Circumcision

Circumcision is a procedure in which pieces of the genitalia are excised for religious, social, or alleged health benefits. For the anatomical male, the operation removes the foreskin (either partially or fully) of the penis. For the anatomical female, it involves the removal of some or all of the external female genitalia. Circumcision may take place at any age, although it is most often done neonatally or during childhood.

Some groups argue that circumcision is a form of genital mutilation, and argue for ending the practice. These groups often cite a perceived decrease in sexual pleasure and the lack of consent on the part of the (often) infant child as indicating child abuse. However, most major medical organizations do not agree with this, including the American Medical Association, the World Health Organization, the American Association of Pediatrics, and the British Medical Association, who do not condemn male circumcision, citing various potential minor health benefits and the right of parents to make choices for their children. On the other hand, no major medical organization outright recommends circumcision; the AAP merely says that benefits outweigh the risks but are not great enough to warrant recommending the surgery. Other organizations and individuals actively defend the practice, as they claim the alleged detriments of the procedure are entirely based on dubious anecdotal evidence and woo. More importantly, in sub-Saharan Africa, where HIV/AIDS has become a serious public-health issue, studies have found that circumcision of males provides an effective way of lessening the risk of the transmission of the virus from infected females to male sexual partners. However, these findings are highly dubious, due to several flaws effectively rendering the studies totally invalid. For example, the authors ended the study prematurely as soon as a significant effect was found. Moreover, they omitted the fact that circumcised men were provided with important information on how to avoid infection (i.e. how to use a condom) after their circumcision treatment.

The literature does not support the contention that the possible drawbacks are serious or likely enough to occur to justify discouraging the practice when performed by a medical professional. However, the possible benefits are equally slight and unlikely in Western countries. In particular, some medical benefits would be just as effective if the decision to circumcise is deferred until adulthood, when a man can choose for himself, or following diagnosis of a condition such as (NSFW). There is also evidence that attitudes to circumcision, even within the scientific literature, are coloured by how normalised the practice is in the practitioner's country.

Groups that circumcise
An estimated 30% of the global male population is circumcised, with the most circumcised areas being the Middle East, Africa, Southeast Asia, Australia, Canada and the United States of America. South Korea has a high circumcision rate as well, probably because they're on the tip of the peninsula.

In the U.S., the majority of males are circumcised. The percentage circumcised has decreased in recent decades. The still-considerable amount of circumcision in the United States has more to do with alleged health benefits than religious requirement. Canada and Australia do it for this reason as well, albeit not nearly to the same extent, and in fact it's been drastically declining in both countries over the last few decades. It is virtually non-existent in most other Western nations, except among Jews and Muslims.

Judaism customarily requires male circumcision, as commanded in Genesis 17:10-14. It is also an integral part of the conversion of a non-Jewish man to Judaism. Islam, through ordering followers to uphold the religion of Ibraheem and respect of the hadiths, similarly strongly supports circumcision. Christians aren't required to practice circumcision because Jesus said he didn't care in Galatians 5:6.

Various issues with the foreskin
Removal of the foreskin ensures that problems such as and  cannot occur. (NSFW)

Of course, no one recommends routinely removing other body parts that might possibly get cancer or experience other medical issues. As a justification for circumcision, this argument amounts to a rationalization.

HIV prevention
Circumcision is sometimes promoted as a way of reducing HIV transmission, especially in endemic regions. This is because the cells of the underside of the foreskin, for reasons that aren't yet fully understood, are especially susceptible to the virus. By removing this portion of the foreskin, circumcision may reduce HIV transmission rates by up to 70%. In another study, HIV incidence decreased by 51% in all sociodemographic, behavioural, and sexually transmitted disease symptom subgroups.

The World Health Organization is quite clear on the role of circumcision in reducing HIV transmission among heterosexual males in epidemic regions:

There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Three randomized controlled trials have shown that male circumcision provided by well-trained health professionals in properly equipped settings is safe. WHO/UNAIDS recommendations emphasize that male circumcision should be considered an efficacious intervention for HIV prevention in countries and regions with heterosexual epidemics, high HIV and low male circumcision prevalence.

