoos (both of them have them) or consumption of bacon (a weekly occurrence for my parents) seemed hypocritical, or at least like they were cherry-picking what they wanted to believe and enforce.

To this day, this is something that I still argue with my parents over.

Sexual Aspect

I had discovered orgasm, ejaculation, and masturbation by accident at the age of 11 years. I was in the bathtub when it happened. I remember my mother had been telling me, rather vaguely, that I had to take extra care to wash “that icky part” when I bathed. At the same time, I was raised under the puritanical and religious attitude that touching yourself down there was bad or evil. With both of these conflicting messages, I made efforts to clean my foreskin, taking care not to touch myself too much down there, and I tried not to enjoy it, as per the instructions of my parents. I also knew that I had to pull my foreskin back to keep it clean, so I did that too. I suppose it was only a matter of time before I discovered masturbation, given the special attention I had been told to pay to my penis.

I remember my first orgasm very clearly. I had no idea what was happening. I pulled the foreskin back like I usually had, and gently cleaned it like I usually do, when suddenly, I felt a tingling sensation in my penis, my testicles, and my entire body. I started shaking, partially in pleasure, partially in shock and fright. I had no idea what was happening, and I started hyperventilating as semen left my body for the first time.

I thought for a moment that I was going to die. When the tingling ceased in my entire body, I lay back in the tub, took a moment to catch my breath, and marveled at the new thing I had just discovered. It would be a while before I would try to repeat the circumstances that lead to this marvelous sensation, but when I came around, I was hooked.

I became interested in what this was called, what exactly had happened, and being a precocious and curious young man with many friends the same age (and access to the internet), I found out everything I wanted to know about masturbation.

Being a particularly inquisitive 11-year-old, I wondered if orgasm felt the same for every guy. I wanted to know. I ended up talking to some of my friends about this. It seemed at the time that my experiences were different from theirs. Reading modern male descriptions of orgasm, it seems that my experience is still different.

When pressed for details, my friends described ejaculation as something that felt good for the penis, and pleasure that lasted for about 5 seconds after a while masturbating with lotion.

For me, this experience was (and still is) vastly different. My friends described the sensations of orgasm as something limited to the penis. For me, orgasm was something that not only felt good for my penis, but also felt good for my entire body. Orgasm for me is not some sudden surprise coming, either, but rather something I can feel coming on from the very moment I begin masturbating (or these days, making love). And even when the moment comes, orgasm for me is peak to a gradual and fulfilling crescendo of sexual pleasure, where it reaches an apex after I ride waves of pleasure up and down, and slowly wind down enjoy the aftermath of that feeling.

It is like all of the pleasure that comes from my penis when I ejaculate being multiplied by a factor of 5, and having this intense pleasure everywhere in my entire body at once for about a whole minute, leaving me writhing, and convulsing in ecstasy as I climax. It feels like my entire body is tingling—from my toes, up and down my spine, all over my back, chest, abs, and groin, and all the way to the top of my scalp, leaving my body gently convulsing (sometimes shaking) in pulsing ecstasy. (During this time, I also happen to ejaculate.) And afterward, when my penis begins to become flaccid, even the slightest touch on my penis feels really good, and takes my breath away in a really good way.

This was vastly different from what my friends described, which to me sounded like about 10 minutes of work for 5 seconds of sudden pleasure, followed by boredly staring down at the penis, quickly taking the hands away, and waiting for it to go down (because touching the glans right afterward hurts them for some reason).

I didn’t know why my experience was different. They didn’t know why. One of them wondered aloud if it had anything to do with my having a foreskin. Ironically, his random thought may have actually been right. It is only now that studies like these are being published that science is beginning to scratch the surface of how having a foreskin affects penile sensitivity, and studies like these are showing how circumcision changes the sexual experience.

My first shared sexual experience was with my college girlfriend of one year, at the time. She was shocked by how powerful my orgasm was, and I was equally shocked by how strong hers were. She didn’t really notice that I still had a foreskin until after we had sex. She was at first apprehensive about it, but later fascinated by it. She had never seen an intact penis before, and was curious about how it looked and worked. I suppose that this is an indictment of the American cutting culture, in a way.

