Normal versus Cut - Final Psychological score 100-0

Abstract

The thought came to me like the proverbial thunderclap: No psychological study has ever concluded that circumcision is beneficial to a boy's psyche. But was my sudden hypothesis true? What I discovered after an exhaustive search of the literature was that more than one hundred scientific studies found circumcision painful, traumatic, or psychologically harmful to men and boys, but not one peer-reviewed study has shown it benefits the male psyche.

Full text

By Dan Bollinger, 2014
The thought came to me like the proverbial thunderclap: No psychological study has ever concluded that
circumcision is beneficial to a boy’s psyche. But was my sudden hypothesis true? What I discovered after
an exhaustive search of the literature was that more than one hundred scientific studies found
circumcision painful, traumatic, or psychologically harmful to men and boys, but not one peer-reviewed
study has shown it benefits the male psyche.
Included in my comprehensive search were articles dealing with the short- and long-term psycho-sexual
consequences of circumcision, early trauma, or early sexual abuse. Also included were articles on
neonatal circumcision pain control, and the effect of early pain on the brain and its development.
Background
The pros and cons of other aspects of circumcision are well-discussed in the literature including
medicine, ethics, law, religion and ethics. However, in psychology the discussion is decidedly one-sided
in favor of avoiding the trauma.
Psychology’s study of circumcision began in earnest in 1965 when Gocke Cansever tested children
before and after circumcision with a battery of standard psychological tests and concluded that
circumcision is perceived by the child as an assault.
i
Since then many other studies have researched
circumcision. Bertil Jacobson and Marc Bygdeman found circumcised men are more likely to commit
suicide.
ii
My study with co-author Robert Van Howe found circumcised men were more likely to test
high for alexithymia (inability to identify and express one’s emotions).
iii
Sure there are some op-eds that claim circumcision is the greatest thing since sliced bread. And online
discussions are full of comments from people who are staunch believers in the religio/cultural/sexual
power of cut penises. But opinion and anecdotes are not science.

A seven-part series in Psychology Today on circumcision did not reveal any improvement to a boy’s
psyche. An essay by Kurt Johmann in 2003 listed a plethora of negative consequences, but no positive
ones.
The topic often comes up for discussion in online forums such as Yahoo! Answers. For instance, one
person asked, “Is circumcision beneficial to men’s health?” The best answer, chosen by readers, was:
“There is also the psychological trauma when teens are rejected because their female partners did not
want to engage in sexual activity with an uncircumcised male.” The author did not provide any
references for this claim. Of course the opposite could be claimed as well, especially since the U.S.
intact-to-cut ratio is nearing 50/50.
A comprehensive online survey of 901 men investigated the psychological consequences of
circumcision. The vast majority of the men reported negative consequences with about one-tenth
reporting no negative consequences, but no man reported any positive psychological outcomes.
Is circumcision beneficial?
Now, back to the count. Like I mentioned, I didn’t know offhand of any studies concluding circumcision
is psychologically beneficial, and I have a large library on the topic. However, my claim requires an
extraordinary due diligence for proof. A search of online journal indexes including Pubmed, PsycINFO,
and Google Scholar found no candidates. So, I searched further afield.
A review of the large bibliography in the pro-circumcision website CircInfo.net found only anecdotal
evidence of benefit. They had no peer-reviewed study making the same claim. I suspect that if such an
article existed, this site would be sure to include it.
I did find that in 1947 Herman Nunberg espoused his hypothesis that circumcision may have a favorable
impact on the psychology of the child.
iv
However no one, not even Nunberg, followed up to see if his
hypothesis was true.
What are the harms?
Negative psychological consequences as a result of amputation and mutilation are well reported in the
literature and there is no reason to believe that loss or partial loss of the penis is exempt. Potential
effects of loss of body parts are: grief for altered body image or function, anxiety, depression, denial,
sexual problems, and obsessive preoccupation with the loss.
v
vi
vii
John Rhinehart reported that adults circumcised in childhood displayed feelings of terror, anger, and
dissociation when confronted with dangerous situations in adulthood. He went on to suggest that
preventing circumcision in the first place would be ideal.
viii
Cultural relativism and norming have an effect upon sociology and societal acceptance, but not
necessarily psychology. Three studies found that intact boys raised in a circumcising culture felt more
ashamed of their bodies.
ix
x
xi
At first glance this might seem to show psychological benefit, but this
effect is also likely true of intact girls where female circumcision is practiced, even though it is generally
accepted that all forms of female circumcision are detrimental to their psyche. Presumably, the counter-
argument holds true, too. Circumcised boys and girls would likely feel uncomfortable if they were raised
in a non-circumcising culture. Therefore, it is not circumcision that is the culprit, but living in a dissonant
culture.

