Under the Knife: Circumcision rates have fallen dramatically

From:
The Toronto Star
Monday, September 11, 1995
Life Section, Page C4

UNDER THE KNIFE:  Circumcision rates have fallen dramatically since docts 
concluded there are no valid reasons to justify the procedure

By:  David Johnston
     Southamstar Network

Montreal  –  Six years ago, Christos, a 24 year old student at Concorida 
University, went to a medical clinic and had his penis circucmised.  He 
did it purely for cosmetic reasons.

"I'd get comments from females who thought an uncircumcised penis was 
ugly," he says.  "And at the gym, most of the guys were circumcised and 
the fact that I wasn't made me feel different.  I didn't want to feel 
different."

Today, Christos regrets his decision.  Three months ago, he joined a 
foreskin-restoration support group in Montreal.  Like the 25 other 
participants, Christos is trying to restore his foreskin by manually 
stretching the skin on his penile shaft over the glans, or the tip or 
knob, of his penis.  He says he can't get used to "being uncovered" and 
he finds his penis has become less sensitive without a foreskin.

Christos' support group is the only one of its kind in Montreal, although 
a similar group exists in Vancouver and there are plans to set one up in 
Toronto.  The groups are more common in the United States, particularly 
California, though by no means part of the mainstream of male sexuality.  
Still, their very existence is part of a larger trend in North America: 
the massive change in public attitudes toward male circumcision.

A generation ago, 60 per cent of Canadian newborn boys were circumcised, 
with rates rising to 80 per cent in English Canada and 90 per cent in the 
United States.  But with the birth of baby boomers' own children, 
circumcision rates have fallend dramtically  –  to an estimated 25 per 
cent in Canada and 60 per cent in the U.S., according to various studies.

most health-care practitioners now discourage the procedure.  Where 
circumcision was once thought to have clear hygienic benefits, the 
Canadian Pediatric Society plans to issue a statement in October saying 
there are no valid medical reasons to justify routine infant male 
circumcision, says Dr. Eugene Outerbridge of the Montreal Children's 
Hospital, chief consultant to the society's fetus and newborn committee.

While Jews and Muslims circumcise as a religious rite, North America is 
the only continent in the world where circumcision has been adopted for 
non-religious reasons, principally hygiene.  In Britain, the infant 
circumcision rate is 1 per cent.

Christos' Montreal support group meets monthly to exchange information.  
Everyday in the privacy of their own homes, group members stretch the 
skin on their penile shaft as much as they can without it hurting, then 
use surgical tape to attach it to the glans.  once the skin has been 
stretched enough to naturally cover half of the glans, they attach a 
weighted device to the tape to help pull the skin the rest of the way 
over the glans by force of gravity.  The whole process takes up to three 
years to copmlete.

Members follow instructions contained in a book entitled The Joy Of 
Uncircumcising written by Jim Bigelow, the founder and director of 
UNCIRC, an anti-circumcision lobby group in the U.S.

"Yes, you can stretch skin on the penile shaft  –  but only as an adult, 
not as a child," says Dr. Yves Homsy, a urologist affiliated with the 
Montreal Children's and Ste. Justine hospitals.  "But it's really 
time-consuming and you must really want it (a restored foreskin) to do it."

Most foreskin-restoration groups are offshoots of lobby groups like 
UNCIRC.  Most of those groups are no more than 5 years old, their growth 
paralelling the rise of the political wing of the North American men's 
movement.  Founded seven months ago, the Montreal group is still trying 
to find a doctor to work with it.

The change in public attitudes toward circumcision predates their 
activism by some two decades.  Attitudes started changing in the 1960s, 
when a back-to-the-earth counterculture came to value breastfeeding, 
natural childbirth and the uncircumcised penis precisely for their 
natural qualities.

In the 1970s, a series of studies persuaded most health-care 
practitioners that there is no medical indication for circumcision.

Those studies moved British Columbia in 1984 to remove infant 
circumcision from its list of eligible procedures under its medicare 
plan.  Quebec and Alberta followed suit in 1987, and Ontario last 
October.  Most clinics and hospitals in those four provinces now charge 
between $80 and $135 for an infant circumcision.

Medicare covers only circumcisions required for medical reasons, the most 
common one being a treatment for phimosis, or a tight foreskin.  Many 
cases of phimosis are caused by parents who try to retract a boy's 
foreskin before it naturally is able to retract, in most cases by age 3.

No one seems clear on the purpose of the foreskin.

Gray's Anatomy (1989) makes not even a faint suggestion of its raison 
d'etre.  Some North American anatomy textbooks have even gone so far as 
to eliminate the foreskin from their illustrations.

"We really do tend to talk about the penis much more than we know about 
it," says Dr. John Taylor, a pathologist at the Manitoba Health Sciences 
Centre.

Taylor set out to change that, and examined the foreskins of 22 deceased 
adult men in his morgue.  His very elementary finding  –  that the 
inside of the prepuce contains highly specialized nerve endings, and that 
anatomically "the prepuce very much resembles the lip"  –  was 
considered newsworthy enough by the British Journal of Urology that it 
accepted Taylor's foreskin study for publication.

Taylor found the inside of the foreskin contains a band of ridged skin, 
the ridges holding a number of round nerve endings.  Those round nerve 
endings rub up and down the penile shaft during intercourse, leading 
Taylor to postulate that the purpose of the foreskin is to encourage the 
ejaculatory reflex.

The medical literature is totally silent on a related question: the 
relationship between sexual performance and circumcised state among 
middle-aged and older men.

After circumcision, the skin of a male's glans kerotinizes  –  thickens 
and toughens up.  If a man's sex drive declines as he gets older, does a 
thin-skinned glans allow him more sexual sensation than a thick-skinned one?

This question, unfortunately, stands at the unstudied frontier of male 
sexuality.


(Reprinted from the Montreal Gazette)
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