Circumcision

Circumcision, or the act of cutting the foreskin (piece of skin that covers the top of the penis), is practiced in different countries and different communities for religious (as for Jews, Muslims) or traditional reasons (in sub-Saharan Africa) and because of the presumed hygienic advantages of doing so (especially in the US).

What to think about it?

More and more people contact us to know our position on the matter and ask if we also help men who suffer from their circumcision.

Like female genital cutting, circumcision is an intervention on a child’s body without the child’s consent. Unlike female genital cutting, Jews and Muslims consider circumcision as a religious duty. Unlike female genital cutting, Jews and Muslims consider circumcision as a religious duty. However, it is important to keep in mind that male and female circumcision are ancient cultural practices that existed before the age of monotheist religions. They are not based on religion but on tradition.

On the long term, a circumcised man who doesn’t protect himself will be contaminated, because the only efficient protection is wearing a condom.

About the positive effects on health: It is true that some randomised and controlled studies show a decreased risk of transmission of HIV by 50% from the woman to the (circumcised) man. This decrease is only proven true on the short term: demographic and health studies demonstrate that there is no difference in HIV prevalence between circumcised and non-circumcised men in countries where HIV already exists at a high rate, or in countries where HIV is more present amongst circumcised men (Cameroon, Malawi or Lesotho²) . Meaning that on the long term, a circumcised man who doesn’t protect himself will be contaminated, because the only efficient protection is wearing a condom. This decrease of contamination of HIV cannot in any way justify the circumcision of babies and youngsters: they are not at risk because they are not sexually active.

Phimosis (foreskin being too narrow to retract) is usually treated with circumcision, whilst exisitng less radical ways and it is an infrequent pathology if the boy’s penis remains untouched. At birth, the penis is naturally sealed to the glans penis. Unnecessary pulling back the foreskin happens regularly because of ignorance about the anatomy and its functions. This may cause problems such as phimosis and paraphimosis instead of preventing it. Hospitals and clinics officially use phimosis as a (medical) treatment for circumcision, so that parents may get refund.

The function of the foreskin is usually underestimated in the domain of sexuality. Many think it is nothing but a piece of skin, while this area contains the higher amount of nerves in the male genital organ. A circumcised man has less sensations at the levels of the foreskin and of the glans, the absence of foreskin causes the skin of the glans to thicken and harden when in contact with air and clothes. The foreskin also plays a role in the lubrication of the vagina thanks to it rolling in and out.

If the consequences of circumcision on health seem less harmful than the consequences of female genital cutting, one should not underestimate its impact, because GAMS Belgium has received calls from men who are suffering, which shows us that the consequences are real and should be heard.

Our team is made of people from different cultures and origins. Since 2014, the issue on circumcision has often been discussed in our organisation. So far, we did not reach an agreement on the matter because opinions vary according to one’s cultural and religious background. Each member of the team has been confronted to the arguments for and against circumcision.

If you are looking for more information, you may want to contact the French organisation “Droit au corps” (http://www.droitaucorps.com/) that not only provides information on prevention, but also supports circumcised men, and guides parents who question the practice.

For the moment, there is no association like that in Belgium, but GAMS Belgium started gathering information to inform at best circumcised men looking for support.

Opinion of the Advisory Council on Bioethics of Belgium on the ethical aspects of non-medical circumcision:   Dutch   French

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¹Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, et al. (2005) Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial. PLoS Med 2:e298. 
Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 2007;369:643-56.
Gray RH. Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 2007;369:557-66.

²Garenne M. Male circumcision and HIV control in Africa. PLoS Med 2006;3(1):e78.
Garenne M. (2008). Long-term population effect of male circumcision in generalized HIV epidemics in sub-Saharan Africa. African Journal of AIDS Research; 7(1):1-8.