Question: What do you call the useless little flap of skin on the end of a penis?
Answer: A man.
“The silence was soon broken by a piercing scream — the baby’s reaction to having his penis pinched and crushed as the doctor attached the clamp to his penis. The shriek intensified when the doctor inserted an instrument between the foreskin and the glans, tearing the two structures apart…..The baby started shaking his head back and forth — the only part of his body free to move — as the doctor used another clamp to crush the foreskin length-wise, where he then cut. This made the opening of the foreskin large enough to insert a circumcision instrument, the device used to protect the glans from being severed during the surgery.
“The baby began to gasp and choke, breathless from his shrill, continuous screams. How could anyone say that circumcision is painless when the suffering is so obvious? My bottom lip began to quiver, tears filled my eyes and spilled over, I found my own sobs difficult to contain. How much longer could this go on?
“During the next stage of surgery, the doctor crushed the foreskin against the circumcision instrument and finally amputated it. The baby was limp, exhausted, spent.
“I had not been prepared, nothing could have prepared me, for this experience. To see a part of this baby’s penis being cut off — without an anesthetic — was devastating. But even more shocking was the doctor’s comment, barely audible several octaves below the piercing screams of the baby: `There’s no medical reason for doing this’. I couldn’t believe my own ears, my knees became weak, and I felt sick to my stomach. I couldn’t believe that medical professionals, dedicated to helping and healing, could inflict such unnecessary pain and anguish on innocent babies.
An account of modern circumcision by US nurse Marilyn Fayre Minos[i]
The parents of Goodluck Caubergs paid Grace Adeleye £100 to circumcise their son. In April 2010, at an address in Chadderton, Greater Manchester, the 66-year-old midwife performed the procedure with scissors, forceps and olive oil, leaving a “ragged wound” from which, the following day, Goodluck would bleed to death.[ii]
Adeleye was charged and convicted with manslaughter by negligence; she was given a suspended sentence.
In 2012, Angelo Ofori-Mintah died aged four weeks as a result of losing three-quarters of his total blood volume following circumcision. A verdict was returned of accidental death and Rabbi Mordehai Cohen, the mohel (the Jewish ritual circumciser) who caused his death, faced no charges; he was, said the court, “entirely blameless”.[iii]
The Manchester Royal Children’s Hospital treats around 3 such cases a month;[iv] most children survive. In a single hospital in Birmingham, 105 boys were treated for circumcision complications in 2009 alone.[v] An audit on an Islamic school in Oxford revealed 45% of boys suffered complications.[vi]
National figures for complications and deaths from male circumcision, a procedure dismissed by its proponents as medically inconsequential, are difficult to come by; deaths, mercifully, are rare, but complications such as haemorrhaging and infection from unsterilized implements are common, and long-term problems, as we shall see, accompany all cases.
In the US, it is estimated that 117 babies die each year from an entirely unnecessary circumcision.[vii]
Male circumcision has been in slow and erratic decline in the UK since it peaked in the 1930s and ‘40s, but a survey from 2000 showed that 15.8% of men aged between 16 and 44 reported being circumcised; prevalence was highest amongst Jewish men, at 98.7%.[viii] It is estimated that 12,200 religious circumcisions are performed annually, 2,000 in Jewish communities and 10,000 in Muslim.[ix] A further 32,000 are performed for “medical” reasons, of which 91% are deemed to be unnecessary.[x]
The incidence of male circumcision is higher – at 56% – in the US than in the UK;[xi] as recently as the 1970s, some 91% of American males were being circumcised.[xii] This makes circumcision the most commonly performed surgical procedure in the US, earning several hundred million dollars a year.[xiii]
Worldwide, an estimated 650,000,000 men have been circumcised.[xiv] While there is almost no official support for female genital mutilation, organisations such as the WHO and UNAIDS are still promoting male circumcision as a means to control HIV.[xv]
By contrast, female circumcisions in the UK are much rarer – an estimated 18 in 2015/16,[xvi] and the number of women circumcised worldwide may be as many as 200,000,000;[xvii] complications requiring medical intervention generally affect women who were circumcised outside of the UK, prior to immigrating. Nevertheless, feminist campaigners have fastened on female circumcision – or “female genital mutilation”, as they prefer to call it, focusing, perhaps unexpectedly, on achieving the first successful prosecution.
