A Cruel Cut?

Skin is a living, breathing organ that is constantly renewing itself. Foreskin is no different – put it under tension, and it will grow. Which is why eight circumcised men are meeting in Watford Town Hall. They want new foreskins. “When people come to my house,” says Laurie, “I don’t go ‘Hello there, I’m Laurie, I’m growing my foreskin’. But I’ve often got research papers out on the table, so word gets out. I do find people are really very interested in what I’m doing.”

Laurie is sharing his experience of restoration (as the process of foreskin renewal is called) with the members of NORM-UK. In the USA, where NORM was born, it stands for National Organisation of Restoring Men. NORM-UK is about more than that, but Laurie is on a roll. And the other members don’t want to interrupt him. After all, in two-and-a-half years, Laurie has achieved glans coverage when flaccid. In the world of restoration, that is major.

NORM-UK meetings are small and intimate. Not usually as small and intimate as this one, but there’s been a pile-up on the M1. There’s a few handshakes, but otherwise little in the way of physical display – “people are always worried we’re going to drop our trousers,” says David Smith, the general manager of NORM-UK. Laurie wouldn’t be averse to the idea to show off his stretching. Women stretch skin for reconstruction after a mastectomy. So why shouldn’t men stretch a foreskin?

Some NORM-UK members can’t restore – they are too tightly circumcised, and have no tissue left to grow. But others can. And they’re busy availing themselves of products like the TLC Tugger, Tug Ahoy and the Your-Skin cone (all available at a 10% discount to NORM-UK members). Some have found their own DIY solutions. They use funnels and gaskets to stretch the foreskin, and sash-window weights to provide the traction. If only B&Q knew their real customer base.

The whole idea of restoration sounds funny. Like the time that Laurie was having a go with sticky tape – the most primitive of the restoration methods. He pulled what skin he had left over his glans, and taped it down. “I only had the tape on for half an hour”, says Laurie, “but it was hell. I was walking down the High Street and suddenly had to dive into the nearest toilet to check my penis hadn’t gone black, green or blue. Or dropped off altogether.”

It sounds funny, but it isn’t. Not if it’s happening to you. Smith remembers sitting through East Is East – especially the scene where the father tries to catch the son and take him to be circumcised. “ I remember the cinema was in hysterics” says Smith. “And they were laughing when he was wheeled into the operating theatre, but all I could hear was the boy’s screams. My wife turned to me and said ‘I’ve got to go – I can’t watch this’.”

When the foreskin is removed, it leaves the glans exposed. And, for most men, that is difficult. “I always had a problem with my penis giving me stimulation I didn’t want” says Kevin, “and I had to keep adjusting it through my pocket. I was near the climbing frame in the playground when, all of a sudden, everyone started chanting ‘Kevin is dirty – he’s always playing with himself’. I didn’t like the feeling of being odd. Of being deformed. Suicide would have been a good option.”

Kevin is now 56 – with a fully-restored foreskin. But he’s left with questions like why was he circumcised in the first place? His mother read the Bible and went to Sunday school. “But I was conceived out of wedlock when she was 17. And my father was a divorcee. They wanted to get married in church, so I think I was circumcised as some kind of apology to Jesus. My father wasn’t circumcised himself, so I really don’t understand.” And that is a feeling he shares with many members of NORM-UK.

The members all feel some kind of pain. Meetings are on a first-name-only basis because members don’t like to be identified. At the last AGM, one member took a photograph. Three members threatened to walk out unless the photograph was destroyed immediately. “Many men who come to meetings won’t even speak to their families about the pain they’re suffering – we are dealing with victims of abuse here” says Smith.

NORM-UK currently have just short of 300 members. Less than one enquiry in ten results in membership, but NORM-UK isn’t strictly about the numbers. “Men often want the information to restore,” says David Smith, “but they want to keep it to themselves. They are frightened about being found out. When they ring me up, they say, ‘Please ensure that the information is in plain envelopes and don’t put me on a mailing list’.”

