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#21
August 15th 04, 09:09 PM
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"Chotii" wrote in message .. . "Briar Rabbit" wrote in message ... Sarah Vaughan wrote: No. To be one of the uncircumcised, regardless of whether that's the minority or the majority, because it avoids unnecessary harm and discomfort. Harm? What harm would that be? The discomfort of the post circumcision period is minor and should not be exaggerated ... unless you have an agenda? No more than your own, sir. In the study you quote, please note that the participants were consenting adults who chose to have surgeries. Their post-surgical discomfort was within tolerable ranges, and they were pleased with their choice. Presumably, there were also men who chose not to have the surgery, and remained intact. If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? It seems to me that the dissatisfaction of that minority who now, having been altered at birth, discover they must go to years(!) of effort in order to re-create a facsimile of what other men take for granted....matters. It matters to *them*. And neither you nor I may tell them that they should just be happy with what they don't have, because they're not. Conversely, for all the millions of men who are perfectly happy with their altered state, we must accept that they are happy. It is not our place, as a society, to decide that all men will or should be happy being altered, and that the few who won't be are irrelevent - and anyway, even if they are unhappy, they shouldn't be and there's something wrong with them - and cut all male infants anyway. The cost to those who will be unhappy afterward is too high. To those who wish to be altered later, as you say......the discomfort is minor and should not be exaggerated. --angela I agree 100%, to follow up on the post-surgical discomfort, and as you stated in your post, the participants of the study were all men who willingly choose to have their foreskin amputated. Now then lets take a group of 100 intact men, randomly chosen and FORCE THEM to undergo circumcision, even if they don't want it. And you will have a very high rate of dissatisfaction and postoperative pain. Take a round the house example. You decide to paint your house bright green, so you either hire someone to do it, or go get the paint/supplies and do it yourself. Chances are you will be happy with the result, because you underwent the project KNOWING it was what you wanted to do. Now lets say that your neighborhood association came along and told you that you must paint your house hot pink, now lets assume that you HATE hot pink. Chances are you will NOT like the results even tho you didn't have to do a thing. So whats the difference between the two scenarios.... In one case someone did the research and made a choice to proceed, in the other case it was a forced change that was not wanted. Circumcision is the same. If someone dislikes being intact and wants to be circ'd they will most likely be pleased with the result (unless there are complications!). If someone likes being intact but is forced to cut, i bet they won't like it at all, even if its "painless". I have a wonderful idea... LETS FORCE EVERYONE TO CUT OFF THEIR EARLOBES... I bet you won't like that, I won't like it for that matter, even tho it has very little (if any) function i bet you don't want to part with it. Now lets assume that you don't like your earlobes, and want to cut them off yourself, then i bet you'd be happy with the results after surgery. Another example of skewed statistics to meet an agenda. (did you know that dihydrogen monoxide is found in 100% of all people that die from cancer?) 
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#22
August 15th 04, 09:33 PM
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Chotii wrote:
"Briar Rabbit" wrote in message ... Sarah Vaughan wrote: No. To be one of the uncircumcised, regardless of whether that's the minority or the majority, because it avoids unnecessary harm and discomfort. Harm? What harm would that be? The discomfort of the post circumcision period is minor and should not be exaggerated ... unless you have an agenda? No more than your own, sir. In the study you quote, please note that the participants were consenting adults who chose to have surgeries. Their post-surgical discomfort was within tolerable ranges, and they were pleased with their choice. Presumably, there were also men who chose not to have the surgery, and remained intact. There were two issues. One related to post surgical discomfort and the second (and unrelated) was about adults being happy or unhappy about being circumcised. Why did you choose to fuse the two together? You state that (from the study I posted) the "post-surgical discomfort was within tolerable ranges". Where did you get that from? The study did not refer to this aspect at all. Why do you choose to misrepresent the study? If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? Try that again in English please. It seems to me that the dissatisfaction of that minority who now, having been altered at birth, discover they must go to years(!) of effort in order to re-create a facsimile of what other men take for granted....matters. It matters to *them*. And neither you nor I may tell them that they should just be happy with what they don't have, because they're not. Conversely, for all the millions of men who are perfectly happy with their altered state, we must accept that they are happy. Oh ... you mean those sad and pathetic creatures called "tuggers" who hang weights from their penises to stretch themselves some skin? Here is a study into the psychosexual pathology behind the practice of foreskin restoration. ==================== Archives of Sexual Behavior, Vol. 10, No.4, 1981 Prepuce Restoration Seekers: Psychiatric Aspects Paul C. Mohl, M.D.I,2 , Russel Adams, Ph.D.,3 Donald M. Greer, M.D.,4 and Kathy A. Sheley, Ph.D. A new subgroup of patients within the homosexual community has been identified who are characterized by preoccupation, with their absent foreskins. They associate their circumcised status with a sense of incompleteness, anger over a lack of choice, and their sense of masculinity.' Four patients who sought surgical reconstruction are reported. None were Jewish or psychotic. All tolerated surgery well. Preliminary etiologic hypotheses are advanced, emphasizing psychodynamic and imprinting possibilities. KEY WORDS: circumcision; uncircumcision; foreskin; homosexuality; prepuce reconstruction. INTRODUCTION A distinct subgroup within the homosexual community characterized by an erotic attachment to and/or preoccupation with the foreskin has recently come to our attention. This resulted when circumcised members of this subgroup requested surgical reconstruction of their foreskins. The existence of three separate organizations and publications devoted to the concerns of these individuals demonstrates that these individuals represent an authentic, definable group. The organizations are involved in political action such as lobbying against neonatal circumcision, information dispensing, and social and cultural activities. The publications include a quarterly newsletter, a membership directory, and a pornographic magazine. One of the organizations reports 1200 members, 80% homosexual, 10% bisexual, and 10% heterosexual, with 65% uncircumcised, 30% circumcised, and 5% "partially" circumcised. Age range is primarily young adult to early middle age with every state and several foreign countries represented (U.S.A. Newsletter, 1976). Our patients and the newsletter suggest that many of these individuals have been in touch with physicians in an attempt to obtain reconstruction. A few have obtained surgical reconstructions of their foreskins, although most report hostile, amused or anxious responses from physicians (U.S.A. Newsletter, 1974). Despite this evidence of prior contact with physicians, there are no reports in the literature describing these patients. Prior surgical reports have emphasized techniques applied to congenital deformities, traumatic injury, and transsexuals (Goldin, 1975; DeSouza, 1976; Manchanda et al., 1967; Noe et al., 1974). Psychiatric descriptions of patients who have sought "uncircumcision" have emphasized Jews seeking' to disguise their identities during times of political and cultural crises (Tushnet, 1965; Schneider, 1976; Levin, 1976). There is one report describing the surgical technique used to reconstruct the foreskin of a patient who sought this for psychological reasons and is reported to have recovered from his emotional discomfort following surgery (Penn, 1963). Another patient, probably psychotic, killed his surgeon following a similar procedure.6 Most of our colleagues assumed that these patients must be psychotic when we initially discussed the subject. None of our patients has been Jewish or psychotic, nor has any had preputial or penile disease or trauma. None bear any resemblance to transsexuals. These patients have a personally motivated obsession to obtain a new foreskin, an obsession sufficiently strong that these patients are willing to undergo an acknowledged experimental procedure of uncertain outcome bearing risk of permanent disfigurement.6 This rumor was confirmed by the Duke University Information Service. CASE REPORTS Case # 1 Mr. A is a successful 36-year-old schoolteacher from a large southwestern city. When he first presented he was so guarded and hostile he seemed paranoid. He viewed physicians as cruel and sadistic, convincing mothers to have their sons circumcised and then refusing later remedy. He was especially angry that he had had no choice in the matter of his own circumcision. He had contacted 20 physicians with his request prior to being referred to us. The patient had been concerned about his absent foreskin throughout his life and related this to longstanding identity problems. He complained of lifelong excruciating pain at the tip of his penis, which he attributed to his circumcised status. He also held his circumcised status responsible for his sexual difficulties with women, whom he' saw ,as less sensitive than men, and for his decision to avoid physical education during high school. He reported always feeling "yukky" about himself and his body, having been overweight most of his life, frequently depressed, and having obtained rhinoplasty and hair transplants in the past. At one time, he wondered if he was a transsexual, but he reported having satisfactorily come to terms with his homosexuality. He described his father as an uncircumcised authoritarian, domineering, aloof military man and his mother, an "army brat" herself, `as more understanding and closer to the patient. However, he viewed them as "the most married people I know" so that there was little room for a child in their lives. He felt they preferred his younger sister to him. Currently, the patient reported a number