The Home Secretary, Amber Rudd, has been the most recent to jump on this particular bandwagon, establishing a new forum made up of the usual professionals, charities, campaigners and survivors with a view to end female genital mutilation (FGM) at home and abroad,[xviii]
We are still yet to see a perpetrator brought to justice and I am determined to see the first successful prosecution for FGM. And most importantly, we need to protect women and girls by preventing acts of FGM before they happen.
This failure to achieve a successful prosecution is an increasing frustration amongst campaigners, and persists despite a series of measures by the Home Office, including—
- introducing a new offence of failing to protect a girl from FGM;
- extending the reach of extra-territorial offences;
- introducing lifelong anonymity for victims of FGM;
- introducing civil FGM Protection Orders (FGMPOs); and
- introducing a mandatory reporting duty for known cases in under 18s.
The campaigners have consequently demanded yet more measures to make prosecution easier, through further legislation. The Government has responded[xix] by citing the measures already introduced and stating that it has no present intention to legislate further – it is difficult to see what further legislative measures could be introduced. It warned that prosecutions can be brought only where there is sufficient evidence; given that cases of FGM performed on UK soil are rare, it is understandably difficult to find a case which ticks all the boxes making it suitable for prosecution.
This pattern, of failing to see the advances it has made, is typical of feminism. FGM is now, rightly, unacceptable in the UK and in most countries; worldwide it is in decline. It would be a mistake to be complacent, but the campaigners have won. The failure to find a case suitable for prosecution may actually be something to celebrate.
Let us take a quick look now at female circumcision, with which, we are repeatedly told, male circumcision must never be compared.
Female Genital Mutilation
The United Nations (UN) and the World Health Organisation (WHO) employ the term Female Genital Mutilation (FGM) to describe what in UK law used to be referred to as Female Circumcision. Both terms have become emotionally and politically loaded, and it is important to recognise that circumcised women and the parents of girls who believe it is in their daughters’ best interests may consider the term FGM degrading to women. The WHO categorises FGM into four types:[xx]
Type I: Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).
When it is important to distinguish between the major variations of Type I mutilation, the following subdivisions are proposed: Type Ia, removal of the clitoral hood or prepuce only; Type Ib, removal of the clitoris with the prepuce.
Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).
When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora.
Type III: Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).
When it is important to distinguish between variations in infibulations, the following subdivisions are proposed: Type IIIa: removal and apposition of the labia minora; Type IIIb: removal and apposition of the labia majora.
Type IV: Unclassified: All other harmful procedures to the female genitalia for non-medical purposes, for example, pricking, piercing, incising, scraping and cauterization.
While FGM is still very common in many countries, incidence in the UK is difficult to determine, but is most prevalent amongst minority ethnic populations from Djibouti, Eritrea, Ethiopia, Sierra Leone, Somalia, Sudan and Nigeria.[xxi]
Any degree, however minor, of pricking, nicking or cutting is considered by the WHO to be genital mutilation, and is thus illegal. The word usually carries the sense of the cutting off or removal of tissue. Two people were convicted in Australia in November 2015, despite the lack of evidence for any injury which could possibly be considered a “mutilation”.[xxii]
Data for FGM in the UK is incomplete, but indicates it is rare for girls born here, with 43 new cases in 2015/16 of which 40% were the less severe type IV.[xxiii] In only 18 cases was it established that the FGM had taken place in the UK, and 10 of these were Type IV.[xxiv]
The figures usually given are for women who experience problems in pregnancy and child-birth as a result of being circumcised in their countries of origin. There were 5,702 such cases newly identified in 2015/16.[xxv] Other figures given are for the number of girls claimed to be at risk of FGM, but who have not actually undergone the procedure and may never do so.