Imagine me at the age of 21 years showing my girlfriend, a third-year nursing student of the same age, what a normal penis was like and how it worked. She had no idea otherwise. She had thought that the foreskin was like a “flap of skin,” when it in reality is much more like a pleasantly slinky sleeve that protects the penis and vagina from abnormal amounts of abrasion and friction during intercourse.

It was a week later that my girlfriend told me that she expected sex to hurt, according to what many her friends had been telling her, and was surprised that it didn’t hurt or burn for her either during or after our first sexual encounter, nor any others after that. I can’t help but wonder if the unnatural tightness of circumcised penises and the friction that it might generate for the vagina has anything to do with how common this complaint is in America, seeing how circumcised penises generally lead to dryer vaginal sex.

I can’t confirm that, but I suspect such to be the case.

Social Aspect

I am from the rural Midwest, where many men are circumcised as infants. The first time I ever saw other people my own age naked was during the after-phys-ed showers that began in the 5th grade. Due to my lung capacity, I kept up moderately well in the class itself, but would take a requisite break every now and then for my inhaler when needed.

I knew, from what my parents had been telling me, that “everybody” was circumcised, and that I would be the odd one out. I had expected the word “everybody” to be a bit of an exaggeration, but I estimate in retrospect that I was one of two, maybe three males in my entire grade (about 100 students, 50 male) to have intact genitals. In my school of about 400 students (200 of them males), I estimate that including the ESL students, there were no more than 15 male students in the entire school that had intact genitals.

Some guys would sometimes say the stereotypical things in that locker room about foreskin to tease me. None of this teasing was done very maliciously, though. Guys at that age (11 years) tease each other about everything. In the same way that someone else was teased for having red hair, or another guy about being very tall, or another about having glasses, I was teased for having a foreskin. However, this teasing did not go as stereotypically as one might expect, on account of my being a witty and quick-witted smart-alec.

For example, the guy who is now my best friend once said to me in a cajoling manner, “Elephants belong in the circus” in regards to my foreskin and penis resembling an elephant trunk. The locker room was suddenly quiet, as someone had finally made a reference to the metaphorical and proverbial elephant in the room: my penis that didn’t match up with everyone else’s. I felt a bit self-conscious with so many eyes suddenly on me.

I simply looked down at my own penis, as if in wonder, and replied with “Wow, thanks! I didn’t think it was that big,” in a feigned, misunderstood reference to penis size. My wit was greeted with uproarious laughter, and my friend blushed. There were no hard feelings about this. Other times I would cajole right back with things like “why… are you looking at my penis?” This general method of lighthearted deflection kept things friendly and non-confrontational.

A few girls at that age had once heard that I was intact, and thought foreskin sounded gross. This was only a couple of years after we had all collectively moved on from our years of “cootie” epidemics, so I did not take this personally. Beyond that, I had no problem with gals in regards to my foreskin.

My foreskin had never received much more actual acknowledgement from my peers until I was about 15 years old. Some friends and I were out exploring the woods in the countryside of Minnesota when we stopped for a bathroom break. We ended up making our group bathroom break into a peeing contest, as guys sometimes are wont to do.

From there, we ended up comparing penises. I remember that the other three guys in this group were all circumcised, and I had the only intact penis in the group.

At first they teased me about it (lightheartedly) as was par for the course up until this point. After a while, one of them said that he was kind of jealous that I had foreskin, and that he wished his parents wouldn’t have had him cut at birth.

At this point, the focus was on my foreskin and things I could do with it. I gave them all a demo of how it works and how fantastically simple it is to take care of (retract, rinse, replace in the shower, taking 5 seconds, pull back to pee, etc.). They all ended up staying at the end of this that they wished they had their foreskins back.

I have heard a few men say things like “I’m so glad my parents had me circumcised,” but to this day, I don’t know whether or not they really are, or if they are simply saying such things to preserve their egos. I can say though, from personal experience, that convincing yourself that what you are missing is not a big deal is only harder to do when you come face to face with what you’ve come to convince yourself you are better off without.

