Researching Circumcision, Part 1: What Is the Foreskin?

February 16th, 2010 by Dionna | 24 Comments
Posted in Circumcision/Intactivism, Compassionate Advocacy, Healthy Living, natural parenting, Pregnancy and Birth

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Even though infant circumcision is still referred to as a “routine” aspect of newborn care, as many as 46% of expectant parents are not given any information on the procedure by their doctors. (1) What’s worse? Over 82% “of parents in the first six months of their baby boy’s life regretted the decision they made about circumcision.” (2)

This article is the first in a series I am writing to help expectant parents get a jump start on their research about circumcision. Please check back the next two Mondays for the follow-up articles in this series. Part one is on the foreskin and its normal, necessary functions. Part two will look at the circumcision procedure: what it removes, how it is performed, and what the short- and long-term consequences are. Part three will present information on many of the common concerns parents have when considering circumcision (including an examination of the research on STD’s, cancer, and other health issues).

Please take a moment now to subscribe to my RSS feed for free updates so that you will not miss the remaining articles in this series.

If you are an expectant parent, please read this series, the sources cited herein, and then continue to research information on your own. You owe it to your son to arm yourself with the facts before considering a procedure that will permanently alter his genitals.

If you have any questions, I would be happy to help answer them (or direct you to someone who can). As always, respectful comments are welcome.

What is the Foreskin?

Each baby boy is born with a normal, intact penis. Every normal, intact penis has a continuous skin system that begins at the base of the penis and ends at the tip of the foreskin or “prepuce.” The foreskin is actually two layers of skin: the penis’s skin system folds in on itself near the tip (the glans or “head”) of the penis and reattaches somewhere behind the glans. This fold is the foreskin. (3)

Some people mistakenly think that the foreskin is just an “extra flap,” unnecessary, separate. This could not be further from the truth. In reality, the foreskin is as much a part of the whole penis as the glans is. The penis is made up of an outer foreskin layer (the continuation of the skin of the penis’s shaft), an inner foreskin layer, a ridged band (the interface between the two layers), the glans, and the frenulum (a connecting membrane on the underside of the penis).

“The foreskin contains a rich concentration of blood vessels and nerve endings. It is lined with . . . a smooth muscle layer with longitudinal fibers.” This muscle layer protects the urinary tract from contaminants. The inner layer of the foreskin is packed with nerve endings that provide erogenous sensitivity later in life. The inner layer of the foreskin is actually more sensitive than the head of the penis. (4)

The Functions of the Foreskin

The foreskin provides many functions that are lost after circumcision. These functions include:

1. Protection: Just as the eyelids protect the eyes, the foreskin protects the glans and keeps its surface soft, moist, and sensitive. It also maintains optimal warmth, pH balance, and cleanliness. The glans itself contains no sebaceous glands-glands that produce the sebum, or oil, that moisturizes our skin. The foreskin produces the sebum that maintains proper health of the surface of the glans.

2. Immunological Defense: The mucous membranes that line all body orifices are the body’s first line of immunological defense. Glands in the foreskin produce antibacterial and antiviral proteins such as lysozyme. Lysozyme is also found in tears and mother’s milk. Specialized epithelial Langerhans cells, an immune system component, abound in the foreskin’s outer surface. Plasma cells in the foreskin’s mucosal lining secrete immunoglobulins, antibodies that defend against infection.

3. Antibacterial Function: To help fight harmful bacteria, the foreskin supports a rich flora of beneficial bacteria. . . . The good bacteria that live in the inside of the foreskin are similar to the bacteria found in the mouth, nose, the female genitals, and the skin in general. It must be stressed that this good bacteria is both harmless and highly beneficial. Without these friendly bacteria, the urethra would become an easy entry point for germs and harmful strains of bacteria, which could cause disease.

4. Erogenous Sensitivity: The foreskin is as sensitive as the fingertips or the lips of the mouth. It contains a richer variety and greater concentration of specialized nerve receptors than any other part of the penis. These specialized nerve endings can discern motion, subtle changes in temperature, and fine gradations of texture.

