These men want their foreskins back

MSNBC News, October 1, 2003.

These men want their foreskins back

Activists decry circumcision and offer `restoration' process

Jon Bonné
MSNBC

Oct. 1 — "I am covered and have overhang." R. Wayne Griffiths, 70 and a grandfather, is speaking frankly about his foreskin — which really is the only way one can speak on that topic. More to the point, he is gleefully describing the sensation of having his foreskin back after decades of living with a circumcised penis. "It's delightful," he says.

AS HEAD OF the National Organization for Restoring Men, Griffiths spends his days advocating that circumcised men reclaim what he suggests is their birthright: a penis unmolded by the will of others.

Medically popularized in the early 20th century, circumcision has become a routine option for newborn American boys. But a backlash has surfaced in recent years, often bolstered by conflicting medical data about the procedure's benefits. Out of that debate has emerged a tiny but growing movement of men who not only oppose circumcision, but want back what they consider taken from them. They want to regrow their foreskin.

The notion doesn't pass many peoples' laugh test. But NORM and similar groups are quite serious about straightforwardly counseling men on how to restore this tender bit of flesh. As they portray it, circumcision comprises an insidious conspiracy; in performing an unnecessary procedure, doctors are either ignorant or greedy; hospitals simply look the other way; parents don't know any better and are hounded into consent.

`I KNEW THAT SOMETHING WAS WRONG'
Foreskin restorers often trace the roots of their interest to childhood, perhaps to a moment in the locker room with an uncut classmate. "From the first time I noticed that a little boy was different than me, I knew that something was wrong with one of us ... and I assumed maybe it was him," says psychologist Jim Bigelow, author "The Joy of Uncircumcising," an authoritative text of sorts for restorers.

That, in turn, could lead to shame. Born into an evangelical Christian family in 1933, Bigelow spent years as a boy trying to understand why he was circumcised — in part because he says the procedure left him with scars. "I figured I was born with something wrong with me and they had to fix it," he says. "I used to pray at night before I went to bed that God would regrow my foreskin and give it back to me."

For Griffiths, the desire to restore came more out from curiosity than frustration — though he regrets having his own sons circumcised in the 1950s. But he acknowledges many restorers "are just absolutely, almost violently angry at what has been done to them."

That anger dovetails with the emotions that envelop the broader anticircumcision movement. Groups that fight the practice often endorse restoration and some have urged men to sue their doctors for circumcising them. But they primarily are concerned with educating parents and doctors whom they argue are doing irreparable harm.

"You cannot cut off normal, healthy sexually functioning tissue without cutting off normal, healthy sexual functioning," says Marilyn Milos, a registered nurse and director of NOCIRC, the National Organization of Circumcision Information Resource Centers. "It's a sexual issue, and it's a human rights issue."

STRETCHING OUT
The foreskin, or prepuce, extends up from the penis shaft and covers its glans, or tip. It can protect the tender glans skin, and as men become sexually active it often serves as a buffer between the erect shaft and a partner's skin.

Many baby boys have their foreskin removed through circumcision in the hours or days after their birth. Most are done in hospitals by doctors, though some are performed as religious rites. (Ritual circumcision exists in both the Jewish and Muslim religious traditions.) Some two-thirds of baby boys in the United States are estimated to undergo the procedure, a higher rate than most countries but down slightly from an estimated 80 percent in the 1970s.

Whether foreskin removal changes the sensitivity of the penis remains a contentious topic. Those opposed to circumcision insist the extra skin makes a big difference, but a recent study by urologists found little difference in sensitivity in the penises of circumcised and uncircumcised men.

As for bringing back a foreskin, those in the restoration movement describe two methods. They rarely discuss the first, perhaps because many harbor a deep distrust of doctors: skin tissue, usually from the scrotum, is surgically grafted to the penis shaft in a way that replicates the foreskin's shape and function.

The other method essentially requires a man to stretch himself a new foreskin from his existing penis tissue. A variety of methods and devices help accomplish this — elastic bands, weighted metal containers, even special tape. Some are commercial products with names like P.U.D. (Penile Uncircumcision Device) and Tug Ahoy. Others are homemade with anything from silicon caulk to brass instrument mouthpieces. Several ounces of weights are sometimes added to speed the process.

"Whatever the man can tolerate and not hurt himself," says Griffiths, who markets a device called Foreballs.

All of these products basically distend the skin forward toward the glans and hold it in place to induce new cell growth, essentially forcing new skin to be created. Regrowth often takes years, with devices worn for 10 to 12 hours each day. Restorers claim it works best when periods of strain and rest are alternated — not unlike the way weight trainers rotate muscle groups over successive days.

