1. The protective cover of the glans, the prepuce, is destroyed [by circumcision]. The penile appearance is changed forever. The glans is no longer an internal organ and there is no way of protecting it from environmental objects that it was never meant to contact, e.g. urine, feces, dry and wet diapers, and clothing. The epithelium of the glans eventually becomes dry, dull, leathery, brownish, keratinized, taking on the character of skin, rather than mucous membrane. A large portion of the glands producing smegma are destroyed, thus depriving the glans of its normal moistness and softness. The mechanism for distributing this smegma over the glans -- the prepuce -- is absent.
2. The recuperative heat mechanism -- the foreskin -- which maintains the glans at a fairly uniform body temperature, is no longer present to hasten the resolution of minor glans abrasions incurred occasionally in sexual dalliance. In the penis with a prepuce, if any uncomfortable fissures or abrasions occur on the glans, the discomfort can be instantly relieved by drawing the foreskin forward over the glans. The increased heat from the covering prepuce accelerates the healing of minor skin irritations.
Certain penile injuries have a greater potential for seriousness in a penis unprotected by a foreskin. In third degree burns, the glans and urethral meatus are vulnerable, and any attempt at surgical correction of the burn deformity produces a totally unacceptable result. In the normal penis the foreskin would take the thermal insult and the damaged foreskin could be circumcised. The statistical probability of a severe genital burn damaging the glans is much greater than the probability of the individual eventually having carcinoma of the penis.
3. Circumcision represents a subtraction. The circumcised male has less penis. About a quarter of the entire integumental covering of the penis is removed and discarded. The prepuce in itself is very sensitive. The circumcised male has fewer pleasurable sensory units in his genitals.
4. The exposed urethral meatus is exposed to constant abrasive trauma from soiled diapers, and after infancy, to the external abrasion of clothing. The meatus often becomes ulcerated and scarred, loses its normal slit-like aperture, and, in about one-third of circumcised children, becomes stenotic, theoretically or actually causing varying degrees of urinary tract obstruction. A meatotomy may be needed to enlarge the scarred meatus.
5. The corona, the most sensitive portion of the entire penis, is damaged especially because of its prominence and dorsal location, where it is impossible to protect it from clothing abrasion. Its surface, richly supplied with neurovascular corpuscles and free nerve endings, becomes keratinized and less sensitive.
6. The penis is scarred ... The patient sees the scar, not only at the time of sexual play, but every time he washes or urinates. There may be a jagged end to the penis; there may be skin tags; the glans is lack-luster and leathery; the penis may bow, turn up, or veer to the side, whether this organ is flaccid or turgid. Consciously or unconsciously, the male is reminded that his normal penis has been surgically altered by someone at a time when he had no control over the matter. He may harbor anger and resentment over his altered state, and experience discomforture at his tarnished self-image of completeness and masculinity. He may perceive his circumcision as child abuse.
7. Masturbation becomes more difficult and con- trived ... Indirect stimulation of the glans is practically impossible after circumcision; instead the glans must be touched and stimulated directly.
8. The penile skin sheath is now relatively immobile and the skin proximal to the glans is anchored to the penile shaft. The penis now more nearly approaches the structure of a dowel. The male's loose mobile sheath has been destroyed. The psychic pleasure of uncovering the glans either in masturbation or in sexual play has been denied to him. The visual and psychic pleasure has likewise been denied to his paramour. Traction on the frenulum and its indirect effects on the glans have been spoiled. The glans must now be stimulated directly. With intravaginal containment of the normal penis, the male's mobile sheath is placed within the woman's vaginal sheath. It is impossible to imagine any better mechanical arrangement for non-abrasive stimulation of the male and female genitalia than this slick "sheath within a sheath." Circumcision destroys the one sheath within the sheath.
Circumcised males often need additional lubricant (other than that of the vagina) for non-irritating intercourse. The sheath within a sheath of the normal penis obviates such a need. In estrogen-deprived women, atrophic vaginitis is an important cause of dyspareunia [painful intercourse]. I would hazard a guess, that dyspareunia is more common in the woman whose husband is circumcised.
Following estrogen withdrawal at menopause, the vaginal mucosa becomes thin, atrophic, drier, and less tolerant of abrasive irritation, especially for a dowel-like penis lacking a mobile skin sheath. . . .
[O]ne would be foolish to discount the circumcised male's immobile penile skin sheath as an ancillary item contributing to vaginal, abrasive discomfort.
9. The greatest and most tragic sequel of circumcision is the effect that the altered penile function and obtunded sensation have on the man-woman relationship. The male can never reach his full God-given potential of genital pleasure. The woman in her turn can never be a witness and recipient of her lover's full response. Therefore she is deprived and cheated out of what she should rightfully share and receive.
10. There are some nebulous sequelae of circumcision about which one might speculate: The male with a penis already moderately obtunded by circumcision may be less apt to use a condom, which he feels may further decrease his genital sensitivity. (Actually a lubricated condom does not detract one bit from the sensitivity of the normal, uncircumcised penis.) Also, because most American males lack a facile prepuce, the period of foreplay and dalliance may be abbreviated in the rush to the intra-vaginal method of penile stimulation. Both these factors conceivably could be of significance in increasing the rate of venereal disease, including AIDS, and unwanted, teenage pregnancies.
Shortening the period of foreplay would likewise be undesirable for most women.
An additional sequela which seems very logical is the greater incidence of impotence in the older man whose genitals have been rendered less sensitive as a result of circumcision.