Male Genital Mutilation
Male Genital Mutilation is not a term in general use to describe male circumcision. It has been adopted by campaigners purposefully to draw attention to the alleged similarities between male and female circumcision.
In the case of Re B and G,[xxvi] the President of the Family Division, Lord Justice Munby, described male circumcision thus:
 Circumcision of the male (from the Latin circumcidere to cut round) is the removal of some, or all, of the prepuce (foreskin), the retractable fold of skin that surrounds and covers the glans of the penis, so as to expose the glans. Circumcision involves the removal of a significant amount of tissue, creates an obvious alteration to the appearance of the genitals and leaves a more or less prominent scar around the circumference of the penis. Apart from the removal of the foreskin, and sometimes of the frenulum, the ligament that connects the foreskin to the glans, the genitals are left intact.
Munby went on to observe—
It can readily be seen that although FGM of WHO Types I, II and III are all very much more invasive than male circumcision, at least some forms of Type IV, for example, pricking, piercing and incising, are on any view much less invasive than male circumcision.
We might dare to go further, and suggest that typical (Jewish style) male circumcision is anatomically similar to Type Ia female genital mutilation, and that on the FGM spectrum MGM falls about halfway, though we have to acknowledge that many of the complications caused are the result of the – usually – far less sanitary conditions in which FGM is performed.
Traditional, ritualistic forms of male circumcision do not employ anaesthesia and cause significant pain which is believed to interfere with bonding between the infant and the mother and to cause other behavioural problems.[xxvii] Some argue that babies experience pain more acutely than children and adults.[xxviii]
As Munby observed, “a significant amount” – between a third and a half – of the most sensitive penile skin is removed, together with up to 20,000 specialised nerve endings; these include Meissner’s corpuscles which detect light and fast touch, Merkel’s disc cells which detect light pressure and texture, Ruffini’s corpuscles which respond to slow sustained pressure, skin tension, stretch, and slip, and Pacinian corpuscles which respond to deep touch and vibration.
These cells are found only in the tongue, lips, palms, nipples, fingertips, the female clitoris, and the ridged band of the male foreskin. It is misleading, therefore, to compare the male foreskin with the female, which does not contain these cells. It is also inaccurate to maintain that the male glans does contain these cells and that it can thereby compensate for the loss of the foreskin.
The catalogue of structures lost includes the peripenic dartos muscle, the frenar band, part of the frenulum, lymphatic vessels, apocrine glands (producing pheromones), sebaceous glands, and Langerhans cells (a part of the defence system). If you are unfamiliar with these structures, why do you imagine their removal is beneficial? Nothing resembling this remarkable organ exists anywhere else on a man’s body, which is why surgical reconstruction using skin from elsewhere is of very limited effect.
Normally the glans (the Latin word means “acorn”) is covered, and exposed only during urination, washing and sexual arousal. After circumcision, the reciprocal stimulation caused by movement of the foreskin over the glans during masturbation and intercourse is lost. During normal intercourse, the glans slides in and out of its protective sheathe, lubricated by secretions from the vagina, it does not come into direct contact with the vagina. Following circumcision, the glans rubs directly against the vagina and the lubrication function is lost, removing secretions from the vagina, leading to dryness and reduced pleasure to both partners and necessitating artificial lubrication.
This is also often necessary in masturbation. Indeed, widespread adoption of circumcision in the Jewish style began in the Victorian era to reduce the pleasure derived from masturbation, which was believed to be immoral and to cause a variety of maladies, without interfering too much with procreation.[xxix] Of course, circumcised boys continue to have no less desire to masturbate than the uncircumcised, and just require more determination.
The surface of the glans – especially where infant circumcision has forcibly ripped the foreskin away from the glans – will be discoloured, pitted and scarred; as time goes by, it becomes increasingly keratinised, leading to further loss of sensation. The scar left by the circumcision itself constricts the penis during erection, making masturbation and intercourse uncomfortable or painful. Mohalim and surgeons even pride themselves on achieving a “nice, tight scar”.
