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For simplicity, this page may now be cited as www.circumstitions.com/sex.

The Foreskin, Circumcision and Sexuality

"Like being hugged by the Venus de Milo"

Contents

The Foreskin

  • The ridged band of the foreskin
  • Touch sensitivity
    • Sorrells et al. - first to test the foreskin A poster about the Sorrells study

First-person accounts:

The effect of circumcision on sex

Science

Comparisons between intact and men circumcised as infants Men circumcised as adults Which do women prefer?
Who can compare them? Meta-science
  • Work in progress
  • Male and female prepuces - closer than we thought?
  • Resources
  • 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 eyelashes)

    The ridged 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 intercourse.

    - 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 pleasurable.

     

    First-person accounts

    By men:

    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 the normal course of events if the foreskin does not retract on its' own when 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 rough?

    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"

     

    AlterNet
    April 15, 2008

    Uncut is better I have proof

    by ashkewoof

    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

     

    By women:

     

    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 sad realization.

    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

    Ooh, and 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.

    And you 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 intercourse! Hooray!!

    - a 26-year-old from Pittsburgh living in Belgium

     

    THE 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

     

    The foreskin is my go-to guy when I'm lazy during BJ or handjobs! It's the dick that strokes itself!

    - dictaste 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!
    Sincerely,
    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 :) ..

    - newtrack on the Chronicle of Highr Education, June 23, 2010

     

    ... someone 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 their equipment.

    Sunday Morning in the Independent, May 7, 2011

     

    A love letter to your uncircumcised dick

    Dear boyfriend,

    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 with.

    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.

    Sincerely,

    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.

    Abstract

    BACKGROUND:
    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.

    METHODS:
    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 ning.

    RESULTS:
    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 dyspareunia [painful intercourse] (12 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.

     

    Circumcision and sexual dysfunction - chart

    [Graph created for this site based on the above data]

     

    Conclusions
    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 alia:

    ... 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 epidemiology journal.

    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 function."

    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:

    Fine-touch 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

    BJU 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.

    Positions on circumcised penis of touch-sensitivity tests
    Larger image

    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.

    Key: darker,stronger colours mean more sensitive

    Positions on intact penis of touch-sensitivity tests
    Larger image

    Chart showing touch-sensitivity of different places on the penis
    Larger image

    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 circumcision.

    "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 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.

    Abstract
    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 non-medical reason.

    OBJECTIVES:
    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.

    RESULTS:
    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 shaft.

    CONCLUSIONS:
    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 sexuality.

     

    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.

    Masters and Johnson's ''normal'' penis
    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 identify it.

    Masters and  Johnson's normal penis
    FIGURE 12-3 Male pelvis: normal anatomy (lateral view). (p 180)

    The corona glandis is misidentified.

    The next four drawings are similar to this one:

    Masters and Johnson's erect penis
    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:

    Masters and Johnson's flayed penis
    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

    Pathology
     Benign prostatic hypertophies
     Unilateral testicular atrophies
     Undescended testicle
     Inguinal hernia (non-symptomatic)
     Inguinal hernia (symptomatic)
     Varicocele (symptomatic)
    Additional Data
     Uncircumcised penises

    p 17

    and table 2-8

    Surgical History of Male Study Subjects

    Major pelivic surgery
     Prostatectomy
      Transurethral
      Perineal
     Inguinal herniorrhaphy
     [but not circumcision].

    p 18

    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 and ugliness):

    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 [Real scientists aim to test, not prove or disprove] the false 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 sex.]

    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 "automanipulation" (masturbation):

    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 foreskin.]

    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 acknowledgement.

    The claim of "no effect" was quoted as recently as February 2002 in the American Association of Family Physicians' Policy Statement.

     

    "What were those experiments?"

    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 sexuality".

    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.)

    In sharp contrast is the importance Masters and Johnson attach to the role of the clitoral hood (female prepuce) in intercourse:

    A mechanical 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.

    - p.58

    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 wrote:

    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 orgasm. Oooohlalallaaaaaaaa...

     

     

    A more recent study makes the same mistake, perhaps more glaringly. Abstract of a paper presented at a meeting of the American Urological Association in Chicago on April 29, 2003.

    Publishing ID: 1260 Abstract ID: 100769

    EFFECTS OF CIRCUMCISION ON MALE PENILE SENSITIVITY

    Clifford B 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 sensitivities.