John D was like that. He felt abused because his circumcision was unnecessary – a course of antibiotics had already cleared up his urinary infection. “But my father agreed with the Doctor, and told me I was going to have a minor operation” he says. “I remember the nurses giggling as I was taken off to theatre. They wore these big sickly grins, and said ‘We’re taking you to be done up now. Hee hee hee’. I was eight, but suffice it to say that they knew what was happening to me and I did not.”

“I remember waking up,” says John D, “after the general anaesthetic had worn off, and looking down. My beloved penis had been replaced with wrinkled skin, a collar of thorns – the black stitches – and an ugly great dome on top. I experienced shock at first, later deep anger and resentment. The stitches disappeared, but the mutilation didn’t. My father said ‘I didn’t think it would look like that’. It was misinformed consent. And an operation I didn’t even need.”

There are lots of horror stories about circumcision. Like the time in Baltimore in 1964 that it went so badly wrong that the doctors decided to change the child’s sex. Or the time in London in 1991 when a 16-year-old was circumcised so badly that he bled all night and died in the morning. But these cases are extraordinary, and far from typical. Circumcision is a safe and easy operation. The members of NORM-UK don’t see it like that.

John E is registered blind. But it’s not his blindness that keeps him away from NORM-UK’s meetings. “It’s that fact I feel I’ve been more devastated than everyone else” he says. “They’ve got their lives in order. And they’ve got sexual partners. I haven’t. My life has been ruined by circumcision, although I hate that word. I prefer ‘foreskin amputation’. It’s not an operation – there’s no medical benefit. It’s a rite. A faith crime.”

In the Bible, circumcision was God’s covenant with Abraham and the Jewish people. Of all of the commandments in Judaism, the brit milah (literally, covenant of circumcision) is probably the most universally observed. And although circumcision isn’t actually mentioned in the Qur'an, it is mentioned in the Hadith. Most Muslims believe it’s fundamental because Allah ordered Muhammad to follow the way of Abraham.

Religious circumcisions are frequently performed without anaesthetic, and are intensely painful, even when they’re being performed on newborn babies. Adults can testify to the pain for themselves and can give their informed consent – but children can’t. NORM-UK claim that the circumcision is traumatic, and can result in lifelong damage – including psychological trauma and a reduced sex drive. So, if they’re not medically necessary, why are religious circumcisions still allowed?

NORM-UK say, actually, they aren’t. They point to the UN Convention on the Rights of the Child, which declares that violence to children cannot be justified on grounds of “religion, culture or tradition.” Children are not the possessions of their parents, to do with as they please – the legal standard in Western society is that parents aren’t allowed to carve up their children without their permission unless it is absolutely necessary. We make an exception for circumcision because it’s mentioned in Genesis.

Dr Zarifa from Docklands in East London is one of the few surgeons prepared to advertise the fact that he will circumcise males for religious or ethnic reasons. “Why not?” he says. “The operations are justified by the General Medical Council. And they will happen whether I do them or not. It’s much better for the operations to happen in my surgery under clinical conditions with anaesthetic, where I can provide all the necessary aftercare.”

Even non-practising Jews want to circumcise their sons. It was, after all, the first command given to Abraham and the defining physical mark of the Jewish people. Circumcision requires ‘Hatafat Dam Brit’ – a drop of blood that seals a covenant. Which does, for some, suggest that removing the foreskin goes beyond what is actually required by God. But, according to Rabbi Dr Jeremy Rosen, that is to miss the point.

“People are always trying to find ‘rational’ reasons for Jewish laws” says Rabbi Rosen. “They ask if our dietary laws improve hygiene. They ask if observing the Sabbath helps mental relaxation. And they ask if circumcision prevents STDs. But even if these rational reasons stood up to objective scrutiny, they wouldn’t be a reason for keeping – or abandoning – our laws. One keeps to these rules out of religious commitment.”

