Sunday, April 30, 2017

Intact Male Hygiene: You're Doing It Wrong

Right, so something intact guys often get dirt for is being "dirty" and "smelly" all the time, and having to take extra steps to keep clean.

First off, this is a bit unfair, not to mention sexist.

I mean, let's just ignore the fact that there is an entire aisle of hygiene products for women.

Yes, I'm pretty sure women's genitals perpetually exude the aroma of fresh raspberries and cream, especially around that time of the month.

There is so much a woman has to do to keep clean, tidy and fresh-smelling down there, but let's give intact men all the shit for it.

What's an intact man's penis supposed to smell like?
Giving advice to one woman self-conscious about her smell, another woman gave this advice:
 "Your vagina is supposed to smell like a vagina, not a mango. If your partner complains about the natural smell or taste of your vagina, they can go fuck a mango." ~Lily R. Mason

I want to bring attention to the contrasting advice that women get vs. what men get.

While most women are told to love their bodies as they are, men get body shamed. Why is this?

Why can't intact men get similar advice as above?

A penis is supposed to smell like a penis, not some tropical fruit.

Partners that complain about the natural smell or taste of your penis should go eat a banana or something.

What's the right way for an intact man to wash?
First off, let's start with how NOT to wash.

Ever been told to retract your foreskin and use soap and water to wash under it?


It's wrong.

As it has been mentioned before on this blog, sadly, doctors in the United States are geared towards circumcision, and they gear their patients and their parents towards circumcision, so any information they give is often wrong for one or all of the following:
  • They were taught misinformation in med school regarding anatomically correct male organs and they never bothered to do any actual research on the matter (Why should they? Their patients are all going to be circumcised anyway, right?)
  • They're pulling it out of their rear end (As doctors with PhDs, they need to sound like they know what they're talking about, even when they actually don't.)
  • They are quite deliberately giving patients and their parents misinformation that will give them iatrogenically caused problems that they can use as an example of why all males need to be circumcised

Soap should never be used to clean the delicate mucosal tissue on the inside of the foreskin and on the glans because:
  • It disrupts the natural flora of the penile microbiome
  • It can dry out the mucosal tissues on the inside of the foreskin and on the glans, which are normally supposed to be moist and supple.
If you use soap to wash under the foreskin, you run the risk of giving yourself a yeast infection (AKA balanitis) and a reason for charlatan doctors to suggest circumcision.

In the industrialized world, including the US, women are told not to use soap or to douche too often for the same reason; it results in disruption of the natural flora that grow in the vagina and around the vulva, increasing the risk for a yeast infection.

So how should an intact man wash?
If he can, he should retract the foreskin of the penis, and let water from the shower head fall over it. Using his fingers he should play with the foreskin to knock loose any smegma and let the water wash it away. Once he is finished, he should pull his foreskin back up over the penis. That's it. The whole process takes two or three seconds to complete.

 When in the shower, merely pull back the foreskin as far back as it will go
and allow water to wash over it. Use your fingers to knock any smegma loose
and let the water wash it away. When you're finished, put the foreskin back
over the glans. This should take no longer than a few seconds.

Video of a Man Showing How It's Done
The following video shows a man in the shower demonstrating how intact men usually wash down there. As it is a naked man in the shower, please be advised that this video is not suitable for work.

Hygiene in Children and Early Adolescents
It has been mentioned in a previous post, but it is common for the foreskin not to be retractable in children and adolescents. Usually, baby boys are born with the foreskin fused to the glans, so not being able to retract the foreskin is normal in babies. Research conducted in Europe and Japan shows that retraction can take place anywhere between 0 and 17 years of age, the median age for retraction being 10 years of age.

Do not listen to a doctor that says a child's foreskin should be retracted and washed with soap; this advice is mistaken and the doctor is giving parents potentially harmful advice that can result in serious, permanent damage.

Forced retraction can cause bleeding, infection and other complications.
Do not attempt to forcibly retract your child's foreskin, as this can result in injury.
Do not let a doctor forcibly retract your child's foreskin.

Beware of doctors who insist that they must retract your child's foreskin. When taking your child for checkups, warn your doctor not to retract your child's foreskin. If your doctor disrespects your wishes, you may be able to take legal action. Click on this link for further information.
What respected medical organizations have to say on early, forced retraction
Medical associations advise not to forcibly retract the foreskin of an infant, as this interferes with normal penile development, and may result in scarring or injury.(1)(2).

Camille et al (2002), in their guidance for parents, state that:

"[t]he foreskin should never be forcibly retracted, as this can cause pain and bleeding and may result in scarring and trouble with natural retraction."(3)

Simpson & Barraclough (1998) state that:

"[n]o attempt should be made to retract a foreskin in a child unless significant separation of the subpreputial adhesions has occurred. Failure to observe this basic rule may result in tearing with subsequent fibrosis and consequent [iatrogenically induced] phimosis. ..."(4)

The American Academy of Pediatrics cautions parents not to retract their son's foreskin, but suggest that once he reaches puberty, he should retract and gently wash with soap and water.(5) The Royal Australasian College of Physician as well as the Canadian Paediatric Society emphasize that the infant foreskin should be left alone and requires no special care.(6)

Forcibly retracting the foreskin in babies, children and young adolescents can result in permanent injury that may require surgery. Some sneaky doctors may actually be deliberately giving this "advice"; they see a price tag at the end of your child's penis.

So how should you clean your child's penis?
First off, do not try to retract your child's foreskin, especially in a baby or a young child.

Merely wash his penis without retracting the foreskin as you would any other part of his body, like his fingers or toes. No special care is needed.

 Clean your child's penis like you would any other port of his body.
First, wipe the shaft like you would a finger, wiping between the
shaft and the scrotum. Next, clean around the scrotum, between the
folds of skin where the child's legs connect with his abdomen.
Always leave the anus and surrounding areas for the very last.

In an older child, ask if he is able to retract the foreskin, and if he can, let water fall over it washing away any buildup.

If your child can't retract, or can only partially retract
Sometimes, the foreskin becomes completely retractable all at once, sometimes it takes time, and the retraction process happens in increments. Your child may be at a stage where the foreskin is still adhered to the glans and the foreskin only retracts half-way, for example. Sometimes most of the glans is visible, but the foreskin is attached to the glans just above the corona. Your child's foreskin may be tight and not allow for retraction at all. This is normal and your child's foreskin will come loose as time passes, as the child experiments with himself in the shower, or when he's by himself exploring his body. Remember, complete retraction can happen any time between 0 and 17 years old, 10 being the median age. Please read more about the foreskin retraction process here.

Ask your child to retract as far as he can without feeling discomfort, and let water wash over the exposed part of his glans. Then ask him to pull his foreskin back forward to the default covered position, and he's done.

Never ask your child to retract his foreskin further than is comfortable for him. Some children retract earlier and quicker than others, and in some children the process is slow. But don't worry; a child's foreskin usually becomes fully retractable with time. Never forcibly retract a child's foreskin, as this can result in serious, sometimes permanent injury. Please read more about the foreskin retraction process here.