of satisfying friendships, satisfaction with work and hobbies, but current difficulty with his first long-term intimate homosexual relationship. His prior pattern had been to have several ongoing sexual relationships. Once the patient perceived the open and honest stance of the surgeon, much of his suspiciousness and hostility abated. Since he was able to accept the risks of surgery, appreciate the uncertainties of outcome, and establish a solid collaborative relationship, the surgery was performed. His father was supportive during the operations, frequently bringing Mr. A for his postoperative visits. Mr. A subsequently sought psychotherapy from the evaluating psychologist,which continued for seven months, weekly, and was focused on "here-and-now" issues of trust. Three years after surgery, he reports no further pain, no further depressions, satisfaction with his body, and increasingly gratifying interpersonal relationships, though he has decided not to seek a sustained, intimate sexual relationship at this time. He attributes his greater self-satisfaction to the surgery and his improved interpersonal relationships to the psychotherapy. Case # 2 Mr. B was a very anxious bisexual man of 42 from the Midwest. He had a Masters Degree in Library Science but spent his time in travel and study, working off and on as a gardener, model, and at other odd jobs He had been in Jungian therapies for 10 years. He had been concerned about being "cut" as long as" he could remember, recalling his childhood fascination with a baby's "natural state." He felt that sex was better with uncut partners and sought out such persons. He described the uncircumcised phallus as more beautiful, more pleasing, and more masculine and felt uncircumcision was related to greater creativity. He viewed circumcision as a barbaric mutilation. He described much concern with his identity and body image, recently having changed his name and feeling that a circumcised phallus made his body inconsistent with his soul. He worked part-time as a nude model. Mr. B was raised in the South in a Victorian atmosphere, the eldest of four children. His father was a photographer whom the patient viewed as hyper-religious, but bigoted and hypocritical. He was constantly critical and emotionally cold. Every time the patient attempted to communicate with him, their relationship seemed to deteriorate. The father considered sex dirty, and the patient recalled discussions about sex in the father's unlit darkroom. He had thought his father had been circumcised, but is now unsure. He viewed his mother as devoting her entire life to preventing her temperamental husband from becoming upset. Mr. B was partly raised by a paternal grandmother in whose bed he slept until early adolescence. He described both female figures as "enveloping" him. He recalls no close peer relations during childhood or adolescence, describing himself as "painfully shy." His first homosexual experience occurred during college with a partner who first checked to ensure that Mr. B had been circumcised. The patient, at age 30, was seduced by a woman whom he subsequently married for five years. During that time, he had rare homosexual contacts. He reported no current intimate relationships, nor did he report any close friends. He did make references to friends in the past but described most relationships in terms of their physical and/or sensual qualities. He reported frequent depressions in the past. He was preoccupied with his own internal experiences and had great difficulty communicating them effectively, frequently blocking. His thought processes were highly intellectual and eccentric, though he displayed no loose associations. His eye contact and rapport with the interviewer were distant. He was extremely anxious during the initial part of the interview, with vague answers alternating with clear direct responses. As the interview continued, he seemed to settle down, and his cognition became more appropriate and controlled. Despite our concerns about this patient's impoverished object relationships, difficulty managing anxiety, and eccentric thought processes, his ability to comprehend and accept the nature of the surgery led us to proceed. Postoperatively, he experienced some significant complications which resolved over time. Using telephone contact with the surgeon, he was able to tolerate the complications well. Now, two years after surgery, he reports that he is doing well, satisfied with the outcome, and' psychologically about as before. Case #3 Mr. C is a 52-year-old homosexual interior designer from a large northeastern city who completed two years of college and three years of night school. He could recall being preoccupied with his circumcised status for as long as he could remember, especially feeling strange and different from his uncircumcised father and childhood peers. As a child, he had thought he was born different from his father and other males. He wondered, as a child, if this made him more effeminate. He expressed anger at having been circumcised without his permission. He described circumcised males as "society oriented, pretentious, and condescending." He felt that he wanted a foreskin "for myself,"' seeing it as more aesthetic and pleasing. He also looked forward to using it in sexual foreplay. He reported past associations of uncircumcision with sexual prowess and masculinity but felt he had resolved those issues. " Mr. C was born and raised in a large Midwestern city. His earliest memory is from around age 3, when he was at a vacation cottage surrounded by several male adult family members staring at his penis saying "he's too young to have one" (presumably an erection). At age 5, he was caught "playing doctor" by his father, who directly threatened castration as punishment. His father was a general contractor who was uncircumcised. The patient reported a "terrible relationship" with him and saw him as rigid and distant. He saw his mother as warmer but very anxious, using the patient to calm herself. He is on good terms with his 5years-older sister but has never been able to discuss his feelings with any family member. At age 10, he had his first homosexual experience with a neighborhood boy who was "verrry uncircumcised." During high school he dated girls, and during an army stint he engaged in group heterosexual activities with Pacific Island natives. He consulted a psychiatrist for two months in his late 20s due to emotional turmoil associated with an unhappy love affair. He has had four prior cosmetic plastic surgical procedures (including acne removal, hair transplant, face lift, and blepharoplasty). He had sought foreskin reconstruction unsuccessfully from several plastic surgeons. The patient reported having several gratifying sexual partners, one nonsexual lover, and several close friends. He finds his work gratifying, although he had wanted to be an architect. When initially evaluated, the patient was extremely anxious and ambivalent about the surgery. He was preoccupied with a foreskin making him more "macho" and increasing his sexual pleasure, feelings he knew fo be unrealistic. He elected not to have the procedure. Six months later he returned, less anxious, less ambivalent, and more realistic in his expectations. He established excellent rapport, was very open during both psychiatric interviews, and clearly had above-average intelligence. He tolerated the surgery well, including some anxiety-provoking and very painful testicular swelling due to epididymitis, which responded to treatment. He has continued in his well-established, gratifying lifestyle and is pleased with the result of surgery one year postoperatively. Case #4 Mr. D is a 45-year-old bisexual, self-employed architect who lives alone in a rural area of the Pacific Northwest. He had undergone 18 prior procedures to restore his foreskin by another plastic surgeon who became reluctant to perform additional surgeries. The patient consulted us due to continued dissatisfaction with the results. He seemed to be seeking a perfect phallus. He recalled being preoccupied with his absent foreskin since age 5 or 6, when his parents slapped him for asking any questions about his body. He feels that had they explained circumcision to him at that time he would not have focused all his feelings of insecurity and inadequacy on his absent foreskin. He sees the phallus as the outward sign of his masculinity, which is, in turn, the most important part of his self. He expressed anger at the absence of choice in his circumcision and a feeling of incompleteness without a foreskin. Mr. D was born in the Southeast, the only child of a rigid Victorian woman and an alcoholic man. He was to have been the "cement" of their troubled marriage but became, instead, the "burden." The patient's father was circumcised, though the patient was unaware of this until he was 36 and insisted on viewing his father's naked body for the first time prior to burial. The father was preoccupied with his own masculinity, collected guns, enjoyed scaring people, turned hugs into painful experiences, and verbally abused the patient. The mother imposed rigid rules and tried to obtain her emotional needs from the patient, leaving him feeling inadequate. The patient's first homosexual experience occurred when he was 5, and he continued with these contacts through latency. In high school and college, the patient dated women and almost married twice under pressure from his mother. In his mid-20s, he acknowledged his primary homosexual orientation. He was by then a successful architect and sculptor. He saw a psychoanalyst for two years in his early 30s due to recurrent feelings of depression and inadequacy. This therapy was very helpful to him, although he was disappointed in its failure to affect his foreskin preoccupation. He felt that his analyst was unable to listen objectively when he discussed his foreskin obsession. Subsequently, he was able to establish a 4-year-long intimate relationship, the abrupt ending of which precipitated his move to the West Coast. At that time he "rediscovered women." His current relationships consist of homosexual "one night stands," an episodic heterosexual relationship, and several close friends who live in a city two hours away by car. He finds a committed relationship best for him but has been unable to establish one, thus far. The patient describes himself as vain about his body, enjoying exhibiting it at nude beaches, baths, and gymnasiums. He has had a blepharoplasty in addition to the 18 foreskin procedures. He related in an open, intellectual manner, yet" there was a sense of guarded rage and tension. He acknowledged difficulty with his hostility. Due to the patient's perfectionist hopes and his unwillingness to allow contact with his prior surgeon, an impasse was reached, and we refused to contemplate any further procedures. DISCUSSION All four of these patients (and four others we have evaluated) were seen not in