“I have no medical expertise” says Rabbi Rosen, who runs the London branch of the the liberal Yakar Educational Foundation , “but I am convinced that circumcision is harmless, and not traumatic. But even if it is, we Jews have done pretty well on it over the years – and so indeed have Muslims. And I cannot for the life of me understand why anyone would want spend any money or go through any discomfort trying to reverse it.”

But circumcision on females was made illegal in the UK in 1985. So, why isn’t the same protection afforded to males? The answer, let’s be honest, is that making male circumcision illegal would involve taking on two of the world’s great religions. Most forms of female circumcision are, certainly, more damaging than male circumcision, but the distinction in law between male and female circumcision just can’t be justified objectively. It’s a double standard.

Circumcision wasn’t actually practised in Britain at all until the eighteenth century. And it really only gained popularity in the nineteenth century, after claims that it stopped the vile habit of masturbation. By stopping masturbation, Victorians thought circumcision would cure everything from epilepsy and hip trouble to asthma and alcoholism. And whenever a new disease became a matter of social concern, circumcision was wheeled out as the cure.

It’s still happening. A recent paper in the British Medical Journal found a link between an intact foreskin and HIV infection – but a paper in the British Journal of Urology found exactly the opposite. At best, circumcision is appropriate as a routine measure in regions with a high rate of HIV infection, such as sub-Saharan Africa. But there certainly isn’t enough evidence to recommend circumcision as an HIV-preventive measure in the UK.

There is irrefutable medical evidence that circumcision reduces the incidence of cancer of the penis, and of the cervix for the women whose partners are circumcised. But according to NORM-UK, the evidence is rather dated. They say, when it comes to the transmission of disease, it’s likely that the lack of cleanliness is more important than the lack of a foreskin. Once again, the potential medical benefits of circumcision aren’t enough to recommend it routinely.

NORM-UK don’t want to see circumcision banned altogether. They accept there are a few medical conditions where it is necessary – but only a few. The others can be treated by simple, non-surgical means. And that means changing the way doctors think. “We need to educate the medical profession,” says Smith, “because they seem unaware of the alternatives to circumcision. They are certainly unaware of the problems that it is causing.”

John D is typical of NORM-UK members in that circumcision changed his entire persona. “I became less sociable,” he says, “and I started talking to myself. I was fearful of changing rooms. I had no close relationship with the opposite sex until I was 41, and I still haven’t been able to reach orgasm through sexual intercourse. Over the years, I’ve had real problems with depression, and I’m sure I could trace it back to that day.”

But doctors need to have more up-to-date information. Take a look at the General Practice notebook, an online medical encyclopaedia used by GPs, and its listing for phimosis – a condition where the foreskin won’t retract. Most infants are born with a foreskin that can’t be retracted and the foreskin is often tight until after puberty. Phimosis disappears in almost all cases given time. A fully retractable foreskin occurs on its own in 99% of 18-year-olds. But the notebook recommends circumcision.

The notebook makes no mention whatsoever of the non-invasive solutions to the problem – like, for instance, stretching, steroid cream or a simple operation. Similarly there are simple, non-surgical solultions to balanitis, a condition where the foreskin retracts too tightly, causing the glans to swell. “It sounds silly,” says John D, “but balanitis can be cured by putting the penis in a bowl of sugar. The swelling goes down, and the foreskin to be returned to its resting position.”

Dr Zarifa isn’t sure about the bowl of sugar – but he insists that doctors always explore the non-invasive options first. “The truth of the matter is that stretching can be quite painful” he says. “And it’s quite an undertaking for a small child. For some boys, the pain of the stretching is as bad as the pain of the circumcision. And I would say that 40-50% of boys who use steroid cream end up having a circumcision in the end. But it’s always the last option.”

