History of Circumcision

Abbreviated American History of Circumcision

In light of all the information presented by the HuFo Project and medical literature, it is fairly common for one to wonder, “If the foreskin is such an integral component of the penis, how did we end up in this mess?” Well, circumcision has a long, sordid history that extends back almost 10,000 years, but we’ll focus on the secular American timeline.

HuFo

It is important to note that circumcision has the most extensive literature for a seemingly simple medical procedure. That is because circumcision is not a medical procedure, but rather a cultural one. Many themes contributed to the introduction and then popularization of this prophylactic surgery. Although many of these were distinct justifications, they often built off of each other to amplify circumcision’s appeal.

The Medicalization of Circumcision

Circumcision used to be confined to just religious and tribal groups until the mid-19th century. At the time physicians believed that masturbation was not only immoral but unhealthy and caused all manner of physical and mental disease. (1) (2) To combat the evils of masturbation physicians implemented circumcision in both sexes.

Although the introduction of male and female circumcision seems extreme today, it fit nicely into the historical context of the times. Sexuality, especially male sexuality, was seen as perverse, aggressive and a threat to the social order during the Victorian Era at the turn of the 19th century. Genital surgery was commonplace, whether it be the application of carbolic acid on the clitoris or the insertion of high-voltage electric probes in genital orifices to solve all types of promiscuity, masturbatory insanity (a medical term) being a major one. (3) (4) (5) One can see College Humor’s crude, and comical yet surprisingly accurate depiction of this time here, which is also indicative of the changing mindset in the youthful generation.

“Evidence” to Support Circumcision

In addition to stemming the tide of masturbation, doctors had an actual public health crisis on their hands, venereal diseases. At the turn of the century, gonorrhea and syphilis were epidemic in urban populations. Having a tentative grasp on germ theory, physicians postulated that the hardened skin on the circumcised penis was resistant to the microbes that seeped from those infected with VD. (6) To prove this hypothesis, physicians performed population studies of circumcised vs. intact men and "discovered" that circumcised men had significantly lower mortality, morbidity, and STD rates than intact men (7) (8) … the catch? The only circumcised men back then were Jewish men. What the researchers failed to realize was that they were studying the differences in Jewish and Gentile culture, NOT the effects of the presence or absence of a foreskin. Since Jews tend to occupy higher socioeconomic classes, and are often demographically more educated, and sexually more conservative, they enjoyed lower mortality, morbidity, and STD contraction rates. (9) 

The Mark of High Class

Lithograph Depicting Angel of Cleanliness From the 1880s onwards, America underwent a cleanliness reform where bathing regularly became a symbol of high class. (10) Simultaneously genitals were classified by default as unclean, especially normal genital secretions, to conform to the prevailing Victorian ideology. (11) Since circumcision made masturbation difficult (genitally intact males don’t need lube to masturbate), removed the presence of smegma (healthy genital secretions all male and female mammals produce), and blunted sexual pleasure (6) it was welcome in sexually repressed 19th century America.

In the final decade of the 19th century, millions of Europeans began immigrating to the US. Xenophobia was rampant and immigrants were largely classified as unclean; the foreskin becoming the physical symbol of neglect and low-class. (9) Circumcision was seen as a status symbol, confined to the upper-class, to distinguish oneself and one’s offspring from the filth represented by the immigrant population. (12)

Conflation of Religion and Medicine

During the institutionalization of circumcision in the US, medical journals relied more on theological and moral tenants rather than scientifically sound studies or ethics. As public opinion started favoring this surgery, many physicians seized the opportunity to bridge the gap between their religious and scientific beliefs. This phenomenon is readily observed in the medical literature, with common sentiments expressed to “follow in the footsteps of Moses” (13) or to follow “Abraham and his contemporaries’ demonstrated knowledge of hygiene.” (14) This religious rhetoric continued throughout the 20th century, especially from some of the more vehement promoters. Abraham Ravich, the man responsible for popularizing the thoroughly discredited carcinogenic smegma, cervical, and prostate cancer myths (15) compared his observations in Brooklyn to that of Moses’ as he poured over Biblical papyri to perform complex epidemiological studies to assess the risk factors of having a foreskin in ancient Egypt. (16)

Although it may not be surprising that such gross negligence was published in “scientific” journals in a pre-Civil Rights America, this religious rhetoric in secular medical journals still existed as late as the 90s, i.e. when many millennials were born! Gerald N. Weiss, one of the most ardent foreskin fighters of our time, published in two highly respected journals, Clinical Pediatrics and Pediatric Infectious Disease Journal, articles where he performs biblical exegesis, speculates about biblical characters’ sex lives, and cites religious philosopher’s and Freud’s arguments that circumcision reduces sexual pleasure which was beneficial as it “promoted self-control of the organ” to justify this procedure! (17) (18) Why did these ridiculous assertions end up in respected medical journals? Because many of the peer-editors were elderly, white, circumcised males whose paradigm of the world includes a circumcised penis being a normal one.