A word of caution regarding bubble baths
Some, though not all children, may be sensitive to chemicals in soaps and bubble baths. Exposing the inner mucosa of the foreskin to soap or bubble bath in these children may cause the foreskin and surrounding areas to become inflamed. For this reason, it's not a good idea to allow your baby to soak in soapy water or bubble baths.

If you notice that your child's penis may be inflamed, discontinue the use of the bubble bath solution immediately, and/or do not allow your child to sit in soapy water. It could be that chemicals are interfering with the natural flora in the microbiome of your child's penis. Sometimes trying a different, mild soap is advised

Instead, allow your child to sit in warm, non-soapy water after washing and rinsing his body thoroughly.

Keep in mind that this advice is nothing special; it is the same advice given to parents of girls, where some soap products may cause inflammation in a baby girl's vulva, and in cases where a baby girl's genital become inflamed, discontinuing the use of bubble bath solution and/or changing soaps is advised. 

Related Posts:
My Doctor Says I Should Get Circumcised

Medical References:
1. "Care of the Uncircumcised Penis". Guide for parents. American Academy of Pediatrics. September 2007.

2. "Caring for an uncircumcised penis". Information for parents. Canadian Paediatric Society. July 2012.

3. Camille CJ, Kuo RL, Wiener JS. Caring for the uncircumcised penis: What parents (and you) need to know. Contemp Pediatr 2002;11:61.

4. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3.

5. American Academy of Pediatrics: Care of the uncircumcised penis, 2007

6. Royal Australasian College of Physicians. (2010) Circumcision of Infant Males.

Friday, March 31, 2017

Talking About It: Opening Up the Lines of Communication

In the last post, we talked about potential problems that could befall an intact male. The fact is that, even though problems are rare, they can and do occur. However intact males face an even bigger challenge; talking about it.

As it was discussed, because problems are rare, chances are you're not suffering any kind of problem, and what you are experiencing is normal. But, how are you supposed to know?

Especially if you're an American male, it doesn't help that information regarding the male reproductive organ in the USA is mostly geared towards circumcision. As the US has a for-profit medical system, doctors will most likely tell you that you have a condition called "foreskin," and it must be cured right away, and that conveniently they can be the ones to do it.

Believe it or not, even though the great majority of  men it the world are intact (something like over 70%), men in other parts of the world often stay silent about any problems they have or think they have too.


Talking about the penis in many cultures is a taboo subject!

Saying the word "penis" is a horrific thought in and of itself, let alone telling someone you think you might have a problem. We have special words like "down there," "plumbing" and "junk" to avoid having to call it what it is.

As a result, we have a situation where men are in the dark about their own bodies. They don't know what is "normal" or "abnormal." Even in countries where anatomically correct male organs are the norm, men and even their parents are simply unaware of the normal development of male organs.

So what to do?

Start Talking About It
First and foremost, we need to work on changing the society in which we live; it needs to become  normal and acceptable to talk about our bodies.

"Penis" isn't a bad word.

This applies everywhere, not just the US.

Perhaps it's because of Western Society's Judeo-Christian roots that men are ashamed to talk about their problems; if men are suffering, or think there might be something wrong with their reproductive organs, the tendency is for men to remain silent and try to pretend like everything is OK.

A man may not even be suffering a problem at all, but without any feedback from anyone, there is no way for him to be sure.

This generation needs to work on breaking this silence.

Fathers need to tell their sons it's OK for them to ask them any questions regarding their bodies.

Boys and men mustn't be ashamed to share their insecurities with someone they trust.

We must eliminate the stigma of talking about our genitals outside the context of comedy.

Particularly in the US, men need to become aware that in the medical community information regarding anatomically correct male organs is often lacking, and often misinformed if at all present.

Intact men need to educate themselves regarding their own bodies (the information is out there, you've just got to look, because American doctors will not give it to you), and pay it forward.

We need to tell other men that it is safe to talk about their problems with us.

If we have children, we need to tell them and let them know from a very young age that they can talk to us about anything, and mean it.

When fathers speak to their children about sex, they need to come straight out and say "This is how your penis works. If you can't pull your foreskin back, don't worry. This is normal for your age, and you shouldn't be worried."

Educating ourselves and helping educate others can help save us so much trouble.

If you think you have a problem, you shouldn't suffer in silence.

Information and links to medical literature will be available on this blog. We are working on bringing you a list of intact friendly doctors. We will post links to medical resources.

We have started a page on Facebook to coincide with this blog. If you have any questions, feel free to ask in the comments below, or visit our Facebook page here. Other intact and restoring men will be there for you to ask questions and/or give their feedback.

Related Posts:
Am I Circumcised or Intact?

My Doctor Says I Should Get Circumcised

Find Us on Facebook!Intact Male Facebook Page

Tuesday, February 28, 2017

My Doctor Says I Should Get Circumcised

CAUTION: This blog post contains medical images of penises suffering medical conditions. It is not for the squeamish.

Maybe you're an intact male who was born in America and were, up until this point, blissfully unaware that circumcision is deeply ingrained in North American culture, and having anatomically correct genitals carries social stigma. (Your blogger didn't know his penis was a "problem" until his junior year in high school.)

Maybe you're a European male visiting the United States for a job or study abroad, and you come from a country where having a foreskin is simply as plain as having lips, eyelids and a nose.

But now you're doctor is telling you you need to get circumcised.

You came in for a cough, but for whatever reason the doctor asked you to take off your pants because he wanted to see your dick. He takes one good look at your intact member and he says "Oh, you got it bad. We need to schedule you for a circumcision."

The question is, do you?

There are a few considerations that you need to get out of the way before you entertain this thought any further, particularly if you are an intact male living in North America.

In America, "Whole Penis" is a Medical Condition
America and Europe are different in many ways. One of the biggest differences between both continents is in the way we view circumcision and anatomically correct male genitals. Whereas circumcision, particularly the routine circumcision of infant males, is a common, culturally ingrained practice in the United States, it is rare or virtually not practiced in Europe, except among Jews and Muslims.

Perhaps due to Judeo-Christian roots, people in both continents share a taboo surrounding nakedness, so they are unaware of each others' practices. People in Europe often believe that circumcision is limited to religious groups, such as Judaism and Islam, and generally believe that their American counterparts hold male circumcision in the same regard. In great contrast, people in America believe anyone who's anyone is circumcised. It often comes as a shocking surprise to people in either country, when they find out the truth; Americans are surprised that the rest of the English-speaking world does not circumcise, and Europeans are horrified to find out that in America, male newborns are often circumcised.

You do WHAT?

It is no surprise, then, that American and European physicians hold different views when it comes to male genitals and circumcision. What they learn in medical school concerning male genital development is vastly different; while European physicians are taught to regard unaltered male genitals as nature made them as healthy and normal, American physicians are taught to look at the same genitals as aliens from another planet. While in Europe, physicians are taught to look at the foreskin as an intrinsic part of the male organ, akin to labia in female organs, in the United States, the physicians are taught to treat the presence of a foreskin as a superfluous growth, like some sort of cancer or tumor. Indeed, some hospitals will list the presence of a foreskin alongside other medical problems.

This picture was taken at an American hospital. Notice that being uncircumcised

is a "problem," along side hearing loss and poor growth and weight gain.

