General Discussions of Male Circumcision

General Articles and Books

This file indexes selected general articles and books about male circumcision that have appeared since 1949. The articles are indexed in chronological order.

Introduction

No careful medical investigation ever preceded the introduction of neonatal male circumcision as a routine procedure. It was introduced on the opinion of a few influential nineteenth and early twentieth century physicians without any research into safety or efficacy.

Since 1949, many articles and books have appeared both in the medical literature and elsewhere that question the execution of circumcision by medical doctors and cite accumulating evidence that male circumcision is not beneficial and is actually injurious to the patient. This file presents some of the more important of these articles and books.

No article here finds male circumcision to be medically necessary. Several say it should not be performed. There appears to be a progression in the thought through the years from the mildly negative viewpoint toward the strongly negative viewpoint toward male circumcision. This viewpoint is supported by the increasing availability of information about the adverse effects of male circumcision. A social transformation is taking place.

Highlights

The Fate of the Foreskin2 by British paediatrician, External link Douglas Gairdner, DM, which appeared in 1949, led to a profound reexamination of circumcision in the U.K., with the result that the procedure is rare today. Historically, it is a classic, along with its sequels.

Foley (1966) provides a far ranging discussion of the problems ofmale circumcision. Foley was one of the first to point to social and psychological problems associated with the practice. He challenged the then-prevalent belief that circumcision could prevent cancer. Foley also discusses potential legal liability resulting from the performance of circumcision.7

Wright's 1967 condemnation of circumcision helped to influence the Australian Pædiatric Association to adopt an anti-circumcision policy in 1971.8

Øster's Further Fate of the Foreskin10 (1968) fully explores the normal development of the foreskin through adolescence.

Leitch's Circumcision - A Contining Enigma (1970) influenced the Australian Pædiatric Association, which adopted an anti-circumcision policy in 1971.10

Preston's Whither the Foreskin?12 appeared in 1970. This article heavily influenced the American Academy of Pediatrics, which declared in a statement issued in 1971 that there is no medical indication for circumcision in the neonatal period.

Falliers (1970) highlights the aesthetic and erogenous values of the prepuce.13

Grimes' Routine Circumcision of the Newborn,15 which appeared in 1978, expressed concern about possible psychological injury from the pain. This concern was proven valid years later. This article was the official rejection of male circumcision by the American College of Obstetrics and Gynecology.

Gellis reports that there are more deaths from complications of circumcision than deaths from penile cancer.16

Oliver (1979) calls male neonatal circumcision a cruel procedure and calls for legal protection of children from this procedure.18

Baker (1979) reports that there are 229 infants a year die from results of non-therapeutic neonatal circumcision.20

Prucha (1980) raises a Canadian voice against the non-therapeutic circumcision of boys.23

Metcalf et al.26 (1983) reported an in-hospital complication rate of four percent and a later complication rate of thirteen percent, for a total rate of seventeen percent.

Thompson (1983) reports how controversy and emotion result in AAP statements being compromises to satisfy the pro-circumcision individuals.27

Wallerstein (1985) gives us a comparison of US practice with that of other nations and suggests corrective actions.30

Hughes reported his findings on the influence that circumcision has on sexuality and marital relations in 1990. Hughes believed that circumcision contributes to marriage failure.31

Chessare (1992) reports that non-circumcision produces the highest utility (i.e, the best health).32

Thompson (1992) takes the view that there is no proof that incidence of UTI is reduced by circumcision and argues that the procedure should not be performed.33

Poland, who served on the 1989 American Academy of Pediatrics Task Force on Circumcision, showed that the true cause of penile and cervical cancer is the human papilloma virus in 1990. Poland states that circumcision should not be part of routine medical care.34 This article proved to be influential with the Canadian Paediatric Society, which quoted from it.

The British Medical Journal has on three occasions (1949, 1979 and 1993) published editorials regarding the practice of male circumcision.1,17,37 The first introduced Gairdner's landmark article on circumicsion.1 The second17 condemned the practice of non-therapeutic neonatal circumcision and the third36 attacked unnecessary post-neonatal circumcision.

