Although it is rare for a man to contact a sex therapist
regarding circumcision, sometimes the issue comes up tangentially—and sometimes
what a man believes about his foreskin becomes a topic of exploration. In practice, men may report one of the following:
·
I was robbed of sexual pleasure as an infant!
·
The circumcision was performed on me when I was
born without my consent!
· If only I had my foreskin, I know my partner would
have an orgasm!
With all the controversy swirling around now about female genital
mutilation, also called circumcision, and issues of consent, it is no wonder
that sex therapists may feel confused when presented with these issues. Is it wrong to take away a part of a male
penis from a helpless infant, unable to make decisions? Isn’t it the same as mutilation? Or is it?
And whatever I believe, how can I join with my client without being
biased?
All good questions, which can be answered with facts. Worldwide, about one-third of males have been
circumcised, some for religious reasons but also for health benefits. These health benefits are supported by
research, including prevention of STIs including HIV and chlamydia; fewer UTIs
in male infants; and a significant decreased in penile cancer in adult men.
Circumcision also prevents the problem of phimosis, or
difficulty retracting the foreskin, or balanitis, inflammation of the glans. It
is these health benefits that set it apart from the practice of female circumcision,
which has no health benefit whatsoever and in fact can create problems
including infection and menstrual issues.
Circumcision is a simple, inexpensive procedure performed under
anesthesia on an infant with only a 3% risk of any complication, but is a riskier,
more expensive surgery for an adult.
However, despite benefits various organizations have not
found them compelling enough to make a universal recommendation, and the choice
is one made by parents for religious or other reasons.
As for concerns about sexual pleasure—desensitization of the
glans of the penis through rubbing on clothing and so on—and aesthetics, these seem
to be unfounded. In males who have been
circumcised as adults, there is no difference reported in pleasure, erection
quality, latency time, or libido. As for
aesthetics, more women prefer a circumcised penis over one that is
uncircumcised. People have different
sexual tastes and preferences, so no one conclusion should be drawn from any
data.
What to do when men make statements about having been robbed
of pleasure, or having their body modified without their consent? Listen to their narrative; no need to
dissuade them with education unless they ask questions, in which case you can
share what the research says. Empathize
with feelings of loss or powerlessness, then perhaps help the person discover
the best ways to heal or replenish what they perceive has been taken. How can this person have more pleasure or
feel more power or control when they are having sex? Now that they are an adult, they can
communicate. What is it that they want
to say to their partner? What narrative
do they want to create? As in most
cases, the therapist sharing their personal opinion may be unhelpful and not do
anything to further the therapeutic relationship.
