Foreskin, Circumcision and Sexuality
"Like being hugged by the
Venus de Milo"
The foreskin in sex
Structure of the foreskin
It has been known since antiquity that the foreskin gives pleasure,
and only forgotten in the US in the last century or so.
Central to Intactivist claims about foreskin function in sex is the
work of Taylor et
al., demonstrating that the foreskin itself is richly innervated
with Meissner corpuscles, which are sensitive to light touch. They make
the foreskin's sensitivity comparable to that of the fingertips or the
lips (but probably less than that of the tip of the tongue or the
band now has its
own website, hosted by its discoverer, Dr John Taylor.
... the type, not just the amount, of skin lost to
routine male circumcision is often overlooked. Anatomically and
physiologically, the skin of the penis is designed to activate the male
sexual reflex mechanism. To perform this interesting function it is
richly endowed with smooth muscle fibres that cause its upper, (sexual
contact) surface to 'firm up' and wrinkle - and become much more
frictional - during erection.
During vaginal intromission these conformational
changes in penile skin ensure stretching of ridged band and reflex
contraction of bulb muscles .
In short, the penile skin behaves in exactly the
same way, during erection, as scrotal skin. Almost certainly,
uniquely-structuresd penile and scrotal skin play an important role in
activating and moderating erogenous sensation and sexual reflexes for
ejacuation. As far as I know, there is no female equivalent.
In short, male circumcision completely alters the
way male sexual sensations and reflexes are generated during vaginal
- John Taylor
The role of the foreskin in intercourse
The movement of the
foreskin is unique. On the in-stroke of intercourse, considered from
the point of view of its stationary outer layer, the inner layer rolls
outward and applies itself to the vagina. The ridged band engages with
the internal ridges of the vagina. On the out-stroke, that movement
reverses. Depending on the various dimensions and techniques used,
there is considerable variation from that basic pattern and the two
sets of ridges may then rub over each other like clothes on an
old-fashioned washboard. That might be painful for women if the
foreskin were dry like the circumcised penis. Instead, the effect is
What happens with me is that during entry into the
vagina, the labia
minora (inner vaginal lips) catches the foreskin and retracts it behind
the ridge of the glans. That's where it stays until intercourse is
complete and the erection subsides. My partner tells me that this is
normal course of events if the foreskin does not retract on its' own
it becomes erect. The labia minora are so shaped as to catch under the
edge of the foreskin, which is usually partially retracted, and push it
back. The exposed glans is then exposed to the full friction of the
vaginal walls when thrusting.
This is one of the variations. The ridged band is in
intimate contact with the labia minora rather than the vaginal walls,
another kind of intimacy unavailable to the circumcised man.
Moderate stretching of the foreskin may also be
pleasurable for the man. This gives rise to the "balloon job" -
inflating the foreskin - possible only for an intact man. (Air should
not be forced down the urethra, and on no account should high-pressure
air supplies be used.)
European porn actor Mario Rossi:
Rossi: You know what? European girls know how to
suck the European c ck. They are soft and nice and gentle and they know
that. Because we're more sensitive so we need a gentle treatment.
Adair: So you're saying American girls are too
Rossi: Yeah because if you're circumcised it
means you're not as sensitive and so the girls have to be rough.
- from the film: "Georgia
Adair - Self Portrait"
April 15, 2008
Uncut is better I have proof
Uncut by birth, got cut at 18 because I was
confused that cut penises looked better.
I have tried to live without regret and I swore
when I got circumcised, I would never regret it.
I now live with that regret. I am reminded of this
regret every time I am intimate with a partner.
With my foreskin went a wonderful degree of
sensuality and sensitivity that I will never get back and never knew I
would miss until it was gone. I had a whole lot of experience with a
foreskin before I was cut and a whole lot of experience without one
after I was cut.
I am in a very good position to speak on the
subject clearly since I have experienced both sides of the issue for
long periods of time.
I want to scream when I hear parents making the
choice to mutilate their child for cleanliness, aesthetics or misplaced
notions of health. With a few necessary medical exceptions, this is
barbarity and it is mutilating your son in the most intimate of ways.
My penis was always clean, happy and wonderful.
Now part of it, a truly wonderful part of it is gone and restoration
will not bring it back.
Stop butchering your children and STOP making this
choice for them!
It should be illegal to do this to children. If
they want to do so later on their journey through this life, when they
are adults for whatever reason, religious or otherwise, let them. No
one should mutilate children at an age especially when they can not
consent to it.
RE: Uncut is better I have proof
Posted by: Dr. P. Mooney on Apr 15, 2008 8:47 AM
I totally, agree with you. I too, have been on
both sides of this issue having my "child-hood operation" at the age of
24 or 25 yrs. old. It was done for medical reasons and had nothing to
do with any of the other reasons associated with having it done. One
does lose a lot of sensitivity removing the foreskin. It offers many
functions from protection of the glans to lubrication of it. When the
glans is continually, exposed to the elements, it loses sensitivity. I
think all reasons for removing it save, medically, are not worth
mutilating a functioning piece of anatomy.
I was cut as an adult (medical error), so I know the difference. It
would be a cliché to say "day and night", so I should describe it like
this: if being intact is a
milkshake, being cut is skimmed milk; circumcision greatly reduces the
"flavor" of sex.
So you see, I can't regard circumcision as
anything but absolutely evil. As far as I am concerned, anyone who
performs a circumcision is even more depraved than someone who would
rape that same child.
-Rodrigo Girao on Huffington Post October 3, 2011
im 50 now at the age of 30 i decided to get
circumcised. since then i have no sensation whatsoever. i am numb and
there is no pleasure. i do not enjoy masterbation like before and i do
not enjoy sexual intercourse ...
from someone who knows. don't do this to your babies
- meanmachinemarine on YouTube, 2009
I was intact until I was 19, and after some bad
medical advice I was circumcised. There is no comparison in sensation -
before I had an exquisitely sensitive sexual organ. Now the sensation
is nil. I have erectile dysfunction and do not orgasm.
I wish every day I could go back and not make that mistake. It has
totally destroyed my life.
- Steve Bennett on MindofOwn, June 22, 2012
When I was younger I lived in Italy and the men I
had sex with were very vocal and ecstatic in their lovemaking, and
specifically in their orgasmic voice. Back in the USA my boyfriends did
not express sexual pleasure the same way. They would kind of grunt, set
their jaw or say, "Oh God, I'm going to cum!" but - not SING from the
centers of their souls.
I thought that it was a cultural thing, that
somehow the Italians had learned to express themselves (like some women
learn to fake noises to thrill their partner) and the American guys had
conversly learned to supress their expression of their feelings. At the
time I didn't make a connection, I thought it had to do with Italian
vs. American culture.
Then, years later, I had a British boyfriend who
was culturally much more like an American than like an Italian, but
when he came he sang and cried out - not with a feminine voice, but
with a passion that was "feminine" only in as much as - in my American
world - women have it and men don't....
At that point I was able to see that it was not
Italians vs Americans, but Intact men vs circumcised men. It was a very
Although I will never know what they were actually
feeling - how it was different - I do know that what I could see and
hear and feel as an observer there seemed to be a dramatic difference.
- S on Facebook, July 10, 2011
LILAC COLORED GLASSES
here's the best part. Okay, girls who have done it with a cut penis,
hopefully you know what I mean...you know right when the penis is going
in, there's almost like, a sharp sensation? Not, like, ouch, knife
sharp but more like...like how an orange must feel when you stick a
wooden juicer into the middle of it? Well when the penis has foreskin,
that sensation isn't there. Entry feels a lot smoother and to me that's
much more enjoyable.
know that drop of pre-ejaculate (pre cum in laymen's terms)? Well when
I was with circumcized guys that was kind of like "ew, wipe it off" but
with foreskin that drop of fluid is preserved and serves as a lubricant
for the man. Know what that means? No rawness or chafing after repeated
26-year-old from Pittsburgh living in Belgium
JOYS OF THE UNCIRCUMCISED PENIS
I have never been with anyone who was uncircumcised until I met my new
boyfriend, and it's amazing. The extra skin is like having an extra
ridge there. When I have children, I won't have the boys circumcised,
because I want their wives to be very happy. It's almost like he has a
cock ring on. You know those condoms that have the big ridges on them?
Well, that's what it's like. Besides, a dick is a dick. It just looks a
little different. And my boyfriend's is the perfect size. You usually
don't remember how big men's dick's are, but you remember the really
small ones. Girth matters and size and length matter. Basically, I have
to have a perfect dick. And now I've got the length and the girth and a
bonus I didn't even know existed.
- Heidi Mark, Playboy's
Miss July, 1995
foreskin is my go-to guy when I'm lazy during BJ or handjobs! It's the
dick that strokes itself!
on Dodson and Ross, April 8, 2010
My sons will NOT be cut! I think the increased
sexual pleasure far outweighs the rare risk of problems (which still
can be handled later in life if need be).
From the female point of view, my intact boyfriends were MUCH, MUCH,
MUCH! more sensitive during intercourse, and neither had any problems
with odor or infection. One I was with for over 10 years, so I
certainly would have known.
When I discovered my current significant other was uncircumcised, I
felt I had hit the jackpot! Women who are "afraid" of an uncircumcised
man have no idea what they are missing!
Enlightened female in the US.
-Bargain shopper on Amazon.com, June 2, 2011
I have two
sons under three. Their father is cut, but I persuaded him not to
circumcise them. A previous longtime boyfriend had been uncircumcised,
and as a woman with a narrow vaginal opening, the sex with him, which
had often been painful with others even with lubricant, was much easier
and kinder on my body. (After giving birth, this was no longer an issue
on the Chronicle
of Highr Education, June 23, 2010
who was probably done at birth, ...
and who has absolutely no idea what it's like to have a foreskin. Or
indeed any idea of what it's like from a woman's point of view to put
up with a circumcised man pounding
away for what seems like hours, getting more and more sore.
I've only got a sample of two to go by, but the experience with those
two men was fundamentally different to those where the men had all
Sunday Morning in the Independent, May 7, 2011
A love letter to your uncircumcised dick
I love your dick.
I'm using a
throwaway account even though I have a throwaway account already,
because you know about my real throwaway account, and I don't want you
to think I'm some dick-obsessed psycho. I feel like if you read this,
you'd know it was me, but you probably won't ask me, because saying,
"Hey, did you write a post on Reddit about how much you love my dick?"
is a weird thing to ask someone, so I think I'm in the clear. But
anyway, I really need to write this. So, new throwaway, here goes.
I love your dick.
I love giving you blowjobs.
I love having sex with you.
I love the way your dick looks when it's hard.
And I also love the way it looks when it's
flaccid, because guess what?
I love your foreskin.
Honestly, I do. Your dick is my favourite one I've
ever had the privilege of seeing. Not that I've seen that many dicks in
real life, but out all all the ones I've seen, I like yours the best.
I've told you that before, but you shrugged it off because that's the
kind of thing that girls say to every single boyfriend they have for
reassurance. But it is the truth.
You don't believe me because girls aren't supposed
to like uncircumcised dicks. We're supposed to be grossed out by them
and not know what to do with them and think you're some kind of
weird-dicked freak. The first time you pulled down your pants, you
probably expected me to be disappointed that you weren't cut, like
everyone else I've ever been with. You still try to cover your dick
whenever it's soft, with a blanket after sex, or your hand when you get
dressed. You think it's embarrassing because when it's flaccid, you
cant just pull your foreskin back and make it look cut.
But I love it. I love the slightly taboo nature of
your dick. I love how your foreskin is like some rare and secret
special thing that not everyone else has. It's like a gift. I love how
there's something raw about having sex with you. How even when we're
"fucking" it still feels like "making love", because it's like you're
somehow closer to me (that might be because I fucking love you, but I'm
sure your dick doesn't hurt either). I love how having sex with you
feels. So much. It literally turns me on to type this. Physically (duh)
and emotionally. You're the best sexual partner I've ever had. It's
somehow more intimate to be with you than anyone else I've ever been
One day I'm gonna just tell you to your face how
much I love your dick and how I masturbate thinking about it and how
it's literally become a fetish for me since we started dating. I tell
you everything, but goddamn, it's hard to tell someone that something
they think is weird is the biggest turn on ever for you. But I'm gonna
tell you. Hopefully you won't think I'm too crazy.
But for now, I'll just post this on reddit, and go
touch myself and think about you.
Your dick-crazed girlfriend.
- oopsiloveyourdick on reddit, April 14, 2014
The effect of
circumcision on sex
Int J Epidemiol. 2011 Jun 14.
[Epub ahead of print]
Male circumcision and sexual function in
men and women: a survey-based, cross-sectional study in Denmark.
Frisch M, Lindholm M, Grønbæk M.
One-third of the world's men are circumcised, but little is known about
possible sexual consequences of male circumcision. In Denmark (~5%
circumcised), we examined associations of male circumcision with a
range of sexual measures in both sexes.
Participants in a national health survey (n = 5552) provided
information about their own (men) or their spouse's (women)
circumcision status and details about their sex lives. Logistic
regression-derived odds ratios (ORs) measured associations of
circumcision status with sexual experiences and current difficulties
with sexual desire, sexual needs fulfilment and sexual functio
Age at first intercourse, perceived importance of a good sex life and
current sexual activity differed little between circumcised and
uncircumcised men or between women with circumcised and uncircumcised
spouses. However, circumcised men
reported more partners and were
more likely to report frequent orgasm difficulties after
adjustment for potential confounding factors [11
vs 4%, OR(adj) = 3.26; 95% confidence interval (CI)
1.42-7.47], and women with circumcised spouses more often reported incomplete sexual needs fulfilment
(38 vs 28%, OR(adj) = 2.09; 95% CI 1.05-4.16) and frequent sexual function difficulties
overall (31 vs 22%, OR(adj) = 3.26; 95% CI 1.15-9.27), notably orgasm
difficulties (19 vs 14%, OR(adj) = 2.66; 95% CI 1.07-6.66) and
vs 3%, OR(adj) = 8.45; 95% CI 3.01-23.74). Findings were
stable in several robustness analyses, including one restricted to
non-Jews and non-Moslems.
created for this site based on the above data]
Our study shows hitherto unrecognized associations
between male circumcision and sexual difficulties in
both men and women. While confirmatory findings in
other settings are warranted, notably from areas
where neonatal circumcision is more common, our
findings may inform doctors and parents of baby
boys for whom the decision of whether or not to circumcise
is not dictated by religious or cultural traditions.
Additionally, since it appears from our study
that both men and women may have fewer sexual
problems when the man is uncircumcised, and because
preputial plasties may sometimes serve as suitable
alternatives to standard circumcision, our study
may stimulate a more conservative, tissue-preserving
attitude in situations where foreskin pathology
requires surgical intervention.
