Andrew Gross
Published: June 4, 2022
Updated: August 5, 2022
A Texas anti-circumcision activist has experienced nausea, insomnia, uncontrolled crying, a panic attack, and feelings of helplessness and grief. [1] A student at Western Kentucky University experienced daily emotional breakdowns and nightly insomnia. [2] After a week of depression an intactivist in Toronto was hospitalized at a mental health facility. [3] An enraged activist in Alaska punched through a glass window. [4] A Delaware intactivist suffered stress, severe depression, insomnia, eating disorders, and a deep sorrow for months at a time. [5]
Some would nod and offer these cases as evidence that infant circumcision afflicts men with lifelong psychological trauma. They would be wrong. None of these people is a man. Each one is a woman whose fixation on the genitals of infant boys caused untold trauma in her life.
SEXUAL AND PSYCHOLOGICAL EFFECTS
With that in mind how should one view Male Circumcision Grief: Effective and Ineffective Therapeutic Approaches? This 2017 paper makes the case that mental health therapists lack knowledge of the detrimental sexual and psychological effects of circumcision. Armed with ignorance, therapists provide ineffective and counterproductive treatment for unhappy circumcised men. [6]
Authors Lindsay Watson and Tom Golden say that circumcision removes "several thousand encapsulated nerve endings that make up the male foreskin," which "provides a major part of the sensory input during sexual activities" and "reduces the force needed to penetrate the vagina." Watson wrote that "circumcised genitals are not fully operational," [7] and he has stated that circumcised men must use artificial lubrication for masturbation and vaginal intercourse. [8] The authors made broad statements about the psychological reactions of circumcised men, and they claimed that "circumcision has been an under recognized cause of male body-loss grief." [6]
Those statements are not accurate. Some of the studies the authors cited to support their claims are low quality. Others studies are misapplied, argumentative, or taken out of context. Consider the following examples.
The authors cited a 2002 study by Donald Taves as proof of their contention that foreskin "reduces the force needed to penetrate the vagina." [9] Taves cut a hole in the bottom of a Styrofoam cup and mounted the cup on a diet scale. The University of Washington psychiatrist penetrated the hole with his erect penis - alternately with his glans exposed and with his foreskin covering the glans. [10] Either Watson and Golden believe that sexual intercourse with a Styrofoam cup - an absurd "experiment" that didn't involve a single vagina or circumcised penis - can provide insight about the amount of force a man uses to enter his female partner, or (more likely) they didn't bother to read the study. This citation is a disgrace and shows that the authors reached their conclusions without employing the scientific method.
The authors cited a 1998 paper by Peter Maguire and Colin Murray Parkes to support their claim that reactions of unhappy circumcised men - including
"violent retributive thoughts toward the circumciser, recurrent nightmares, depression and suicidal thoughts and attempts, self-harm, body eudysmorphia, poor self-image, alexithymia and an inability to engage in intimate relationships ... are consistent with those experienced by people coping with the loss of other body parts (Maguire & Murray [sic]). As amputees can develop an obsessive preoccupation with their missing body part (Maguire & Murray [sic], 1998), so circumcised men may also become obsessive about their missing foreskin." [11][12]
Maguire and Parkes studied subjects coping with the recent or impending loss of previously functioning limbs. Several years ago I asked Dr. Parkes whether he concurred with the application of his conclusions to unhappy circumcised men. Parkes replied,
"It is not necessarily the case that people will grieve for the loss of something that they never had or lost when too young to know they had it. Thus children born with congenital deformities grow up with this body as their norm. Only when they are brought face to face with others who have what they lack do they suffer a mixture of distressing emotions that may include grief, shame, anger and much else. I have no recollection of my circumcision that took place, on medical advice, shortly after my birth. I am unaware of any feelings of loss, mutilation or inferiority as a result and I have no need to grieve." [13] [14]
An analysis of patients dealing with a recent loss of arms and legs has no application to able-bodied men upset over the neonatal removal of a flap of skin about which they have no memory.
