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.
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.
“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.
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. (Note: 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.) 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.
I stopped looking for articles concluding circumcision was psychologically harmful when they 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.
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- Bigelow The joy of uncircumcising! Exploring circumcision :History, myths, psychology, restoration, sexual pleasure, and human rights. Aptos CA: Hourglass Book Pub., 2nd Edition 1995.
- Bollinger D, Van Howe, RS. Alexithymia and circumcision trauma: A preliminary investigation. Int J Men’s Health. 2011;10(2):184-95.
- Bronselaer GA, Schober J, Meyer-Bahlburg HF, T’Sjoen G, Vlietinck R, Hoebeke PB. Male circumcision decreases penile sensitivity as measured in a large BJU Int. 2013;111(5):820-827.
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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. 2003;29(4): 275-280.
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xii Yavuz M, Demir T, Dogangun B. The effect of circumcision on the mental health of children: A review. Turkish Journal of Psychiatry, 2012; 23(1): 63-70.
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xv Available online at: http://clinicaltrials.gov/ct2/show/NCT01726036