5. Coverage During Erection: As it becomes erect, the penile shaft becomes thicker and longer. The double-layered foreskin provides the skin necessary to accommodate the expanded organ and to allow the penile skin to glide freely, smoothly, and pleasurably over the shaft and glans.

6. Self-Stimulating Sexual Functions: The foreskin’s double-layered sheath enables the penile shaft skin to glide back and forth over the penile shaft. The foreskin can normally be slipped all the way, or almost all the way, back to the base of the penis, and also slipped forward beyond the glans. This wide range of motion is the mechanism by which the penis and the orgasmic triggers in the foreskin, frenulum, and glans are stimulated.

7. Sexual Functions in Intercourse: One of the foreskin’s functions is to facilitate smooth, gentle movement between the mucosal surfaces of the two partners during intercourse. The foreskin enables the penis to slip in and out of the vagina nonabrasively inside its own slick sheath of self-lubricating, movable skin. The female is thus stimulated by moving pressure rather than by friction only, as when the male’s foreskin is missing. (5)

Circumcision Removes a Healthy, Functioning Sexual Organ

The foreskin is a necessary part of a complete, functioning penis. These vital protections and benefits are stripped along with the foreskin in circumcision.

If you are considering circumcision for your newborn or you know someone who is expecting, please read the information found at some of the links below first and then pass the knowledge on to others. It is our responsibility as parents to make informed, ethical choices for our children.

Get this sticker and more FREE (or leave a donation) at http://www.tlctugger.com/prodStickers.htm

Resources and Information on the Foreskin and Circumcision

Are You Fully Informed? (includes an excellent list of books, articles, and websites dedicated to the subject of circumcision and the normal, intact foreskin)

Basic Care of the Intact Child (it’s easy: clean what you see and never retract)

Circumcision: What I Wish I’d Known

Cut: Slicing Through the Myths of Circumcision (a documentary on circumcision)

Cutting Kids

Doctors Opposing Circumcision Genital Integrity Policy Statement, Chapter 2: The Prepuce

Functions of the Foreskin: Purposes of the Prepuce

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Please see the following sources (including the studies and material cited therein) for more information.

(1) One of Attachment Parenting International‘s (API) eight principles of parenting is to prepare for pregnancy, birth, and parenthood. Part of that preparation is to “[r]esearch all aspects of ‘routine’ newborn care, such as bathing, circumcision, eye drops, blood samples, collecting cord blood, etc.” “Prepare for Pregnancy, Birth, and Parenting,” http://attachmentparenting.org/principles/prepare.php
(2) Fleiss, Paul, M.D., “What Your Doctor May Not Tell You About Circumcision” at xi, available in part at http://books.google.com/books?id=rQUqA-AftAQC&dq=fleiss+what+your+doctor+may+not+tell+you+about+circumcision&printsec=frontcover&source=bl&ots=rXqG60HLo7&sig=6iNt8qLfkoOUuWylWWM51mLkO6M&hl=en&ei=oU7GSo2TBZLU8QbJqpBG&sa=X&oi=book_result&ct=result&resnum=1#v=onepage&q=&f=false
(3) Garcia, Francisco, “What Exactly Is Circumcision and What Is It Not?,” http://www.cirp.org/library/anatomy/garcia/
(4) CIRP, “Anatomy of the Penis, Mechanics of Intercourse,” http://www.cirp.org/pages/anat/; Fleiss, Paul, M.D., “The Case Against Circumcision,” http://www.mothersagainstcirc.org/fleiss.html; “Fine-touch Pressure Thresholds in the Adult Penis,” http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/HTMLSTART?CRETRY=1&SRETRY=0; What Exactly Is Circumcision and What Is It Not?
(5) The Case Against Circumcision. Dr. Fleiss goes on to say: “The foreskin may have functions not yet recognized or understood. Scientists in Europe recently detected estrogen receptors in its basal epidermal cells. Researchers at the University of Manchester found that the human foreskin has apocrine glands. These specialized glands produce pheromones, nature’s chemical messengers. Further studies are needed to fully understand these features of the foreskin and the role they play.”; “Functions of the Foreskin: Purposes of the Precupuce,” http://www.drmomma.org/2009/09/functions-of-foreskin-purposes-of.html