psychoanalytic psychotherapy but in pre-surgical diagnostic consultation. Thus, we did not obtain the kind of anamnesis and fantasy material which would lend itself to confident psychodynamic exegesis. Further, the material we do have must be addressed in terms of the individual dynamics and as potentially descriptive of a large group of patients and potential patients. Finally, the issue of our use of surgical intervention must be considered. Certain themes emerge from the four case histories. First, all of our patients were currently or had in the past been exclusively homosexual. All had family constellations frequently reported with homosexuality: a Victorian attitude toward sexuality, a distant father, and an emotionally intrusive mother. Second, all four of our patients reported a lifelong concern about circumcision, starting with early childhood recollections. Concern with the status of their father's penis was also prominent. Lifelong concern with identity and body image was another consistent finding. Body image was associated with both narcissistic and exhibitionistic issues. Third, depressions were a common experience for all four patients, some apparently lifelong, others more episodic. Psychotherapy had been helpful to three of the four patients, though the preoccupation with the foreskin remained unaffected. Fourth, three issues were regularly associated with the foreskin: a sense of incompleteness when it was absent, an association of masculinity with the foreskin, and anger related to the absence of choice and control in the decision. Fifth, previous approaches to physicians had been consistently painful, this exacerbating the anger. On the other hand, these patients showed a diversity in their patterns of interpersonal relationships, preferred coping mechanisms, and personality patterns. Mr. A was diagnosed as a narcissistic personality with paranoid trends prior to treatment and obsessive compulsive with narcissistic traits following psychotherapy. Mr. B appeared to be a well-treated schizotypal personality. Mr. C was diagnosed as mildly obsessive compulsive, and Mr. D was thought to be severely obsessive compulsive, with narcissistic traits. In spite of the degree of psychopathology noted, they all tolerated the procedures well. The three we ,have operated on report satisfaction with their treatment. In attempting to understand these phenomena, several hypotheses come to mind. In these patients, for some reason, conflicts at every developmental level have been condensed or displaced onto the absent foreskin. The sense of incompleteness, difficulties in interpersonal relationships, and identity concerns suggest primitive object relationship issues; the rage over the absence of choice suggests anal conflicts; and the masculinity concerns suggest phallic issues. Two reported cases may be of help here. Khan (1965) described a patient with a foreskin fetish. This fetish was found to be a defense against severe latent ego pathology. The state of excitement in which the patient sought another's foreskin was seen as a panicky state in which symbiotic fusion with the breast/mother was symbolized by the' penis/foreskin. This patient also experienced feelings of humiliation and rage following completion of his fetishistic acts. This was understood as a sadomasochistic mechanism. Another relevant case was reported by Nunberg (1947). In this case, a man developed symptoms in response to the circumcision of his infant son. This was eventually related to the patient's identification of his penis with his primitive infant self, and his foreskin with his enveloping mother/vagina. Circumcision was seen as a symbolic separation from mother. Our patients are somewhat different from these two cases, being preoccupied with their own foreskins. The patient who preferred uncircumcised partners did not seem to be fetishistic in his preoccupation. None of our patients reported sadomasochistic activities or fantasies, although we suspected some in Mr. D's case. Mr. A and Mr. B expressed strong feelings about the role of physicians and/or society in neonatal circumcision. These feelings were expressed in terms of the barbarity and cruel mutilation involved in circumcising a helpless infant. Similar feelings were echoed by many writers in the pages of the USA Newsletter. Support for the foreskin as fetishistic object comes also from the pages of the USA Newsletter, where many writers describe a variety of practices in which them foreskin appears to be central object of sexual activity. Practices for manipulating, stimulating, and decorating the prepuce are glowingly described. Most of our patients, however, described these practices as bizarre and dissociated themselves from those they saw as excessive or extreme in their prepuce preoccupation. Our patients do, however, report some material which lends support to the foreskin as primitive mother and/or self-symbol hypothesis. They all spoke of the foreskin with a sensual warmth and reverence. All spontaneously described themselves as feeling "incomplete" without one. Mr. A and Mr. B spoke of feeling empty. All patients described feelings of loneliness, depression, and inadequacy at some points in their lives. All reported lifelong identity concerns. Mr. Band Mr. D overtly articulated the connection between their identity concerns and foreskin preoccupations. The feelings of incompleteness and deep warmth toward the foreskin are also reported frequently in the USA Newsletter. To summarize these psychodynamic observations, these patients all experienced major defects in early mothering, leading to self and object relations pathology. Two report clear early memories of events which focused their attention on the absent foreskin. The other two recall a lifelong concern but appear to have repressed similar early experiences. Thus, there is strong likelihood that this symptom is connected to and, perhaps, defends against severe ego pathology. Of concern, however, is the resistance of the symptom to psychotherapeutic intervention, even when the self and object relations pathology seemed to improve. All our patients continue to view their concern as normal, natural, and non-symptomatic. We are hoping to identify one of these patients who has undergone, or would like to undergo, a thorough psychoanalysis. Money et al. (1957) emphasized the issue of imprinting in sexual identity. This hypothesis, closely related to primitive object relationship issues, suggests that there is a failure to form an adequate mother-infant bond, which may lead to failure in establishing any clear definition of one's body and self. Then, depending on later experience, this deficit may be focused in a variety of ways (transsexualism, paraphilias, etc.). The imprinting hypothesis suggests a biological fixedness to these disorders which the psychodynamic hypotheses do not. One rationale for treating these patients with surgery rather than psychotherapy is the imprinting paradigm. The resistance of our patients to psychotherapy tends to support this, although further clinical research is necessary. Although we obviously favor consideration of surgical restoration, we do not advocate it for all such cases. We have now seen a total of eight patients but have operated on only four. We have refused surgery to those who" had unrealistic expectations or who displayed overt, untreated psychiatric symptoms. We recommended extensive psychiatric treatment to three before reconsideration of surgical intervention. We emphasize to these patients, as we emphasize to all candidates for reconstructive surgery, that the surgery will not affect their conflicts, anxieties, or interpersonal relationships, that it will only make their bodies more as they wish. The ethical issues are no different than for any other cosmetic procedure. There is high risk of psychological sequellae in any patient with unrealistic, conscious or unconscious wishes or hopes with respect to the surgery, and it would be inappropriate to offer this procedure to such a patient or to one lacking the ego strength or support system necessary to cope with the frustrations and anxieties of a multistage procedure. It would also be inappropriate to withhold reconstruction from a patient who met the above criteria but had other psychological problems. Many physicians have great difficulty dealing with these patients, generally reacting with anger, amusement, rejection, or assumptions that the patients are psychotic. The source of these countertransference reactions is not clear. Intellectually, the request is similar to a request for augmentation mammoplasty. Both are requests for change to bring the body into compliance with a self body image. The operation is more difficult than mammoplasty but is not mutilating like transsexual surgery, which is far more accepted. We are not the first professionals to encounter such patients; however, prior clinicians have been reluctant to report these cases even when they were willing to proceed with the surgery! We were not immune to countertransference feelings, but our curiosity overcame our initial feelings of shock and horror. Our curiosity led to empathy for the discomfort felt by these patients, discomfort largely relieved by the foreskin restoration in the four we accepted for surgery. Whether these patients represent a new diagnostic entity or an unusual symptom that may be related to a variety of personality or neurotic psychopathology is unanswered at the present time. They tolerate and respond to surgical restoration of their foreskins despite the presence of other psychopathology and postoperative complications. Their body image preoccupations have been unresponsive to conventional psychotherapy despite benefit in other areas. Further research will be necessary to confirm these preliminary observations. Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284. 2Psychosomatic Consultation/Liaison Section, Psychiatry Service, Audie Murphy Veterans Administration Medical Center, San Antonio, Texas 78284. JDepartment of Behavioral Science, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma 73190. `Department of Surgery and Division of Plastic and Reconstructive Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284. `Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284. 383 0004-0002/81/0800-0383803.00/0 @ 1981 Plenum Publishing Corporation B Hanash, K. A., Furlow, W. L., Utz, D. C. and Harrison, E. G., Jr.: Carcinoma of the penis: a clinico. pathologic study. J. Ural., 104: 291. 1970. 9 Ekstrom, T. and Edsmyr, F.: Cancer of the penis: a clinical study of 229 cases. Acta Chir. Scand., 115: 25. 1958. . 10 Editorial: Routine circumcision. J.A.M.A., 185: 780, 1963. 6 Hardner, G. J., Bhanalaph, T., Murphy, G. P., Albert, D. J. and Moore, R. H.: Carcinoma of the penis: analysis of therapy in 100 consecutive cases. J. Ural., 108: 428, 1972. 7 Riveros, M. and Gorostiaga, R.: Cancer of the penis. Arch, Surg., 85: 377, 1962.
