Circumcision (eBook)

Chapter One

Circumcision 101

The Basics

What Is The Foreskin?

When I was growing up in Chicago, I heard that the foreskin was just “a useless flap of skin.” I don’t know how this pervasive idea got started, but a doctor as far away as Australia has blogged that he received the same childhood message. I’ve read the same phrase other places online, and it slipped into the pages of the book Sexy Origins and Intimate Things.8,9 But the foreskin is not useless, not a flap, and not just skin. Calling the foreskin “skin” is as foolish as categorizing the hand as “skin” because skin envelopes it. The medical term for foreskin is prepuce, which is a better term because it transcends the skin classification, but I will use the term foreskin because I want this book to be accessible to the general reader.

The foreskin is an elegantly designed solution to a complex evolutionary dilemma. The penis must have a resilient and dry exterior to prevent unwanted adhesion to clothing and other external elements while it protrudes from the body. Yet it also must be exquisitely sensitive and moist enough to promote the dance of sexual pleasure within the embrace of the vagina. The solution is the insulating foreskin sheath around the penis that is dry on the outside and lubricated on the inside so that when it unfolds upon erection, it will present a slick surface to the vagina. And voilà, here is a side view of an intact penis (Figure 1).

If you’ve never seen the whole intact apparatus, it may seem odd to you.10

In Figure 2, some of the important parts are labeled. Notice how the skin of the shaft and foreskin blend together at about the shaft midpoint, without an easily viewed line of demarcation. This is a significant problem in removing the foreskin that I’ll discuss later. Also, note that the glans is the head of the penis. Remember that term, because it will come up a lot.

While the exterior foreskin that encases the penis is visible, you can’t see the moist mucous membrane on the inside, which is lubricated by oily secretions called smegma, which keeps the glans soft. The foreskin is analogous to the eyelid, which retracts and also has a mucous membrane that keeps the eye moist.11

The foreskin is infused with a network of specialized nerve endings and sensory structures such as fine touch receptors (which sense pressure, touch, and vibration), the most important of which are Meissner’s corpuscles.12,13 To get an idea of how these corpuscles feel, try this experiment.14

During erection, the foreskin turns inside out on the shaft, as depicted here in a time series (Figure 3).

Part 1: Place your left hand over the top of your right hand, like in Figure 4.

Now run your left hand slowly over the top of your right hand (on a spot that doesn’t have hair—that’s important) and notice the sensation.

Part 2: Run your left hand slowly over your right hand’s palm. This should feel more sensitive and enjoyable. That’s because palms are suffused with Meissner’s corpuscles. It is probably one reason we enjoy petting animals. Reader, would you willingly give this up? The foreskin’s muscle fibers stretch during sexual intercourse, stimulating the Meissner’s corpuscles. 

Besides Meissner’s corpuscles, the foreskin is a bundle of nerves, sweat glands, muscle, blood vessels, oil glands, and a mucous inner layer.15 The adult foreskin is surprisingly large—if it were unfolded and laid flat, it would approximate the size of a 3-by-5-inch index card, or about 15 square inches (97 square centimeters).16 In fact, one anticirc organization is named 15 Square.17

The foreskin has several erogenous zones: the frenulum, ridge mucosa, preputial orifice (where the foreskin opens), and external fold (Figure 5).

Continuous stimulation of any of these usually elicits orgasm and ejaculation.18 The highest concentration of Meissner’s corpuscles is where the ridged band merges with the frenulum.19 Dr. Alfonso Cepeda-Emiliani calls this region the frenular delta, which he says is “ground zero for sexual pleasure—the F-spot” due to the unique, dense confluence of four different nerve types.20

Jewish circumcision always removes the frenulum, and I grieve its loss the most. Some of the intact men I interviewed were shocked that I didn’t have one and said they couldn’t imagine sex without it.

Hygiene and Foreskin Retraction

At birth, the foreskin is fused to the glans, like a fingernail on a finger, blocking irritants. The glans is further protected by the regular flow of sterile urine.21 The foreskin retracts on its own, some time before puberty. After that, cleaning it requires only running water. Regular soap should be avoided because it can irritate the foreskin. Those determined to do a more thorough cleaning can buy special gels designed for this purpose.22

Purpose of the Foreskin

Every male placental mammal has a foreskin;23 in primates alone, it has existed for 65 million years.24 Its longevity indicates that it likely has essential functions—and here is the list:25

Mechanical Functions

1. Protects an infant’s glans from fecal matter and ammonia. In his first months, muscle fibers allow the foreskin to function as a one-way valve, preventing entry of contaminants but allowing passage of urine.
2. Shields the sensitive glans from abrasion.
3. Keeps the glans soft with smegma, an oily substance under the foreskin.26

Sexual Functions

1. Stokes sexual sensations during sexual intercourse when sliding up and down the shaft, by alternately covering and exposing the glans, which allows nerves time to fire and reset. After penetration, the foreskin provides a gliding action that significantly reduces friction.27,28,29
2. Lubricates with smegma during intercourse.30,31
3. Provides a vaginal seal that retains a woman’s sexual fluids during intercourse.32
4. Contains most of a male’s erotic nerve receptors.
5. Stimulates a female partner during intercourse.
6. Makes the penis look longer and thicker.

Biochemical Functions

1. Produces antibacterial and antiviral proteins such as lysozyme.33
2. Contains fibroblast cells that promote wound healing. (These fibroblasts are quite valuable, as we’ll see in chapter 4 on foreskin finances.)
3. Contains epithelial Langerhans cells, an immune system component.34
4. Secretes immunoglobulins, which are antibodies against infection.35
5. Might emit pheromones (gases that stimulate sexual attraction).36

Is the Foreskin an Organ?

Intactivists are political activists who promote keeping the penis intact. They refer to the foreskin as an organ unto itself because of its special functions, vast nerve network, muscles, mucous coating, and unique ability to unfold on itself. Also, the American Academy of Pediatrics defines circumcision as the “amputation of the foreskin,”37 which sounds like an organ elimination to me. But most doctors continues to just call it skin, not an organ, so I will defer to that majority opinion.

What is Male Circumcision?

Male circumcision is the partial or complete removal of the foreskin.

There are different styles of circ. A “high” cut is far up the shaft, away from the glans and removing the most foreskin, whereas a “low” cut is closer to the glans. Medical circ removes widely varying amounts of foreskin. For example, when my friend had his son circumcised in a...