24 Responses to:
"Researching Circumcision, Part 1: What Is the Foreskin?"

  1. Mark Lyndon

    You might also want to check out the following:

    Canadian Paediatric Society
    http://www.cps.ca/english/statements/fn/fn96-01.htm
    “Recommendation: Circumcision of newborns should not be routinely performed.”

    http://www.caringforkids.cps.ca/pregnancy&babies/circumcision.htm
    “Circumcision is a ‘non-therapeutic’ procedure, which means it is not medically necessary.”
    “After reviewing the scientific evidence for and against circumcision, the CPS does not recommend routine circumcision for newborn boys. Many paediatricians no longer perform circumcisions.”

    Royal Australasian College of Physicians
    http://www.racp.edu.au/index.cfm?objectid=B5610716-9E3E-6C97-A8D87880FD002E3B
    “After extensive review of the literature, the Paediatrics & Child Health Division of the Royal Australasian College of Physicians has concluded that there is no medical reason for routine newborn male circumcision.”
    (almost all the men responsible for this statement will be circumcised themselves, as the male circumcision rate in Australia in 1950 was about 90%. “Routine” circumcision is now *banned* in public hospitals in Australia in all states except one.)

    British Medical Association
    http://www.bma.org.uk/ethics/consent_and_capacity/malecircumcision2006.jsp#Circumcisionformedicalpurposes
    “to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be unethical and inappropriate.”

  2. This issue seems so strange, given that we don’t routinely circumcise in the UK. We don’t have any problems with foreskins. Men don’t walk around with permanent infections because they still have a foreskin. It just seems barbaric to cut a tiny baby boy’s penis – the very thought makes me feel sick. I am so glad that people like you are standing up against this horrible cultural practice.

  3. Ted

    Thanks for this important post – most of the world agrees with you!

  4. I am sitting here sobbing, mad as hell at myself that I ever let my boys have this horrific thing done to them. I was even told that my first son has “slept right through it” which I can only conclude to be a lie. I am mad that I was never told the truth,I was told it was best that everyone looked the same, if Dad had it done, them baby should have it done. That was what I was told, along with “its a quick painless procedure” I hate our western medical world! I don’t think I will ever be able to forgive myself, not completely, it is going to take some time to get to the point that I don’t tear up every time I look at them and don’t feel extremely guilty for what I have done. I will make sure that they are informed so that when they have kids they know the truth, but hopefully by then this barbaric practice will be gone from our culture.

    • CodeNamePapa   CodeNamePapa

      I was going to email Dionna this little blurb, but decided to reply to you instead…

      my main point: You can’t beat yourself up forever, take your emotions and turn them into something positive… We need to do what what we can to help people who are making the decision soon and future generations as well. It takes a while for “enlightened” information to become mainstream, especially something that’s so deeply entrenched like circumcision.

    • Dionna   CodeNameMama

      Megan, I just emailed you, but I wanted to add something here for your benefit and anyone else who is in your position.

      I do NOT judge the parents who have circumcised in the past. People didn’t know. Our doctors, family, and friends told us that it was the right thing to do, the only option. The ignorance was epidemic. And not only did we hear “do it for their health,” we heard “do it so they don’t get made fun of by their friends.” And we were and are guilted into it.

      But now we have the opportunity to save future generations of our sons from unnecessary pain. It is YOUR story that will help do that. Thank you for posting so honestly.

  5. DT

    As always, I’d like to know the religious aspects of circumcision. I know it’s common in the United States, but I wonder if it was brought over from a European custom. (Probably the Catholic Church, but I have no idea) Like most religious traditions, Judaism, Islam, and Christianity have a way to “set themselves apart,” yet early Christian records seem to not care about circumcision. (Romans 3 perhaps) I really don’t have time to look anything up, but I’m sure someone who reads this wonderful website has researched it a bit.

  6. Restoring Tally   RestoringTally

    I applaud your efforts here. Education is the way to change the circumcising culture in the US. Thank you.

    I was circumcised at birth. For my first 52 years of life I never knew that I was missing a foreskin. Sure I know I was circumcised, but I did not understand. I recently learned and I am actively restoring my foreskin. I am learning that the foreskin is a wonderful part of the male anatomy. The more I restore, the more I realize that I have missed out on a lot.