Circumcision Scales Up

In 1900 less than 5% of all childbirths occurred in a hospital. By 1960 almost all childbirths did. (19) As the number of hospital childbirths scaled up so did the rate of circumcision being about 30% in 1910 to almost 90% throughout the 70s and 80s.[1]  Circumcision became a routine way to process newborn males. How did such an invasive and unnecessary surgery catch on in 20th century America? As explained previously, there are various reasons, but complete ignorance of normal penile development, combined with financial incentives and press complicity allowed this procedure to take hold of our nation.

Systemic Ignorance of Natural Penile Anatomy and Physiology

The foreskin has been largely ignored throughout the study of the human body leading to common myths such as “the foreskin is a vestigial flap of skin” or “it’s nothing but a dangerous and dirty appendage.” Many doctors throughout the first half of the 20th century actually diagnosed every man, child, and baby with phimosis! (20) (21) Phimosis in the adult male is a rare treatable condition where the foreskin doesn’t retract. Phimosis does not exist in children since the foreskin is supposed to be fused to the glans until puberty when humans are programmed to reproduce and need to expose that part of their body.[2] Because of their ignorance, doctors were and many continue to diagnose children with a condition they don’t have, to perform a surgery they don’t need, to get money they don’t deserve.

Historically it has been known that the foreskin is an important source of pleasure, which is why it was amputated! (22) (23) (24). But, as the American medical field began finding all types of miracle cures by way of circumcision, from paralysis to epilepsy, from hernias to cancer, it was forgotten that the foreskin was an important source of sexual sensation. Even if it was, doctors’ primary concern was medical diagnosis and treatment, not healthy sexuality. Consequently, arguments that circumcision damaged natural sexual physiology and sensation were deemed unimportant.

In 1996, when Dr. John R. Taylor classified the foreskin as primary erogenous tissue, not to be discarded but respected in its own right (25) [3], public opinion about healthy sexuality was changing as well. Recognizing the importance of natural form, function, and feeling, not to mention the right to bodily integrity, Canada and Australia’s pediatric societies’ rightfully condemned circumcision as an unnecessary and invasive violation of the child’s rights. (26) (27)

Even today, many American physicians remain completely ignorant of the foreskin’s highly erogenous properties and role in natural sexual function. Most practicing urologists were born in the age of mass circumcision, grew up with circumcised peers, and studied from textbooks that omitted the foreskin without explanation or mentioned it as an afterthought. (28) (29) Only having crude exposure to the foreskin at best, American physicians are some of the least qualified doctors, let alone people in the world to provide advice on circumcision.

Financial Incentives to Continue Circumcision

Circumcision is a lucrative business. For a relatively simple and low-risk surgery that takes anywhere from 5 to 30 minutes, the circumciser pockets a few hundred dollars, the hospital pockets closer to a thousand dollars, and then more money is made off of the sale of the neonatal tissue to research and cosmetic companies. (30) (31) (32) To give you a sense of scale of the compulsory tissue harvesting industry in America, it’s on the order of 1-2 billion dollars a year! (33) (34) [4]  So the question to ask yourself is, “Would the American-medical complex compromise its ethical integrity to avoid blame of past wrong-doing while making a killing?” (No pun intended although some estimates exceed 100 mortalities in the US every year from surgical complications or infections from this elective surgery) (35)

Press Complicity

Throughout the 20th century to current day, American press has been markedly pro-circumcision and primarily responsible for the widespread misinformation surrounding the foreskin and its removal. Indeed, whenever a new justification for circumcision was “discovered” the mainstream press jumped at the opportunity to document it.