To Europeans, penises in American textbooks may appear strange, as they are depicted as circumcised, as if this is they the human penis appears in nature. To Americans, the pictures of penises in European textbooks appear to be "Ew, gross!" The foreskin, if mentioned at all in American textbooks, is often described as "that loose piece of flesh at the end of a penis, which is removed in circumcision." Whereas European textbooks present the penis as-is and moves on, American textbooks must describe various reasons why circumcision is performed, and why parents ought to make a "decision."

In short, when it comes to knowledge of basic male anatomy, Americans aren't getting the full package.

So intact males beware; unless a North American physician has actually taken the time to study how the natural male organ works, s/he will know little to nothing with how to deal with a man who's organs remain as nature gave them to him. Some physicians will see having a foreskin as a problem in and of itself. They see the foreskin as a tumor and will prescribe circumcision upon seeing it. The only thing they ever learned in medical school regarding the foreskin is that it must be removed.

Circumcision is Deeply Ingrained in North American Culture
It's a relatively new phenomenon that began only about a century ago, but male circumcision has become deeply ingrained in American culture. The phenomenon of male circumcision in America has evolved over the decades. It started as a way to prevent masturbation, because masturbation was thought to be the source of physical and mental disease. Then it turned into a status symbol, where being circumcised meant you were born into a family that could afford to go to the doctor, and not being circumcised meant you came from a poor family. Other associations were made with it too, including being "unhygienic" and "dirty."

In recent years, the rate of male infant circumcision has fallen from about 80 to 90% in the 1980's, to about 56%, according to the CDC, but the overall number of adult males circumcised from birth continues to be about 80%, so there is an overwhelming compulsion to continue to see male circumcision as "normal," and having intact genitals as foreign and alien, sometimes even as "dirty," "diseased" and/or "undesirable," so intact males need to be aware that in America, having intact genitals carries social stigma, and doctors may be trying to push their bias that all men need to be circumcised on them.

Religious Conviction to Circumcision
For some, the compulsion to stigmatize anatomically correct male genitals is religious in origin. Particularly for adherents of Judaism, circumcision, particularly male infant circumcision, is seen as divine commandment. Adherents of Islam often see male circumcision as a good Muslim virtue, although this is not a requirement (not all Muslims circumcise), and it is not mentioned once in the Quran. Some adherents of Christianity see male circumcision as desirable, as it was commanded to Abraham, although it is stated in the New Testament that circumcision profits the Christian nothing. (See Galatians 5) On the front, doctors who advocate for circumcision may state that they do so because of the so-called "medical benefits" it supposedly affords, but in actuality, they may be cloaking a religious conviction which disallows them from saying anything negative about circumcision, and only highlighting all the "benefits" of it.

Circumcision is a Moneymaker
Hey. Everybody has to make a living. We all need to eat somehow. Used car salesmen make their living selling used cars. Companies spend millions of dollars on infomercial campaigns trying to convince you that you absolutely need to buy their product. In America's for-profit medical system, doctors may try to convince you that you absolutely need the service they offer, the drug they push, the surgery they specialize in. In America, some doctors make their sole living on convincing males, and/or their parents, that they need circumcision. In a culture that's already geared toward having a circumcised penis, some men, having endured the social stigma of having intact genitals, happily oblige.

"It is difficult to get a man to understand something, when his salary depends upon his not understanding it." ~Upton Sinclair

So the first thing to consider when a doctor tells you you need to be circumcised is, "Is my doctor biased?"

Is your doctor actually fully educated as to how the intact penis works?

Does he himself have a personal bias in favor of circumcision?

Does s/he have a religious conviction in favor of circumcision?

Does your doctor make a great part of his living by prescribing circumcision and isn't actually interested in solving your problem?

If you're in North America, chances are he or she is, and it would be wise of you to seek a second opinion.

Standard medicine dictates that surgery should be used as a last resort, and only where alternative, less invasive methods of treatment have failed.

If your doctor hasn't even bothered trying to treat your problem in other ways before resorting to surgery, this should be a good indicator that you probably need to see another doctor.

It is best to seek a doctor that you know for sure is interested in preserving your body, taking care of your problem conservatively, and isn't trying to push his or her bias that all men should be circumcised on you. Such doctors will be known as "foreskin friendly," or "intact friendly" doctors hereafter. In the future, we will compile a list of doctors who have their knowledge of anatomically correct male genitals up-to-date.

Intact Male's View of Surgical Treatment
The goal of this website is to promote anatomically correct male genitals, to spread awareness, and to help intact males realize there's nothing wrong with having organs as nature meant them to be, and to build confidence. However, this is not to say that problems don't occur, and that corrective surgery is never necessary. We want to promote having intact genitals, but we also acknowledge that there may be cases where surgery may be inevitable.

One of the greatest goals of this website is to spread education and awareness about anatomically correct male genitals, and this includes problems that could occur with them, and what methods of treatment are available, including, when needs be, surgery.

The view of this website is that although surgery is a valid method of treatment when there is medical indication, it should be treated as a very last resort when all other methods of treatment have failed, or when a male individual is able to weigh the pros and cons and make an informed decision. Some males may decide that surgery is the best treatment for them, and may want to forgo alternative treatment, and that's OK too, so long as they are fully informed, and they're the ones making that decision.

How do I know I actually need surgery?
Let's begin to address this question by stating some facts.

First and foremost, attention must be brought to the fact that empirical evidence shows that problems of anatomically correct male genitals which require surgical correction are extremely rare.

According to the current medical literature, only about 1% of intact males, if not less, ever develop problems that require surgical treatment.

The fact is that about 70% of males are not circumcised globally, and there is simply no epidemic of "problems," no mob of men banging down the door at urologists' offices demanding to be circumcised.

In the United States, doctors may use any and every alibi as a reason to circumcise, including the mere presence of the foreskin itself.

Intact males need to be aware that medical indication for circumcision is already quite rare, and that if a doctor is calling for him to be circumcised, without any medical indication, without any tests, without trying other methods of treatment first, this should raise a red flag.

Let's Begin By Talking About What is "Normal"
Part of the problem here is that the foreskin has been absent from the American psyche for so long that a lot of people don't actually know what is "normal," because we've been conditioned to think that being circumcised should be "normal" by default, and that there is a problem otherwise.

In an intact male, the foreskin usually covers the head of the penis when it is flaccid, bunching up at an area called the acropostheon.

The part of the foreskin that bunches up and hangs over the glans (head of the penis), is called the "acropostheon," colloquially known as the "overhang." Some people think this part of the penis is so important so as to warrant special attention, so much that they created a website dedicated to it. You can visit the website here.

The foreskin does not always cover the glans completely, however. Some foreskins are shorter than others.

In some penises, the head of the penis protrudes from the acropostheon. How much the foreskin covers the glans varies from penis to penis. The degree to how much the head of the penis is covered is called "coverage" in some circles.

How much "coverage" do you have? A "Foreskin Coverage Index" has been created, showing the different degrees of "coverage" that men may have. Visit the website here.

In most penises, the foreskin retracts to reveal the glans when the penis is erect.

Some may need a little "help," however...

So now that we've established a benchmark of "normality" for intact guys, let's talk about problems that may warrant surgical intervention.