    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. [They compared 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, and hypertension.

    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 than Hispanics.

    [Again, 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 research. ]

    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.

     

    And again:

    J Sex Med. 2007 Apr 6; [Epub ahead of print]

    Sensation and Sexual Arousal in Circumcised and Uncircumcised Men.

    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 sexual function.

    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.

    Graph of temperature rise on showing eroitc film to circumcised and intact men - the intact start lower, but reach the same temperature

    [This is news, suggesting the foreskin functions as a radiator - but the surface of the one small region of the penis they measured, "just below {proximal to?} 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 pain sensitivity.

    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 :

    Discussion
    ... 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 [22], or to prevent masturbation [23]. 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.]

    Conclusion
    ... 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. did this])....

    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.
    [Conspicious by their absence from these citations are Sorrells et al. 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 Curtis Dolezal

    [This 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 parameters measured.]

    OBJECTIVE
    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).

    SUBJECTS AND METHODS
    Eighty-one healthy, sexually active, men aged 22–57 years (median 33), with no history of genital surgery, completed the SAGASF-M.

    ...

    RESULTS
    ...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), ‘skin between the scrotum and anus’, ‘back side of the scrotum’, ‘front side of the scrotum’, and ‘around anus’, but not all pair differences were significant.

    CONCLUSION
    The SAGASF-M discriminates reasonably well between various genital and nongenital areas in terms of erotic sensitivity, when administered to genitally unoperated men varying widely in age and socio-economic level.

    ...
    SUBJECTS AND METHODS
    For this methodological study we targeted English-speaking men with no history of genital surgery and with a variable educational background.

    ...

    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] 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)’ [apparently they merged foreskin measurements with upper shaft measurements for no apparent reason], ‘skin between the scrotum and anus’, ‘back 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, increases the potential for (objective) variations in sensory thresholds [the potential?] 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 harsh criticism by patients, because of recurrent reports of the experience after surgery of poor cosmetic quality and/or impaired sexual functioning in adulthood [28]. Some intersex activists have even called for a moratorium on genital surgery, until more adequate followup data are provided [29].

    ...

    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.

    [The 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.]

    DISCUSSION
    ... 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 spinal nerve] might migrate. It could also be that sexual sensitivity ratings include a pressure-related sensation rather than only a fine-touch or tactile sensation.

    [Now 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 from stimulation.

    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 ... the 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 systems.

    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 S. Blumberg,
    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.

       

      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, totally lacking.

      ...

      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 windshield.

      Her new vision was "absolutely delightful," Sue wrote. "I had no idea what I had been missing."

      - Oliver Sacks, The Mind's Eye

      It includes both the immediate loss of sensation from the foreskin itself, and the progressive desensitisation of the glans as the surface keratinises.

      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."
    or
    "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 sensitivity 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.

     

    Marilyn Milos writes:

    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:

     

    "Speaking as a Cavalier, I'm flummoxed by one proposition of the anti-snipping crowd: that circumcision "reduces sensitivity." Well, thank God I had it trimmed back, then; if the serpent were any more easily provoked, I'd have to spend my days wearing a hoop skirt.

    Lyle Neff in the Vancouver Courier, July 21, 2004

    "They say taking the skin causes a decrease in sensitivity…I don't think I could stand much more sensitivity. I'd pass out."

    Fumanchudad on Miss Britt, October 3, 2008

    I'm a 30 year old circumsised male and I have no problem with sensitivity. In fact I have the complete opposite - it takes all my willpower not to become too aroused!

    Dave on The Art of ManlinessFebruary 24, 2009

    "I’m sensitive enough without my foreskin. I shudder to think of how much less control I would have with it."

    MariusSilverWolf on The Frisky, June 17, 2009

    "You'd have more feeling? I wouldn't last 2 seconds"

    Alohaalaloha on Mother Jones, November 17, 2010

    I brought up the issue with my (circumcised) husband because in case we have a boy several years from now I don't want to be arguing about this in the delivery room. He did not find my points against male circumcision very convincing. (Maybe that's his experience - I don't know if he could stand being any *more* sensitive. The head of the penis, in our experience is super sensitive even if circumcision has taken place.)

    DistantStarlight on HealthKicker, April 17, 2010

    I'm a 55 year old cut man and the head of my penis is so sensitive that if it were any more sensitive I would loose my load upon entry.