Denniston (1992) calls male circumcision medically unnecessary and points to the positive value of the intact foreskin.35

Warren and Bigelow describe circumcision as a sacrifice and report on the importance of the foreskin in sexual relations in 1994.39

LeBourdais (1995) discusses the declining incidence of the practice of neonatal circumcision. She points to the changing legal enviroment, and points out the tendency of circumcised doctors and circumcised fathers to repeat the trauma of circumcision.41

Duckett, in a letter addressed to the American urological community, cites the strong bias of the urological community in favor of circumcision. Duckett criticises that position and calls upon the urological community to temper its enthusiasm for circumcision and to respect the right of the patient to remain intact. He believes that one million circumcised men would choose circumcision reversal if it were to be made available.42

Storms (1996) calls attention to the need to update the official reports on male circumcision. She cites the higher incidence of STDs among circumcised men. She notes the positive correlation between incidence of male circumcision and incidence of AIDS in the industrialized countries.45

Laumann reveals in Circumcision in the United States in 1996 that circumcised males tend to have more sexually transmitted diseases and tend to engage in a wider variety of sexual practices.47

Konopka suggests a possible role of circumcision in the problems of male menopause (impotence).48

Fleiss's discussion of male circumcision which appeared in late 1997 is the most thorough and up-to-date article on male circumcision.51 Fleiss provides a comprehensive, documented contemporary report on non-therapeutic male circumcision.

External link Zoske brings a men's studies background and perspective to the examination of male circumcision.53 Zoske calls circumcision an abusive wounding of males.

Roberton describes male neonatal circumcision as mutilation. This may be the first pediatric text to describe male circumcision as mutilation.55

Dritsas reports on the current debate about non-therapeutic neonatal circumcision. He recommends that the practice of male neonatal circumcision be suspended until a consensus emerges.58

Dave et al. (2003) report a higher incidence of sexually transmitted disease in circumcised males, however the difference is not statistically significant. They also report a higher incidence of homosexual experience in circumcised males.62

Elder (2006) calls for an end to health insurance payments for non-therapeutic circumcision.65

Dalton (2007) reviews the certain harms and injuries inherent in child circumcision.66

Hill (2007) examines the psychosocial problems that prevent medical societies from publishing an honest assessment of the circumcision of male children. He also examines the emotional forces that cause the medical literature on circumcision to be voluminous and polarized.67