"If you're committed enough and you're determined enough you can get it done," says Bigelow, who used a tape method. "But it can be, for some men, a 5- or 6-year procedure."

SEEKING PLEASURE
Of course, it's impossible to truly restore foreskin and restorers admit results are partial at best. Certain specialized nerve endings simply won't return. For example, researchers have described a "ridged band" just inside a natural foreskin's tip of specialized nerve endings known as Meissner's corpuscles, which help detect light touch.

Instead, restorers focus on what they can bring back: revived friction on the penis shaft and what some claim is the "dekeratinization" of the glans: thicker skin peels off and leaves a tender layer beneath.

Nonetheless, restorers speak with quiet joy about their new foreskins. They describe heightened sexual sensation — increased sensitivity for a man, less friction for his partner. They insist that the newly covered glans can become more sensitive.

Before he was restored, Griffiths says, those qualities made him envious. "I had to just absolutely beat myself to death, so to speak, to get feeling, to get some pleasure," says Griffiths. "The intact man just goes on forever. He enjoys the trip."

But the real value, restorers insist, is a new sense of dignity. Language used by restorers and other anticircumcision activists at times resembles that used to describe the healing process for female rape victims or women whose clitorises were cut off in "female circumcision" procedures.

The rhetorical similarities are clearly intentional. Milos starkly describes male circumcision as "the torture and mutilation of infants."

As such, advocates of foreskin restoration like to frame the subject as primal empowerment, mirrored in flesh.

Exact numbers are a mystery, but NORM holds regular meetings around the San Francisco Bay area — part how-to sessions and part support group.

Says Griffiths: "There's emotional healing that goes on for many, many men that says, `I'm finally taking charge of my body ... I'm finally taking back what was taken from me without my consent.'"

`DON'T GO NEAR THEM'
If restorers urge men to share the experience with loved ones, they are equally fervent when they argue it be done without a doctor's help. Most insist the medical community will be dismissive, if not outright hostile. On this point in particular, restorers reinforce the views of the broader anticircumcision movement.

"Patients do call me and they want a doctor and I say: Don't go near them," says Dr. George Denniston, president of Doctors Opposing Circumcision. "They'll tell you you're crazy and you need psychiatric evaluation."

Denniston and Milos both decry their experiences with medical circumcision, the training for which they describe as little more than an afterthought in obstetrics. The procedure, they argue, amounts to a violation of the "first, do no harm" precepts of modern medicine; its popularity in the medical community means parents can't possibly make informed decisions.

A MEDICAL PUZZLE
Data on the medical value of circumcision largely remains inconclusive. Some studies suggest it improves hygiene and reduces incidence of STDs; other studies have found health problems associated with the procedure.

In the past several years, medical groups have equivocated. Notably, the American Academy of Pediatrics reevaluated the practice in 1998 and essentially refused to endorse it. The American Medical Association came to the same conclusion a year later, noting circumcision was a choice often made "on social and cultural rather than medical concerns."

Both groups underscored ethical precepts surrounding circumcision: anesthesia is essential, parents should take an active role in deciding whether to have it done and doctors need to accurately state the medical logic on either side.

Circumcision has its own fervent advocates. Dr. Edgar Schoen, a longtime pediatrician and researcher in Oakland, Calif., not only remains unswayed about the procedure's benefits but also serves as a foil of sorts to the anticircumcisers. As author of the AAP's previous position on circumcision in 1989, which largely praised its benefits, he remains what could charitably be called dismissive of restoration.

"It's not a serious medical procedure," he says. "The people who are involved in this have a lot of problems that are not related to the foreskin."

As for the stretching process, few medical concerns are raised since it mimics well-tested methods to grow skin. "But you've got to spend a lot of time on stretching," says Dr. Ira Sharlip, a San Francisco urologist and spokesman for the American Urological Association. "It's not a very practical thing to do."

Sharlip says a patient may occasionally inquire about surgical restoration — which really amounts to cosmetic surgery — but few urologists have regularly dealt with the issue. "The great majority of men have no problems with having been circumcised," he says, even if fewer parents are now choosing it for their children. Foreskin restorers see it differently. They believe most men are simply too afraid to address an unquestionably awkward topic.

"Most men who do suffer, who are troubled by what was done to them, suffer in silence," says Bigelow. "If we didn't have what is this foolish tradition in our culture, we wouldn't have to do this."


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