    Anonymous at EmpowHER, December 22, 2010

    ... studies show that being circumcised takes away nerves that increase the pleasure? Well if that's the case I dont want them because if I felt any more pleasure, then the sex wouldnt only last 5 mins.

    Bob at the Guggie Daily, January 12, 21011

    Fine, but if I had much more sensation, I'd probably be ejaculating in my pants.

    Clifton100 on Youtube, January 22, 2011

    ... only one of the (somewhere-in-the-low-double-digits) partners I've had has been uncircumcised, and let's just say that they all seemed plenty sensitive to me. (A couple were a little too sensitive for the situation, ifyouknowhatimean.)

    EmpressCallipygos on MetaFilter, February 3, 2011

    So it's more sensative 'with',? but who needs that? It's hard enough holding back with a hot chick as it is. Haha.

    financehawk on YouTube, April 1, 2011

    I must confess, every time I hear about how much sensation and pleasure my circumcised penis is missing out on I can't help but wonder why MORE would be a desirable objective. I'm afraid it would simply make for an all too ephemeral enterprise.

    - Poweslave on Science Blogs, May 3, 2011

    ... if it were any more sensitive, I'd have two spare pairs of boxers in the truck lest I get the "come hither" look at intersections or I have to scratch it. ...

    EFIS on Salt Lake Tribune May 17, 2011

    ...i am circumcised, i last about 21 seconds in bed. the thought of having thousands of additional nerve endings makes me think id technically be a virgin forever.

    Anonymous at Viceland, June 17, 2011

    on the sensitivity issue the debate is laughable.if we were any more sensitive we would be raping females all day and all night.trust jewish boys when they say they feel far too much sensitivity.

    - jacob levy in the Jewish Daily Forward, June 29, 2011

    I'll pass on the sensitivity thing. Last thing i need is to go from the 10 minute wonder to the 5 minute wonder.

    - astralvortex at FARK.com, July 15, 2011

    i had someone explain to me how uncircumcised people experience more pleasure which made me think: how much more pleasure do we need? I have no complaints right now....if anything I think it would be too much to handle.

    - sturg1dj onGawker, July 29, 2011

    "But it decreases pleasure with sex!" Good. Sex is physically pleasurable enough. I have more of a problem with coming too quick than too slow.

    CambridgeHeights on YouTube, July 29, 2011

    ...to be honest, about the last thing I want is to be MORE sensitive in that area, resulting in even shorter lovemaking time.

    Bowen Houffon MSNBC, September 2, 2011

    I don't know about other males, but I sure as hell have enough sensitivity and can't imagine wanting anymore.

    Bob in Sun City on MSNBC, September 3, 2011

    I am 37, circumsized as well and I sure as hell have enough sensitivity at times it is painful. I couldn't imagine being even more. Sex would be a 30 sec ordeal everytime.

    Wantsmore on Talk About Marriage, September 13, 2011

    I have enough trouble staying the course as it is. If it felt any better, I'd last about 3 seconds.

    FlyingSquid on Talking Points Memo, October 4, 2011

    So, I tend to think that seriously dramatic overreactions to having been routinely circumcised are unwarranted. I mean, if I were any more sensitive, I’d be coming right now, and who wants that?

    howardpierce on Lousy Canuck's blog, December 27, 2011

    My husband is so glad he doesnt have his foreskin. He actually wants to be able to please me in bed and even with out all those extra 20,000 nerve endings he still climaxes before me every time. He wishes he could be even less sensitive so he could hold out long enough for me to climax.

    Laura Zoey - posted on Circle of Moms, June 15, 2010

    Any female who uses the argument that it removes nerve endings has no idea. I am a circumcised male and I think I have enough nerves in that spot, anymore and I couldn't handle it. lol

    Derek McKenzie on Facebook, November 17, 2012

    I'm circumcised and if I had more sensitivity, I'd cream my pants just walking.

    Foals on Record in the Guardian, December 18, 2012

    I honestly felt like If I could get anymore sensitive down there...it would probably be painful.

    Un3ven on Yahoo Answers, January 21, 2012

    ... I am circumcised and I am certainly not disappointed in any way. I won't go into details but my wife has no trouble driving me completely crazy. If it was any more intense I wouldn't be able to stand it.

    economykiller on Newsvine, February 18, 2013

    Well, I am circumcised, and damn glad for it, cause as it is now I am way too sensitive. Not that the sensitivity is a bad thing...it's just a bit too much to handle.