By contrast, circumcision does not seem to reduce risk of transmission for men who have sex with men.

The World Health Organization also has information on other means of sexual protection, such as condoms, which it finds reduces the risk of HIV and other STIs by 80%.

In the U.S., where 77% of men are circumcised as of 2010, the prevalence of HIV is 0.3%, whereas in Denmark, where only 1.6% of men are circumcised, the prevalence of HIV is only 0.1%.

However, for those living in areas where HIV infection is not endemic, this is less of an issue. Indeed, the BMA has this to say:

There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral, or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proved except to the extent that there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues. Indeed, it would be difficult to formulate a policy in the absence of unambiguously clear and consistent medical data on the implications of the intervention. As a general rule, however, the BMA believes that parents should be entitled to make choices about how best to promote their children’s interests, and it is for society to decide what limits should be imposed on parental choices. So, in short, outside of high-risk areas, the jury is still out on medical circumcision.

Sexual pleasure
Though the foreskin is noted for its significant innervation, there does not appear to be a clear consensus in the medical community on whether or not circumcision markedly reduces overall sexual pleasure. While numerous anti-circumcision sources claim the existence of tens of thousands of nerve endings in the foreskin, these numbers have been described as "dubious, if not downright bogus". "No study currently available identifies the number of nerve endings on an adult foreskin."

A study performed by the British Journal of Urology found that, of their sample of roughly 1,300 men, those that were circumcised "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 [as well as other complications])."

In a meta-study run in Australia by Professor Brian Morris, spanning 40,473 males, the studies rated most accurate 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." On the flip side, circumcision can lead to delayed ejaculation.

Lack of safety
Unfortunately, non-medical circumcision performed by religious leaders is unambiguously risky. In New York City, at least 11 baby boys were infected with herpes over an 11-year period in the early 21st century due to an Ultra-Orthodox Jewish circumcision ritual in which a mohel orally sucks off the tip of the bloody baby penis sucks blood out of the incision. Other sects of Judaism do not have the mohel suck blood out of the incision, so their practices are less risky. According to Dan Bollinger, "a prominent opponent of circumcision", around 117 neonatal deaths occur in the United States every year due to circumcision, or 1 out of every 77 neonatal deaths. This is compared with 44 neonatal deaths from suffocation, 8 in automobile accidents and 115 from Sudden Infant Death Syndrome. However, this statistic is "widely disputed by medical professionals. A spokeswoman for the Centers for Disease Control and Prevention said the agency did not keep track of deaths from infant circumcision [in the United States] because they are exceedingly rare. In the agency’s last mortality report, which looked at all deaths in the country in 2010, no circumcision-related deaths were found."

Unfortunately, as with any medical procedure, on rare occasions things can go wrong, even with a medical circumcision performed by professional surgeons in a hospital; the tragic story of began with a botched circumcision due to phimosis, which left his penis so badly mutilated that it necessitated removal.

Penile cancer
Obviously, by removing the foreskin (or any other part of the human body), circumcision removes any risk of cancer in the removed body part, though penile cancer, in general, is very rare and often stems from infection with HPV.

Proponents of circumcision often bring up research from the Journal of the American Academy of Dermatology, which finds that "Regarding penile cancer, epidemiologic data have shown that penile SCC is extremely rare in men circumcised at birth." However, due to later studies contradicting it, medial authorities have largely dismissed it. For example, the American Cancer Society writes "the protective effect of circumcision wasn't seen after factors like smegma and phimosis were taken into account." In fact, to quote a study from the National Center for Biotechnology Information: "Recent medical literature has failed to confirm the protective effect of circumcision on penile neoplasms. Physicians need to be aware that men circumcised after 1 month of age may be at higher risk for penile cancer than those never circumcised."

Furthermore, the lifetime risk of developing penile cancer in the United States, where around 77% of all men are circumcised as of 2010, is 1/1437. However, in Denmark, where only 1.6% of all men are circumcised, the lifetime risk is only 1/1694.