In 1942, when Abraham Ravich published his findings that the (non-existent) carcinogenic properties of preputial secretions infect every body part it came in contact with cancer, primarily penile, prostate, and cervical cancer (36), Newsweek lauded Ravich’s “discoveries” claiming his work may “indirectly shed light on the cause of all cancer.” (37) (my emphasis)

In 1954, when disciplined researcher Ernst Wydner published his findings that “marital status, number of sexual partners, partner’s circumcision status, socioeconomic class, etc.” may increase risk of cervical cancer (38), Times egregiously misrepresented his research stating “circumcision is an important factor in reducing cervix cancer in years to come,” (39) thus effectively giving women a stake in the circumcision decision. Surprisingly, Times did not retract their unabashed endorsement of circumcision when Wydner himself discredited his 1954 study stating that he cannot conclude circumcision’s preventative effect since people were unable to correctly identify their personal or their partner’s circumcision status. (40) A mistake still prevalent today, considering only 2/3 of adolescents can even correctly identify whether they have a human foreskin or not. (41)

Although these historical examples may seem extreme, they are only amplified with time.

In 1986, vehement pro-circumciser, Aaron Fink, whose previous justifications for circumcision ranged from prevention of streptococcus disease (42) to preventing sand in foreskins that debilitate a solders’ effectiveness in war (43), created a novel new justification: prevention of HIV. Fink erroneously asserted that genitally intact sex is more liable to induce bleeding and thus increases HIV infection risk in heterosexual males. (44) Although he conceded he had no evidence at the time, the press liked his hypothesis and immediately gave Fink coverage to spread his dogma. (45)

Since Fink proposed circumcision prevented heterosexual HIV contraction at a time when there was conveniently no heterosexual HIV population to study in the US, studies were shifted to Africa. Not only are the African studies outrageously biased (as explained here), but even if they weren’t they’re completely irrelevant in the US. An elementary epidemiologist can identify the overwhelming external bias in these studies, i.e. HIV is spread in a complex social and cultural manner. The vectors of disease in sub-Saharan Africa cannot simply be mapped to a North American population. (46) Especially when the incidence of HIV in Africa is many dozens of times higher and where it is spread mostly through heterosexual sex where other VDs and foreign sexual practices are rampant; this population is not comparable to a primarily homosexual North American population that shares almost nothing in common in the way of sexual practices or the subsequent disease transmission.

Let us not forget, that HIV studies, like all circumcision studies go both ways, i.e. “prove” that it mitigates or has no effect on the contraction of HIV. The press, however, primarily promotes three studies, all showing circumcision’s prophylactic effect, all conducted in much the same way, and all ended early because they were “too effective”[5] . (47) (48) (49) Studies invalidating this belief enjoyed a virtual media blackout. (50) (51) (52) (53) Not only is this cherry-picking of studies intellectually dishonest, it is important to recognize who conducted these studies. Many of the lead researchers had been promoting circumcision for years (Bertran Auvert, Robert C. Bailey, Stephen Moses, Ronald H. Gray) and the funders of these studies are government institutions, some of the same organizations who have historically promoted circumcision and have a vested interest in continuing to avoid blame for wrong-doing and justifying their own cultural biases: NIAD, HHS[6] , NIH, WHO. Don’t worry though, all three studies assure us “We declare that we have no conflict of interest.”

Now why would the American press have such a vested interest in misrepresenting circumcision literature to shape public opinion in favor of it? We can only speculate, but the observation that most media outlets are headed by elderly, white men is probably significant in that they would like to normalize their cultural bias and personal circumcision status as well as avoid placing blame on their complicit government entities.

Circumcision Today & The HuFo Project

As the press laments the falling circumcision rates in America, rates continue to drop. (54) (55) (56) (57) It is promising that parents can find accurate information on the human foreskin and its role in natural sexuality online. It is Foregen’s hope that HUFO not only devastates the rate of neonatal circumcision in America, by revealing its true cost, but also inspires men to reclaim what they have lost. Although it is much easier to protect one’s ego and find a group of men who have convinced themselves that their foreskin has no effect on their sex life, HUFO viscerally demonstrates otherwise. To give men a sense of what is lost with circumcision, beyond just the physical loss of HUFO, studies have shown that the most erogenous parts of a genitally intact male are the ridged band, the frenulum, and the inner mucosa. The most erogenous part on a circumcised man, which ranked less sensitive than the least sensitive part on the genitally intact, was the circumcision scar, i.e. the most sensitive part of the circumcised man is the scar line where his G-spot along with the rest of his HUFO has been amputated. (58) This is dark; this is not news we enjoy breaking. You’re welcome to align your views with the popular narrative and convince yourself that amputating HUFO has no effect on sexual pleasure, (59) but the evidence to the contrary is right in front of you.