This study was attacked by, predictibly,
circumcision advocates Brian Morris, Jake Waskett and Ronald Gray.
Frisch as roundly defended it, saying inter
as these critics repeatedly refer to Morris’ pro-circumcision manifesto1
as their source of knowledge, their objectivity must be questioned.
Morris et al. argue that our finding of
considerably higher rates of frequent orgasm difficulties in
(partially) circumcised than uncircumcised Danish men (11 vs 4%, OR
3.26) may not apply in countries where circumcision means complete
amputation of the foreskin. This may well be the case. If partial
amputation of the foreskin truly entails frequent orgasm difficulties
in a noticeable proportion of men (as experienced by 11% of circumcised
men in our study), comparable proportions may well be larger and
associated ORs even higher in countries where circumcised men
experience greater tissue loss due to more extensive circumcision
procedures. Obviously, more data are needed from rigorous studies using
carefully constructed questionnaires. ...
Morris et al. should be commended for their
creative attempt to dismiss the higher prevalence of frequent
dyspareunia in women with circumcised (12%) than uncircumcised (4%)
spouses (ORs between 4.17 and 9.00). They suggest that Danish women
with circumcised spouses may be so psychologically troubled by the
shape of their spouse's penis that it might result in painful
intercourse. A more plausible explanation would be that reduced penile sensitivity may raise the
need among some circumcised men for more vigorous and, to some women,
painful stimulation during intercourse in their pursuit of orgasm.
Two of the authors, Morris and Waskett, both
internationally recognized circumcision activists,6,7
forget to declare their conflicts of interest. Even in situations that
are out of context, Morris promotes himself as a neutral ‘authority on
the extensive medical benefits of this simple surgical procedure',8
whereas at the same time he argues that neonatal male circumcision 'should be made compulsory'
and that 'any parents not wanting their child circumcised really need
good talking to'.9
Like in critical letters to the editor following
other recent studies that failed to support their agenda,10–12
Morris et al. air a series of harsh criticisms against our study. As
seen, however, the points raised are not well founded. It seems that the main purpose, as with
prior letters, is to be able in future writings to refer to our study
as an 'outlier study' or one that has been 'debunked', 'rejected by
credible researchers' or 'shown wrong in subsequent proper statistical
analysis'. This in spite of the fact that our study was
carried out using conventional epidemiological and statistical methods,
underwent peer-review and was published in an international top-ranking
I would like to thank the IJE editors for
withstanding the pressure from one
particularly discourteous and bullying reviewer who went to
extremes to prevent our study from being published.
After the paper's online publication, I have received emails from
colleagues around the world who felt our contribution was useful and
potentially important. One colleague informed me that the angry reviewer was the first author of
the above letter to the editor. In an email, Morris had
called people on his mailing list to arms against our study, openly
admitting that he was the reviewer and that he had tried to get the
paper rejected. To inspire his followers, Morris had attached his two
exceedingly long and aggressive reviews of our paper (12 858 words and
5291 words, respectively), calling for critical letters in abundance to
the IJE editors. Breaking unwritten confidentiality and courtesy rules
of the peer-review process, Morris distributed his slandering criticism
of our study to people working for the same cause. Rather than
resorting to such selective distribution among friends, Morris should
make both reviews freely available on the internet by posting them in
their entirety on his pro circumcision homepage (www.circinfo.net).
Alternatively, interested readers should feel free to request them from
me at the e-mail address above. Despite poorly
founded criticisms and attempts
at obstruction our findings suggest that male circumcision may be associated with
hitherto unappreciated negative sexual consequences in a non-trivial
proportion of men and women.
It is repeatedly claimed that
"Circumcision has no effect on sexual
For example in "Babywatching",
Desmond Morris says circumcision "has no effect, one way or the other,
on the sexual performance of the adult male." Books for young people,
especially, protest too much, such as the British Family Planning
Association's "How Sex Works": "Whether you have a foreskin or not will
not affect your sexual health in the future."
This claim flies in the face of common sense. The
foreskin is ideally placed to both give and receive sexual stimulation,
and it would be extraordinary if it did not.
This study shows that the foreskin is the most
touch-sensitive part of the penis:
pressure thresholds in the adult penis
Morris L. Sorrells, James L. Snyder, Mark D. Reiss,
Christopher Eden, Marilyn F. Milos, Norma Wilcox, Robert S. Van Howe
International 99 (4), 864-869 (British Journal of Urology International,
Volume 99 Issue 4 Page 864 - April 2007)
Circumcision removes the most sensitive part of a
man's penis. Sorrells and others enlisted 159 men from the San
Francisco Bay area, 91 of them circumcised, and conducted
touch-sensitivity tests, using instruments
that press with calibrated hairs, on 11 or 17 different places on their
penises. The men could not see where they were being touched.
They found that the most sensitive part of a
circumcised penis is on the scar in the middle underneath (19). But
several places on the foreskin (3, 4, 13, 14) are more sensitive than
that. The glans (8, 9, 10 11) is the least
sensitive part of the penis, contrary to a common claim, but
where it is covered by the foreskin (8, 9,11), the glans of the intact
penis is more sensitive than the circumcised.
The experimenters took into account the men's age,
type of underwear worn, time since last ejaculation, ethnicity, country
of birth, and level of education.
This study was of course criticised because its authors
are Intactivists, but carrying out such studies take considerable
dedication, so few who conduct them can be completely without
involvement, and the data is there to be checked for accuracy. (Just
getting ethical approval is a major hurdle, even though circumcision
itself has never had ethical approval.) A critique
by Morris and Waskett
succeeded in nullifying the data by the simple expedient of removing
the measurements from the foreskin "since these are ... not present on
a circumcised penis". Well, duh. They invoke "the Bonferroni method to
correct for multiple comparisons" but that is not appropriate here.
This result has been confirmed - at least for the glans
- by Yang et al.
in Guangzhou, China, who are certainly not Intactivists - in fact their
experimental group was 96 men with "redundant prepuce", i.e. normal,
who were measured before and then at monthly intervals after
"Extraordinary claims demand extraordinary proof," but
the Sorrells study only demonstrates what should be obvious. The value
of this study is that it is much more thorough and less biased in its
design toward circumcision than the ones below. More studies are needed
to establish the link between touch-sensitivity and sexual pleasure,
but it should be obvious to most men.
One of the circumcised experimental subjects reports on the experience.
A presentation was given at the World Association of
Sexuality Congress in Sydney in April 2007, contrasting the Sorrells
study with Masters' & Johnson's. A large poster
accompanying the presentation can be downloaded (pdf, 3.2MB).
A Belgian study has two potential
flaws. It is survey-based, and the measure of sexual sensitivity is by
self-report, but it has a large number of subjects
BJU Int. 2013 Feb 4. doi:
10.1111/j.1464-410X.2012.11761.x. [Epub ahead of print]
Male circumcision decreases penile
sensitivity as measured in a large cohort.
Bronselaer GA, Schober JM, Meyer-Bahlburg
HF, T'sjoen G, Vlietinck R, Hoebeke PB.
Department of Urology, Ghent University Hospital, Ghent, Belgium.
WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The
sensitivity of the foreskin and its importance in erogenous sensitivity
is widely debated and controversial. This is part of the actual public
debate on circumcision for non-medical reason. Today some studies on
the effect of circumcision on sexual function are available. However
they vary widely in outcome. The present study shows in a large cohort
of men, based on self-assessment, that the
foreskin has erogenous sensitivity. It is shown that the foreskin is more sensitive than the
uncircumcised glans mucosa, which means that after
circumcision genital sensitivity is lost. In the debate on clitoral
surgery the proven loss of sensitivity has been the strongest argument
to change medical practice. In the present study there is strong evidence on the erogenous
sensitivity of the foreskin. This knowledge hopefully can
help doctors and patients in their decision on circumcision for
To test the hypothesis that sensitivity of the foreskin is a
substantial part of male penile sensitivity. To determine the effects
of male circumcision on penile sensitivity in a large sample.
SUBJECTS AND METHODS:
The study aimed at a sample size of >1000 men. Given the
intimate nature of the questions and the intended large sample size,
the authors decided to create an online survey. Respondents were
recruited by means of leaflets and advertising.
The analysis sample consisted of 1059 uncircumcised and 310 circumcised
men. For the glans penis, circumcised
men reported decreased sexual pleasure and lower orgasm intensity.
They also stated more effort was
required to achieve orgasm, and a higher percentage of
them experienced unusual sensations (burning, prickling, itching, or
tingling and numbness of the glans penis). For the penile shaft a
higher percentage of circumcised men described discomfort and pain,
numbness and unusual sensations. In comparison to men circumcised
before puberty, men circumcised during adolescence or later indicated
less sexual pleasure at the glans penis, and a higher percentage of
them reported discomfort or pain and unusual sensations at the penile
This study confirms the importance of the foreskin for penile
sensitivity, overall sexual satisfaction, and penile functioning.
Furthermore, this study shows that a higher percentage of circumcised
men experience discomfort or pain and unusual sensations as compared
with the uncircumcised population. Before circumcision without medical
indication, adult men, and parents considering circumcision of their
sons, should be informed of the importance of the foreskin in male
Masters and Johnson
The entire basis of the claim that
circumcision has no effect on sexuality was until recently an
"experiment" performed over 40 years ago by William H. Masters MD and
Virginia E. Johnson and reported in their 1966 best-seller, "Human
Sexual Response". Their bias toward circumcision and their ignorance of
the intact penis are manifest.
Their first picture, of the "normal" anatomy,
shows no sign of a foreskin.
FIGURE 12-1 The
penis: normal anatomy (lateral view). (p 177)
What is labelled "coronal ridge" looks more like a
circumcision scar. The corona
(glandis) is actually the high point to the left of that.
Their next picture shows the foreskin but does not
FIGURE 12-3 Male
pelvis: normal anatomy (lateral view). (p 180)
glandis is misidentified.
The next four drawings are similar to this one:
FIGURE 12-4 Male
pelvis: excitement phase. (p 182)
They look as though someone unfamiliar with the
foreskin added it to a diagram of a circumcised penis, but it is still
not identified. None of the pictures of erections show that the
foreskin can retract, or how.
Thank heaven an erection is (usually) "Reversible"!
This is actually a picture of a dissected penis
(from below) with all skin removed:
FIGURE 12-8 The
penis: erect (ventral view). (p 187)
Masters and Johnson's bias towards circumcision is
further shown by their table 2-6
Reproductive Organ Pathology in Male Study Subjects
Benign prostatic hypertophies
Unilateral testicular atrophies
Inguinal hernia (non-symptomatic)
Inguinal hernia (symptomatic)
and table 2-8
Surgical History of Male Study
Major pelivic surgery
This belies any claim to objectivity.
Their discussion of circumcision (pp 189-190)
begins with a claim that because only 16 (actually 9 according to their
own table) of the 231 men aged 21-40 were intact (compared to 26 of the
81 older men), there was "a medical trend toward urging routine
circumcision of the newborn male infant." This ignores males under 21,
and hence the most recent 21 years of medical history. They also assume
their sample of 315 volunteers (who were comfortable having sex in
front of the experimenters) was representative of the whole population
of the US, and the 35 intact ones representative of all intact men.
They continue (in prose famous for its obscurity
The phallic fallacy that the uncircumcised male
can establish ejaculatory control more effectively than his circumcised
counterpart was accepted almost universally as biologic fact by both
circumcised and uncircumcised male study subjects. [The popular press at the time was
widely claiming the reverse. Magazines like Penthouse
were suggesting that intact men with premature ejaculation might get
circumcised to prevent it.] This concept was
founded on the widespread misconception that the circumcised penile
glans is more sensitive to the exteroceptive [ie, from outside] stimuli
of coition or masturbation than is the glans protected by the residual
foreskin. [A misconception
indeed! "Residual" is a prejudiced way of saying "intact". All involved
in this fallacy seem to have been unaware that the foreskin can
retract. Masters and Johnson ignore the possiblity that the foreskin
itself is involved in sexual sensation.]
Therefore, the circumcised male has been presumed to have more
difficulty with ejaculatory control and (as many study subjects
believed) a greater tendency towards impotence.
A limited number of the male study-subject
population was exposed to a brief clinical experiment designed to disprove
scientists aim to test, not prove or disprove]
premise [If it had not yet
been disproved, how did they know it was false?]
of excessive sensitivity of the circumcised glans. The 35 uncircumcised
males were matched at random with circumcised study subjects of similar
ages. Routine neurologic
testing for both exteroceptive and light tactile discrimination were
conducted on the ventral and dorsal surfaces of the penile body, with
particular attention directed toward the glans. [No further details are given as to
the nature of these tests and it has
proved impossible to find out. It is unclear what "particular
attention" means. It goes without saying that no attention was given to
the foreskin, nor could it be with the circumcised "male study
subjects".] No clinically significant difference
could be established between the circumcised and the uncircumcised glans during
these examinations. [Surprise!
Masters and Johnson didn't find what they weren't looking for. NB: this
testing was purely for the sense of touch. It had nothing to do with
An elaborate explanation of this "finding"
follows, based on Masters and Johnson's observation that 29 out of the
35 "uncircumcised male study subjects" had foreskins that retracted
during intercourse. They were apparently previously unaware that
foreskins usually retract.
This is linked to a later (p197) discussion of
Uncircumcised males have not been observed to
concentrate specifically on the glans area of the penis. [Of course not! They were playing
with their much more sensitive foreskins but
Masters and Johnson failed to notice that.]
Normally they follow the usual pattern of confining manipulative
activity entirely to the penile shaft [of
which the foreskin is an integral part].
Stroking techniques rarely move sufficiently distal on the shaft of the
penis to encounter more than the coronal ridge of the glans even late
in plateau phase just before ejaculation. [The
coronal ridge is quite sufficient, forming an anvil on which to rub the
Masters and Johnson conspicuously fail to notice a
common technique of intact men, of using only one or two fingers and
the thumb to move the foreskin on and off the glans - which contrasts
sharply with the furious grasping, squeezing and grinding of the shaft
and glans by circumcised men.
Masters and Johnson's only interest in the
foreskin in intercourse is whether it covers the glans:
This is obviously a different picture from that
occasioned by active intercourse. With full vaginal containment the
foreskin not tightly attached to subjacent tissue usually retracts
freely from a major portion of the glans during active male coital
thrusting before ejaculation.
On this was based the whole of the case that
"circumcision has no effect on sexual function" until further studies
with flaws of their own (see below) were used to make the same claim.
In "Dear Dr HIPPocrates", Dr Eugene Schoenfeld
elaborates it to
"As for the question of decreased sensitivity of the
glans, Masters and Johnson studied this question in their researches
into the physiology of sex. Extensive
neurological testing of such sensations as touch and pain sensitivity
failed to reveal any differences in those with and without foreskins."