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#23
August 15th 04, 09:47 PM
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nooneimportant wrote:
"Chotii" wrote in message .. . "Briar Rabbit" wrote in message ... Sarah Vaughan wrote: No. To be one of the uncircumcised, regardless of whether that's the minority or the majority, because it avoids unnecessary harm and discomfort. Harm? What harm would that be? The discomfort of the post circumcision period is minor and should not be exaggerated ... unless you have an agenda? No more than your own, sir. In the study you quote, please note that the participants were consenting adults who chose to have surgeries. Their post-surgical discomfort was within tolerable ranges, and they were pleased with their choice. Presumably, there were also men who chose not to have the surgery, and remained intact. If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? It seems to me that the dissatisfaction of that minority who now, having been altered at birth, discover they must go to years(!) of effort in order to re-create a facsimile of what other men take for granted....matters. It matters to *them*. And neither you nor I may tell them that they should just be happy with what they don't have, because they're not. Conversely, for all the millions of men who are perfectly happy with their altered state, we must accept that they are happy. It is not our place, as a society, to decide that all men will or should be happy being altered, and that the few who won't be are irrelevent - and anyway, even if they are unhappy, they shouldn't be and there's something wrong with them - and cut all male infants anyway. The cost to those who will be unhappy afterward is too high. To those who wish to be altered later, as you say......the discomfort is minor and should not be exaggerated. --angela I agree 100%, to follow up on the post-surgical discomfort, and as you stated in your post, the participants of the study were all men who willingly choose to have their foreskin amputated. But you miss the point dear skin freak. If as you skin freaks state that an uncircumcised man would rather die than willingly submit to circumcision why would these men have lined up to be liberated from that hideous appendage? And I notice that you choose to ignore the following: "All sexual partners who were aware of the man's new circumcision status were very satisfied with the results." Now why would this be? You skin freaks have been trying to sell a crock that women prefer a foreskinned man. What drives you skin freaks to be such shocking liars?
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#24
August 15th 04, 09:50 PM
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On Sun, 15 Aug 2004 22:33:55 +0200, Briar Rabbit
wrote: Here is a study into the psychosexual pathology behind the practice of foreskin restoration. snip This whole study seemed extremely strange, but the thing that really made me doubt its credibility was in the first paragraph: Four patients who sought surgical reconstruction are reported. None were Jewish or psychotic. Huh? Thats a *very* strange way of putting it indeed. FWIW I think the fact that I am not seeing the adult males of my acquaintance, almost all of whom are intact (those who aren't were circumcised for religious, not cosmetic, reasons), queueing up to be circumcised as adults is pretty good evidence they are perfectly happy to be intact. Megan
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#25
August 15th 04, 09:59 PM
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"Briar Rabbit" wrote in message ... Chotii wrote: "Briar Rabbit" wrote in message ... Sarah Vaughan wrote: No. To be one of the uncircumcised, regardless of whether that's the minority or the majority, because it avoids unnecessary harm and discomfort. Harm? What harm would that be? The discomfort of the post circumcision period is minor and should not be exaggerated ... unless you have an agenda? No more than your own, sir. In the study you quote, please note that the participants were consenting adults who chose to have surgeries. Their post-surgical discomfort was within tolerable ranges, and they were pleased with their choice. Presumably, there were also men who chose not to have the surgery, and remained intact. There were two issues. One related to post surgical discomfort and the second (and unrelated) was about adults being happy or unhappy about being circumcised. Why did you choose to fuse the two together? You, sir, have fused them. You imply that the pain from circumcision is so minor as to be irrelevent, and that any man who is unhappy with having been altered is somehow wrong in the head. You have fused them by saying the one is irrelevent, and the second is an indication of some mental abberation. You state that (from the study I posted) the "post-surgical discomfort was within tolerable ranges". Where did you get that from? The study did not refer to this aspect at all. Why do you choose to misrepresent the study? Excuse me. I conflated your comment that the pain is minimal, with the study finding that adverse effects were "mild or moderate and resolved within hours or several days of detection". If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? Try that again in English please. If post-surgical discomfort is so minor, then why can it not be left to consenting adults to choose, or not choose, as they see fit? The amount of pain is negligible, and brief, and should have no impact on said informed, consenting adult who chooses it. It seems to me that the dissatisfaction of that minority who now, having been altered at birth, discover they must go to years(!) of effort in order to re-create a facsimile of what other men take for granted....matters. It matters to *them*. And neither you nor I may tell them that they should just be happy with what they don't have, because they're not. Conversely, for all the millions of men who are perfectly happy with their altered state, we must accept that they are happy. Oh ... you mean those sad and pathetic creatures called "tuggers" who hang weights from their penises to stretch themselves some skin? Here is a study into the psychosexual pathology behind the practice of foreskin restoration. We emphasize to these patients, as we emphasize to all candidates for reconstructive surgery, that the surgery will not affect their conflicts, anxieties, or interpersonal relationships, that it will only make their bodies more as they wish. The ethical issues are no different than for any other cosmetic procedure. There is high risk of psychological sequellae in any patient with unrealistic, conscious or unconscious wishes or hopes with respect to the surgery, and it would be inappropriate to offer this procedure to such a patient or to one lacking the ego strength or support system necessary to cope with the frustrations and anxieties of a multistage procedure. It would also be inappropriate to withhold reconstruction from a patient who met the above criteria but had other psychological problems. Many physicians have great difficulty dealing with these patients, generally reacting with anger, amusement, rejection, or assumptions that the patients are psychotic. The source of these countertransference reactions is not clear. Intellectually, the request is similar to a request for augmentation mammoplasty. Both are requests for change to bring the body into compliance with a self body image. The operation is more difficult than mammoplasty but is not mutilating like transsexual surgery, which is far more accepted. We are not the first professionals to encounter such patients; however, prior clinicians have been reluctant to report these cases even when they were willing to proceed with the surgery! We were not immune to countertransference feelings, but our curiosity overcame our initial feelings of shock and horror. Our curiosity led to empathy for the discomfort felt by these patients, discomfort largely relieved by the foreskin restoration in the four we accepted for surgery. Whether these patients represent a new diagnostic entity or an unusual symptom that may be related to a variety of personality or neurotic psychopathology is unanswered at the present time. They tolerate and respond to surgical restoration of their foreskins despite the presence of other psychopathology and postoperative complications. Their body image preoccupations have been unresponsive to conventional psychotherapy despite benefit in other areas. Further research will be necessary to confirm these preliminary observations. Perhaps you missed the part where the researchers' "curiosity led to empathy for the discomfort felt by these patients, discomfort (with body image) largely relieved by the foreskin restoration". It appears to me that these men have benefitted from having their bodies "restored". Why exactly is this a problem? Why is it "pathetic" for tuggers to alter their bodies to match their body image? Do you have the same reaction to women who seek breast augmentation, rhinoplasty, or any other body alteration? The simple fact is, any consenting adult male can choose to alter his body by circumcision, and *you* clearly think this is a fine thing. But let a man attempt to alter his (already altered) body by tugging, surgery, or other means, and you think he's pathetic. You are inconsistent. And you lack the empathy that the researchers confess to having felt. And by the way, a study of four men doesn't convince me that ALL men seeking foreskin restoration are suffering identical "issues". It does tell me something about those men. That's all. --angela
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#26
August 15th 04, 10:06 PM
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"Briar Rabbit" wrote in message ... nooneimportant wrote: "Chotii" wrote in message .. . "Briar Rabbit" wrote in message ... Sarah Vaughan wrote: No. To be one of the uncircumcised, regardless of whether that's the minority or the majority, because it avoids unnecessary harm and discomfort. Harm? What harm would that be? The discomfort of the post circumcision period is minor and should not be exaggerated ... unless you have an agenda? No more than your own, sir. In the study you quote, please note that the participants were consenting adults who chose to have surgeries. Their post-surgical discomfort was within tolerable ranges, and they were pleased with their choice. Presumably, there were also men who chose not to have the surgery, and remained intact. If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? It seems to me that the dissatisfaction of that minority who now, having been altered at birth, discover they must go to years(!) of effort in order to re-create a facsimile of what other men take for granted....matters. It matters to *them*. And neither you nor I may tell them that they should just be happy with what they don't have, because they're not. Conversely, for all the millions of men who are perfectly happy with their altered state, we must accept that they are happy. It is not our place, as a society, to decide that all men will or should be happy being altered, and that the few who won't be are irrelevent - and anyway, even if they are unhappy, they shouldn't be and there's something wrong with them - and cut all male infants anyway. The cost to those who will be unhappy afterward is too high. To those who wish to be altered later, as you say......the discomfort is minor and should not be exaggerated. --angela I agree 100%, to follow up on the post-surgical discomfort, and as you stated in your post, the participants of the study were all men who willingly choose to have their foreskin amputated. But you miss the point dear skin freak. If as you skin freaks state that an uncircumcised man would rather die than willingly submit to circumcision why would these men have lined up to be liberated from that hideous appendage? Ok... where did i state that? I simply stated that in that study the participants had a CHOICE... how many other intact men had that choice and choose NOT to get cut and participate in that study? The big factor is and always will be CHOICE. I don't have a single problem if someone CHOOSES to get cut, thats their choice, and i'm quite sure they will be happy with it. But taking that choice away and making it a requirement is flat out wrong. Whose body is it? Hideous Appendage is your opinion, and i'm sure many people will agree with you, but the fact of the matter is that its not the ONLY opinion. I for one think pink ties are hideous, but not everyone does. And I notice that you choose to ignore the following: "All sexual partners who were aware of the man's new circumcision status were very satisfied with the results." AGAIN these were participants who WILLINGLY got cut. Could it not be possible for the particapants partner to have an opinion of the decision making? How may intact men have satisfied partners? Just cus a man is intact doesn't automagically mean that their partner is NOT satisifed. You are skewing logic here. Now why would this be? You skin freaks have been trying to sell a crock that women prefer a foreskinned man. What drives you skin freaks to be such shocking liars? There you go again, throwing a blanket accusation, you really are good at that you know, been lurking for a long time and thats all i see you do with any skill. I am quite sure that there are women that prefer cut men, and understandably so in a society that is mainly cut, cus its what they are used to. Go to europe, and ask the same question to women who have largely known intact men...... Even here in the States there are women that prefer an intact penis, but many have NEVER EVEN HAD THE CHANCE TO TRY ONE cus they have been systemically removed from our culture, i know that simple statement hurts because it goes against your blanket accusation. GIVE MEN A CHOICE, GIVE WOMEN MORE OPTIONS.