    Adam Burman on The Times of Israel, February 19, 2013

    find it hard to believe it can get any more sensitive than it already is (circumcised). Might never stop hyperventilating and eyes never roll back to normal position if it was.

    PlainTruth on Yahoo News, March 8, 2013

    My dick is too sensitive as it is. I don't want it more sensitive.

    The Crunge on Grasscity, March 23, 2013

    I always like the statement that being circumcised reduces pleasure. I'm circumcised and if I enjoyed it any more than I already do, I'd never last long enough for my wife to ever reach orgasm...

    Kenneth Anderson in the Wall Street Journal, June 18, 2013

    @Adrian I am a helmet guy and I have never had a problem with sensitivity. If anything my problem was the other way, I get aroused far too easily. ...

    mont_y in the Sydney Morning Herald, August 14, 2013

    ''Sometimes too much sensitivity''

    O Canada, December 5, 2013

    Playing with my dick feels pretty fucking fantastic and it has no extra skin over it. If it felt any better i would last all of 5 seconds. I am completely fine with being circumcised. I will ride my cut dick all the way to hell!

    [Name in Japanese characters] on Facebook, January 10, 2014

    My first body modification. 20,000 nerve endings severed? I'm cut & sensitive as hell. If I wasn't cut, I'd orgasm with every step under that theory.

    Ken Cole on Facebook, January 9,2014

    I already got trouble lasting long in good p*ssy, I don't need any more pleasure

    ChrisDorner on The ColiJanuary 22, 2014

    I am circumcised. If I had more sexual pleasure than I already have I might have problems with premature ejaculation. And I might not be able to last as long, thus depriving my partner of as much pleasure.

    FreeRanger on The Daily Beast, February 2, 2014

    To all those people saying it's WAY more sensitive and better to have an uncircumsized penis... here is my arguement:

    I am circumcised and love sex. It feels fantastic. I don't really wish for any more sensation, because it's overwhelming at times as it is. I feel like if it were any more sensitive, I would just immediately cum, and wouldn't be able to 'stay in the game'.

    So thank you parents for circumcising me; I am now able to adequately service ladies without prematurely ejaculating.

    kebob on Reddit, February 10, 2014

    You mean its even better that what I have? I don't believe you. I would definitely suffer from premature ejaculation. Then my partners would be unsatisfied - still who cares about them? Not some people obviously.

    justliveandletlive on YouTube, March 2013

    One man drove by and yelled, “If I had any more sensation I’d only last 5 seconds!

    - Brian Herrity reporting on a demonstration at Walnut Creek, CA, March 23, 2014

    if i had anymore sensation i dont think i would last more than 20secs... i love my circumcision, really sets my junk apart from the others.

    - oxymoronic on MMO, April 15, 2014

    Tyler: more than enough pleasure

    Tyler Palmer College Humor, May 7, 2014

    ... Personally my penis still has way too much feeling in it...

    Jaden Oldfield on Youtube, May 9, 2014

    "He says it reduces penis sensitivity"
    Yeah, more sensitivity. That's JUST what I need.

    Papagano on MLive, September 6, 2014

    (44 anecdotes - all unsolicited and remarkably similar)

     

    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":

     

    I ... acknowledge that maybe the pleasure diminished by the lack of foreskin, but I've always managed to have a good time in bed somehow.

    Hardmannyc on queerty, September 20, 2008

     

    Arrgh, so tired of these dipshits equating circumcision with "mutilation." As the procedure does not interfere with function or the ability to orgasm "modification" may be a better word.

    Qjersey on queerty, December 12, 2010

     

    @aido92 It may be far less, but it's still a lot, at least to me, besides it doesn't bother me, I can still orgasm, and all that, so I'm fine.

    CJCA915 on YouTube, December 24, 2010

     

    Sexual sensation is there and I doubt there is any lose in sensation. ...

    grandmastergooch on YouTube, January 23, 2011

     

    But as anyone who has been circumcised can attest, it does not interfere with the ability to have amazing orgasms.

    Richard at Eye on a Crazy Planet, January 25, 2011

     

    Orgasm is in the brain, not the penis. What is unsaid and unspoken is that about 20+% of the male population is inorgasmic, painful organsm or difficulty reaching orgasm for unknown reasons. [And has any study disproved circumcision as a cause?] The mechanics work, but not the brain. These men mistakenly [?] attribute, if they ever actually realize they are inorgasmic, this loss to circumcision. It is true that there are aesthetic botches and even functional botch jobs, and even excisions, but unlike female circumciscion, it doesn’t necessarily interefer with achieving orgasm in men.