The BMA support conservative solutions where possible. They reckon to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be “unethical and inappropriate”. But unnecessary circumcisions are still happening . And, as the House of Commons Health Committee noted, they are happening “because doctors don’t understand the natural history of the foreskin.”

Circumcision is ‘the snip’ – dismissed like it’s something and nothing. But it could still result in serious bleeding, or an adverse reaction to the anaesthetic . “And you cannot cut off normal, healthy, sexually-functioning tissue without cutting off normal, healthy, sexual functioning,” says Marilyn Milos, a registered nurse and director of NOCIRC, the National Organization of Circumcision Information Resource Centers. “It’s a sexual issue, and it’s a human rights issue."

The foreskin isn’t a useless flap that evolution should have got rid of long long ago – it’s skin that is rich with blood vessels, highly innervated, and uniquely endowed with stretch receptors. These contribute greatly to the sexual response of the intact male. The stretching of the foreskin over the glans activates nerve endings, enhances sexual excitability, and contributes to the ejaculatory reflex. There’s no escaping it – the foreskin is sexual tissue.

Laurie can laugh about it now, but he missed his foreskin. He was getting on for 60, and rapidly losing the feeling in his penis. “To be honest,” says Laurie, “sex was like pushing a rolling pin in. And I’m not referring to size when I say ‘rolling pin’ – you can get little rolling pins. I just could not feel a thing.” His glans had been badly desensitised after years of rattling around – so much so that he could have an orgasm and not even feel it. That is when he approached NORM-UK.

During heterosexual intercourse with a circumcised man, the penis removes natural lubrication as it moves in and out of the vagina. “So my poor wife was buying artifical lubricant by the gallon” says Laurie. During heterosexual intercourse with an uncircumcised man, the glans moves but the foreskin stays put. And so does the lubrication. The woman doesn’t feel friction at all – what she does feel is a variation in pressure.

Laurie is delighted. “And so is my wife” he says. “The skin grew in jumps. I did a lot of work for a long time and nothing happened, like with the sticky tape, but suddenly I woke up one morning and thought ‘Where’s that come from?’.” The new foreskin didn’t have the nerve endings it once did. But the glans, which had been badly keratinised, recovered all its sensitivity. “For 40 years my wife and I had to use lubrication. Not any more. We’re delighted.”

Laurie is a charming poster boy for restoration. But NORM-UK need something to make the whole anti-circumcision thing sexy. Something that will look good on a t-shirt, and that Sting will want to sing songs about. NORM-UK are all about keeping doctors up-to-date with medical practice, and allowing patients to make an informed choice, so Sting should sing songs about it. But they need a slogan. “We’ve just started working with a primary care trust in Stoke-on-Trent” says Smith – it’s hardly catchy.

Smith is NORM-UK’s one paid employee. The sad truth of the matter is, he’s only just started owning up to it. He didn’t admit he worked for the charity until his parents died – he couldn’t bare the questions. When NORM-UK was founded, it was the first charity in history of the Charity Commission to be put on probation for 12 months. There was suspicion that it was a cover for pornography, and Smith still has to make sure that the charity literature, in his words, “isn’t wanking fodder”.

Smith’s wages come out of a grant from Lloyds TSB. But, apart from Smith, the trustees of NORM-UK are all volunteers. And it’s a big job, correcting public misinformation. The charity are, for instance, liaising with Great Ormond Street to correct the circumcision ‘fact file’ on the hospital website, setting up meetings with the Family Planning Clinic, and doing mail-outs to midwives, recommending the alternatives to circumcision.

Circumcision imposes a heavy financial burden on the NHS. But that is a side-issue. Meet the members of NORM-UK and you’ll understand that it’s more important to look at the complications of circumcision, and its physical and psychological side-effects. In the fullness of time, if NORM-UK have their way, routine circumcision will come to be seen as yet another deluded fad, along with bleeding, electro-convulsive therapy and the frontal lobotomy.