The authors cited a 1999 paper by psychologist Ronald Goldman to support their assertion that circumcision causes men to suffer negative psychological reactions. [15] Goldman, an anti-circumcision activist, has conceded that “there is no empirical research on circumcision trauma and memory,” [16] and he admitted that "the effects of circumcision trauma can be chronic and so deeply embedded that it is very difficult to distinguish them from personality traits or effects resulting from other causes.” In other words, a researcher with an agenda who is looking for psychological harm might mistakenly attribute as circumcision trauma what are actually personality traits or mental problems from other causes.
Notably, I gained insight into two of the above studies merely by emailing the authors. Watson and Golden blindly cited the studies without even attempting to confirm their validity or relevance. Most of their other claims about physical, sexual, and psychological effects of circumcision also have little to no merit. While it would be impractical to analyze each paper for this article, readers can find discussions of most of the studies in these Circumcision Choice articles:
The Styrofoam Vagina [analysis of the Taves study]
STUDY OF "CIRCUMCISION GRIEF"
The heart of the paper involves a study of men who sought mental health counseling to deal with negative feelings about their own circumcisions, feelings that the authors labeled “circumcision grief." Watson and Golden recruited 22 subjects via advertisements on three anti-circumcision websites. While admitting that "some men had additional psychological problems" and that "the number of respondents [were] too few" for a qualitative analysis, the authors failed to consider the glaring weaknesses of their review.
First, the study introduced the possibility of self-selection bias by allowing respondents to choose whether or not to complete and return the survey. "Self-selection bias is the problem that very often results when survey respondents are allowed to decide entirely for themselves whether or not they want to participate in a survey... In most instances, self-selection will lead to biased data, as the respondents who choose to participate will not well represent the entire target population." [17]
Of the three websites on which the recruitment ads appeared, Foreskin Restoration and Restoring For Men seek to agitate men to use skin stretching devices on the penile shaft in an attempt to replace their foreskin. [18] A Voice For Men promotes violent hatred of women. [19-21] By limiting their subject pool to visitors to those sites, the authors guaranteed that they wouldn't hear from any men who may have benefited from traditional therapy strategies.
It gets worse. The advertisement featured leading statements dismissive of circumcision and circumcised men (e.g. that circumcision is a human rights violation, that men's feelings are rejected based on a North American "sexual bias," that circumcised men lack "sensory input during sexual activities" and "a linear bearing between the penile shaft and the vaginal walls.") The ad contained reactions from men who apparently had previously contacted the authors, as well as the reported reactions of their therapists. [22] Reading the ad may have influenced subject to provide concurring responses. A recruitment ad that discloses actual responses to the survey questions is extraordinary, perhaps unprecedented. The unorthodox ad makes it highly unlikely that the respondents are representative of all men who seek therapy to deal with negative feelings about circumcision. They certainly don't represent the feelings of circumcised men in general.
The authors stated that "some men discover information [online] that shocks them into an awareness that they have lost out sexually." Watson has indicated that "information on the internet" is the most common cause of negative feelings about circumcision. [23] Well, yes - that's the problem. The internet offers plenty of information that is false, misleading, biased, or otherwise unreliable and suspect. The Circumcision Choice website exists, in part, to scrutinize articles and assertions related to circumcision to ascertain their validity and relevance. The eagerness of the authors to assume the accuracy of online content is further indicative that their conclusions are not based on science.
Watson and Golden reported that "several therapists said that circumcision grief indicated deeper problems or was 'a metaphor for something else.'" The various diagnoses "included OCD, body dysmorphia, obsessive behavior, sexual fetishism, paranoia, sex addiction, sexual abuse as a child, autism spectrum disorder and the obsession was 'a political issue.'" [emphasis in the original] These diagnoses are consistent with the observations of sex therapist Dr. Marty Klein [emphasis added]:
"I have talked with more men about their penises than you can shake a stick at... A small number of men have talked about how they feel about being circumcised or not circumcised. Invariably, anyone who talks about the issue is convinced that they'd be better off different than they are - the cut guys want to be uncut, and uncut guys want to be cut. Most of these thousands of patients were sane enough people who were over-concerned about their penises. Others were a bit less sane. And a few were intensely involved with their feelings to the point of ignoring science, logic, and the sworn statements of one or more lovers... In 31 years of talking with men about circumcision, I have never met a man who felt damaged, mutilated, or emasculated by his circumcision who did not have other emotional problems. The pain they claim to remember from the brief procedure is impossible; the rejection from ’all women‘ a childish overgeneralization; the sense of being incomplete a neurotic problem that has other sources." [24]
THE PARADOX
It's strange that Watson and Golden expressed no puzzlement at the inconvenient truth that the overwhelming majority of circumcised men have positive or neutral feelings about their circumcision status. On the contrary, the authors flippantly dismissed these men, declaring that "most circumcised men, including physicians and psychiatrists, live in a state of denial that they have been damaged." [6] In a paper where they demand that the feelings of unhappy circumcised men be validated, the authors waved their hands and rejected the views of happily circumcised men. They appeared to have no awareness of their own hypocrisy.