    I would like to point out that another function of the foreskin is to make intercourse more comfortable and pleasurable for the woman. The foreskin is mobile and serves to maintain the vaginal lubrication where it belongs, in the vagina. A foreskin prevents vaginal dryness and also eliminates the soreness many women experience from sex with a circumcised man. See “Effects of male circumcision on female arousal and orgasm” New Zealand Medical Journal, http://www.nzma.org.nz/journal/116-1181/595/

  7. Lexie

    I would like to know how you back up your stats? Where you get the 46% of parents and the other information you have gathered. Did i miss the source page?
    Thanks

  8. the Grumbles   thegrumbles

    I’m a little intimidated to post on this, but I’ve been thinking about it for a few days so I’ll be brave:

    We circumcised our son when he was born in September. I did all the research, read all the links you have listed above, and was vehemently AGAINST doing it. But my husband, who is circumcised, was just as dead-set FOR it. Not because he wanted his son to “look like him” or some stupid reason like that, but because of the studies recently that have shown how it can help protect from STD’s and disease. This is one of the only issues in the history of our marriage that we just couldn’t see eye-to-eye on. In the end, I let my husband choose because he HAS a penis and I don’t. He knows what it’s like to be circumcised, and unlike the gentleman above, he isn’t sad about it at all.

    So, I’m probably going to get roasted alive for posting this but in the end, I was happy with our compromise. Our pediatrician was sensitive to the fact that I wasn’t crazy about the whole idea and used anesthesia and gave our son a “long cut”.

    Posts like this are SO IMPORTANT to help educate people but I hope you won’t hold my choice against me.

    • Dionna   CodeNameMama

      I won’t roast you alive, and I will edit/delete anyone else who tries to.

      I will disagree with the rationale though: we plan on educating our son about how to avoid STDs: the key is to choose his sexual partners wisely and use a condom. Circ doesn’t PREVENT STDs. Condoms do.

      The fact of the matter is, the US has the most circumcised males, and the highest rates of STDs – if circumcision really helped prevent STDs, don’t you think it would be reflected in the statistics?

      And even if circumcision did help prevent STDs, I still wouldn’t permanently alter my child’s sexual organ. I would be PISSED if someone had taken away my clitoral hood in an effort to protect me from STDs. I get a lot of pleasure from that portion of my body. It is MINE.

      Or what about breast cancer? The chance of a woman having invasive breast cancer some time during her life is a little less 1 in 8. One out of four Americans between ages 15 and 55 will catch at least one STD. (That statistic includes both women AND men, so let’s be unscientific, double that, and say one out of 8 men will get an STD). So if the rationale is “lop off the body part that may get an STD at a 1 in 8 risk,” then it also makes sense to say “well, let’s just remove our infant girl’s breast buds – same risk.”

      But that thought is horrifying, isn’t it?

      The third post in this series (that’s already written) is about STDs & the risks of being circ’d v. intact (among other things). I will have more there.

      Thank you for having the courage to post. I don’t want anyone to be afraid to post a comment. I may disagree with you, but I will never try to attack you.

      • the Grumbles   thegrumbles

        GAH! YES! SEX EDUCATION! I agree with you a thousand times over. Trust me, it was yelled more than a few times at our house during these “discussions”.

        Continue on with your excellent educating.

    • Dionna   CodeNameMama

      One more thing: I completely respect you for taking time to research and educate yourself on the subject. Most people don’t (not because they are horrible people, but b/c circ is so common still that no one expects them to). There are many sites that make circ seem like the best option. I just happen to disagree with them.

    • Mark Lyndon

      Men who’ve been circumcised seem a lot more likely to believe in the supposed benefits of circumcision. Personally, I don’t think they should be given the final say just because they have a penis. If I was married to a circumcised Egyptian woman (I used to date one), I wouldn’t let her have the final decision on having a girl cut. The final decision should be with the person whose body it is. It’s not a big deal if someone decides they want to be circumcised when they’re older, but someone who’s been cut can never be intact again. Anesthesia should always be used for neonatal circumcision btw, but I’ve seen estimates that it’s only used about half the time.