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Footnotes

[1] Exact historical rates of circumcision are unavailable as many hospitals did not accurately report on what they deemed a minor and unimportant surgery.

[2] Doctors still diagnose children with phimosis. Most famously the recent FL case of estranged parents fighting over the circumcision for their 4 year old (who expressly said he does not want to be circumcised). The doctor diagnosed the child with phimosis, an impossible diagnosis for a 4 year-old – thus providing a perfect current-day example of the absolute ignorance of the foreskin that still exists in medicine today.

[3] Notice this groundbreaking study was published in the British Journal of Urology, even though his findings are far more relevant to a US audience. This was likely out of necessity rather than choice.

[4] Although more contemporary studies are difficult to find (since the compulsory tissue harvesting industry seems to be of little interest to academics), the number of circumcisions is roughly the same as when these studies were done. Due to rising medical costs, it is likely that the costs of circumcision are greater to the taxpayer and more lucrative to hospitals and circumcisers than stated above.

[5] Since a man is unable to have sex for months post-circumcision, he cannot contract the disease. Terminating the studies early drastically biases these studies towards the intended conclusion.

[6] CDC is a division of U.S. Dept. of Health and Human Services (HHS)


Sources

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2. Kellogg, John Harvey. Treatment for self-abuse and its effects. 1888.

3. Nervous Diseases Connected with Male Genital Function. Beard, G. M. 1882, Medical Record (New York), pp. 617-621.

4. Scull, Andrew and Favrean, Diane. 'A Chance to Cut Is a Chance to Cure': Sexual Surgery for Psychosis in Three Nineteeth Century Societies. 1986.

5. Money, A. Treatment of Disease in Children. Philadelphia : s.n., 1887.

6. Remondino, Peter Charles. History of Circumcision. 1891.

7. Vital Statistics of the Jews. Billings, J. S. 1891, North American Review, pp. 70-84.

8. Universal Circumcision as a Sanitary Measure. Wolbarst, Abraham L. 1914, Journal of the American Medical Association, pp. 92-97.

9. Gollaher, David L. Circumcision: A History of the World's Most Controversial Surgery. New York, NY : Basic Books, 2001.

10. Bushman, R.L. and Bushman, C.L. The Early History of Cleanliness in America. 1988.

11. A Practical Suggestion in Regard to the Technique of the Operation of Circumcision. Brown, J. Y. 1890, Medical Mirror (St. Louis).

12. Tonsillectomy and Circumcision: Comparisons of Two Cohorts. Calnan, M., Douglas, J. W. and Goldstein, H. 1978, International Journal of Epidemiology, pp. 78-85.

13. Circumcision. Williams, A. U. 1889, Medical Standard (Chicago).

14. A Plea for Circumcision. Lehman, Mark J. 1893, Medical Review, pp. 64-65.

15. Prophylaxis of Cancer of the Prostate, Penis, and Cervix by Circumcision. Ravich, Abraham L. and Ravich, R.A. 1951, New York State Journal of Medicine, pp. 519-520.

16. Ravich, Abraham L. Preventing V.D. and cancer by circumcision. New York : Philosophical Library, 1973.

17. A Perspective on Controversies over Neonatal Circumcision. Weiss, Gerald N. 1994, Clinical Pediatrics, pp. 726-30.

18. Prophylactic Neonatal Surgery and Infectious Diseases. Weiss, Gerald N. 1997, Pediatric Infectious Disease Journal, pp. 727-34.

19. Wertz, Richard E. and Wertz, Dorothy C. Lying-In: A History of Childbirth in America. New Haven : Yale University Press, 1989.

20. Immediate circumcision of the newborn male. Miller, R L. and Snyder, D. C. 1953, American Journal of Obstetrics and Gynecology, pp. 1-11.

21. Some practical aspects of circumcision. Gerber, M. L. 1944, US Naval Med Bull, pp. 1147-9.

22. Philo. The Special Laws (Translated to English 1937). ~25 AD.

23. Maimonides, Moses. The Guide of the Perplexed. 1190.

24. On the Advantages of Circumcision. Hutchinson, Jonathan. 1900, Medical News, pp. 707-08.

25. The prepuce: Specialized mucosa of the penis and its loss to circumcision. Taylor, J. R., Lockwood, A. P. and Taylor, A. J. 1996, British Journal of Urology, pp. 291-95.