Other findings
Reading the literature you often come across a statement similar to this one: “Circumcision may be
carried out for varying reasons in different societies. The reasons may be classified as: medical-
therapeutic, preventive-hygienic, religious and cultural.”
xii
Conspicuously absent from such statements is
any mention of a psychological reason.
Two common reason parents give for circumcising is that he’ll be teased in the locker room and that
he’ll look like his dad (if his dad is circumcised, that is). They both could conceivably have negative
psychological factors, too, yet I could find no scientific studies to back up these popular claims.
In a bizarre and ironic twist, a man who attempted to surgically reconstruct his foreskin was initially
thought to be psychotic, but upon further examination was deemed mentally healthy.
xiii
Even with a
clean bill of health they called his act “self-mutilation” instead of calling it “self-reconstructive surgery.”
This is doubly strange since he was attempting to reverse a previous mutilation.
1
No thought was given
to the psychological status of his circumcisers.
In a similar case history, but with a different result, an Indian man suffering from ED chopped off his
penis.
xiv
This story illustrates the psychological importance men give to their body image (and
particularly their penis), their sexuality, and how amputation is sometimes a perceived solution.
Looking over the list I observe that a large amount of research has gone into circumcision pain relief,
including an ongoing study in Cincinnati.
xv
This is a silent acknowledgement that the procedure is overly
traumatic for the child. But it begs the question; What if the procedure was pain free? Many of the
articles listed below show that even if pain free, circumcision is still traumatic, debilitating, and sexually
maiming, and therefore has a detrimental effect on the boy’s psyche.
Conclusion
I stopped looking for articles concluding circumcision was psychologically harmful when exceeded one
hundred. I’m sure the list would have been much longer if I had been as diligent in trying to find even
just one article that showed a positive psychological result.
The Articles
1. Anand KJS, for the International Evidence- Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the
newborn. Arch Pediatr Adolesc Med. 2001;155:173-80.
2. Anand KJS, Hickey PR. Pain and its effects in the human neonate and fetus. New Engl J Med. 1987;317(21):1321-9.
3. Anand KJS, Scalzo FM. Can adverse neonatal experiences alter brain development and subsequent behavior? Biol Neonate. 2000;77( 2):69-82.
4. Aust S, Härtwig EA, Heuser I, Bajbouj M. The role of early emotional neglect in alexithymia. Psychological Trauma: Theory, Research, Practice, and
Policy. 2013;5(3):225-232.
5. Bensley AG & Boyle GJ. Physical, sexual and psychological effects of male infant circumcision: an exploratory survey. In Understanding circumcision: a
multidisciplinary approach to a multidimensional problem. Eds: Denniston GC, Hodges FM & Milos MF. New York: Kluwer Academic/Pluwer Publishing.
2000;207-231.
6. Berenbaum H, James T. Correlates and retrospectively reported antecedents of alexithymia. Psychosom Med. 1994;56:353-359.
7. Bigelow J, Griffiths RW. Increasing awareness of iatrogenic damage consequent to male circumcision. . In Bodily integrity and the politics of
circumcision: Culture, controversy, and change. Eds: Denniston GC, Gallo PG, Hodges FM, Milos MF & Viviani F. New York: Springer. 2006;165-176.
8. Bigelow J. The joy of uncircumcising! Exploring circu mcision :History, myths, psychology, restoration, sexual pleasure, and human rights. Aptos CA:
Hourglass Book Pub., 2nd Edition 1995.
9. Bollinger D, Van Howe, RS. Alexithymia and circumcision trauma: A preliminary investigation. Int J Men’s Health . 2011;10(2):184-95.
1
The American Heritage Medical Dictionary definition of mutilate is; "Disfigurement or injury by removal or
destruction of a conspicuous or essential part of the body.” And the McGraw-Hill Concise Dictionary of Modern
Medicine gives genital mutilation as an example.