Library Holdings

  1. Anonymous. A ritual operation (editorial). Br Med J 1949;2:1458-9.
  2. Douglas Gairdner, DM, MRCP.The Fate of the Foreskin. British Med J, Volume 2, 1433-1437, Dec 24 1949.
  3. Gairdner D. The fate of the foreskin (letter). Br Med J 1950;2:440-1.
  4. The Widdicombe File (unsigned editorial). The Lancet (15 Aug 1953): Pages 337-338.
  5. Spence J. On circumcision. Lancet 1964;2:902.
  6. Morgan WKC. The rape of the phallus. Journal of the American Medical Association 1965; 193:123-4.
  7. Foley JM. The unkindest cut of all. Fact Magazine July-August 1966.
  8. Wright JE. Non-therapeutic circumcision. Med J Aust 1967;1:1083-6.
  9. Morgan WKC. Penile plunder. Med J Aust 1967;1:1102-1103.
  10. Jakob Øster. Further Fate of the Foreskin: Incidence of Preputial Adhesions, Phimosis, and Smegma among Danish Schoolboys. Archives of Disease in Childhood (published by the British Medical Association), April 1968. p. 200-202.
  11. Leitch IOW. Circumcision: a continuing enigma. Aust Paediatr J 1970; 6: 59-65.
  12. Capt. E. Noel Preston, MC, USAF. Whither the Foreskin? Journal of the American Medical Association (JAMA), Vol 213 No 11 on September 14, 1970.
  13. Falliers CJ. Circumcision (letter). JAMA 1970;214(12):2194.
  14. Editorial: Circumcision as a hygiene measure. Med J Aust 1971; 2: 175.
  15. Grimes DA. Routine circumcision of the newborn infant: A reappraisal. American Journal of Obstetrics and Gynecology 130(2): January 15, 1978; 125-129.
  16. Gellis, SS. Circumcision. American Journal of Diseases of Childhood 1978; 132:1168.
  17. Editorial: The case against neonatal circumcision British Med J 6172 (5 May 1979):1163-64.
  18. Oliver JE. Circumcision and cruelty to children.Br Med J 1979;2(6195):933.
  19. Carter, Nicholas. Routine Circumcision: The Tragic Myth. London: Londinium Press; Torrance, Calif.: Noontime Press, c1979.
  20. Baker RL. Newborn male circumcision: needless and dangerous. Sexual Medicine Today 1979;3(11):35-36.
  21. Wallerstein, Edward. Circumcision: An American Health Fallacy. Springer Publishing Company, New York (1980). (Out of Print) (The text of this book is now available by attached file in either PC or Mac format from NOCIRC. Contact NOCIRC by e-mail at nocirc@concentric.net.)
  22. Grimes DA. Routine circumcision reconsidered. American Journal of Nursing 80 (Jan. 1980), 108-109.
  23. Prucha ZS. Circumcision? Cutting the routine cut. Can Med Assoc J 1980;122:834.
  24. McHugh M. Circumcision — Is it ever necessary. Irish Med J 1981:74(2):55-6.
  25. King LR. Neonatal circumcision in the United States in 1982. J Urol 1982;128:1135-6.
  26. Thomas J. Metcalf, M.D., Lucy M. Osborn, M.D., MSCM. E. Mark Mariani, M.D. Circumcision: A Study of Current Practices. Pediatrics, April 1983. >From the Department of Pediatrics, University of Utah Medical Center, Salt Lake City, Utah.
  27. Thompson HC. The value of neonatal circumcision: An unanswered and perhaps unanswerable question. Am J Dis Child 1983;137(10):939-40.
  28. Tan HL. Foreskin fallacies and phimosis. Ann Acad Med Singapore 1985;14(4):626-30.
  29. Romberg, Rosemary. Circumcision: The Painful Dilemma. Bergin & Garvey, South Hadley, MA, USA 1985 (Out of Print)
  30. Wallerstein E. Circumcision: the unique American medical enigma. Urologic Clinics of North America 1985; 12:123-32.
  31. George K. Hughes, MD. Circumcision: Another Look. Ohio Medicine 1990 February, vol. 86(2): p. 92.
  32. Chessare JB. Circumcision: Is the risk of urinary tract infection really the pivotal issue? Clinical Pediatrics 1992;31(2):100-4.
  33. Thompson RS. Routine circumcision in the newborn: an opposing view. J Fam Pract 1990;31(2):189-196.
  34. Poland RL, M.D. The question of routine neonatal circumcision. N Eng J Med 322:18 (May 3 1990): 1312-1315.
  35. George C. Denniston, M.D., MPH. Commentary: Unnecessary circumcision. The Female Patient,Vol.17,July 1992.
  36. Rickwood AM. The unkindest cut of all? Journal of the Irish Colleges of Physicians and Surgeons 1992; 21(3) (July) 1992:179-81.
  37. Andrew Gordon and Jack Collin. Save The Normal Foreskin. British Medical Journal 306:1-2 (2 January 1993)
  38. Nigel Williams, Julian Chell, Leela Kapila. Why are children referred for circumcision? Brit Med J 1993; 306:28.