Medical Aspect

After being born, my parents wished to have me circumcised, but my small lung capacity made me a poor candidate for the surgery as it is usually performed in infancy. Infants are usually conscious and screaming during the surgery (local anesthesia seems not to be able to block the pain entirely), or they may be silent after going into a form of neurogenic shock, and the doctors determined that going through this sort of stressful event as an infant might kill me. They told my parents that their best bet would be to wait until I was older, a bit stronger, and that at such a point I would be able to receive general anesthesia if they still wished for me to be circumcised.

My parents took me in for regular check-ups (and then some) on account of my smaller-than-normal lungs. I remember that they used to ask at practically every doctor appointment about a circumcision. The doctors generally said that they would not want to do something like that, which would require general anesthesia use, so they simply didn’t do it.

The closest I have ever come to being circumcised happened when I was seven years old. A doctor told my parents that she felt confident that she could circumcise me safely under local anesthesia, as long as I did not panic or freak out.

I remember the agonizing months leading up the appointment my parents told me was coming. I couldn’t stop crying, and I was so terrified. I nearly sobbed endlessly for a whole month, weeping, crying, and begging my mother not to let this stranger cut part of my penis off.

I told her that I liked my penis the way it was. I told her that I had done a great job keeping the “icky” part clean like she had told me to. I begged her not to do it. I told her that God would still love me if I got to keep that part. After all, God loves everybody.

She would hear none of it, and the days passed agonizingly before the appointment. Nothing I ate had any taste, I felt constantly depressed, and I cried myself to sleep for night after night, haunted with the notion that I was somehow not good enough for my parents and that somebody was going to take sharp things to my private parts because of it.

I went in to that appointment. I was terrified beyond all measure. I remember being on that table, shaking as much as my body could shake. Hot tears were streaming from my eyes and onto my face. I sobbed silently as the nurses and surgical techs around me were all trying to get me to calm down while preparing me for surgery. My pants and shoes and socks were off, and they put a surgical garment over me, and pulled my penis through it. I jumped every time somebody even touched me. I had never felt so vulnerable in my entire life. As they were about to apply local anesthesia via a needle to my penis, I started hyperventilating out of sheer fear, stress, terror, and lost consciousness as a result.

After reviving me, they decided that doing surgery on me with only local anesthesia and how frightened I was would be dangerous to me. I remember thanking one of the nurses who helped me get dressed. I ended up hugging her and sobbing into her scrubs for a while out of relief as another nurse went out to fetch my parents to collect me, and to explain what had happened during pre-op preparation. In my entire life, I have never felt more relieved and safer than I had with my face buried in that nurse’s scrubs, her hand petting my hair as she hugged me back to help me calm down. They must have told my parents during that 15 minute period what had happened. I heard shouting going on. I recognized my mother’s voice shouting.

On the car ride home, I remember I was still shaking. My father seemed ashen-faced, but only my mother seemed angry. I was called many things that day by her. “Coward” was one of those things. We have never discussed what happened that day after it happened. My parents from then on at doctor appointments on would only entertain the notion of being able to circumcise me while under general anesthesia.

It is a wonder that I did not grow up with prescription-grade castration anxiety, looking back on this story.

Throughout my life, due to my undersized lungs, I would see a pulmonologist about twice a year, and had a yearly check-up with my regular doctor. I remember my parents would often ask during these appointments if the doctor thought I was healthy enough to get circumcised with general anesthesia.

This continued for years until it was found when I was 17 years that I had normal lung capacity, and would be able to likely survive general anesthesia without any debilitating or fatal respiratory complications.

During this period, I continued to take care of my foreskin while bathing. I found that merely pulling it back felt really good, and that I never forgot to do it. I don’t even think about it–I just do it. At every shower, nowadays, I still get erections from washing under it no matter how quickly I do it. It feels great to do. I suppose there is some intrinsic reward in staying clean, I guess.

I digress.

My parents finally arranged for me to see an urologist in regards to circumcision. Again. Over the years of enjoying my penis as it was, I had inwardly decided that I did not want a circumcision, but I did not really voice my thoughts about this matter. Fundamental Baptists are very strong on the concepts of parental respect and authority, and I didn’t really feel like I had much of a say in this.

I remember that appointment. The male doctor was a really funny guy. I remember sitting (fully clothed) on the examination table, fuming in silent fury about this whole situation, as my parents both explained to the doctor that they wanted to have me circumcised for health and religious reasons.