In "Healthy Sex" by Miriam Stoppard (Dorling
Kindersley), the claim about a myth of greater control by intact men,
and the alleged reason for it, is paraphrased almost verbatim, without
The claim of "no effect" was quoted as recently as
February 2002 in the American
Association of Family Physicians' Policy Statement.
"What were those
In January 2001, PhD student Tina Kimmel tried to
find out just what the experiments were that have proved so influential
in maintaining the claim that "circumcision has no effect on
William H. Masters, 85, was in a nursing home in
Arizona with Parkinson's disease and had no memory of the experiments.
He died a few weeks later.
Collaborator Robert Kolodny said that he never
once heard Masters or Johnson refer to this study, but thought Masters
might have done it in collaboration with his physiologist at the time,
Dr. William Slater.
Slater died years ago.
Kolodny says most of the research notes from that
period have been discarded, because of the rising costs of storage.
He guessed that "light tactile discrimination"
meant single-point threshold sensitivity, although he had no idea what
"exteroceptive discrimination" meant.
Ms Kimmel could not reach Virginia Johnson in St.
Louis, but everyone she spoke to thought Johnson was most probably not
involved in the study at all.
(It has recently been suggested that Masters
and Johnson faked the evidence for their claim of converting
78% of willing subjects from homosexuality to heterosexuality.)
contrast is the importance Masters and Johnson attach to the role of
the clitoral hood (female prepuce) in intercourse:
traction develops on both sides of the clitoral hood of the minor labia
subsequent to penile distention of the vaginal outlet. With active
penile thrusting, the clitoral body is pulled downward toward the
pudendum [Masters and
Johnson define the "pudendum" as "the mons pubis, labia majora, labia
minora, and the vestibule of the vagina".] by
traction exerted on the wings of the clitoral hood....
When the penile
shaft is in the withdrawal phase of active coital stroking, traction on
the clitoral hood is somewhat relieved and the body and glans return to
normal pudendal-overhang positioning....
... If the
vaginal outlet is too expanded to allow strong traction on the
minor-labial hood by the thrusting penis, minimal clitoral excursion
will occur and little if any secondary stimulation will develop.
But the role
they attach to the female prepuce is still a passive one, and they do
not consider the possibility that it may be the source of erotic
sensation in its own right, either.
In "The Hite
Report" (Dell/Summit, 1977, p. 271) and "The New Hite Report", Shere
Hite grants the importance of the role of the clitoral hood, but pours
scorn on Masters and Johnson's emphasis on the role of "active penile
thrusting" calling it "a Rube Goldberg model".
In response to an enquiry about the role of the
clitoral hood, "Charlou" at RichardDawkins.net
Direct stimulation of my clitoris concentrates the
sensation too intensely for me, particularly close to and during
clitoral orgasm. Manipulation over and around the hood and labia is
both exquisitely pleasurable and extends the orgasm. Often controlling
and delaying the clitoral orgasm this way generates a deeper internal
A more recent study makes the same mistake, perhaps more
of a paper presented at a meeting of the American Urological
Association in Chicago on April 29, 2003.
EFFECTS OF CIRCUMCISION ON
Bleustein*, Haftan Eckholdt, Joseph C Arezzo, Arnold Melman, Bronx, NY
Introduction and Objective:
Controversy continues to exist about the effect of circumcision on
penile sensitivity and sexual satisfaction. This study was designed to
evaluate penile sensitivity in both circumcised and uncircumcised
males. We evaluated both large and small axon nerve fibers using
vibration, pressure, spatial perception, and warm and cold thermal
thresholds. Measurements both in functional men and men with erectile
dysfunction (ED) were obtained to evaluate for differences in penile
Methods: Seventy-nine patients were
evaluated. In the cohort evaluated, 54% (43/79) were uncircumcised,
while 46% (36/79) were circumcised. All patients completed the erectile
function domain of the International Index of Erectile Function (IIEF)
questionnaire. Patients were subsequently tested on the dorsal midline glans of the penis. In
uncircumcised males, the foreskin was retracted for testing.
the exterior of the foreskin with the glans, while
it is the interior where the ridged
band is] Vibration (Biothesiometer),
pressure (Semmes-Weinstein monofilaments), spatial perception (Tactile
Circumferential Discriminator), and warm and cold thermal thresholds
(Physitemp NTE-2) were measured. [These
tests are all tuned to the kinds of sensitivity the glans is best at.]
Bivariate relationships were assessed using chi square, t test, and
Pearson correlations. [With
such small samples, such sophisticated statistical methods are suspect.]
Composite null hypotheses were assessed with mixed models repeated
measures analysis of variance allowing us to covary for age, diabetes,
Results: Functional group t test
analysis only demonstrated a significant (p= 0.048) difference for warm
thermal thresholds with a higher threshold (worse sensation) for
uncircumcised men. However, significance was lost when we controlled
for age, hypertension, and diabetes. For the dysfunctional groups t
test analysis only demonstrated a significant (p= 0.01) difference for
vibration (biothesiometry) with a higher threshold (worse sensation)
for uncircumcised men. Again, this also lost significance (p=0.08) when
controlling for age, hypertension, and diabetes. We also found that
overall race is related to circumcision status with Caucasian men 25
times and African American men 8 times more likely to be circumcised
with such a small and non-random sample - all urology patients - it is
preposterous to generalise to the whole population. This breaks down to
actual numbers as
30 out of 34 white men (88%)
5 out of 17 black men (29%) and
1 out of 28 Hispanic men (3.6%) having been circumcised.
An enormous amount hangs on that one circumcised Hispanic man: if just
one other was circumcised, Melman et al.'s figures would fall to 12.5
times and 4 times as likely - and if he had been left intact, they
would have found Caucasians and Blacks are infinitely
more likely to circumcise than Hispanics! This is irrelevant to
sensitivity, but its innumeracy casts grave doubt on the rest of the
Conclusions: We present a comparative
analysis between uncircumcised and circumcised men using a battery of
quantitative somatosensory tests that evaluate the spectrum of small to
large axon nerve fibers. We demonstrated that there are no significant
differences in penile [glans]
sensation between [these]
circumcised and uncircumcised men with respect to vibration, spatial
perception, pressure, warm and cold thermal thresholds in both patients
with and without erectile dysfunction.
al. measured only the outside of the foreskin, and ignored
their finding that it was more sensitive to touch
Journal of Urology
Sensitivity in Neonatally Circumcised and Intact Men Using Quantitative
Jennifer A. Bossio, Caroline F. Pukall,
Stephen S. Steele
Little is known about the long-term implications
of neonatal circumcision on the penile sensitivity of adult men,
despite recent public policy endorsing the procedure in the United
States. [It did not.]
In the current study we assessed penile sensitivity in adult
men by comparing peripheral nerve function of the penis across
Materials and Methods
A total of 62 men (age 18 to 37 years, mean 24.1,
SD 5.1) completed study procedures (30 circumcised, 32 intact). [That's very few from which to generalise.
Men with sexual dysfunction were excluded
by design.] Quantitative sensory testing protocols were
used to assess touch and
pain thresholds (modified von Frey filaments) and warmth detection and
thresholds (a thermal analyzer) [What
does heat pain have to do with
sexual pleasure?] at a control site (forearm)
and 3 to 4 penile sites (glans penis, midline shaft, proximal to
[It is not
clear why two so similar sites on the shaft were
than more divergent sites, such as the 19 used by
al, including the frenulum, the ridged band and the
and foreskin, if present
[and of course
when it is not present it has no
sensitivity at all] ).
is where they measured the sensitivity of the foreskin:
would be surprising if this tested any differently from the rest of the
Penile sensitivity [at
those three points on the cut penis] did not
circumcision status for any stimulus type or penile site. The foreskin of intact men was more
sensitive to tactile stimulation than the other penile sites,
but this finding did not extend to any other stimuli (where foreskin
sensitivity was comparable to the other sites tested). [The foreskin of cut men
was completely insensitive, having been
cut off and thrown away 18-37 years ago. This self-evident observation
is the elephant in the room.]
[The full text says: "Similar to
Sorrells et al., we found
that—of all the genital sites tested—the foreskin was the most
sensitive to tactile sensation stimuli. However, given the
high prevalence of fine-touch pressure receptors (Meissner corpuscles)
in the preputial mucosa, this finding was not unexpected." They somehow
think that because it is not unexpected, it can be ignored, because
they proceed to ignore it.
They express the result in this graphic (colouring
and emphasis mine):
glosses over the fact that the cut men have no foreskin sensitivity
Findings suggest that minimal long-term
implications for penile sensitivity exist as a result of the surgical
excision of the foreskin during neonatal circumcision [If you ignore the fact that you
are significantly reducing the total innervation of the penis.]
this study challenges past research suggesting that the foreskin is the
most sensitive part of the adult penis. [?]
Future research should consider
the direct link between penile sensitivity and the perception of
pleasure/sensation. Results are relevant to policy makers, parents of
male children [but not to
adult men?] and the general public.
circumcision, male, infant, newborn, penis, sensation, sensory
not prepuce or foreskin]
J Sex Med. 2007 Apr 6; [Epub ahead of print]
Sensation and Sexual Arousal in Circumcised and
Payne K, Thaler L, Kukkonen T, Carrier S, Binik Y.
Riverside Professional Center, Ottawa, Canada
Introduction. Research, theory,
and popular belief all suggest that penile sensation is greater in the
uncircumcised as compared with the circumcised man. However, research
involving direct measurement of penile sensation has been undertaken
only in sexually functional and dysfunctional groups, and as a
correlate of sexual behavior. There are no reports of penile sensation
in sexually aroused subjects, and it is not known how arousal affects
sensation. In principle, this should be more closely related to actual
Aim. This study therefore
compared genital and nongenital sensation as a function of sexual
arousal in circumcised and uncircumcised men.
Methods. Twenty uncircumcised
men and an equal number of age-matched circumcised participants
underwent genital and nongenital sensory testing at baseline and in
response to erotic and control stimulus films. Touch and pain
thresholds were assessed on the penile shaft, the glans penis, [but not the foreskin]
and the volar surface of the forearm.
[volar = of the palm - meaning upper when the palm is up?] Sexual
arousal was assessed via thermal imaging [of
one small region] of the penis.
Results. In response to the
erotic stimulus, both groups evidenced a significant increase in penile
temperature, which correlated highly with subjective reports of sexual
arousal. Uncircumcised men had significantly lower penile temperature
than circumcised men, and evidenced a larger increase in penile
temperature with sexual arousal.
is news, suggesting the foreskin functions as a radiator - but the
surface of the one small region of the penis they measured, "just below
the glans penis, adjacent to the coronal ridge on the lateral right
surface of the penile shaft" is skin on the intact man, but may be
mucosa on the circumcised. Since they ignore the foreskin, they also
ignore the fact that the foreskin rolls back on arousal, so that mucosa
is exposed on both.]
No differences in genital sensitivity were found
between the uncircumcised and circumcised groups. Uncircumcised men
were less sensitive to touch on the forearm than circumcised men [Suggesting overall
hypersensitivity is a long-term consequence of circumcision?].
A decrease in overall touch sensitivity was observed in both groups
with exposure to the erotic film as compared with either baseline or
control stimulus film conditions. No significant effect was found for
Conclusion. These results do
not support the hypothesized penile sensory differences associated with
circumcision [so long as
you ignore the foreskin]. However, group
differences in penile temperature and sexual response were found.
PMID: 17419812 [PubMed - as supplied by publisher]
In the full text, it says :
... It is possible that the uncircumcised penis is more sensitive due
to the presence of additional sensory receptors on the prepuce and
frenulum, [Possible? It
should be blindingly obvious. The receptors a baby is born with are not
"additional"] but this cannot be compared with
the absence of such structures on the circumcised penis. [Something cannot be compared with
nothing, but that doesn't mean something doesn't exist or is
irrelevant. They could have compared the senstivitities of the prepuce
and intact frenulum with those of the glans and shaft.]
This notwithstanding, the present data do cast doubt on the notion that
the glans penis is more sensitive in the uncircumcised man due to the
protective function of the prepuce. [Doubt
perhaps, but this begs the question that glans sensitivity is all that
matters. Note also that this perfectly reasonable supposition is
demoted to a "notion".] Possible explanations
for the origin of such a belief may date back to historical traditions,
whereby circumcision was performed in order to reduce sexual
gratification , or to prevent masturbation . This may have led
to the general notion that circumcised men were somehow "less sexual"
and therefore less "sexually sensitive" than uncircumcised men. [Got that? "People got the false
idea that circumcision reduces sensitivity because they circumcised
with that purpose." Or could they possibly have done it because it
does? These pages consider other effects
of glans exposure.]
... In light of these findings, the examination of penile sensory
diffrences between uncircumcised and circumcised men warrants further
study via a replication with a larger sample size [Sorrells
et al. had this] including
the measurement of multiple sensory modalities over multiple penile
locations (comprising those believed to be directly affected by
circumcision [i.e. the
foreskin, and Sorrells et al.
22 Maimünides [sic] M. The guide for the perplexed.
Shlomo P, tr. Chicago, IL: University of Chicago Press; 1963.
23 Moscucci O. Clitoridectomy, circumcision, and the politics of sexual
pleasure. In: Miller AH, Adams JE, eds. Sexualities in Victorian
Britain. Bloomington, IN: Indiana University Press; 1996:60-78.
their absence from these citations are Sorrells
and Taylor et al.]
The authors of this study tried as hard as they
could to ignore the effect of circumcision
BJU International 103 (2009), 1096 – 1103
Self-ratings of genital anatomy, sexual
sensitivity and function in men using the
'Self-Assessment of Genital Anatomy and
Sexual Function, Male' questionnaire
Justine M. Schober, Heino F.L. Meyer-Bahlburg and
study will be hard for European and other intact men to comprehend,
without adopting the authors' apparent assumption that circumcision
is not genital surgery and has no effect on the
To assess the perceptions of healthy men of
their genital anatomy and sexual sensitivity,
along with the re-test reliability of these
ratings, in a new self-reported questionnaire,
the Self-Assessment of Genital Anatomy and
Sexual Function, Male (SAGASF-M).
Eighty-one healthy, sexually active, men
aged 22–57 years (median 33), with no
history of genital surgery, completed the
...Ranked by degree of
'sexual pleasure', the area 'underside of the
glans' was highest, followed by 'underside of
the penile shaft', 'upper side of the glans',
'left and right sides of the glans', 'one or both
sides of the penis', 'upper side of the penile
shaft', 'foreskin' (11 subjects),
the scrotum and anus', 'back side of the
scrotum', 'front side of the scrotum', and
'around anus', but not all pair differences
The SAGASF-M discriminates reasonably well
between various genital and nongenital
areas in terms of erotic sensitivity, when
administered to genitally unoperated
varying widely in age and socio-economic
SUBJECTS AND METHODS
For this methodological study we targeted
English-speaking men with no
genital surgery and with a variable
Given that this was a largely healthy sample
with no history of
genital surgery, the initial
ratings of genital anatomy, which showed
little variability, are not described here. [It
might have been interesting, with sufficient sample size, to compare
intact and circumcised men's rating of their genital anatomy.]