    Dean Blake, J. D. on The Good Men Project magazine, February 4, 2011

     

    Circumcision isn't all that catastrophic, guy. An orgasm is an orgasm, and you can still get there, perhaps even drawing out the experience.

    cool dude on Yahoo! Answers, March 31, 2011

     

    Well I am still getting stimulated enough to get off. If anything it will prolong ejaculation and make sex last longer.

    RH on Yahoo, April 29, 2011

    ... millions of men have had circumcisions and continue to have apparently normal sexual relations. ... There are pain sensing nerve endings in the prepuce and the glans. There are also pleasurable nerve endings in both. This is why virtually every circumcised male can have intercourse including orgasm. ...

    James Biggerstaff MD on Amazon.com on May 17, 2011

    I don't agree that circumcision is clearly mutilation - it's not like circumcision renders a man unable to have orgasms (which I understand the female "mutilation" does).

    Terry Martorana in the Wall Street Journal, May 25, 2011

    A male organ has it's need and as for the act of fornication/ejaculating the method regardless isn't impeded is it?

    Jon SR Ranta on Amazon.com, June 9, 2011

    "What can a circumcised man do to simulate the experience of having a foreskin?" As far as I can tell I do every time I cum…........

    GAD on Project Reason, August 12, 2011

    It's obvious to me that, unlike most women, circumcised men have no problems achieving orgasm. [Perhaps women have problems because circumcised men "achieve orgasm" too easily?]

    janellect on MSNBC, September 2, 2011

    Yet I can certainly testify that my satisfaction is genuine satisfaction. I get an erection and climax with satisfaction when I have sex. Who can tell me I’m wrong?

    howardpierce on Lousy Canuck's blog, December 27, 2011

    I was circumcised as a baby and never had any trouble masturbating or reaching orgasm my entire life, and I'm 65 now

    Peter Groubert on the Purdue Exponent, February 24, 2012

    ''We may not experience release''

    Gil Origin on YouTube, February 2014

    ''I can still bust a good nut''

    Mike Bragg on YouTube, May 16, 2014

     

    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.

     

    The Laumann study

    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 sex."

    The reference to the white population is usually left out. The reference to anal sex is false. This CNN report later says

    "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:

    Masturbation
    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 intact)

    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 intact man.

    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.

    Sexual dysfunction

    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 make headlines.

    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 significant differences:

    • 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.

    Erectile 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. shenzhj@mail.hz.zj.cn

    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 = 0.04).
    CONCLUSIONS: Adult circumcision has certain effect on erectile function, to which more importance should be attached.

    PMID: 14979200 [PubMed - in process]

    [This 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.

    BJU International
    January 2008

    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

    OBJECTIVE
    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 conflicting results.

    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 NCT00425984.

    RESULTS
    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 = 0.8).

    CONCLUSION
    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 [19]. 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 who thought that women enjoy sex more with circumcised men were over five times more willing to have the procedure [15]. [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 reassuring and provide important information for future programmes.

    There were six measures,

    • desire [Laumann et al. found 12-16% of men "lacked interest in sex"]
    • difficulty with penetration
    • difficulty with ejaculating (nothing about premature ejaculation)
    • pain on intercourse/dyspareunia
    • "a problem regaining erection after ejaculation" (?)
    • satisfaction (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 "reassuring" implies.

    Also

    1. The subjects were all volunteers for circumcision. Those who enjoyed having their foreskins would be much less likely to volunteer.
    2. The subjects were all paid (substantially, by local standards) to take part.
    3. 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.)
    4. What does that culture say about sexual satisfaction and how it is measured?
    5. What does that culture say about admitting to sexual failures?

    Already this 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 sexual function.
    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 made.] Changes 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.

    [Another 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 sexuality:

    ... 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 or not.

     

    Acta 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. Saracoglu

    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 the Brief Male Sexual Function Inventory (BMSFI), consisting of sexual drive, 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 was 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 warranted also regarding the other dimensions of circumcision. [References: 13]

    [This 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!

    In 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 perception threshold
    [Article in Chinese]
    Yang DM, Lin H, Zhang B, Guo W.