10. Bronselaer GA, Schober J, Meyer-Bahlburg HF, T'Sjoen G, Vlietinck R, Hoebeke PB. Male circumcision decreases penile sensitivity as measured in a large
cohort. BJU Int. 2013;111(5):820-827.
11. Cansever G. Psychological effects of circumcision. Br J Med Psychol,1965;38: 321-331.
12. Cepeda MS, Carr DB, Lau J, Alvarez H. Music for pain relief. (Review). Cochrane Database Syst Rev 2006: art. no. CD004843.
13. Chamberlain DB, Babies remember pain. Pre - and Perinatal Psych. J. 1989;3:297-310.
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MF. New York: Springer. 2009;1-14.
15. Committee on Fetus and Newborn, Committee on Drugs, Section on Anesthesiology, Section on Surgery, American Academy of Pediat rics. Prevention
and management of pain and stress in the neonate. Pediatrics. 2000;105(2):454-61.
16. Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics; Task Force on Pain in Infants, C hildren, and
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7.
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20. Denniston GC. Circumcision and sexual pleasure. In Flesh and Blood: Perspectives on the p roblem of circumcision in contemporary society. Eds:
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43. Holman JR, Stuessi K. Adult Circumcision. A merican Family Physician. 1999;67(6):1514 -1520.
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47. Irwin MG, Cheng W. Comparison of subcutaneous ring block of the penis with caudal epidural block for post -circumcision analgesia in children. Anaesth
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48. Jacobson B, Bygdeman, M. Obstetric care and proneness of offspring to suicide as adults: Case -control study. BMJ. 1998;317:1346-1349.
49. Jeannine Parvati Baker. Ending circumcision: Where sex and violence first meet. Primal Renaissance: The Journal of Primal Psychology. 1996;2(1):54-58.
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References
i
Cansever G. Psychological effects of circumcision. Br J Med Psychol. 1965;38: 321-331.
ii
Jacobson B, Bygdeman, M. Obstetric care and proneness of offspring to suicide as adults: Case-control study. BMJ
1998;317:1346-1349.
iii
Bollinger D, Van Howe, RS. Alexithymia and circumcision trauma: A preliminary investigation. Int J Men’s Health.
2011;10(2):184-95.
iv
Nunberg H. Circumcision and the problems of bisexuality. Int J PsychoAnal. 1947;145-179.
v
Bensley AG. Boyle GJ. Physical, sexual and psychological effects of male infant circumcision: an exploratory
survey. In Understanding circumcision: a multidisciplinary approach to a multidimensional problem. Eds: Denniston
GC, Hodges FM & Milos MF. New York: Kluwer Academic/Pluwer Publishing. 2000;207-231.
vi
Dekkers W, Hoffer C. Wils JP. Scientific contribution, bodily integrity and male and female circumcision. Med
Health Care Philos. 2005;8(2):179-191.
vii
Maguire P. Parkes CM. Coping with loss: Surgery and loss of body parts. BMJ. 316: 1086-1088.
viii
Rhinehart J. Neonatal circumcision reconsidered. Transactional Analysis Journal. 1998;29(3): 215-221.
ix
Ozturk O. Ritual circumcision and castration anxiety. Psychiatry. 1973;36(1): 49–59.
x
Sahin F, Beyazova U. Akturk A. Attitudes and practices regarding circumcision in Turkey. Child Care Health Dev.
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Available online at: http://clinicaltrials.gov/ct2/show/NCT01726036