Examining Sexual Correlates of Neonatal Circumcision in Adult Men
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Circumcision—the surgical removal of some/all of the male prepuce (foreskin)—is among the oldest and most common surgical procedures globally. Research on circumcision—and the recent North American policy endorsing it—focuses on health outcomes; sexual correlates of circumcision remain largely unexplored. A review of the circumcision literature was conducted (Chapter 2), and four studies investigated the sexual correlates of neonatal circumcision. Chapter 3 employed quantitative sensory testing (detection/pain thresholds using punctate/thermal stimuli) to examine penile sensitivity in healthy adult men (circumcised, intact). Findings indicate minimal differences across circumcision status. Chapter 4, which compared sexual functioning across circumcision status, found no significant differences between circumcised and intact men with respect to genital response (via laser Doppler imaging: LDI), subjective experiences of sexual arousal, or sexual/urological history variables. Chapter 5 explored men’s attitudes towards their circumcision status and the implications of these attitudes on body image and sexual functioning. A proportion of circumcised men who completed this online survey indicated high distress about their circumcision status. Furthermore, negative attitudes towards one’s circumcision status—as opposed to circumcised status per se—was related to worse body image and sexual functioning. Chapter 6 assessed the impact of a man’s circumcision status on their female and male sexual partners. In this online study, circumcision status did not impact partner’s sexual functioning, but gender differences emerged with respect to attitudes towards one’s partner’s circumcision status (women preferred circumcised partners, men preferred intact). Overall, however, women and men were satisfied with their partner’s circumcision status and did not wish for it to change. Taken together, this research program indicates that minimal physiological differences exist between circumcised and intact men (i.e., sensitivity, sexual response, the experience of sexual arousal). However, attitudes towards one’s circumcision status—as opposed to circumcision status alone—was an important aspect of men’s and their sexual partners’ sex lives. In particular, dissatisfaction with one’s circumcision status is associated with worse body image and sexual functioning in men. Here, we provide a multidimensional perspective of the sexual correlates of circumcision with implications for public policy and individual stakeholders (e.g., medical professionals, parents, men).