Other complications include:
- Haemorrhage – possibly the most common cause of death associated with circumcision, significant blood-loss can be disguised by super-absorbent disposable nappies;
- Infection – associated with circumcisions performed in less than sterile conditions, and potentially leading, albeit rarely, to further complications such as meningitis, necrotizing fasciitis, gangrene, and sepsis;
- Skin bridges or adhesions between the glans and the shaft of the penis which do not grow as the rest of the body grows, leading to permanent discomfort and pain;
- Removal of too much tissue or even partial degloving of the shaft, leading to severe scarring which, again, does not grow with the individual;
- Removal of too little tissue, necessitating further surgery;
- Blocking of the urethra with scar tissue, necessitating further surgery;
- Tearing of the remains of the frenulum during intercourse;
- Pubic hair growing on the scar;
- Inclusion cysts;
- Peyronie’s disorder: a curved or bent appearance of the erect penis due to unsymmetrical scarring.
Affected men very rarely discuss these issues, which is why they are poorly recognised; it takes courage to face up to what they have lost.
There are three stages to a Jewish ritual circumcision. In the milah, the foreskin is pulled forward, away from the glans, and removed. This (“tug-and-chop”) process results in most of the foreskin remaining, preserving its protective and sexual function, with just the tip of the glans protruding. A minimal amount of erogenous tissue is removed.
The second stage, peri’ah (opening), involves forcibly separating the remaining foreskin from the glans (at 8 days the two have not yet separated naturally) and cutting it away. This has been compared with ripping a finger nail away from its bed.[xxx]
This measure was introduced in the 2nd century AD because Jewish athletes wishing to compete naked with uncircumcised Greek athletes were undergoing painful operations to stretch their foreskins to re-cover the glans. Total removal of the foreskin prevented this.[xxxi]
The third stage is the metzitzah b’peh (sucking), in which the mohel sucks blood from the penis with his mouth. This practice can transfer infections such as syphilis and herpes; in 2005, a New York mohel who had performed some 12,000 circumcisions killed a boy in this way, but was pardoned.[xxxii]
Medical circumcisions are performed differently, but are modelled on the Jewish form and the end result is identical. Because anaesthetic is not always used, the baby must be strapped down to a rigid board to prevent movement. An instrument is used to tear the foreskin away from the glans; the foreskin is then crushed against this instrument and cut away. During this process, which typically takes twelve minutes, the baby will scream until he is exhausted. The removed foreskin is not thrown away: they are used to cultivate tissue for skin grafts or sold to cosmetics companies for injectable wrinkle treatments or face creams.[xxxiii]
In 2013, TV personality Oprah Winfrey was widely condemned for promoting a face cream in which human foreskin was an active ingredient. The manufacturer protested that they hadn’t harvested a foreskin for 20 years and were using a cell culture, but critics countered, “Imagine how Oprah would respond if a skin cream for men went on the market that was made from parts of the genitalia of little girls. That would be an outrage and rightly so.”[xxxiv] Imagine.
The original justification for male circumcision is religious – in Leviticus 12:3, Jehovah (whom James Joyce dubbed the “collector of prepuces”[xxxv]) says to Abraham,
every male among you shall be circumcised. And ye shall be circumcised in the flesh of your foreskin; and it shall be a token of a covenant betwixt Me and you. And he that is eight days old shall be circumcised among you, every male throughout your generations… And the uncircumcised male who is not circumcised in the flesh of his foreskin, that should shall be cut off from his people; he hath broken My covenant.
Abraham circumcised himself at the age of 80, apparently using an axe.
The foreskin of Jesus himself is, of course, a sacred relic, claimed by as many as 18 churches (including one in Stoke-on-Trent) and believed to have miraculous properties. It first appeared in 800 when Charlemagne gave it to Pope Leo III; the last remaining one was stolen by a priest from the church of Calcata, Italy in 1983.