    Abstract

    OBJECTIVE:
    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.

    METHODS:
    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.

    RESULTS:
    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).

    CONCLUSION:
    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.

    ABSTRACT
    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] (11.3% versus 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 = 0.007) and low sexual desire (OR 7.49, P = 0.029) were significant predictors for de novo delayed orgasm.

     

    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!

    - scott, 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

        "[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."

        So its results have qualitative if not quantitative merit.

      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 serious:
      • 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:
        • 77% said circumcised penises "seemed more natural"
        • 54% said circumcised penises "stayed softer"
        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.

        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 source.

      SEXUAL SATISFACTION OF WOMEN PARTNERS OF CIRCUMCISED MEN IN A RANDOMIZED TRIAL OF MALE CIRCUMCISION IN RAKAI, UGANDA

      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

      BACKGROUND: Some 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.

      RESULTS: Only 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 sexual satisfaction.

      [Why 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 satisfaction.

      It 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?]

    Here is one woman's story.

    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 preference
    • 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 today...)

    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, though:

    • Men 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.

      Back in 1964, ... I was serving a tool and die apprenticeship in a machine shop with several men that had served in the military during WWII. They shared their experiences 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 the wealthy were born in hospitals, and even then, only some of them were circumcised), but he felt very much differently about it afterwards.

      The second man would not have wanted it done, but he was too sick to give his view on it before the operation. ... Both commented that their losses were very significant (one said he experienced a 70% loss of feeling, and the 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, I 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 had been 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 it 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 Pienaar,
      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).

       

      J Urol 2002 May;167(5):2113-2116

      Adult Circumcision Outcomes Study:
      Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction

      Fink KS, 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 Carolina.

      PURPOSE: 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.

      MATERIALS 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.

      RESULTS: 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.]

      CONCLUSIONS: 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.]

      PMID: 11956453 [PubMed - as supplied by publisher]

       

      A small survey of men circumcised as adults finds detriment

      09 Does circumcision improve couple's sexual life?
      I. Solinis, A. Yiannaki


      I. Solinis
      Department of Urology,
      General Hospital of
      Didimoticho, Didimoticho,
      Greece

      A. Yiannaki
      Department of Urology,
      General Hospital of
      Didimoticho, Didimoticho,
      Greece

      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 below.
      Results: 16% answered that their sex life was improved, while 35% reported a worse sex life after circumcision. There were no significant 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 couple's 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. [The results support the view that newborns should not be circumcised.]

      journal of men's health & gender
      Vol. 4, No. 3, pp. 357-378, September 2007 361

      Circumcised men are more likely to have premature ejaculation

      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
      DOI: 10.1111/j.1743-6109.2011.02280.x

      ABSTRACT

      Introduction. Premature ejaculation (PE) is common. However, it has been underreported and undertreated.

      Aims. To determine the prevalence of PE and to investigate possible associated factors of PE.

      Methods. This 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 dysfunction, circumcision, 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 of premature ejaculation in a primary care setting: A preliminary cross-sectional study. J Sex Med **;**:**–**.


    •  
    • Men 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, de-keratinised glanses.

    • 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 preference for 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.

      Docking
      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

      Topco 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 real foreskin."

      Docking aid

      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.)

    Meta-science

    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 result.

    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.

    ABSTRACT

    Introduction
    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 controversial.

    Aims.
    The study aims to conduct a systematic review of the scientific literature.

    Methods
    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.

    Results
    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 meta-analysis.

    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.

    Conclusion
    The highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction.

    News Flash! Circumcision advocates advocate circumcision!

    Circumcision advocates Brian Morris and John Krieger's "meta-analysis" (annotated version here) compounds the faults of the above studies.

    • They rank the ill-defined and circumcision-driven Masters 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 sexual satisfaction.
    • They unfailingly mark down all studies finding detriment to circumcision and mark up all those finding benefit.
    Professor Morris has a track record of statements that do not correspond with the facts.

     

    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."

    "Foreskin's Lament"
    Sunday Star-Times
    (New Zealand)
    July 29,2001

    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 in sex.

    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 of MGM.)

    However, one women's experience suggests that that is not the case and that a woman's "foreskin" is as sensitive as a man's:

    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,

     

     

    Resources
    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

    cover

    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

    foreskin     Cutting 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.

    cover

    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.

    Related pages:

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