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#27
August 15th 04, 10:37 PM
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Chotii wrote:
"Briar Rabbit" wrote in message There were two issues. One related to post surgical discomfort and the second (and unrelated) was about adults being happy or unhappy about being circumcised. Why did you choose to fuse the two together? You, sir, have fused them. You imply that the pain from circumcision is so minor as to be irrelevent, and that any man who is unhappy with having been altered is somehow wrong in the head. You have fused them by saying the one is irrelevent, and the second is an indication of some mental abberation. I did not imply anything of the kind. I said: "The discomfort of the post circumcision period is minor and should not be exaggerated." This does not imply anything of the sort you attempt to misrepresent me with. The right treatment, the right analgesics and any post-surgical discomfort is indeed minor. So why are you misrepresenting what I said? You state that (from the study I posted) the "post-surgical discomfort was within tolerable ranges". Where did you get that from? The study did not refer to this aspect at all. Why do you choose to misrepresent the study? Excuse me. I conflated your comment that the pain is minimal, with the study finding that adverse effects were "mild or moderate and resolved within hours or several days of detection". I said the discomfort was minor. In the absence of analgesics the pain would be significant. The % of AE's were so low as not to be a factor other than to consider where poverty related poor diets lead to suppressed immune systems and a higher than normal likelihood of infections then an anti-biotic shot should be considered at the time of the procedure or even before. If post-surgical discomfort is minor, then why should not consenting adults choose it if they wish? Try that again in English please. If post-surgical discomfort is so minor, then why can it not be left to consenting adults to choose, or not choose, as they see fit? The amount of pain is negligible, and brief, and should have no impact on said informed, consenting adult who chooses it. They did choose you silly old goose. They were the first 380 volunteers in a greater study on the protective effect of male circumcision against HIV infection. Now the connection between HIV infection and the foreskin is another horror story. Oh ... you mean those sad and pathetic creatures called "tuggers" who hang weights from their penises to stretch themselves some skin? Here is a study into the psychosexual pathology behind the practice of foreskin restoration. Perhaps you missed the part where the researchers' "curiosity led to empathy for the discomfort felt by these patients, discomfort (with body image) largely relieved by the foreskin restoration". Of course there must be empathy, pity and all the rest. These people are mentally ill, they need help, they need to be cared for, they need to be on medication. It appears to me that these men have benefitted from having their bodies "restored". Why exactly is this a problem? Why is it "pathetic" for tuggers to alter their bodies to match their body image? Do you have the same reaction to women who seek breast augmentation, rhinoplasty, or any other body alteration? I feel the same pity. The simple fact is, any consenting adult male can choose to alter his body by circumcision, and *you* clearly think this is a fine thing. But let a man attempt to alter his (already altered) body by tugging, surgery, or other means, and you think he's pathetic. Yes any male can choose to be circumcised or to hang weights from his penis to get some skin. One can accept that. The question is why do they decide to do it? These questions need to be answered and we may not always like the answers we get. You are inconsistent. And you lack the empathy that the researchers confess to having felt. No I am consistently unsympathetic to these lunatic "tuggers". If they just locked themselves in the attic and hung weights from their penises that would be manageable. They could be placed on the mental health watch register and managed on a case by case basis. It is when then attempt to justify there psycho-sexual pathology by waging war against all circumcision for whatever reason. They then need to be institutionalized and certainly restricted from contact with children. And by the way, a study of four men doesn't convince me that ALL men seeking foreskin restoration are suffering identical "issues". It does tell me something about those men. That's all. Be careful now. Sarah Vaughan's sample of "several men who support keeping the foreskin" seemed to have passed unchallenged by you. Why was that? Who is being inconsistent now?
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#28
August 15th 04, 10:48 PM
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nooneimportant wrote:
"Briar Rabbit" wrote in message But you miss the point dear skin freak. If as you skin freaks state that an uncircumcised man would rather die than willingly submit to circumcision why would these men have lined up to be liberated from that hideous appendage? Ok... where did i state that? I simply stated that in that study the participants had a CHOICE... how many other intact men had that choice and choose NOT to get cut and participate in that study? The big factor is and always will be CHOICE. I don't have a single problem if someone CHOOSES to get cut, thats their choice, and i'm quite sure they will be happy with it. But taking that choice away and making it a requirement is flat out wrong. Whose body is it? Hideous Appendage is your opinion, and i'm sure many people will agree with you, but the fact of the matter is that its not the ONLY opinion. I for one think pink ties are hideous, but not everyone does. see separate reply And I notice that you choose to ignore the following: "All sexual partners who were aware of the man's new circumcision status were very satisfied with the results." AGAIN these were participants who WILLINGLY got cut. Could it not be possible for the particapants partner to have an opinion of the decision making? How may intact men have satisfied partners? Just cus a man is intact doesn't automagically mean that their partner is NOT satisifed. You are skewing logic here. I am not saying they are automatically unhappy. I would love to know how the deal with the stink though. What you say ... no head? Now why would this be? You skin freaks have been trying to sell a crock that women prefer a foreskinned man. What drives you skin freaks to be such shocking liars? There you go again, throwing a blanket accusation, you really are good at that you know, been lurking for a long time and thats all i see you do with any skill. I am quite sure that there are women that prefer cut men, and understandably so in a society that is mainly cut, cus its what they are used to. Go to europe, and ask the same question to women who have largely known intact men...... Even here in the States there are women that prefer an intact penis, but many have NEVER EVEN HAD THE CHANCE TO TRY ONE cus they have been systemically removed from our culture, i know that simple statement hurts because it goes against your blanket accusation. GIVE MEN A CHOICE, GIVE WOMEN MORE OPTIONS. Yes I know there are women (in the US) who prefer the uncircumcised penis under all and any circumstance. 1% as found by the Williamson survey. They are called skin freaks as they seem to be turned on by the bodily excrement found under the foreskin. I suppose they would be into "rimming" (butt licking) as well. Here is the Williamson survey: http://groups.yahoo.com/group/unasha...rc/message/413 =============================== WOMEN'S PREFERENCES FOR PENILE CIRCUMCISION IN SEXUAL PARTNERS Marvel L. Williamson, Ph.D., R.N. Assistant Professor, College of Nursing The University of Iowa Iowa City, IA 52242 Paul S. Williamson, M.D. Associate Professor, College of Medicine The University of Iowa Iowa City, IA Abstract Regardless of pediatricians' attempts to negate routine newborn circumcision, U.S. circumcision rates remain constant. This study hypothesized that, because circumcision is usually a maternal choice and the circumcised penises are perceived by young women as more attractive, most women prefer circumcision for sexual reasons. Of 145 new mothers of sons responding to this survey, 71-83% preferred circumcised penises for each sexual activity listed. Visual appeal and sexual hygiene were predominant reasons for favoring circumcised sexual partners. Even among women having sexual experience only with uncircumcised partners, only half preferred uncircumcised penises for sexual partners. Eighty-nine percent of the sample had had their sons circumcised. This study furthers debate over whether circumcision decisions should be based solely on medical considerations limited to the newborn period. In spite of recent attempt by the American Academy of Pediatrics and other organizations to persuade the public to abandon the practice of routine newborn circumcision (e.g., Thompson, King & Knox, 1975; American Academy of Pediatrics, 1984), new parents have continued to request the procedure at the same high rates (Metcalf, Osborn, & Mariani, 1983). In the United States, approximately 75-90% of newborn males are circumcised, compared to only 10% of Europeans and 20% of males in general worldwide (Jones, 1985; Wallerstein, 1985). One survey of 200 women concerning their maternal attitudes [towards] circumcision revealed that mothers were not giving medically valid reasons for having their sons circumcised, and the authors concluded that health care providers needed to do a better job of educating parents about the medical risks and benefits of the procedure (Lovell & Cox, 1979). Even after other researchers launched extensive programs to inform prospective parents about the lack of "absolute medical indication" for circumcision, no significant change in the rate of newborn circumcisions could be observed in targeted samples (Herrera, Hsu, Salcedo, & Ruiz, 1982; Herrera, Cochran, Herrera, & Wallace, 1983; Land & Policastro, 