Mental health
A Danish cohort study by Frischcor and Simonsen identified a correlation between circumcision and autism spectrum disorder. They also found that circumcised boys in non-Muslim families were also more likely to develop hyperkinetic disorder.

Biblical references
In Judaism, the call for circumcision is first found in Genesis 17; specifically, -14, as a covenant (or contract) between God and Abraham, and unto his descendants (e.g., all male children of Israel). Where his son Ishmael was circumcised at the age of 13, Isaac was seen as more holy for being circumcised on the 8th day of life. Isaac was not as holy as Shem though; Shem was born without a foreskin, a rare medical condition called aposthia.

In Christianity, as Paul of Tarsus specifically speaks against it (as synecdoche for the Law of Moses) in Galatians. suggests that Jesus did not care about whether you were cut or not, but Paul's words paint him as suffering from a little butthurt dickhurt.

It is worth considering that originally, only the very tip of the foreskin was cut away. It wasn't until the Hellenization period that periah, the removal of the entire foreskin, caught on. This was because a fair number of Hebrew traditionalists were upset with how younger men were restoring their foreskin under advice and/or pressure from the Greeks, who viewed even the slight circumcision as a vile travesty against the sacrosanct physical body. Despite the end of Hellenization, reversion to pre-periah has been... slow.

Comparisons with female genital mutilation
The procedure sometimes called "female circumcision" (FGM) involves pricking, piercing or excision of parts of the female genitalia; in extreme cases this includes removing the clitoris and the inner labia. The vast majority of such procedures are carried out without the consent of the individual involved, as with male circumcision. Most studies conclude that FGM is significantly more dangerous than male infant circumcision, but many do not account for the other forms, only examining the most extreme ones. Therefore, this should not be used as an excuse for performing male circumcision. Naturally, it must be judged on its own merits.

Interestingly, circumcision is not banned in most countries where FGM is, in large part to the fact that certain religions require or recommend it, while none require FGM. Circumcision's a touchy point with men's rights activists because they believe that outrage over FGM and acceptance of circumcision is proof of anti-male bias.

Some argue this is a false equivalence as circumcision generally does not cause the serious damage commonly seen with the harsher forms of FGM; however others point out that even the minor forms of FGM are banned in most western countries.


 * In 2015 in Australia, there was a landmark case where 3 people were convicted of performing a less severe form of FGM (doctors were unsure whether it was Type I or IV) on 2 girls and sentenced to 15 months in prison.


 * In 2017 in Michigan, USA, several people were prosecuted for performing a minor form of FGM that involved “removing a sesame seed-sized amount of mucous membrane from the clitoral hood" without removing the clitoris. This corresponds to Type Ia FGM.

More congruous procedures would be castration, or a penile subincision or, and although not entirely dead, traditions involving these have fortunately disappeared in many of the cultures previously featuring it. Gloria Steinem and Ayaan Hirsi Ali, both feminists and human rights activists, have condemned the procedure in addition to condemning female genital mutilation.

Non-surgical techniques
Accomplished by stretching tissue to stimulate mitosis. Can be done manually or with a device. Just make sure you know what the heck you're doing so you don't rip your dick off get sore.

Surgical

 * Foreskin reconstruction
 * Involves skin transplant
 * Foreskin regeneration
 * Regrowing the patient's foreskin — the organization ForeGen has professional assistance to prove out preliminary procedures needed, including the successful decellularization of a human foreskin scaffold.

Uses for the foreskin
Historically the main use of severed foreskins was in religious practice, with holy foreskins ostensibly from Jesus's weiner featuring in various Roman Catholic rituals. However, publications have reported that foreskins could be the next big beauty treatment. Epidermal growth factor from the foreskins of newborn boys reportedly helps "generate collagen and elastin, which can help to boost the radiance of your face". "Neonatal foreskin fibroblast culture" features in the TNS range from SkinMedica of Carlsbad, CA, USA, and in one clinical trial showed a statistically significant improvement in the appearance of fine lines.