		A Cruel Cut? Skin is a living, breathing organ that is constantly renewing itself. Foreskin is no different – put it under tension, and it will grow. Which is why eight circumcised men are meeting in Watford Town Hall. They want new foreskins. “When people come to my house,” says Laurie, “I don’t go ‘Hello there, I’m Laurie, I’m growing my foreskin’. But I’ve often got research papers out on the table, so word gets out. I do find people are really very interested in what I’m doing.” Laurie is sharing his experience of restoration (as the process of foreskin renewal is called) with the members of NORM-UK. In the USA, where NORM was born, it stands for National Organisation of Restoring Men. NORM-UK is about more than that, but Laurie is on a roll. And the other members don’t want to interrupt him. After all, in two-and-a-half years, Laurie has achieved glans coverage when flaccid. In the world of restoration, that is major. NORM-UK meetings are small and intimate. Not usually as small and intimate as this one, but there’s been a pile-up on the M1. There’s a few handshakes, but otherwise little in the way of physical display – “people are always worried we’re going to drop our trousers,” says David Smith, the general manager of NORM-UK. Laurie wouldn’t be averse to the idea to show off his stretching. Women stretch skin for reconstruction after a mastectomy. So why shouldn’t men stretch a foreskin? Some NORM-UK members can’t restore – they are too tightly circumcised, and have no tissue left to grow. But others can. And they’re busy availing themselves of products like the TLC Tugger, Tug Ahoy and the Your-Skin cone (all available at a 10% discount to NORM-UK members). Some have found their own DIY solutions. They use funnels and gaskets to stretch the foreskin, and sash-window weights to provide the traction. If only B&Q knew their real customer base. The whole idea of restoration sounds funny. Like the time that Laurie was having a go with sticky tape – the most primitive of the restoration methods. He pulled what skin he had left over his glans, and taped it down. “I only had the tape on for half an hour”, says Laurie, “but it was hell. I was walking down the High Street and suddenly had to dive into the nearest toilet to check my penis hadn’t gone black, green or blue. Or dropped off altogether.” It sounds funny, but it isn’t. Not if it’s happening to you. Smith remembers sitting through East Is East – especially the scene where the father tries to catch the son and take him to be circumcised. “ I remember the cinema was in hysterics” says Smith. “And they were laughing when he was wheeled into the operating theatre, but all I could hear was the boy’s screams. My wife turned to me and said ‘I’ve got to go – I can’t watch this’.” When the foreskin is removed, it leaves the glans exposed. And, for most men, that is difficult. “I always had a problem with my penis giving me stimulation I didn’t want” says Kevin, “and I had to keep adjusting it through my pocket. I was near the climbing frame in the playground when, all of a sudden, everyone started chanting ‘Kevin is dirty – he’s always playing with himself’. I didn’t like the feeling of being odd. Of being deformed. Suicide would have been a good option.” Kevin is now 56 – with a fully-restored foreskin. But he’s left with questions like why was he circumcised in the first place? His mother read the Bible and went to Sunday school. “But I was conceived out of wedlock when she was 17. And my father was a divorcee. They wanted to get married in church, so I think I was circumcised as some kind of apology to Jesus. My father wasn’t circumcised himself, so I really don’t understand.” And that is a feeling he shares with many members of NORM-UK. The members all feel some kind of pain. Meetings are on a first-name-only basis because members don’t like to be identified. At the last AGM, one member took a photograph. Three members threatened to walk out unless the photograph was destroyed immediately. “Many men who come to meetings won’t even speak to their families about the pain they’re suffering – we are dealing with victims of abuse here” says Smith. NORM-UK currently have just short of 300 members. Less than one enquiry in ten results in membership, but NORM-UK isn’t strictly about the numbers. “Men often want the information to restore,” says David Smith, “but they want to keep it to themselves. They are frightened about being found out. When they ring me up, they say, ‘Please ensure that the information is in plain envelopes and don’t put me on a mailing