1983; Rand, Emmons, & Johnson, 1983; Stein, Marx, Taggart, & Bass, 1982). Parents within the United States who do not have their sons circumcised report the main reason is cultural. That is, most are a part of a subgroup, often Hispanic, that traditionally does not circumcise (Ernst, Philip, & Orman, 1987). Only 10% of the subjects who choose to leave their sons uncircumcised cite being convinced on the basis of reading or on physician's advice (Kreuger & Osborn, 1986; Stein et al., 1982). It has been demonstrated that mothers more than fathers usually decide whether to have their sons circumcised (Bean & Egelhoff, 1984; Williamson & Williamson, 1984). Although informed consent for circumcision now includes information on how easy it can be to give proper penile hygiene to an uncircumcised baby, mothers persist in their desire to have their male infants circumcised. This trend is particularly noteworthy within the current financial context in which many third party payers deny coverage for newborn circumcisions (Medical World News, 1986. Review of the Literature and Conceptual Framework Controversy characterized the history of circumcision. Circumcision has existed since the Stone Age for unknown reasons (Jacobs, 1943). In earliest written records documenting its use, religious beliefs required that the male foreskin be removed as an outward display of faith and membership in the group. In some cultures, circumcision signified a boy's entrance into manhood. In whatever setting, the uncircumcised were looked down upon for being pagan or unmasculine. Later, the European elite class made circumcision exclusive privilege in the Victorian era (Jones, 1985). This notion persisted even into the early twentieth century as evidence that a man had been born into a situation where the luxury of circumcision could be afforded. Circumcision has not solely been a status symbol, however. Within certain circumstances it was a necessity. Entire armies found themselves immobilized by balanitis, a painful inflammation under the foreskin due primarily to lack of access to bathing facilities. (King, 1979) Societies that live in arid, sandy environments where water is precious learned long ago about the merits of circumcision. Even today, hygiene can be so difficult within some segments of the health care system, such as in institutions for the elderly or the mentally handicapped where patients may resist personal hygiene care, that circumcision eventually has to be performed to prevent infections or other complications of the foreskin (Harris, 1986). Inadequate penile hygiene, which is more likely in uncircumcised men, is resurfacing again as a predictor of carcinoma of the penis (Jussawalla, Yeole, & Natekar, 1985). After the proclamation by the American Academy of Pediatrics against circumcision, studies have since begun reporting a relationship between uncircumcision and the incidence of urinary tract infection in male children (Ginsburg & McCracken, 1982; Shapiro, 1984; Wiswell et al, 1987). Other complications, especially balanitis, bring about significantly more medical visits for uncircumcised boys than for penile problems in circumcised boys (Herzog & Alverez, 1986). Good hygiene, which itself can be difficult for even the best intentioned parents, does not entirely eliminate these problems (Krueger & Osborn, 1986). It is argued, therefore, that pediatricians have an incomplete perspective in the current debate over whether circumcision for newborns is necessary. Furthermore, medical indications and contradictions aside, insight into the cultural and sexual rationale for why the American public and American women in particular prefer circumcision is missing. Social reasons for circumcision, when conceded at all, are dismissed by medical personnel as being unjustifiable vis-a-vis existing "scientific" proof. In addition, arguments that cite historical fallacies about circumcision fail tests of logic when posing as premises for concluding that circumcision for any reason is wrong (Grossman & Posner, 1984). The debate on medical grounds seems to miss a major portion of the reasoning, though. In the face of the current campaign against circumcision, why is it still requested at such high rates? What motivations do American women have for wanting American males to be circumcised? In a study by Bean and Egelhoff of 277 new mothers of sons, 78% reported favoring circumcision even before becoming pregnant and having to make a conscious choice affecting a son, and 91% ultimately decide to have their newborn son circumcised (1984). Even those woman whose husbands were uncircumcised overwhelmingly opted for circumcision. The reason must seem important enough to woman for them to withstand pressure from physicians and others who oppose circumcision. Brown & Brown go as far as to say that "the circumcision decision of the United States is emerging as a cultural ritual rather than the result of medical misunderstanding among parents" (1987). One idea that has been overlooked is that the penis is a sexual instrument, not just a passageway for urination. For example, circumcision at puberty in nonliterate cultures is in some ways a sexual recognition of the emerging man (Bettelheim, 1954; Money, Cawte, Bianchi, & Nurcombe, 1970; Kitahara, 1976). The permanent exposure of the glans of the penis renders it a sexual tool. Most research conducted previously on the reasons newborn males are circumcised fails to include a reference to the perceived sexual appeal of a circumcised penis over an uncircumcised one. Typical lists of reasons from which the subjects could choose offered only hygiene, religion, father's or sibling's circumcision status, and other traditional explanations. At the most, an "Other" category included in some surveys caught untold thoughts on the perceived advantage of circumcision. Without the inclusion of sexual attitudes toward penis type on such a list, respondents would typically hesitate to spontaneously present sexual rationale favoring circumcision, particularly in reference to a newborn penis. Admitting to sexual desires and preferences is difficult enough for subjects even in straightforward studies. Without the researcher conceding the possibility, it is not likely a mother would volunteer information about her hopes for her son's future sexual attractiveness. It was not until a study on cultural values associated with the decision to circumcise, in which Harris used unstructured interviews, that the sexual overtones of newborn circumcision were explicitly reported (1986). One of her findings was that a circumcised penis has a certain "cosmetic appeal," that in America the exposed glans is more pleasing aesthetically. She concluded that circumcision could be an acceptable practice based on cultural values, and that the health care delivery system could be a more "perceptive cultural broker" with regard to honoring a society's view of beauty. In asking various groups about why circumcision may be indicated, a few surveys have included a response category labeled "cultural," which may have been construed by some subjects to include sexual attitudes. One such study found that significantly more obstetricians than pediatricians believed that the culture was a valid reason for neonatal circumcision (Herrera & Macaraeg, 1984). What the concept of culture means, though, is that to many Americans circumcision seems to be normal because that is what they are accustomed to seeing. This could certainly be true, in that what people are used to is what they prefer. This cultural perspective brings circumcision into a new arena, one in which the rigidity by some health professionals fosters alienation and resistance (Gellis, 1978). Some go so far as to say that opting for circumcision indicates an emotional response that is not based on rational decision making (Brown & Brown, 1987). A study of female preference for certain male body parts showed that 89% of woman students at a southern college preferred pictures of circumcised penises over uncircumcised ones (Wildman, Wildman, Brown & Trice, 1976). This is as close as the literature comes to facing the persistent preference by American women for circumcision, as best displayed by new mothers of male infants. To date, no study has explored the possible sexual motivations behind circumcision, however. It was the purpose of this investigation, therefore, to determine if women, particularly mothers who recently made a decision about circumcision of their newborn sons, do indeed prefer circumcised sexual partners, and if so, for what reasons. This study hypothesized that most American woman prefer circumcised penises in their sexual relations, a factor unrelated to the purported lack of medical indications for the procedure. Methods Women 18 years of age and older who delivered full-term healthy sons within the previous month at a major midwest medical center comprised the targeted sample. Candidates for the study were chosen during a 6-month period based upon their willingness to participate in an earlier study that dealt with who and what influenced their decisions to circumcise or not circumcise their babies. The sample had been randomly selected and 85% made up the group to whom questionnaires were mailed for this study. Of the 269 women who received the questionnaire, 148 returned their forms yielding a response rate of 55%. Three were unusable, yielding a final sample of 145. Due to the explicit sexual nature of the questions, this rate compares favorably to the other research studies investigating such personal sexual issues. Because there had been no previous data collection tool seeking this type of information, it is necessary to first confirm the content validity through its review by several experts. The survey instrument was tested on a pilot group of women who gave subsequent feedback about its clarity and the completeness of the response options available from which to choose. By comparing the outcome of this questionnaire to certain items on the previously conducted study on the group of 269, it was also possible to establish the reliability of the individual subject's responses over a period of time. The survey