By far, the most common "problem" in intact males is the inability to retract the foreskin to reveal the glans, often called "phimosis." It is said that about 10% of men will develop problems retracting their foreskin, and about 1% may actually need surgical treatment. The word "phimosis" originates from the Greek word phimos (φῑμός) which means "muzzle".  Today, "phimosis" is a vague blanket term that refers to any condition where a male can't retract his foreskin, but it actually refers to a specific medical condition. Oftentimes, what doctors call "phimosis" may not even be a problem at all.

Writing off a male with a non-retractile foreskin as having "phimosis" is problematic for many reasons. For one, it refers to an actual medical condition caused by a pathological condition, which we'll get into shortly. For another, a non-retractile foreskin is actually a normal stage of development in an intact male's life. A male may be too young to be said to be having any kind of "problem," and even when a male's foreskin can't retract, it doesn't necessarily mean he has a medical problem.

In order to understand when the inability to retract the foreskin is a problem, I think its necessary that we understand what the normal stages of development are for males with anatomically correct genitals. Sadly, this is information that American doctors don't learn, and even in European countries, isn't talked about. In this post, we will talk about the normal stages of development for intact males, what phimosis is, what it isn't, when there may actually be a problem that requires medical attention,  how doctors should be assessing the problem, and when doctors should be offering patients surgical treatment. I have included references to medical literature that readers can use to confirm the information I present here.

What are the normal stages of development?
At Birth 
Typically, when a baby boy is born, the foreskin is long with a narrow tip.(1)(2) Retraction is not possible in the majority of infants because the narrow tip will not pass over the glans penis.

Moreover, it is normal for the inner mucosal surface of the prepuce to be fused with the underlying mucosal surface of the glans, or head of the penis,(1)(2)(4)(5) by means of a membrane called synechia, also known as the balano-preputial membrane or balano-preputial lamina,(1) further preventing retraction. This attachment forms early in fetal development and provides a protective cocoon for the delicate developing glans.(6) It is normal for the foreskin to be non-retractable in infancy and early childhood.(6)

Retraction of the Foreskin 
In normal development, the foreskin usually separates from the glans and becomes retractable with age.(4) As the infant matures into a boy and the boy into a man, the tip of the prepuce becomes wider, and the shaft of the penis grows, making the tip of the prepuce appear shorter. The membrane that bonds the inner surface of the prepuce with the glans penis spontaneously disintegrates and releases the prepuce to separate from the glans. The prepuce spontaneously becomes retractable.

In order for retraction to occur, the foreskin must have separated from the glans and the opening of the foreskin must have widened to allow it to slip back over the glans. Throughout childhood and adolescence, there is a release of hormones. As hormone levels rise, the fiber-dense tissue of the prepuce is replaced with a more elastic tissue. A boy will begin to explore his genitals as he grows, and as time passes, the elastic tissue will allow the opening of the foreskin to widen. This can happen at any age but it is not common in young boys. 

The amount of time it takes for a boy's foreskin to become fully retractable varies from boy to boy; this process can take many years for some boys, and yet minutes for others. In some boys, the foreskin may not be retractable until after puberty.(7)(8)(9) This is an entirely normal stage of development and should not be diagnosed as any kind of "problem." 

When Does Retraction Happen?
According to the experience of doctors and researchers in cultures where circumcision is uncommon, retraction happens at varying ages, and a non-retractable foreskin rarely requires treatment. Observations from doctors in Denmark, and Japan and other countries indicate that spontaneous loosening usually occurs with increasing maturity.(7)(8)(9)(10)(11)(12) 

Non-retractability is considered normal for males up to and including adolescence. The process whereby the foreskin and glans gradually separate may not be complete until the age of 17.(4) A Danish survey (2005) reported that average age of first foreskin retraction is 10.4 years.(13) Marques et al (2005) reported that 99% of boys can retract their foreskins by age 14.(12)(14)(15)(16) One may expect 50% of 10-year-old boys; 90% of 16-year-old boys; and 98-99% of 18 year-old males to have a fully retractable foreskin. Treatment is seldom necessary. 

A 1999 study by Cold and Taylor shows that at 6 to 7 years, approximately 60% of the boys had natural adhesions. At 10-11 years, close to 50% of the boys still had adhesions. At 14-15, approximately only 10% of the boys had adhesions. As they approach the age of 17, only a very small percentage of boys will have adhesions. That means that, left uncircumcised, most boys will be able to retract their foreskin before they are 17 years old. 

Foreskin Retraction as Observed in Children in Other Countries 

Jakob Øster, a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in Denmark, where circumcision is rare.(7) Øster (1968) found that the incidence of fusion of the foreskin with the glans penis steadily declines with increasing age and foreskin retractability increases with age.(7) 

Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5, and they also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42% of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9% in boys aged 11-15.(8) Imamura (1997) reported that 77% of boys aged 11-15 had a retractile foreskin. 

Thorvaldsen and Meyhoff (2005) conducted a survey of 4000 young men in Denmark. They report that the mean age of first foreskin retraction is 10.4 years in Denmark.(13) Non-retractile foreskin is the more common condition until about 10-11 years of age. 

Current medical literature indicates that the foreskin is non-retractable in the majority of males until they begin to approach puberty. Until a boy begins to reach sexual maturity, non-retractability of the foreskin is a normal part of growing up.

Readers, are you catching this?

If a male is under 17, having a foreskin that does not retract is not a "problem," and perfectly normal, and he is still too young to be diagnosed with "phimosis." 

So when is "phimosis" a problem?
Given the empirical facts stated above, it is already mistaken to assume that just because the foreskin cannot be retracted to reveal the head of the penis, a male has some sort of pathological condition. As evidenced by the facts given above, the great majority of male children who have anatomically correct genitals will have foreskins that cannot be retracted, and it is a mistake to assume that all children undergo this transitory "illness" where they can't retract their foreskins, akin to the mumps, measles or chicken pox. Girls do not begin to menstruate until the onset of puberty, and they are not considered to be suffering any sort of medical condition until then.

Preputial Stenosis
Non-retractability of the foreskin may pose a problem if it continues well past puberty, but unless it meets certain criteria, it still can't be considered a medical problem that needs surgery.

Typically the foreskin has dilated to allow retraction as a result of the release of hormones. In a small percentage of males, the production of these hormones is insufficient, and the foreskin fails to dilate, resulting in a condition known as "preputial stenosis," or, a narrow foreskin. This is a physiological problem and can't technically be called "phimosis." This condition may make hygiene and sexual intercourse difficult, if not impossible, but not always. In older men that have bad hygiene habits and who smoke regularly, having a non-retractile foreskin can increase the chances of developing penile cancer.

In some males, the end of the foreskin may fail to dilate, resulting in a
narrow foreskin opening that makes foreskin retraction difficult or impossible.
This condition is often diagnosed as "phimosis," but unless the presence of
certain pathogens is not detected, it isn't "true" phimosis as we will describe below.

Having a narrow foreskin that does not retract (preputial stenosis) is not necessarily a problem. Some men go their entire lives without ever seeing the head of their penis; it does not hurt them to masturbate, and sexual intercourse is not a problem. Some men may see help in becoming able to retract, but some do not, and unless this is causing them pain or problems with intercourse, it's not an actual problem that necessarily needs remedy.