The authors offered no evidence to support their serious accusation that millions of happily circumcised men are in denial. A psychological coping mechanism, denial involves avoiding a confrontation with a problem or reality by denying the existence of the problem or reality. This self-serving accusation is dependent on the premise that circumcision is harmful - a premise they failed to prove. Denial is a closed circle argument, one "where there is no possibility of convincing [the authors] that they might be wrong. They are right because they’re right." [25] A closed circle argument, one that is unproven and unfalsifiable, is meaningless.
THERAPY STRATEGIES
Watson and Golden based their analysis of therapy strategies on their own false beliefs about circumcision. The authors accused therapists of "[failing] to acknowledge the actual causes of the anguish." By contrast the authors themselves failed to acknowledge the possibility that at least some of the diagnoses were accurate.
Therapists reportedly offered a range of strategies for their patients. Watson and Golden identified the following "interventions as unproductive: being told to stop viewing foreskin restoration websites, meditation…, telling patients to 'get over it,' being told that some girls prefer circumcised partners..., diminishing circumcision pain and grief..., and referring patients to therapists based in hospitals..." The authors claimed that patients who experience circumcision grief "are very knowledgeable about the anatomy and sexual functions of the male genitals." The authors accused therapists - especially male therapists - of pushing "their own personal bias and insecurity, favoring circumcision at the expense of establishing patient rapport."
With the exception of establishing rapport, the authors' conclusions are based entirely on the circumcision grief paradox. Watson and Golden reflexively assumed that therapists are ignorant - based on their own false beliefs about circumcision and foreskin function. It's striking that the authors failed to ask other mental health professionals for observations on the effectiveness of therapy strategies. Nor did they contact physicians who might have challenged their beliefs about circumcision and foreskin function.
The authors claimed that grieving over the loss of foreskin is normal, yet they failed to provide any evidence for this assertion. A 2015 YouGov survey of 1,000 American men found that 86% of circumcised men were happy or unconcerned, while 10% wish that they had not been circumcised. One may presume that only a portion of the ten percent dwelt on their circumcision status at length. (Recall that Klein described many of his patients who ruminated about their circumcision status as perfectly sane, while others were less sane, and only "a few" were obsessed "to the point of ignoring science, logic, and the" testimonies of romantic partners. [24]) By comparison 67% of uncircumcised men in the YouGov survey were happy or unconcerned with their circumcision status, and 29% wish that they had been circumcised at birth. In other words, the percentage of uncircumcised men who regretted their parents' decision was three times higher than the percentage of circumcised men with regret. [26] These results suggest that grieving over the loss of foreskin is not normal behavior.