list’.” John D was like that. He felt abused because his circumcision was unnecessary – a course of antibiotics had already cleared up his urinary infection. “But my father agreed with the Doctor, and told me I was going to have a minor operation” he says. “I remember the nurses giggling as I was taken off to theatre. They wore these big sickly grins, and said ‘We’re taking you to be done up now. Hee hee hee’. I was eight, but suffice it to say that they knew what was happening to me and I did not.” “I remember waking up,” says John D, “after the general anaesthetic had worn off, and looking down. My beloved penis had been replaced with wrinkled skin, a collar of thorns – the black stitches – and an ugly great dome on top. I experienced shock at first, later deep anger and resentment. The stitches disappeared, but the mutilation didn’t. My father said ‘I didn’t think it would look like that’. It was misinformed consent. And an operation I didn’t even need.” There are lots of horror stories about circumcision. Like the time in Baltimore in 1964 that it went so badly wrong that the doctors decided to change the child’s sex. Or the time in London in 1991 when a 16-year-old was circumcised so badly that he bled all night and died in the morning. But these cases are extraordinary, and far from typical. Circumcision is a safe and easy operation. The members of NORM-UK don’t see it like that. John E is registered blind. But it’s not his blindness that keeps him away from NORM-UK’s meetings. “It’s that fact I feel I’ve been more devastated than everyone else” he says. “They’ve got their lives in order. And they’ve got sexual partners. I haven’t. My life has been ruined by circumcision, although I hate that word. I prefer ‘foreskin amputation’. It’s not an operation – there’s no medical benefit. It’s a rite. A faith crime.” In the Bible, circumcision was God’s covenant with Abraham and the Jewish people. Of all of the commandments in Judaism, the brit milah (literally, covenant of circumcision) is probably the most universally observed. And although circumcision isn’t actually mentioned in the Qur'an, it is mentioned in the Hadith. Most Muslims believe it’s fundamental because Allah ordered Muhammad to follow the way of Abraham. Religious circumcisions are frequently performed without anaesthetic, and are intensely painful, even when they’re being performed on newborn babies. Adults can testify to the pain for themselves and can give their informed consent – but children can’t. NORM-UK claim that the circumcision is traumatic, and can result in lifelong damage – including psychological trauma and a reduced sex drive. So, if they’re not medically necessary, why are religious circumcisions still allowed? NORM-UK say, actually, they aren’t. They point to the UN Convention on the Rights of the Child, which declares that violence to children cannot be justified on grounds of “religion, culture or tradition.” Children are not the possessions of their parents, to do with as they please – the legal standard in Western society is that parents aren’t allowed to carve up their children without their permission unless it is absolutely necessary. We make an exception for circumcision because it’s mentioned in Genesis. Dr Zarifa from Docklands in East London is one of the few surgeons prepared to advertise the fact that he will circumcise males for religious or ethnic reasons. “Why not?” he says. “The operations are justified by the General Medical Council. And they will happen whether I do them or not. It’s much better for the operations to happen in my surgery under clinical conditions with anaesthetic, where I can provide all the necessary aftercare.” Even non-practising Jews want to circumcise their sons. It was, after all, the first command given to Abraham and the defining physical mark of the Jewish people. Circumcision requires ‘Hatafat Dam Brit’ – a drop of blood that seals a covenant. Which does, for some, suggest that removing the foreskin goes beyond what is actually required by God. But, according to Rabbi Dr Jeremy Rosen, that is to miss the point. “People are always trying to find ‘rational’ reasons for Jewish laws” says Rabbi Rosen. “They ask if our dietary laws improve hygiene. They ask if observing the Sabbath helps mental relaxation. And they ask if circumcision prevents STDs. But even if these rational reasons stood up to objective scrutiny, they wouldn’t be a reason for keeping – or abandoning – our laws. One keeps to these rules out of religious commitment.” “I have no medical expertise” says Rabbi Rosen, who