How do you treat "preputial stenosis?"
Assuming that a male who has a narrow foreskin actually wants to be able to retract his foreskin like most males, a doctor could provide stretching exercises that will remedy the problem. It depends on the extremity of the narrowness of the foreskin; there are different degrees. Some men may choose to take the time to stretch their foreskins, some men may choose to simply get it over with and get circumcised. In most cases, stretching should work.

It must be remembered that a narrow foreskin, is not necessarily a problem if the male is not experiencing pain or discomfort during sex. A male with a narrow foreskin may feel he is fine just the way he is and it's not a problem.

If you are reading this, you think you might have preputial stenosis and you're interested in stretching out your narrow foreskin, visit My Phimosis Journey, a very informative blog about a man who chose to go through with stretching out his narrow foreskin over getting circumcised.

"True Phimosis"
There is another reason why the foreskin may not be retractable in a male, and that is because he has suffered an infection with balanitis xerotica obliterans, or BXO for short. In this case, the tip of the foreskin has become scarred and indurated, and has the histological features of a pathological infection. The foreskin of a male who has suffered an infection with BXO will have developed a fibrotic ring, which makes retraction difficult or impossible. It is this pathologically induced non-retractability which can be correctly termed "phimosis."

To differentiate between the normal stages of development, and even the physiological state of a foreskin which has failed to dilate as a result of lack of hormones, from pathologically-caused non-retractability, doctors have invented the term "true phimosis." It is this non-retractability caused by pathological infection with BXO that can actually be considered "phimosis" and an actual problem. 

 In "true phimosis," the end of the foreskin has resulted in a fibrotic ring caused
by an infection with balanitis xerotica obliterans, otherwise known as BXO.

Can "phimosis" be cured? How Do I Know I Need Surgery?
It is estimated that 2% of males go their entire lives without their foreskins ever becoming retractable. How this condition can be treated will depend on what the actual problem is. The physiological condition where a foreskin has failed to dilate as the result of a lack of hormones, otherwise known as "preputial stenosis," tends to respond to steroid cream therapy, coupled with stretching exercises and/or stretching devices. As mentioned earlier, if a narrow foreskin isn't necessarily causing pain or problems with sexual intercourse, a man may decide to stay the way he is.

Non-retractability as a result of a BXO infection, however is different, as this is caused by a resulting fibrotic ring at the end of the foreskin, which is scarification that may or may not respond to steroid cream treatment or stretching exercises. It is non-retractability caused by BXO infection that can be genuinely considered a problem which may call for corrective surgery.

It should be noted that non-retractability of the foreskin as a result of BXO infection occurs in less than 1% of males. Additionally, it should be noted that even when a case of "true phimosis" may require surgical correction, it does not always entail a complete removal of the prepuce. There are procedures that can correct phimosis which can preserve the foreskin and its functions. Surgical methods range from the complete removal of the foreskin (circumcision) to more minor operations to relieve foreskin tightness, such as a "dorsal slit" (AKA "superincision") a "ventral slit" (AKA "subterincision") and "preputioplasty."

If treatment should be necessary, it should not be done until after puberty and the male can weigh the therapeutic options and give informed consent.(9)

How should a genuine case of phimosis be diagnosed?
In order to correctly determine that there is a real problem occurring in a male, a learned doctor will begin by ruling a few things out.

  • If, for example, a child hasn't reached puberty yet, and because non-retractability is common for this age group, the doctor should consider that the child may be experiencing normal stages of development.
  • If, for example, a child hasn't reached puberty yet, but he was able retract his foreskin previously, it may be probable that the child may have experienced an infection with BXO.
  • If, for example, an adult male who has already gone through puberty still has a non-retractile foreskin, the doctor needs to determine if this is a physiological problem caused by a lack of hormones (preputial stenosis), or if it is a pathological problem as a result of infection with BXO (AKA "true phimosis").

Because non-retractibility of the foreskin can be both a normal stage of development, and a pathological problem, it can be very easy for doctors to make an inadvertent, or even deliberate misdiagnosis. Particularly in countries like the United States, where circumcision is a perceived norm, and doctors may not be educated in the differences between normal stages of development and phimosis as a pathological condition, it can be very easy for doctors to say that a child or adult male is suffering a condition that may require surgical correction, where in fact, there is actually none. 

For a correct diagnosis, a doctor who is knowledgeable about the difference between normal stages of development and non-retractability caused by BXO infection will correctly have the male analyzed for signs of lesions of BXO. Then, and only then, can a doctor properly make the diagnosis that a male is suffering a medical problem, and that the person may need surgery to correct the problem.

Because non-retractability in adult males is rare, and "true phimosis" (pathologically induced non-retractability) even more rare, there is a high probability that a diagnosis for "phimosis" may actually be false, especially in younger males, where non-retractability of the foreskin is a part of normal development.

Readers Beware: The Doctor May Have Actually GIVEN You Your Problems
Problems with the retraction of the foreskin may either be the result of a lack of hormones, the result of an infection with BXO, or, they could be iatrogenically induced. (E.g. actually caused by the doctor himself.)

It has been widely recognized by the medical profession for most of the 20th century that normal male infants have foreskins which are incompletely separated from the epithelium of the glans.(17) The foreskin cannot be retracted without tearing the fusion and adhesions which are commonly present between the inner foreskin and the glans penis in normal stages of development.

In English-language medicine, there is an absence of proper knowledge of the foreskin and its development in the medical curriculum. According to McGregor et al (2005), physicians often have difficulties distinguishing between this normal, natural state of the penis in neonates and pre-pubecent boys and pathological phimosis caused by BXO.(17)(18) Spilsbury et al (2003) suggest that doctors may be likely to confuse the aforementioned conditions with pathological phimosis.(19) In America, doctors may be predisposed to seeing the presence of a foreskin as inherently problematic.

Unaware of the harmless nature of the normal, natural state of the penis in neonates, and the presence of adhesions in infants and pre-pubecent boys, and unaware that this can be damaging, doctors have been known to forcibly attempt to retract the foreskin in healthy, developing children, just to see if it retracts, tearing natural adhesions and/or ripping the foreskin in the process. Furthermore, they have been known to erroneously instruct parents that a child's foreskin needs to be retracted in order to "clean under it," arguing that they will develop infections otherwise.(20) (!!!)

Premature, forcible retraction of the foreskin is an extremely painful, serious, and potentially permanent injury(17). It can damage the glans and mucous inner tissue of the foreskin. Forcibly retracting a child could result in iatrogenically induced phimosis, where the raw, open wounds of ripped adhesions could heal and fuse together, or where a forcibly dilated foreskin could develop scarification, resulting in a fibrotic ring similar to the one caused by BXO infection. Additionally, this can result in a complication known as "paraphimosis," where the narrow foreskin strangles the penis trapped behind an enlarged glans, thereby necessitating surgical intervention.

 Adhesions such as this one occur whenever raw wounds heal together.
This happens in circumcised males when the raw circumcision wound
adheres to the glans, or in intact males where raw wounds caused by forcible
retraction heal together and become fused. Surgery is needed to cut these loose.