The authors stated that effective therapy strategies include having a patient write about his feelings and encouraging him to restore his foreskin. Yet it would be irresponsible and potentially dangerous to recommend that a man use a skin stretching device without consulting a physician. [18] The authors emphasized the necessity of validating a patient’s feelings and beliefs about circumcision. One of their subjects wrote, "Frankly, I think the therapist probably needs to accept that circumcision really is an act of sexual mutilation and rape - a violation of the most intimate part of one's body. I don't see how a therapist who thinks their patient is delusional can be highly effective." [6]
Such a strategy constitutes another closed circle argument, because the strategy is based on the assumption that circumcision is physically, sexually, and psychologically harmful. For a therapist treating a patient with a delusion, an initial step will be to establish rapport and trust with a non-judgmental attitude. Challenging a delusional belief in the early stages of treatment can be counterproductive. However eventually the patient's delusion must be addressed, not affirmed. "Once a strong relationship has been established, the therapist can begin to focus on increasing the client's self-confidence, and slowly challenge the delusional thought process." [28]
I spoke with a Harvard psychiatrist who has counseled patients suffering from countless different anxieties - from aquaphobia (fear of water) to lepidopterophobia (fear of butterflies.) During his 40+ years of practice, not one of his thousands of patients revealed any dissatisfaction with the patient's circumcision status. Nor have any of his colleagues had a patient who expressed negative feelings about circumcision. The psychiatrist concluded that a level of anxiety with one's circumcision status as described in the paper would be extremely rare. He said that each patient should be treated with respect and dignity. While acknowledging that not all therapists are good, he expressed skepticism that a therapist would laugh at an unhappy patient or dismiss a patient's feelings. He said that an accurate assessment of the effectiveness of particular therapy methods would be difficult, based on the one-sided accounts. [29]
THE TRUE CAUSE
Watson and Golden associated a man's recognition of the physical loss of his foreskin with bitterness, depression, frustration, recurrent nightmares, powerlessness, trauma, and suicidal thoughts. Watson has stated that common emotional reactions include "anger (47%), shock (40%), and sorrow (35%)." [30]
Those reactions are not unique to circumcised men, but are widespread across the intactivist community. Uncircumcised men have experienced anger, stress, social anxiety, and crying fits - emotional responses associated with their intactivist activities. [31] Female intactivists, including those cited at the beginning of this article, have also suffered many negative reactions related to their activism. These men and women cannot be reacting to their neonatal circumcisions - they aren't circumcised. Rather than circumcision being the source of the grief, it seems more likely that intactivism - the fanatical obsession with circumcision that these individuals have in common - is the root cause. A growing body of evidence indicates that - irrespective of biological sex or circumcision status - intactivism causes stress, anxiety, anger, rage, jealousy, nightmares, flashbacks, sleeplessness, PTSD, OCD, paranoia, and suicidal thoughts. [31]
Researchers who support circumcision as a parental choice have argued that exposure to intactivist myths may cause psychological harm. "Gullible men with little or no critical judgement or scientific understanding may succumb to the barrage of anti-circumcision arguments they read and become convinced that their circumcision is at the root of their sexual problems... The stress caused by a belief that they are victims of their newborn circumcision, and that they had no say in the 'circumcision decision', may lead such men to develop psychological problems." The researchers concluded, "Harm felt by some men likely stems from belief in pervasive anti-circumcision propaganda portraying circumcision as harmful." [32]
RECOVERY
If intactivism is the cause of "circumcision grief," then a road to recovery might begin by accepting that intactivist beliefs are not true and by removing intactivist influences from one's life. In 2020 a man (whom I agreed to identify by his initials) emailed Circumcision Choice to commend us and to share his own experience. SL reported that after he had reached out to the anti-circumcision group NOCIRC:
"The material I received was really upsetting and appalling. I was told I had lost 50% of the skin covering my penis, 100,000 erogenous nerve endings, a 'gliding mechanism' which would make for a more smooth and effortless sexual experience, that I had a 'chaffed' and uncomfortable glans that caused friction [during sex] and discomfort when wearing boxer briefs, and a number of other claims... With nothing to oppose these claims, you tend to believe them, simply because they are uncontested." [33]
Eventually SL realized that his own experiences contradicted the information in the NOCIRC materials.
"Within a few years of feeling body shamed, and inferior, and after hearing other circumcised men who bought into this nonsense refer to themselves as 'sexual cripples' ... I decided their claims needed a bit of looking into. First, I wondered, how these people could know anything about my penis, one they have never seen or examined? 50% of the skin lost? How did they know that? A dried out glans causing uncomfortable sex? I never experienced that... And boxer shorts being uncomfortable? What? That's all I wore and I never experienced the slighted bit of discomfort. The worst of their arguments are those of lost penile sensitivity and that of delaying orgasm and causing less sexual pleasure. Again, these are things I never experienced. Besides, sexual sensitivity doesn't equate with sexual pleasure... And trouble reaching orgasm? I never experienced that either. Needing artificial lube for sex? Quite the contrary. I had had too much lubrication, so much so I felt I needed a towel half the time to dry off." [33]
Several women formerly involved in intactivism have reported that their mental health improved significantly once they left the movement. "Man am I grateful that I went into therapy instead of continuing to be a die-hard Intactivist," wrote the creator of The Bitchy Intactivist Facebook page. [34]
Jeni wrote, "Personally, I was regretful from the day that it was done... I took the opportunity to apologize to [my adult son] and profess my guilt. He looked at me like I was a bit insane and told me that he loves his body, he has no regrets, and he asked me to let that useless guilt and regret go... Once I let go of my regret, I started to feel less hostile and angry, and I started listening instead of bashing others for making the same choice that I did more than twenty years ago." [35]
CONCLUSION
The Circumcision Grief paradox runs throughout the paper. While they insist that therapists validate the feelings of unhappily circumcised men, Lindsay Watson and Tom Golden seek to invalidate the feelings and experiences of millions of happily circumcised men. Perhaps the two authors are motivated by a realization that such persistent and widespread feelings and experiences challenge their own beliefs about circumcision. At any rate they cannot have it both ways.