      In your case, it just seems wrong to have had your son cut just in case he has unsafe sex with someone who has an STI. Using anesthesia and having a loose cut makes it not as bad, but I still think it should have been your son’s decision.

      In Europe, almost no-one circumcises unless they’re Muslim or Jewish, and they have significantly lower rates of almost all STI’s including HIV. The longest study in a western country (the umm Dickson study in New Zealand) showed a very slightly higher rate of STI’s in the circumcised group.

      Even in Africa, there are six countries where men are *more* likely to be HIV+ if they’ve been circumcised: Cameroon, Ghana, Lesotho, Malawi, Rwanda, and Swaziland. Eg in Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Rwanda, the HIV rate is 3.5% among circumcised men, but only 2.1% among intact men. If circumcision really worked against AIDS, this just wouldn’t happen. We now have people calling circumcision a “vaccine” or “invisible condom”, and viewing circumcision as an alternative to condoms.

      The one study into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw.

      ABC (Abstinence, Being faithful, Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.

  9. Woman Uncensored   WomanUncensored

    When they say “Over 82% of parents in the first six months of their baby boy’s life regretted the decision they made about circumcision.” does that include parents who decided NOT to circumcise? Did it measure whether a portion of them regretted NOT doing it? Would just really love to know for sure on that one, since I haven’t gotten to read the book.

    AWESOME freakin post by the way, thanks so much for sharing :-)

    • Dionna   CodeNameMama

      Thanks! Honestly, I had the same question when I read the statistic, but the author of the book does not make it clear. That sentence is lifted right out of the book – there’s nothing to explain further. Sorry I can’t be of more help!

    • Restoring Tally   RestoringTally

      Why would anyone regret not circumcising their infant? Parent’s don’t normally regret not cutting off the hands or other body parts of their babies. The foreskin is just another healthy body part.

      OK, maybe because of family and societal pressure some parents may regret not cutting their babies. Also, some parents may regret it because they do not know how to care for an intact penis and may forcibly retract it, causing later problems that require correction. I do not consider either of these to be valid reasons to regret circumcising a baby.

  10. Cheryl

    Christians and Catholic Christians did not bring circumcision over here. It became more popular as a means to deter masturbation amongst puritanical minds. Kellog.
    There is no room for debate or speculation. Christians are forbidden from practicing routine infant circumcision by the New Testament.
    http://www.stopcirc.com/christian.html
    http://www.noharmm.org/christianparent.htm
    http://www.cirp.org/pages/cultural/lewis1/
    http://www.catholicsagainstcircumcision.org/
    http://www.drmomma.org/2009/06/information-on-circumcision-for.html
    And to know your heritage and tradition as a Jew we should research, learn and know that Circumcision. in the beginning was not the removal/amputation of the foreskin, but just a cut of the foreskin. The modern circumcision was integrated into society as a cure for masturbation.

  11. Amy

    Great post here!! I just want to add my own two cents :)

    I think one of the issues with the US doctors is that they themselves were likely circumcised so the majority don’t really understand what it means/feels like to be left intact (for the man AND his future partner(s)!). Medical textbooks and photos will also show circumcised penises rather than intact penises, although I hope that’s improving!!

    I wonder if they tend to spread misinformation because they were misinformed about their own personal experiences. I know they are supposed to let the parent’s have informed consent but are they really *informing*?

    One of my personal concerns is that an newborn or infant can’t consent. If an intact adult chooses to have a circumcision performed that is absolutely their right but we don’t know which the infant wants. I would venture to guess the least uncomfortable ;) There is a reason for foreskin and I tend to side with evolution and natural selection in matters like this (yes, I majored in physical anthropology but loved my cultural anth and public health classes too, if anyone was wondering lol). With that said, I understand and respect parents for whatever *informed* choice they make and hope they are putting babies interests first.

    My last point is related to STD’s. I understand that the discussion is related to what is *riskier* and being able to minimize that risk but I find the whole thing a little fruitless. You can get an STD if you are circumcised or intact, use a condom or not, have one partner or more than one partner. If you have sex, you can get an STD. Period. And you may not even know!!!

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