Why???

Mika S. Mage, BA

http://images.askmen.com/blogs/news_60/75_circumcision-safety-has-its-price.jpg

Vestigiality“A bodily part or organ that is small and degenerate or

imperfectly developed in comparison to one more fully developed in an earlier stage of the individual, in a past generation, or in closely related forms.”10

“Clinical” vestigiality?

Analogy to the appendix… “We demonstrated an important role of the young rabbit appendix

and other gut associated lymphoid tissue in primary diversification of the antibody repertoire and positive and negative selection of B-lymphocytes. We are now investigating whether human appendix may play a comparable role in early development of the human immune repertoire.”8

Rose Mage, PhD

Classifying something as “vestigial” is a fallacy and a “cop out”. Assumes complete knowledge of the human body. Precludes possibility of any positive factors existing or being

discovered.

Evolution of the Foreskin Intuition… protective function? At least 25% of adult men have foreskins which don’t

fully cover the glans.2

Inhibition of sexual initiation.2

Suspected that 50% or more of adult men would enter adulthood with phimosis if circumcision were not performed.

Reduced force of insertion.9

40-50 g v. 500 g of force needed for insertion (unretracted v. pre-retracted). Implications for female mucosal tearing?

Rape.2

Could explain evolutionary differences in penis size and shape between primates.

“Non-Clinical” Benefits…Ease of auto stimulation.2

“Circumcised males masturbated using the hand with a lubricant in motions which mimicked the friction of coitus. Uncircumcised men…masturbated by manipulating the foreskin.”

Preservation of sensitivity. Males: Evidence for decrease in pleasure,5 but also no

change.4

Females: Repercussions of Semen Displacement Theory?1,3

Why isn’t this discussed more? General lack of acknowledgment that sexual practices are

natural and important to human health and wellbeing. Intentional ignorance due to feelings of moral supremacy. Belief “sexual” benefits are trivial compared to reduction in

disease risk.

Implications The potential exists for an AMA

recommendation that all male children be circumcised at birth.7

Based on flawed assumptions of vestigiality? How to adequately weigh sexual benefits v. disease risk?

When advising potential patients: Ethical to call the foreskin “vestigial”? To claim there will

be “no drawbacks” to the procedure or “no real change” in sexual factors?

What judgments do YOU make of someone who refuses circumcision to preserve sexual function?

“Minor” invasive procedures are still invasive! Surgery is not risk free. Alternatives to circumcision may exist, such as inducing

keratinization of the inner foreskin.6

Works Cited1Bensley, Gillian A., and Gregory J. Boyle. "Effects of Male Circumcision on Female Arousal and Orgasm."

The New Zealand Medical Journal 116.1181 (2003): 595-96. Print.

2Cox, Guy. "De Virginibus Puerisque: The Function of the Human Foreskin Considered from an Evolutionary Perspective." Medical Hypotheses 45 (1995): 617-21. Print.

3Gallup Jr., Gordon G., and Rebecca L. Burch. "Semen Displacement as a Sperm Competition Strategy in Humans." Evolutionary Psychology 2 (2004): 12-23. Print.

4Kigozi, Godfrey, Stephen Watya, Chelsea B. Polis, Denis Buwembo, Valerian Kiggundu, Maria J. Wawer, David Serwadda, Fred Nalugoda, Noah Kiwanuka, Melanie C. Bacon, Victor Ssempijja, Frederick Makumbi, and Ronald H. Gray. "The Effect of Male Circumcision on Sexual Satisfaction and Function, Results from a Randomized Trial of Male Circumcision for Human Immunodeficiency Virus Prevention, Rakai, Uganda." British Journal of Urology International 101 (2008): 65-70. Print.

5Kim, DaiSik, and Myung-Geol Pang. "The Effect of Male Circumcision on Sexuality." British Journal of Urology International 99.3 (2006): 619-22. Print.

6Laurence, Jeffrey. "Keratinization: A Biologic Alternative to Male Circumcision in the Prevention of HIV Infection?" The AIDS Reader 18.8 (2008): 394-95. Print.

7Report 10 of the Council on Scientific Affairs (I-99). Rep. American Medical Association (AMA), Dec. 1999. Web. 4 Oct. 2010. <http://www.ama-assn.org/ama/no-index/about-ama/13585.shtml>.

8"Rose G. Mage." Faculty: Rose Mage. GWU Medical Center. Web. 04 Oct. 2010. <http://www.gwumc.edu/immunology/faculty/faculty_pages/mage.htm>.

9Taves, Donald R. "The Intromission Function of the Foreskin." Medical Hypotheses 59.2 (2002): 180-82. Print.

10"Vestigial - Definition and More from the Free Merriam-Webster Dictionary." Merriam-Webster Online. Merriam-Webster, Incorporated. Web. 04 Oct. 2010. <http://www.merriam-webster.com/dictionary/vestigial?show=0&t=1286227601>.