The practice is much older, however, than Abraham, and rooted in ritual; it is said the Jews and Arabs learnt the practice in Egypt. A man could not go to be married uncircumcised; indeed, the Hebrew word for “bridegroom” is linked to the Arabic word for “circumcise”. Circumcision was a part of the Israelite national character, and uncircumcised races, such as the Philistines, were viewed with contempt.
It is the shedding of blood which seems to be more significant than the removal of the foreskin, and circumcision is a particularly bloody procedure with blood loss difficult to control even in clinical conditions. Where boys are born without a foreskin or have been circumcised medically, a ritual is still held to prick the glans and produce a drop of blood. A sacrifice is of no worth unless it is of something most valuable; a circumcised man is of no less value as a worker or in battle, but by surrendering all pleasure derived from the sexual act he demonstrates his devotion to his god. Or he would if he sacrificed his own foreskin rather than someone else’s.
Circumcision establishes a blood covenant which bonds a Jewish male to his god. It thus empowers men in a patriarchal brotherhood from which women are excluded. Jewish women are not Jews in quite the same way that Jewish men are, and this justifies a degree of discrimination against women. The obvious solution – female circumcision – never became part of Jewish culture.
Within Islam, circumcision (khitan) is widespread but not universal; it is more common for men than for women. It is not mentioned in the Koran, but is referred to in the hadith and Sunnah. According to some traditions, Mohammed was born without a foreskin, according to others he was circumcised at 7 days. Circumcision is recommended by some hadiths but not others, presumably indicative of pre-Islamic traditions.
Islamic circumcision tends to take place much later than Jewish, after the foreskin and glans have separated; in some cultures, it is a ritual of puberty. It is usually conducted in clinical conditions, and the amount of foreskin removed varies.
The circumcision of girls forms part of several hadith and many fatwa. In the jurisprudence (Fiqh) of Shafii madhhab and many Ulama of Hanbali madhhab, female circumcision is a religious duty (wajib). Mohammed instructed the muqaṭṭiʿa al-buẓūr (cutter of clitorises) Umm ‘Aṭiyya, “[Cut] slightly and do not overdo it”.[xxxvi] Female circumcision is carried out on the foreskin over the clitoris, though little flesh, if any, is removed.
In some cultures, male circumcision is a more severe mutilation. In 1938, Dr Andreas Lommel described how the aborigines of Australia sliced open the urethra from the scrotum to the base of the glans, with a stone knife, pressing it flat against the rock on which the pubescent boy was sitting.[xxxvii] Quite how intercourse then took place is not explained; these men are obliged to urinate in a squatting position, like women.
Amongst some African tribes it is a rite of passage, conducted in the bush with unsterilised knives and spearheads. In South Africa alone, between 2008 and 2014, more than half a million boys were admitted to hospital and over 400 died through loss of blood and infection.[xxxviii] The source of this figure euphemistically refers to circumcision as “initiation”. One man who lost his penis to gangrene was publicly humiliated and beaten after telling his story.[xxxix]
For the great scholar, Sir James G Fraser, circumcision was part of the drive by primitive societies to control sex and death; it was an initiation rite by which a small part of the boy’s body was sacrificed to the divine powers to redeem his community.[xl] For Mircea Eliade, writing in 1958, it was an expression of ancient beliefs.[xli]
Circumcision may occur at any time between a few days after birth up to the ages of 15 or 16. It may mark the beginning of life or the end of childhood; it seems to symbolise inclusion into the tribe and separation from the mass of humanity. Van Gennep observed that both male and female circumcision remove that part of the sexual organs which most resembles the opposite sex.[xlii] Male circumcision creates the appearance of a permanent erection – which is why the Greeks found it indecent – and renders the penis more masculine and less effeminate. Following this scheme, female circumcision removes the protruding parts of the female genitalia, which can resemble a miniature penis.
Notes to Part 1
[i] Minos, M. F. (1990). In B. R. Boyd, Circumcision: what it does. Taterhill Press.
[ii] Fogg, A. (2012, December 17). Male circumcision: Let there be no more tragedies like baby Goodluck. The Guardian.
