Jim Bigelow. Hourglass, £16.95, pp 239, ISBN 0-9630482-1-X
Written in populist style, The Joy of Uncircumcising! is based on three premises: that infant circumcision is performed without consent; that circumcision diminishes penile sensation and therefore reduces sexual enjoyment; and that techniques of prepucial reconstruction can restore lost sensitivity to the glans penis.
Of these contentions, the first warrants the most serious consideration. There is no question that the widespread practice of infant circumcision, performed for cosmetic or religious indications, carries small but important risks. Complications such as infection, meatal stenosis, or even ischaemic tissue loss undoubtedly occur occasionally. As Dr Bigelow forcefully points out, there is little evidence that early circumcision confers any health gain to the individual in the longer term. The original argument that penile carcinoma is almost unheard of in circumcised men carries little weight as the incidence of penile cancer has become rare throughout the developed world. It is certainly a legitimate question whether children who were circumcised in infancy would themselves have elected to undergo the procedure had it been delayed until an age when informed consent would have been feasible.
Does circumcision detract from sexual enjoyment? Here we move to a much more tenuous hypothesis. In neurophysiological terms sensation to the glans penis is subserved by sensory nerve endings that transmit impulses to the brain via the pudendal nerves. While circumcision might conceivably desensitise the glans to normal tactile sensation such as that induced by contact with clothes, there is little reason to suppose that sexual stimuli would be similarly affected.
Can "uncircumcision" restore this putative lost glandular sensitivity? Uncircumcision as advocated by Dr Bigelow entails either penile skin expansion, by progressive stretching, or plastic surgery to gain extra skin length. These procedures are certainly feasible, but they are not without considerable risks, not least of which is loss of sensation of the penile shaft. To support his claim for their efficacy Dr Bigelow publishes correspondence from many men who have availed themselves of these techniques. Unfortunately, the placebo effect of attaching weights to the penis or undergoing quite complicated penile reconstructive surgery cannot be discounted. It is the converted who are preaching.
In an open society we pride ourselves on the freedom to debate every issue. The advisability of infant circumcision is certainly worthy of discussion. I personally doubt the wisdom or efficacy of "uncircumcision," but a little further controversy in this already emotive topic will do little harm.
Note: See also Waskett's analysis.