They told my life story, from everything about my early birth and lung condition, to my failed circumcision attempt at seven years, and many other things. The doctor asked a bunch of doctor-y questions: questions whose answers might suggest phimosis, previous infections, pain during erections, and the like. My parents answered many questions on my behalf, and I sat silently, listening to them bullshitting this doctor about how much I supposedly needed circumcision. My parents later left the room for the examination.

I will never forget the conversation between the doctor and me. I quietly undressed from the waist down, and he began examining my genitals. During the exam, this doctor, a younger fellow around the age of thirty-odd years of age, asked me some more questions about how my foreskin was working for me, and he finally said to me,

“Your parents have made it clear what they want to see happen, but I want to know from you what you want to happen. Do you want to get circumcised?”

“No,” I said. “Not really.” My stern countenance began to unfrown itself.

The examination continued.

“Your parents mentioned religion earlier. This is none of my business, but does your family follow Judaism?”

“No,” I said. “We’re Baptists.” The young doctor gave me a surprised look, but dropped the matter of religion.

The doctor did a few more things, checked me for hernias by having me cough, and had me pull up my pants. He thoughtfully scribbled some notes on a pad for a few moments, pulled his rolly-chair over to the examination bed, and set his clipboard aside.

The urologist put on a look of concern, and looked me in the eye. “I’ll be honest with you,” he said. “I see no medical reason to circumcise you, and the only reason I have left that I would do it for is a cosmetic reason, and it would have to be something that you wanted. Do you want to go forward with something like this?”

I shook my head. “No,” I said.

“Do you want to tell your parents that?”

I was shocked by how much this doctor seemed to understand my situation.

“No, not really.”

The doctor looked at me thoughtfully, for a moment. He suddenly dropped all his formality by saying to me,

“You know, I’ve sort of been in your shoes before, and if you don’t mind my saying, from experience, the only problem I have ever had in my entire life with having a foreskin is with other people having a problem with that, and that really seems to be the case here, between you and your parents.”

I looked at the doctor, astonished, but grateful at having found a sympathetic ally like I had at a time like this.

I told him this was the case, and that I did not want to be circumcised, no matter what.

The doctor took this all in, picked up his clipboard, and continued speaking informally, gazing at my chart. “You know, I am the only urologist in this facility, and all the urology-related matters for five counties end up at my desk.”

The doctor took a hesitant breath, and he said to me, “You know, you are legally an adult in about a month, and looking at my schedule, the earliest I would be able to fit you in is well after your birthday, at which point you would be well within your rights to refuse surgery if you wanted to. Otherwise, I could just say something to your parents about not going through with this.”

I smiled. “I would like that. Please, do that.”

He scribbled down one last note.

He said “Alright, then, sounds like a plan! I’ll go collect ‘Mom and Pop’ from the waiting room, and we’ll go ahead and tackle this head-on.”

A relief poured over me not quite unlike it had 10 years previously, at my last nervy appointment regarding the surgical modification of my penis.

My doctor brought them in. He ended up telling them, in brief, that there was absolutely nothing wrong with my penis, no signs of previous infections or injuries, and no medical reason for me to get circumcised. He mentioned that insurance would therefore not cover circumcision then, since it would be purely elective and cosmetic, that it would cost anywhere between $2,000 and $5,000, and that full functional recovery could take up to a month and a half after surgery. On top of that, he said that the earliest he could get me in for another appointment would be more than a month later. The doctor hadn’t mentioned my wishes at that point.

Based on the reaction of my parents, he wouldn’t have had to.

My mother finally spoke up. “You know, marching band is starting pretty soon, and I don’t want my son to miss out on his last year of this. We can push this off until next summer, then. It is not like he is getting any less circumcised.” My father laughed nervously, and my mother artificially laughed with him. I sat silently and smiled for entirely different reasons. My doctor, a new-found friend, maintained a stoic expression. My parents had played right into our hands without knowing it.

I ended up sending that doctor a private email of thanks afterward.

The outcome of this situation brought me the moniker I use today, which still proves to be true (“The only problem I have ever had with having a foreskin is with other people having a problem with that”), and one heck of an argument that almost broke out that next summer when the cat got out of the bag that I would be keeping my foreskin, and there legally wasn’t a darned thing my parents could do about it.

I suppose I took the coward’s way out by doing this just before a month-long trip on my behalf away from home, and counting on them to settle down about this while I was away. This merely resulted in a very uncomfortable and tense summer before college, but things worked and calmed down after they missed me more (on account of me being at college) than they wanted me to get circumcised.

I have had a few medical run-ins with my foreskin after this, but they savor of anticlimax, in comparison.

It would be a few years later that the place I was working at was offering its employees free physicals as performed by nursing students under guided instruction. I decided to go and get one, simply to support the nursing students from my college.

My examiner (an international nursing student that I know from school, conversationally) during this physical was checking me for a hernia, like they usually do, and is eye-level with my penis.

Here is what he says to me, conversationally:

“So, have you been making sure to keep your foreskin clean?”

Me: “Well, yeah. It isn’t rocket science, and only takes about 10 seconds in the shower.”

Elderly female instructor, helpfully: “Have you ever considered circumcision to keep things more hygienic down there?”

Me: “No.”

Chilean nursing student to the instructor: “Me either. Why do they do this so much in the US? I mean, you guys have more access to plumbing and soap and stuff than any other place, and it is so easy to take care of.”

The instructor frowned.

Nobody talked about the elephant in the room at that point (the fact that both of us had foreskins and thought circumcision was dumb), and the instructor regarded the both of us with a troubled look.

Restoration Aspect

When I was 16 years old, my best friend once missed phys-ed. This happening was something completely unheard of. Nobody missed phys-ed. Even I with my health problems did not miss phys-ed. Missing phys-ed meant you were either out of town or had a note from a doctor. My friend was still at school but he was not in phys-ed. Naturally, I put two and two together and became concerned for his well being.

I asked if he was OK. He looked pale, exhausted, and at the verge of tears.

He told me to wait until after school that day, and then he would tell me.

I waited.

He told me.

He was in the ER the night before, on account of his penis ripping open and bleeding during a nocturnal erection. My best friend from high school had to go to the ER in the middle of the night because his penis flesh literally ripped open. The doctors determined that the circumcising doctor 16 years previously took so much skin from my friend’s penis that he had too little left to accommodate his erections.

The ER doctors told him there was not much they could do to prevent a repeat episode of this from happening again without more surgery or some sort of a skin graft.

He didn’t go with that option.

I was concerned and started doing research on this, and I found manual methods of foreskin restoration. Not using the term “foreskin restoration,” because I was unsure of how my friend would react to it, I told him that I had been reading about men using tension and stretches to grow more skin on their penis to make more skin slack. I told him about how when my foreskin was a bit tighter at the opening how I had successfully and permanently stretched it wider and looser, and that it could possibly work for him (longitudinally, and not laterally as I had done). I inadvertently turned my best friend into a foreskin restorer, and he later became an intactivist with me.

He now wants to go the whole way through with it, and I am very supportive of him.

I have come to understand that there is a large movement out there of circumcised men who are going through the same process of trying to regrow their foreskins. I support the idea of being in control of one’s body, and I wish them well in this regard.

I can only imagine how empowering it must feel to do something like that. I was never circumcised, but I remember feeling so helpless on that table the first time at age 7. I wonder if circumcised men who are restoring have that same feeling of being helpless–of not being in control over their body. I wonder if that is the reason so many of them feel better when restoring is because they are taking control over something that should have been theirs to control in the first place.

I’ll have to ask my friend.

Intactivism Aspect

Since learning about my friend’s unfortunate circumcision, I began searching on the internet for things that could go wrong with circumcisions, and I was shocked, to say the least, at the sheer amount of photographic horrors, personal and traumatic stories, and deaths associated with circumcision. I felt lucky, oddly enough, for having been born prematurely with the problems I had because it spared me from an operation that could have gone very badly.

Since learning about all of these things, I have become an intactivist on principle. I really wish that all human beings on this planet, male, female, or otherwise, would be granted the basic human right to self-determination in regards to their genital configuration.