was highly personal, asking the women about their own sexual experiences with men and about their preferences for circumcised or uncircumcised penises for various sexual activities. No reference was made to the women's decision to circumcise their own sons or not. This survey dealt entirely with adult sexual experiences and preferences in order to distinguish the two issues and allow for correlational tests between their choices as parents and their attitudes as sexual adult women. Each subject had received a thorough review of circumcision at the hospital when deciding about their son's candidacy for the procedure. Each was also shown drawings of both uncircumcised and circumcised penises. It was assumed, therefore, that the subjects knew what circumcision meant and what types of penises their sexual partners had. Lay terminology was used in each question. Prior to implementation of the study, all procedures and tools received approval by a human research subjects' rights board. Confidentiality was guaranteed to the subjects and was maintained throughout the study. Results Most of the newborn sons of mothers in the sample had been circumcised (89%). This percent is similar to the circumcision rate prevailing in the geographic area at the time of data collection. Of the women in the sample, 83.7% were married, 12.8% were single, and 3.5% were separated, divorced, or widowed. By race, 97.9% were Caucasian, 1.4% were black, and 0.7% were Hispanic. Another characteristic consistent with the midwest population generally was religion: 46.1% were Protestant, 21.3% were Catholic, 29.1% claimed no religion, 0.7% were Jewish, and the remaining 2.8% listed other religions. The group was well educated. All but 12.7% had finished high school and 25.3% had at least some higher education. Fourteen percent had finished college. There was a weak correlation between higher education and the choice to circumcise the newborn (rpb = 0.27). In response to the question "With which penis types have you had sexual experience?", 16.5% revealed that they had had sexual contract with both circumcised and uncircumcised men. Only 5.5% had sexual experience exclusively with uncircumcised sexual partners, and the remainder of the sample was sexually experienced only with circumcised men. The responses to "If you could choose anyone for your ideal male sex partner, which circumcision type would you prefer he have for the following activities?" as shown in Table 1. There was a strong correlation between the circumcision status of her newborn son and a woman's ideal male partner's status for the purpose of intercourse (phi = 0.86)m, and a moderate correlation for visual appeal (phi = 0. 50). To investigate any possible relationship between the circumcision status of one's father or brothers and the preferred type of ideal sexual partner, correlational tests were made on those subjects who knew whether these family members were circumcised. No similarities were found that could be attributed to childhood exposed to penises of either type (phi = 0.12 for fathers and 0.06 for brothers). It was interesting to note that 22% of the sample did not know whether their fathers were circumcised and of those who had brothers, 9% did not know whether they were circumcised. TABLE ONE Activity Penis Type Circumcised (%) Uncircumcised (%) Either (%) Sexual Intercourse.......71.............6...............2 3 Looking at to achieve....76.............4...............20 sexual arousal Giving manual............75.............5...............2 0 penile stimulation Giving Fellatio..........83.............2...............1 5 It could be surmised that some women prefer circumcised penises because that is their sole experience in sexual contacts. However, of the group with dual experience (N = 24), two-thirds favored circumcision exclusively and a significantly greater proportion preferred circumcised partners for all the sexual activities listed in Table 1 (p 0.01). Among those women who had sexual experience only with uncircumcised partners (N = 8), their past was more clearly correlated to their preferences. For each of the sexual activities presented, approximately half of this sub-group desired an uncircumcised penis and the other half said that penis type did not matter. Evidently, almost any sexual exposure to a circumcised [penis] swayed women to sexually prefer circumcision. That is only 1% of the entire sample consistently preferred uncircumcised partners for all sexual activities, and those subjects came entirely from the group which had had sexual experience only with uncircumcised penises. When asked "Why do you prefer one penis type over another for sex?", subjects were instructed to mark all options that applied to them. Among those preferring a circumcised penis, the reasons they indicated appeared in the following ranked order from most frequent to least: Stays cleaner (92 %) Looks sexier (90%) Feels nicer to touch (85%) Seems more natural (77%) Smells more pleasant (55%) Stays softer (54%) It was fascinating to find that so many women thought a circumcised penis seemed more natural, probably meaning to them "familiar" within the American cultural context. Among those preferring an uncircumcised penis, most also stated that to them it looked more natural, but no one in the entire study thought that an uncircumcised penis looked sexier. Overall, the factor correlating most strongly with whether the newborn son was circumcised was the subject's favorite penis type for sexual intercourse. There was little or no correlation between the newborn circumcision decision and demographic factors including race, upbringing, or sexual experiences. Conclusions This study clearly support the hypothesis that American women prefer circumcision for sexual reasons. The preference for circumcision does not necessarily come out of ignorance nor from lack of exposure to uncircumcised men. Even when women grow up with uncircumcised fathers and brothers, or have uncircumcised sexual partners, the majority of such a group still prefer circumcised sexual partners. Women state a preference for circumcised penises particularly for sexual activities like fellatio, but also for intercourse, manual stimulation, and visual appeal. They say that this is primarily due to circumcised penises being cleaner and looking sexier. The cleanliness of circumcised penises within the sexual context means something different from cleanliness as a hygiene factor to prevent balanitis and other complications. To a sexual partner, cleanliness is important because the penis tastes, smells, and looks more appealing. Spontaneous sexual activity is more likely to be enjoyable with a man who is circumcised, because bathing efforts last for longer periods of time. For the uncircumcised, washing under the foreskin must be attended to frequently to prevent the accumulation of any smegma, whereas in the circumcised male, the constant exposure or the coronal ring and the glans to air prevents the build up of odors and secretions. Of almost equal importance to cleanliness of the penis for sexual activities is the visual attractiveness of a circumcised penis. What is sexier about a circumcised penis? Perhaps visualizing the glans, the urinary meatus, and the corona without them being hidden under a foreskin is arousing. After all, such is the appearance of an erect penis, and sexual imagery of the erect penis involves exposure of the glans. While the foreskin of an uncircumcised penis can be retracted, the circumcised penis exists in exposed beauty whether flaccid or erect. Furthermore, in some uncircumcised men the foreskin can actually detract from the visual appeal of the penis. American producer of erotic films and publishers of photographic literature are careful, for example, on those rare occasions when uncircumcised models or actors are used, to select penises with foreskins that are smooth and free from extra wrinkled skin. Particularly to the unaccustomed eye, a puckered or wrinkled foreskin can lack sexual appeal. These findings suggest that the decision to have a new-born son circumcised may not be significantly affected by increasing the already rigorous efforts to explain the supposed lack of medical indications. While many mothers may not consciously view their sons as sexual beings, many may opt for circumcision with the belief that the son will be more sexually attractive to his future sexual partners, based on how they themselves feel. Future research can address this issue within a different cultural setting where most males are uncircumcised. Newborn circumcision need no longer be performed without local anesthesia (Kirya & Werthman, 1978; Williamson & Williamson, 1983), silencing the outcry against circumcision as a form of "barbarism" (Foley, 1966). Removal of the foreskin may be viewed as preventive care, not unlike procedures done in other areas of health care (such as the extraction of asymptomatic wisdom teeth). The opponents of circumcision argue in return against the imposition of such a decision without the affected newborn male's consent. In response, those favoring circumcision point out that the many men who later want or need to be circumcised face a major surgical procedure that would have presented only a minor inconvenience if done as an infant. Circumcision has, therefore, now become a much broader issue than one that can be dismissed on such narrow grounds as those proposed by the American Academy of Pediatrics. Not least among the considerations is the worth of sexual preference for male circumcision within the American culture as a valid reason for continuing the practice. References American Academy of Pediatrics (1984). Care of the uncircumcised penis. Elk Grove Village, IL: Author. Bean, G., & Egelhoff, C. (1984) Neonatal Circumcision: When is the decision made? The Journal of Family Practice, 18, 883-887. Bettelheim, B, (1954) Symbolic wounds: Puberty rites and the envious male. New York: Free Press. Brown, M., and Brown C. (1987) Circumcision decision: prominence of social concerns. Pediatrics, 80, 215-219. Ernst, T., Philip, M., & Orman, R. (1987). Neonatal circumcision rates in a multiethnic hospital population. Family