Paraphimosis happens when the foreskin gets trapped behind the glans
as a result of forced retraction. Forcibly trying to retract the foreskin in a
child or young man whose foreskin fully retracted can result in injury.
For this reason, all respected medical organizations recommend that the
foreskin not be forcibly retracted in children and youths, not even for "cleaning."

It must be noted here that these problems rarely present themselves in countries where circumcision is rare or not practiced. There is simply no epidemic of foreskin problems in countries where male children aren't circumcised. These problems tend to suspiciously present themselves in countries where circumcision is common, and diagnosed by doctors who happen to specialize in child circumcision. Children may have been circumcised to correct "problems" that either never existed, or whom were given their problems by ignorant doctors to begin with.

It is harmful and misleading to tell parents that a child's foreskin must be forcibly retracted. In children whose foreskins are still adhered to the glans, or where the foreskin has not dilated to allow the glans, this can be a harrowing experience. Forcibly retracting a child's foreskin "to clean under it" is the equivalent of cleaning out a girl's vagina with a pipe cleaner. Surely, a doctor who would instruct parents to clean out their child's vagina would be dismissed as a lunatic. Medical associations advise not to forcibly retract the foreskin of an infant, as this interferes with normal penile development, and may result in scarring or injury.(21)(22).

Camille et al (2002), in their guidance for parents, state that "[t]he foreskin should never be forcibly retracted, as this can cause pain and bleeding and may result in scarring and trouble with natural retraction."(23)

Simpson & Barraclough (1998) state that "[n]o attempt should be made to retract a foreskin in a child unless significant separation of the subpreputial adhesions has occurred. Failure to observe this basic rule may result in tearing with subsequent fibrosis and consequent [iatrogenically induced] phimosis. ..."(24)

The American Academy of Pediatrics cautions parents not to retract their son's foreskin, but suggest that once he reaches puberty, he should retract and gently wash with soap and water.(25) The Royal Australasian College of Physician as well as the Canadian Paediatric Society emphasize that the infant foreskin should be left alone and requires no special care.(26)

Summary on Phimosis
The facts, which are well-documented in medical literature, speak for themselves.

A foreskin that is adhered to the glans and/or will not retract is a normal stage of development in all healthy male children in infancy. The belief that a foreskin that is "tight" and will not retract is a problem in male infants implies that all human male children are born with some kind of birth defect, congenital deformity or genetic anomaly akin to a 6th finger or a cleft.

In the great majority of males, the foreskin separates from the glans and becomes retractable as they approach puberty, without the aid of medical or surgical intervention.

A foreskin that will not retract in older males is rare, and may or may not be a pathological problem. In order to determine the cause of a non-retractile foreskin, a knowledgeable doctor who understands anatomically correct male genitals, the normal stages of development of healthy males, and true pathological problems of male genitalia, must run the correct analyses in order to detect the presence or absence of pathological lesions; then, and only then, can the doctor determine whether there is an actual problem, and whether or not it can be remedied with conventional medicine or by means of surgical correction.

A narrow foreskin is not necessarily a case of "phimosis," but instead a condition known as "preputial stenosis." A narrow foreskin that will not retract is in itself not a problem, if the male is comfortable with himself and his condition does not cause him pain or difficulty with masturbation or sexual intercourse. A narrow foreskin that is not the result of a pathological condition responds well to stretching exercises, and if it is a problem, can be alleviated without surgery.

Even when a genuine case of phimosis that necessitates surgical intervention presents itself, circumcision, or the full excision of the foreskin is not always called for; there are surgical interventions which will correct phimosis while preserving the foreskin and its functions.

Intervention to hasten the retraction of the foreskin in otherwise healthy, prepubescent males may actually cause iatrogenically induced problems. The forced retraction of the foreskin may itself cause non-retractability. Forcibly dilating the foreskin causes scar tissue to form, which may result in a fibrotic ring at the end of the foreskin. Breaking the natural adhesions which occur between the glans and the foreskin during normal stages of development may cause new adhesions to form between the glans and the foreskin, becoming fused as the raw wounds of the broken adhesions heal together. Forcibly pulling back naturally narrow foreskin over the glans in otherwise healthy children may result in paraphimosis, where the narrow foreskin catches behind the glans, preventing the foreskin from returning to its neutral position covering the glans, ironically necessitating the need for surgical intervention.

It is a shame that there is a gap in medical knowledge between the United States and other English-speaking countries. The information presented here is well-documented knowledge that all doctors need to know. This is the information that a doctor needs to be giving to parents of a male child. Anything other than this is misinformation or an outright lie.

American medical curricula is either omitting information, teaching outdated information, if not outright teaching misinformation. Efforts need to be made to bring English-language curriculum on the foreskin, the natural stages of development and genital pathology up to date. Doctors need to educate themselves and stop dispensing erroneous and dangerous advice to parents. They need to learn to differentiate between the normal stages of development in human males, and actual pathological phimosis.

Doctors who diagnose "phimosis" in a perfectly healthy male  are either uneducated when it comes to the foreskin and natural stages of development, or may in fact be committing medical fraud, deliberately inventing a misdiagnosis in order to justify surgery in a healthy, non-consenting minor, and/or collecting medicaid funds intended for actually medically necessary surgery.

Until American medicine undergoes this long-needed overhaul, long-term visitors to the United States ought to be warned that doctors in America are often inadvertently, or quite deliberately misinformed about anatomically correct male genital anatomy, and that visiting American-trained doctor could be hazardous to their health.

The information presented on this blog should not be taken as medical advice. A male who is suffering a problem, or believes he may be suffering a problem should seek the counsel of a foreskin-friendly doctor. Intact males should beware of the bias and predisposition that American doctors have against the foreskin, and in favor of male circumcision, and should seek a second opinion if the doctor is pushing him to get circumcised.

1. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7.

2. Spence J. On Circumcision. Lancet 1964;2:902.

3. Deibert GA. The separation of the prepuce in the human penis. Anat Rec 1933;57:387-399.

4.  Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3.

5. Catzel P. The normal foreskin in the young child. (letter) S Afr Mediense Tysskrif [South Afr Med J] 1982 (13 November 1982) 62:751.

6. Wright J.E. (February 1994). "Further to 'the further fate of the foreskin'". The Medical Journal of Australia 160 (3): 134–5. PMID 8295581.

7. Øster J. Further fate of the foreskin: Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child (published by the British Medical Association), April 1968. p. 200-202.

8. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. Journal of Urology, 1996 Nov, V156 N5:1813-1815.

9. Warren JP: NORM UK and the Medical Case against Circumcision. In: Sexual Mutilations: A Human Tragedy; Proceedings of the 4th Intl Symposium on Sexual Mutilations , Denniston GC and Milos MF, Eds. New York, Plenum, 1997) (ISBN 0-306-45589-7)

10. Celsus. De medicina, vol 3. Harvard University Press, Cambridge, p 422

11. Celsus. De medicina, 6.18.2. In: Spencer WG (ed and trans) (1938) Celsus. De medicina, vol 2. Harvard University Press, Cambridge, p 269

12. Hodges FM. Phimosis in antiquity. World J Urol 1999;17(3):133-6.

13. Thorvaldsen MA, Meyhoff H.. Patologisk eller fysiologisk fimose?. Ugeskr Læger. 2005;167(16):1852-62.

14. Marques TC, Sampaio FJ, Favorito LA (2005). "Treatment of phimosis with topical steroids and foreskin anatomy". Int Braz J Urol 31 (4): 370–4; discussion 374. doi:10.1590/S1677-55382005000400012. PMID 16137407.