runs the London branch of the the liberal Yakar Educational Foundation , “but I am convinced that circumcision is harmless, and not traumatic. But even if it is, we Jews have done pretty well on it over the years – and so indeed have Muslims. And I cannot for the life of me understand why anyone would want spend any money or go through any discomfort trying to reverse it.” But circumcision on females was made illegal in the UK in 1985. So, why isn’t the same protection afforded to males? The answer, let’s be honest, is that making male circumcision illegal would involve taking on two of the world’s great religions. Most forms of female circumcision are, certainly, more damaging than male circumcision, but the distinction in law between male and female circumcision just can’t be justified objectively. It’s a double standard. Circumcision wasn’t actually practised in Britain at all until the eighteenth century. And it really only gained popularity in the nineteenth century, after claims that it stopped the vile habit of masturbation. By stopping masturbation, Victorians thought circumcision would cure everything from epilepsy and hip trouble to asthma and alcoholism. And whenever a new disease became a matter of social concern, circumcision was wheeled out as the cure. It’s still happening. A recent paper in the British Medical Journal found a link between an intact foreskin and HIV infection – but a paper in the British Journal of Urology found exactly the opposite. At best, circumcision is appropriate as a routine measure in regions with a high rate of HIV infection, such as sub-Saharan Africa. But there certainly isn’t enough evidence to recommend circumcision as an HIV-preventive measure in the UK. There is irrefutable medical evidence that circumcision reduces the incidence of cancer of the penis, and of the cervix for the women whose partners are circumcised. But according to NORM-UK, the evidence is rather dated. They say, when it comes to the transmission of disease, it’s likely that the lack of cleanliness is more important than the lack of a foreskin. Once again, the potential medical benefits of circumcision aren’t enough to recommend it routinely. NORM-UK don’t want to see circumcision banned altogether. They accept there are a few medical conditions where it is necessary – but only a few. The others can be treated by simple, non-surgical means. And that means changing the way doctors think. “We need to educate the medical profession,” says Smith, “because they seem unaware of the alternatives to circumcision. They are certainly unaware of the problems that it is causing.” John D is typical of NORM-UK members in that circumcision changed his entire persona. “I became less sociable,” he says, “and I started talking to myself. I was fearful of changing rooms. I had no close relationship with the opposite sex until I was 41, and I still haven’t been able to reach orgasm through sexual intercourse. Over the years, I’ve had real problems with depression, and I’m sure I could trace it back to that day.” But doctors need to have more up-to-date information. Take a look at the General Practice notebook, an online medical encyclopaedia used by GPs, and its listing for phimosis – a condition where the foreskin won’t retract. Most infants are born with a foreskin that can’t be retracted and the foreskin is often tight until after puberty. Phimosis disappears in almost all cases given time. A fully retractable foreskin occurs on its own in 99% of 18-year-olds. But the notebook recommends circumcision. The notebook makes no mention whatsoever of the non-invasive solutions to the problem – like, for instance, stretching, steroid cream or a simple operation. Similarly there are simple, non-surgical solultions to balanitis, a condition where the foreskin retracts too tightly, causing the glans to swell. “It sounds silly,” says John D, “but balanitis can be cured by putting the penis in a bowl of sugar. The swelling goes down, and the foreskin to be returned to its resting position.” Dr Zarifa isn’t sure about the bowl of sugar – but he insists that doctors always explore the non-invasive options first. “The truth of the matter is that stretching can be quite painful” he says. “And it’s quite an undertaking for a small child. For some boys, the pain of the stretching is as bad as the pain of the circumcision. And I would say that 40-50% of boys who use steroid cream end up having a circumcision in the end. But it’s always the last option.” The BMA support conservative solutions where possible. They reckon to