Medicine, 19, 227-228. Foley, J, (1966). The practice of medicine - a reevaluation. New York: Materia Medica. Gellis, S. (1978). Circumcision. American Journal of Diseases in Children, 132, 1168-1169. Ginsberg, C., & McCracken, G. (1982). Urinary tract infections in young infants. Pediatrics, 69, 409. Grossman, E., & Posner, N. 1984. The circumcision controversy: An update. Obstetrics and Gynecology Annual, 13, 181-195. Harris, C. (1986). Cultural values and the decision to circumcise. Image: Journal of Nursing Scholarship, 18, 98-104. Herrera, A., Hsu, A., Salcedo, U., & Ruiz, M. (1982)The role of parental information in the incidence of circumcision. Pediatrics, 70, 597-598. Herrera, A., Cochran, B., Herrera, A. & Wallace, B. (1983). Parental information and circumcision in highly motivated couples with higher education. Pediatrics, 71, 233-234. Herrera, A., & Macaraeg, A. (1984) Physicians attitudes toward circumcision. American Journal of Obstetrics and Gynecology, 145, 825-826. Herzog, L., & Alvarez, S. (1986). The frequency of foreskin problems in uncircumcised children. American Journal of Obstetrics and Gynecology, 140, 254-256. Jacobs, S. (1943). Ritual circumcision. Urologic and Cutaneous Review, 47, 679. Jones, S. (1985). Infant circumcision: Procedures complications, and indications. Continuing Education, 833-845. Jussawalla, D., Yeole, B. Cancer in Indian Moslems, Cancer, 55, 1149-1158. King, L. (1979) The pros and cons of neonatal circumcision. Surgical Rounds, 2, 29. Kirya, C., & Werthman, M. (1978). Neonatal circumcision and penile dorsal nerve block - a painless procedure. Journal of Pediatrics, 92, 998-1000. Kitahara, M. (1976). A cross-cultural test of the Freudian theory of circumcision. International Journal of Psychoanalytic Psychotherapy, 5, 535-546. Kreuger, M. & Osborn, L. (1986). Effects of hygiene among the uncircumcised. The Journal of Family Practice, 22, 353-355. Land, J., & Policastro, A. (1983). Parental Information and circumcision: Another look, Pediatrics, 72, 142-143. Metcalf, T., Osborn, L., & Mariani, E. (1983). Circumcision: A study of current practices. Clinical Pediatrics, 22, 575-579. Money, J., Cawte, J. Bianchi, G., & Nurcombe, B. (1970). Sex training and traditions in Arnhemland. British Journal of Medical Psychology, 43, 383-399. More insurers ending circumcision coverage. (1986). Medical World News, 27, 34. Rand, C., Emmons, C., & Johnson, J. (1983). The effect of an educational intervention on the rate of neonatal circumcision. Obstetrics and Gynecology, 62, 64-68. Shapiro, S. (1984). UTI in uncircumcised infants Report presented at the Symposium on Pediatric Infectious Diseases, University of California, Davis, School of Medicine and the Sacremento Pediatric Society. Stein, M., Marx, M. Taggart, S., & Bass, R. (1982). Routine neonatal circumcision: The gap between contemporary policy and practice Journal of Family Practice, 15, 47-53. Thompson, H., King L., & Knox, E. (1975) Report of the ad hoc task force on circumcision. Pediatrics, 56, 610-611. Wallerstein, E. (1985). Circumcision: The uniquely American medical dilemma. Urologic Clinics of North America, 12, 123-132. Wildman, R., Wildman II, R., Brown, A., & Trice, C. (1976) Note on males' and females' preferences for opposite sex body parts, bust sizes, and bust-revealing clothing. Psychologic Reports, 38, 485-486. Williamson, P., & Williamson, M. (1983). Physiologic stress reduction by a local anesthetic during newborn circumcision. Pediatrics, 76, 36-40. Williamson, P. & Williamson, M. (1984). The circumcision decision: Influences that determine newborn penile status. Unpublished manuscript. Wiswell, T, Enzenauer, R., Holton M., et al. (1987) Declining frequency of circumcision: Implications for changes in the absolute incidence and male to female ratio of urinary tract infections in early infancy. Pediatrics, 79, 338-342. ====================== This papers reference: Williamson, Marvel L., Ph.D., R.N. and Williamson, Paul S., M.D. Women's preference for penile circumcision in sexual partners. Journal of Sex Education and Therapy, Vol. 14, No. 2 (Fall/Winter 1988): pp. 8-12.
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#29
August 15th 04, 10:57 PM
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nooneimportant wrote:
"Briar Rabbit" wrote in message Now why would this be? You skin freaks have been trying to sell a crock that women prefer a foreskinned man. What drives you skin freaks to be such shocking liars? There you go again, throwing a blanket accusation, you really are good at that you know, been lurking for a long time and thats all i see you do with any skill. I am quite sure that there are women that prefer cut men, and understandably so in a society that is mainly cut, cus its what they are used to. Go to europe, and ask the same question to women who have largely known intact men...... Even here in the States there are women that prefer an intact penis, but many have NEVER EVEN HAD THE CHANCE TO TRY ONE cus they have been systemically removed from our culture, i know that simple statement hurts because it goes against your blanket accusation. GIVE MEN A CHOICE, GIVE WOMEN MORE OPTIONS. Well the poor dears just don't have the option in these traditionally non-circumcising countries. Is it demanded by you skin freakls that expectant parents are sat down and given a balanced set of facts about the pros and cons of circumcision and allowed to make an educated guess? You don't because when it comes to the foreskin you have the very strange view that foreskins must be saved come what may ... and are not going to allow a few facts to get in the way of you grand obsession. Here is an example of what can happen when men in a non traditionally circumcising environment become informed about circumcision. http://groups.yahoo.com/group/unasha...rc/message/347 ======================= Male circumcision: an acceptable strategy for HIV prevention in Botswana. Kebaabetswe P, Lockman S, Mogwe S, Mandevu R, Thior I, Essex M, Shapiro RL. The Botswana-Harvard AIDS Institute Partnership, Private Bag BO 320, Bontleng, Gaborone, Botswana. The Botswana Ministry of Health, Private Bag 0038, Gaborone, Botswana. The Harvard School of Public Health, Department of Immunology and Infectious Diseases, 651 Huntington Ave, FXB 401, Boston, MA 02115, USA. The University of Botswana, Private Bag UB 0022, Gaborone, Botswana. Sex Transm Infect. 2003 Jun;79(3):214-219. BACKGROUND: Male circumcision is known to reduce the risk of acquiring HIV, but few studies have been performed to assess its acceptability among either children or adults in sub-Saharan Africa. METHODS: We conducted a cross sectional survey in nine geographically representative locations in Botswana to determine the acceptability of male circumcision in the country, as well as the preferred age and setting for male circumcision. Interviews were conducted using standardised questionnaires both before and after an informational session outlining the risks and benefits of male circumcision. RESULTS: Among 605 people surveyed, the median age was 29 years (range 18-74 years), 52% were male, and 15 ethnicities were represented. Before the informational session, 408 (68%) responded that they would definitely or probably circumcise a male child if circumcision was offered free of charge in a hospital setting; this number increased to 542 (89%) after the informational session. Among 238 uncircumcised men, 145 (61%) stated that they would definitely or probably get circumcised themselves if it were offered free of charge in a hospital setting; this increased to 192 (81%) after the informational session. In a multivariate analysis of all participants, people with children were more likely to favour circumcision than people without children (adjusted odds ratio 1.8, 95% CI 1.0 to 3.4). Most participants (55%) felt that the ideal age for circumcision is before 6 years, and 90% of participants felt that circumcision should be performed in the hospital setting. CONCLUSIONS: Male circumcision appears to be highly acceptable in Botswana. The option for safe circumcision should be made available to parents in Botswana for their male children. Circumcision might also be an acceptable option for adults and adolescents, if its efficacy as an HIV prevention strategy among sexually active people is supported by clinical trials. http://makeashorterlink.com/?N29212925
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#30
August 16th 04, 12:35 AM
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"Briar Rabbit" wrote in message ... Chotii writes: It appears to me that these men have benefitted from having their bodies "restored". Why exactly is this a problem? Why is it "pathetic" for tuggers to alter their bodies to match their body image? Do you have the same reaction to women who seek breast augmentation, rhinoplasty, or any other body alteration? I feel the same pity. At least you're consistent. Point in your favor. No I am consistently unsympathetic to these lunatic "tuggers". If they just locked themselves in the attic and hung weights from their penises that would be manageable. They could be placed on the mental health watch register and managed on a case by case basis. It is when then attempt to justify there psycho-sexual pathology by waging war against all circumcision for whatever reason. They then need to be institutionalized and certainly restricted from contact with children. Turn that around, sir. If you'd just lock yourself in the attic and enjoy your cut penis, you'd be manageable. You could be placed on the mental health register and managed. It's when your attempt to justify your psycho-sexual pathology by waging war against all uncircumcision for whatever reason.... then you need to be institutionalised and certainly restricted from contact with children. Fair? I didn't figure you'd think so. Of course, your very willingness to label every single man involved in improving his body to conform with his preferred body-image a 'freak' who needs to be on a 'mental health register' says a great deal more about you than it does about them. --angela
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