15. Denniston; Hill (October 2010). "Gairdner was wrong". Can Fam Physician 56 (10): 986–987. PMID 20944034. PMC 2954072. Retrieved 2014-04-05.

16. Huntley JS, Bourne MC, Munro FD, Wilson-Storey D (September 2003). "Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons". J R Soc Med 96 (9): 449–451. doi:10.1258/jrsm.96.9.449. PMID 12949201. PMC 539600.

17. McGregor TB, Pike JG, Leonard MP (April 2005). "Phimosis—a diagnostic dilemma?". Can J Urol 12 (2): 2598–602. PMID 15877942.

18. Metcalfe PD, Elyas R. Foreskin management. Survey of Canadian pediatric urologists. Can Fam Physician 2010;56:e290-5.

19. Spilsbury K, Semmens JB, Wisniewski ZS, Holman CD (February 2003). "Circumcision for phimosis and other medical indications in Western Australian boys". Med. J. Aust. 178 (4): 155–8. PMID 12580740.

20. Osborn LM, Metcalf TJ, Mariani EM. Hygienic care in uncircumcised infants. Pediatrics 1981;67:365-7.

21. "Care of the Uncircumcised Penis". Guide for parents. American Academy of Pediatrics. September 2007.

22. "Caring for an uncircumcised penis". Information for parents. Canadian Paediatric Society. July 2012.

23. Camille CJ, Kuo RL, Wiener JS. Caring for the uncircumcised penis: What parents (and you) need to know. Contemp Pediatr 2002;11:61.

24. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3.

25. American Academy of Pediatrics: Care of the uncircumcised penis, 2007

26. Royal Australasian College of Physicians. (2010) Circumcision of Infant Males.

Tuesday, February 7, 2017

My Girlfriend Wants Me to Get Circumcised

Ever been nagged by a sexual partner about having anatomically correct genitals?

If you live in a country where male circumcision is the norm, chances are you have.

Not too long ago, One Direction's Harry Styles dumped American singer Taylor Swift, because she kept nagging about his intact genital status.

Whereas circumcision is a cultural norm in the United States, it's basically unheard of in the UK, where Harry Styles is from, and pretty much the rest of Europe.

How do you respond to that?

What are you supposed to say to a woman who wishes your genitals were modified to fit her tastes?

Circumcision Fetish
Merriam-Webster Dictionary defines the word "fetish" as follows:
an object or bodily part whose real or fantasied presence is psychologically necessary for sexual gratification and that is an object of fixation to the extent that it may interfere with complete sexual expression

If a person is so fixated with something that it is necessary for sexual gratification, and the absence of that something interferes with complete sexual expression, that crosses over into the fetish realm.

The word acrotomophilia, which describes a paraphilia where an individual expresses strong sexual interest in someone who has had a part of his body cut off, comes to mind.

I dare say that America has become a nation of acrotomophiliacs, where people have become so fixated with circumcision, that a male partner not being circumcised is a problem.

So what's an intact male to do if he encounters a man or woman who has a sexual fixation with a circumcised penis?

Sexist Double-Standard
Before going on, I'd like to bring attention to one of the greatest sexist double-standards in America today.

In this country, girls are taught to demand respect for their bodies, and that men should not view them as just another piece of meat,

On the other hand, boys are taught that they have to sacrifice themselves to appease a girl.

Women are not to be objectified. Women's rights activists decry the notion that beauty can only be found on the cover of a fashion magazine. They fight to send girls the message that they don't have to fit themselves into the mold of a Barbie doll to appease others.

Yet, at the same time, more than half of all US born males are taught from birth that their bodies are not their own, and that they must sacrifice it for social conformity.

When parents are asked why they want to circumcise their sons, their reasons are often social conformity, and the appeasement of some hypothetical female partner.

"I don't want him to be made fun of in the locker room," goes one quip.

"I think it's more attractive, and I don't want any hypothetical girlfriends to be grossed out," goes another.

Self-respect and empowerment for one sex, conformity and subjection for the other.

How would a man be viewed if he was constantly poking fun at a part of a woman's body he wasn't satisfied with, and kept nagging on her to get cosmetic surgery to satisfy his aesthetic tastes?

What would we think of a man who kept telling his female partner that she's got no boobs and that he'd like at least a C-cup?

Maybe he thinks his partner's nose is too big, and she needs to get a rhinoplasty.

What if he kept nagging her to get a labiaplasty because he thinks her labia are "Ew, gross?"

Intact Guys Need to Develop a Positive Self-Image
It can be tough being an intact guy in a predominantly cut world.

The American media is constantly sending the message that being intact is disgusting and undesirable.

American sit-coms like Seinfeld and Sex In The City send the message to viewers that they ought to have their children circumcised, and that women find, or should find, intact men sexually undesirable, and that said men ought to go get circumcised to appease said women.

The fact is that the great majority of the male population is intact globally.

Something like 70% of the men in the world have genitals as nature gave them.

When our European counterparts view American TV shows and they see us trying to make fun of circumcision, they wonder what's supposed to be so funny.

Intact guys need to become educated regarding their own bodies, and to learn to love themselves as they are.

When women go get surgery to enlarge their breasts, get plastic surgery or undergo labia reduction surgery (AKA "designer vaginas"), some health professionals argue that their decisions originate from an unhealthy self-image induced by their comparison of themselves to the women they see on television and/or pornography.

Similar concerns don't seem to exist for men who are trying to conform to the images they see on TV or pornography though.

While there's this struggle to try to convince women to love themselves "as they are," men are encouraged to go get circumcised to appease the ongoing circumcision fetish.

Intact men, we must ask ourselves, why the sexist double-standard?

Show Him/Her The Door
So how do you deal with a man or woman who balks at your anatomically correct manhood?

The best thing you can do is to simply have some self-respect and show that person the door, because a man or woman who doesn't love you for who you are, as you are, isn't worth it.

Just as a woman shouldn't be expected to sacrifice her body to appease a man, the same should be true for males; a man shouldn't have to mutilate himself to gain the favor of any woman.

She either loves a man for who he is, or she does not.

Such women are shallow and aren't actually interested in you; a plastic doll or dildo could do a better job.

Find someone who doesn't have a fetish for mutilated penises and who will love you as you are.

Saturday, January 28, 2017

Am I Circumcised or Intact?

This should be a no-brainer, but the fact is that some men don't actually know whether they have anatomically correct genitals or not.

Because the nature of the subject is taboo, male genitals, let alone the topic of circumcision, are rarely openly talked about.

As a consequence, some men go for much of their lives not knowing the status of their genitals with certainty.

Some parents have their children circumcised and hope that the question never comes up. Others keep their children intact but still don't bother to tell them important information about the facts of life, information about sexuality and how their anatomy functions, what kind of country they live in, what prejudice they might encounter, etc.

Men go about their lives not knowing, not giving too much thought to the status of their genitals, until one day, it catches the men they become by surprise.