Note that, because there were
few (11) uncircumcised men in this sample,
'area A/foreskin' was excluded from
statistical analysis, but for comparison
purposes included in the Fig. 2B–E). Ranked
by degree of 'sexual pleasure' (Table 1), the
area 'underside of the glans' [Yes,
the frenulum, in circumcised men the last remnant of Taylor's ridged band]
followed by 'underside of the penile shaft',
'upper side of the glans', 'left and right sides
of the glans', 'one or both sides of the penis',
'upper side of the penile shaft' '(foreskin)' [apparently
they merged foreskin measurements with upper shaft measurements for no
apparent reason], 'skin between the scrotum and
side of the scrotum', 'front side of the
scrotum', and 'around anus', but not all pair
differences were significant.
Surgical modification or removal of genital
tissue, as it occurs in genital reconstruction
surgery or circumcision,
potential [just the potential?] for (objective)
variations in sensory
thresholds and might
also alter structural
integrity, meatal position, straightness during
erection, erectile capacity, and personal and
partner views of cosmesis [25–27]. In recent
years, genital surgery, especially when done
without the patient's consent as is common
in intersex children [and
very common in normal boys], has come under
criticism by patients, because of recurrent
reports of the experience after surgery of poor
cosmetic quality and/or impaired sexual
functioning in adulthood . Some intersex
activists have even called for a moratorium on
genital surgery, until more adequate followup
data are provided . ["Even"?
Is that so outlandish, just to be left alone?]
Men with a history of genital
masculinizing surgery or genital excision
surgery were excluded. Circumcision status
was documented, but this genital surgery was
not an exclusion criterion.
only time they admit that circumcision is genital surgery. If it had
been an exclusion criterion, they would only have had 11 subjects!
Intact and circumcised subjects should certainly have been treated
separately on all measures.]
... The present study provided somewhat
surprising data on orgasmic sensitivity. Both
the ventral penile shaft and the area of the
ventral glans penis were rated at an almost
equal level of orgasmic sensitivity and sexual
pleasure, significantly above the levels of all
other areas rated. This is different from what
might be expected, considering the nerve
density shown by Yucel and Baskin's example
of the fetal penis. The terminal nerves there
end in the foreskin
and dorsal glans. The
difference noted in the present study might
be a consequence of the high circumcision
rate of the respondents of the study. When
terminal nerves are excised, a dermatome [area of skin served by one
might migrate. It could also be that sexual
sensitivity ratings include a pressure-related
sensation rather than only a fine-touch or
what we need is someone to use the SAGASF-M with more sagasfity,
comparing and contrasting intact men with circumcised.]
Removal of the foreskin does affect the surface of the
glans. It becomes keratanised,
covered in a hardened coating. This shields the nerves of the glans
These two effects together combine to change the
quality, and reduce the quantity, of sensitivity of circumcised men.
The neurology has not been studied in detail, but other work suggests
that when nerves are severed in infancy they reconfigure themselves -
Fetal and infant brains exhibit an admirable
adaptability to unique developmental conditions—whether those
conditions are unique to individuals within a species (as with armless
wonders [people born without arms]) or are unique among species (as
with jerboas [long-legged jumping rats]). This adaptability is
essential given the unpredictable size and conformation of our bodies.
Predetermined brain function is neither feasible nor desired. Instead
functional organization of the nervous system reflects how it interacts
during development with its particular sensory and motor systems.
That individuals can exhibit compensatory
responses to sensory loss might be familiar even to people who have not
met an "armless wonder." Have you ever wondered whether the
extraordinary musical ability of Stevie Wonder owes anything to sensory
compensation resulting from his congenital blindness? There is now
evidence that it does. Moreover, sensory compensation is accompanied
by brain reorganization. For example, in congenially blind humans, the
part of the cerebral cortex that, in sighted people, would process
light arriving from the eyes is recruited to process tactile
information arriving from the fingers. This reorganization was
demonstrated experimentally by disrupting the functioning of the
"visual" part of the brain (by exposing it to powerful magnetic
stimulation) as blind individuals used their fingers for Braille
reading. This stimulation distorted the tactile perceptions of these
blind subjects, whereas similar manipulations of the brains of sighted
individuals disrupted vision without affecting tactile perceptions.
Thus, even after millions of years of processing visual information,
the mammalian "visual" cortex remains open to inputs from other sensory
This reorganization of the cerebral cortex also
has been observed in short-tailed opossums that were experimentally
blinded soon after birth. When their adult brains were examined,
sensory maps of the brain surface showed extensive
encroachment of the areas responding to sound and touch into areas
that, in a sighted animal, would respond only to light.
We might say that in the
absence of visual stimulation,
the visual cortex is colonized
by other sensory systems.
... For all of the reasons discussed so far, it is
clear that sensory organs on the
periphery "instruct" the developing brain to produce functional
map-like representations. But this instruction is not
mindless. On the contrary, it appears that the final organization of
the cortex reflects the structure of the peripheral organ and
the uses put to that organ early in development. ... We know from
research in human adults that experience sach as playing a stringed
instrument—can modify cortical organization. Such experience is even
more profound in early infancy, when the most fundamental relationships
between peripheral structures and the brain—and among systems within
the brain—are being established. When new sensory structures arise ...
they take advantage of the inherent plasticity of the infant brain to
make sense of the sensory information provided. One neuro-scientist
sums up these relationships in one simple sentence: "The developing
nervous system is also an evolving nervous system."
Every undergraduate, graduate, and medical student
learning about the brain must memorize the various lobes of the
cerebral cortex and their particular roles in vision, hearing, touch,
and smell. I certainly did. But such lessons in memorization are rarely
accompanied by the caveat that our current discussion demands: that
each lobe of the brain reliably can be ascribed a particular function
only because the eyes, ears, fingers, and nose reliably send their
neural connections to particular locales within the brain.
Thus, our brains are not preprogrammed
to expect the presence of any appendage, whether arms, legs [or] eyes
.... Rather, it is the reliability of sensory targeting (and
other developmental factors) that produces the illusion
of a preprogrammed brain. So, if we were to examine the brain of an
armless wonder, we would find a cerebral cortex that lacks map-like
representations of the missing arms. In their place, we would discover
enlarged representations of legs, feet, and toes. [And if we were to examine the
brain of a circumcised man, we would find a cerebral cortex that lacks
a map-like prepresentation of the missing foreskin. In its place, we
would discover an enlarged representation of the glans and frenulum.]
- "Freaks of Nature" by Mark
Oxford (2009) pp 146-7, 150-1
- so that men circumcised in infancy find pleasure in
stimulation of the glans (for which it was not designed / did not
evolve) that intact men do not. This suggests that men circumcised in
adulthood react differently from men circumcised as babies:
All of us must learn how our particular bodies
work. We are not hardwired for sex and there is no innate instruction
manual. Getting sex right, for our partners and us, entails many trials
and a lot of errors. As with any learning process, feedback is
essential. Slicing away at sexual organs to produce a cosmetic
improvement severs communication between genitals and brain, thereby
thwarting the very learning process that makes the development of
sexual behavior possible.
ibid p211 (in the context of
gender assignment surgery)
- When a man is circumcised in adulthood, his loss of
sensation has been well documented elsewhere.
It has been compared to sight without colour, hearing with
one ear or seeing with one eye.
It includes both the immediate loss of sensation from the foreskin
itself, and the progressive desensitisation of the glans as the surface
Errol Morris, the filmmaker, was born with strabismus
and subsequently lost almost all the vision in one eye, but feels he
gets along perfectly well. "I see things in 3-D," he said. "I move my
head when I need to - parallax is enough. I don't see
the world as a plane." He joked that he considered stereopsis [3D
vision] no more than a "gimmick" and found my interest in it "bizarre."
I tried to argue with him, to expatiate on the special character
and beauty of stereopsis. But one cannot convey to the stereo-blind
what stereopsis is like; the subjective quality, the quale, of stereopsis is unique and
no less remarkable than that of color. However brilliantly a person
with monocular vision may function, he or she is, in this one sense,
With prismatic spectacles and
exercises, Sue Barry recovered stereo vision after a lifetime of using
her two eyes separately:
I went back to my car and happened to glance
at the steering wheel. It had "popped out" from the dashboard. I
closed one eye, then the other, then looked with both eyes again, and
the steering wheel looked different. I decided that the light from the
setting sun was playing tricks on me and drove home. But the next day I
got up, did the eye exercises., and got into the car to drive to work.
When I looked at-the rear-view mirror, it had popped out from the
Her new vision was "absolutely delightful,"
Sue wrote. "I had no idea what I had
- Oliver Sacks, The
Immediately after circumcision, the nerves of the
glans bombard the brain with the new sense impressions they are
constantly receiving, which the brain interprets as pain. (Newly
circumcised men are advised to wear loose clothing - none if this is
practicable.) This fades over time. One reason will be that the brain
learns to disregard these signals, like any other constant sensation.
They have been called "false alarms".
- In the case of infant circumcision, the position is
rather more complicated. The boy develops his sexuality with what he
has left. We may speculate that the portion of the sensory region of
the brain that was expecting signals from the foreskin is colonised by
nerves from adjacent areas, such as the glans, with the result that the
glans of an infant-circumcised man becomes erogenous in a way that the
glans of an intact man does not. There is anecdotal evidence for this.
That explains why infant-circumcised (but not
adult-circumcised) men commonly say
"I couldn't cope with any more sensitivity than
I have now."
"If I was any more sensitive I'd have a heart attack!"
The sensitivity they have left, from their glanses, and
which intact men do not experience as pleasure, is closely allied to pain.
The quality of sensation from the foreskin is quite different, more
like tickling. This would also suggest that circumcised men have a more
hair-trigger kind of sensitivity. Having fewer nerves available to
stimulate the centres that lead to ejaculation and orgasm, the nerves
they have must work harder. Thus it could well be true that "the
circumcised male has more difficulty with ejaculatory control."
Circumcision changes not only the amount but the kind
of the glans, as well as removing all the
sensitivity of the foreskin, except the anomalous stimulation from
cut-off nerves that have formed the growths known as neuromas.
I have dealt, time and again, with talk show hosts
who say "If I had any more sensitivity, I couldn't stand it." I think
the reason for this is that, without the Meissner's
corpuscles in the ridged
band of the foreskin to provide sensory feedback, a man
doesn't know where he is in relation to the orgasmic threshold. Many
men think their inability to control orgasmic timing is due to
over-sensitivity rather than the fact the lack tens of thousands of
important nerve endings that provide essential feedback.
In fact, men who talk like those hosts
implicitly condemn circumcision for making their sensitivity too
hair-trigger. (This growing collection of anecdotes is on another
This also suggests a mechanism for what has often been
noted informally (and complained of by women), that circumcised men are
more goal-oriented about sex. Getting to orgasm is more important than
any pleasures to be had on the way. Circumcised men commonly say that
there is nothing wrong with their sexuality because "I can still
reach ejaculation and orgasm". (This growing collection of
anecdotes is on another page.)
When the ridged band is missing, the nervous connection
between stimulation and arousal is so thin (the "bandwidth" is so low,
if you like), that the level of stimulation has to be high and
uninterrupted to reach orgasm at all. Thus circumcised men can only
relax and enjoy sex when orgasm has been reached, and orgasm is
something that has to be achieved, it may not be pleasurably delayed.
(A sex manual of 1961, "The Marriage Art" by John D. Eichenlaub,
nowhere mentions the foreskin, but recommends that a woman apply ice
to her partner's perineum
for a special thrill.)
Circumcised men commonly find their frenulum (that is,
whatever remnant of their ridged
band was left on them) to be the most sensitive part of their
penis. Many sex manuals assume this is true for all men. None has
questioned why sexual sensitivity should be so concentrated.
Like Masters and
Johnson, the Laumann study "Circumcision in
the United States: prevalence, prophylactic effects, and sexual
practice" is widely misrepresented as "showing that
circumcised men enjoy more varied sexual practices and less sexual
dysfunction than intact men."
It was extracted from a much larger study that was
not designed to study circumcision. It relied on self-reporting to
determine circumcision status. Self-reporting has been shown to be
remarkably inaccurate in other studies.
In statements that have been much
more widely broadcast than the original study, Edward Laumann
himself misquoted his own study:
"We were quite surprised to see such clear
evidence, at least within the white population, that masturbation was
correlated with being circumcised as well as engaging in oral sex and anal
The reference to the white population is usually
left out. The reference to anal sex is false. This CNN report later
"Circumcised men were found to be nearly 1.4 times
more likely [as likely]
to engage in heterosexual oral sex than uncircumcised men, the study
reported. They also were more likely to have had homosexual oral sex
and heterosexual anal intercourse."
The only significant results of the study are:
Of white men (N=1067, to p<=0.05 t test), 50% of circumcised men
said they had masturbated as much as once a month or more in the last
year, vs 34% of intact men. (That figure sounds suspiciously low.)
Heterosexual oral sex
Again, only white men (84% of circumcised vs 73% of intact) said they
had ever experienced either "active" or "passive
heterosexual oral sex" and black men (N=189, 71% of circumcised vs 57%
of intact) had ever had "passive heterosexual oral sex" only - but
these terms are not defined.
Homosexual oral sex
Only Hispanics (N=90) and only "active" (10% of circumcised vs 2% of
Heterosexual anal sex
NOT AT ALL. In no group was there a significant difference.
Notice that the actual differences are quite
small, or in the case of
homosexual oral sex, the actual prevalence is small. They are quoted as
if ALL circumcised men have much more of ALL the practices than ANY
To draw any conclusions from these results,
whether "circumcision makes men enjoy sex more" or "circumcised men
desparately seek out more varied practices to make up for what they
have lost", is beside the point when the data are so weak.
Such significance as there is can readily be
explained by class-differences and more conservative attitudes towards
sex in general of classes that are less likely to circumcise.
CNN: "The study found circumcised men have a
slightly lower risk of sexual dysfunction, especially later in life."
WRONG: The study found circumcised men over 44 are
somewhat less likely to report certain kinds of sexual dysfunction, but
not others, than intact men over 44 - but that kind of result doesn't
The study asked the men if they had ever
experienced "lack of interest in sex, unable to ejaculate, ejaculated
prematurely, experienced pain during sex, did not enjoy sex, was
anxious about performance, had trouble achieving/maintaining erection".
(Some of those categories overlap: a man who experienced pain during
sex would probably not enjoy sex, for example.)
Only in men aged 45-59 (N=340) were there any
- 37% of the intact men reported premature
ejaculation, vs 25% of the circumcised men
- 22% of the intact men reported performance
anxiety, vs 13% of the circumcised men
- 29% of the intact men reported trouble
achieving or maintaining erection vs 13% of the circumcised men. Only
this measure achieved significance for men of all ages (17% of all the
intact men vs 10% of all the circumcised men).
The measure "had any dysfunction" - apparently a
summation of the others - was significant only for the 45-59 age group
(58% of the intact men vs 40% of the circumcised men).
It needs some explaining why cutting part of the
penis off could make it easier to achieve or maintain an erection, but
no explanation is forthcoming.
For the actual study, see http://www.cirp.org/library/general/laumann/
Men cut as adults:
|Zhonghua Nan Ke Xue. 2004 Jan;10(1):18-9.
function evaluation after adult circumcision
[Article in Chinese]
Shen Z, Chen S, Zhu C, Wan Q, Chen Z.
Department of Urology, First Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou, Zhejiang 310003, China.
OBJECTIVE: To evaluate the erectile function of
adults after circumcision.
METHODS: Ninty-five patients were investigated on erectile function by
questionnaire before and after circumcision, respectively.
RESULTS: Eighteen patients suffered from mild erectile dysfunction
before circumcision, and 28 suffered from mild or moderate erectile
dysfunction after circumcision(P = 0.001). Adult circumcision appeared
to have resulted in weakened erectile confidence in 33 cases (P =
0.04), difficult insertion in 41 cases (P =0.03), prolonged intercourse
in 31 cases (P = 0.04) and improved satisfaction in 34 cases (P =
CONCLUSIONS: Adult circumcision has
certain effect on erectile
function, to which more importance should be attached.
PMID: 14979200 [PubMed - in process]
is quite a small sample, and it is not clear why the men were
circumcised, but what makes it interesting is that the social climate
in China, unlike the US, would not predispose them to circumcision, nor
very much against it.]
Absence of evidence is not evidence of absence.
The effect of male circumcision on sexual
satisfaction and function, results from a randomized trial of male
circumcision for human immunodeficiency virus prevention, Rakai, Uganda
Godfrey Kigozi, Stephen Watya, Chelsea B. Polis,
Denis Buwembo, Valerian Kiggundu, Maria J. Wawer, David Serwadda, Fred
Nalugoda, Noah Kiwanuka, Melanie C. Bacon, Victor Ssempijja, Frederick
Makumbi and Ronald H. Gray
To investigate the relationship between adult male circumcision and
sexual satisfaction and function in men, as observational studies on
the effect of adult male circumcision on sexual satisfaction show
SUBJECTS AND METHODS
We investigated self-reported sexual satisfaction
and function among men enrolled in a randomized trial of male
circumcision for human immunodeficiency virus (HIV) prevention
conducted in Rakai, Uganda. In all, 4456 sexually experienced
HIV-negative males aged 15–49 years were enrolled; 2210 were randomized
to receive immediate circumcision (intervention arm) and 2246 to
circumcision delayed for 24 months (control arm). Men were followed up
at 6, 12 and 24 months, and information on sexual desire, satisfaction
and erectile dysfunction was collected. These variables were compared
between the study arms and over time within the study arms, using
chi-square or Fisher's exact tests. The trial registration number is
There were no differences between the study arms at enrolment and
problems with sexual satisfaction and function were reported by
<2% of participants in both study arms at all time points. At 6
months, no difficulty with penetration was reported by 98.6% of
circumcised men and 99.4% of controls (P = 0.02), and no pain on
intercourse was reported by 99.4% circumcised and 98.8% of
uncircumcised men (P = 0.05). There were no differences between the
study arms in penetration or dyspareunia at later visits. Sexual
satisfaction increased from 98.0% at enrolment to 99.9% at 2 years
among the controls (P < 0.001), but there was no trend in
satisfaction among circumcised men (enrolment 98.5%, 2 years 98.4%, P =
Adult male circumcision does not adversely affect sexual satisfaction
or clinically significant function in men.
"There are limitations to the present study.
Questions regarding sexual desire or
satisfaction are, of necessity, subjective and
refer to the individual's self-perception. The
questionnaire focused on difficulties with
sexual function and did not ascertain more
subjective aspects of sexual satisfaction such
as changes in time to ejaculation, subjective
intensity of orgasm or the partner's
satisfaction with intercourse . Also,
circumcision status could not be completely
concealed from the interviewers so there is a
theoretical possibility that interviewer bias
might affect participant response.
Understanding how circumcision affects
sexual pleasure is important in formulating
public health messages to promote the
acceptability of circumcision as an HIVprevention
strategy. In KwaZulu Natal, South
Africa, those men who thought that
circumcised men enjoy sex more than
uncircumcised men were seven times more
willing to be circumcised, and men
thought that women enjoy sex more with
circumcised men were over five times more
willing to have the procedure . [All the men enrolled for the
trial were willing to be circumcised, so all were predisposed to
believe that circumcision would have no ill-effects.]...
Thus, our findings that circumcision had no adverse
effects on sexual satisfaction or function are
and provide important information
for future programmes.
There were six
- desire [Laumann et al. found
12-16% of men "lacked interest in sex"]
with ejaculating (nothing about premature ejaculation)
- pain on
- "a problem
regaining erection after ejaculation" (?)
(on a 4-point scale - but they reported only two, satisfied or
not satisfied. Why did they fail to report what might have
been a salient difference?)
and the lowest
measure in anything was 98.4% Laumann
et al. found a 39-46%
incidence of sexual dysfunction in this age group in the US. (Maybe we
should all move to Uganda - it's a sexual paradise!)
It seems their
measures were too crude to measure anything. Remember, this is only a
part of their study of circumcision and HIV, and they didn't want
to find that circumcision harmed sexual satisfaction - as the word
- The subjects
were all volunteers for circumcision. Those who enjoyed having their
foreskins would be much less likely to volunteer.
subjects were all paid (substantially, by local
standards) to take part.
- The subjects
were members of another culture than the experimenters. What does that
culture say about e.g. telling people what they want to hear? (It's
pretty obvious that someone who circumcised you thinks circumcision is
a good thing.)
- What does
that culture say about sexual satisfaction and how it is measured?
- What does
that culture say about admitting to sexual failures?
null finding has been reported around the world with headlines like
"Circumcision Good For Sex" (Modern Ghana), "Circumcision Does Not
Deter Men from Enjoying Sex" (Dr Bruno's Blog) and "Study: Circumcision
Does Not Affect Sexual Satisfaction" (Fox News). Now watch these
studies of adult volunteers in Uganda being used to "prove" that
circumcising babies in the US is harmless!
More research with an agenda
J Sex Med.
2008 Nov;5(11):2610-22. Epub 2008 Aug 28
Adult male circumcision: effects on sexual
function and sexual satisfaction in Kisumu, Kenya.
Krieger JN, Mehta SD, Bailey
RC, Agot K, Ndinya-Achola JO, Parker C, Moses S.
INTRODUCTION: Male circumcision
is being promoted for HIV prevention in high-risk heterosexual
populations. However, there is a concern that circumcision may impair
AIM: To assess adult male circumcision's
effect on men's sexual function and pleasure.
METHODS: Participants in a controlled
trial of circumcision to reduce HIV incidence in Kisumu, Kenya were
uncircumcised, HIV negative, sexually active men, aged 18-24 years,
with a hemoglobin >or=9.0 mmol/L. Exclusion criteria included
foreskin covering less than half the glans, a condition that might
unduly increase surgical risks, or a medical indication for
circumcision. Participants were randomized 1:1 to either immediate
circumcision or delayed circumcision after 2 years (control group).
Detailed evaluations occurred at 1, 3, 6, 12, 18, and 24 months.
MAIN OUTCOME MEASURES: (i) Sexual
function between circumcised and uncircumcised men; and (ii) sexual
satisfaction and pleasure over time following circumcision.
RESULTS: Between February 2002 and
September 2005, 2,784 participants [men
who had all volunteered to be circumcised in the hope it would protect
them from HIV] were randomized, including the
100 excluded from this analysis because they crossed over, were not
circumcised within 30 days of randomization, did not complete baseline
interviews, or were outside the age range. For the circumcision and
control groups, respectively, rates of any reported sexual dysfunction
decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at month
24. [In other words some
other factor caused sexual dysfunction to decrease over time, vastly
more than any difference circumcision might have
over time were not associated with circumcision status.
Compared to before they were circumcised, 64.0% of circumcised men
reported their penis was "much more sensitive," and 54.5% rated their
ease of reaching orgasm as "much more" at month 24. [Yes, and what did the men who were
not circumcised report? Since
everybody's sexual dysfunction decreased dramatically over the time of
the experiment, did the non-circumcised men's sensitivity and/or ease
of reaching orgasm also increase?]
CONCLUSIONS: Adult male circumcision was
not associated with sexual dysfunction. Circumcised men reported
increased penile sensitivity [What
ever became of "If I was any more
sensitive ..."?] and enhanced ease of
reaching orgasm. [Some
call it "enhanced ease of reaching orgasm", others may call it greater
tendency to premature ejaculation.] These data
indicate that integration of male circumcision into programs to reduce
HIV risk is unlikely to adversely effect male sexual function.
paper flowing from the same study, and therefore with the same faults,
gained worldwide headlines in April 2009: Krieger, J; Mehta, S; Bailey,
R; Agot, K; Ndinya-Achola, J; Parker, C; Moses, S. Adult male
circumcision: effects on sexual function and penile coital injuries. J
Urol, suppl, 2009: 181, 4 ]
Morten Frisch writes in passing in his
rebuttal to the responses of Morris, Waskett and Gray to his studies showing circumcision impairs
... The questionnaires used to assess potential
sexual problems in the two cited randomized controlled trials in Kenya
and Uganda were not presented in detail in the original publications.4,5
Rather than blindly accepting such findings as any more trustworthy
than other findings in the literature, it should be recalled that a
strong study design, such as a randomized controlled trial, does not
offset the need for high-quality questionnaires. Having obtained the
questionnaires from the authors (RH Gray and RC Bailey, personal
communication), I am not surprised that these studies provided little
evidence of a link between circumcision and various sexual difficulties.4,5
Several questions were too vague to capture possible differences
between circumcised and not-yet circumcised participants (e.g. lack of
a clear distinction between intercourse and masturbation-related sexual
problems and no distinction between premature ejaculation and trouble
or inability to reach orgasm). Thus, non-differential misclassification
of sexual outcomes in these African trials probably favoured the null
hypothesis of no difference, whether an association was truly present
Neurologica Belgica 108: 90-93 (2008)
The effect of male circumcision on
pudendal evoked potentials and sexual satisfaction
M.G. Senol, B. Sen, K. Karademir, H. Sen, M.
Circumcision is generally considered a simple,
rapid operation with medical benefits which accrue throughout life. [The authors are in Turkey.]
The influence of circumcision on
sexual satisfaction has always
been argued. In this study, the assessment of the pudendal
evoked potentials (PEP) in adults before and at least 12 weeks after
circumcision vas done. Healthy males aged between 18-27 years, who were
willing to undergo circumcision were included in the study,
Before and after circumcision, sexual performance was evaluated with
Brief Male Sexual Function Inventory (BMSFI), consisting of sexual
erection, ejaculation, problem assessment, and overall satisfaction
sections. Forty-three adult males were enrolled in the study. Mean PEP
latency was 41.97 +/- 0.25 (39.90-44.50) ms and 44.73 +/- 0.33
(40.90-47.60) ms before and after circumcision, respectively. Mean
difference between pre- and postoperative PEP values was 2.76 ms which
statistically significant (p < 0.001). [But
significant of what? A long PEP - the time for signals to go from the
genitals to the brain - is a symptom of erectile dysfunction.]
Mean ejaculatory, latency time was
significantly longer after circumcision (p < 0.001). In the
light of our
findings, we conclude that circumcision may contribute to sexual
satisfaction by prolonging PEP latency but further studies are
also regarding the other dimensions of circumcision. [References: 13]
is bizarre. These doctors asked the men some questions about their
sexual satisfaction but don't mention the answers (presumably
non-significant, because they asked the wrong questions) and jump to
the conclusion that circumcision is a Good Thing because of an
electrical measurement of the nerves!
Turkey, men aged over 18 who had not been circumcised and were willing
to be, or needed to be, would be a very skewed sample of the
population. This is truly junk science. ]
Circumcision decreses glans senstivity
Zhonghua Nan Ke Xue. 2008 Apr;14(4):328-30
Circumcision affects glans penis vibration
[Article in Chinese]
Yang DM, Lin H, Zhang B, Guo W.
To evaluate the effect of circumcision on the glans penis sensitivity
by comparing the changes of the glans penis vibrotactile threshold
between normal men and patients with simple redundant prepuce and among
the patients before and after the operation.
The vibrotactile thresholds were measured at the forefinger and glans
penis in 73 normal volunteer controls and 96 patients with simple
redundant prepuce before and after circumcision by biological vibration
measurement instrument, and the changes in the perception sensitivity
of the body surface were analyzed.
The G/F (glans/finger) indexes in the control and the test group were
respectively 2.39 +/- 1.72 and 1.97 +/- 0.71, with no significant
difference in between (P > 0.05). And those of the test group
were 1.97 +/- 0.71, 2.64 +/- 1.38, 3.09 +/-1.46 and 2.97 +/- 1.20
respectively before and 1, 2 and 3 months after circumcision, with significant difference between pre- and
post-operation (P < 0.05).
There is a statistic [significant?] difference in the glans penis
vibration perception threshold between normal men and patients with
simple redundant prepuce. The glans
penis perception sensitivity decreases after circumcision.
Circumcision increased sexual dysfunction and
difficulty reaching orgasm
Andrologia. 2013 Apr 20. doi:
10.1111/and.12101. [Epub ahead of print]
Adult circumcision and male sexual
health: a retrospective analysis
Dias J, Freitas R, Amorim R, Espiridião P, Xambre L, Ferraz L.
We aimed to evaluate possible associations of circumcision with several
sexual dysfunctions and to identify predictors for the development of
these outcomes post-operatively. Telephone surveys about sexual habits
and dysfunctions before and after intervention were conducted
post-operatively to patients that underwent circumcision in Centro
Hospitalar Vila Nova de Gaia/Espinho during 2011.
McNemar test was used for a matched-pairs analysis
of pre- and post-operative data. Odds ratios, adjusted in a
multivariate analysis, explored predictors of de novo sexual
dysfunctions after circumcision. With intervention [circumcision],
there was an increase in
frequency of erectile dysfunction (9.7% versus 25.8%, P =
0.002) and delayed orgasm [as
a sexual dysfuntion, i.e. trouble reaching orgasm]
48.4%, P < 0.001), and a significant symptomatic improvement in
patients with pain
with intercourse (50.0% versus 6.5%, P < 0.001). Significant
predictors for de novo
erectile dysfunction were diabetes mellitus (OR 9.81, P = 0.048) and
lack of sexual
desire (OR 8.76, P = 0.028). Less than three sex partners (OR 7.04, P =
low sexual desire (OR 7.49, P = 0.029) were significant predictors for
Intact men are happier to
be intact than men cut as babies or children are happy to be cut
|Arch Sex Behav
Toward One’s Circumcision Status Is More Important than Actual
Circumcision Status for Men’s Body Image and Sexual Functioning
Jennifer A. Bossio, Caroline F. Pukall
Abstract Research exploring the impact
of circumcision on the sexual lives of men has failed to consider men’s
their circumcision status, which may, in part, help to explain
inconsistent findings in the literature. The current study explored the
potential relationship between attitudinal factors toward one’s
circumcision status, timing of one’s circumcision, and sexual
correlates. A total of 811 men (367 circumcised as neonates,107
circumcised in childhood, 47 circumcised in adulthood, and 290 intact)
aged 19–84 years (M=33.02,SD=12.54) completed an online survey.We
assessed attitudes toward one’s circumcision status, three domains of
body image (Male Genital Image Scale, Body Exposure during Sexual
Activities Questionnaire, Body Image Satisfaction Scale), and
self-reported sexual functioning (International Index of Erectile
Function). Men who were circumcised as adults or
intact men reported higher satisfaction with their circumcision status
than those who were circumcised neonatally or in childhood.
Lower satisfaction with one’s circumcision status—but not men’s actual
circumcision status—was associated with worse body image and sexual
findings identify the need to control for attitudes toward circumcision
status in the study of sexual outcomes related to circumcision.
Future research is required to estimate the number of men who are
dissatisfied with their circumcision status, to explore the antecedents
of distress in this subpopulation, and to understand the extent of
negative sexual outcomes associated with these attitudes.
Mean responses to questions assessing men’s satisfaction with their own
circumcision status. Note. Group means are significantly different
unless otherwise specified with NS (nonsignificant). Error bars
represent standard error. Y-axis represents participant response
reduce the excessive spacing between
[to 10 on five measures (]
happy/positive/negative/important/often), where 5 represents neutral.
X-axis represents circumcision status group.
a How happy are you with your circumcision status? (Happy).
b How much is your circumcision status a positive issue for you in
everyday life? (Positive).
c How much is your circumcision status a negative issue for you in
everyday life? (Negative).
d How much do you think about your circumcision status as a significant
part of who you are? (Significant).
e How often do you think about your circumcision status? (Often)
[a. Intact men are significantly more happy to be
intact than non-consented cut men are to be cut.
b. Intact men's status is significantly more positive for them
than non-consented cut men's.
c. Non-consented cut men's status is significantly more
negative for them than intact men's.
d. Adult-cut men think about their status as a significant part of who
e. Intact men think about their status less often (and adult-cut men
more often) than non-consented cut men.
Men cut as adults may have really needed it and
benefited from it, or wanted it and be happy to get what they wanted.]
Men’s Attitudes Toward Their Circumcision Status
of the descriptive statistics revealed that—for a substantial
proportion of men in this sample—circumcision status was not a negative
or important issue. In fact, men in this sample who underwent
circumcision as adults or intact men reported high levels of
satisfaction with their circumcision status. [It
is bizarre to see these two diametrically opposite groups being lumped
there was a subgroup of men for whom their circumcision status was
highly distressing, and these men were more likely to have been
neonatally circumcised. One possible explanation for the
levels of distress among some circumcised men, and the relative
importance of one’s self-reported happiness with their circumcision
status, is the role of choice in their circumcision status. [Possible? Of course it is!]
The issue of choice in neonatal circumcision has been the center of a
heated debate (Earp, 2015; McMath, 2015; Svoboda, Van Howe,
2000). Perhaps this finding is, in part, reflective of the fact that
men who were not neonatally circumcised were able to rectify
dissatisfaction with their circumcision status by undergoing
circumcision. On the other hand, circumcised men have far fewer options
to reverse their circumcision status,and the options that are available
to them (e.g., foreskin ‘‘restoration’’; Hammond, 1999) are timely
[apparently meaning "time-consuming"], labor-intensive, and never truly
‘‘restorative’’ (because the nerve fibers lost to circumcision cannot
Future research is needed to obtain an accurate
base rate estimation with respect to the frequency that men fall into
the category of ‘‘distressed’’over their circumcision status, as this
reaction to one’s circumcision status—among others—should be addressed
in future public policy statements about circumcision. In a recent
study exploring genital dissatisfaction in a national sample of U.S.
men aged 18–65 (Gaither et al., 2017), 7% of the 3996
participants who answered the genital satisfaction questions reporte
ddissatisfaction with their circumcision status, 62% reported
satisfaction, and 31% reported neutral satisfaction. Dissatisfaction
was determined by a score of 1, 2, or 3 on a seven point scale,
satisfaction was 5, 6,or 7, and a score of 4 was considered neutral. It
should be noted, though, that actual circumcision status was not
assessed in Gaither et al.’s national survey [which
makes it worthless].
it appears that the number of men who reported feeling unhappy with
their circumcision status was a minority in the current study,
regardless of timing of circumcision status [but
not if timing was regarded].
observed effect sizes for group differences ranged from large (e.g.,
Happy, Positive) to medium (Negative, Significant,Often) suggesting
that, at least within the current sample, attitudes
toward one’s circumcision status vary greatly across circumcision status.
ought to be self-evident. Compare attitudes towards one's amputation
status: people with feet cut off are more likely to be unhappy about it
than people with feet.]
However, even small group differences would be theoretically relevant
in this case, as this study is the first to document that the life
stage at which one undergoes circumcision is associated with the level
of dissatisfaction toward one’s circumcision status in a subsample of
men. Understanding the antecedents of this dissatisfaction is needed to
elucidate what separates the distressed group from the neutral or
satisfied men (e.g., reason
for circumcision, mental health correlates such as depression, anxiety,
body dysmorphia, social comparison) with the intent of decreasing
distress related to circumcision status.
[Wow! Way to ignore the Elephant In The Room! Cut men hate
being cut when it was an unnecessary reductive imposition on them, and not so much when they actually needed it or wanted it.]
Participants who reported feeling ‘‘unhappy’’ or ‘‘neutral/happy’’
toward their circumcision status, broken down by timing of circumcision
||Unhappy n (%)
||Neutral/happy n (%)
|Circumcised as child
|Circumcised as adult
were missing for 5 individuals
are entirely comparable with other self-selected polls. The
results might be even more dramatic if we could see what proportion
were actually happy, and not just neutral.]
and Pukall treat dissatisfaction with being genitally cut as a mere
variable in studies of sexual function, not as an issue in itself,
and to a large extent, like many pro-cutters before them, treat
being intact as equivalet to dis/satisfaction with being genitally cut
- as though the fact of being cut without consent was not itself an
issue - while dissatisfaction with being intact arises indirectly, e.g.
from being different from others (and even being bullied by them for being intact), or some abnormality of the foreskin.
|Archives of Sexual Behavior
LETTER TO THE EDITOR
Antecedents of Emotional Distress and
in Circumcised Men: Previous Findings and Future
Directions—Comment on Bossio and Pukall (2017)
Tim Hammond, Mark D. Reiss
Received: 29 September 2017 / Accepted: 21 February 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Bossio and Pukall (2017) make an important contribution by identifying
the subpopulation of men distressed by having been circumcised
nontherapeutically as infants or children. This group, heretofore largely overlooked, has been recognized for
decades by grassroots citizens concerned about risks, harms, and
disadvantages of culturally motivated genital cutting.
We agree that “Future research is required to…explore the antecedents
of distress in this subpopulation.” Although earlier explorations of
such antecedents were reported, those surveys relied on self-selecting samples and should be regarded
as preliminary (Hammond, 1999; Hammond & Carmack, 2017). Even
so, serious and even debilitating distress over having been circumcised
in infancy has now been described in several reports (Earp &
Based on available data, such distress can be caused by physical
damage, including excessive skin removal causing tight, painful
erections; meatal stenosis; prominent or irregular scarring; numb,
hypersensitive or painful scars; unsightly scar pigmentation; painful
skin bridges; gouges in and/or toughening of the glans; and other
issues. Extensive photographic evidence of physical damage submitted by
Hammond’s respondents is viewable at www.CircumcisionHarm.org.
Sexual distress may be caused by, among other variables, insufficient
skin mobility for self-pleasuring or ease of vaginal/anal penetration;
loss of mechanical lubrication, reduced seminal fluid preservation, inability to achieve sufficient
stimulation from vaginal intercourse to reach orgasm (causing
respondents to resort to anal, oral, manual or artificial stimulation);
premature/delayed orgasm; and erectile dysfunction perceived as
attributable to circumcision.
Still others endure psychological, emotional, and selfesteem issues
subsequent to acquiring knowledge regarding the significant loss of
erogenous tissue (Earp, Sardi, & Jellison 2018); elimination of
the foreskin’s valuable protective, sexual, and immunological functions
(Fleiss, Hodges, & VanHowe 1998); and one’s lack of choice and
determining how much of their genitals they were permitted to keep.
These circumcision sufferers often express a deep sense of having been
damaged or mutilated; feelings of compromised masculinity or shame;
depression; addictive behaviors; alexithymia; and body eudysmorphia
[meaning true dysmorphia where the body itself is
distorted] (Watson & Golden, 2017). Others describe feelings of
violation of their basic human right to bodily integrity and autonomy
through medical, religious, and governmental neglect; a breakdown in
sexual intimacy; betrayal by parents and medical professionals; and
compromised relationships with family, friends, and others who discount
or ridicule their pain. Others experience suicidal ideation and/or
Previously published books exploring the disadvantages and harm of
nontherapeutic newborn circumcision (Goldman, 1997; Watson, 2014) and
proliferating social media outlets (Foregen, 2017; I Am Not Thankful, 2017; Men Do Complain, 2017;
National Organization of Restoring Men, 2017; Personal Accounts of
Circumcision Resentment, 2017) provide a broad and deep foundation for
research. Moreover, specific guidelines for exploring longterm adverse
physical, sexual, and mental health effects of newborn circumcision may
be found in Hammond’s two surveys. Caution, however, is warranted in
drawing too many conclusions from quantitative analyses. Researchers
must also listen to the lived experiences of this subpopulation.
Since an estimated 30% of the world’s males were subjected to
nontherapeutic circumcision as newborns or children (U.N. International
NGO on Violence Against Children, 2012), the scope of this problem
could be significant and will surely grow as knowledge about foreskin
anatomy, development, and physiology becomes more easily accessible
with the expansion of the Internet.
Even without further research into this subpopulation, we support
Bossio and Pukall’s recommendation that “…this reaction to one’s
circumcision status—among others—should be addressed in future public
policy statements about
Which do women prefer?
I studied in North America at University, once
arriving at the University and living in halls, with the English accent
and dry humour, I did pretty well with the lady's. However, once the
word went round, like wild fire, that I was 'uncut', I have never had
so much action in my life, I had girls coming up to me in bars, in the
cafeteria, and they couldn't stop examining it! I didn't complain the 1
year exchange was the happiest time of my life!
cornwall, UK, in the Daily Mail, January 27, 2012
Three studies have addressed this question, and come to
opposite conclusions. All were flawed.
- The O'Hara
and O'Hara study in the UK was a self-selected, voluntary
survey. Some of its subjects were recruited from anti-circumcision
sources, tending to bias results away from circumcision, but it had two
strikes in its favour.
- All the women who took part had experienced sex
with both intact and circumcised men.
- They described in detail what they experienced,
and sometimes found favourable attributes in spite of their preferences
So its results have qualitative if not quantitative merit.
"[The] women [who] preferred circumcised
partners ... still found unaltered partners to evoke more vaginal fluid production, a lower
vaginal discomfort rating and fewer complaints ... during
intercourse than their circumcised partners."
"Respondents overwhelmingly concurred that the mechanics of coitus was
different for the two groups of men. Of the women, 73% reported that circumcised men tend to thrust harder and
deeper, using elongated strokes, while unaltered men by
comparison tended to thrust more gently, to have shorter thrusts, and
tended to be in contact with the mons pubis and clitoris more,
according to 71% of the respondents."
The O'Hara study - like these pages - is written
from the point of view that intactness is normal, which may look like
an anti-circumcision bias in the prevailing pro-circumcision climate.
The authors have developed their findings into a book, Sex As Nature Intended It.
- The Williamson and
Williamson study in Iowa was a cohort study, but it had a
very high (46%) non-response rate, tending to bias the results in an
unknown way. The women had all just delivered sons, further biassing
the study away from the entire female population. [August 25, 2010: Truth will out.
At least one
of the women had just had a daughter but
when she said if she had had a son she would have had him circumcised,
she was invited to take part.] Its faults are
- Only 16.5% of those who answered had experienced
sex with both intact and circumcised men.
- Some of their responses were irrational,
suggesting they didn't know what they were talking about:
Predictibly, a majority of the women preferred circumcised penises for
sex, but interestingly, that majority (71% for vaginal intercourse) was
lower than the proportion (78%) who
had never known anything else.
- 77% said circumcised penises "seemed more
- 54% said circumcised penises "stayed softer"
The Williamsons' study is written with a clear pro-circumcision bias.
It assumes that a mother's sexual preference is a reasonable basis on
which to decide whether to cut part off her son's genitals. (Consider
if the sexes were reversed!)
- A random controlled study, but from a a dubious
SEXUAL SATISFACTION OF WOMEN PARTNERS OF
CIRCUMCISED MEN IN A RANDOMIZED TRIAL OF MALE CIRCUMCISION IN RAKAI,
IAS Conf HIV Pathog Treat 2009 Jul
19-22;5th: Abstract No. MOPDC104
G. Kigozi, I. Lukabwe, M. Wawer, D. Serwadda,
F. Nalugoda, J. Kagayi, N. Kiwanuka, F. Mangen Wabwire, T. Lutalo, D.
Nabukenya, G. Kigozi Nalwoga, R. Gray
activists have objected to male circumcision because of
the lack of data on female sexual satisfactions and sociologists have
urged that circumcision roll out programs consider social factors that
may affect women, including female sexual satisfaction. There has also
been speculation that removal of the foreskin reduces female sexual
satisfaction because the gliding action of the foreskin is thought to
facilitate vaginal penetration. We assessed the effect of adult medical
male circumcision on postoperative female sexual satisfaction.