26. Australian College of Paediatrics. Position Statement: Routine Circumcision of Normal Male Infants and Boys. Parkville, Victoria : s.n., 1996.

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31. A cost-utility analysis of neonatal circumcision. Van Howe, R.S. 2004, Medical Decision Making, pp. 584-601.

32. Circumcision Cost. CostHelper. [Online] 2012. http://health.costhelper.com/circumcision.html#extres3.

33. Pitta, J. Biosynthetics. Forbes. May 10, 1993, pp. 170-1.

34. Infant Circumcision: The debate over parents' rights, human rights and the right to choose. Fauntleroy, G. 2001, The New Mexican.

35. Lost Boys: An Estimate of U.S. Circumcision-Related Infant Deaths. Bollinger, Dan. 2010, THYMOS: Journal of Boyhood Studies, pp. 78-90.

36. The Relationship of Circumcision to Cancer of the Prostrate. Ravich, Abraham L. 1942, Journal of Urology, pp. 298-99.

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38. A Study of Environmental Factors in Carcinoma of the Cervix. Wydner, Ernst. 1954, American Journal of Obstetrics and Gynecology, pp. 1016-52.

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41. Self-assessment of circumcision status by adolescents. Risser, J. M., et al. 2004, American Journal of Epidemiology, pp. 1095-97.

42. Is hygiene enough? Circumcision as a possible strategy to prevent neonatal group B streptococcal disease. Fink, Aaron J. 1988, American Journal of Obstetrics and Gynecology, pp. 534-5.

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44. A Possible Explanation for Heterosexual Male Infection with AIDS. Fink, Aaron J. 1986, New England Journal of Medicine, p. 1167.

45. Glick, Leonard. Marked In Your Flesh. New York : Oxford University Press, 2005. p. 207.

46. Do the benefits of male circumcision outweigh the risks? A critique of the proposed CDC guidelines. Earp, Brian. 2015, Frontiers in Pediatrics.

47. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. Auvert, B., et al. 2005, PLoS Med.

48. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Bailey, R.C., et al. 2007, Lancet, pp. 643-56.

49. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Gray, R. H., et al. 2007, Lancet, pp. 657-66.

50. Circumcision and HIV infection: review of the literature and meta-analysis. Van Howe, R. S. 1999, International Journal of STD C& AIDS, pp. 8-16.

51. Circumcision for HIV Prevention: Failure to Fully Account for Behavioral Risk Compensation. Kalichman, Seth, Eaton, Lisa and Pinkerton, Steven. 2007, PLoS Medicine.

52. Long-term population effect of male circumcision in generalised HIV epidemics in sub-Saharan Africa. Garenne, Michel. 2008, African Journal of AIDS Research, pp. 1-8.

53. Male circumcision and its relationship to HIV infection in South Africa: Results of a national survey in 2002. Connolly, Catherine, et al. 2008, South African Journal of Medicine.

54. Firger, Jessica. Circumcision rates declining in U.S., study says. CBS News. [Online] April 2, 2014. http://www.cbsnews.com/news/circumcision-rates-declining-health-risks-rising-study-says/.

55. Carroll, Linda. Circumcision Rate Falls Despite Health Risks. NBC News. [Online] April 2, 2014. http://www.nbcnews.com/health/kids-health/circumcision-rate-falls-despite-health-risks-n69891.

56. Sifferlin, Alexandra. If Circumcision Rates Keep Falling, Health Costs and Infections WIll Spike. TIME. [Online] August 21, 2012. http://healthland.time.com/2012/08/21/if-circumcision-rates-keep-falling-health-costs-and-infections-will-spike/.

57. Study: As circumcision rates drop, costs increase. FOX NEWS. [Online] August 21, 2012. http://www.foxnews.com/health/2012/08/21/study-as-circumcision-rates-drop-costs-increase/.

58. Fine-touch pressure thresholds in the adult penis. Sorrells, Morris L., et al. 2007, BJU International, pp. 864-869.

59. Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction?—A Systematic Review. Morris, Brian J. and Krieger, John N. 2013, The Journal of Sexual Medicine, pp. 2644-2657.

 

 

 


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