circumcise for therapeutic reasons where medical research has shown other techniques to be at least as effective and less invasive would be “unethical and inappropriate”. But unnecessary circumcisions are still happening . And, as the House of Commons Health Committee noted, they are happening “because doctors don’t understand the natural history of the foreskin.” Circumcision is ‘the snip’ – dismissed like it’s something and nothing. But it could still result in serious bleeding, or an adverse reaction to the anaesthetic . “And you cannot cut off normal, healthy, sexually-functioning tissue without cutting off normal, healthy, sexual functioning,” says Marilyn Milos, a registered nurse and director of NOCIRC, the National Organization of Circumcision Information Resource Centers. “It’s a sexual issue, and it’s a human rights issue." The foreskin isn’t a useless flap that evolution should have got rid of long long ago – it’s skin that is rich with blood vessels, highly innervated, and uniquely endowed with stretch receptors. These contribute greatly to the sexual response of the intact male. The stretching of the foreskin over the glans activates nerve endings, enhances sexual excitability, and contributes to the ejaculatory reflex. There’s no escaping it – the foreskin is sexual tissue. Laurie can laugh about it now, but he missed his foreskin. He was getting on for 60, and rapidly losing the feeling in his penis. “To be honest,” says Laurie, “sex was like pushing a rolling pin in. And I’m not referring to size when I say ‘rolling pin’ – you can get little rolling pins. I just could not feel a thing.” His glans had been badly desensitised after years of rattling around – so much so that he could have an orgasm and not even feel it. That is when he approached NORM-UK. During heterosexual intercourse with a circumcised man, the penis removes natural lubrication as it moves in and out of the vagina. “So my poor wife was buying artifical lubricant by the gallon” says Laurie. During heterosexual intercourse with an uncircumcised man, the glans moves but the foreskin stays put. And so does the lubrication. The woman doesn’t feel friction at all – what she does feel is a variation in pressure. Laurie is delighted. “And so is my wife” he says. “The skin grew in jumps. I did a lot of work for a long time and nothing happened, like with the sticky tape, but suddenly I woke up one morning and thought ‘Where’s that come from?’.” The new foreskin didn’t have the nerve endings it once did. But the glans, which had been badly keratinised, recovered all its sensitivity. “For 40 years my wife and I had to use lubrication. Not any more. We’re delighted.” Laurie is a charming poster boy for restoration. But NORM-UK need something to make the whole anti-circumcision thing sexy. Something that will look good on a t-shirt, and that Sting will want to sing songs about. NORM-UK are all about keeping doctors up-to-date with medical practice, and allowing patients to make an informed choice, so Sting should sing songs about it. But they need a slogan. “We’ve just started working with a primary care trust in Stoke-on-Trent” says Smith – it’s hardly catchy. Smith is NORM-UK’s one paid employee. The sad truth of the matter is, he’s only just started owning up to it. He didn’t admit he worked for the charity until his parents died – he couldn’t bare the questions. When NORM-UK was founded, it was the first charity in history of the Charity Commission to be put on probation for 12 months. There was suspicion that it was a cover for pornography, and Smith still has to make sure that the charity literature, in his words, “isn’t wanking fodder”. Smith’s wages come out of a grant from Lloyds TSB. But, apart from Smith, the trustees of NORM-UK are all volunteers. And it’s a big job, correcting public misinformation. The charity are, for instance, liaising with Great Ormond Street to correct the circumcision ‘fact file’ on the hospital website, setting up meetings with the Family Planning Clinic, and doing mail-outs to midwives, recommending the alternatives to circumcision. Circumcision imposes a heavy financial burden on the NHS. But that is a side-issue. Meet the members of NORM-UK and you’ll understand that it’s more important to look at the complications of circumcision, and its physical and psychological side-effects. In the fullness of time, if NORM-UK have their way, routine circumcision will come to be seen as yet another deluded fad, along with bleeding, electro-convulsive therapy and the frontal lobotomy.

		© Richard Johnson 2000 - 2009