In more than four years since publication, Male Circumcision Grief has received absolutely no attention. [36] Watson has taken this silence to imply that experts concede the factual basis of the paper, an example of the Argument from Silence fallacy employed by the producer of American Circumcision. Some might ask why I would bother to critique a paper that has been ignored by the academic community. The authors present a case that on the surface appears compelling, but which falls apart upon examination. This critique will be available, if at some point in the future, the paper is cited as evidence about circumcision or counseling.
In a 2014 podcast discussion, Tom Golden inadvertently admitted that he may be motivated more by his own visceral emotional reaction to circumcision than by an objective scientific analysis. While dismissing medical arguments, he erupted: “They're going to these huge lengths to try and create this aura that 'this is the right thing to do.' BULLSHIT! IT'S NOT THE RIGHT THING TO DO! STOP CUTTING OFF PENISES! GEEZ!" [37] In a forward to Watson's book, Golden implied that circumcision should be prohibited by law. [38]
Yale University psychiatrist Sally Satel has warned about the consequences when a therapist uses his practice to advance an ideological agenda:
"When therapists use patients as receptacles for their worldview, patients are not led to introspection, nor are they emboldened to experiment with new attitudes, perspectives, and actions. Patients labeled by their therapists as ... oppressed learn to see themselves as feeble victims. It is difficult to imagine how a healthy therapeutic alliance between counselor and patient - a core bond nurtured through a clinician’s posture of caring neutrality and compassionate detachment - could thrive under these conditions." [39]
Watson wrote that men remain in denial "as a way of dealing with their shame." He wrote that such men are stuck in a "circumcision coma" - a lifelong "dream-like state not unlike that conjured by Morpheus [a character in the 1999 file The Matrix ] ... from which they never awaken." [SEE UPDATE BELOW] It's no coincidence that the red pill, another theme from The Matrix, is associated with A Voice For Men, the misogynist men's rights group the authors used to recruit subjects for the study. [40] British journalist James Ball observed, "In the film, taking the red pill is to accept an alien and horrifying truth rather than stay in a comfortable delusion. And yet red-pilling, as beloved by [men's rights] groups, is to accept vile but comfortable groupthink, to suit your own preconceptions, and see the world in a framing that suits yourself." [41]
Intactivism is the vile but comfortable groupthink, a false reality that deceives men into convincing themselves and each other that they are victims who were sexually crippled at birth. It seems fitting that Watson mischaracterized Morpheus as an antagonist who deceived humanity into ignorance. In the film Morpheus was a hero who awakened the protagonist, Neo, revealing to him the true nature of reality.
UPDATE - July 1, 2022
Researching the name "Morpheus," I realized that Watson may not have been referring to the character from The Matrix, but to a Greek god associated with sleep. If that is the case, then the reference might make more sense. The Morpheus of Greek mythology appeared in dreams as a messenger who communicated future events. He could also portray false realities in order to deceive. However the analogy is far from perfect. Watson described the "circumcision coma" as a deception that keeps men in the dark for their entire lives. By contrast the dreamlike state Morpheus created began every evening and ended each morning. Morpheus was not strictly a deceiver; he often prophesied a true future. He also created terrible nightmares that would afflict a dreamer. Ironically many intactivists have reported suffering terrible nightmares as a result of their circumcision obsession.