I have come to understand that the bulk of rumors and anecdotes circulating about the foreskin in the US are basically only rumors and anecdotes. Practically every supposed and culturally held belief about the foreskin being detrimental to the health is easily and quickly discredited. For example, I find it really hard to believe that circumcision is expected to reduce STI rates, when the majority of sexually active men in the US have been altered at birth, and we still have fantastically high rates of STIs in comparison to other comparable (and largely uncircumcised) nations.

I have since credited such statements to things that men and mothers say to make themselves feel better about a decision that has already been made.

I also have something of a running theory on why erectile dysfunction is so prevalent in the US. If you don’t believe that erectile dysfunction is a problem in the US, go and turn on any football game, and the commercials speak for themselves (that is, unless you feel that no man in the US consumes beer, likes scantily clad and curvy women, or uses medicine for erectile dysfunction).

I get the feeling that circumcision has a major role in erectile dysfunction being as pandemic as it is in the US. I won’t go outright and say it does cause it, but it is possible that circumcision does potentiate the condition.

In physiology, we are always taught that structure went hand-in-hand with function. In this sense, it is impossible to alter structure without altering function. Circumcision cannot be said to do nothing, and certain evidence suggests to me that it is not benign.

To demonstrate this change, it has been estimated that the glans (head) of the penis contains about 4,000 nerve endings. The female clitoris, for comparison, contains about 8,000. I have read estimates of the foreskin containing anywhere between 10,000 to 70,000 nerve endings. I believe that permanent loss of these nerve endings (and therefore, a certain degree of penile sensitivity and sensation) is a large contributing factor to ED in the US.

The most condemning evidence I have discovered since I have started pharmacy school lies in the sales data sheet for Pfizer Pharmaceuticals’ drug sildenafil (Viagra), a PE-5 inhibitor commonly prescribed for erectile dysfunction.

As of 2010, the US was the largest consumer of Viagra, in terms of millions of dollars. Internationally, the largest importer of Viagra is the country of Israel. While they account for about %30 of all Viagra sales outside the US, I think the most telling evidence is that number in conjunction with the population of Israel. The population of Israel is about 8,000,000 people, according to recent estimates. For comparison, Germany is a country of an estimated 82,000,000 people, and they only consume less than half of the Viagra that Israel does, in spite of having more than ten times the population. This is quite a disparity.

It is now at the point that Pfizer is trying to market Viagra over-the-counter to meet demands in Israel.

Now, while it is true that other conditions contribute to the prevalence of physically-based ED (conditions like diabetic neuropathy, hypertension, hypercholesterolemia), I don’t think that Israel suffers from those same sets of problems at the same rates as the US does, and the common denominator between the US and Israel (male infant genital cutting) seems to make sense. I can only speculate how altering genitals in a non-hospital setting when it is done by a Mohel and not a doctor might potentially damage the male sex organs more than a standard infant circumcision, if at all.

In a related story, as a student of medicine, I am often asked “I-have-a-friend” questions– questions by which people usually ask for advice pertaining to their own personal concerns under the guise of “having a friend who was concerned.” Thus far, I have had a few questions here and there about what to do with excess or expired medicine and what the expiration dates meant, but I was surprised by the number of young men around the age of 20 years asking me in strict confidence about erectile dysfunction.

As I am in the Midwest, circumcision rates are relatively high, and I cannot help but to speculatively connect the dots in my mind. Twenty years old. Twenty! Erectile dysfunction was never meant to be a problem of men so young! And these men never reported performance anxiety or any other likely causes of ED, but rather loss of sensation in the middle of sex, and difficulty maintaining erection during sex. This isn’t supposed to happen. Why do so many of these young men lose sensation during sex? I can only speculate, as I don’t wish to spread medical rumors.

Since taking on an intactivist mindset, I have really been surprised by what otherwise ethically typical people will do or say to justify infant genital cutting. Thus far, I have called this phenomenon “selective suspension of rationality.” I find it strange when people somehow think circumcision is more hygienic when it creates an open penis wound in the environment of the diaper. We in the US have more access to running water and soap than many other places on earth. Foreskin care is so simple, and I honestly think that the last problem we ought to have is worrying about men in the shower not touching their penises enough, either for hygiene or otherwise! But these things are swept under the rug when people elect to suspend rational thought.

