To Cut or Not to Cut
By PePe A.C.

GAY – ERR, MALE – ISSUE

Despite the growing ill-repute of circumcision, many – mostly men – will, understandably, argue that circumcision has benefits.

Perceived benefits include improving hygiene (71% of surveyed Filipinos believe so, since the foreskin may harbour bacteria if not properly cleaned), improvement of sexual attraction (11%), and enhanced sexual pleasure (18% of Kenyans in the Nyanza Province).

Of course, even as it’s been noted that circumcised men have higher prevalence of genital warts than uncircumcised men (results from 1999 to 2004 US National Health and Nutrition Examination Survey, 4.5% to 2.4%), various studies have also shown that uncircumcised men are at bigger risk of the human papilloma virus (HPV) infection (some type of HPV can cause genital warts).

A bigger issue regarding circumcision’s effect on health of grown men – including gays – is the finding by the WHO, the Centers for Disease Control and Prevention (CDC), and the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2007 that male circumcision is an effective intervention for HIV prevention (even if it “only provides partial protection and should not replace other interventions to prevent the transmission of HIV).  In trials, compelling evidence was found that male circumcision provides a 50% to 60% reduction in HIV transmission, so that “male circumcision should now be recognized as an efficacious intervention for HIV prevention” – it’s because a layer of keratin can provide protection from viral entry, and keratin is thinner on the foreskin than the glans penis, and thinnest on the inner surface of the foreskin, so removing the foreskin means removing the risk of infection.

However – and this is a big BUT – the efficacy was only noted among heterosexual men (penile-vaginal sex), not among homosexual men, and that data remains “lacking on the transmission rate of men who engage in anal sex with either a female or male partner, as either the insertive or receptive partner.”

Thus, aside from admitting that circumcision “does not provide complete protection against HIV infection, more studies need to be done on the issue as circumcision is “no cure-all.”

SECOND TAKE

A growing number of men are now taking a second look at circumcision because, as the American Urological Association (AUA) states, circumcision should only be presented as an option for health benefits.  Other medical organizations, including the American Medical Association, American Academy of Paediatrics, Canadian Paediatric Society, Royal Australasian College of Physicians, and the BMA, second that choice should be presented, thereby allowing those who decide on circumcision to look at the pros and cons of the procedure.

In the Foreskin Advantage, noharmm.org, an advocate of the “intact” (those not circumcised), stresses that going uncut has multiple benefits, including bigger penis size (The prepuce or foreskin constitutes 50% or more of the skin system of the penis, so it creates a visibly longer penis; aside from the engorging of the foreskin with blood during erection, creating a thicker shaft and glans); protection of the glans from abrasion, drying, and callusing; addition to sensation (the foreskin contains branches of the dorsal nerves, as well as up to 20,000 erotogenic nerve endings, capable of sensing slight motions and stretches, et cetera); ensure protection of frenulum (largely considered the male G-spot); and provides immunological defense (the soft mucosa of the inside of the foreskin is said to produce plasma cells, thereby secreting antibacterial/antiviral proteins).

Other benefits mentioned are the proper lymph flow (the foreskin has lymphatic vessels); production of pheromones; produces oils (through sebaceous glands) for lubrication; protects dartos fascia, which helps regulate temperature of male genitalia; and zero risk of surgical injury.

“The foreskin is necessary for optimal health and well-being of the male, as well as contributing to fulfilment in his sexual relationships,” Gary Harryman states for noharmm.org.

Thus, the call is for circumcision to be done only when asked by a man – or, in case of children, when not doing so is detrimental to health.  Of course, for as long as perspectives on circumcision (for or against it) are not changed, in the Philippines, particularly, it will be continued to be practiced.