RELATED
[1] Dani Alexander Fitzpatrick; Facebook post; December 12, 2019 (Facebook.com/dani.alexander.3720)
[2] Kalei Cherise Valery; Friends of Bloodstained Men Facebook post; November 15, 2019
[3] Melissa Annette; Intactivism Uncensored Facebook group posts; May 4-5, 2020
[4] Rosemary Romberg Facebook post; April 18, 2019
[5] Shelley Wright, Facebook note: "My personal struggle"; November 23, 2014
[6] Lindsay Watson and Tom Golden; "Male Circumcision Grief: Effective and Ineffective Therapeutic Approaches"; New Male Studies; 2017
[7] Lindsay R. Watson; "Unspeakable Mutilations: Circumcised Men Speak Out"; CreateSpace Publishing; June 20, 2014.
[8] Ibid. "Circumcised males need to resort to using artificial lubricants for both masturbation and intercourse." [emphasis added]
[9] Donald R. Taves; “The intromission function of the foreskin”; Medical Hypotheses, pp 180-182; August 2002
[10] Donald R. Taves; email to Andrew Gross; December 5, 2016. "I was the only subject. The comparison was the force needed for intromission of the artificial entroitus (the opening in the cup) when my foreskin was retracted as compared to when it was in place."
[11] Peter Maguire and Colin Murray Parkes; "Coping with loss: Surgery and loss of body parts"; British Medical Journal; April 4, 1998
[12] It's unclear why the authors identified Parkes by his middle name.
[13] Colin Murray Parkes; email to Andrew Gross; April 2, 2016
[14] I also would have emailed Peter Maguire, but he is deceased as of 2006.
[15] Ronald Goldman; "The psychological impact of circumcision"; BJU International; January 1, 1999
[16] Ronald Goldman; "Circumcision: The Hidden Trauma"; Vanguard Publications; 1997
[17] Paul J. Lavrakas; "Self-Selection Bias"; Sage Research Methods; January 1, 2011
[18] In an episode of The Doctors, a physician cautioned against the use of such devices without the care of a medical professional. “You might injure your skin and cause an opening for an infection. But you might stretch your skin in ways that are deformed when you’re all done and regret it and can’t go back… So it’s really not a good idea to do this or any other kind of surgical procedure at home.”
[19] "Male Supremacy"; Southern Poverty Law Center. "Though male supremacy lives in a coalition of online spaces, its most established proponents are two hate groups: A Voice for Men, a men’s rights website started by the violently bigoted Paul Elam... On these websites ... the harassment of women is encouraged... [Elem] has claimed that were he to serve on a jury for a man accused of rape, he would automatically declare the defendant not guilty, regardless of the facts of the case.'"
[20] Mariah Blake; "Mad Men: Inside the Men's Rights Movement - and the Army of Misogynists and Trolls it Spawned"; Mother Jones; January 2015. "Soon after, A Voice For Men launched a site called Register-Her.com; modeled after sex offender registries, it purported to track female murderers and rapists, as well as women who scheme against men... 'Mary Jane Rottencrotch wants to say that her husband beat her just for the sake of gaining leverage in a divorce,' Elam complained on his online radio show. The solution, he said, was to give the husband a place to publish her personal information, 'even the route she takes to work, if she bothers to have a job.' Elam added that there would no longer be 'any place to hide on the internet anymore' for 'lying bitches.'"
[21] Posts by A Voice For Men founder Paul Elam promoting violence against women set the standard.
"When is it OK to Punch Your Wife?" - Elam said that many women deserve a "solid ass kicking" or "a right hook ... hard enough to leave them in an unconscious ... pile on the ground."
"If You See Jezebel in the Road, Run the Bitch Down" - Elam proposed that October be named "Bash a Violent Bitch Month." (Elam later claimed that it was a satirical response to a post on Jezebel, a popular feminine website. But in the post he admitted that he wasn't being serious - not because it's wrong. But because anyone who followed his advice would face legal consequences.)
"Challenging the Etiology of Rape" - Elam argued that women who dress and act provocatively are "begging" to get raped. "There are a lot of women who get pummeled and pumped because they are stupid (and often arrogant) enough to walk through life with the equivalent of a I'M A STUPID, CONNIVING BITCH - PLEASE RAPE ME neon sign glowing above their empty little narcissistic heads."