  39. J.P. Warren MD FRCP and J. Bigelow PhD. The Case Against Circumcision. British Journal of Sexual Medicine, Sept/Oct 1994.
  40. Sandra Pertot, Ph.D. Sensitivity is the rising issue on circumcision. Australian Doctor, 25 November 1994.
  41. LeBourdais E. Circumcision no longer a routine surgical procedure. Can Med Assoc J 152(11), June 1, 1995, pp. 1873-1876.
  42. John W. Duckett, M.D. A temperate approach to neonatal circumcision. Urology 1995
  43. Mark Davenport. External link Problems with the penis and prepuce. British Medical Journal, Vol 312, 3 February 1996, p 299-301. (Link to www.bmj.com)
  44. J.P. Warren MD FRCP et al. Letter to the Editor. British Medical Journal, Vol. 312, p. 377, 10, February 1996.
  45. Storms MR. AAFP Fact Sheet on neonatal circumcision: a need for updating. Am Fam Physician 1996;54(4):1216-17.
  46. Goldman R.,Ph.D. Circumcision: The Hidden Trauma, Vanguard Publications, Boston 1997 (ISBN 0-9644895-3-8).
  47. Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: Prevalence, Prophylactic Effects, and Sexual Practice. Journal of the American Medical Association, Vol. 277 No. 13, Pages 1052-1057. April 2, 1997.
  48. Konopka AM. Circumventing circumcision. Infectious Diseases in Children Vol 10, No 7, Page 4, July 1997.
  49. Denniston, GC & Milos MF, Eds. Sexual Mutilations, A Human Tragedy, Plenum Press, New York and London, 1997 (ISBN 0-306-45589-7).
  50. Hitchcock R. Commentary. Arch Dis Child 1997;77:260.
  51. Fleiss PM, MD. The case against circumcision. Mothering Magazine (Santa Fe), Winter 1997: pages 36-45.
  52. Hofmann V, Kap-Herr S. Circumcision in Germany. Pediatr Surg Int 1989;4:227-8.
  53. Zoske J. External link Male Circumcision: a gender perspective. The Journal of Men's Studies 1998; 6(2): 189-208.
  54. Denniston GC, Hodges FM, Milos MF (eds). Male and Female Circumcision: Medical, Legal, and Ethical Considerations in Pediatric Practice. New York, Boston, Dordrecht, London, Moscow: Kluwer Academic/Plenum Publishers, 1999 (ISBN 0-306-46131-5).
  55. N.R.C. Roberton, Care of the Normal Term Newborn Baby, in Textbook of Neonatology, eds. Janet M. Rennie, N.R.C. Roberton, 3rd ed. (Edinburgh: Churchill Livingston, 1999), pp. 378-379. (ISBN 0-443-05541-6)
  56. Magoha GA. Circumcision in various Nigerian and Kenyan hospitals. East Afr Med J 1999;76(10):583-6.
  57. Gollaher, David A., Circumcision: A History of the World's Most Controversial Surgery. New York: Basic Books, 2000. 253 pages. (ISBN: 0-465-04397-6)
  58. Dritsas LS. Below the belt: doctors, debate, and the ongoing American discussion of routine neonnatal circumcision. Bulletin of Science, Technology & Society 2001;21(4):297-311.
  59. Fleiss PM. Hodges F. What your Doctor May Not Tell you about Circumcision: Untold Facts on America's Most Widely Performed - and most Unnecessary Surgery. New York: Warner Books, 2002. (ISBN: 0-446-67880-5)
  60. Legato MJ. Rethinking Circumcision: Medical Intervention, Religious Ceremony, or Genital Mutilation? J Gend Specif Med 2002;5(4):8-10.
  61. Hofvander Y. Circumcision in Boys: time for doctors to reconsider. World Hosp Health Serv 2002;38(2):15-17.
  62. Dave SS, Johnson AM, Fenton KA, et al. Male circumcision in Britain: findings from a national probability sample survey. Sex Trans Infect 2003;79:499-500.
  63. Clark C, Huntley JS, Munro FD, Wilson-Storey D. Managing the paediatric foreskin. Practitioner 2004;248(1665):888, 891-2, 894 passim.
  64. Richters J, Smith AMA, de Visser RO, et al. Circumcision in Australia: prevalence and effects on sexual health. Int J STD AIDS 2006;17:547–54.
  65. Elder JS. Circumcision—are you with us or against us? J Urol 2006;176(5):1911.
  66. Dalton J. External link Male circumcision – see the harm to get a balanced picture. J Mens Health Gend 2007;4(3):312-17. (PDF)
  67. Hill G. External link The case against circumcision. J Mens Health Gend 2007;4(3):318-23. (PDF)
  68. Hurme T, Reunanen M. Circumcision of boys in Finland - a questionnaire to Finnish paediatric surgeons. (Poikien ympärileikkaus: Kysely lastenkirurgien hoitokäytännöistä.) Suom Laakaril 2008;63:2781-6.

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