Perhaps they have a sexual encounter with a partner who comments on the presence or absence of a foreskin.

I've seen cases where guys were so sure they were intact until they asked their parents, and their parents told them, much to their disappointment, that they were circumcised at birth.

Strangely enough, some women don't know how to correctly identify their partner's penises either. While they've heard of circumcision, they couldn't tell whether a penis was or wasn't.

That's where blogs like these come in to shine some light on the subject.

Anatomically Correct Genitals
All boys are born with a fold of flesh that covers the head of their penis called a "foreskin."

In early childhood years, this is usually fused together with the glans, or head of the penis, until a child nears puberty, and the foreskin becomes retractable.

Extensive research conducted in Denmark, Japan, and other countries shows that the foreskin retracts at different ages, ranging from infancy, to about the age of 17, the median age for foreskin retraction being about 10 years of age.

In most intact males, the foreskin covers the glans, or head of the penis, when the penis is in its soft, flaccid state. As the penis becomes erect, or "hard" during arousal, the foreskin tends to retract, thereby revealing the head of the penis.

Of course, some men have longer or shorter foreskins than others. In some men, the foreskin is so long that it covers the glans, even in an aroused state, and some so short that the glans protrudes from the foreskin, even in an unaroused state.

Most men can glide their foreskins back and forth, covering and uncovering the glans, or head of the penis.

Circumcised Genitals
Circumcision is the surgical removal of the fold of flesh that covers the glans, or head of the penis.

In most circumcised males, the foreskin has been completely removed, permanently exposing the glans, such that the glans is always exposed and visible, even when the penis is in a hanging, flaccid, unaroused state.

Side-by-side comparison of intact and circumcised penises, flaccid

 In most intact men, the head of the penis is covered in a flaccid, unaroused state.
In most circumcised men, the head of the penis is permanently exposed, even when flaccid.

A flaccid, intact penis with its foreskin retracted.
Some intact men can retract their foreskin in a flaccid state.
Not all intact men are able to do this, however.

Side-by-side comparison of intact and circumcised penises, erect

Erect intact and circumcised penises for comparison.
 Note the head of the penis is moist, shiny and glistening.
In comparison, the head of the circumcised penis is dull and faded.

Permanent exposure and keratinization
Because the glans is permanently exposed, the normally moist mucosal membranes on the glans and inner mucosa of the foreskin become dried out. Without the protection of the foreskin, the surface of the glans builds layers of dead skin cells in a process called "keratinization," giving it a dry, faded, leathery appearance.

 A side-by-side comparison of the glans in intact and circumcised penises.

In contrast, the mucosal tissue of the glans and surrounding areas in an intact male are usually shiny and glistening with moisture.

Personal lubrication
One of the most notable differences between circumcised and intact males is that circumcised males must often employ the use of artificial lubricants to enjoy masturbation and/or sexual intercourse.

When masturbating, some circumcised men may choose to "go dry," using whatever loose skin they have left.

Some men, however, have had so much skin removed that this quickly grows uncomfortable, and in some cases, men cause themselves to bleed if they continue without the aid of lubrication.

The history of the origins of male circumcision in the Western world attests to the fact that making masturbation difficult was precisely the intended purpose of circumcising males.

Because the mucosal surfaces of the glans and inside of the foreskin are usually always moist, most intact males don't need lubrication to masturbate or have sex; their own natural lubrication is enough.

The moist inner mucosa of the foreskin glides back and forth over the moist, slippery surface of the glans without much effort.

So am I circumcised or intact?
I feel sad for you if you're reading this, and you still don't know the answer to this question with certainty. Your parents should have told you what they allowed to happen to you in infancy. It's sad when guys have to crawl in the dark looking for answers concerning their own genitals.

If you're too ashamed to ask your parents, or if you simply don't want to, the descriptions and pictures on this blog might help.

If the head of your penis is covered when flaccid, chances are you have intact genitals. I say this because there are varying degrees of circumcision; some men were cut "tighter," some "looser" than others. Some men had so little foreskin removed that they could pass for "intact," even though hospital records show they were circumcised at birth.

Yet others had so much skin removed that it actually hurts to have an erection. In some cases, so much skin was removed, that hairy skin rides up their shaft, making it look as if hair grows along the shaft of their penises.

 Hair on the shaft like this is not normal. Were this man intact, he would
be able to pull this hairy skin back. Now, it's stuck where it is, just behind the glans.
Men with hair growing on their shafts have no choice but to shave or pluck, because
the hair could irritate their partner's genitals, or it could get in the way of oral sex.

If the head of your penis is permanently exposed, chances are you were circumcised at birth; I say this because some men actually have foreskins so short they could pass for being "circumcised."

In fact, being born without a foreskin is a congenital deformity known in medical literature as "aposthia."

A telltale sign of circumcision to look for is a ring-like scar around the shaft of your penis. If you can see this, there is no doubt.

 The circumcision scar is the dark ring of skin about an inch below the corona of the glans.

If you want to be certain, however, probably the best resource for this would be your own parents, or if possible, you could try searching through your medical records.

Why don't males know about their own genitals?
Part of the problem with the information blackout that we have in this country concerning male genitals is the fact that people are so uptight about sex.

We live in a paradox where we are more sexually liberated than before, and yet we still can't seem to be able to have a serious conversation about our genitals unless it's some kind of joke.

We need to break this taboo and open up the lines of communication.

Fathers need to talk with their sons about their sexual development, what was done to them as infants, how their genitals work, what they might encounter, how to deal with prejudice etc.

Otherwise, males grow up in the dark, learn misinformation about their genitals, spread it, and we stay in these dark ages of sexuality.

*On this blog, we refer to male organs as they are in nature as "natural," "normal," "anatomically correct," and "intact," because that is what they are. In every day speech, unaltered male organs as they would normally be left up to nature are often referred to as "uncircumcised," or "uncut." This is erroneous, however, as it normalizes circumcision, which is actually an artificial, forced phenomenon. We do not refer to women with breasts as "unmastectomized," or people who haven't had nose cosmetic surgery as "unrhinoplastied." We do not refer to women who haven't had labia reduction surgery as having "unlabiaplastied vulvas" because we don't automatically assume that they should be. We simply call an unaltered vulva, "the vulva." One of the goals of this website is to allow men with unaltered genitals to feel comfortable in their own skin, as it were, and to raise awareness of the fact that actually, having unaltered genitals is "normal" and this doesn't have to be described with a negative verbal clarifier.

External Links
How intact, or how circumcised are you? I've included a link to a resource if you are interested in finding out. The Foreskin Coverage Index page at is a page that can give you a ballpark to determine where you stand on the intact/circumcision spectrum. Like this blog, the page is explicit, and shows intact and circumcised penises in their erect and flaccid states.

Foreskin Coverage Index

Are you circumcised and you want to reverse some of the damage? It's possible to gain back some foreskin and foreskin coverage through tugging and stretching. Some men have been able to reverse the effects of keratinization; by restoring coverage, the dead skin cells slough away, regaining sensitivity in the glans and surrounding mucosa, and restoring to it its shine and luster.

This is the same penis before and after restoration.
Notice how the shine and luster return to the glans.

For more information about foreskin restoration, visit: