A preliminary poll of men circumcised in infancy or childhood.

Generally, men circumcised in childhood remain uninIntroduction formed of its eCects. Lilienfeld et al. [9] found that onethird of circumcised men were unaware they were An estimated 650 million males [1] and 100 million females [2] living today were genitally altered as children. circumcised. Schlossberger et al. [10] revealed that 34% of circumcised adolescents reported their status incorAnnually, 13 million boys and 2 million girls in developing and developed nations undergo customs of rectly; circumcised boys were more uncertain of their status than intact boys. Schlossberger et al. determined genital cutting, euphemistically termed ‘circumcision’. These values are the estimated worldwide incidence of that, ‘Factors aCecting satisfaction with circumcision status are currently not known and need to be exammale circumcision (http: //www.noharmm.org/incidenceworld.htm, annualized from a ratio of 6.5 male circumined’, emphasizing, ‘Since the desire to be similar to peers typically fades during progression into later adocisions for each female circumcision, based on total and annual estimates of circumcision). The severity of mutilescence and adulthood, the eCect of increasing age on satisfaction also needs to be examined’ [10]. lation diCers among individuals, operators and cultures. Most female and male genital mutilations occur under Examining these ‘factors’ and ‘eCects’ is hindered by circumcised men’s ignorance of natural penile physiosimilar unsanitary conditions [3,4], although some procedures are conducted under medical conditions. logy. Other limits to reliable assessment may include subjects’ convictions that circumcision is beneficial or Although 80% of the world’s males remain genitally intact [5], male preputial excision has become diCused benign; unfamiliarity with identifying circumcision damage; assumptions that iatrogenic irregularities are and entrenched through legitimisation by the medical community. ‘normal’ or ‘a birth defect’; and defensive denial of harm. Also, the reorganization of erogenous zones is described The last medically advanced nation to persist in circumcising most of its boys for no therapeutic or religious in circumcised women [11]. If, after excision of the male prepuce its erogenous functions are assumed by other reason is the USA. The current national average circumcision rate in the USA is 60% (down from 85% in the genital zones, this too may impede a thorough comprehension of the loss. Therefore, a man’s silence, trivializ1970s) [6]. Over 1.25 million infants are circumcised annually, i.e. one child every 26 seconds; 80% of ation or defence of his circumcised condition does not indicate that circumcision is benign or that he will never American men were circumcised in childhood, aCecting an estimated 100 million adults to varying degrees. The fully comprehend the loss. medical community has never measured the long-term outcomes; this article explores the personal and interperDocumenting the consequences of circumcision sonal impact of childhood circumcision on men. Assumptions that men circumcised in childhood are satisfied with or suCer no adverse eCects from circumAssessing men’s knowledge of genital anatomy cision have no scientific foundation. The American and function Academy of Pediatrics reported that the exact incidence of postoperative complications is unknown [12]; Accurate measurement of the eCects of childhood circumcision on adult health and well-being requires a Williams and Kapila assert that a realistic value is 2–10% [13]. Lacking accurate records of these complithorough understanding of the functions of the intact (non-circumcised) penis and knowledge of the complications, it is not surprising that the medical community has not documented degrees of severity or long-term cations of circumcision. The prepuce contributes to the pleasure and dynamics of movement, sensation and consequences. Unrecognized outcomes in childhood may become more apparent and troublesome in adulthood. lubrication during masturbation, foreplay and intercourse [7]. However, in the medical community, ‘articles The Virginia Urologic Society’s former president acknowledged, ‘Often a poor surgical result is not recogand editorials on the advantages and disadvantages of circumcision consistently fail to discuss the prepuce as nized until years after the event. Adverse long-term consequences of infant circumcision on the sexual health tissue worthy of preservation’ [8].