Another medical myth out there is about how people seem to think that circumcision prevents HIV. There were three methodologically flawed studies done in Sub-Saharan Africa years ago that showed that after a circumcision, a man had a slightly smaller change of contracting HIV. The actual changes were from numbers around a 2.3% to 1.5% chance, which is a very unimpressive change. This chance in absolute risk is actually well within the margin for error in medical studies, but to get around this, the publishers of the studies used relative risk calculations, and called changes like these “a 60% reduction.” On top of that, the publishers of the studies failed to account for the fact that the recently circumcised men had to abstain from sexual intercourse for a long period of time, in at least one study they received free doctor-patient counseling about safe sex practices and condoms at every wound checkup visit, and that the studies were so short in length. It is a fact that therapies become statistically less effective as time goes on, and the fact that these studies were self-admittedly cut short is alarming.

Additionally, it was never assessed how these men contracted HIV. HIV is pandemic in many places in Africa. It has once been estimated that in certain hospitals in Africa, one has a 1/12 chance of contracting HIV in a hospital from treatment rendered therein simply due to unsafe medical practices.

On top of that all, circumcision is not at all like a vaccine like some would have you believe. Most vaccines can prevent disease with about 99% effectiveness. Circumcision can boast no such number. Circumcised men get STIs every year, just like intact men do. Calling a circumcision a vaccine, to me, seems like an insult to the nature of vaccines, basic principles of healthcare, and an insult to the forerunners of the vaccine like Louis Pasteur.

One other thing that many health professionals will not admit is that it makes no sense to circumcise infants in the US based on the Sub-Saharan HIV studies. The immediate ethical problems with this are that consenting adult men chose to undergo surgery in Africa, and infants are not afforded that choice. Furthermore, I don’t expect infants to be having much intercourse, so circumcision for this reason makes no sense. Additionally, it makes no sense to do this in the US because the HIV rates between the US and Africa are so vastly different.

This light bulb went off this last semester for me when I was taking Biostatistics. We were reading about a sample case-study where prophylactic use of surgical face-masks was used to combat an epidemic of viral influenza. We were reading that the practice did very little to slow the infection rate of viral influenza. Oddly enough, we were asked “should the statistics generated from this data be used to influence health practices in the US?”

The answer key read “no.” The explanation read that “influenza rates are not comparable to the rates in the US.” When base populations are not comparable, one does not extrapolate assumptions from one to the other.

And finally, I ask the rhetorical question: if your baby girl had some sort of an infection (like a UTI), would you give her antibiotics? If so, what would you do if your baby boy had that same UTI? Would you give him antibiotics, or pay someone to partially amputate his genitals? Don’t our baby boys deserve the same tender loving care as our baby girls?

Conclusions:

It seems strange to me how far-reaching this one aspect of my life has been. Having a foreskin and being an intactivist is not something I do to prove some sort of point. It is something I do out of love for mankind.

I want to be able to contribute to the prevention of unnecessary harm being done to human beings on a daily basis.

I understand that there are many people out there who are ignorant to the damages of circumcision, and naively cling to the medical myths about the “benefits” of such an operation. Some people do so to spare their egos. Some do so for more sinister reasons.

But ultimately, I think the best thing for many intactivists out there to understand is that these people are generally not malicious, but rather misguided. Such people have been raised to believe that circumcision is somehow a good thing, and they are victims to outdated cultural beliefs.

Circumcising parents are usually people who deeply love their children, but honestly don’t know any better. I know and have experienced firsthand the anger surrounding this situation (when somebody feels it is their right to alter your body, and tell you it isn’t a big deal), and all the incredulity and injustice associated with it. I understand that there are very many out there that have been personally hurt by genital cutting, but I have seen and still observe regularly that speaking out of anger does not do much to convince people about the harms thereof.

I have been that angry intactivist, and I know that this doesn’t work. I have learned that speaking out of love and concern, compassion and caring, can do so much more than pointed conflict.

The world is changing more and more in regards to genital cutting.

I can only hope that at the end of the day, common sense wins out over selective suspension of reason.

Having intact genitals is a basic human right, for men and women alike (and everything in between). I can only hope that someday, people in my country will come to recognize this truth on a larger basis. I get the feeling, though, (and certainly hope) that this day isn’t too far away.

Respectfully submitted,

life-intact   http://life-intact.tumblr.com/


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