METHODS: We investigated self-reported sexual
satisfaction among 455 women partners of men circumcised in a
randomized trial of male circumcision for HIV prevention in Rakai,
Uganda. Women aged 15-49 were interviewed about their sexual
satisfaction before and after their partners were circumcised. We
analyzed female reported changes in sexual satisfaction using
Chi-square or Fisher's exact tests.
2.9% (13/455) of women reported less sexual satisfaction after their
partners were circumcised. 57.3% (255/455) reported no change in sexual
satisfaction and 39.8% (177/455) reported an improvement in sexual
satisfaction following their partners' circumcision. There was no
statistically significant difference in reported change in sexual
satisfaction before and after partner's circumcision by age, religion
and education status.
CONCLUSIONS: The overwhelming
majority of women (97.1%) report either no change or improved sexual
satisfaction after their male partner was circumcised. These findings
suggest that male circumcision has no deleterious effect on female
add "no change" to the satisfied? Putting the opposite spin on it, the
majority of women, 58.9% (268/455) report no improvement in sexual
is clear from the wording what outcome the researchers wanted. There
could be no blinding of the results or placebo control. This abstract
does not give before and after figures, but a
study of men by the same researchers - who have produced
several papers all supporting circumcision - found no difference
because satisfaction approached 100% both before and after. This raises
the question, in each group, how good was it before, and how good
after. What if the 39.8% experienced marginal improvement while the
2.9% suffered catastrophic losses?]
The Canadian journal of human sexuality
You either have it or you don’t: The impact of male circumcision status
on sexual partners
Jennifer A. Bossio, Caroline F. Pukall,
and Katie Bartley
This study was an exploration of the impact of men’s circumcision
status on their sexual partners, focusing on sexual functioning, sexual
satisfaction, general preferences for circumcision status, and beliefs
about circumcision status. A total of 196 individuals (168 women, 28
men) currently in a sexual relationship with a man were recruited for
an online survey. Sexual functioning for female or male participants
(assessed by the FSFI or IIEF-MSM, respectively) was not impacted by
circumcision status, but women with
intact partners reported higher levels of sexual satisfaction,
while no differences were observed in the male sample. Women’s
responses indicated that circumcision status minimally impacted
satisfaction with partner’s genitals, while men
with intact partners indicated significantly higher levels of
satisfaction than those with circumcised partners.
Overall, women and men rated high levels of satisfaction with their
partner’s circumcision status and did not wish for it to change. Women
indicated a slight preference for circumcised penises for vaginal
intercourse and fellatio, and held more positive beliefs about
circumcised penises, while men indicated a strong preference toward
intact penises for all sexual activities assessed and held more
positive beliefs about intact penises. The current study demonstrates
distinct gender differences in attitudes toward circumcision status but
minimal impact of circumcision status on sexual functioning. Future
research should further explore sexual correlates of circumcision
status, with a focus on directionality of said correlates and the
impact on couples, as well as replicating the findings with a larger
sample, specifically with respect to the male sample.
Eligible participants met the following criteria: (i) over the age
of 18; (ii) able to read and write English fluently; and (iii) in a
sexual relationship with a cisgendered (i.e., biologically born)
male partner for at least the past 3 months. Participants were
excluded based on the following criteria: (i) if they or their
partner were circumcised as an adult, or circumcised
correct a medical condition (e.g., phimosis); (ii) if they
their partner had any anatomic or medical abnormalities of
the penis (e.g., complications
during circumcision, hypospadias, genital modifications
such as piercings); and (iii)
if their partner had a
diagnosis of a sexual dysfunction.
main groups who might have made genital cutting look worse
were excluded before the study began! ]
A total of 196 individuals who met eligibility
criteria completed the study in full, 168 women and 28 men.
[The experience of sex with a man is of
course very different for men and women.]
76 (45.2%) of the women's
partners were intact, 14 (50%) of the men's.
[The study did not record the
effect of genital cutting on the cut men themselves, but on their
partners. (Imagine for a moment a study of female cutting the
asked only the cut women's partners about their experiences.)]
Women with intact partners reported
levels of sexual satisfaction than women with circumcised partners
The observation that women with intact partners
endorsed higher sexual satisfaction ratings on the F[emale ]S[exual
]F[unction ]I[ndex] is interesting, considering that women’s responses
to other subsections of this survey indicated a preference for
circumcised penises (e.g., higher self-report satisfaction with their
partner’s flaccid penis compared to women with intact partners, higher
preference for circumcised penis during some sexual activities, more
positive beliefs about circumcised penises). It is possible that the presence of
foreskin provides some benefits to sexual satisfaction outside of the
domains assessed by the FSFI. Additional
research is required to clarify the nuanced role of foreskin in sexual
intercourse and partner enjoyment/sexual satisfaction, particularly
Here is one
The underlying fact is that women prefer what they are
familiar with. But regardless of what a woman prefers, this should not
be a consideration for circumcising a baby boy because
- He might grow up to be celibate
- He might grow up to be gay
- The majority preference might have changed by the
time he grows up
- His future partner might not share the majority
- Forcibly cutting part off one person to suit another
(hypothetical, unknown) person is unethical
- His preference should be
overriding. (Imagine trying to justify circumcision of girls
to suit men's preferences in the Western world
If a man chooses to be circumcised to please his wife,
that's his decision - but read on.
Who can compare them?
It is impossible for any man to both have been circumcised in infancy
and left intact; any studies must compare different men. Two groups of
men have some experience of both having and not having a foreskin,
circumcised in adulthood
Their reactions vary widely. One problem is that some of the most vocal
proponents of circumcision from this group chose to be circumcised for
sexual reasons - they already had a sexual investment in having a
circumcised penis. Others had physical problems with their foreskins
that were solved by circumcision. In general, reports from those who
were circumcised in adulthood for non-sexual reasons take a negative
view of the outcome.
in 1964, ...
serving a tool and die apprenticeship in a machine shop with several
that had served in the military during WWII. They shared their
with having been circumcised as adults. They were both circumcised when
they found themselves in military hospitals during the war. One thought
of it as a really good thing before it was done, (It would be a status
symbol because both men came from a small coal mining town, and only
wealthy were born in hospitals, and even then, only some of them were
circumcised), but he felt very much differently about it afterwards.
second man would not have wanted it done, but he was too sick to give
view on it before the operation. ...
Both commented that their losses were
very significant (one said he experienced a 70% loss of feeling, and
other said he had lost about 3/4 of his). You have to realize that this
was only their opinions, and not the result of some measurement. Still,
find the similarities in numbers very interesting.
The man that would have objected tossed in one
other insight. He mentioned that masturbation was almost a complete
loss. He commented that you could still do it of course, but that it
stripped of its main pleasures. He said you could do it "to scratch an
itch", but it was mostly work until he would orgasm, which he said was
pretty much the same as before. The other thing that he mentioned was
that now he needed either a pinup picture, or a "girly" magazine to get
to work, where he never had to use any props before. ...
- John Soemer
December 11, 2005
As mentioned above, the effects on the nervous
system of adult circumcision are different from those of infant
circumcision. The circumcised boy also experiences the whole
development of his sexuality with a circumcised penis - he learns to
use what he's got. A man circumcised in adulthood has to relearn, and
may be unable to do so.
You do lose an enormous amount of sensitivity.
It has no effect on ejaculation, or whether you can get an erection or
not. Because you lose so much sensation you have to work much harder to
get the same sensation which affects sex completely.
Performance artist Peet
who filmed and exhibited his own circumcision in 2000
His view is interesting because his reason for
getting circumcised is neither medical nor sexual (and if it was
covertly sexual, he presumably expected an improvement).
These men responded within a few hours of a contrary article being
Urol 2002 May;167(5):2113-2116
Adult Circumcision Outcomes Study:
Effect on Erectile Function, Penile Sensitivity, Sexual Activity and
Carson CC, DeVELLIS RF. Robert Wood Johnson Clinical Scholars Program
and Division of Urology, School of Medicine, and the Department of
Health Behavior and Health Education, School of Public Health,
University of North Carolina at Chapel Hill, Chapel Hill, North
Evidence concerning the effect of circumcision on sexual function is
lacking. Men circumcised as adults are potentially in a unique position
to comment on the effect of a prepuce on sexual intercourse. We examine
sexual function outcomes in men who have experienced sexual intercourse
in the uncircumcised and circumcised states.
AND METHODS: Men 18 years old or older when circumcised were
identified by billing records during a 5-year period at an academic
medical center. Medical charts were reviewed for confirmation of the
procedure and to identify the indication(s). These men were surveyed to
assess erectile function, penile sensitivity, sexual activity and
overall satisfaction. Data were analyzed using paired t tests to
compare category scores before and after circumcision.
A total of 123 men were circumcised as adults. Indications for
circumcision included phimosis
in 64% of cases, balanitis
in 17%, condyloma
in 10%, redundant
foreskin in 9% and elective in 7%. The response rate was 44% among
potential responders. Mean age of responders was 42 years at
circumcision and 46 years at survey. Adult circumcision appears to
result in worsened erectile function
(p = 0.01), decreased penile
sensitivity (p = 0.08), no change in sexual activity (p =
0.22) and improved satisfaction (p = 0.04). Of the men 50% reported
benefits and 38% reported harm. Overall, 62% of men were satisfied with
having been circumcised.
[Presumably this means 12% reported
no change, and they were counted among the satisfied. Considering that
the 64% who were circumcised for phimosis would have expected sexual
benefits, this is a remarkably poor success rate.]
Our findings may help urologists better counsel men undergoing
circumcision as adults.[Notice
how circumcision is taken as a given. What these findings should do is
encourage urologists to seek alternatives to circumcision.]
Prospective studies are needed to better understand the relationship
between circumcision and sexual function. [And
before they do that, studies are needed to better understand the
relationship between the foreskin and sexual
function, but this is something they don't seem to want to think about.]
11956453 [PubMed - as supplied by publisher]
A small survey of men
circumcised as adults finds detriment
Circumcised men are more likely to
have premature ejaculation
09 Does circumcision improve couple's sexual life?
I. Solinis, A. Yiannaki
Department of Urology,
General Hospital of
Department of Urology,
General Hospital of
Background: The aim of the
study was to
compare sexual life and enjoyment of men
(and their partner) that were circumcised as
adults before and after their circumcision.
Methods: The study included 123 sexually
active men that were circumcised two years
before or more. [The
effect of circumcision on a man's sex life depends on why he was
circumcised. If it was for a sex-related problem, an improvement is to
be expected.] The mean age was 36 years (22-
64). All the men filled a questionnaire about
the quality of their sexual life and the sexual
enjoyment before and after circumcision. Also,
there were questions about partner's sexual
life improvement. The results are presented
Results: 16% answered that their sex
improved, while 35% reported a
worse sex life
after circumcision. There were no
differences in erection and ejaculation.
65% reported that the ejaculation latency time
increased significantly after circumcision but
only 10% of them reported that this fact
improved sexual life. 46% of men reported that
their partner's sexual life worsened after circumcision,
33% reported that their partner's
sexual life improved and 21% reported no
significant difference. [Men's
reporting of women's sexual satisfaction is notoriously inaccurate.]
Conclusion: There was a decrease in
sexual life after circumcision indicating
that adult circumcision adversely affects sexual
function in many men or/and their partners,
possibly because of complications of
surgery and loss of nerve endings. The results
support the view that physicians and parents
should be informed of the potential benefits
and risks before newborns are circumcised.
results support the view that newborns should not be
journal of men's
health & gender
Vol. 4, No. 3, pp. 357-378, September 2007 361
Prevalence and Correlates of Premature
Ejaculation in a Primary
Care Setting: A Preliminary Cross-Sectional Study
Wei Shuong Tang, MMed and Ee Ming Khoo, MD
Kuala Lumpur, Malaysia
ejaculation (PE) is common. However, it has been underreported and
Aims. To determine the
prevalence of PE and to investigate possible associated factors of PE.
cross-sectional study was conducted at a primary care clinic over a
3-month period in 2008. Men aged 18–70 years attending the clinic were
recruited, and they completed self-administered questionnaires that
included the Premature Ejaculation Diagnostic Tool (PEDT),
International Index of Erectile Function, sociodemography, lifestyle,
and medical illness. The operational definition of PE included PE and
probable PE based on the PEDT.
Main Outcome Measure.
Prevalence of PE.
Results. A total of 207 men
were recruited with a response rate of 93.2%. There were 97 (46.9%)
Malay, 57 (27.5%) Chinese, and 53 (25.6%) Indian, and their mean age
was 46.0 ± 12.7 years. The prevalence of PE was 40.6% (N = 82) (PE:
20.3%, probable PE: 20.3% using PEDT). A significant association was
found between ethnicity and
PE (Indian 49.1%, Malay 45.4%, and Chinese 24.6%; chi2
= 8.564, d.f. = 2, P = 0.014). No significant association was
found between age and PE. Multivariate analysis showed that erectile
dysfunction (adjusted odds ratio [OR] 4.907,
95% confidence interval [CI] 2.271, 10.604), circumcision
(adjusted OR 4.881, 95% CI 2.346, 10.153), sexual
intercourse <= 5 times in 4 weeks (adjusted OR 3.733, 95% CI
1.847, 7.544), and Indian ethnicity (adjusted OR 3.323,
95% CI 1.489, 7.417) were
predictors of PE.
Conclusion. PE might be
frequent in men attending primary care clinics. We found that erectile
Indian ethnicity, and frequency of sexual intercourse of <= 5
times per month were associated
with PE. These associations need further confirmation.
Tang WS and Khoo EM. Prevalence and correlates
ejaculation in a primary care setting: A preliminary cross-sectional
study. J Sex Med **;**:**–**.
who have restored their foreskins
The same objection can be made, that men who restore do so for sexual
reasons (though some do so more as a political statement, to get back
what they feel was taken unjustly, and find new sexual pleasures to be
a bonus). Further, non-surgical restoration is time-consuming and
requires dedication, so those who complete the process are strongly
motivated. Even then, restoration can never hope to replace all that
was lost. In spite of this, there are clear differences in quality:
restored men report good sensations from the movement of their
secondary foreskins, and increased sensitivity from their covered,
- Gay men
Gay men are in a unique position to compare intact and circumcised
penises, being likely to have experience of both kinds, and first hand
experience of one kind or the other. (Intact men are especially likely
to notice the difference.) No consensus has emerged, but some magazines
cater especially to a taste for intact men, and erotic fiction -
presumably market-driven - almost invariably includes them. A growing
genre of gay erotic videos is made in Central Europe, featuring
all-intact casts. This has been badmouthed as a "fetish", but it is the
an amputation over the whole body part that is in every other
case considered the fetish, and a rather bizarre one.
Intact gay men typically report that their
circumcised partners are "too rough" and circumcised gay men that their
intact partners are "too gentle" (untill they are taught), strongly
confirming the suggestion that circumcision reduces sensitivity.
