Late cuts: an international look at adult circumcision

Most circumcised men have no recollection of the procedure that claimed their foreskins. A human brain retains little, if any, of what its owner experiences during infanchappy mother and boyy, when the vast majority of circumcisions occur. But there are some men who not only remember their circumcisions, they booked the appointments themselves.

Adult circumcision is not as common as infant circumcision, but it’s not exactly uncommon either. In a few countries, actually, the practise is thriving. Some men do it to improve hygiene or because they believe a hoodless penis looks better. Others do it for reasons related to health, religion or peer pressure.

African countries with high HIV rates have seen the largest bump in adult circumcision in recent years, following clinical trials in South Africa, Kenya and Uganda that found circumcised men are 51%–60% less likely to contract the virus from heterosexual intercourse than their intact countrymen (PLoS Med 2: e298. doi: 10.1371/journal.pmed.0020298 and Lancet 2007;369:64356 and Lancet 2007; 369:65766).

“The true benefits exceed risks by an astronomical amount,” Brian Morris, professor of molecular medical science at the University of Sydney in Australia, writes in an email. “At the same time, the claims that male circumcision somehow leads to impaired sexual function, sensitivity, sensation during arousal or satisfaction has been disproven by just about every good research study.”

Morris has written extensively on the health benefits of circumcision, claiming in one paper that it is a “biomedical imperative” (BioEssays 29:114758). The data from the African trials, he notes, has convinced several international organizations to support mass circumcision. “In March 2007, the WHO [World Health Organisation] therefore endorsed circumcision as an important additional weapon in the fight against AIDS,” he states in the paper. “The WHO, UNAIDS and others have done projections estimating the millions of lives that will be saved by implementation of circumcision, which has been equated to an effective vaccine.”

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