[iii] Queen’s Park baby bled to death two days after being circumcised. (2012, June 22). Brent & Kilburn Times.
[v] Poole, G. (2012, July 14). Birmingham NHS Bosses Stay Silent As Botched Circumcisions Put 100 Boys In A&E. Retrieved from endmalecircumcision.blogspot.co.uk.
[vi] Campbell, D. (2010, July 11). NHS urged to offer circumcisions to avoid botched operations. The Guardian.
[vii] Bollinger, D. (2010, April 25). Lost Boys: an estimate of US circumcision-related intant deaths. Thymos: Journal of Boyhood Studies, 4(1), 78-90.
[viii] Dave, S., Johnson, A., & Fenton, K. (2003). Male circumcision in Britain: findings from a national probability sample survey. Journal of Exually Transmitted Infections, 79, 499-500.
[ix] Poole, G. (2012, May 04). 100 Unnecessary Male Circumcisions performed every day. Retrieved from endmalecircumcision.blogspot.co.uk.
[xiii] Frisch, M. (2017, January 12). Denmark’s 29,000 Doctors Declare Circumcision of Healthy Boys an “Ethically Unacceptable” Procedure Offering no Meaningful Health Benefits. Huffington Post.
[xiv] A figure often cited, but I cannot track down a definitive source.
[xvi] National Health Service. (2016, July 21). First ever annual statistical publication for FGM shows 5,700 newly recorded cases during 2015-16. Retrieved from content.digital.nhs.uk.
[xix] FGM Unit – Home Office. (2016). Female genital mutilation: abuse unchecked. London: Her Majesty’s Stationery Office.
[xx] Op. Cit., World Health Organization. (2016, February).
[xxi] Royal College of Midwives. (1998). Female genital mutilation (Female circumcision), Position Paper 21.
[xxii] Jabour, B. (2015, November 12). FGM: mother and retired nurse both found guilty of mutilating two sisters. The Guardian.
[xxiii] Op. Cit., National Health Service. (2016, July 21).
[xxv] National Health Service. (2016, July 21). Female Genital Mutilation (FGM) – April 2015 to March 2016, Experimental Statistics. Retrieved from content.digital.nhs.uk.
[xxvi] Re B and G (Children) (No2),  EWFC 3 (Family Court 2015).
[xxvii] Kroeger, M., & Smith, L. J. (2003). Circumcision. In Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum (pp. 197-8). Sudbury, Massachusetts: Jones and Bartlett Publishers.
[xxviii] Goksan, S., Hartley, C., Emery, F., Cockrill, N., Poorun, R., Moultrie, F., . . . Slater, R. (2015, April 21). fMRI reveals neural activity overlap between adult and infant pain. Elife, 4.
[xxx] Bates, F. (2001, August). Males, medical mutilation and the law: some recent developments. Journal of Law and Medicine, 9(1), 68-75.
[xxxi] Hall, R. G. (1992, August). Epispasm: Circumcision in Reverse. Bible Review, 52-57.
[xxxii] Newman, A. (2005, August 26). City Questions Circumcision Ritual After Baby Dies. The New York Times.
[xxxiii] Margulis, J. (2013). The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby Before their Bottom Line. Scribner Book Company.
[xxxiv] Morris, J. (2013, January 24). Oprah faces protest for using wrinkle cream made with foreskin. Retrieved from vancouver.24hrs.ca.
[xxxv] Joyce, J. (1922). Ulysses. Paris: Sylvia Beach.
[xxxvi] Corbett, S. (2008, January 20). A Cutting Tradition. The New York Times.
[xxxviii] Commission for the Promotion and Protection of the Rights of Cultural, Religious & Linguistic Communities. (2014). Report on Public Hearings on Initiation Schools in South Africa.
[xl] Fraser, J. G. (1890). The Golden Bough: A Study in Comparative Religion. London: MacMillan & Co.
[xli] Eliade, M. (1958). Rites and Symbols of Initiation.
[xlii] van Gennep, A. (1909). Rites of Passage.