One practice, "docking", "snoodling" or "frontage" (one man's glans
inside another's foreskin), is only possible between men, at least one
of whom is intact. "Double docking" (one foreskin inside another) is
only possible when both are intact. While few parents would choose to
leave their son intact just in case he grows up to want to dock, he is
hardly going to thank them for removing that option if he does.
Circumcising him will not of course prevent him from growing up gay,
nor prevent him from docking if he does - he will just have to find
intact men do to it with. (Heterosexual couples - if the man is intact
- may enjoy foreskin-nipple-, foreskin-clitoris-, foreskin-tongue- or
just foreskin-finger-play, too.)
Sex manuals for gay men written by circumcised men
have a hard time coping with docking: they can't deny that at least one
foreskin is essential, so they downplay the whole thing, saying such
things as "the pleasure is more psychological than physical" - whatever
that might mean.
A Docking Aid
Sales manufactured "The Docker", a cylinder of gel-plastic
for two men to insert their penises from opposite ends:
"Whether you're cut or uncut, you can enjoy the sensation of docking
with your partner!"
"Smooth, soft, realistic Cyberskin® feels like
Like the Manhood, the existence of such a toy
underlines what is lost by circumcision. (The product no longer seems
to be available, but a very similar one, enabling two
men to touch penises - without reference to foreskins or docking - is.)
The Foreskin and fertility
New Scientist Daily News June 5,
Male circumcision is a weapon in the sperm wars
By Kurt Kleiner
Circumcision and other forms of male genital
mutilation have always been a puzzle. The ritual mutilations can leave
the man vulnerable to infection and even death. So why do some
societies insist on such a risky ritual for their men?
There may be an evolutionary explanation,
according to Christopher Wilson, of Cornell University in New York, US.
It could function to reduce a young man’s potential to father a child
with an older man’s wife, he says.
Sperm competition theory predicts that males will
evolve ways to ensure that their sperm, and not another male’s,
fertilises a female’s eggs. Genital mutilation, in this view, is just
another way to win the sperm war.
In some forms of mutilation, the handicap to sperm
competition is obvious. There is subincision, for example, where cuts
are made to the base of the penis. This causes sperm to be ejaculated
from the base rather than the end, and is performed in several
Aboriginal Australian societies, says Wilson.
In some African and Micronesian cultures, young
men have one of their testicles crushed.
Male genital mutilation makes it less likely that
a male will manage to father a child with another man’s wife, Wilson
Circumcision is one of the less painful forms of
mutilation [This is, to say
the least, debatable], but it is also less
effective at reducing sperm
competition. Wilson suggests, however, that the lack of a foreskin
could make insertion or ejaculation slower, meaning brief, illicit sex
is less likely to come to fruition and lead to a pregnancy.
Younger men, he says, willingly submit to having
their reproductive ability reduced because they benefit socially from
the older men, by forming alliances, and by gaining access to weapons
or tribal lore.
The older men have also gone through the ritual,
and seen their own reproductive effectiveness reduced. But if a man
with, say, four wives wants to ensure that any children his wives
produce are his, there is pressure to make sure other men can’t
successfully impregnate them.
The husband’s own reproductive ability is
impaired, but continuous and repeated access to his wives makes up for
it, while any genital mutilation is a greater handicap to an interloper
trying to sneak brief occasional sex with his wives.
Wilson has now tested the idea. If the sperm
competition theory is correct, he reasoned, then male genital
mutilation should be more common in societies where men tend to have
multiple wives, especially those in which the wives live apart from the
The mutilation would also probably be carried out
in a public setting, witnessed mostly by other men, and performed by a
non-relative. Men who refused would face social sanctions.
Who’s the daddy?
Wilson searched anthropological databases and
found that his predictions were borne out: 48% of highly polygynous
societies practice some form of male genital mutilation, and in
societies in which wives live in separate households that increases to
would be skewed, depending on the kind of statistical analysis, by the
fact that the vast majority of societies the cut male genitals are
Only 14% of the monogamous societies in the
database practice male genital mutilation.
It might also be the case that selection works at
a group level, so that societies that enforce mutilation are more
stable because of less conflict over paternity, Wilson says.
David Barash, an evolutionary biologist at the
University of Washington in Seattle, US, says that the paper makes a
Journal reference: Evolution and Human Behavior (vol 29 p 149)
Evolution & Human Behaviour,
May 2008, Vol 29, Issue 3, pp 149-164
Male genital mutilation: an
adaptation to sexual conflict
Christopher G. Wilson
Male genital mutilation (MGM) takes several
forms and occurs in about 25% of societies. This behavior has puzzled
anthropologists, doctors and theologians for centuries, and presents an
evolutionary challenge since it involves dangerous and costly surgery.
I suggest that MGM is likely to reduce insemination efficiency,
reducing a man's capacity for extra-pair fertilizations by impairing
sperm competition. MGM may therefore represent a hard-to-fake signal of
a man's reduced ability to challenge the paternity of older men who are
already married. Men who display this signal of sexual obedience may
gain social benefits if married men are selected to offer social trust
and investment preferentially to peers who are less threatening to
their paternity. Clitoridectomy and vaginal infibulation serve a
parallel signaling function in women, increasing a husband's paternity
certainty and garnering his increased investment. Especially in
societies where paternity uncertainty and reproductive conflict are
high, the social benefits of MGM as a signal may outweigh its costs.
This ‘sexual conflict’ hypothesis predicts that MGM should be
associated with polygyny, particularly when co-wives reside far apart,
and that MGM should reduce the frequency of extramarital sex. MGM
rituals should facilitate access to social benefits; they should be
highly public, watched mainly by men, and performed by a nonrelative. I
found support for these six predictions in two cross-cultural samples.
I also examined an alternative hypothesis suggesting that MGM signals
group commitment for collective action, particularly inter-societal
warfare. Although other forms of male scarification fit this model, the
distribution of MGM is not predicted by frequency of inter-societal
Gordon Gallup et al. put forward a
theory that the shape of the glans has evolved with the function of
pumping a rival's sperm out of the vagina, tending to ensure that a
child born after that intercourse is that of the man concerned and not
an earlier one. Their widely-quoted study does not
mention the foreskin. One of the popularisers of
that theory, Jesse Bering, put readers' questions to Gallup
for Scientific American (May 30, 2009) about that issue.
READERS: The latex genitalia study wasn't terribly
convincing because the models were circumcised, and in real life the
foreskin would interfere with the semen-displacing functions of the
coronal ridge. So, does the foreskin pose a problem for the semen
GALLUP: The length of the foreskin is one of the
most variable features of the human penis. When most uncircumcised
males achieve an erection it pulls the foreskin back over the glans and
back down the shaft of the penis, enabling the coronal ridge to do its
business and scoop rival males’ semen away from the woman’s cervix. [It may also serve as a "gasket",
retaining semen, contradicting the sperm displacement theory.]
Because circumcision reduces the diameter of the shaft immediately
behind the glans and accentuates the coronal ridge, we’ve speculated
that the practice of circumcision may have unwittingly modified the
penis in ways that enable it to function as a more effective semen
displacement device. Armchair speculation? No. The idea could be tested
by comparing the incidence of non-paternity between circumcised and
intact males. My prediction would be that circumcised males ought to
experience a lower incidence of being cuckolded.
READERS: So why did human penises evolve to have
foreskin at all then?
GALLUP: Evolution does not occur by design. The
best way to think about most adaptations is in terms of cost/benefit
ratios. I suspect that the foreskin provided protection of the glans
and what you see is the result of a statistical compromise of sorts.
A dire power
Meta-analyses appear to be the ideal subject of
scientific debate - by combining dozens or hundreds of previous
studies, they allow us to have a truly massive set of trials to work
our statistics on, and at the same time seem to offer balance in so far
as irregularly positive studies are often balanced out by
uncharacteristically negative ones. However, there is a dire power
within a meta-analysis, secretly wielded by the author, and it is this
highly subjective aspect that lends each analysis its unique end
Put simply, the author gets to weigh how much an
experiment counts to the aggregate through his evaluation of its
quality. ... In other words, if you want a study to count less, you
tend to find more flaws with it, and if you want it to count more, you
tend to gloss over flaws that might exist. In a normal study, this
power would wreak comparatively minor havoc, because the trial number
is low enough that a modest result doesn't lead to massive
odds-against-chance numbers. However, when you exercise this power
with millions of pieces of data, the impact is colossal ...
Dale DeBakcsy, "When Big
Evidence Isn't: The Statistical Pitfalls of Dean Radin's Supernormal"
Skeptical Inquirer, January-February, 2014
J. Sex Med.2013 Aug 12. doi:
10.1111/jsm.12293. [Epub ahead of print]
Does male circumcision affect
sexual function, sensitivity, or satisfaction?-A systematic review.
by Morris BJ and Krieger JN.
Circumcision of males is commonly carried out worldwide for reasons of
health, medical need, esthetics, tradition, or religion. Whether
circumcision impairs or improves male sexual function or pleasure is
The study aims to conduct a systematic review of the scientific
A systematic review of published articles retrieved using keyword
searches of the PubMed, EMBASE, and Cochrane databases was performed.
Main Outcome Measures
The main outcome measure is the assessment of findings in publications
reporting original data relevant to the search terms and rating of
quality of each study based on established criteria.
Searches identified 2,675 publications describing the effects of male
circumcision on aspects of male sexual function, sensitivity,
sensation, or satisfaction. Of these, 36 met our inclusion criteria of
containing original data.
Those studies reported a total of 40,473 men,
including 19,542 uncircumcised and 20,931 circumcised. Rated by the
Scottish Intercollegiate Guidelines Network grading system, 2 were 1++
(high quality randomized controlled trials) and 34 were case-control or
cohort studies (11 high quality: 2++; 10 well-conducted: 2+; 13 low
quality: 2-). The 1++
, 2++, and 2+ studies uniformly found that circumcision had no overall
adverse effect on penile sensitivity, sexual arousal, sexual sensation,
erectile function, premature ejaculation, ejaculatory latency, orgasm
difficulties, sexual satisfaction, pleasure, or pain during
penetration. Support for these conclusions was provided by a
Impairment in one or more parameters was reported
in 10 of the 13 studies rated as 2-. These lower-quality studies
contained flaws in study design (11), selection of cases and/or
controls (5), statistical analysis (4), and/or data interpretation (6);
five had multiple problems.
The highest-quality studies suggest that medical male circumcision has
no adverse effect on sexual function, sensitivity, sexual sensation, or
News Flash! Circumcision advocates
Circumcision advocates Brian Morris and John
Krieger's "meta-analysis" (annotated version here) compounds
the faults of the above studies.
Professor Morris has a
track record of statements that do not correspond with the facts.
- They rank the ill-defined and
and Johnson "study", never peer-reviewed or published in a
scientific journal, as "2++ (high quality)".
- They review a Kenyan study in detail, entirely
uncritically, though one of them is a co-author.
- They refer to their own critiques of studies
that find detriments of circumcision, without reference to rebuttal of those critiques.
- Several of the studies cited provide no data on
- They unfailingly mark down all studies finding
detriment to circumcision and mark up all those finding benefit.
Work in progress
Some experiments are underway, using anaesthetics to
remove sensation from the foreskin but not the glans, or the glans but
not the foreskin:
"Ken McGrath, senior lecturer of pathology at
Auckland University of Technology...an internationally recognised
researcher on the effects of circumcision...recently simulated
circumcision by anaesthetising his foreskin. He describes it as a
disturbing experience, going from full sensitivity to almost none."
Other measurements of tactile sensitivity - those that Masters and Johnson and Melman et al. ought to have done -
are now being made. They may further clarify the role of the foreskin
Evidence is growing that intact men's arousal is more
graduated - that orgasm comes less suddenly and hence is more
controllable. This can be predicted from the possession of more nerve
endings - a volume control, not just a switch, for sexual feelings.
Male and female sexual anatomy
- closer than we thought?
Intactivists have been inclined to suppose that
male and female genitalia are differently innervated - the clitoris
apparently being richly endowed with nerves compared to the glans penis
- and it has been assumed that the clitoral prepuce, the woman's
equivalent to a foreskin, is correspondingly nerveless. (This, in part,
gives rise to the failure to communicate between opponents of FGM and
However, one women's experience suggests that that
is not the case and that a woman's "foreskin" is as sensitive as a
In myself, I have ... encountered what would be
the inner layer of foreskin (that rests against the glans). If a
woman's clitoral hood is properly pulled back, a very distinct line of
demarcation, separating the inner foreskin from the outer non-sensitive
skin, is quite visible. Stimulation of this "inner foreskin" gives me
greater pleasure than just direct glans stimulation.
I have read that without the foreskin, men do not
have a warning system to tell them when orgasm is imminent. I believe
that women have the same reaction. When I can stimulate the "inner
foreskin" of my clitoral hood, the sensations are much different, more
intense, than if I do not stimulate it. And when I do not, I, as a
woman, also get the "orgasm sneaking up" problem. I think this may well
be because of a lack of triggers, much like a circumcised man.
Also, the pliability of the skin allows for more
variation in masturbation technique, like an uncut man also gets to
employ. I can cover or uncover at my will, when I feel the need; this
liberty that I take for granted has been denied millions of men.
- Private communication
If this is true, it is obscured by the (generally
agreed) fact that women's sexual response is more "global" and less
centred on the genitalia than men's,
One of the few sex guides available in the US that assumes the male to
be intact is The
Guide to Getting It On! (The Universe's Coolest and Most
Informative Book About Sex) by Paul Joannides, illustrated by Daerick
Gross, available from Amazon.com, where the first eight reviews have
all rated it five stars
An instant classic when it first came out in 1972, "The
Joy of Sex" by Alex Comfort, illustrated with drawings by Charles
Raymond and Christopher Foss, Modset Securities Ltd/Quartet Books Ltd
(London), was more or less pro-foreskin
off this structure...persists - on the ground ... either that cancer of the cervix
and penis is rarer when
it is done (washing probably works as well) or that it slows down
orgasm (for which there is no evidence). We're against it, though for
some it is already too late. 'To cut off the uppermost skin of the
secret parts', says Dr. Bulwer, 'is directly against the honesty of
nature, and an injurious insufferable trick put upon her.'
p 65 (1974)
and illustrated mainly with intact men. The latest
edition, The New Joy of Sex (The Joy of Sex Series) by Alex Comfort,
edited by Julie Rubenstein, photographs by Clare Park. now attracts
mainly negative reviews at Amazon.com for its old-fashioned attitudes.
Offsite: an intact Briton with a US wife has written a
page for women about how
to please an intact man. He generalises from himself, is a
bit shaky on his anatomy, and presents a rather alarming metallic
analogy, but has a detailed chart of what gives pleasure.